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Nurse Tina Carlson’s Poems on the Generational Consequences of War

By Joy Jacobson

April 28, 2017

It’s National Poetry Month for another minute or two, and since you probably haven’t dedicated as much time to memorizing poems as the month might suggest, I offer you absolution in the form of a poem composed by a woman whose work concerns itself with absolution.

 

Tina Carlson, Ojo Caliente, NM

Tina Carlson, a psychiatric nurse practitioner, released her first book of poems, Ground, Wind, This Body, through University of New Mexico Press in March. The book is a chronicle of sorts, one that winds through the wretchedness wrought by war and the deep, lifelong impression it leaves in the lives of a returning soldier’s children.

Tina is a dedicated nurse who works with the homeless in Albuquerque and a true poet—and what a combination: a carer both of human beings and of the language we use to shape and reshape our experience—who is also one of my dearest friends.

 

Try reading this poem aloud. It comes about midway through her book (offered here with the poet’s permission): 

Summer Nights

 

After rain, the earth shines in gratitude. We are nine,

awake on wet grass and the sky, a vast cup of stars.

Because our lives are small fires buried under dry fields,

the muddy homes of childhood, auditoriums of weeds, and trees.

Even discomfort glistens here.

The whole world breathes together, watches messages

pass across the wide face of the moon. We were born into wildness

after the war. Each year, watch the hillsides burn aspen yellow,

then the wind changes everything to brown.

For you, I am an arsonist.

Our fathers take aim at us behind doors with imaginary weapons,

still living in battle. Almost criminal, our desire to thrive in this world.

Our futures arrested, like the cat’s gift in the doorway:

birdlike, perfectly curled into the shape of an egg, gelatinous.

Even after several re-readings I am left breathless by that last image.

 

With the astonishing opening lines we begin in thankfulness for a thirst quenched, for the simplicity of wet grass and cupped stars—a childlike sweetness that gives way immediately to an underground fire. By line 3 we know we are in hell, navigating atemporally a place that by some unnamed grace makes even pain beautiful.

 

The poem doesn’t let on who “we” are, and so it allows me to step as a nine-year-old into that space. “For you, I am an arsonist,” the speaker says, implicating me in the near-criminality of a “desire to thrive,” despite our aborted future that has been left uncannily as a “gift.”

 

When the speaker states “We were born into wildness / after the war” she means the Second World War, but she could also be referencing our current landscape of perpetual War on Terror. Regardless, wildness in this poem’s universe is a two-headed thing, both a natural and a manmade chaos, one that helps us survive our wounded fathers and also nearly annihilates us.

 

Such antipodal tensions abound in this poem, as throughout the book. Redemption is almost always at hand, as in these brilliant lines, in which it seems that the entire world is being born and dying at the same time:

The whole world breathes together, watches messages

pass across the wide face of the moon.

Yesterday was Poem in Your Pocket Day, but it’s not too late to print this one out, or another of her poems from the book, “Ojo Caliente: Metamorphoses,” that recently appeared on Verse Daily. Carry it with you. Give it to a colleague. Read it to a friend over lunch.

 

I asked Tina what it’s been like to have this book published. She said by email: “Having this book out in the world was initially terrifying. So much was never supposed to be spoken. But the book itself, like a child, has its own life now, and wants the secrets to be over and the war wounds to be healed.”

 

Poetry has often served to bear witness and to speak the unspeakable.

 

I’ve been reading Tina Carlson’s numinous poems for more than 20 years. It thrills me that now you can read them, too.

Joy Jacobson
Joy Jacobson is the CHMP’s poet-in-residence and cofounder of our Writing Reflective Narratives for Clinicians program.

CAPABLE Program Helps Seniors Age in Place

By Liz Seegert

April 25, 2017

 

We know that most older adults want to age in their own homes and communities, but the environment, health disparities, and lack of home and community supports can make that impossible. More public pressure and outreach can help change the situation.

 

credit: Johns Hopkins School of Nursing

I was pleased to attend a recent panel at the Association of Health Care Journalists conference which addressed this important issue. One speaker, Sarah L. Szanton, Ph.D., ANP, FAAN, a professor at Johns Hopkins School of Nursing in Baltimore, discussed a vital community based research study, called, CAPABLE, which helps seniors stay safer, and remain in their homes longer.

 

CAPABLE — or Community Aging in Place – Advancing Better Living for Elders, combines handyman services with nursing and occupational therapy. The program helps to improve mobility, reduce disability, and lower healthcare costs, according to Szanton, who developed the initiative. The results will help to determine if certain services can help older adults maintain their independence longer.

 

“The highest health care spending happens not when people have several chronic conditions, but when they have functional limitations, she said. “It’s completely unaddressed in current health care system.”

 

CAPABLE targets individual goals in self care – activities of daily living (ADLs) like bathing and dressing, and independent activities of daily living (IADLs) like cooking, cleaning or food shopping, she explained. It is client-directed, not client-centered, so that goals of the individual are addressed.

 

An older person may want something straightforward, like the ability to bathe alone. That can be addressed by installing grab bars in the shower. The capacity to cook for one’s self may mean the difference between staying independent at home or being forced to move into a faciltiy. Relatively simple fixes, like adjusting shelves, lowering cupboards or purchasing a microwave are simple, low-cost solutions that go a long way. Improving a person’s confidence while reducing their risk of falls when navigating stairs, can be taken care of by installing handrails on both sides of the staircase. It could determine whether an older person sleeps in their upstairs bedroom or on the living room couch.

 

CAPABLE clients received six occupational therapy and four RN visits over four months. Szanton said the program has shown “remarkable success,” for less than $3,000, per client. This includes a $1,300 handyman budget. In a randomized clinical trial and as a CMS demonstration project, CAPABLE “significantly reduced” the number of ADL issues over a five- month period among the study population, whose average age was 71.

 

Additionally, she said, depression among participants improved without medication. And, over the course of two years, the program saved Medicare about $10,000 per patient in preventive health costs, like fewer falls.

 

Preliminary results were published in the Journal of the American Geriatics Society in 2015. More recently, Szanton co-authored a policy-centered discussion about the importance of home and community based interventions in Health Affairs.

 

I asked Szanton what was perhaps an unanswerable question: while the Centers for Medicare and Medicaid Services promotes lowering costs, reducing hospital admissions and encourages aging in place, why doesn’t Medicare actually pay for some of these simple ideas that could save thousands of dollars per person over the long term? Apart from supporting small demonstration programs like this, how serious is the government about addressing the needs of the fast-growing older population, who only want to live out their lives in their own homes?

 

By educating journalists at panels like this one, Szanton is optimistic that the public will pressure policymakers to stop talking about what a good idea aging in place is, and start doing more to actually make it happen.

 

 

 

Liz Seegert
Liz Seegert is a health care journalist and directs the media fellows program at the Center. She serves as topic editor on aging for the Association of Healthcare Journalists, writes for a variety of print and online publications and coproduces HealthCetera Radio on WBAI-FM. She tweets @lseegert. 

Choices for End Stage Kidney Disease

By Diana J. Mason

April 20, 2017

Source: kidneybuzz.com

Over 100,000 people are diagnosed each year with End Stage Renal Disease (ESRD) and almost half a million people are living with it. The  progressive nature of the disease often eventually requires patients to go on kidney dialysis to survive, but the quality of life often deteriorates as patients spend multiple hours on each of several days every week hooked up to the dialysis machine. Despite this challenging course, only 10% of  patients with ESRD report having an end-of-life conversation with their nephrologist. The Coalition for Supportive Care of Kidney Patients is seeking to change this picture by having people with ESRD be fulling informed of their end-of-life options throughout the progression of the disease.

 

On April 20, 2017, HealthCetera Radio producer Diana Mason, PhD, RN, interviews two health professionals who are working with the Coalition on this aim through an initiative called My Way: Dale Lupu, MPH, PhD, Associate Research Professor with the Center for Aging, Health and Humanities at the George Washington University School of Nursing and Senior Adviser to the Coalition; and Liz Anderson, DSW, Assistant Professor of Social Work at Western Carolina University and Consultant/Palliative Care Expert for the Coalition. They discuss ESRD, advance directives, and a new brochure that’s available to help people with ESRD to make their end-of-life wishes known.

So tune in on Thursday, April 17th at 1:00 PM to WBAI, 99.5 FM in NYC or streaming at www.wbai.org. Or you can listen anytime by clicking here:

 

Diana J. Mason
Diana is a founder of the Center for Health, Media & Policy, and HealthCetera Radio. She is the President of the American Academy of Nursing, the Rudin Professor of Nursing at Hunter-Bellevue School of Nursing, and a health policy expert and leader. Diana tweets @djmasonrn.