Discussions of Book of Mormon issues and evidences, plus other topics related to The Church of Jesus Christ of Latter-day Saints.

Sunday, January 16, 2022

Taliban Hackers Hijack Salt Lake Tribune Website, Call for Totalitarian Oppression of Unvaxxed

Thanks to certain contacts across Asia and the Middle East, I've heard off the record that a well-funded group of hackers working for the Taliban--now flush with resources after our generous exit--were responsible for the January 15 hacking of the normally secure Salt Lake Tribune website. On behalf of the Taliban, the hackers posted a shocking opinion column calling for government persecution, if not eradication, of the unvaxxed as if they were loathsome infidels. The result, of course, was the notorious column, "Utah leaders have surrendered to COVID pandemic, the Editorial Board writes." The piece calls for one immediate action so radical that I feel readers should have immediately spotted the prank and recognized the hand of the Taliban:

Were Utah a truly civilized place, the governor’s next move would be to find a way to mandate the kind of mass vaccination campaign we should have launched a year ago, going as far as to deploy the National Guard to ensure that people without proof of vaccination would not be allowed, well, anywhere.


Of course, this uncreative parody of Soylent Green, funny as it may be, reflects foreign confusion about how things work in America, where citizens don't need to carry papers to get a police state's approval to go places, and where a governor can't simply order troops to drive out citizens or even exterminate them (the apparent implication of not being allowed to be, well, anywhere, of course) when they don't comply with a regime's wishes of the moment. These are the crude fantasies of stone-age totalitarians (no offense to the Taliban intended -- there were many positives about the Stone Age, such as being relatively carbon neutral), not the fruit of the more literate and genteel minds behind the Tribune. 

So please, don't take this seriously, and don't blame the Tribune. It's a Taliban thing, and not even the Taliban in general, I'm told, but a specific radical splinter group known as the Talibune, proud for one day to have written for the Salt Lake Talibune. Unfortunately, with the many billions of capital they recently received from us, they may have funding for many more similar gags in the near future, so please be on guard and be ready at all times to ignore apparent threats to your Constitutional rights. 

Another tell-tale sign of Taliban origins is the so-last-year implication that this is a pandemic of the unvaccinated, and the appallingly divisive notion that if we can only get rid of those deplorables, our problems will be solved. The educated among us have long-since learned that the benefit of the vaccines is reducing personal risk when ill. Except for those living in caves (again, no offense, Taliban -- caves can be lovely places high in equity, vibrant communal living, and energy conservation), we've all realized that the vaccines don't do much to prevent transmission or prevent infection. Vaccines may be effective, especially for older people or and those with various health risks, in greatly reducing the impact of the disease, but the disease is going to spread and persist and mutate for years to come. Omicron is spreading among vaccinated and unvaccinated alike. I'm double vaxxed and was diagnosed early last week with COVID. as was my wife, who is also double vaxxed. It seems we can spread it and get it easily, vaxxed or not. I'm glad I'm vaxxed, but we need to respect the choice of those who hesitate or have legitimate reasons to wait

Finally, the surest evidence of all that the good folks at the real Salt Lake Tribune (not the Salt Lake Talibune!) did not write the hacked column of Jan. 15 might be the diversity implications of the piece. The Taliban don't yet understand that certain minorities in the US tend to be less vaccinated than white people. The pro-diversity and pro-equity minds that gently guide the Tribune certainly would not call for oppressive means to compel hesitant people of color to be denied basic rights. To think that we need to use the military power of the National Guard to bully them in order for Utah to be "more civilized" should make this ugly prank all the more obvious. It's just too bad it wasn't published on April 1 so readers would be more willing to ask if this was just an insensitive joke. With hackers like this running unfettered, from now on we must consider every day as April 1 when we read the news.

Without a legitimate social good argument, without a reasonable right in America to deny personal privacy and body sovereignty ("my body, my choice"), and now with the availability of effective treatments for mitigating the impact of the disease, there is no justification to compel anyone to take an injection, especially one that has not had the normal years of extensive safety testing, an injection that is not needed as the only possible way to cope with an existential threat. Whether to get it or not must be a personal decision based on informed consent and free will, not bureaucrats deciding they should determine what medical treatment others get, and forcing all of us to carry papers are if subjects of totalitarians who get to determine where and when we can have their permission to gather or travel. That may seem OK to the writers of a gag column on the other side of the world, but this is still America, a place with traditions, freedoms, and laws that the Talibune authors obviously do not grasp.

But how could this have happened in the first place? How did the primitive Talibune manage to bypass 21st century security systems to place their divisive verbal malware on the Tribune's site? My hacker friends in Asia (whose existence I can neither confirm nor deny, for the record) believe the breach occurred via a non-compliant Windows 10 computer that had refused the latest anti-virus booster. The partially unvaxxed device is being hauled away by the National Guard as we speak for the greater good and will be recycled into pleasant green motherboard materials to sustain more worthy low-carbon-footprint computers in the future. 

Again, please remain calm, carry on, and above all don't blame the Tribune or cancel your subscription.

Do I Dare Join the Woman in the Boat?

 

Arthur Becher: Woman Reading in a Boat, ca. 1910
"Woman Reading in a Boat"
by Arthur Becher, ca. 1910.
I just awoke from a dream, or series of dreamlike images, in which I stood on my familiar shore at a dock. There at the side of the dock was a small boat, a row boat, with a passenger waiting for someone to join her. The woman in the boat was not necessarily beautiful but certainly young, perhaps 30, and mysterious. She was dressed warmly and in a very old style. Her smile was familiar and seemed to beckon: "Come join me for a ride. You row, and I'll show you how different your shore looks from the middle of the lake where I live. What is big to you now will seem small. And you'll also see where I live. It's on the island, in a secluded building behind a wall. It's called a sanitarium."

The term "sanitarium" was part of the dreamlike experience and recalled my days in China were I was surprised to see buildings with titles like "City of Shanghai Workers' Sanitarium." To me, "sanitarium" often means a residence for the treatment of the severely mentally ill, but it can also mean a place or institution concerned with promoting health. Rather than an institution for those society shuns as insane, it might be simply a place for healing of many kinds.

But why would I set foot on the boat and begin the hard work of rowing just to see a new perspective offered by a stranger? This is the challenge readers have when confronted with the invitation from any author. Why should I bother? Why should I care about seeing my world from afar or getting up close to you and your island and especially your sanitarium? That just sounds a little crazy.

It took several glances for me to understand the familiarity of the dark-haired woman and her smile. She was quiet, she was patient, and she simply sat there, waiting, as if she knew eventually I would take the frightening step of shifting my weight away from what is firm and safe for the rocky, insecure boat, to pick up the oars and begin what could be a difficult journey to unknown regions.

The woman, I suddenly realized after the dream sequence, was my mother. Not quite the same eighty-nine-year-old dementia patient I now call Mom, who doesn't remember my name and who, when not in cheerful mood, will yell or scream with an operatic voice to command me and others to whatever has suddenly become urgent, but the woman in the boat was my mother when she was much younger, perhaps when she was a young mother quite busy in caring for her firstborn and soon five more siblings to follow me. Much of her mind today is trapped in times when she was still young and active, and her mind was keen. Sharp-witted, well read on a number of topics, humorous, sometimes cynical or angry, she has left many writings in journals and letters that can entertain but also trouble or perplex. I feel something about her is inviting me to pick up the oars and row to join her in seeing a different horizon and understanding that deep down, she is not the dementia patient that her decaying mind presents, but a young woman inviting me to see her in another way, on her island, in a sanitarium, or sanatorium, a place of nurturing and healing where the healing may be mine.

In my next visit, I see it's time I take her documents more seriously and begin rowing.

The invitation to step into a boat and row to a new place can be frightening, but I think many of our ancestors are inviting us to take this journey. Such journeys I think are part of the spirit of family history work, connecting the hearts of the children to the fathers and certainly to the mothers. It may be as simple as learning their names, their birthplace, and a few details about their lives, while for others there are mysterious clues wrapped up in just a few pages of writing and perhaps a damaged photograph or two. For some there are worlds of exploration open to us now through their writings or other compilations of information and stories that can lead us to see details of their islands and let us view our own comfortable world with new respect, understanding how some things we think are big may be quite small, and how some of the biggest things don't even come into view until we've rowed for quite a while.

How odd that some random dreams and images could move me to arise at 3 AM to write about a new resolution for this year. I look forward to learning more about that mysterious woman in the boat, the familiar woman I've known as "Mother" all my life.

Tuesday, January 11, 2022

Science as a Faith: Do We Need Another Restoration?

One of our nation's leading bodies of scientific influence, the Center for Disease Control, is citing their recent scientific study -- as are their media allies like the New York Times -- to encourage parents to have their children vaccinated. The study has some easy-to-understand objectives and principles that make it a great topic for talking about science and how science works. If you care about the science education of those around you, this study might be a good one to discuss. Strangely, it can also help you understand how science is much different than religion and politics, particularly political propaganda.

When scientists do science, they must always understand that an apparent effect can have many causes and that there can be random variation that influences their observations. A "study" that doesn't try very hard to honestly consider such problems is not scientific. For example, if I have a friend who wears bright green shirts and that friend has diabetes, I might think, "Ah ha, perhaps bright green colors cause diabetes." But something else might be the cause. One human data point is not enough. To be more fair, I might go interview hundreds of diabetes patients and ask them if they have ever worn bright green colors or eaten foods with bright green food coloring. "Wow, 52% of diabetes patients have repeatedly worn bright green, and 96% have eaten bright green, and 72% regularly eat bright green! Bingo!" But that still doesn't mean anything. It's too early to condemn Mountain Dew, Skittles, and green apple Jelly Belly jelly beans for their greenness. A control group is needed in which we compare people who are similar but don't have diabetes. 

Things become more meaningful and more interesting when you add a control group. Imagine interviewing 1000 healthy people and finding that only 50% of them have ever knowingly worn or consumed bright green. Hypothesis confirmed? We're not there yet. What if the healthy people were also much younger than the diabetes patients we interviewed? What if they live in much different environments, have much different genes, have much different patterns of exercise and diet, and eat much different foods? Even if we do our best to account for all this, there is still the possibility that a statistically significant relationship between diabetes and bright green foods is not because bright green food coloring causes diabetes, but is merely correlated with a factor that is the actual cause. In this case, bright green food coloring may be consumed more by those with diabetes because it is part of a less healthy diet that they prefer, a diet with abundant bright green food coloring added to candy, soda, and various sweets, for example. The point here is that doing a study in a scientific way takes a lot of caution and thinking, and a desire to be fair and honest before we dare to declare that a hypothesis even seems to have scientific support. 

Now let's look at the CDC study on diabetes and COVID. The study is "Risk for Newly Diagnosed Diabetes > 30 Days After Sars-CoV-2 Infection Among Persons Aged < 30 Years -- United States, March 1, 2020 - June 28, 2021," prepared by Catherine E. Barrett et al., released Jan. 7, 2021. Here is the summary as published on the CDC website:

Summary

What is already known about this topic?

SARS-CoV-2 infection is associated with worsening of diabetes symptoms, and persons with diabetes are at increased risk for severe COVID-19. SARS-CoV-2 infection might also induce newly diagnosed diabetes.

What is added by this report?

Persons aged <18 years with COVID-19 were more likely to receive a new diabetes diagnosis >30 days after infection than were those without COVID-19 and those with prepandemic acute respiratory infections. Non–SARS-CoV-2 respiratory infection was not associated with an increased risk for diabetes.

What are the implications for public health practice?

The increased diabetes risk among persons aged <18 years following COVID-19 highlights the importance of COVID-19 prevention strategies in this age group, including vaccination for all eligible persons and chronic disease prevention and treatment.

So the CDC is calling for increased vaccination of young people because of the frightful risk of diabetes that can be caused by COVID, as demonstrated by their scientific study. Many parents will be frightened by this and may feel an increased need to take the risk of vaccination for their kids to prevent lifelong harm from diabetes. Here is where you can start doing science, if you are not a scientist, by thinking for yourself and asking questions, a practice that is actually the foundation of the scientific method. That's right, "follow the science" in the scientific world really means follow the scientific method, which begins with daring to ask questions and then seeing if the data fits a hypothesis, or not. Unfortunately, in some other worlds, such as the world of politics, ,"follow the science" means just the opposite: quit asking questions and trust your glorious leader. That's actually much more like religion when it tells you to just believe. (Good religion, in my opinion, allows for questions and doubt while seeking to provide meaningful answers and yet recognizing that faith is always needed, but not blind faith. I like faith that can grow as a result of asking questions and seeking answers patiently.)

Step one is understanding what the study did. It begins by mentioning that it is known that adults with COVID are more likely to have diabetes than those who don't. It's well known that obesity is a major factor associated with risk of death and hospitalization for adult COVID patients. The studies cited (references 4-7 in the study) all deal with patients requiring medical care. That's clear from the titles of three of the studies, and the other one (Sattish et al.) was a meta-analysis of many studies wherein "all studies were hospital-based, and the patients were mostly severely or critically ill." COVID patients needing hospitalization are much more likely to be obese. Sattish et al. state that, "While newly diagnosed diabetes in COVID-19 patients could be attributed to the stress response associated with severe illness or treatment with glucocorticoids, the diabetogenic effect of COVID-19 should also be considered...." But again, this is looking at hospitalized patients who are much more likely to be obese and have other comorbidities. What happens when BMI or other indicators of obesity are considered? that's an important question for adults and perhaps the first issue to consider in a study of children.

So how did the CDC study account for the important issue of obesity and other related factor? Here you don't have to wade through the entire study. Just search for the word "obesity" and note that it occurs only once in this critical sentence: "Third, the present analyses lacked information on covariates that could have affected the association between COVID-19 and incident diabetes, including prediabetes, race/ethnicity, and obesity status."

Hold on, you mean that the extensive healthcare databases they relied on didn't include any clues about the basic health of the children being examined? Nothing on body weight, BMI, or other indicators on obesity? No data on blood sugar level (prediabetes means blood sugar is high)? Really? 

But that's just one of several gaps. As you read the study, there are a number of questions one should ask to see if the study is based on real science or something else. A very mainstream doctor and scientist, Vinay Prasad MD MPH, a hematologist-oncologist and Associate Professor in the Department of Epidemiology and Biostatistics at the University of California San Francisco, has done some of that work for you already in his post, "Does COVID19 cause diabetes in kids? The CDC's publishes an embarrassing study," Jan. 8, 2021. Here's an excerpt that begins with a discussion of the two databases that were used, IQVIA and HealthVerity:

In IQVIA, among kids with COVID19, a whopping 68 out of 80,000+ or 0.08% ended with diabetes; among kids without COVID19, it was 132 out of 400,000+ or 0.03% ended up with diabetes, and among kids with prior respiratory infection it was ~0.06%

The absolute risk of diabetes due to COVID (if you believed this is causal) appears to be an increase on par with a swiftly eaten bag of skittles.

Now in the HealthVerity database, the risk of diabetes post COVID19 was 0.25% (a quarter of 1 percent), if you were tested for COVID19 but negative, it was 0.19% (one fifth of 1 percent). Here, COVID appears as risky as a McDonalds supersized soda.

The CDC trumpets this finding as “children and teens 18 years & younger who have had #COVID19 are up to 2.5 times more likely to have a #diabetes diagnosis after infection”

Is that a fair take away or a fear-mongering distortion?

First, the whole analysis hinges on the idea that age-sex matched kids without COVID should be comparable to the kids who got covid in terms of risk of diabetes. The only difference between the kids should be that some, unfortunately, had COVID. But COVID may be more likely to affect kids of lower socioeconomic status, of certain races, and kids who were already overweight or suffering from medical problems.

Does the CDC attempt to correct for any of these confounders? Not at all. They surely have height and weight, and could adjust for BMI, but do not. I am truly puzzled as to why.

Second, they don’t have the true denominator. This is only kids who present and have a COVID19 diagnosis. Seroprevalence [evidence of COVID from blood tests] is needed to find the real denominator of kids with COVID19. This will lower the absolute risks. COVID19 may be downgraded from a whole bag of skittles to a single, red skittle.

Does the CDC adjust for this? Nope

Third, kids who seek medical care for COVID19 may get more blood tests than those without COVID19, and perhaps more than those with other respiratory viruses in yesteryear. This too may capture more diabetes.

Does the CDC correct for ascertainment? Not at all

Finally, the HealthVerity database is particularly odd, as the kids who get tested but test negative might be very dissimilar from those with COVID19. It may include some who are planning a trip to Maui (Hawaii used to require testing to visit), and compare them to kids who come in feeling very sick.

Does the CDC correct for this? No....

Lastly, the CDC uses this study to push vaccination, the findings “underscore the importance of COVID-19 prevention among all age groups, including vaccination for all eligible children and adolescents…”. But, the study provides no useful information to further weigh the risk benefit balance for vaccination beyond what was presented at the VRBAC meeting for 5 to 11, and a prior one on 12-17, a topic of wide global debate, with differing recommendations by nation (US vs UK).

As Marty Makary says, the CDC’s study would not pass a 7th grade science fair competition. It is certainly not serious scholarship. I have no idea if COVID19 causes more diabetes in kids than not having it; and the study gives me no better information to guide vaccination policies.

 Or you can watch Dr. Prasad discuss this study on YouTube:


Maybe it's true that the databases the CDC study chose to examine did not make such information available, but even then, given what is known about obesity and COVID, it should have been possible to make some reasonable adjustments. In fact, the CDC's own data could have been applied to make this study slightly more reasonable. See V. Wanga et al., "Characteristics and Clinical Outcomes of Children and Adolescents Aged <18 Years Hospitalized with COVID-19 — Six Hospitals, United States, July–August 2021," MMWR Morbidity and Mortality Weekly Report, 70 (2021):1766–1772, DOI: http://dx.doi.org/10.15585/mmwr.mm705152a3. There we find that among young people hospitalized for acute COVID, "approximately two thirds of those aged 12–17 years had obesity." That's much higher than normal, according to the CDC's data on childhood obesity or to data shared by StateofChildhoodObesity.org.

Failure to even try to consider obesity and prediabetes means that this study wasn't about doing real science, but something else. Propaganda, perhaps, for the noble cause of scaring parents into having their children be vaccinated for a disease that has almost no risk for children and has not had the years of safety testing normally needed to approve a new vaccine nor even the same level of testing as the vaccines approved for adults. 

I know, to question the CDC or Fauci is to question the faith, the Faith of Science itself, where the new scientific method is to listen faithfully to the Anointed Experts and High Priests of Science, and stop asking apostate questions or be cancelled and shamed. But back in the days before science became a faith, the scientific method was all about asking questions and not relying on authority but data and inquiry to figure things out. Maybe it's time for another restoration, or a little less faith.




 

Saturday, January 01, 2022

Many Questions about Dementia and Just One Answer So Far

An expert on senior care, Professor Thomas Kitwood, once quipped that "when you've met one person patient with dementia, you've met ... one person with dementia." The point, of course, is that every dementia patient is unique, with an endless range of variety in behavior and symptoms.

The past 3 years and especially the past 3 weeks have given my wife and me a wide variety of experiences with dementia. We have experienced very little compared to those hidden heroes of humanity who are helping a loved one every day for years, giving much of their life in complete but often unthanked service. Still, in our occasional efforts to assist others with their heavy caregiver duties, we've encountered incredible variety.

One woman was sweet and grateful for every little thing we did, while another was angry, demanding, and utterly implacable. Another was deeply spiritual, always speaking of her faith and the Lord, with an authority as if she were a prophetess dictating scripture for her posterity, while shortly after that I dealt with a patient who mocked the Church and my faith, cackling with sarcasm about the idiotic Mormons. One was shy and very private, unwilling to allow me as a male to assist in bathroom duties, while another was uninhibited and highly inappropriate in sexual language and flirtatious behavior.  

One was quiet and demure, while another cursed constantly, apparently feeling, as many modern comedians do, that her repetitive use of profanity was wildly entertaining. One kicked, scratched, gouged, and screamed at the top of her mighty lungs with what seemed like a powerful operatic voice gone evil, while another was gentle and loved to have her hand held and her back scratched. Yet another also yelled loudly, but in exuberant joy, shouting "Hallelujah" and singing in delight when someone she loved showed up or when she ate an especially delicious and exotic delicacy such as my wife's amazing buttered toast with a touch of honey.

One is deeply moved by beautiful music, becoming calm and even moved to tears of joy when listening to Handel's Hallelujah Chorus, while the same music causes another to grow angry as if listening to pure noise, demanding that we "turn that cra* off!" One was noted for her passionate interest in her cats, even secretly stashing away bits of Kentucky Fried chicken wrapped in tissues under her bed, in her pockets, and elsewhere so that she could later feed her favorite food to her precious cats when her guardians weren't watching since the vet had ordered her to not feed that greasy food to the overweight "children," as she called them. Another knew she had pets but largely ignored them, neither feeding nor petting her once beloved felines, though she would look at them occasionally.

One is constantly on the go, demanding that we hurry, hurry, hurry and move her about or rush her into the car and take her to her birthplace in southern Utah, loving nothing more than a long drive, while another will become agitated in the car and may strongly resist getting in, even when it is necessary for a doctor visit or other purpose.

One missed her husband dearly and constantly asked where he was. Time after time after time she became solemn when I broke the bad news that he had just passed away last week, last month, or last year. Another seems to have no idea that she had been married, and one, in spite of raising six children in a long and happy marriage, suddenly "came out" this week and declared that she loved and wanted women, women, women (though it soon appeared that her orientation at the moment was actually bisexual). 

Such variety among elderly people with dementia was surprising to me, especially since all of them are the same person, my mother.

I mention this with the approval of her guardian, my sister, and in a desire to know what others experience and what science might tell us, if any of you are up on the latest research. I'm also interested in the possibility that these wildly different aspects of one person with dementia might be related to dissociative identity disorder (also called multiple personality disorder). Years ago, a noteworthy amount of my time while serving as bishop involved working with a woman with dissociative identity disorder.  In exploring what this woman was going through, it turned out that there were 76 distinct identities, I think all with names and many with ages, possibly related to various times of great fear in her terribly painful life, victimized by a large number of people. Some of the greatest spiritual experiences and most obvious miraculous events in my life occurred when working with that woman, and I feel that period was one of the most precious and important times of my life. She had excellent professional help, but I hope that my efforts to help were also of some value. In any case, today she strikes me as an amazingly helpful and successful woman who blesses the lives of many others in hearty service. She attributes her healing to the power of the Savior, which I think is the only explanation for the healing and restoration that has occurred.

The phenomenon of multiple personalities, though disparaged by some experts, is one that I find to be real and convincing, based on two people I've worked with, both of whom experienced severe trauma in their lives. But that phenomenon seems surprisingly familiar to me in dealing with my mother these days, where there seem to be a number of distinct personalities that can switch in and out. I used to just think of these as "moods" but it's not just a happy mood or bad mood. It really is more like different sets of characteristics coming in and out of focus, sometimes very quickly, triggering between the cackling sarcastic woman who seems possessed by demons to the sweet, gentle, grateful mother I like best or versions of the various characters described above. There are differences and maybe it's better to consider just a collection of diverse attitudes that can be brought out by different triggers. Whatever it is, I'm curious to know more and welcome your thoughts.

Do any of you see similar traits in the elderly people with dementia that you deal with? Is it possible that the fragmentation behind multiple personality disorders could have a relationship with some forms of dementia?

There is one thing that seems certain and clear amid all this mental vacillation and all my unanswered questions. No matter where she is mentally, she remembers that she has children and wonders where they are. She may not remember their names, where they live, or even how many she has, but she knows she has them, and she wonders why they aren't here with her. She is happy when family members are around. She loves to be the center of attention, but also loves just to have the bustle of multiple loved ones nearby, even if they are talking to each other and not always with her. "Where are the others?" is a common question when few are in the house, and the desire to be loved seems to be the basis of this trait.

While she forgets so much and can ask the same question over and over again for many minutes without remembering that she's been given the answer already, she recognizes people who love her and is happy to have them around. If someone treats her poorly, as had happened in her mind with some caregivers or healthcare workers, she doesn't trust them after that. Strangers who come to serve her with kindness will soon gain her trust and she will recognize them and be happy to seem them once that rapport is built. She's very sensitive and very aware, even if the names of things and loved ones slip away. She may seem like a wild animal or toddler at times, but there's a sensitive woman in there in need of compassion and love.

I have many questions about this tiring work of caring for the elderly and know so little, but have learned that those like my sister and her husband or an aunt of mine and her husband who have sacrificed so much of their lives and careers to provide the best care at home (when this is possible) for a declining parent or loved one are real heroes and deserve more support and recognition from the rest of us. I also suspect that no matter how desperate the mental state of a loved one is, visits and attention will bless them, even if they can't say thanks, even if they don't seem grateful or happy, and even if when they first look at you, as my mother did to me at the beginning of this visit, they say, "Get the he** out!" I left for a while, and a couple hours later she was grateful that I was here.

Questions abound about what to do (e.g., home care vs. care in a facility) and what's happening in their head, but as with so many of our deepest challenges in life, love is the answer. Treat them with love, even though it may never be reciprocated in this life, knowing that our elderly are beloved sons and daughters of God who sense and feel our love for them, at least in their souls, and this love will be remembered when we meet again after this life. Spend time with them and express your love as best you can to follow that basic commandment, "Honor thy father and thy mother." 

In addition to seeking to love our elderly, let's be sure to love, respect, and support those who step up for what can be the most difficult service of all, caring day after for a person in need of constant help. I'm amazed at the love and sacrifice of some of these heroes.  We'll be heading back to the comforts of home and the joy of our own nearby grandchildren soon, while the needs of this unpredictable woman will continue on and on. I'm so touched by the work of those who live with her and week after week oversee her care.

The woman who was angry, shouting, and trying to gouge me in the middle of the night is now cheerful and is begging to get in the car and go. We're going to give this a try and see how far we can go. The weather looks great for a change. Wish us luck!