Monday, February 9th, 2026: Black Range, Hikes, Sawyers, Southwest New Mexico.
My new physical therapist, trying to treat my right knee, gave me a new exercise that instead, triggered pain in my left foot. The left foot condition was diagnosed 9 years ago by my San Francisco foot doctor, a national authority on biomechanics, and the nonsurgical treatment required 18 months of twice daily ultrasound. Since then, I’ve been able to control two or three minor flareups with something called contrast bathing, which is even more inconvenient than the ultrasound.
So for the past two weeks, I’ve been doing both the twice daily contrast bathing for the left foot, and three times daily icing on my right inner ankle bone. But on Sunday morning, getting dressed for another hike, I discovered that as soon as I put my boot on, the ankle bone hurts just as much as before.
I spent another half hour experimenting with padding. Finally, in desperation, I tried attaching one of the “beveled” metatarsal pads I use for the left foot, just below the ankle bone. And miraculously, that worked – apparently it’s the lower edge of the ankle bone that’s suddenly become a pressure point, and the pad holds the boot lining away and absorbs most of the pressure.
Today’s hike would be one that’s been on my list for months – just the right distance and elevation gain. I’ve been avoiding it because the drive is dangerous, the habitat is almost exclusively burn scar, and the last time I tried it I gave up because it was overgrown with thorny locust.
But that was years ago, and I figured by now, it would’ve either been cleared or seen enough traffic to beat back the thorns.
The sky was mostly clear, and the high in town was forecast to reach the mid-60s. So despite the high elevation – this hike climbs a peak, from 8,200 to 9,700 feet – I expected most of the snow we’d had weeks ago to be melted by now, especially in the exposed ground of a burn scar. I carried my gaiters and trekking poles but didn’t expect much trouble.
Sadly, I was wrong. Like many trails in the Southwest, this is routed mostly on north and east slopes to reduce solar heating, and most of the trail was snow-covered, up to 16 inches deep. And making it much worse, someone or something had walked the trail shortly after the last big storm, punching deep holes at intervals longer than my own footsteps. And adding insult to that injury, the snow had then melted and frozen repeatedly. Each step I took would either land on rigid snow, or snow that would compress a few inches, or snow that would collapse a foot or more, and there was no way to anticipate without taking the step. In the process, my foot might sink directly down, or slide forwards, backwards, or sideways, and sometimes end up tilted, throwing me further off balance.
For the first few hundred yards the snow was only a few inches deep and packed by a confusion of tracks, but after that, it was only Bigfoot, with a stride length of a meter – more than a yard. What human can stride like that in deep snow? The only animal out here that approaches that stride is a bull elk, with from two to three feet between tracks – and this was longer than that. What are the chances that an elk would stick to a man-made trail, back and forth across the crest, for three miles? And I saw no elk droppings all day.
I immediately thought about giving up on this hike, but as usual, figured I would just try it and see how far I got. The trail begins in the high pass on the crest of the north-south range, and proceeds for more than a mile in long traverses up a bleak northwest-facing canyon on the west side.
When I reached the crossover to the shadier east side of the crest, the patches of snow became deeper, and I strapped on the gaiters and broke out the trekking poles, hoping they would improve my balance as I lurched across the sometimes frozen, sometimes soft snow between deep holes punched by Bigfoot. The view from the east side – across rocky foothills and the Rio Grande Valley to 12,000 foot Sierra Blanca Peak over a hundred miles away in the Sacramento Mountains – would be spectacular except for the skeletons of pines and firs killed by the 2013 wildfire.
Two-thirds of a mile farther, I reached a saddle which reminded me of previous hikes on this, the southern extension of the crest trail. I’ve hiked over 17 miles of the northern crest, but since the 2013 fire, this southern part has only been cleared for the three miles to the saddle below the peak. Back in 2020, I tried bushwhacking farther south, but only made it a little over a mile, where the old trail disappeared under an obstacle course of blowdown and deadfall.
On that 2020 hike, I encountered four bull elk with huge racks and a group of six mule deer bucks, likewise with nice horns. Then, while bushwhacking to what I thought was the peak, I was caught in a hailstorm with lightning striking all around me. Finally, at this very saddle, I discovered a lost dog, abandoned by its owner, a dog so depressed that even after I offered it food and water and tried to lead it by a nylon strap I carry in my pack, it refused to leave the saddle and I had to leave it behind, presumably to be eaten by a mountain lion.
At the next saddle, the trail crosses to the west side and passes through remnants of intact forest. Even there, patches of snow with holes punched by Bigfoot kept slowing me down. But now, I could glimpse the peak looming hundreds of feet above, so I was no longer likely to give up.
At a saddle just below the peak, the trail crosses to the east side again, but here, Bigfoot continued straight up the steep slope. I’d done that before, there was no way I was going to try it in snow that was now over a foot deep. So I followed what I thought was the trail, beckoned by the tracks of a lone deer. I was halfway across the traverse to the next saddle when I realized the deer had led me off the actual trail, and I would now have to pick my way through deadfall to the back side of the peak, where the slope is gentler.
I finally found myself above the little saddle on the south side of the peak, where I normally start my bushwhack upwards. Although the south slope is gentler, it was burned in the fire and is becoming crisscrossed with more and more deadfall every year as giant pine and fir snags continue to topple.
I started to make my way across it, but every glance upward was more discouraging. I finally stopped and decided to give up on the peak – at least for a few minutes. But how could the masochist in me turn back when my goal was so close?
The horizontal distance is only a few hundred yards. But climbing over or around those huge fallen logs seems to take forever – and just when you think you’re approaching the peak, it turns out only to be an outlying shoulder or false peak.
When I finally saw a bald mound above me, I felt like something was wrong. The peak I’d climbed several times in the past was surrounded by a dead forest of standing snags that blocked its view, whereas this peak was completely clear all around.
I finally realized that what I thought was the peak in the past, was only a false peak a hundred yards east. How could I have made such a mistake, over and over? Anyway, it was nice to have my labors rewarded with a view.
Of course, going the distance meant I’d have to repeat that struggle with snow postholed by Bigfoot on the way down. I kept using the trekking poles, although it was a toss-up whether they helped or hindered, because they had the same problem as my boots – either hitting rigid snow, or sinking part or all the way. And when they sank all the way into the snow, they often snagged and yanked me further off balance. And they constantly got caught in the thorny locust that leaned over most parts of the trail.
My right knee, that had set my hiking back for two years, was finally doing well. And the right ankle that had been so excruciating during recent weeks, was now merely uncomfortable. But as if to compensate, the left foot was getting worse and was now becoming my limiting factor. Contrast bathing had not reduced the inflammation enough – would I have to repeat the ultrasound and give up hiking for another 18 months? Might as well just put me out of my misery.
When I reached the last crossover from east to west, the sun was rapidly setting and it was clear this seven-mile hike would end up taking me a full seven hours, due to the uneven snow. This is one of the worst hikes I could’ve picked at this point in my “recovery”. But as usual, the late-afternoon sun and colors on the landscape were beautiful, and a couple of pain pills helped salvage my attitude.
Wednesday, February 4th, 2026: Arts, Literature.
11/4/21
Waiting in the airport
Outside security
Just waiting
So sad
Lights, colors, shapes
Stillness in front, movement behind
Parallel lines vanishing in perspective
Waiting
So many years
So many airports
Alone
Waiting alone
Thinking of nothing
Thinking of you
Thinking of them
Waiting in airports
Waiting in between
Waiting
Time goes by
Time
So sad
1/11/26
Waiting in the airport
Hours of my life, draining away
Gone forever, why?
Buried in this passageway
False suns overhead
While somewhere
Outside
Sun striding on heaven, oblivious
Strangers hurry, strangers stop
Wheels turning, inside wheels
Air rushing, rushing out
Loud voices from machines
Soft murmurs from strangers
Life’s broken music
Caught in transit
While I wait, buried here
Life’s hours drain away
Lost now, lost forever
Every hour, getting older
1/11/26
I walked through glass
And steel
In buildings so vast
We could not feel
Walls or ceiling
Only a diffuse light falling
Everywhere and nowhere
Crowds milling in noisy bright caverns
Moving stairways, sudden turns
Moving, moving, no place to rest
They used to call them arcades
Glancing past, the walls
Like big screen movies of a living world
Impossible outside
The sun, mountains, towers, wires
Great works these
Ordered by a distant voice
Erected by legions
From trains converging across the desert
Marshaling the gray-haired merchant
The housekeeper in her burka
Boy rapper, skateboard in arm
Workers of the nation
Breeders of the future
I walked with them
Through tunnels of glass and steel
So vast inside they seemed a world
Built only to convey
To channel passage
Forever, endless
As outside, the fires burned
Trees died
Winds blew, ashes spread
Night fell, long rains
Floods rising, snow falling, silence
We walked, we glimpsed it like a movie
Through the distant glass and steel
Night or day, we could not stop
Our lives a journey
Like rats in a maze
Monday, February 2nd, 2026: Hikes, Mogollon Mountains, Southwest New Mexico, Whitewater.
The hosting service for this blog tracks visits, and during the past two weeks, I’ve suddenly been bombarded by visits from Hong Kong and Singapore. Apparently this consists of bots scanning my content for personal data that can be harvested for criminal purposes. I assume this will fade away as they fail to find anything useful. Reminds me of when my dad died and his estate went through probate. The court shared my personal data with criminals who harassed me for up to a year by phone and mail, including a syndicate in China who sent me what appeared to be a legal document by express mail with signature requested.
I do try to omit personal data, but I’ve been liberal with personal feelings lately, so the idea of criminals greedily delving into that is pretty creepy. Let me know if you think I’m a fool and should just shut this thing down completely.
After last week’s excruciating hike, I was finally able to scale back my ambitions for this Sunday. From 9 miles and 3,000 vertical feet before, I was hoping to cover only 7 miles and 1,500 vertical feet. After a week in sneakers, I was hoping the inflammation on my ankle had subsided – I certainly couldn’t feel anything.
At least, I didn’t feel anything until I put my boots on. Then the pain came back just as bad as last Sunday. So my hike started with an hour of searching for some kind of padding – at home, then all over town, because the nearest drug store was closed due to staff shortages.
Armed with a couple of pads, I drove north to the trailhead.
The sky was clear and the expected high in town was in the high 50s. Arriving late at the trailhead, I started trying out my purchases. None of them did anything to reduce the pain. I finally dug a cotton handkerchief/bandanna out of my pack – I carry three, they come in handy for all sorts of hiking issues – folded it into a pad a little over a quarter inch in thickness, and stuck it in my boot. Over that, I laced the boot skipping the hooks nearest my ankle. It didn’t stop the pain but it helped enough to get me going.
This is a shortcut into the biggest canyon through our tallest mountains. It starts by climbing over a ridge then cuts back into a deep side canyon. Traversing from the ridge into the side canyon I spotted an older couple approaching from below. They stepped off to let me past. The man, in front, scowled at me, but his partner smiled as I asked, “How’s it going?”
The man clearly wanted to keep going, but the woman engaged me in a conversation, about my plans and where I was coming from. It turned out they live in the remote river valley, ten minutes away, but visit town often – as all country folks do. We talked about healthcare and elder care, and how the shortage of resources around here are more than compensated for by the quality of life.
Despite my determination to scale back the difficulty of my hikes, this rocky trail has a lot of steep ups and downs. I began using the trekking poles to take some load off the ankle. But after descending into the side canyon, climbing out, and climbing up and down past several dramatic rock formations high above the roaring creek, my ankle had once again reached 8 on the pain scale. I stopped at a flat boulder in the sun, figuring I’d gone less than two miles, but simply couldn’t go any farther. I ate lunch, took a couple pain pills, and waited for my GPS device to send a waypoint to a satellite.
But after resting a while, I figured I might as well make another try at padding and relacing my boot. This reduced the pain to a 6, and I soon reached the switchbacks that descend about 300 vertical feet to the narrow canyon bottom.
Of course, once I reached the cold shade of the canyon bottom, the pain pills took effect, and I was in denial that the trail upcanyon continues to climb steeply around massive boulders and cliffs. So I kept going, as the pain began increasing again despite the pills.
I was surprised by swarms of gnats – I ended up having to wear my headnet all day.
Finally, I reached my planned destination, the junction where a trail up a side canyon crosses the creek. There’s a fallen log where I could sit in the sun and listen to the creek tumbling over the rocks. Crossing the creek would soak my boots and add to my misery, so I rested there for another half hour, and began yet another experiment with my ankle.
This involved wrapping the existing bandanna pad with the Ace bandage I keep in my first aid kit, and trying yet another lacing technique, bypassing all but the top hooks of the boot.
The new lacing significantly reduced the pain, and the pills continued to help too, so that by the time I reached the top of the switchbacks the pain was down to about a 4.
From the top of the switchbacks, with my mind off the pain in my ankle, I could better enjoy the late sunlight on the rock formations all around me, and the balmy weather – I’d hiked in my shirtsleeves all day.
I was finally so relaxed that it wasn’t until I’d gone a half hour past the top of the switchbacks that I realized my ankle pain was completely gone! What had changed? I still didn’t know whether this was soft tissue inflammation or nerve pain, and there was no way to tell whether it had been eliminated by my treatment back at the creek, by the pain pills, or by natural loosening of the boot as I hiked.
Whatever made the pain go away, it sure made it easier to cross that side canyon, and the final ridge before descending to the mesa.
This is a trail I always think of first when I need something short, with less elevation gain, because it’s the most scenic short trail in our region. The beauty of that mesa is hard to convey in a photo – especially because the naked eye picks out the reflections of stock ponds far in the distance below.
However, as soon as I got in the driver’s seat and started working the pedals, my ankle pain came right back. So bizarre, and so frustrating. Now I face weeks of icing both this and my inflamed left foot, which still hasn’t calmed down.
Letters to My Mother, Part 5: What Are We to Do?
Thursday, January 29th, 2026: Letters to My Mother, Problems & Solutions, Society, Stories, Trouble.
Previous: I Tried to Help
Life and Death in Long-Term Care
Beliefs, Plans, and Denial
Our Family
Papaw, my dad’s father
Died quickly, in hospital
Of heart failure
Mamaw, his wife, widowed and living alone
Began hallucinating
Her son flew back and tricked her into a nursing home
Said they were going to the doctor
Aides grabbed her from the car
She died miserable, among strangers
My grandpa, your daddy
Died suddenly at home
Of a massive heart attack
Your mother, my grandma
Voluntarily entered a nursing home
Thrived there, singing, comforting
Cheering the other residents
My dad, your first husband
Found freelance home helpers by word of mouth
Paid them minimum wage
Lived at home, managing his own affairs
Until he died during a final trip to the ER
You never made plans for the end of your life
Refused to talk about it
Said you would never leave your home
Would rely on home help when the time came
I believed you irresponsible, living in denial
Until I realized that in the culture of our ancestors
Traditions in family and community
Provided for the end of life
Individuals were not forced to figure it out for themselves
My Friends
In our society, you were at one end of the spectrum
Some of my friends are at the other
Always worried about the future
They devote time and energy to planning for their end
One friend worries about dementia
Worked to create legal provisions for assisted suicide
If he begins to lose his mind
But as we found
Mental illness can defy science
Losing your mind
You could still think and remember
You were afraid to die
And you fought for your life, even while unconscious
What would the law say about that?
Is it really possible to plan for losing your mind?
Other friends prepare for the end of life
By buying long-term care insurance
Implicitly planning to spend their final days in facilities
Like the ones that failed us
Some voluntarily move into “retirement communities”
When they get tired of maintaining their homes
Long before they actually need home care
They like the idea of having care
Available onsite when they need it
With visions of daily golf or bridge
They don’t mind being sequestered among other old people
Isolated from community, families, and youth
Having spent two years
Seeking and working with the kind of care
Many people expect to be available
I believe we’re all in denial
With healthcare and elder care commodities
In our statist, capitalist, bureaucratic society
The kind of care many expect simply doesn’t exist
And often, we are forced into situations
We never could have planned for
Hospitalized with a sudden, unexpected crisis
Suddenly ending up in permanent long-term care
My End
As someone whose quality of life
Depends on hiking and making music, art, and stories
I want my life to end
When I can no longer do those things
I want my life to end
Before I become dependent on the care of others
The rural Irish lived in homes
That included apartments for their elders
When the elders were too old to tend the farm
They moved out of the main house
And became advisors to the young
Traditional societies around the world
Facing limited resources
Condoned suicide by elders
Who could no longer care for themselves
Stories of grandparents jumping or thrown off cliffs
Abandoned on ice floes
Trudging off alone in winter
In our colonial culture
Suicide is such a deep and strong taboo
Science is discouraged from studying these practices
And with our deep puritanical bias
We outlaw voluntary drug overdoses
When friends ask
I tell them when the time comes
I’ll just walk out into the wilderness
But what if it’s too late
And I can no longer get there on my own?
Healthcare Realities
Doctors and Hospitals
Your primary care doctor retired
Just before your final crisis began
Her office made no attempt
To find you a replacement
Our loved ones’ decline often begins in a crisis
Where they end up in the ER
The emergency department of a hospital
The goal of the ER is to rush a diagnosis,
Treatment, and discharge
Frequently, they’re wrong
A loved one must be onsite
To ensure you’re adequately examined
Safely discharged to a place with adequate care
Receiving timely follow-up with a physician
If a patient is in danger of dying
Staff will ask
Do you want us to save you?
This is called Full Code
Involving CPR, intubation, defibrillation
Breaking ribs, puncturing lungs
Risking severe disabilities
If the patient is hard of hearing or confused
By strangers and an unfamiliar environment
They will typically agree
This decision is impossible for family to change
Doctors agree it’s wrong, but that’s the system
If the patient is unable to make a decision
The nurse on hand calls and wakes up next of kin
In the middle of the night, demanding an immediate decision
When your condition is critical
But you need more than a few hours
Of testing and treatment
They admit you to Med Surg
It’s a catch-all unit
Where your case is supervised by a hospitalist
Coordinating a team of specialists
But not all hospitals have all the relevant specialties
And in our colonial society’s reductive paradigm
Specialists have no interest in
Or knowledge of other specialties
They regularly claim authority
And make false conclusions, even let patients die
Based on ignorance
And a narrow perspective
If the issue is behavioral or mental
A hospital psychiatric unit should be the last resort
These units are designed like prisons
To restrain and prevent violent behavior
Because you had no PCP during your crisis
When you were discharged from hospital
There was no follow-up
No confirmation that diagnosis was correct
No confirmation that treatment was successful
Money and Care
Some people will assume that our problems
Resulted from limited and substandard healthcare
In our hometowns
The capital of a notorious red state, and a remote rural town
Many people assume the best healthcare can be found
In affluent enclaves in New York, Boston, the Bay Area, Los Angeles
Minneapolis or Phoenix, with their Mayo Clinics
But the real picture is much more complicated
Yes, I had to fly to Seattle for specialized hip surgery
And to San Francisco for nonsurgical foot treatment
I could afford that, even in my low-income bracket
So there was no need to live in those places
Critical patients in small towns are always referred to cities
For specialist treatment not available locally
But you had an excellent heart surgeon in your Midwestern city
And our small-town psychiatrist was likewise exceptional
Home Care Realities
With few exceptions, our homes and our parents’ homes
Are not designed to be accessible
And most could not be adapted for parents with mobility issues
Parents who need outside caregivers
Requiring their own space and facilities in the home
Our ancestors cared for their parents at home
The architecture and skills handed down by tradition
I yearned to restore that tradition
But dreaded the need when I saw it coming
Our society fails to train us to be caregivers
Like everything else, caregiving is commodified
With low pay, high burnout and turnover
Home care agencies abound in every community
But unless you can prove low income and assets
Qualifying for Medicaid
Private pay is your only option
$30-40 per hour
My dad found freelance home help by word of mouth
Most of them were adequate
For you and your disabled son, I hired an agency
Most caregivers, supposedly trained
Were hopeless and had to be replaced
Nearing the end, when you needed 24/7 monitoring
An agency promised that home care was an option
We agreed on 8 hours per day
With me taking care of you during the remaining 16 hours
But at the last minute
Discovered caregivers are unavailable overnight
On weekends or holidays
So when could I sleep, or take a break?
Forget about overnight trips or vacations
Care Home Realities
Types and Differences
Depending on our degree of independence and need for care
Our colonial, statist, capitalist, bureaucratic society
Offers a spectrum of facilities
As service commodities we can purchase or qualify for
Depending on our financial status
These facilities are most often designed
To offer a continuum of care
In which we can progress from more independence
To more care, as we decline
And most are owned or franchised
By national or regional corporations
Those who actually prefer to age among their peers
Sequestered from the rest of society
Can move to a facility with private homes, duplexes
Or apartments where “seniors” can live
As independently as they please
These are called retirement communities,
Senior living, independent living, etc.
Both my parents experienced health crises
After which they were discharged to a short-term rehab facility
Intended to prepare them to return home
Rehab is basically a skilled nursing facility
A short-term nursing home, part of the continuum of care
So that when a patient fails rehab, they can move directly
Into long-term care
And short-term rehab is covered by Medicare
Assisted living refers to an apartment complex
Where residents can live independently
With onsite access to as much care as they may need
Assisted living facilities may stand alone
Or may be part of a continuum of care
For qualified low-income residents,
Room and board are covered by Medicaid
In the facilities I reviewed
Private pay can range from $3,000 to $9,000 per month
Large corporate facilities at the low end
Small privately-owned facilities at the high end
Memory care refers to long-term residential care
Primarily for those diagnosed with dementia
But as your case showed, they may accept
Anyone struggling with behavioral issues
These are secure units
Typically requiring a keypad code for entry
They may be designed more as homes
Or more as skilled nursing facilities
In any case, memory care facilities may stand alone
Or may be a unit within a larger continuing care facility
Again, Medicaid pays for room and board
And private pay ranges from $10,000 monthly
Those who need help with medications
And activities of daily life (ADLs) in general
Such as dressing, toileting, hygiene, and feeding
Typically end up in long-term care
A skilled nursing facility
Traditionally known as a nursing home
With rooms like in a hospital
Shared or private
For those unqualified for Medicaid
Private pay ranges from $10,000 per month
The larger urban facilities we encountered
Encompassed all types in one building:
Short-term rehab, assisted living apartments,
Memory care and long-term skilled nursing units
Finding a Facility
Image Versus Reality
National magazines with retired subscribers
Have always been full of ads
For supposedly elite elder care facilities
Mostly in the East
My Stanford alumni magazine has glossy full-page ads
For “senior living communities” in affluent enclaves
Like Carmel Valley
But the places with big advertising budgets
Are the places that are not good enough
To survive on word-of-mouth
That’s the way advertising works
And even if we got our parents into one of those places
We wouldn’t be able to visit them regularly
Some believe that more money
Will get you better care
That’s how we’re indoctrinated
In a capitalist economy
But that’s not what I found
The best places I found are the smallest and hardest to get into
They may or may not be the most expensive
But because they’re small
The elite homes
Soon become confining, claustrophic
I suspect the really rich
Are able to offer incentives and accommodations
For paid, live-in caregivers at home
I’ve driven past, and been referred to
Huge facilities with hundreds of apartments or rooms
Landscaped grounds, vegetable gardens
Bistros, pools, theaters
I would never place a loved one there
The best places I found in Indianapolis and Tucson
Were private homes staffed by the owners
And small, locally-owned facilities
Designed around family-centric models
But all those had waiting lists
And because you weren’t able to plan ahead
Our needs were urgent
We had to settle for places with immediate openings
Our Experience
In your metro area of Indianapolis
With a population of nearly a million
An online search returns about 20 elder care homes
The search for Carmel, the affluent northern suburb
Returns an additional 15
There will be lower numbers for suburbs
To east, west, and south
Hence, for a big city
Dozens of options within weekly driving distance
But due to uneven property values
Typically located far from our homes and workplaces
Most of these follow the “continuing care” model
With units for rehab, assisted living, memory care
And long-term skilled nursing
Like most – maybe all large cities
Indianapolis has placement agents for elder care
An agency I worked with has “scouts” for each part of the city
But they only provide placement at large corporate chains
Tucson, with the same population as Indianapolis
Has an agent that will identify and show you
Options to meet your specific needs
At a broad range of facilities
From corporate chains to private homes
Overwhelmed by choices
And the unreliability of online ratings
I followed personal recommendations
From people I trusted
But was disappointed anyway
Life and Death in Long-Term Care
Management
All the management I dealt with
At every facility
Showed two faces
Friendly and caring at first
Then, if family takes a close interest in their loved one’s care
Management reacts to suggestions defensively
Reacts to issues offensively
Blames resident or family
Before considering their own responsibility
They all exhibited a top-down culture
In which management behavior
Was imitated by staff
Dishonesty, manipulation, and retaliation were common
Management always spoke with authority
Of residents’ conditions and mood
When they never spent time alone with residents
Never engaged residents in substantive conversations
They get away with all this
Because it’s a seller’s market
They have waiting lists
Can reject you and move on
Family Relations
Again and again, I’ve heard from friends
About what a wonderful home they found
For their parent
And over and over, in care facilities
I’ve met residents who are lonely and bitter
Because their loved ones abandoned them there
And seldom if ever visit
I did meet a few – less than ten percent
Who say they’re content
In my grandparents’ generation
If elders went into a care facility
Their children and grandchildren
Lived only a few blocks away
Visited after work or school
In our highly mobile society
Where families are dispersed across continents
Sometimes across oceans
Children are used to going months
Without seeing their parents
Most care facilities are designed to replace the family
Encourage residents to trust staff
Attempt to foster community among residents
Why do families accept that?
Because most families have no room for elders
They have careers, children of their own
Or want to enjoy their retirement
Visit their loved ones only at their convenience
In our blind worship of progress
We’ve abandoned native traditions
Elders no longer accumulate stories and wisdom
That could help us and keep them engaged
Different facilities have different policies
Some allow visits 24/7
Some provide meals for visitors
A few may even have overnight accommodations
Many facilities, designed for staff convenience
Create barriers against both visits and outings
Long walks from parking
Long interior hallways
A series of locked doors or gates
Some requiring staff to open
Others, like your final home
Only allow visits during limited hours
Don’t allow family to share meals
Conditions
Facilities are typically designed and managed
For staff convenience first
Resident comfort second
At the time in your life
When you’re least resilient, least adaptable
These facilities force you into a schedule
For their own convenience
Confusing you, making you feel helpless
The hearts of these facilities are the nurse’s stations
And the dining rooms
Once you’re identified as a fall risk
Fearing liability, institutions will confine you to bed
Limit your mobility to a wheelchair
May even confine you to the nurse’s station
Sleeping all day, slumped in your wheelchair
The hearing impaired
Can’t communicate adequately with staff
So their health conditions
Are never fully known or treated
And they’re frustrated in group activities and events
Many facilities advertise chef-cooked meals
Made from healthy, fresh, even local ingredients
But even at the highest-rated facilities
This is often merely marketing hype
The only way to tell is to visit at mealtime
Day in and day out
Who can do that?
Even the best facilities lack the ability
To offer personalized food
On a personalized schedule
Dysphagia (difficulty swallowing)
And aspiration (accidentally inhaling while drinking or eating)
Are common among elders
We can easily train ourselves
To eat and drink safely
But with the liability of choking
Institutions force residents onto a pureed diet
Where, unable to recognize their food
They lose weight and weaken
You literally starved to death
Because your home could not give you
What you liked, when you needed it
Many homes have no way
For residents to call for help
Even with call buttons
With 8-12 residents per aide
It can take up to 45 minutes
For a resident to get help
Lying in a soiled bed
If you yell, staff get angry
Or make fun of you
Good staff are hard to find
With high burnout and turnover
Some are good at what they do, and care
Many of them are studying, for higher pay
And will move on soon
Most are just burnt out, collecting a paycheck
What they call activities and entertainment
Are designed for the lowest common denominator
Bingo, juvenile cliches, celebrities
Insecure, embarrassing volunteers
I always found wonderful people
Both staff and volunteers
Who deserve endless praise for showing up
Giving their heart, soul, and time
But they were in the minority
Hospice
When you are admitted to hospice
You fall under the care of a doctor you will never see
Their primary function to prescribe medications
At the request of a nurse
Who visits you weekly
Under Medicare rules
You’re ineligible for most therapies, treatments
Or visits to doctors
You can still get them on a private pay basis
For us, the result was that I became your doctor
I saw you the most, spent the most time with you
Since I was the only one you trusted
I had the most accurate experience of your symptoms
I studied and requested your medications
If I hadn’t been available
Symptoms would’ve been missed
Your care would’ve suffered
Our big-city hospice provider was wonderful
Professional help available 24/7
On call nurse within 30 minutes
Social worker helped find resources, completed paperwork
Small-town hospice had limited staff
Completely lacking some functions
No help in a crisis
Their social worker a disaster
We loved your hospice nurses
And some of your hospice aides
Who came to bathe you two or three times a week
Provide personal care as needed
Hospice promises to provide comfort at the end of life
I discovered that was a lie
Not even morphine could relieve your suffering
In the final days
Closing the Cycle
The colonial tradition brought by our English founders
And still observed in conservative families
Is to preserve the body by chemical embalming
Hold an open casket funeral for viewing by the community
Followed by underground burial officiated by a pastor
With the goal of protecting the physical body
From returning to its natural elements
Indigenous societies worldwide
Implemented a variety of practices
Ranging from burial to abandonment and cremation
Our bodies came from the earth
Evolving and rebuilding constantly
From the resources we ingest
Ultimately originating in nature
Clouds, rocks, rivers, soils, plants, animals
Burial and cremation, while practical in some habitats
Deny nature the resources she gifted us
This is recognized today in colonial society
By a tiny minority in the natural burial movement
You asked for cremation
I planned to honor your wishes
But when the time came I was unprepared
Had no idea what would happen
I had to choose a funeral home
The funeral director came, I had to leave
They took your body away
Put you in cold storage, as found
I had to get permission from the state
To have you cremated
I waited all week
Wanting to be with you
I vaguely knew that in our ancestral tradition
Family and others from the church
Washed, dressed, and casketed the body for burial
I had no idea what would happen to your body
Wanted to be a part of that
But had never been trained
It turned out that you would just be conveyed from storage
Into the chamber, for incineration
By strangers
Burning and cooling would take hours
I thought of waiting outside
But it’s a big building
There would be nothing to see
In the end, I received your ashes
In a plastic bag
Inside a plastic box
Human Nature
An institution is only as good as its people
What happens to the people
When society itself is dysfunctional
And its institutions are failing?
The villains of your story
The corrupt police and prosecutor
Your troubled second husband and his insecure daughter
The arrogant, ignorant doctors and facility managers
The cruel and thoughtless aides
They all hurt us
In some cases terribly
In some cases repeatedly, over time
But we understood them, you and I
None of them is all bad
Like you said, most of them were two-faced
Sometimes kind, sometimes cruel
Insecure, damaged people
Taking out their own fears on the weak, the helpless
Their jobs some of the most difficult
Shouldn’t be jobs in the first place
Should be traditional roles in a healthy community
Not careers in an economy
What Are We to Do?
Our statist, capitalist model
For elder care as a commodity
The result of what we believe
To be generations of “progress”
Works no better than our other institutions
The only healthy way to care for elders
Is within healthy families
Within healthy communities
Which our society fails to create or cultivate
Which our “progress” actively destroys
Via technologies of mobility and long-distance communication
What we are left with is institutional care
Subsidized by the state at generally low standards
Or purchased by us at from $36,000 to $144,000 per year
Depending on the level of care we need
A decade ago
I fought your husband’s estate
For a settlement that would keep you secure
But there was no way I could predict
Your ultimate needs
During your last year
When you were nearing the highest level of care
Not knowing how long you would last
I worried about running out of money
I assumed that if you had a prognosis of a few weeks
And if I could find home help
We could afford to keep you at home
But in the end, home help was only available
During regular business hours
Leaving me on duty overnight and all weekend
I assumed that if you had a prognosis of a few years
We could afford to keep you in a care facility
But science can’t provide a prognosis that accurate
I believe that as families
The closest we can come
To a healthy traditional model for aging and dying
Is to provide lodgings for our elders in our homes
And when they need care, to enlist family
And community, providing care in the home
But since technology disperses our families
And capitalism leaves us burnt out
And isolated, on a fixed income
When our elders need care
This model is only available
To the very wealthy
Based on our experience
The second best model is emerging
In large metro areas
Families who convert their homes
Into private elder care facilities
With typically 4 to 6 bedrooms
These facilities are in great demand
And typically have long waiting lists
Sometimes years
Hence they’re not options we can rely on
Because who can plan
When their elders will need help?
For those of you who worry about the future
What’s your plan for civil war?
What’s your plan for economic collapse?
Science could not explain or treat your suffering
Drugs could not relieve it
Care homes could not provide loving care
Hospice could not comfort you at the end
Society does not allow our bodies to return to nature
What are we do to?
Monday, January 26th, 2026: Hikes, Holt, Mogollon Mountains, Southwest New Mexico.
I’d spent September through November rebuilding my hiking capacity. By December I felt like I was on a path to recovery, but life spun out of my control. I went from 8-9 hikes per month, to only 5 hikes in the past two months.
Still, my brain was stuck in recovery mode, so even with 2-3 weeks of down time between them, every hike had to be more challenging than the last, leaving me in lots of unnecessary pain. Before this latest hike, I even wrote a big note to myself: Take it Easy! But we’d had a two-day storm, and in the end, the only hike that appealed to me was one that would get me up into some snow. It was an old favorite hike I’ve done many times, and this would be the first time since my knee injury that I would try to reach the first milestone – a spring just below the 9,500 foot crest.
Under clear skies, the air temperature in the shade was in the 20s as I began the traverse into the canyon. In a sunny spot where the dirt of the trail had melted, I came upon the bootprints of a lone hiker – probably a man – who had gone out and back yesterday.
Expecting snow, I was wearing my winter boots for the first time in almost two years, and after entering the wilderness area in the first half mile, the stiff boots had triggered a pressure point on the inside of my right ankle, and it felt like someone was driving a nail into the joint.
Three options: (1) dose myself with pain meds, which I hate to do this early in the day, (2) stop, take off my boot, roll back my socks and thermal bottoms, dig the adhesive-backed felt out of my backpack and cut a piece to fit around the hurt area, or (3) keep going and hope it would get better. (Actually, a 4th option would be alternate lacing, but I’m not thinking too well these days.)
I chose option 3, and instead of it getting better, I just decided to put up with it, every step hurting equally for the next 4-1/2 miles.
It’s about a mile to the canyon bottom. From there, the trail up the creek bank is easy for another mile, but after that, the grade up the canyon increases steadily for another mile, to the base of switchbacks that climb to the crest.
And I discovered that, probably because I’d had so many inactive intervals between hikes recently, I’d lost much of my cardio conditioning. Any grade at all – even less than 5 percent – immediately left me out of breath. The farthest I could go without stopping was about 100 feet. How could I possibly make it up those increasingly steep switchbacks?
One thing that kept me motivated was the gaps in the forest opened up by drought-induced tree mortality, providing better views of the rock formations on the slopes above. And at one point I got a glimpse of snow-laden trees on the crest. They were two thousand feet above me – at this rate, and in this much pain, how would I ever make it?
I couldn’t remember ever having to stop so often, but every time, after long minutes of regaining my breath, I continued for another 50-100 feet. I expected deeper snow in shady spots ahead, and my pant legs were already getting soaked from creek crossings, so in the first bare spot I pulled out and strapped on my gaiters.
In shady spots where the snow was deepest, I found the other hiker’s deep tracks overlaid with an inch or so of overnight snow. I knew if I could make it past the lower steep part of the switchbacks, I would have a much easier time on the long stretches traversing the upper slopes of this side canyon. Holding that thought, I finally reached the overlook, on an outlying shoulder at 8,400 feet. This is always an inspiring moment, because you actually look down on the mountain that was looming above you while you were ascending the canyon bottom.
I’d made it most of the way to the crest – but the steepest climb was still ahead of me. As before, I just doggedly continued in very short stages. The steep part faces west and was mostly snow-free. And I eventually made it, to the higher shoulder with a little rock outcrop which is where I stopped the first time I hiked this trail, seven years ago.
Past that outcrop, the trail turns back into shade and gets steeper – hence it held snow, mostly about 4 inches deep. I hadn’t planned to go any farther. But the sight of untracked snow ahead – the other hiker had stopped either at the overlook below, or here at the little outcrop – tantalized me. I believed I had plenty of time, and it’s only another quarter mile to the spring.
What I’d forgotten is that this stretch of the trail crosses two deep gullies on a steep, shady slope where snow drifts two or three times as deep. The first drift completely obliterated the trail. If I lost my balance or slipped crossing that drift, I would slide 60 feet down a 45 degree slope before hitting a log.
But I’d brought trekking poles, and I figured I would just cross the drift a step at a time, taking short steps and kicking a foothold in the drift before the next step. With that, and the poles for balance, it took me about fifteen minutes to traverse 50 feet – but it worked.
Despite the constant ankle pain, the safe crossing and a view of snow-frosted trees above elevated my mood. I was going to make it to the spring after all! I would definitely dose myself with pain meds here, and hopefully have less pain on the descent.
What a magical place! There’s a small ledge below the spring where someone had apparently built a cabin a hundred or more years ago – hauling tools and supplies on muleback, cutting native timber. Now all that’s left is the spring and the ledge. I’ve drunk from this spring many times – delicious – but there’s no trail and the slope is too steep to climb in snow. So I just dosed and started back down, trying to keep as much weight off my ankle as possible with the trekking poles.
On the way up, the pain in my ankle had distracted me from discomfort in my left foot, where I have chronic inflammation that was triggered a few weeks ago. I clearly hadn’t recovered, because on the way down I found myself shifting weight to the outside of that foot. And with weight shifted to the outside of both feet, I soon had sharp pain in the outside of both knees. Of course my right shoulder was in constant pain from the long-standing rotator cuff tear, so the 4-1/2 mile descent was an increasing ordeal.
I reached the bottom of the switchbacks, where it was getting very dark. And halfway from there to the trail junction, I suddenly developed cramps in the inside of both thighs. I literally screamed and fell over on the ground, jerking around in excruciating pain, and couldn’t find a position that relieved the cramps. That nightmare went on for about ten minutes.
After the cramps faded away, the ankle and knee pain became bearable! I made it up the final climb out of the canyon just as the sun was setting behind the range in the west. Sitting in the vehicle, I actually felt free of pain for the first time all day. It had taken me 8 hours to go 9 miles out-and-back.
But at home, the minute I tried carrying my gear up the stairs to my back porch, all that knee and ankle pain came back, worse than ever. Even my shoulder was screaming. So I took another dose of meds, and spent the night waking over and over, never able to find a comfortable position. When will I ever learn?
