Senate Leaders Racing to Beat Fiscal Deadline





WASHINGTON — Senate leaders and their aides spent Saturday searching for a formula to extend tax cuts for most Americans that could win bipartisan support in the Senate and final approval in the fractious House by the new year, hoping to prevent large tax increases and budget cuts that could threaten the fragile economy.




As part of the last-minute negotiations, the lawmakers were haggling over unemployment benefits, cuts in Medicare payments to doctors, taxes on large inheritances and how to limit the impact of the alternative minimum tax, a parallel income tax system that is intended to ensure the rich pay a fair share but that is increasingly encroaching on the middle class.


President Obama said that if talks between the Senate leaders broke down, he wanted the Senate to schedule an up-or-down vote on a narrower measure that would extend only the middle-class tax breaks and unemployment benefits. The Senate majority leader, Harry Reid of Nevada, said he would schedule such a vote on Monday absent a deal.


If Congress is unable to act before the new year, Washington will effectively usher in a series of automatic tax increases and a program of drastic spending cuts that economists say could pitch the country back into recession.


The president and lawmakers put those spending cuts in place this year as draconian incentives that would force them to confront the nation’s growing debt. Now, lawmakers are trying to keep them from happening, though it seemed most likely on Saturday that the cuts, known as sequestration, would be left for the next Congress, to be sworn in this week.


“We just can’t afford a politically self-inflicted wound to our economy,” Mr. Obama said Saturday in his weekly address. “The housing market is healing, but that could stall if folks are seeing smaller paychecks. The unemployment rate is the lowest it’s been since 2008, but already families and businesses are starting to hold back because of the dysfunction they see in Washington.”


The fear of another painful economic slowdown appears to have accelerated deal-making on Capitol Hill with just 48 hours left before the so-called fiscal cliff arrives. Weeks of public sniping between Mr. Reid, the Democratic leader, and Senator Mitch McConnell of Kentucky, the Republican leader, ebbed on Friday evening with pledges of cooperation and optimism from both.


On Saturday, though, that sentiment was put to the test as 98 senators waited for word whether their leaders had come up with a proposal that might pass muster with members of both parties. The first votes in the Senate, if needed, are scheduled for Sunday afternoon.


“It’s a little like playing Russian roulette with the economy,” said Senator Mark Warner, Democrat of Virginia. “The consequences could be enormous.”


Members of Congress were mostly absent from the Capitol on Saturday, after two days of Senate votes on other matters and a day before both chambers were to reconvene. However, senior aides were working on proposals in their offices or at their homes.


Speaker John A. Boehner stopped by the Capitol briefly to see his chief of staff on Saturday afternoon. Mr. McConnell spent much of the day in his office.


Aides to Mr. Reid were expecting to receive offers from Mr. McConnell’s staff, but no progress was reported by midday. Even if the talks took a positive turn, Senate aides said, no announcement was expected before the leaders briefed their caucuses on Sunday.


The chief sticking point among lawmakers and the president continued to be how to set tax rates for the next decade and beyond. With the Bush-era tax cuts expiring, Mr. Obama and Democrats have said they want tax rates to rise on income over $250,000 a year, while Republicans want a higher threshold, perhaps at $400,000.


Democrats and Republicans are also divided on the tax on inherited estates, which currently hits inheritances over $5 million at 35 percent. On Jan. 1, it is scheduled to rise to 55 percent beginning with inheritances exceeding $1 million.


The political drama in Washington over the weekend was given greater urgency by the fear that the economic gains of the past two years could be lost if no deal is reached.


Some of the consequences of Congressional inaction would be felt almost at once on Tuesday, in employee paychecks, doctors’ offices and financial markets. Analysts said the effect would be cumulative, building over time.


An early barometer would probably be the financial markets, where skittish investors, as they have during previous Congressional cliffhangers, could send the stock market lower on fears of another prolonged period of economic distress.


In 2011, the political battles over whether to raise the nation’s borrowing limit prompted Standard & Poor’s to downgrade its rating of American debt, suggesting a higher risk of default. The Dow Jones industrial average fell 635 points in a volatile day of trading after the downgrade.


This month, traders have again nervously watched the political maneuvering in Washington, and the markets have jumped or dropped at tidbits of news from the negotiations. Two weeks ago, Ben S. Bernanke, the chairman of the Federal Reserve Board, predicted that if lawmakers failed to reach a deal, “the economy will, I think, go off the cliff.”


Immediately — regardless of whether a deal is reached — every working American’s taxes will go up because neither party is fighting to extend a Social Security payroll tax cut that has been in place for two years.


Robert Pear and Jennifer Steinhauer contributed reporting.



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Army Corps of Engineers clear-cuts lush habitat in Valley









An area that just a week ago was lush habitat on the Sepulveda Basin's wild side, home to one of the most diverse bird populations in Southern California, has been reduced to dirt and broken limbs — by the U.S. Army Corps of Engineers.


Audubon Society members stumbled upon the barren landscape last weekend during their annual Christmas bird count. Now, they are calling for an investigation into the loss of about 43 acres of cottonwood and willow groves, undergrowth and marshes that had maintained a rich inventory of mammals, reptiles and 250 species of birds.


Much of the area's vegetation had been planted in the 1980s, part of an Army Corps project that turned that portion of the Los Angeles River flood plain into a designated wildlife preserve.





Tramping through the mud Friday, botanist Ellen Zunino — who was among hundreds of volunteers who planted willows, coyote brush, mule fat and elderberry trees in the area — was engulfed by anger, sadness and disbelief.


"I'm heartbroken. I was so proud of our work," the 66-year-old said, taking a deep breath. "I don't see any of the usual signs of preparation for a job like this, such as marked trees or colored flags," Zunino added. "It seems haphazard and mean-spirited, almost as though someone was taking revenge on the habitat."


In 2010, the preserve had been reclassified as a "vegetation management area" — with a new five-year mission of replacing trees and shrubs with native grasses to improve access for Army Corps staffers, increase public safety and discourage crime in an area plagued by sex-for-drugs encampments.


The Army Corps declared that an environmental impact report on the effort was not necessary because it would not significantly disturb wildlife and habitat.


By Friday, however, nearly all of the vegetation — native and non-native — had been removed. Decomposed granite trails, signs, stone structures and other improvements bought and installed with public money had been plowed under.


In an interview, Army Corps Deputy District Cmdr. Alexander Deraney acknowledged that "somehow, we did not clearly communicate" to environmentalists and community groups the revised plan for the area 17 miles northwest of downtown Los Angeles. He added that the corps would "make the process more transparent in the future."


But Kris Ohlenkamp, conservation chairman of the San Fernando Valley Audubon Society, asserted that the corps had misrepresented its intent all along.


Walking Friday through what once had been a migratory stop for some of the rarest birds in the state — scissor-tailed flycatchers, yellow-billed cuckoos, least Bell's vireos, rose-breasted grosbeaks — Ohlenkamp said: "We knew that the corps had a new vision for this area, but we never thought it would ever come to this."


Frequent catastrophic floods prompted civic leaders in the 1930s to transform the river into a flood-control channel. Nearly the entire 51-mile river bottom was sheathed in concrete, except in a few spots such as the Sepulveda Basin.


Over the decades, awareness of the river's recreational potential grew. And with pressure from environmental groups, Los Angeles County and corps officials in the 1980s made major changes. The waterway and surrounding flood plain were slowly transformed into a greenbelt of parks, trees and bike paths, courtesy of bond measures approved by voters.


Then in 2010, the Environmental Protection Agency deemed the entire river to be navigable and therefore subject to protections under of the Clean Water Act.


A year ago, Army Corps of Engineers District Cmdr. Col. Mark Toy issued a license allowing the Los Angeles Conservation Corps to operate a paddle-boat program in the Sepulveda Basin, along a 1.5-mile stretch of river shaded by trees teeming with herons, egrets and cormorants.


This summer, paying customers will disembark a hundred yards from the corps' recent clear-cuts.


"Environmental stewardship is critical for us," Deraney said. "But assuring public safety and access to infrastructure designed to deal with flooding are paramount."


As he spoke, a Cooper's hawk swooped down and landed on a nearby tree stump.


louis.sahagun@latimes.com





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Ambitious Tome Chronicles the Rise of a New Urbanist Community











All images: Dhiru Thadani




Joseph Flaherty writes about design, DIY, and the intersection of physical and digital products. He designs award-winning medical devices and apps for smartphones at AgaMatrix, including the first FDA-cleared medical device that connects to the iPhone.

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Follow @josephflaherty on Twitter.



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Stahl arrested for investigation of lewd conduct






LOS ANGELES (AP) — Los Angeles police say actor Nick Stahl has been arrested for investigation of lewd conduct.


The 33-year-old “Terminator 3″ star was arrested about 8 p.m. Thursday on Hollywood Boulevard. He was booked on a misdemeanor count of lewd conduct and released from custody.






The Los Angeles Times reports (http://lat.ms/YU6uBO) that Stahl was arrested at an adult movie shop during a routine undercover police operation.


In May, Stahl had been reported missing by his wife, but he later turned up.


Stahl was a child star who performed in the 1993 film “The Man Without a Face.” He also has appeared in the 2003-2005 HBO series “Carnivale’” and starred in “Mirrors 2″ in 2010. An email seeking comment from his publicist was not immediately returned Friday.


___


Information from: Los Angeles Times, http://www.latimes.com


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Memphis Aims to Be a Friendlier Place for Cyclists


Lance Murphey for The New York Times


The Shelby Farms Greenline, which replaced a Memphis rail line.







MEMPHIS — John Jordan, a 64-year-old condo appraiser here, has been pedaling his cruiser bicycle around town nearly every day, tooling about at lunchtime or zipping to downtown appointments.




“It’s my cholesterol-lowering device,” said Mr. Jordan, clad in a leather vest and wearing a bright white beard. “The problem is, the city needs to educate motorists to not run over” the bicyclists.


Bike-friendly behavior has never come naturally to Memphis, which has long been among the country’s most perilous places for cyclists. In recent years, though, riders have taken to the streets like never before, spurred by a mayor who has worked to change the way residents think about commuting.


Mayor A. C. Wharton Jr., elected in 2009, assumed office a year after Bicycling magazine named Memphis one of the worst cities in America for cyclists, not the first time the city had received such a biking dishonor. But Mr. Wharton spied an opportunity.


In 2008, Memphis had a mile and a half of bike lanes. There are now about 50 miles of dedicated lanes, and about 160 miles when trails and shared roads are included. The bulk of the nearly $1 million investment came from stimulus money and other federal sources, and Shelby County, which includes Memphis, was recently awarded an additional $4.7 million for bike projects.


In June, federal officials awarded Memphis $15 million to turn part of the steel truss Harahan Bridge, which spans the Mississippi River, into a bike and pedestrian crossing. Scheduled to open in about two years, the $30 million project will link downtown Memphis with West Memphis, Ark.


“We need to make biking part of our DNA,” Mr. Wharton said. “I’m trying to build a city for the people who will be running it 5, 10, 15 years from now. And in a region known to some for rigid thinking, the receptivity has been remarkable.”


City planners are using bike lanes as an economic development tool, setting the stage for new stores and enhanced urban vibrancy, said Kyle Wagenschutz, the city’s bike-pedestrian coordinator, a position the mayor created.


“The cycling advocates have been vocal the past 10 years, but nothing ever happened,” Mr. Wagenschutz said. “It took a change of political will to catalyze the movement.”


Memphis, with a population of 650,000, is often cited among the unhealthiest, most crime-ridden and most auto-centric cities in the country. Investments in bicycling are being viewed here as a way to promote healthy habits, community bonds and greater environmental stewardship.


But as city leaders struggle with a sprawling landscape — Memphis covers about the same amount of land as Dallas, yet has half the population — their persistence has run up against another bedeviling factor: merchants and others who are disgruntled about the lanes.


A clash between merchants and bike advocates flared last year after the mayor announced new bike lanes on Madison Avenue, a commercial artery, that would remove two traffic lanes. Many merchants, like Eric Vernon, who runs the Bar-B-Q Shop, feared that removing car lanes would hurt businesses and cause parking confusion. Mr. Vernon said that sales had not fallen significantly since the bike lanes were installed, but that he thought merchants were left out of the process.


On McLean Boulevard, a narrow residential strip where roadside parking was replaced by bike paths, homeowners cried foul. The city reached a compromise with residents in which parking was outlawed during the day but permitted at night, when fewer cyclists were out. Mr. Wagenschutz called the nocturnal arrangement a “Cinderella lane.”


Some residents, however, were not mollified. “I’m not against bike lanes, but we’re isolated because there’s no place to park,” said Carey Potter, 53, a longtime resident who started a petition to reinstate full-time parking.


The changes have been panned by some members of the City Council. Councilman Jim Strickland went as far as to say that the bike signs that dot the streets add “to the blight of our city.”


Tensions aside, the mayor’s office says that the potential economic ripple effect of bike lanes is proof that they are a sound investment.


A study in 2011 by the University of Massachusetts found that building bike lanes created more jobs — about 11 per $1 million spent — than any other type of road project. Several bike shops here have expanded to accommodate new cyclists, including Midtown Bike Company, which recently moved to a location three times the size of its former one. “The new lanes have been great for business,” said the manager, Daniel Duckworth.


Wanda Rushing, a professor at the University of Memphis and an expert on urban change in the South, said bike improvements were of a piece with a development model sweeping the region: bolstering transportation infrastructure and population density in the inner city.


“Memphis is not alone in acknowledging that sprawl is not sustainable,” Dr. Rushing said. “Economic necessity is a pretty good melding substance.”


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Senate Leaders Set to Work on a Last-Minute Tax Agreement


Luke Sharrett for The New York Times


In a televised statement at the White House after meeting with Congressional leaders on Friday, President Obama said he was “modestly optimistic” that an agreement could be reached.







WASHINGTON — At the urging of President Obama, the Democratic and Republican leaders of the Senate set to work Friday night to assemble a last-minute tax deal that could pass both chambers of Congress and avert large tax increases and budget cuts next year, or at least stop the worst of the economic punch from landing beginning Jan. 1.




After weeks of fruitless negotiations between the president and Speaker John A. Boehner, Mr. Obama turned to Senator Harry Reid, the majority leader, and Senator Mitch McConnell of Kentucky, the Republican leader — two men who have been fighting for dominance of the Senate for years — to find a solution. The speaker, once seen as the linchpin for any agreement, essentially ceded final control to the Senate and said the House would act on whatever the Senate could produce.


“The hour for immediate action is here. It is now,” Mr. Obama said in the White House briefing room after an hourlong meeting with the two Senate leaders, Mr. Boehner and Representative Nancy Pelosi, the House Democratic leader. He added, “The American people are not going to have any patience for a politically self-inflicted wound to our economy, not right now.”


Senate Democrats want Mr. McConnell to propose an alternative to Mr. Obama’s final offer and present it to them in time for a compromise bill to reach the Senate floor on Monday and be sent to the House. Absent a bipartisan deal, Mr. Reid said Friday night that he would accede to the president’s request to put to a vote on Monday Mr. Obama’s plan to extend tax cuts for all income below $250,000 a year and to renew expiring unemployment compensation for as many as two million people, essentially daring Republicans to block it and allow taxes to rise for most Americans.


Bipartisan agreement still hinged on the Senate leaders finding an income level above which taxes will rise on Jan. 1, most likely higher than Mr. Obama’s level of $250,000. Quiet negotiations between Senate and White House officials were already drifting up toward around $400,000 before Friday’s White House meeting. The two sides were also apart on where to set taxes on inherited estates.


But senators broke from a long huddle on the Senate floor with Mr. McConnell on Friday night to say they were more optimistic that a deal was within reach. Mr. McConnell, White House aides and Mr. Reid were to continue talks on Saturday, aiming for a breakthrough as soon as Sunday.


“We’re working with the White House, and hopefully we’ll come up with something we can recommend to our respective caucuses,” said Mr. McConnell, who has played a central role in cutting similar bipartisan deals in the past.


The emerging path to a possible resolution, at least on Friday, appeared to mirror the end of the protracted stalemate over the payroll tax last year. In that conflict, House Republicans refused to go along with a short-term extension of the cut, but Mr. McConnell reached an agreement that permitted such a measure to get through the Senate, and the House speaker essentially forced members to accept it from afar, after they had left forChristmas recess.


This time, the consequences are more significant, with more than a half-trillion dollars in tax increases and across-the-board spending cuts just days from going into force, an event most economists warn would send the economy back into recession if not quickly mitigated. With the House set to return to the Capitol on Sunday night, Mr. Boehner has said he would place any Senate bill before his chamber and let the vote proceed and the chips fall. The House could also change the legislation and return it to the Senate.


If the Senate is able to produce a bill that is largely bipartisan, there is a strong belief among House Republicans that the same measure would easily pass the House, with a large number of Republicans. While Mr. Boehner was unable to muster enough votes for his alternative bill that would have protected tax cuts for income under $1 million, that was because the measure lacked Democratic support, and was roughly a few dozen votes shy of passage with Republicans alone.


Helene Cooper and Ron Nixon contributed reporting.



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Russian ban on U.S. adoptions meant to cast Americans as abusers









Anyone unfamiliar with the hyperbole of post-Cold War politics might be perplexed by Moscow’s move to outlaw American adoption of Russian orphans.


More than 60,000 Russian children once condemned to a hellish institutional life have been brought into U.S. homes over the last two decades, most of them suffering disabilities that would have gone untreated had they been left in the Dickensian orphanages of their homeland. The disabled remain victims of stigma in Russia, while a struggling economy and the Stalin-era brand of orphans being “children of the enemies of the people” continue to dissuade Russians from adopting their own unfortunates.


But Russians’ inability and unwillingness to take care of their legions of unwanted children is nevertheless the source of deep embarrassment and wounded national pride, Russia experts say. And having Americans swooping in and rescuing them by the thousands each year nurtures an inferiority complex that has only deepened since the superpower rivalry purportedly ended with the Soviet Union's 1991 breakup.





Nationalist lawmakers in the State Duma overwhelmingly approved the U.S. adoption ban last week, and the upper house of the legislature passed it unanimously on Wednesday. President Vladimir Putin signed the law Friday, and it will take effect on New Year’s Day.



Putin’s parliamentary allies pushed through the ban by conjuring up an image of American adoptive parents as sinister hunters of transplant organs, child sex slaves and sacrificial soldiers for foreign aggressions, perhaps even against Russia.


Like most good lies, the sickening picture of American motives painted to get the adoption ban passed was built on a morsel of truth. The measure was named the Dima Yakovlev Act, in memory of the Russian-born toddler who died of heatstroke in 2008 when his American adoptive father left him locked in a car for hours.


Dima was one of 19 Russian-born children to die from accidents or neglect after being brought to the United States over a span of more than 15 years, according to the Moscow-based advocacy group Right of the Child. The agency, which opposed the U.S. adoption ban, reports that at least 1,200 accidental or abuse deaths occurred over that same time among children adopted by Russian families.


Russia has about 740,000 children in state care, UNICEF reports, and the United States is the most frequent destination for foreign adoptions, taking in about 3,000 on average each year. Fewer than 7,000 are adopted by Russian families each year, or less than 1% of those dependent on state care, Right of the Child Director Boris Altshuler has calculated.


The U.S. adoption cutoff is widely seen as retaliation for the Magnitsky Act, a bill President Obama signed into law two weeks ago that sanctions Russian officials for alleged human rights abuses. The bill was named for Sergei Magnitsky, a Russian lawyer who died in a Moscow jail in 2009 after being arrested and beaten for blowing the whistle on $230 million in tax graft by Russian police.


Putin bridles at any U.S. allegation of abuse by Russian officials and believes moves to punish his government are part of an elaborate scheme to undermine and dominate Russia, said Steven Fish, a political science professor and Russian expert at UC Berkeley.


The adoption ban is “an asymmetrical move ... and is very much a product of this prickly wounded nationalism,” Fish said. “These kids are now just going to be caught in a system that already can’t take care of them.”


Adoption has always been a sensitive issue in Russia, he said, because having to depend on American largess to provide adequate care for orphans casts the country and its leadership as "weak and poor.”


Letting a few thousand young Russians leave for new lives with U.S. families each year also plays into the nationalist hysteria over Russia’s demographic crisis, Fish added. He blamed rampant alcoholism for Russian men’s persistently low life expectancy as a far larger  contributing factor to the annual population shrinkage of 150,000.


Paul Gregory, a senior fellow at Stanford’s Hoover Institution, said  Putin’s followers have churned up public animosity toward U.S. adoptions by resurrecting the Soviet-era propaganda tactic of casting the United States as a dangerous and depraved nation.


“Clearly they want to say that if we’re cracking down on their rights abuses that it’s even worse in the United States. They come up with rather ridiculous cases of cross burnings, and bombings of Jewish synagogues and civil rights abuses to prove that the Magnitsky death in prison was nothing bad at all compared to what goes on here,”  Gregory said. “What they fail to mention is that the persecution and prosecution of Magnitsky was done by the Russian government, whereas these unfortunate actions in the United States were done by fringe groups or crazies.”


The Magnitsky Act bars any Russian official associated with the lawyer’s treatment or with other alleged rights abuses from travel to the United States or access to its financial institutions.


The Russian political leadership’s overreaction to the Magnitsky censure, Gregory said, shows that it has yet to overcome its terrible history under the dictatorship of Josef Stalin of mistreating the children of political opponents. 


"Putin's not going to shed a tear over it," Gregory said of the 1,500 pending U.S. adoptions likely to be blocked by the new law. "He’s going to look at this ban as a weapon in his arsenal of retaliations for the Magnitsky Act, something we can see is really causing those in the leadership some pain.”


ALSO:


Putin inclined to sign U.S. adoptions ban


Attack on Afghanistan police post kills 4


Nelson Mandela home from hospital but still under medical care

A foreign correspondent for 25 years, Carol J. Williams traveled to and reported from more than 80 countries in Europe, Asia, the Middle East and Latin America.

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carol.williams@latimes.com

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12 Tech Moments of 2012 That Made You Say 'WTF?'

The tech world never ceases to amaze. Sometimes, people build amazing things. And sometimes, the people who build amazing things do other stuff that leaves your jaw on the floor. Some of it's good. Some of it is oh so very bad. And some of it is just plain weird.

Here, we give you our 12 most amazing tech moments of 2012. (Click on the images above.) Yes, you'll get all kinds. The good. The bad. And the weird. Lots o' weird.

Above:



Hands down, this is the craziest story of the year. A man is found dead, floating in a pool in Belize, and when authorities try to question his neighbor, Silicon Valley legend John McAfee, he hides overnight beneath a cardboard box and then goes on the run, phoning in dispatches from safe houses and, finally, surfacing in Guatemala where he was the star of a full-fledged international media circus.

McAfee says he's innocent, but he's got a serious credibility problem. He says a lot of things, and not all of them add up. McAfee — the guy who basically invented the computer antivirus industry — is a self-admitted master of social engineering, the art of deceiving others to achieve his own ends. On discussion forums, he's claimed to be an expert on the amphetamine-like drunk known as bath salts, and then later said it was all a joke. In Guatemala, he faked a heart attack to delay his extradition.

When last we heard, McAfee had been extradited to Miami and was heading his way west — staying in cheap motels, and switching into different disguises. Or at least that's what he says.

John McAfee Photo: Brian Finke

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R&B singer Brandy engaged to music executive






LOS ANGELES (Reuters) – R&B singer and actress Brandy Norwood is engaged to music executive Ryan Press, a spokeswoman for the singer said on Thursday.


This will be the first marriage for the singer, who goes by the moniker Brandy. Press is an executive with music publisher Warner/Chappell Music. A date for the wedding has not been announced publicly.






Norwood, 33, has a 10-year-old daughter with her former boyfriend, music producer Robert Smith.


Norwood has starred in numerous television and films since the 1990s and is best known as the lead character in the popular television series “Moesha” from 1996-2001 on the now-defunct channel UPN.


She also scored a hit song in 1998 with “The Boy is Mine,” a collaboration with the singer Monica, which garnered the pair a Grammy award. Brandy released her sixth studio album “Two Eleven” in October this year.


(Reporting by Eric Kelsey; Editing by Piya Sinha-Roy and David Brunnstrom)


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The New Old Age Blog: United States Lags in Alzheimer's Support

This month, the United States Senate Special Committee on Aging released a report examining how five nations — the United States, Australia, France, Japan and Britain — are responding to growing numbers of older adults with Alzheimer’s disease and dementia.

Every country has a strategy, but some are much further ahead than others. Notably, France began addressing Alzheimer’s disease and dementia in 2001 and is in the midst of carrying out its third national plan. (Scroll down at this link to find the English version of the 2008-2012 French plan.)

By contrast, the United States released its first national plan to address Alzheimer’s in May.

The Senate report highlights several trends under way in all five countries, including efforts to coordinate research more effectively, diagnose Alzheimer’s disease more reliably and improve training in dementia care by medical practitioners.

Most relevant to readers of this blog is another trend with increasing international scope: an accelerating effort to keep patients with Alzheimer’s disease and other forms of dementia at home and arrange for care and treatment there, rather than in institutions.

Anyone who’s followed reader response to Jane Brody’s column this week on aging in place knows the burden that this can place on families, especially if government support for home-based services (companions or home health aides who help with bathing, dressing, toileting and other tasks), adult day care or respite care is scarce or nonexistent, as is the case for most middle-class families in the United States.

Is care at home for patients with Alzheimer’s necessarily more humane? Only if caregivers have the resources — financial, physical and emotional — to handle this draining, exhausting, immeasurably difficult job. And only if the institutions that serve people with more advanced forms of Alzheimer’s disease and other types of dementia are so poorly financed, staffed and operated that we wouldn’t feel comfortable leaving loved ones in their care.

Three charts in the new Senate report underscore the extent to which the United States differs from other countries in what is expected of family caregivers. The first, on Page 60, shows countries’ support for paid long-term care services for residents age 65 and older. This includes all residents who need long-term care, including those with Alzheimer’s disease, other forms of dementia and other disabling chronic illnesses. Not included are services provided by unpaid family caregivers.

Look at where the United States ranks compared with Australia, Japan, France and the 30 other developed countries that belong to the Organization for Economic Cooperation and Development. Paid support for long-term care is much less in our country than in theirs.

The second chart, on Page 64, gives a sense of how much paid support for long-term care is provided in people’s homes. Again, the data is not specific to Alzheimer’s disease or dementia, although these are primary reasons older adults need long-term care.

And again, the United States falls short in terms of the amount of paid care it provides in home settings, even though older people tend to prefer these settings over institutions.

The third chart, on Page 75, brings results in the other two down to the level of families. When paid long-term care support is scarce or unavailable, you would expect a heavier load to fall on unpaid caregivers, and this is what the chart shows. Look at the number of caregivers in the United States who put in 10 to 19 hours a week (34.2 percent) or 20 hours or more a week (30.5 percent), and compare those with similar figures for France, Australia and Britain, all of which provide more paid long-term care than we do. Where are informal caregivers working the hardest? Right here at home in the United States.

For me, the take-away is clear. Other countries with which the United States is closely aligned have embraced long-term care as an essential social responsibility while we have not. Unless and until we do so, caregivers here will be among the most harried, stressed and burdened among wealthy, developed countries in the world.

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