Governor Candidates and Elder Care
Gov candidates all support elder care program
by Dan Olson, Minnesota Public Radio
October 6, 2010
Maplewood, Minn. — In the midst of a contentious debate over how to fix the state's $5.8 billion budget deficit, Minnesota's candidates for governor appear to agree on one piece of the budget.
Republican gubernatorial nominee Tom Emmer, Democratic nominee Mark Dayton and Independence Party candidate Tom Horner all say it's a good idea to preserve a little-known program that helps keep older people who are poor and disabled out of expensive nursing homes.
The Elderly Wavier program is a growing part of the state budget that helps pay for their care. That's a big concern for many Minnesotans, as nursing homes are expensive. Monthly rates can easily exceed $7,000.
Federal and state taxpayers pay nursing home costs for old people who are poor. Yet nearly all surveys show older people, including those with health problems, would prefer to stay at home, and of course, it's much cheaper.
The Elderly Waiver program, created 30 years ago after a federal rule change allowed Minnesota and other states to do so, allows old people in poor health who have run out of money to stay at home, or in some cases at an assisted-living apartment. They receive care there instead of going to a nursing home.
It helps people like Jackie Mavis, 84, who lives in a tidy but small efficiency in Lakeview Commons, an assisted-living community in Maplewood.
Mavis, who arrived at Lakeview Commons several years ago, never expected to live there.
"I had back surgery and I got what they call a club foot from that, and that's the reason I came here," she said. "I did say I'd come for two or three months, but I guess six years is a little longer, isn't it?"
After working 42 years for an insurance company, Mavis had some savings, a pension, a bit of insurance coverage and Social Security. But that wasn't enough to afford the $3,000 to $4,000 a month cost of living at Lakeview Commons.
"I was on my own for awhile here, but the money goes fast," she said.
When nearly all of Mavis' money was gone, she qualified for the Elderly Waiver. Now she pays just over $800 a month. Taxpayers pick up the rest, which is on average, about $1,300 a month for Minnesotans getting the help.
The alternative is a nursing home that costs as much as five times that amount.
The cost savings are one reason the candidates for governor agree Elderly Waiver is worth keeping -- even in the face of a projected $5.8 billion state budget deficit.
During a recent debate in Brainerd, the candidates were asked whether Elderly Waiver should be saved.
Dayton praised the program.
"Many elderly who'd like to stay in their homes should be supported in doing so," Dayton said. "That benefits them, it benefits the larger community."
Emmer has said the state's health and human services spending should focus on children and the elderly. He has called for cutting some government programs to balance the budget, but not Elderly Waiver.
"That should be one of our priorities," Emmer said. "But again, you got to go back to this argument that somehow, government should be allowed to expand, no matter what our economic situation is. It isn't the right approach."
Horner also supports the Elderly Waiver program. But he said government needs to get better value for the money it spends.
"It is exactly the kind of investment we ought to be making for the future," Horner said.
Given the consensus among the candidates, the program likely will survive regardless of who is elected governor.
Spending on Elderly Waiver takes a relatively small portion of Minnesota's overall state budget. This year, it will cost about $303 million for nearly 21,000 recipients, according to Minnesota Department of Human Service projections. Of that, 60 percent will be paid with federal dollars and 40 percent by the state.
Next year, Minnesota's contribution rises, as it will have to pick up half of the costs.
In recent years, the state has tightened requirements and reduced Elderly Waiver payments to care providers. Because of those changes, some care providers are turning away folks who qualified for the program.
That's happened as Minnesota's elderly have become one of the fastest-growing components of the state population.
Tom Horner Talks Aging
1. In 2020, Minnesota will have more seniors than children for the first time in our history. What are opportunities for innovation that you see as it relates to this unprecedented demographic shift often called “The Age Wage”?
We need to integrate technology into care delivery to achieve the highest quality, most cost-effective services and outcomes:
- Use technology to manage the chronic illnesses of older Minnesotans on a daily basis to help them live healthier, more active lives and avoid expensive hospitalizations. New online services are now connecting older Minnesotans with care providers for daily interaction through special internet connections. This is another reason why a statewide broadband system is so important.
- Use specifically designed computers that can perform daily monitoring of blood pressure and other vital signs and face-to-face conversations that give care providers a chance to spot warning signs and make adjustments in medication or diet before a crisis occurs. Where these systems have been implemented, they are proving to be enormously successful in improving the quality of life while reducing costs.
- Implement technologies to allow seniors to stay in their own homes longer, saving them money and, potentially, saving tax dollars in the event the senior spends down to Medicaid. In addition it gives family caregivers, especially those who live far away, a measure of comfort when they are unable to be with their loved one.
In addition, we need stages of care, so that seniors who don’t need highest-cost nursing care can remain as independent as possible. We need to find more ways to encourage local communities to provide the relatively small but crucial services (like snow shoveling, garbage carry-out, meal delivery) that can allow people to stay in their own homes.
2. According to the Minnesota Board of Aging, only half of working adults have access to an employer-sponsored retirement plan; the other half do not and are struggling to save for retirement. The current economic recession further hampers people’s abilities to save. Experts predict that approximately one-third of Minnesotan Baby Boomers cannot afford long-term care costs.
What is your vision for financing long-term care for the coming age wave?
As more options for care become available, payment must become less dependent on rigid and poorly designed public programs. Reforms should encourage individuals to take greater responsibility for funding the cost of care and also make it possible to take advantage of the care setting that best suits their needs. We need to expand the incentives available to help seniors and their families contribute toward their long term care expenses:
- Create incentives for private savings with plans like the 529 program for funding student education
- Develop more affordable catastrophic insurance options as well as focus additional savings incentives for those with lower/moderate income
- Encourage home equity programs with lower administrative fees
- Reduce the incentive to use Medicaid as the sole long-term care insurance program by creating a system where users become responsible for co-payment of long-term care costs.
3. How do you foresee aging policy changing in your administration?
As the population over the age of 65 increases the pressure only grows to solve the problem of affordable and sustainable long term care. I believe my proposal goes a long way toward addressing the immediate and mid-range concerns, while building the base that Minnesota will need to address the long term issues around aging. My administration will consider what some might think of extraneous issues, such as the need for transportation to receive the care that people need as well as other community services that will allow people to age in place. I expect that my push to make broadband internet service available statewide will provide new opportunities for monitoring and treating the ailments of old age, which will benefit families caring for their elders as well as the patients themselves.
4. What is your vision for the way you, personally, will age?
This would be a good question to get the conversation started around Minnesota! I think I share the vision of all Minnesotans who want to age near loved ones with as many freedoms intact as possible. None of us want to be told where we have to go as we get older and need care. However, individually we need to think about what that means, and prepare for older old age. My wife, Libby, and I try to do what the experts advise--watch our diets, get plenty of exercise, and stay involved. My choice is community involvement on issues that matter to me--the environment, helping those less fortunate, and good public policy. One of my heroes in terms of contribution to society and aging well is the late former governor Elmer L. Andersen. Well into his 90s, he was an advisor, a philosopher, and friend to many younger people and cared deeply about our state.
5. Where do you want to live when you are old? Your current home, assisted living or a nursing home?
Like most Minnesotans I would choose to remain in my home as I age. The statements above and the details in my FAIR proposal lay out a plan to keep Minnesotans in their homes as long as it makes sense to them. We would all prefer the kind of assistance that makes continued living at home possible, noting that companionship of people we love, and who care about us, is crucial. I hope not to require full nursing care, but want to make sure the excellent nursing home care available in Minnesota is still there, should that need arise. My plan, if I am elected, is to change the way nursing home care is financed, so that care will be available for anyone who needs it.
Jim Klobuchar on Retirement: Favre, Bliss & Blitzes
Several years ago, a man I knew professionally was on the brink of retirement and found himself anguishing in the throes of indecision. This was at a time when retirement from work was still a sensible proposition. It was before Wall Street permanently retired a sizeable army of the American labor force by paralyzing the economy, passing out executive bonuses while 10 million people lost their jobs.
I asked my friend to describe his dilemmas. “I’m ready,” he said. “I’ve done the work. We’ve saved money. I want to fish. I want to play slow-pitch softball. I want to write poetry. I want to watch the swallows come back to Capistrano. I’m a Grandpa and I want to run in Grandma’s Marathon.”
I thought all of these were reasonable grails for his later years, and he deserved them. He said he was secure in his job but he was ready for freedom. “The trouble is trying to stay relevant,” he said. “Basically, I’m worried about disappearing if I retire. I know that sounds awfully self-absorbed.”
I said I thought self-absorption in small doses was not a capital crime. “Test the waters,” I said. “Tell your boss you want to feel the joys of retirement. You can work out your own agendas, goof off, read Ovid’s Art of Love if you’re out of practice. Tell your boss you’d like to consider this an extended leave, and if it didn’t work out you’d like to come back and burn up the pavement with your old zeal.”
He laughed hysterically. “Name me one guy who could do that,” he said. I couldn’t then. Today I can and he has become avatar of retirement in the 21st century, Brett Favre.
Let me re-introduce Brett Favre. He is here. He is there. He is in the commercials selling Wrangler Pants. He is in the Minnesota Viking huddle not only calling plays but happily ignoring signals from the bench. He is No. 4 in your program and No. 1 in the hearts of students of abnormal psychology.
This is Brett Favre, the retiree of the year. He is also the retiree of last year; and the year before that; and the year before that. There is every probability that he will be the retiree of next year. He has already announced that this will be it, his final season, and the makers of Wrangler Pants are delirious about the possibilities of next year’s promotion campaign when Brett shows up two days after training camp ends. For your records it’s Aug. 23, a Tuesday.
So let’s say you are 65 years old and want to know what all of this portends on the broader scale. Let’s say you are 35 and just as baffled as your venerable elders. What it means basically is that Brett Favre has succeeded where Ponce de Leon failed miserably. There IS a Fountain of Youth. For Brett Favre the Fountain of Youth is football. Never mind that some of his contemporaries—Joe Montana, Dan Marino, John Elway—and a few thousand others made their pile and decided it was time to grow up. Favre recognizes no such generational protocols. A hundred yards of green grass is to Favre what the big bend in the Mississippi River was to Huckleberry Finn. It is an instant invitation and a jolt of adrenalin. It is his renewal. It is the same reason why some aging globe-trotters keep going back to the Himalayas to trek. It is not to prove they can still do it. No, not that. It is reconnecting with a part of life that has fueled their glands and created for them a kind of rough-hewn but special community. For Favre that isn’t necessarily defined by throwing a touchdown pass to the tight end with two Neanderthals draped around his collar bone. Horsing around in the locker room is a big part if it, slapping butts, hollering in the pure primitive joy of winning with a bunching of guys who share both the pain and the euphoria.
That is basically what motivates him. Year after year ... So why not say so? So why doesn’t he drop all of the goofy mimes about not being sure, the ones that turn this extraordinary athlete in to a caricature? Is it a crude negotiation for more money? Fundamentally, not. Somewhere he has choreographed the right time and right way for Brett Favre to retire. The worst way is to be throwing interceptions in the final moments of big games. “I don’t want to fail,” he says. And when he has, in January the last three years, it depresses him and he wants out. Until three months later.
Most people understand a sensible time to retire. Favre agonizes and puts conditions on it. The best way to figure this fellow out is to sit back and to enjoy watching him play. Never mind what he says. Watch what he does. Which is right about now. It will be a show—again.
Jim Klobuchar -- A Small Hallelujah on the Highway
I can explain what I was doing standing on the edge of a heavily-trafficked suburban highway, an oversized red Bible in hand while I peered across the roofs of the onrushing motorcade.
I can explain it without any serious hope of extracting much sympathy. Two friends who recognized me called later to find out whether I had staked out the corner of County Road 6 and Interstate 494 to deliver a prophecy. They said they were surprised because they never heard of a prophet wearing a T shirt illustrated in front with a cartoon of five shaggy Himalayan animals going “Yakety Yakety Yak.”
I am not going to burden you with the fringe embarrassments. The truth is that I was about to run out of gas and was looking for my wife, who I believed at that very moment was charging to my rescue in her handy Prius. I didn’t intend it to become a saga. I considered explaining my vigil to a few motorists who slowed down to inquire. I was going to tell them that I was searching for my wife. But warning buzzers soon sounded in the backwaters of my brain. Talk like that could have subjected my wife to suspicion of desertion, for which I admit ample grounds existed.
What happened was the price I paid for my ignorance of some of the thrilling advances in the dashboard services now available in today’s automobiles. It left me approaching empty on the gas gauge en route to a meeting. The only rescue service available to me was my wife, which is where the melodrama began.
I attend a Tuesday morning men’s meeting where a small group of us gather to explore the repair work needed in the spiritual condition of our lives. We take turns as the weekly presenter. A last minute announcement from the scheduled discussion leader, who was unavoidably extended at a conference out of town, stirred my juices of volunteerism. The morning of the meeting I quickly prepared some talking points and for support hauled with me a Bible I received 25 years ago as birthday gift. I backed my new two-weeks-old car out of the garage 15 minutes away from the scheduled start of the meeting, just enough time to be the first to arrive with an explanation of the curriculum change.
Ten minutes into the ride I checked the instrument panel for the fuel gauge. My eyes settled on the familiar circle and arrow to the left of the stirring wheel. The arrow was set halfway up the gauge. A minute later I reviewed the rest of the metrics and was stunned to confront one on the right side of the wheel, identified at the top with an F for Full and at the bottom with an E for Empty. The arrow pointed indisputably at E. The other thing I noticed was that it was blinking violently. It didn’t matter that I quickly figured out the confusion of dials. The prior week I had been driving six or seven hours a day in a rented van, with the gas gauge left of the wheel.
I stared again at the dial of my new car. At the top it read H for Hot and at the bottom C of Cool. In my misery I imagined a quick change in the alphabet and added a D for Dummy. I turned the car into a service lane just off the highway and phoned my wife at home two miles away. No answer. I tried her cell. Nothing. I tried the land line three times. Voice mail. It was brutal. I could hardly call 911. She answered the fourth call. “I was watering the flowers,” she said sweetly. Apologizing to my wife and the flowers, I gave her an estimate of the situation, the way we learned it in the Army. I might run out of gas before I reached a station plus it would throw the meeting out of whack. I then walked back to the rush hour traffic to spot her, hauling the Bible because we were going to make a quick change—I’d drive her car to the meeting, she drives mine to the gas station. For all of it’s reverence, this was a BIG, DEEP, RED Bible, maybe maroon red, maybe vermilion red, immediately announcing me to part of the curious traffic as a potentially defrocked preacher or a traveling peddler.
My wife saved the day with all flags flying. I made it to the meeting. She filled the tank and the flowers survived. Later, at home, I took my first tour of that little old automobile manual. My wife strode through the house the rest of the day like the commander of the evacuation armada at Dunkirk. Naturally, I saluted.
People - The Pulse of Senior Housing and Services
When you talk with people about why they enjoy working in senior housing and services, they will tell you it's the people they work with. People such as our customer Frances Beck, who just makes you feel good. She lives at Ecumen's Bethany Community in Alexandria, Minnesota, and was named our Volunteer of the Year in 2010. Her joy is infectious. Meet Frances in this news story from the ABC TV station in Alexandria:affiliate in Alexandria:
Ecumen Discusses America's Long-Term Care Future in New Public Policy & Aging Report
Ecumen CEO Kathryn Roberts authored "The CLASS Act: A New Paradigm for Aging in America" in the newest issue of the Public Policy and Aging Report. (PPAR) published by the National Academy on an Aging Society
The Community Living Assistance Services and Supports (CLASS) Act has the potential to transform long-term care financing in the United States from a welfare-based to an insurance-based system, according to the latest issue of Public Policy & Aging Report (PPAR).
With funding from The SCAN Foundation, this installment of PPAR features seven articles that recount the origins of the CLASS Act, analyze the legislation's key provisions, and explore potential hurdles of implementation.
"We consider this issue of PPAR to represent the best of what the publication has to offer," said PPAR Editor Robert Hudson, PhD, chair of the Department of Social Policy at the Boston University School of Social Work. "It is timely, informed, and cutting edge. It goes beyond the headlines and delivers detailed accounts of the emergence of the CLASS Act to a broad audience of policy and academic leaders."
The CLASS Act introduces a voluntary, federally administered insurance program designed to provide middle-class Americans the new choice to plan ahead for personal care and supportive service needs in the face of functional impairment. Enrolled individuals no longer will have to be demonstrably poor or spend themselves into poverty to receive long-term care protection.
According to the U.S. Department of Health and Human Services, at least 70 percent of Americans over the age of 65 will need long-term care services at some point in their lives.
"CLASS is about allowing working Americans to take personal responsibility for planning ahead so they can age with dignity and independence," said Bruce Chernof, MD, president and CEO of The SCAN Foundation. "CLASS enrollees will have the power to choose the services they want in the setting most appropriate to their needs."
Authors aalso include Lisa Shugarman, PhD, of The SCAN Foundation; Joshua Wiener, PhD, of RTI International; Walter Dawson of Oxford University; Barbara Manard, PhD, of the American Association of Homes and Services for the Aging; Anne Tumlinson, MMHS, of Avalere Health; and Rhonda Richards of AARP.
Singapore Investing in Changing Aging Technology
Dig this news from Singapore via futurereadysingapore.com and how their government is talking about aging. The Singapore Government is tripling funding support for aging in place technology inititiatives to $10 million over the next two years. The funding support is for innovative and affordable solutions, which enable seniors to live and remain in the community, across the health and social care continuum.
This is a key step in Singapore’s approach to develop innovative healthcare technologies, products and services for what they call "the silver community." It presents a platform for companies to test and develop their health and wellness innovations at proof-of-concept stage in public hospitals, community hospitals, elder care facilities and public households.
“Seniors generally desire to live independently at home and we hope to live a life that is integrated with our family, friends and community. Our recent Sample Household Survey indicated that more than half of our seniors preferred to live with or close to their children, and seniors have become more active and engaged in the community, compared to a decade ago. As the world ages, the global demand for solutions to enable seniors with care needs to live at home, integrate care across the hospital-to-home settings and manage their own health will grow very rapidly.” says Mr Lim Boon Heng, Minister in the Prime Minister’s Office.
“With the economy of Singapore evolving into one based on Research Innovation and Enterprise there will be many opportunities to develop unique solutions in many fields for the world market. One of these fields is health care. With a fast ageing population, Singapore has to find solutions that will help seniors to have a higher quality of life at an affordable cost. This demand can best be met by the rapid conversion of results from research being done in our tertiary institutions and research institutes into innovative products and services by our industries. Test-bedding will prove that these products and services can work and be of value to seniors. Products and services that will be successful in Singapore will also be able to meet Asia’s fast-growing healthcare needs. We are committed to work with companies to co-develop innovative solutions for Singaporeans and the region at large, and the Silver Community Test-Bed Programme is one key platform,” says Prof Lui Pao Chuen, Chairman, Silver Community Testbed Programme Evaluation Panel.
The grant call is open to companies and institutions. Submitted proposals will be evaluated by a panel co-chaired by Prof Lui Pao Chuen and Ms Chong Siak Ching, President and CEO of Ascendas.
10 Proven Ways to Boost Your Memory from Harvard Medical School
Boosting one's memory is a popular pursuit - from high-tech brain exercises such as Dakim's mPower offered in Ecumen communities to low-tech Suduko. Here are 10 research based do-it-yourself ways from Harvard Medical School to boost your ability to remember:
1. Believe in yourself.
Myths about aging can contribute to a failing memory. Middle-aged and older learners do worse on memory tasks when exposed to negative stereotypes about aging and memory, and better if exposed to messages about memory preservation into old age.
2. Economize your brain use.
Take advantage of calendars and planners, maps, shopping lists, file folders, and address books to keep routine information accessible. Designate a place at home for your glasses, keys, and other items you use frequently.
3. Organize your thoughts.
New information that’s broken into smaller chunks, such as the hyphenated sections of a phone or social security number, is easier to remember than a single long list, such as financial account numbers or the name of everyone in a classroom.
4. Use all your senses.
The more senses you use when you learn something, the more of your brain will be involved in retaining the memory. For example, odors are famous for conjuring memories from the distant past, especially those with strong emotional content, such as visits to a cookie-baking grandparent.
5. Expand your brain.
Widen the brain regions involved in learning by reading aloud, drawing a picture, or writing down the information you want to learn (even if you never look back at your notes). Just forming a visual image of something makes it easier to remember and understand; it forces you to make the information more precise.
6. Repeat after me.
When you want to remember something you have just heard or thought about, repeat it out loud. For example, if you’ve just been told someone’s name, use it when you speak with him or her: “So John, where did you meet Camille?”
7. Space it out.
Instead of repeating something many times in a short period, as if you were cramming for an exam, re-study the essentials after increasingly longer periods of time — once an hour, then every few hours, then every day. Spacing out periods of study is particularly valuable when you are trying to master complicated information.
8. Make a mnemonic.
Mnemonic devices are creative ways to remember lists. They can take the form of acronyms — such as the classic “Every good boy does fine,” to remember the musical notes E, G, B, D, and F on the lines of the treble clef. For older learners, a particularly helpful system is a story mnemonic — that is, a brief narrative in which each item cues you to remember the next one.
9. Challenge yourself.
Engaging in activities that require you to concentrate and tax your memory will help you maintain skills as you age. Discuss books, do crossword puzzles, try new recipes, travel, and undertake projects or hobbies that require skills you aren’t familiar or comfortable with.
10. Take a course.
Memory-improvement courses are becoming more common. Choose one run by health professionals or experts in psychology or cognitive rehabilitation. Stay away from courses that center on computer or concentration games, which generally won’t help you with real-life memory problems. Select a course that focuses on practical ways to manage everyday challenges.
Retired Acrobats Return to the Trapeze and Circus Juventas
Abs of Steel -- at 86! When I read this article I thought surely the performance feats of this 86-year-old were exaggerated. NOT. Circus Juventas' "Sawdust" is playing until the 15th in Saint Paul, and well worth seeing for yourself. (Read more...)
- Andrea Marboe
Jim Klobuchar - The Life of Katharine Wilkes
Jim Klobuchar shares a wonderful remembrance of his step-daughter Katharine Wilkes:
There never had been a mystery about her separate lives. She was a woman of 35, dramatically beautiful and gifted when she was in control of the life urged on her by her doctors, counselors and those who loved her.
There were times when she accepted their wisdom and stayed faithful to the stabilizing prescriptions that were available to her.
When she did she could light up a room with her buoyancy or the deft but harmless satire of her readings, many of which she wrote herself. They didn’t come hard to her, nor did the roles she played in amateur theater, which could easily have blossomed into the professional stage. Her lineage included one America’s pre-eminent theatric families. She could play the piano,strings or reed instruments. She almost certainly could have sold as a painter. She once drew the face of a tiger, first with spare, line sketches that hinted at its strength and then in gripping color that announced the tiger’s maturity, a sequence of images that stopped viewers in their tracks.
But when she would desert the prescriptions, she yielded to the dark and impatient stirrings within her, what medical people today call bipolar disorder and has often been called manic depression. She drifted into a nebulous and chaotic world that would sometimes put her in touch with strange voices and relationships that were pure fantasy.
Her mother, a Minneapolis businesswoman, was her safety net and her hero. But sometimes her mother became her ogre because no one knew her and loved her as much. There were screaming matches in the hospital where her mother took her for care and the medical regimes that would bring her back to the humanity and the safety she regained when she was herself. When she was free of the reckless make-believe, she was a star. She won high grades in her college courses and popularity with fellow workers in an architectural company where her superiors prized her work.
The body of this woman who struggled so long with her torment was found in the Mississippi River In Minneapolis some weeks ago, not far from where she lived alone in her third floor near the Guthrie Theater, where she had friends. She was wearing a bathing suit when she was found and she had been a powerful swimmer, which seemed at odds with a presumption of suicide. So there was no such presumption.
Two weeks later nearly a hundred people who knew her, knew her mother or were related, gathered as witnesses to her life. To her mother’s astonishment they came from as far away as Australia. They came from California, Washington, Arizona and more. If they couldn’t come they called or sent letters, from Florida to France. They spoke and wrote with attitudes that ranged from thanksgiving to hilarity for having been part of her life.
A man from China who had immigrated to America years ago told of meeting her shortly after he had come to Minneapolis, friendless and frankly scared. His tentative efforts to find a community hit a wall. He’d never felt so much an outsider in his life. “She was the first person I met who gave me acceptance,” he said. “We became friends.” It didn’t have to be anything more. “It was a start of a new life for me,” he said. “That was her nature.”
For more than an hour the testimonials streamed from people whose lives had been elevated or altered in some positive and unforgettable way by this young woman who was so often troubled, sometimes absent in an undefined world; but then healthy enough again to answer a call at midnight from somebody who needed nothing more than to talk.
“And she always came,” one of them said.
This was a woman whose lifelong commitment-- at whatever level of health she achieved-- was to the cause of the disadvantaged and the faceless, people ground down and dehumanized by power, whether in Africa, Asia or the America in which she lived.
This was the Katharine they remembered, and their testimony was so strong, warm and earnest that it gave her mother a portrait of her daughter that will outlast the pain.