Блог Анкара

In This Chapter

► U. S. massage spots

► International massage spots

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I Wou’re Going to get double your money’s worth out of this chapter Jr Because it actually includes not ten, but twenty, spectacular places to ^receive a massage, ten in the U. S. and ten in other countries. How can we afford to do this, you ask? Well, we spare no expense when it comes to letting you know about potentially the most spectacular massage experience of your life.

Let’s face it, just about anywhere you are when you’re receiving a massage is an outstanding place. Close your eyes and off you go to paradise. But trust me on this, your experience may be enhanced if you manage to make your way to one of the many truly incredible environments that are waiting for you out there. Any one of the following locales may set your imagination soaring and stimulate your sense of the beautiful in life. You may also find it quite an adventure getting to some of these exotic spots, so buckle up and get ready for some of the most pleasurable explorations of your life.

U. S. Massage Spots

Here are some great places to go in the U. S. when you’re seeking your next fabulous massage experience.

Enchantment, 525 Boynton Canyon Road, Sedona, AZ 86336; 800-826-4180;

Www. arizonaguide. com/enchantment.

This is one place I’m almost reluctant to name because it’s such a special secret hideaway, but because you were kind enough and smart enough to buy this book I suppose you deserve to find out about it. First, go to Sedona, a

Small town two hours north of Phoenix, Arizona. Then follow Boynton Canyon Road a few miles out of town where you enter a spectacular valley sacred to the Native Americans who once lived in cliff dwellings there. The massage you receive in the spa is more than a massage. Be prepared for an exchange of energy between you, the massage therapist, and the powerful vibrations of the canyon itself. It’s filled with something mystical.

Esalen Institute, Highway 1, Big Sur, CA 93920; 408-667-3000;

Www. esalen. org.

This is the only spot to make it onto both the ten top schools list and the ten top massage spots lists. This place deserves it. Some people say that the consciousness of the entire planet has been shifted in a positive direction by people who receive massages on Esalen’s deck overlooking the Pacific. Here, a bunch of talented, sensitive people practice a form of massage that is meant to fine-tune your body and your awareness to an entirely new level. And you experience the whole thing while listening to the majestic fury of the Pacific Ocean pounding the rocks hundreds of feet below. I think you should go there and check it out.

Green Valley Spa, 1871 West Canyon View Drive, St. George, UT 84770; 800-237-1068; Www. i shopper. com/greenval 1 ey.

Just a two-hour drive from gaudy Vegas, Green Valley is a true oasis in the Utah desert — a magical place. To receive your massage, you enter a womblike inner chamber where it’s hard to tell whether you’re inside or outside. All the ingredients used on your skin are plucked by hand from the surrounding hills, and every detail of the environment is chosen to create a special experience, down to the color of the fruit in the water you drink. I personally cannot say enough good things about this place.

Harbin Hot Springs, P. O. Box 782, Middletown, CA 95461; 707-987-2477; Www. harbin. org.

Well, this spot is not for everyone. There are, after all, dozens of naked hippies walking around, seemingly oblivious to the fact that there are lots of other people in close proximity who are not naked hippies. Harbin can indeed feel like a throwback to the sixties or seventies, but the sublime waters gushing from the underground spring are more than enough to make up for the funky surroundings. Take turns dipping your body (naked or not, no one will judge you) into the hot spring and then the cold stream for some intense stimulation before heading into the massage center for your hour-and – a-half appointment with bliss.

Kohala Spa, 425 Waikoloa Beach Drive, Kona, HI 96738; 808-886-1234; Www. kohalaspa. com.

Ever wanted to receive a therapeutic massage from a native Hawaiian healer in preparation for a swim with the dolphins in a natural lagoon pool immedi -

Ately outside the massage room door? Me too. Well, the Koala spa is where you can do just that, and you can also enjoy the amenities at one of Earth’s finer resorts. This could be one of the greatest things you may ever experience, in the realm of massage or any other realm.

Little Palm Island, 28500 Overseas Highway, Little Torch Key, FL 33042; 800-343-8567; www. 1 I ttl epal mi si and. com.

If you’re in the Florida Keys and you’re searching for a secluded resort on its own private island where you can receive a massage in a mangrove tree house, then Little Palm Island is probably the place for you. This is Gilligan’s Island gone upscale, with about two dozen thatched-roof bungalows, a pool, a bar, water sports, and an incredible gourmet restaurant. What else do you need?

Nemacolin Woodlands Resort & Spa, 1001 LaFayette Drive, Farmington, PA; 15437; 800-422-2736; Www.Nemacol in. com.

Tucked away between silos and cow pastures in the Laurel Highlands out near West Virginia, you will find a surprisingly beautiful place called Nemacolin Woodlands Spa that would be considered a jewel in even the most exclusive areas. The newly renovated spa was designed by the well-known artist Clodagh, who has created more of a spiritual experience than a building. Within its walls, you’ll discover an opportunity to commune with the harmonious elements that have been brought together — water and wood, stone and light, sophistication and earthiness. After you’re thoroughly relaxed in these surroundings, request to receive your massage from a massage therapist who’s been on staff for a few years, long enough to have been trained by one of the country’s premier massage instructors, Bob King. Nemacolin flew Mr. King in for a special private training, which is indicative of the way they do just about everything — first class.

The Peaks, P. O. Box 2702, Telluride, CO 81435; 800-789-2220; Www.thepeaksresort. com.

Swoosh down the slopes in this incredible alpine valley, straight into the embrace of a topnotch luxury spa where a squadron of massage pros wait to take care of you. Telluride’s a lovely place in the summer, too. The only downside to receiving a massage here is that you may be lying down for an hour with your eyes closed instead of out exploring the spectacular countryside

Spa of the Rockies, 1 Crystal Park Road, Manitou Springs, CO 80809; 719-685-1198.

This is a little-bitty place, but it has a big heart, and it’s really cool. You can find it up a side street in the old mining town of Manitou Springs, near Colorado Springs and spectacular Garden of the Gods Park. Try to visit in the winter so you can soak outside beneath the chilly night sky in a big hot tub;

Then come inside to the sauna where your massage therapist joins you, beats you with wet oak branches, and covers you with organic honey before leading you to the massage room. Now I call that service!

Ten Thousand Waves, 3451 Hyde Park Road, Santa Fe, NM 87501; 505-992-5000; Www. primenet. com/spareporter/waves. htm.

Besides offering a long list of very talented massage therapists on staff, Ten Thousand Waves gives you that all-too-rare opportunity, a chance to wear a kimono in public! Yes, they hand you a kimono when you check in at the desk. Next, you’re off to the lockers, then out to a clothing-optional hot tub environment that is surrounded by breathtaking mountain scenery. After saunas and soaking, your massage therapist takes you to a light-filled chamber for some high-quality bodywork. As an added bonus, you can head into Santa Fe afterwards for some of the best green chili on the planet.

International Massage Spots

It’s true, the world is big, and there are thousands of tremendous massage experiences waiting out there for you, but the following list at least offers a few good places to get started.

Amandari, Kedewatan, Ubud, Bali, Indonesia; tel. 011 62 361 975333; Www.Amanresorts. com/dari_m. html.

So, say you’re bored. And you have an extra $25,000 or so burning a hole in your pocket. Why not come to Bali and live for several weeks at the incredible Amandari Resort? Locals believe the area to be a spiritual place, with nearby paths meandering through the jungle valley down to a sacred pool. While you’re there, you can partake in the spiritual atmosphere yourself during a one-hour Amandari massage. During this sublime procedure, you will recline beneath a thatched-hut structure out by the tranquil lotus pool while being anointed with indigenous Indonesian oils by a highly skilled native practitioner. It doesn’t get much better than this anywhere on Earth

Camp Eden, Currumbin Creek Road, Currumbin Valley, Queensland, Australia, 4223; Tel. 61 (7) 5533 0333 or (800) 074 157; Www.Campeden. com. a u.

If you don’t mind getting a leech stuck on your big toe, as I did when running the fitness course through the rainforests of lush Camp Eden, then you may surely enjoy a visit to this remote-yet-close health retreat. Camp Eden is near Surfer’s Paradise along the east coast of Australia, where the weather is lovely, the people magnificent, and the massage therapists’ fingers as strong as those of a man wrapping his hand around a can of Foster’s lager after a long day herding sheep in the outback.

Casa del Sol, Av. Gral. Diego Diaz Gonzalez #31, Col. Parres, 62550 Cuernavaca, Mexico; tel. 52 (73) 21-0999, toll-free 01-800-999-9100;

Www. misiondelsol .com. mx.

Ethereal beings clad in white escort you through a complex of buildings constructed of the most natural materials available: clay, wood and stone. You are ushered into inner chambers for your massage, which is more than a massage, because at the same time you are surrounded by the philosophy of Mision del Sol, which attempts to bring your internal environment into total harmony with an ecologically balanced external environment. The end result, hope the resort’s owners, is to increase human consciousness to a universal level. At the very least, you get a killer massage.

Charlie’s Spa at San Souci, Box 103, Ocho Rios, Jamaica; 800-203-7456.

This is the place to go if you’re the type who would like to receive a massage in a picturesque little gazebo out at the end of a walkway surrounded on all sides by the aquamarine waters of the Caribbean. All the while, you hear faint strains of reggae music wash up from the distant beach bar, and a giant sea turtle named Charlie floats effortlessly by in a nearby fresh water grotto. If you’re the type who would like this experience, definitely call this spa.

Javana Spa, Plaza Bisnis Kemang, Building 2, Kemang, Jakarta, 121730, Indonesia; tel. 011 62 21 719-8327; Www. Javanaspa. com.

Up in the cool hills outside of hectic Jakarta, you find a tranquil, spectacular place — Javana Spa. The altitude (1,200 meters) makes for fresh air and a feeling of escape from the humid tropical world of mere mortals below. Hike through forests to hidden waterfalls, then head back to the spa for your massage that includes natural oils and ingredients found right on this Pacific island. If you’re feeling brave, ask for their traditional Indonesian massage, an intense experienceJhat is "not for the faint of heart" as one resort official put it. Also, make sure to book your appointment in one of the rooms facing out toward the rainforest. The lush sights and sounds of tropical wildlife provide an exotic backdrop for your experience.

La Mamounia, Avenue Bab Jdid, Marrakech, Morocco; (212-4) 44-89-81, fax (212-4) 44-46-60; Www. mamouni a. com.

^HLGfy This resort, often described as the best hotel in Northern Africa, was the ^"^^v haunt of Winston Churchill, and it was one of the few places where he felt I serene and removed enough from world affairs to practice his favorite pas-time, watercolor painting. To receive your massage, you enter the Hamam, Or Turkish bath. There an entire ceremony takes place in a beautiful white marbled, Moorish-tiled steam room that is perfumed with natural, delicately boiled herbs. You’re scrubbed with a natural paste, then bathed and toweled before the massage, which is also done in the steam room. The whole process takes about two hours, and afterwards you may feel like a character out of a romantic international novel.

Les Thermes Marins, 2 Ave de Monte Carlo, BP 215, Monte Carlo, France; 98004; tel. 377-92-16-40-40.

If you’re feeling kind of ritzy, put your Ray Bans on, hop in your yacht, and head to Monte Carlo for Les Thermes Marins, a spa with a sea view. And it’s not only a view you get, but sea therapy as well. After a soak in a natural sea-water bath, request an hour-long massage before heading out to the casinos for the evening. This retreat has been called "the most luxurious thalassotherapy center, or seawater spa, in the world," but the price for a full day including four treatments won’t drain your bank account.

Spa Deus, Via Le Piane 35-53042, Chianciano (SI) Italy; 39-(0) 578-63232, Www. spadeus. it.

If you come under the spell of the Tuscan sun and can’t wait to start your Italian getaway, but don’t know where to begin and would like to get a massage while you’re thinking about it anyway, definitely book an appointment at Spa Deus. They offer a good blend of European and American philosophies, and if you ever tire of the fine massages and healthy lifestyle choices there, you can head out in your rented Fiat for a little tour of the magnificent countryside.

Spiritual Massage, Angela Moraes, Rio de Janeiro, Brazil; tel. 5521 274-5195; e-mail: Solgavea@mandic. com. br.

If you happen to be in Rio de Janeiro and you want a spiritual experience, call Angela Moraes, who offers something called Massagem Espiritual, which is Portuguese for spiritual massage. You may not know this, but Brazilians are famous for their spiritual inclinations, as well as their more, um, worldly inclinations. Just being in Rio is a kind of spiritual experience in itself. Call Angela to make it extra special. She has a healing center in a gorgeous area near mountains, ±>eaches, and forests, but still right in the city.

Wat Po Temple, Bangkok, Thailand

If you’re in Bangkok, just ask anybody where Wat Po is, and they may be able to tell you. It’s kind of hard to miss sprawling temples with massive golden Buddhas, right? The massage you receive there has a reputation of being "intense," but in a good way, of course. And it won’t be in a darkened private room with flute music playing, like you may expect, but in an open public pavilion with several beds all together, and you wear loose-fitting clothing. And be warned, the massage is so wonderful, and the price so affordable, you may end up here for hours!

Chapter 23

In This Chapter

^ Philosophising rationally ^ Taking responsibility for your feelings ^ Enhancing your psychological health Staying interested

I\ S we discuss many times in this book, the attitudes you hold about your-Ґ \ self, other people, and the world greatly affect your ability to respond successfully to negative life events. Even in the absence of unusual or difficult circumstances, your core philosophies influence your overall experience of life. People who hold rational philosophies are generally less prone to emotional disturbances, such as anxiety and depression, and are more readily able to solve problems.

This chapter offers ten rational philosophical standpoints that are good for your psychological health. Read them, re-read them, think them through, and test out acting upon them to see for yourself.

Assuming Emotional Responsibility: \lou Feel the Way \lou Think

Bad or unfortunate things, such as splitting up from a partner, being made redundant, or having a car accident, can happen to anyone. You may reasonably have negative feelings in response to such events. Experiencing extreme sadness or annoyance in the face of misfortune is wholly understandable.

In some instances, bad things occur through no fault of your own. In other cases, you may have some personal responsibility. We don’t suggest that you blame yourself for every bad thing that comes your way. However, try to assess a given situation and determine whether you have any Legitimate responsibility For its development and look for a resolution.

Even if you’re not personally responsible for a negative event, you can still take responsibility for your emotional and behavioural Responses To the event. People who deny their part in creating their own emotional problems in the face of negative events don’t recognise how their thoughts and actions can make a bad situation worse. They hand over their personal power to make things better by waiting passively for someone or something to step into the breach.

When you hold an attitude of personal responsibility for your feelings and actions, you’re more able to find creative solutions, and your belief in your ability to cope with adversity is heightened. You empower yourself by focusing on your ability to influence the way you feel even if you can’t control events.

On a cheerier note, when good things happen, you can also assess the extent to which they’re a result of your own efforts – and then give yourself credit where due. You can appreciate good fortune without sabotaging your positive feelings with worries that your luck may run out.

Thinking Flexibly

Making demands and commands – thinking in terms of ‘must’, ‘should’, and ‘have to’ – about yourself, the world around you, and other people has a fundamental problem: Such thinking limits your flexibility to adapt to reality. The human capacity to adapt creatively to what’s going on is one of the hallmarks of the species’ success. However, humans are fallible, and the world continues to be an imperfect place. Insisting ‘It shouldn’t be this way!’ can leave you irate, depressed, or anxious and much less able to focus on how to cope with and adapt to reality.

Although circumstances may well be Desirable, preferable, And even Better \i The situation were different, they don’t Have To be a particular way. Accepting reality and striving to improve it where wise and achievable can help you save your energy for creative thought and action. Refer to Chapter 2 for more on demands, and Chapter 12 for more on developing realistic attitudes towards yourself.

Valuing \lour Individuality

You can express your individuality in many ways, such as in your dress sense, musical tastes, political opinions, or choice of career. Yet perhaps you’re hesitant to express your individuality openly because you fear the reaction of others. People who develop the ability to value their idiosyncrasies and to express them Respectfully Tend to be well-adjusted and content. Accepting that you’re an individual and have the right to live your life, just as other people have the right to live theirs, is a pretty good recipe for happiness.

As social animals, humans like to feel part of a group or social structure, and tend to be happier when interacting meaningfully with other humans. However, the ability to go against group mentality when it’s at odds with your own personal views or values is a tremendous skill. You can be both socially integrated and true to your values by accepting yourself as an individual and by being a selective non-conformist. Check out Chapter 12 for more on accepting yourself.

Accepting That Life Can Be Unfair

Sometimes, life’s just plain unfair. Sometimes, people treat you unjustly and nothing gets done to put the balance right. Bad things happen to the nicest of people, and people who don’t seem to have done a deserving thing in their lives get a winning ticket. On top of being unfair, life’s unpredictable and uncertain a great deal of the time. And really, that’s just the way life is.

What can you do? You can whine and moan and make yourself thoroughly miserable about the lamentable state of the world. Or you can accept things and get on with the business of living. No matter how much you insist that the world should be fair and you should be given certainty about how things are going to pan out, you ain’t going to get it.

Life’s unfair to pretty much Everyone From time to time – in which case, perhaps things aren’t as desperately unfair as you thought. If you can accept the cold hard reality of injustice and uncertainty, you’re far more likely to be able to bounce back when life slaps you in the face with a wet fish. You’re also likely to be less anxious about making decisions and taking risks. You can still strive to play fair yourself, but if you accept that unfairness exists you may be less outraged and less horrified if and when justice simply doesn’t prevail.

Understanding That Approval from Others Isn’t Necessary

Receiving approval from someone important to you is nice. Getting a bit of praise from a boss or a friend can feel good. But if you believe that you Need The approval of significant others or, indeed, everyone you meet, then you probably spend a lot of time feeling unhappy and unsure of yourself. Many people get depressed because they believe they’re only as good as the opinions others hold of them. These people can’t feel good about themselves unless they get positive feedback or reassurance from others.

Accept yourself, independent of overt approval from other people in your life. Having a Preference For being liked, appreciated, and approved of by others – but not believing that you Need Approval – means that your self-opinion can be stable and you can weather disapproval. You may still behave in ways that are more likely to generate approval than disapproval, but you can also assert yourself without fear. You can consider praise and compliments a bonus rather than something you must cling to and work over-hard to maintain.

If you hold the belief that you Need Rather than Desire Approval, you may pay emotionally for it somewhere along the line. You’re likely to feel anxious about whether approval’s forthcoming – and when you get approval you may worry about losing it. If you fail to get obvious approval or – horror of all horrors – someone criticises you, you’re likely to put yourself down and make yourself depressed. Refer to Chapter 9 for more on combating anxiety, and Chapter 10 for tackling depression.

You cannot please all the people all the time – and if that’s what you try to do, you’re almost certainly going to be overly passive. If you can take the view that disapproval isn’t the end of the world, not intolerable, and not an indication that you’re less than worthy, you can enjoy approval when you get it and still accept yourself when you don’t.

Realising LoVe’s besirable, Not Essential

Some people would rather be in any relationship – even an unsatisfying or abusive one – than in no relationship at all. This need may stem from a belief that they can’t cope with feelings of loneliness or get through life in general if

They’re alone. Other people consider themselves worthy or lovable only when they’re reassured by being in a relationship.

Romantic relationships Can Enhance your enjoyment of life, but they’re not essential for you to enjoy life. Holding this attitude can help you to feel good about yourself when you’re not part of a couple and may lead you to make more discerning partner choices in future since you will choose, rather than be compelled. Believing that your basic lovability is relatively constant, regardless of whether a significant other actively loves you, can help you to feel secure within a relationship.

People who strongly Prefer Having a partner and yet believe that they can survive a break up tend to experience little romantic jealousy. Jealousy can be a big obstacle to relationship satisfaction – jealous people tend to believe that they Must Keep their partner and end up focusing on signs of infidelity or waning interest rather than on the pleasure of the relationship. Jealousy’s turned many a relationship sour. A jealous partner can end up alienating the other person through constant reassurance-seeking or monitoring, leaving both members of the couple feeling that mutual trust doesn’t exist between them.

Preferring Instead of Demanding To have a relationship helps you to retain your independence and individuality. Then when you Are In a relationship, you’re less likely to fall into the trap of trying to be the perfect partner -which means you can continue to attend to your own interests while being able to negotiate compromises when appropriate.

Tolerating Short-Term discomfort

Healthy, robust, and successful people are often able to tolerate temporary discomfort in the pursuit of longer-term goals. They practise self-denial and delay gratification when doing so is in their long-term interests. These people are the ones who are able to eat healthily, exercise regularly, save money, study effectively, and so on.

You Can Experience intense pleasure in the present and the future, but often some degree of pain and effort Today Are necessary to win you greater pleasure Tomorrow. This will be true for many of the achievements you’ve already made in life. Putting up with temporary discomfort is also going to be crucial in Reducing Painful feelings of anxiety and depression. Refer to Chapters 9, 10, and 11 for more on overcoming these problems.

Enacting Enlightened Self-Interest

Enlightened self-interest Is about putting yourself first most of the time and one, two, or a small handful of selected others a very close second. Enlightened self-interest is about looking after your own needs and interests while also being mindful of the needs of your loved ones and other people living on the planet.

So why put yourself first? When you reach a certain age, you need to look after yourself because nobody else is going to do so for you. If you can keep yourself healthy and content, you are better able to turn your attention to caring for the people in your life that you love.

Many people make the mistake of always suppressing their own needs and end up tired, unhappy, or ill. People may think they’re doing the right thing by putting others first all the time, but in fact they’re left with very little to give.

Of course you Will Experience times when putting someone else’s needs before your own and making personal sacrifices is a good choice. For example, parents frequently put the welfare of their children before their own. But you must still make space for your own pursuits too.

If you’re starting to get concerned that ‘self-interest’ translates to ‘selfish beast’, stop! To clarify: Self-interest involves taking responsibility for looking after yourself because you understand that you’re worth taking care of. Self-interest means being able to care for others very deeply. When you’re self-interested, you’re able to meet your own needs and take a keen interest in the welfare of other people in the world around you. You can also determine when you’re going to put yourself Second For a period of time because someone else’s need is greater than your own – which is where the ‘enlightened’ part comes into play.

Selfishness is not – we stress, Not! – The same animal as self-interest. Ultimately, selfish people put their own wants and needs first, To the exclusion and detriment of other people. Selfishness is much less about taking responsibility for looking after yourself and much more about demanding that you get what you want, when you want, and to hell with everybody else. The two concepts are very different – so don’t be scared. Head to Chapter 16 for more on building a lifestyle that promotes taking care of yourself.

Pursuing Interests and Acting Consistently u/ith \lour Values

Loads of evidence indicates that people are happier and healthier if they pursue interests and hobbies. Have you let your life become dominated by work or chores at home, and do you spend your evenings sitting in front of the television as a means of recharging? If your answer to this question is ‘Yes!’, then you’re in extremely good, but not optimally healthy, company.

One of the arts of maximising your happiness is to pursue personally meaningful goals, such as furthering your education, participating in sports and exercise, developing skills, improving relationships, or acting in ways that contribute to the sort of world you’d like to live in, for example by doing some voluntary work. Try to structure your life to ensure that you have some time for personally meaningful pursuits. Check that the things you do in life reflect what you believe is important.

As far as we can tell, life isn’t a dress rehearsal. Will you really look back and regret missing a bit of TV because you dragged yourself out to spend time on a hobby, to exercise, to enjoy a night out with your friends, or to participate in some charity work?

Healthy and productive people tend to be prepared to tolerate a degree of risk and uncertainty. Demanding certainty and guarantees in an uncertain world is a sure-fire recipe for worry and inactivity. Safety comes at a cost – fewer rewards, less excitement, fewer new experiences.

The fact that you don’t know what the future holds is grounds for Calculated risks And Experiments, Not avoidance, reassurance-seeking, or safety precautions. You can make educated decisions and take calculated risks, but if you accept that 100 per cent certainty is exceptionally rare, you can reduce undue anxiety and worry.

In This Chapter

► Ten top U. S. schools

► Ten top international schools

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1

M F you decide that, after reading this book, there is absolutely no way that «C You Can go on with your life without rushing out to become a professional massage therapist, I would just like to say… congratulations! You have made a very wise and dynamic career decision. One of the very first places this decision may take you is a massage school of some kind or another. Massage schools each have their own personality, history, reputation, strong points, weak points, and so on. Choosing the right school to spend some important, life-transforming time in over a period of several months or a year is not a decision you should enter into lightly.

In the same way that you end up making friends with the people you are physically close to (in school, at work, as part of white house internship programs, and so on), you usually end up choosing a massage school that is somewhere in the vicinity of your house or apartment. However, if you have the luxury of mobility and can consider schools in a variety of locations, I have compiled a list here that may help. Keep in mind that these schools are some of my personal favorites as well as those recommended by colleagues. There are many other fine schools around. In the U. S. alone, approximately 800 massage schools dot the landscape, and that number just keeps growing.

If you’d like to see a much more extensive list of schools, I suggest the Touch Training Directory, Published by Associated Bodywork and Massage Professionals. It costs about $15, and you can get it by calling 800-458-2267 or 303-674-8478 or visiting www. a bmp. com.

Massage Schools in the US.

And now, if you’d like to consider some really dreamy places to attend massage school in the U. S., check out the following suggestions.

Keep in mind that you can go experience a weekend workshop or a week-long intensive class before deciding to commit to a full course of study at many of these listed schools. This is a highly recommended way to get to know your prospective fellow students, faculty, and the facility itself. Call each school to receive a catalogue of workshops.

Atlanta School of Massage, 2300 Peachford Road, Suite 3200, Atlanta, GA 30338; 770-454-7167; Www. atlantaschoolofmassage. com.

Like many massage schools, the Atlanta School of Massage started out as a small dream in the minds of people who really liked doing massage themselves. Then it grew. And grew and grew. Now it has a management board of its own, and a large, full-time staff. In addition to traditional training programs in Swedish massage, sports massage, and so on, ASM developed one of the first extensive spa therapy training programs offered at any massage school. Students can receive certification for specialties in spa services (see Chapter 15 for more info on spa treatments).

California Healing Arts College, 12217 Santa Monica Blvd., Suite 206, Santa Monica, CA 90025; 310-826-7622; Www. chacmassage. com.

This school, run by a very together woman by the name of Lucinda, has a great referral system and graduate internship program. Students here get one of the best opportunities anywhere to transition themselves into the actual workplace, which is often a shock after spending several months in the rarefied and idealistic air of the massage school environment. The school takes advantage of its urban location in L. A. to get students ready for the real world.

Down East School of Massage, P. O. Box 24, Waldoboro, ME 04572-0024; 207-832-5531; Www. mi dcoast. com/~dsm.

Imagine a private reserve in the woods of Maine, complete with a pond and one dirt road called Moose Meadow Lane. Then add a modern, three-story school building, a devoted, caring owner, and a topnotch, fully accredited massage training program. You then have the ingredients for an intense yet tranquil massage learning experience in one of the most beautiful settings anywhere.

Educating Hands, 120 SW 8th Street, Miami, FL 33130; 305-285-6991;

Www. educatinghands. com.

This is another school I’m rather biased about, right here in my own hometown. Educating Hands has been around for many years, and owner Iris Burman has dedicated herself to graduating students who use their hands to express their hearts. It’s a fun, yet comprehensive, fully accredited program, and the beach is only ten minutes away.

Esalen Institute, Highway 1, Big Sur, CA 93920; 408-667-3000; Www. esalen. org.

As touted in Chapter 2, Esalen can be considered a kind of epicenter for massage consciousness in the U. S. Situated on the dramatic northern California coastline, it acts as a magnet for some of the best teachers in the world. Instructors have developed their own particular massage style there (not surprisingly called Esalen Massage), which you can learn while in residence. Not a bad way to spend your school days.

Heartwood Institute, 220 Harmony Lane, Garberville, CA 95542; 707-923-5000; Www. heartwoodinsti tute. com.

"A school that is more accurately lived than simply attended" is the way this campus set on 240 acres of rolling mountains, meadows, and forests is described. Located way, way, way up in northern California, this is the place to go if you want to experience the "whole enchilada" during your massage training experience. There’s organic food, fresh air, stunning views, and a comprehensive holistic philosophy that permeates your time there, making it one of the most unforgettable episodes in your life.

Kripalu Center for Yoga & Health, P. O. Box 793, Lenox, MA 01240; 41&448-3400; Www. kripalu. org.

Set on a hill overlooking a lake in the Berkshire Mountains of western Massachusetts, Kripalu has had a long, illustrious history of training massage practitioners, especially those interested in the "spiritual" side of massage. Instructors at this residential facility practice a lot of yoga and meditation, making them the perfect peaceful practitioners to teach stressed-out folks from the big city. You may want to test the waters at this somewhat eclectic place before you commit, though, especially if chanting in Sanskrit at 6 a. m. is not your cup of tea.

Scherer Institute of Natural Healing, 935 Alto Street, Santa Fe, NM 87501; 505-982-8398; Www. schererinstitute. com.

If you’re going to go to massage school someplace, why not gorgeous New Mexico, where you can hike, ski, soak in hot pools in the desert, and eat some of the best Mexican food anywhere? The Scherer Institute has had nothing but rave reviews from the press and from friends who’ve gone there. Now with a second facility in Taos, they offer a holistic experience that is unsurpassed.

Suncoast School of Massage, 4910 Cypress Street, Tampa, FL 33607-3802; 813-287-1099.

All right, I admit it, Suncoast is my alma mater, and the owners, Dan and Telka Ulrich, are long-time friends. I may indeed be somewhat biased about this school, but that doesn’t mean you shouldn’t consider going there, because

It’s excellent. The program has consistently turned out highly skilled and competent massage therapists, some of whom even go on to write books about massage.

Swedish Institute, 226 W. 26th Street, New York, NY 10001; 212-924-5900.

Okay, so spending months out in the splendid beauties of nature at some massage school in the mountains eating nothing but organic fruit is not your idea of a good time. Perhaps you would prefer the fast pace and abundant nightlife of a major metropolitan area instead. What metropolitan area is more major than New York City? In fact, one of the oldest massage schools in the country is located right in the heart of New York City. This doesn’t mean you can spend all your time pursuing that acting career or goofing off, though. The program is quite comprehensive and takes 1,224 hours to complete.

International Schools

Therapeutic massage is growing in popularity outside the U. S. — perhaps even faster than it is inside — as many people around the world come to see the value of "alternative" therapies. The following are some neat schools in several countries.

Australian School, 104C Warrigal Rd, Burwood VIC 3125, Queensland Australia; tel. 03 9830 0555.

Many massage schools in Australia receive extra assistance from the government so people can afford to get a massage education there. The Australian School of Therapeutic Massage offers a good basic course and is recommended by an Australian massage association.

Clare Maxwell Hudson’s Massage, 87 Dartmouth Road, London, England NW2 4ER, UK; tel. 00 44 181 450-6494.

Clare Maxwell Hudson has written a number of popular books on massage, and she has a well-known school in London as well. The school started out with basic courses in 1984 and has since evolved into a full-fledged training institute. Much of the class work can be completed part-time, on weekends, to allow for the schedules of busy professionals. Owner Hudson believes one of the most valuable parts of her training is the work placement in hospitals that students are offered each semester. This is a good place to get hands-on guidance from an internationally recognized expert.

Federation of Masseurs, 24 rue des Petits Hotels, 75010, Paris, France; tel. 01 44 83 46 00.

The Federation of Masseurs Kinesitherapeutes is not actually a school. It’s an organization that can lead you in the right direction when you’re seeking massage training in France. Things are different in France for massage therapists because their training is a part of the medical system, and graduates, known as Kines (key-nays), are highly respected professionals within the medical community. If you’re planning on studying at one of the schools in France, you need a keen desire to work in medical settings, and, of course, it helps if you know how to speak French.

Federazione dei Massofisioterapisti (F. N.C. M.), Massofisioterapisti Via Aosta 16, Trento, 38100 Rome, Italy; tel. 03 94 61 915 499; Www.Geocities. com/CapeCanaveral/Lab/2521.

This is another network of people teaching and developing massage techniques. Working with the ministry of health to uphold professional standards, the FNCM also lists classes in many different massage modalities given throughout Italy.

Institute of Thai Massage, 17/7 Morakot Road, Hah Yaek Santitham, Chiang Mai, Thailand; tel. 66-53-218632; www. i nf othai. com/i tm.

If you’re like most people, the first time you receive a Thai-style massage, you immediately want more, and you may even feel the desire to share the great pleasures and health benefits of this ancient art, called Nuad Bo-Rarn in Thailand, with others. Maybe that’s why so many people make the pilgrimage to Chiang Mai to study with Master Chongkol Setthakorn, head teacher at the Old Medicine Hospital there since 1985. Five levels of courses are available, each lasts five days for a total of 180 hours.

Karlsbad Spa Training, Czechoslovakia, contact Dr. Jonathan Paul DeVierville, The Alamo Plaza Spa, 204 Alamo Plaza, San Antonio, TX 78205; U. S. tel. 210-223-5772; www. Karl sbadspa. cjb. net.

Dr. Jonathan Paul DeVierville, Ph. D. is a veritable fountain of information about water. In fact, he knows so much about water and hydrotherapy that he has decided to dedicate his life to sharing the healing message of spas. Each year in May he takes a small group of lucky students to Czechoslovakia with him to study the traditional forms of hydrotherapy and other healing methods used in the spas there.

Northern Institute of Massage, 100 Waterloo Road, Blackpool, England FY4 1 AW; tel. 44 1253 403548.

This school has been around since 1924, and they have graduated over 35,000 students (many of whom are still alive). The students spread out across the English-speaking world to ply their hands-on trade. In the past ten years, the school has seen an upsurge in activity as more and more people in the U. K. become interested in alternative therapies. The school has even opened branch offices in other countries — two in Ireland, and one in the Caribbean. Call if you’re interested in schooling, or even if you’re a visitor just traveling through — workshops are open to everybody.

South Australia Health Education Center, 38 Currie Street, Adelaide, Australia SA, 5000; tel. 08 8410 1975; Www. massage .Net. au.

If you’d like a massage school experience down on the south coast of Australia, and you want to study with people serious about their massage (the principal and several instructors were invited to the Commonwealth Games to offer sports massage to the athletes), this is the school for you.

Sutherland-Chan, 330 Dupont Street, Suite 400, Toronto, Canada; tel. 416-924-1107; Www. sutherland-chan. com.

If you’d like a multi-cultural, multi-ethnic, cosmopolitan experience while studying massage, in a peaceful, laid-back Canadian city, Toronto may be the place for you, and the Sutherland-Chan School & Teaching Clinic may be the perfect school. It’s located right in the middle of downtown Toronto, which features excellent housing and actual humans walking around at night. Sutherland-Chan has been around since 1978. The program is a hefty 2,200 hours, and fully 70 percent of the students already have a college degree when they arrive. What really sets the school apart is its intense clinical outreach program. In order to graduate, every student performs supervised clinical work in area hospitals.

West Coast College of Massage Therapy, 555 West Hastings Street, Vancouver, Canada V6B 4N4; 888-449-2242; Www. col 1 egeofmassage. com.

You have to get ready for some serious schooling if you study massage in Canada, which requires between 2,000 and 3,000 hours of training, depending on which province you live in. The direction and emphasis of training at the West Coast College is based on the medical model approach to healthcare, according to Ron Garvock, dean of massage therapy at this school in Vancouver. This three-year program costs $25,000 Canadian dollars, which perhaps makes it the highest standard in massage education in North America. They also have campuses in the Toronto area and are expanding into Victoria and Niagara as well.

Chapter 22

In This Chapter

^ Improving Part D coverage as you know it ^ Overhauling Part D completely

Mir art D has always been a political hot potato. Over time, it’s tended to V Scorch the fingers of folks who support it and those who oppose it. Why? Because it’s an imperfect, overcomplicated benefit that’s hard to support wholeheartedly. Yet it’s allowed millions of Medicare beneficiaries to buy prescription drugs more affordably than they ever could before, which makes it very hard to oppose wholeheartedly, too.

But of course, anything can be improved. In this chapter, I present ten proposals with the potential to change Medicare prescription drug coverage either in small or more sweeping ways. At the time I’m writing this book, these proposals are only suggestions put forward by consumer groups, policy experts, and/ or members of Congress. But they’re worth keeping an eye on.

SIMplIFyINg Plan ChoICes

Having a multitude of choices supposedly allows people to choose the Medicare private health or drug plan that fits them best. But in practice, it doesn’t necessarily work out that way. Faced with a dizzying number of plans, all with different costs and benefits, people are often too overwhelmed to make careful comparisons. As a result, many Medicare beneficiaries don’t make informed choices at all.

What can improve this situation, while still keeping the principle of choice? One idea that’s gained traction among some lawmakers and consumer advocates is to standardize and simplify plan choices. Medicare beneficiaries would be offered a certain number of standard plans — maybe ten or fewer — that each provide a different benefit package. Each plan would be sold by competing insurance companies for different premiums, according to the level of benefits. Sound

Familiar? It’s modeled on Medigap supplementary insurance, which supporters of the proposal point to as a precedent. The Medigap market was a free-for-all until 1992, when Congress reformed it by introducing ten standardized policies. Choice and competition were preserved, but consumers were able to compare benefits more easily.

Standardization may well simplify choices among Medicare health plans’ medical services, but it’s difficult to see how it’d work on the prescription drug side. One snag is that the best drug plan for consumers depends less on its design and premium and much more on the specific prescription drugs that each person takes. Part D has far more variables in it than Medigap.

Abolishing the Asset Test for Extra Help

More than 2.5 million Americans with limited incomes would qualify for Part D’s Extra Help benefit if it weren’t for the asset test, which takes savings as well as income into account when determining eligibility. Consumer groups protest that the test penalizes individuals who’ve managed to save a little for their old age when they’ll be living on low, fixed incomes. The chances of abolishing the asset test entirely aren’t high, because doing so would add billions of taxpayer dollars to the cost of Part D. But bills have been introduced in the House and the Senate to raise the asset limits to a degree that would allow many more people whose incomes qualify them for Extra Help to actually get it. Some of these bills would also exclude individual retirement accounts and 401(k)s from being counted as assets.

Allowing Medicare to Negotiate Prices

It was obvious from the get-go that a prescription drug benefit in Medicare would eat up a lot of taxpayer money, so you’d think Congress would’ve done everything possible to keep drug prices in check. Yet the 2003 Medicare Modernization Act specifically prohibited the government from negotiating Part D drug prices directly with the manufacturers. Instead of using Medicare’s huge bargaining clout to keep costs down, negotiation was left to individual Part D insurers. Proposals to reverse the ban have many powerful supporters (like AARP and the American Medical Association) and opponents (like the pharmaceutical industry and, latterly, the Bush administration).

In January 2007, the House of Representatives overwhelmingly passed a bill to allow direct negotiation for drugs in Medicare, but a similar bill failed in the Senate. Look for more attempts — and big controversy — in the future.

Eliminating the Doughnut Hole

For consumers, the doughnut hole (also known as the coverage gap) is the most unpopular aspect of Part D. But although many lawmakers have railed against it, no one has seriously tried to move legislation to fill in the gap and give year-round coverage to everyone enrolled in Part D. That’s because doing so would cost an estimated $450 billion over ten years. Abolishing the doughnut hole is a popular enough cause for many lawmakers to continue proposing it. But given the hard choices of raising taxes, cutting benefits in other programs, or keeping Part D’s doughnut hole, eliminating it in reality seems remote unless the whole program is overhauled.

Improving Access to Needed Drugs

Allowing plans to impose restrictions on some drugs (through cost-cutting measures such as prior authorization, quantity limits, and step therapy), and requiring consumers to go through the hoops of the exceptions and appeal process to get those drugs, burdens people unduly and discourages many from requesting the drugs they need, according to many consumer groups. No concrete proposals to simplify this system have been advanced. But one suggestion, for Medicare to require plans to inform enrollees at the point of sale why a drug isn’t covered and how they can request coverage, would lessen many customers’ bewilderment at the pharmacy and may encourage them to file for an exception more quickly.

Cutting Medicare Advantage Subsidies

The 2003 law that created Part D gave Medicare health plans large subsidies to persuade private insurers into the Medicare fold. The extra payments, in turn, allow the plans to offer richer benefits to their enrollees than traditional Medicare offers — an average value of $1,100 more in 2008 for each enrollee. The plans defend this lopsidedness as a boon to people who can’t afford Medigap, whereas critics condemn it as a stealth agenda for essentially privatizing Medicare. Certainly, the extra payments add to Medicare’s overall costs and therefore increase the Part B premium for everyone in Medicare, not just beneficiaries in the plans. In 2008, many members of Congress called for a halt to the subsidies and succeeded in reducing them slightly. But abolishing them would probably cause many Medicare Advantage plans to raise costs, reduce benefits, or withdraw from the market — a tricky political issue for lawmakers with constituents in the plans. Many in Congress still eye the subsidies — estimated to cost $54 billion over five years — as a pot of gold to pay for other priorities. So stay tuned: This issue isn’t going away.

Legalizing Drug Imports from Abroad

Bills making it legal for American consumers to buy prescription drugs from Canada for their own use have been signed into law twice in the past decade. But in each case, the legal language required that the Secretary of Health and Human Services guarantee the safety of drugs imported from other countries, which no secretary has so far been willing to do, so the laws never went into effect. With many supporters on both sides of Congress, the issue will continue to be pressed. But drug pricing is complex, and experts say competition from abroad may not significantly push down prices in the U. S.

Creating a Government-Run Plan

One proposal floated by some Democrats is to create a government-run Part D plan to compete with private plans on a not-for-profit basis. It would allow Medicare to negotiate drug prices for its enrollees and provide "a consistent, uniform drug benefit" available to anyone, according to the House Ways and Means Committee chairman, Rep. Pete Stark. Just as people can choose between traditional Medicare and a private plan, Stark said, they "could remain in the Medicare drug plan or choose to switch to a private option."

Throwing Out Part D and Starting Over

For the severest Part D critics, getting rid of the program and starting over has been a dream since it first became law. But unless a general election throws up a Democratic president and huge Democratic majorities in Congress, it ain’t gonna happen. Even so, overhauling the system would be a huge challenge in the face of Part D’s established infrastructure and opposition from the health insurance industry. More likely, changes to Part D will be made bit by bit over many years.

Bringing in Universal Health Insurance

With 44 million Americans uninsured, and costs rising even for those who have insurance, the need to make health coverage affordable for everyone is a huge political issue. Of course, there’s no consensus on how universal health coverage can be achieved. A wholly government-run health system? A mix of public and private systems? A kind of Medicare for all? Tax breaks for folks who buy health insurance? Who knows? We’ll have to wait to see if whatever system is decided upon (if any) has an impact on Medicare and

Part D.

Part VI

In This Chapter

^ Offering to help your relative with Part D

^ Thinking about the future — for your relative and yourself

A\ Lot is said about baby boomers — born between 1946 and 1964 — but one characteristic is unique: Boomers, much more than any previous generation, are (or will be) caring for elderly parents. Now that people commonly live into their 80s, 90s, and even 100s, often with chronic conditions that impair daily activities, their adult children are mostly the ones who care for them. Today, caregiving usually includes coping with Part D. So in this chapter, I suggest ten ways that you, as a boomer (or perhaps someone even younger), can help an older relative with Part D in the short term, and also prepare for the future when you too will become eligible for Medicare and face Part D.

Helping with Tact

Every family is different, of course. Your relationship with an aging relative may be close, strained, at loggerheads, or even a bit of all three at different times. Perhaps you’re living in the same house or 3,000 miles away — spending a lot of time together or much less than you’d like. So generalizing is impossible. And I’m not about to lecture you on family relationships.

What I can tell you is that helping a relative, especially a parent, with Part D requires sensitivity and tact. Implying that Dad’s incapable of figuring the program out for himself may not go down too well. ("What do you think I am — senile?") Remember that it’s not his age that makes him find Part D confusing. It’s because Part D Is Confusing! So figuring it out together — or at least giving the impression of doing so, even if you’re doing most of the heavy lifting — may bring about a sense of closeness (think "us versus the bureaucracy") that goes far beyond picking a Part D plan.

Identifying the Insurance Your Loved One Has Now

When helping a relative with Part D, you may first need to step back and ask some basic questions about what kinds of health and drug insurance she already has. And don’t be surprised if she doesn’t know! Her mind isn’t going mushy. Seniors often have a perplexing patchwork of different kinds of insurance (not their fault) and aren’t always sure which plan covers what.

For example, your relative may simply say, "I have Medicare." But does that mean traditional Medicare? Or a Medicare private health plan? Or both Medicare and Medicaid? Or Medicare plus a retiree health plan? And does she get her prescription drugs from a Medicare health plan, a stand-alone drug plan, or a retiree plan — or possibly some combination of these? Then again, she may say, "I have Blue Cross." But does that mean a Medigap policy, a Medicare private health plan, a stand-alone drug plan, or a retiree plan? VjjABEfl Large insurers like Blue Cross sell all of these plans.

Here’s how to find what type of medical insurance your relative currently has:

W Find the paperwork for each plan. If you’re lucky, it may be neatly filed and accessible. If not, prepare for some hunting around: "Would it be in a kitchen drawer, Mom, or your dresser? Please, not the attic!"

U Look for the Evidence of Coverage booklet(s). Every private plan (but not traditional Medicare) sends this document annually to enrollees. The EOC may describe a retiree plan, a Medicare health plan, a standalone Part D plan, or Medigap insurance. Make sure the EOC you find is for the current year and not one that’s expired.

U Look to see what each plan is. Your relative’s EOB booklet and plan membership card should clearly identify what kind of plan she has. If you’re still not sure what kind of plan it is, call the plan’s customer service number to find out.

U Check if your relative has health and drug insurance outside of

Medicare. She may have coverage from a previous employer or union, veterans or military benefits, or COBRA insurance. Or she may be enrolled in a State Pharmacy Assistance Program (SPAP). (Chapter 6 covers how these benefits fit in with Part D.)

U Ask if your relative has a Medicaid card if you know or suspect that her income is limited. Medicaid beneficiaries are automatically entitled to Part D’s low-cost Extra Help program, covered in Chapter 5. (Remember: Medicaid, a state program that provides healthcare for low-income people who qualify, is different from Medicare, as explained in

Chapter 1.)

Doing Your Homework

You’ll be much more confident (and competent) about helping your relative if you have a broad understanding of how Part D works. Good thing you picked up this book, huh? Reading the pertinent bits that fit in with your relative’s situation can help you evaluate the insurance he already has and aid you both in deciding which Part D plan most suits his needs or if switching to a different plan may be worthwhile.

Without rehashing the information in the rest of this book, here are a few important points to keep in mind:

U If your relative has any kind of retiree benefits, don’t let him sign up for a Part D plan (or persuade him to do so) without carefully investigating the consequences. Some retiree plans automatically disenroll anyone who signs up for Part D. (Chapter 6 has details.)

U Switching to a Medicare private health plan has consequences, especially in regard to choosing doctors and hospitals (see Chapter 9), that your relative should know about if he currently has traditional Medicare.

U If your relative has a limited income and few savings, check out if he qualifies for Extra Help (see Chapter 5). Many eligible people don’t apply for this Extra Help and miss out on big savings on their medicines.

U Scams are out there, and sometimes sales agents persuade Medicare beneficiaries to buy plans that aren’t right for them. If you think your relative is vulnerable, try to make sure he doesn’t sign anything until after you’ve checked it out. (See Chapter 11 for red flags to look for.)

Offering Your Skills

You (yes, you!) have skills that can be of enormous help to a relative trying to figure out Part D. Of course, many older people are quite able to brave the Part D waters themselves, thank you very much, and don’t need any help. On the other hand, some people can use help but don’t want to admit it. You’ll have to be the judge of that. But you may discover that offering your skills — on the computer, phone, or both — to find a suitable Part D plan for her or to troubleshoot problems will be very warmly received.

One great advantage of the Internet and toll-free phone numbers is that you can use your skills remotely, even if you don’t live anywhere near the person you’re helping. In some families, sorting out Medicare and Part D issues has become part of shared caregiving for a frail or sick parent — a way for the sibling who lives far away to lift at least one responsibility off the shoulders of a brother or sister who lives in the area and is on standby all the time.

Helping to Pick a Plan

If your relative doesn’t have Internet access, or just doesn’t feel up to doing a Web search personally, you can offer to compare Part D plans for him. Using the online Medicare Prescription Drug Plan Finder at Www. medicare. gov is the most effective way of comparing plans and choosing the one that’s most suitable. In Chapter 10, you can find a step-by-step guide to walk you through the process. Or you can call the Medicare help line at 800-633-4227 for similar information, also explained in Chapter 10. After you have a shortlist of the two or three plans that seem the most suitable, you and he can discuss the options to make a final choice.

For a relative enrolling in a Part D plan for the first time, you may need to talk with him about how the program works. For example, you may need to explain that drug coverage is offered through many private insurers, not by Medicare directly, and that he needs to pick one plan. If you’re helping a couple, you may need to explain that the same plan probably won’t be right for both of them.

Following Up

After your relative is in a Part D plan, your help isn’t necessarily at an end. Asking her from time to time how the plan’s working out is a wise precaution. Check that she’s getting the prescriptions she needs. If the plan imposes restrictions on any of her drugs, find out if she needs help asking the plan for an exception (covered in Chapter 4) or filing an appeal (explained in Chapter 19). If so, suggest that she contact one of the help organizations listed in the last section of Chapter 19 or, if necessary, call one yourself.

Another time when your help may be needed is if your relative moves away from her present home. She may need to change her plan if she moves outside of her current plan’s service area (covered in Chapter 17) or into a nursing home or other institutional facility (described in Chapter 18).

Making Part D an Annual Event

Everyone groans at the idea of comparing Part D plans all over again each year, but I strongly urge doing so if you want to make sure your relative continues to be in the plan that best meets his needs. Why? Because every plan can change its costs and benefits every calendar year, and usually they all do. At the very least, make sure your relative reads the Annual Notice of Change that his current plan mails out in October (as explained in Chapter 17), or read it yourself if necessary.

Some families make Part D plan comparisons an annual event — most often when they get together for Thanksgiving, which conveniently falls smack in the middle of open enrollment. It may not seem a task that fits perfectly with a mood of celebration, let alone the general lethargy that follows a big dinner, yet it can be a genuine moment of family connection. What’s more, if you do a plan comparison for your parent(s) every year, the process becomes familiar and easy, taking maybe no more than half an hour on a computer after the remains of the turkey have been cleared away.

Looking to Your Loved One’s Future

No one likes to think about the possibility of loved ones developing dementia or undergoing other medical events, like severe strokes, that rob them of the power to make decisions or even communicate. Yet this scenario happens with tragic frequency. According to the Alzheimer’s Association, more than 19 million Americans are estimated to have a family member with Alzheimer’s disease alone, and nearly one in two Americans who live beyond 85 are likely to have at least some of its symptoms.

^tfBEfl Experts on aging suggest that long before anything like this happens, adult children need to talk with their parents and find out their wishes on what llfii J should be done in the case of incapacity. Certainly this isn’t the easiest discussion topic in the world, but early planning makes for easier decision making should a crisis occur.

One of the most important questions to ask is who makes medical and legal decisions on behalf of your parent if and when she can no longer make her own. (These include decisions about her Part D coverage, especially if she needs to go into a nursing home, which I cover in Chapter 18.) This is a question that requires expert guidance. The process for becoming a legal guardian or obtaining Durable power of attorney — the right to make legal decisions on behalf of someone else — depends on your state’s laws.

ITf ^ For information on advance healthcare directives — in which your parent can specify who should make which decisions if she becomes incapacitated — and other legal instruments, go to the Web site of the American Bar Association’s Commission on Law and Aging at Www. abanet. org/aging/publications/ home. shtml. (Click "Online Publications for Consumers" to access a list of helpful resources.) AARP also has a wealth of information about advance planning, including "Prepare to Care: A Planning Guide for Families," at www. Aarp. org/family/caregiving.

Remembering That Your Time Will Come

Boomers, stereotypically, have never wanted to grow old. (Well, who does?) Many of you have already succeeded in redefining old age: "Fifty is the new thirty! Sixty is the new forty!" Nonetheless, just as you’ll look in the mirror one morning and suddenly see your parent or grandparent staring back, so too will you one day confront at least some of the problems your elders face now.

One benefit of helping older relatives navigate Part D is perceiving what’s in store not too many years down the road and, in a way, getting into training. The first boomers turn 65 — and become eligible for Medicare — in 2011. Will you be panicking about how to sign up? Will you be totally baffled by the complexities of Part D? Not if you’ve already been there, done that on behalf of Mom or Dad.

"Working with aging parents is a voyage of discovery," wrote psychologist Mary Pipher (author of Another Country: Navigating the Emotional Terrain of Our Elders) In her introduction to the AARP guide Caring For Your Parents (Sterling, 2005). "As we travel, we learn about us, about them, and about our relationship. We learn about caregiving and care receiving. And we learn how we want to handle our own old-old age."

Being a Bona Fide Boomer by Making Part D Better

So you’ve confronted Part D, navigated it, and emerged — with what thoughts? That it’s a good program? Better than nothing? In need of major improvements? Boomers traditionally never accept the status quo and believe that anything can be made better, especially if it affects them personally. So you may take a very different view from today’s generation of seniors who are the first to experience Part D and have in recent memory the bad old days when Medicare didn’t cover outpatient prescription drugs at all.

Part D is a creature of politics. So if you don’t like parts of it, don’t blame Medicare. Congress writes the law, and only Congress can change it. Senators and representatives listen when enough of their constituents make a fuss (especially in election years). You can find their contact information at www.

Senate. gov or Www. house. gov.

So if your generation lives up to its reputation, how will Part D evolve? Will future Medicare beneficiaries one day wave a not-so-fond farewell to the doughnut hole? Over to you, guys.

Chapter 21

The 5th Wave By Rich Tennant

"Heartburn? I like the medication that shoves I People in a rovrboat having a picnic, but CliK likes the one v*ith a people on "Roman holiday eating lasagne

In this part. . .

Farlier chapters of this book deal with the daily business of Medicare Part D prescription drug coverage — all the practical things you need to know to get the most out of the program. The two chapters in this part veer off in a different direction. The first assumes you’re a boomer not yet on Medicare but helping an older person — most likely a parent — deal with Part D. It suggests ten ways to manage that process effectively while helping yourself at the same time.

The second chapter alerts you to ten proposals to change Part D that have been put forward by members of Congress and others. These suggestions range from specific improvements to overhauls of the entire program. None may happen any time soon, or even at all. But Part D is a creation of politics, so it’s good to know what’s in the air.

Chapter 20