Mind Faded, Darrell Royal’s Wisdom and Humor Intact Till End

Three days before his death last week at 88, Darrell Royal told his wife, Edith: “We need to go back to Hollis” — in Oklahoma. “Uncle Otis died.”

“Oh, Darrell,” she said, “Uncle Otis didn’t die.”

Royal, a former University of Texas football coach, chuckled and said, “Well, Uncle Otis will be glad to hear that.”

The Royal humor never faded, even as he sank deeper into Alzheimer’s disease. The last three years, I came to understand this as well as anyone. We had known each other for more than 40 years. In the 1970s, Royal was a virile, driven, demanding man with a chip on his shoulder bigger than Bevo, the Longhorns mascot. He rarely raised his voice to players. “But we were scared to death of him,” the former quarterback Bill Bradley said.

Royal won 3 national championships and 167 games before retiring at 52. He was a giant in college football, having stood shoulder to shoulder with the Alabama coach Bear Bryant. Royal’s Longhorns defeated one of Bryant’s greatest teams, with Joe Namath at quarterback, in the 1965 Orange Bowl. Royal went 3-0-1 in games against Bryant.

Royal and I were reunited in the spring of 2010. I barely recognized him. The swagger was gone. His mind had faded. Often he stared aimlessly across the room. I scheduled an interview with him for my book “Courage Beyond the Game: The Freddie Steinmark Story.” Still, I worried that his withering mind could no longer conjure up images of Steinmark, the undersize safety who started 21 straight winning games for the Longhorns in the late 1960s. Steinmark later developed bone cancer that robbed him of his left leg.

When I met with Royal and his wife, I quickly learned that his long-term memory was as clear as a church bell. For two hours, Royal took me back to Steinmark’s recruiting trip to Austin in 1967, through the Big Shootout against Arkansas in 1969, to the moment President Richard M. Nixon handed him the national championship trophy in the cramped locker room in Fayetteville. He recalled the day at M. D. Anderson Hospital in Houston the next week when doctors informed Steinmark that his leg would be amputated if a biopsy revealed cancer. Royal never forgot the determined expression on Steinmark’s face, nor the bravery in his heart.

The next morning, Royal paced the crowded waiting room floor and said: “This just can’t be happening to a good kid like Freddie Steinmark. This just can’t be happening.”

With the love of his coach, Steinmark rose to meet the misfortune. Nineteen days after the amputation, he stood with crutches on the sideline at the Cotton Bowl for the Notre Dame game. After the Longhorns defeated the Fighting Irish, Royal tearfully presented the game ball to Steinmark.

Four decades later, while researching the Steinmark book, I became close to Royal again. As I was leaving his condominium the day of the interview, I said, “Coach, do you still remember me?” He smiled and said, “Now, Jim Dent, how could I ever forget you?” My sense of self-importance lasted about three seconds. Royal chuckled. He pointed across the room to the message board next to the front door that read, “Jim Dent appt. at 10 a.m.”

Edith and his assistant, Colleen Kieke, read parts of my book to him. One day, Royal told me, “It’s really a great book.” But I can’t be certain how much he knew of the story.

Like others, I was troubled to see Royal’s memory loss. He didn’t speak for long stretches. He smiled and posed for photographs. He seemed the happiest around his former players. He would call his longtime friend Tom Campbell, an all-Southwest Conference defensive back from the 1960s, and say, “What are you up to?” That always meant, “Let’s go drink a beer.”

As her husband’s memory wore thin, Edith did not hide him. Instead, she organized his 85th birthday party and invited all of his former players. Quarterback James Street, who engineered the famous 15-14 comeback against Arkansas in 1969, sat by Royal’s side and helped him remember faces and names. The players hugged their coach, then turned away to hide the tears.

In the spring of 2010, I was invited to the annual Mexican lunch for Royal attended by about 75 of his former players. A handful of them were designated to stand up and tell Royal what he meant to them. Royal smiled through each speech as his eyes twinkled. I was mesmerized by a story the former defensive tackle Jerrel Bolton told. He recalled that Royal had supported him after the murder of his wife some 30 year earlier.

“Coach, you told me it was like a big cut on my arm, that the scab would heal, but that the wound would always come back,” Bolton said. “It always did.”

Royal seemed to drink it all in. But everyone knew his mind would soon dim.

The last time I saw him was June 20 at the County Line, a barbecue restaurant next to Bull Creek in Austin. Because Royal hated wheelchairs and walkers, the former Longhorn Mike Campbell, Tom’s twin, and I helped him down the stairs by wrapping our arms around his waist and gripping the back of his belt. I ordered his lunch, fed him his sandwich and cleaned his face with a napkin. He looked at me and said, “Was I a college player in the 1960s?”

“No, Coach,” I said. “But you were a great player for the Oklahoma Sooners in the late 1940s. You quarterbacked Oklahoma to an 11-0 record and the Sooners’ first national championship in 1949.”

He smiled and said, “Well, I’ll be doggone.”

After lunch, Mike Campbell and I carried him up the stairs. We sat him on a bench outside as Tom Campbell fetched the car. In that moment, the lunch crowd began to spill out of the restaurant. About 20 customers recognized Royal. They took his photograph with camera phones. Royal smiled and welcomed the hugs.

“He didn’t remember a thing about it,” Tom Campbell said later. “But it did his heart a whole lot of good.”

Jim Dent is the author of “The Junction Boys” and eight other books.

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Hurricane Sandy and the Disaster-Preparedness Economy

Jeffrey Phelps for The New York Times

An assembly line at a Generac Power Systems plant. Generac makes residential generators, coveted items in the wake of Hurricane Sandy.

FOLKS here don’t wish disaster on their fellow Americans. They didn’t pray for Hurricane Sandy to come grinding up the East Coast, tearing lives apart and plunging millions into darkness.

But the fact is, disasters are good business in Waukesha. And, lately, there have been a lot of disasters.

This Milwaukee suburb, once known for its curative spring waters and, more recently, for being a Republican stronghold in a state that President Obama won on Election Day, happens to be the home of one of the largest makers of residential generators in the country. So when the lights go out in New York — or on the storm-savaged Jersey Shore or in tornado-hit Missouri or wherever — the orders come pouring in like a tidal surge.

It’s all part of what you might call the Mad Max Economy, a multibillion-dollar-a-year collection of industries that thrive when things get really, really bad. Weather radios, kerosene heaters, D batteries, candles, industrial fans for drying soggy homes — all are scarce and coveted in the gloomy aftermath of Hurricane Sandy and her ilk.

It didn’t start with the last few hurricanes, either. Modern Mad Max capitalism has been around a while, decades even, growing out of something like old-fashioned self-reliance, political beliefs and post-Apocalyptic visions. The cold war may have been the start, when schoolchildren dove under desks and ordinary citizens dug bomb shelters out back. But economic fears, as well as worries about climate change and an unreliable electronic grid have all fed it.

 Driven of late by freakish storms, this industry is growing fast, well beyond the fringe groups that first embraced it. And by some measures, it’s bigger than ever.

Businesses like Generac Power Systems, one of three companies in Wisconsin turning out generators, are just the start.

The market for gasoline cans, for example, was flat for years. No longer. “Demand for gas cans is phenomenal, to the point where we can’t keep up with demand,” says Phil Monckton, vice president for sales and marketing at Scepter, a manufacturer based in Scarborough, Ontario. “There was inventory built up, but it is long gone.”

Even now, nearly two weeks after the superstorm made landfall in New Jersey, batteries are a hot commodity in the New York area. Win Sakdinan, a spokesman for Duracell, says that when the company gave away D batteries in the Rockaways, a particularly hard-hit area, people “held them in their hands like they were gold.”

Sales of Eton emergency radios and flashlights rose 15 percent in the week before Hurricane Sandy — and 220 percent the week of the storm, says Kiersten Moffatt, a company spokeswoman. “It’s important to note that we not only see lifts in the specific regions affected, we see a lift nationwide,” she wrote in an e-mail. “We’ve seen that mindfulness motivates consumers all over the country to be prepared in the case of a similar event.”

Garo Arabian, director of operations at B-Air, a manufacturer based in Azusa, Calif., says he has sold thousands of industrial fans since the storm. “Our marketing and graphic designer is from Syria, and he says: ‘I don’t understand. In Syria, we open the windows.’ ”

But Mr. Arabian says contractors and many insurers know that mold spores won’t grow if carpeting or drywall can be dried out within 72 hours. “The industry has grown,” he says, “because there is more awareness about this kind of thing.”

Retailers that managed to stay open benefited, too. Steve Rinker, who oversees 11 Lowe’s home improvement stores in New York and New Jersey, says his stores were sometimes among the few open in a sea of retail businesses.

Predictably, emergency supplies like flashlights, lanterns, batteries and sump pumps sold out quickly, even when they were replenished. The one sought-after item that surprised him the most? Holiday candles. “If anyone is looking for holiday candles, they are sold out,” he says. “People bought every holiday candle we have during the storm.”

If the hurricane was a windfall for Lowe’s, its customers didn’t seem to mind. Rather, most appeared exceedingly grateful when Mr. Rinker, working at a store in Paterson, N.J., pointed them toward a space heater, or a gasoline can, that could lessen the misery of another day without power.

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In Soldier’s Hearing, Afghans Tell of Horror

JOINT BASE LEWIS-McCHORD, Wash. — Through a live video feed from half a world away in Afghanistan, in an extraordinary night court session, descriptions of chaos and horror poured into a military courtroom here as if from an open spigot.

Lois Silver/FR 170774 Associated Press, via Associated Press

In a courtroom sketch, Staff Sgt. Robert Bales, lower right, is shown during testimony on Friday.

Reuters

Sergeant Bales, left, during a 2011 training exercise in Fort Irwin, California.

“Their brains were still on the pillows,” said Mullah Khamal Adin, 39, staring into the camera with his arms folded on the table, describing the 11 members of his cousin’s family he found dead in the family compound — most of the bodies burned in a pile in one room.

Mr. Adin, in a hearing that started here late Friday, was asked about the smell. Was there an odor of gasoline or kerosene?

Just bodies and burned plastic, he replied through a translator.

The Army’s preliminary hearing in the case against Staff Sgt. Robert Bales, accused of killing 16 Afghan civilians in Kandahar Province this year, unfolded last week mostly in the bustling daylight of a working military base an hour south of Seattle. But to accommodate witnesses in Afghanistan, and the 12-and-a-half-hour time difference, the schedule was shifted at week’s end, with testimony through cameras and uplinks in Afghanistan and here at Lewis-McChord starting at 7:30 p.m. Pacific time on Friday and running until shortly after 2 a.m. Saturday.

The attacks, which occurred on March 11 in a deeply poor rural region while most of the victims were asleep, were the deadliest war crime attributed to a single American soldier in the decade of war that has followed the terrorist attacks of Sept. 11, 2001, and they further frayed the relationship between the American and Afghan governments.

The military says Sergeant Bales, 39, was serving his fourth combat tour overseas when he walked away from his remote outpost in southern Afghanistan and shot and stabbed members of several families in a nighttime ambush on two villages. At least nine of the people he is accused of killing were children, and others were women. After the victims were shot, some of the bodies were dragged into a pile and burned.

“ ‘What are you doing? What are you doing?’ ” one witness, a farmer named Haji Naim, said he had shouted to the American soldier, whom he described as wearing a blindingly bright headlamp in a house that, without electricity, was pitch black. The gunman said nothing, Mr. Naim said, and simply kept firing.

“He shot me right here, right here, and right here,” he said, indicating wounds from which he has apparently recovered.

Most of the testimony, however graphic, was circumstantial, pointing to a lone American gunman but not directly implicating Sergeant Bales. The villagers testified on the fifth day of a military proceeding known as an Article 32 investigation, held to establish whether there is enough evidence to bring Sergeant Bales before a court-martial. If a court-martial is ordered and the Army decides to continue the prosecution as a capital case, the sergeant could face the death penalty.

Sergeant Bales, a decorated veteran of three tours in Iraq before being sent to Afghanistan last December, was deployed from Joint Base Lewis-McChord. He was held at the military prison at Fort Leavenworth in Kansas before being brought here for the hearing.

Witnesses earlier in the week talked about the blood-soaked clothes that Sergeant Bales was seen wearing when he returned to his base in Kandahar and his comments to fellow soldiers about having done “the right thing.” There was also testimony about the test for steroids in his system that came back positive three days after the killings.

The hearing’s night sessions, which were scheduled to continue on Saturday, were all about the violence that unfolded the night of March 11. Mr. Adin, who was summoned to his cousin’s compound by a telephone call early the next morning, told of boot prints that were on some bodies, including the head of a child who had apparently been shot and stomped or kicked. Mr. Adin talked about a small child who he said appeared to have been “grabbed from her bed and thrown on the fire.” But Mr. Adin never saw the gunman, arriving after the fact.

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Yale Graduates Seek a Degree in Hip-Hop

IT started with confusion over a Cam’ron lyric.

In 2009, Tom Lehman, a computer programmer, was puzzled by the line, “80 holes in your shirt: there, your own Jamaican clothes” in the rap song “Family Ties.” What were “Jamaican clothes,” he wondered?

A friend from Yale, Mahbod Moghadam, guessed that the lyric referred to the tattered clothing worn by impoverished Jamaicans. That turned out not to be true, but it was enough to inspire Mr. Lehman to build Rap Genius, a Web site that seeks to decipher every lyric in hip-hop.

While rap lyric sites are not new, Rap Genius distinguished itself by adding a Wikipedia-esque twist, allowing anyone to annotate lyrics with words, photos and videos. More than 250,000 people have submitted explanations to date, with contributions vetted by 500 editors, many of them high school or college students.

The result is a mélange of decoded slang, interpretations of varying plausibility and dorky jokes that has struck a chord. The site draws two million unique visitors a month, according to comScore, an independent analytics firm, and last month Ben Horowitz, a well-known venture capitalist in Silicon Valley with a soft spot for hip-hop, announced he was investing $15 million in the site.

But the project has also been dogged by awkward questions about race and authenticity, including a recent dispute over conversations in a chat room that some call racist. Not helping matters is the sometimes-outlandish behavior of its three founders, Mr. Lehman, Mr. Moghadam and a third buddy from Yale, Ilan Zechory.

Rap Genius is run out of two penthouse apartments in Williamsburg, Brooklyn, where the founders seem to fancy themselves as hip-hop personalities in their own right.

Mr. Lehman, 28, sports an unkempt Afro of sorts, and seems to wear a different pair of sunglasses for every conversation. Friends noted a striking accumulation of skinny jeans in various colors after he received Mr. Horowitz’s check. Mr. Lehman is also a stickler for punctuation, which can be torture for someone who runs a crowd-sourced hip-hop Web site.

Mr. Moghadam, 29, favors shirtlessness to show off a muscular upper body, and speaks in a unique patois that mixes phrases like “we got bottles” and “pop it for pimp” with graduate-school-level discussions of Orientalism and religious texts. He can come off as a star-struck fan, bragging about meeting Gucci Mane or Big Boi one moment, before drifting into hyperbolic claims about Rap Genius’s future the next.

Mr. Zechory, 28, cuts a more modest figure. He says that his two friends are playing roles, and marvels at their ability to keep up the act. “I’ve never seen him break character,” he said of Mr. Moghadam.

Perhaps the site’s biggest claim to fame has been its ability to get several famous rappers, including Nas and 50 Cent, to explain their own lyrics on the site. GZA from the Wu-Tang Clan received a tutorial last month. He came away enthusiastic.

“This is a perfect site for me, because I love talking about hip-hop and lyrics,” he said. “The way I write is like a puzzle, so most of it can be broken down and explained in detail.”

But some critics suspect that Rap Genius’s founders are engaged in a sort of perpetual parody of the music they claim to be rhapsodizing. “There’s a consciousness about what they’re doing — we call it ‘slumming,’ ” said Camille Charles, a sociology professor at the University of Pennsylvania who studies race.

The site has been plagued by other troubles. Many of the song transcripts are identical — typos and all — to those found on the Original Hip-Hop Lyrics Archive, a Web site that has existed in varying forms since 1992. And some explanations are cause for eye-rolling.

“It’s frequently incorrect, just straight up wrong, in the transcription and definitely in the interpretation,” said Adam Mansbach, the author of “Go the ____ to Sleep,” a profane play on the bedtime storybook.

Mr. Moghadam said that he is aware of how a hip-hop site created by three Yale graduates might raise suspicions. But he notes that Rap Genius is designed to weed out wrong answers, using as an example his own faulty explanation of “Jamaican clothes,” which the site now says refers to “mesh tank tops with a lot of little holes in them.”

At the same time, Mr. Moghadam’s own actions have given critics plenty to work with.

When Kool A.D., a rapper from the group Das Racist, referred to Rap Genius as “white devil sophistry” in a song last year, Mr. Moghadam posted a response video, in which he raps about the color of Kool A.D.’s skin with a line that some took as racist. (Mr. Moghadam, who is Persian, insists he was making a reference to how he thought Kool A.D. looks sickly.)

But the racial questions arose again a few weeks ago when Bryan Crawford, a prominent hip-hop blogger, posted screen grabs from a Rap Genius chat room that showed users making jokes about slavery.

In response, the founders denounced the jokes as racist, but added that the site could be not be held accountable for every comment, much like Twitter can’t be blamed for every offensive tweet. On his own, however, Mr. Moghadam went further and physically threatened Mr. Crawford in an online chat and on Twitter.

Mr. Moghadam insists that the beef was largely tongue-in-cheek, and that the bluster is just part of the pugnacious hip-hop world. “Dissing is their vocabulary,” he said. “If they’re dissing you, they’re showing you respect.”

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The New Old Age Blog: The Emotional Aftermath of Hurricane Sandy

Let’s talk about the emotional aftermath of the storm that left tens of thousands of older people on the East Coast without power, bunkered down in their homes, chilled to the bone and out of touch with the outside world.

Let’s name the feelings they may have experienced. Fear. Despair. Hopelessness. Anxiety. Panic.

Linda Leest and her staff at Services Now for Adult Persons in Queens heard this in the voices of the older people they had been calling every day, people who were homebound and at risk because of medical conditions that compromise their physical functioning.

“They’re afraid of being alone,” she said in a telephone interview a few days after the storm. “They’re worried that if anything happens to them, no one is going to know. They feel that they’ve lost their connection with the world.”

What do we know about how older adults fare, emotionally, in a disaster like that devastating storm, which destroyed homes and businesses and isolated older adults in darkened apartment buildings, walk-ups and houses?

Most do well — emotional resilience is an underappreciated characteristic of older age — but those who are dependent on others, with pre-existing physical and mental disabilities, are especially vulnerable.

Most will recover from the disorienting sense that their world has been turned upside down within a few weeks or months. But some will be thrown into a tailspin and will require professional help. The sooner that help is received, the more likely it is to prevent a significant deterioration in their health.

The best overview comes from a November 2008 position paper from the American Association for Geriatric Psychiatry that reviewed the effects of Hurricane Katrina and other disasters. After Katrina, “the elderly had the highest mortality rates, health decline and suicide rates of any subgroup,” that document notes. “High rates of psychosomatic problems were seen, with worsening health problems and increased mortality and disability.”

This is an important point: Emotional trauma in older adults often is hard to detect, and looks different from what occurs in younger people. Instead of acknowledging anxiety or depression, for instance, older people may complain of having a headache, a bad stomachache or some other physical ailment.

“This age group doesn’t generally feel comfortable talking about their feelings; likely, they’ll mask those emotions or minimize what they’re experiencing,” said Dr. Mark Nathanson, a geriatric psychiatrist at Columbia University Medical Center.

Signs that caregivers should watch out for include greater-than-usual confusion in an older relative, a decline in overall functioning and a disregard for “self care such as bathing, eating, dressing properly and taking medication,” Dr. Nathanson said.

As an example, he mentioned an older man who had “been sitting in a cold house for days and decided to stop taking his water pill because he felt it was just too much trouble.” Being distraught or distracted and forgetting or neglecting to take pills for chronic conditions like diabetes or heart disease can have immediate harmful effects.

Especially at risk of emotional disturbances are older adults who are frail and advanced in age, those who have cognitive impairments like Alzheimer’s disease, those with serious mental illnesses like schizophrenia or major depression, and those with chronic medical conditions or otherwise in poor physical health, according to the geriatric psychiatry association’s position paper.

A common thread in all of the above is the depletion of physical and emotional reserves, which impairs an older person’s ability to adapt to adverse circumstances.

“In geriatrics, we have this idea of the ‘geriatric cascade’ that refers to how a seemingly minor thing can set in motion a functional, cognitive and psychological downward spiral” in vulnerable older adults, said Dr. Mark Lachs, chief of the division of geriatrics at Weill Cornell Medical College. “Well, the storm was a major thing — a very large disequilibrating event — and its impact is an enormous concern.”

Of special concern are older people who may be in the early stages of Alzheimer’s disease or other types of dementia who are living alone. For this group, the maintenance of ordinary routines and the sense of a dependable structure in their lives is particularly important, and “a situation like Sandy, which causes so much disruption, can be a tipping point,” Dr. Lachs said.

Also of concern are older people who may have experienced trauma in the past, and who may suffer a reignition of post-traumatic stress symptoms because of the disaster.

Most painful of all, for many older adults, is the sense of profound isolation that can descend on those without working phones, electricity or relatives who can come by to help.

“That isolation, I can’t tell you how disorienting that can be,” said Bobbie Sackman, director of public policy for the Council of Senior Centers and Services of New York City. “They’re scared, but they won’t tell you because they’re too proud and ashamed to ask for help.”

The best remedy, in the short run, is the human touch.

“Now is the time for people to reach out to their neighbors in high-rises or in areas where seniors are clustered, to knock on doors and ask people how they are doing,” said Dr. Gary Kennedy, director of the division of geriatric psychiatry at Montefiore Medical Center in the Bronx.

Don’t make it a one-time thing; let the older person know you’ll call or come by again, and set up a specific time so “there’s something for them to look forward to,” Dr. Kennedy said. So-called naturally occurring retirement communities with large concentrations of older people should be organizing from within to contact residents who may not be connected with social services and find out how they’re doing, he recommended.

In conversations with older adults, offer reassurance and ask open-ended questions like “Are you low on pills?” or “Can I run out and get you something?” rather than trying to get them to open up, experts recommended. Focusing on problem-solving can make people feel that their lives are being put back in order and provide comfort.

Although short-term psychotherapy has positive outcomes for older adults who’ve undergone a disaster, it’s often hard to convince a senior to seek out mental health services because of the perceived stigma associated with psychological conditions. Don’t let that deter you: Keep trying to connect them with services that can be of help.

Be mindful of worrisome signs like unusual listlessness, apathy, unresponsiveness, agitation or confusion. These may signal that an older adult has developed delirium, which can be extremely dangerous if not addressed quickly, Dr. Nathanson said. If you suspect that’s the case, call 911 or make sure you take the person to the nearest hospital emergency room.

This is a safe place to talk about all kinds of issues affecting older adults. Would you be willing to share what kinds of mental health issues you or family members are dealing with since the storm so readers can learn from one another?

Read More..

The New Old Age Blog: The Emotional Aftermath of Hurricane Sandy

Let’s talk about the emotional aftermath of the storm that left tens of thousands of older people on the East Coast without power, bunkered down in their homes, chilled to the bone and out of touch with the outside world.

Let’s name the feelings they may have experienced. Fear. Despair. Hopelessness. Anxiety. Panic.

Linda Leest and her staff at Services Now for Adult Persons in Queens heard this in the voices of the older people they had been calling every day, people who were homebound and at risk because of medical conditions that compromise their physical functioning.

“They’re afraid of being alone,” she said in a telephone interview a few days after the storm. “They’re worried that if anything happens to them, no one is going to know. They feel that they’ve lost their connection with the world.”

What do we know about how older adults fare, emotionally, in a disaster like that devastating storm, which destroyed homes and businesses and isolated older adults in darkened apartment buildings, walk-ups and houses?

Most do well — emotional resilience is an underappreciated characteristic of older age — but those who are dependent on others, with pre-existing physical and mental disabilities, are especially vulnerable.

Most will recover from the disorienting sense that their world has been turned upside down within a few weeks or months. But some will be thrown into a tailspin and will require professional help. The sooner that help is received, the more likely it is to prevent a significant deterioration in their health.

The best overview comes from a November 2008 position paper from the American Association for Geriatric Psychiatry that reviewed the effects of Hurricane Katrina and other disasters. After Katrina, “the elderly had the highest mortality rates, health decline and suicide rates of any subgroup,” that document notes. “High rates of psychosomatic problems were seen, with worsening health problems and increased mortality and disability.”

This is an important point: Emotional trauma in older adults often is hard to detect, and looks different from what occurs in younger people. Instead of acknowledging anxiety or depression, for instance, older people may complain of having a headache, a bad stomachache or some other physical ailment.

“This age group doesn’t generally feel comfortable talking about their feelings; likely, they’ll mask those emotions or minimize what they’re experiencing,” said Dr. Mark Nathanson, a geriatric psychiatrist at Columbia University Medical Center.

Signs that caregivers should watch out for include greater-than-usual confusion in an older relative, a decline in overall functioning and a disregard for “self care such as bathing, eating, dressing properly and taking medication,” Dr. Nathanson said.

As an example, he mentioned an older man who had “been sitting in a cold house for days and decided to stop taking his water pill because he felt it was just too much trouble.” Being distraught or distracted and forgetting or neglecting to take pills for chronic conditions like diabetes or heart disease can have immediate harmful effects.

Especially at risk of emotional disturbances are older adults who are frail and advanced in age, those who have cognitive impairments like Alzheimer’s disease, those with serious mental illnesses like schizophrenia or major depression, and those with chronic medical conditions or otherwise in poor physical health, according to the geriatric psychiatry association’s position paper.

A common thread in all of the above is the depletion of physical and emotional reserves, which impairs an older person’s ability to adapt to adverse circumstances.

“In geriatrics, we have this idea of the ‘geriatric cascade’ that refers to how a seemingly minor thing can set in motion a functional, cognitive and psychological downward spiral” in vulnerable older adults, said Dr. Mark Lachs, chief of the division of geriatrics at Weill Cornell Medical College. “Well, the storm was a major thing — a very large disequilibrating event — and its impact is an enormous concern.”

Of special concern are older people who may be in the early stages of Alzheimer’s disease or other types of dementia who are living alone. For this group, the maintenance of ordinary routines and the sense of a dependable structure in their lives is particularly important, and “a situation like Sandy, which causes so much disruption, can be a tipping point,” Dr. Lachs said.

Also of concern are older people who may have experienced trauma in the past, and who may suffer a reignition of post-traumatic stress symptoms because of the disaster.

Most painful of all, for many older adults, is the sense of profound isolation that can descend on those without working phones, electricity or relatives who can come by to help.

“That isolation, I can’t tell you how disorienting that can be,” said Bobbie Sackman, director of public policy for the Council of Senior Centers and Services of New York City. “They’re scared, but they won’t tell you because they’re too proud and ashamed to ask for help.”

The best remedy, in the short run, is the human touch.

“Now is the time for people to reach out to their neighbors in high-rises or in areas where seniors are clustered, to knock on doors and ask people how they are doing,” said Dr. Gary Kennedy, director of the division of geriatric psychiatry at Montefiore Medical Center in the Bronx.

Don’t make it a one-time thing; let the older person know you’ll call or come by again, and set up a specific time so “there’s something for them to look forward to,” Dr. Kennedy said. So-called naturally occurring retirement communities with large concentrations of older people should be organizing from within to contact residents who may not be connected with social services and find out how they’re doing, he recommended.

In conversations with older adults, offer reassurance and ask open-ended questions like “Are you low on pills?” or “Can I run out and get you something?” rather than trying to get them to open up, experts recommended. Focusing on problem-solving can make people feel that their lives are being put back in order and provide comfort.

Although short-term psychotherapy has positive outcomes for older adults who’ve undergone a disaster, it’s often hard to convince a senior to seek out mental health services because of the perceived stigma associated with psychological conditions. Don’t let that deter you: Keep trying to connect them with services that can be of help.

Be mindful of worrisome signs like unusual listlessness, apathy, unresponsiveness, agitation or confusion. These may signal that an older adult has developed delirium, which can be extremely dangerous if not addressed quickly, Dr. Nathanson said. If you suspect that’s the case, call 911 or make sure you take the person to the nearest hospital emergency room.

This is a safe place to talk about all kinds of issues affecting older adults. Would you be willing to share what kinds of mental health issues you or family members are dealing with since the storm so readers can learn from one another?

Read More..

Hurricane Sandy and the Disaster-Preparedness Economy

Jeffrey Phelps for The New York Times

An assembly line at a Generac Power Systems plant. Generac makes residential generators, coveted items in the wake of Hurricane Sandy.

FOLKS here don’t wish disaster on their fellow Americans. They didn’t pray for Hurricane Sandy to come grinding up the East Coast, tearing lives apart and plunging millions into darkness.

But the fact is, disasters are good business in Waukesha. And, lately, there have been a lot of disasters.

This Milwaukee suburb, once known for its curative spring waters and, more recently, for being a Republican stronghold in a state that President Obama won on Election Day, happens to be the home of one of the largest makers of residential generators in the country. So when the lights go out in New York — or on the storm-savaged Jersey Shore or in tornado-hit Missouri or wherever — the orders come pouring in like a tidal surge.

It’s all part of what you might call the Mad Max Economy, a multibillion-dollar-a-year collection of industries that thrive when things get really, really bad. Weather radios, kerosene heaters, D batteries, candles, industrial fans for drying soggy homes — all are scarce and coveted in the gloomy aftermath of Hurricane Sandy and her ilk.

It didn’t start with the last few hurricanes, either. Modern Mad Max capitalism has been around a while, decades even, growing out of something like old-fashioned self-reliance, political beliefs and post-Apocalyptic visions. The cold war may have been the start, when schoolchildren dove under desks and ordinary citizens dug bomb shelters out back. But economic fears, as well as worries about climate change and an unreliable electronic grid have all fed it.

 Driven of late by freakish storms, this industry is growing fast, well beyond the fringe groups that first embraced it. And by some measures, it’s bigger than ever.

Businesses like Generac Power Systems, one of three companies in Wisconsin turning out generators, are just the start.

The market for gasoline cans, for example, was flat for years. No longer. “Demand for gas cans is phenomenal, to the point where we can’t keep up with demand,” says Phil Monckton, vice president for sales and marketing at Scepter, a manufacturer based in Scarborough, Ontario. “There was inventory built up, but it is long gone.”

Even now, nearly two weeks after the superstorm made landfall in New Jersey, batteries are a hot commodity in the New York area. Win Sakdinan, a spokesman for Duracell, says that when the company gave away D batteries in the Rockaways, a particularly hard-hit area, people “held them in their hands like they were gold.”

Sales of Eton emergency radios and flashlights rose 15 percent in the week before Hurricane Sandy — and 220 percent the week of the storm, says Kiersten Moffatt, a company spokeswoman. “It’s important to note that we not only see lifts in the specific regions affected, we see a lift nationwide,” she wrote in an e-mail. “We’ve seen that mindfulness motivates consumers all over the country to be prepared in the case of a similar event.”

Garo Arabian, director of operations at B-Air, a manufacturer based in Azusa, Calif., says he has sold thousands of industrial fans since the storm. “Our marketing and graphic designer is from Syria, and he says: ‘I don’t understand. In Syria, we open the windows.’ ”

But Mr. Arabian says contractors and many insurers know that mold spores won’t grow if carpeting or drywall can be dried out within 72 hours. “The industry has grown,” he says, “because there is more awareness about this kind of thing.”

Retailers that managed to stay open benefited, too. Steve Rinker, who oversees 11 Lowe’s home improvement stores in New York and New Jersey, says his stores were sometimes among the few open in a sea of retail businesses.

Predictably, emergency supplies like flashlights, lanterns, batteries and sump pumps sold out quickly, even when they were replenished. The one sought-after item that surprised him the most? Holiday candles. “If anyone is looking for holiday candles, they are sold out,” he says. “People bought every holiday candle we have during the storm.”

If the hurricane was a windfall for Lowe’s, its customers didn’t seem to mind. Rather, most appeared exceedingly grateful when Mr. Rinker, working at a store in Paterson, N.J., pointed them toward a space heater, or a gasoline can, that could lessen the misery of another day without power.

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Citing Affair, Petraeus Resigns as C.I.A. Director

The sudden development came just days after President Obama won re-election to a second term. Mr. Petraeus, a highly decorated general who had led the wars in Iraq and Afghanistan, had been expected to remain in the president’s administration.

Instead, Mr. Petraeus said in the statement that the president accepted his resignation on Friday after he had informed him of his indiscretion a day earlier.

“After being married for over 37 years, I showed extremely poor judgment by engaging in an extramarital affair,” Mr. Petraeus wrote. “Such behavior is unacceptable, both as a husband and as the leader of an organization such as ours. This afternoon, the president graciously accepted my resignation.”

Mr. Obama released a statement praising Mr. Petraeus for his “extraordinary service” to the country and saying that Michael J. Morell, the deputy director of the C.I.A., would take over once again as acting director. He served in that position briefly after Leon E. Panetta left the agency last year.

“By any measure, through his lifetime of service, David Petraeus has made our country safer and stronger,” the president said. Without directly addressing the affair, Mr. Obama added: “Going forward, my thoughts and prayers are with Dave and Holly Petraeus, who has done so much to help military families through her own work. I wish them the very best at this difficult time.” Ms. Petraeus is the assistant director of the Office of Servicemember Affairs at the Consumer Financial Protection Bureau.

The development came as a shock to the national security establishment. In a statement, James R. Clapper, the director of national intelligence, called the decision “a loss” to the country.

“Dave’s decision to step down represents the loss of one of our nation’s most respected public servants.” Mr. Clapper wrote. “From his long, illustrious Army career to his leadership at the helm of C.I.A., Dave has redefined what it means to serve and sacrifice for one’s country.”

By acknowleding an extramarital affair, Mr. Petraeus, 60, was confronting a sensitive issue for a spy chief. Intelligence agencies are often concerned about the possibility that agents who engage in such behavior could be blackmailed for information.

In his statement, Mr. Petraeus did not provide any details about his behavior, saying that he asked the president to be allowed “for personal reasons” to resign.

Mr. Petraeus praised his colleagues at the C.I.A.’s headquarters in Langley, Va., calling them “truly exceptional in every regard” and thanking them for their service to the country. He made it clear that his departure was not how he had envisioned ending a storied career in the military and in intelligence.

“Teddy Roosevelt once observed that life’s greatest gift is the opportunity to work hard at work worth doing,” he said. “I will always treasure my opportunity to have done that with you, and I will always regret the circumstances that brought that work with you to an end.”

Over the last several years, Mr. Petraeus had become one of the most recognizable military officials, serving as the public face of the war effort in Congress and on television.

Under President George W. Bush, Mr. Petraeus was credited for helping to develop and put in place the “surge” in troops in Iraq that helped wind down the war in that country. Mr. Petraeus was moved to Afghanistan in 2010 after Mr. Obama fired General Stanley H. McChrystal over comments he made to a magazine reporter.

In Afghanistan, Mr. Petraeus led the push for a similar increase in troops ordered by Mr. Obama, but he was unable to replicate the success he had in the Iraq conflict.

Last year, Mr. Obama persuaded Mr. Petraeus to leave the Army after 37 years to lead the C.I.A., succeeding Mr. Panetta, who moved to the Defense Department.

This article has been revised to reflect the following correction:

Correction: November 9, 2012

An earlier version of this article incorrectly stated that David H. Petraeus was expected to remain in President Obama’s cabinet. The C.I.A. director is not a cabinet member in the Obama administration.

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Groupon Earnings Miss Expectations on Weakness in Europe

SAN FRANCISCO (Reuters) — Groupon reported financial results late Thursday that fell short of Wall Street’s already cautious expectations, as the daily-deal company failed to turn around its struggling European business.

Groupon also confirmed that it had laid off about 80 employees, mainly in sales, as part of an effort to automate the way it handles its deals.

The company’s shares fell as low as $3.21 in after-hours trading, down as much as 18 percent from their closing price of $3.92. Groupon was the darling of investors during last year’s consumer dot-com boom in initial public offerings, but now it has shed more than 80 percent of its value since making its public debut at $20 a share.

Wall Street has grown uneasy about Groupon’s prospects as daily-deals fever wanes among consumers and merchants, and as growth rates sputter. Adding to the difficulties, the S.E.C. has been looking into Groupon’s accounting and disclosures, an area of controversy during its initial public offering.

Groupon reported third-quarter revenue of $568.6 million, compared with $430.2 million a year earlier. Analysts had expected revenue of $590 million, according to Thomson Reuters.

The company posted a quarterly net loss of $3 million, or break-even on a per-share basis, compared with a net loss of $54.2 million, or 18 cents a share, in the third quarter of 2011.

Andrew Mason, chief executive of Groupon, said a “solid performance” in North America was offset by weakness in Europe. International revenue, including Europe, grew 3 percent to $277 million; North American revenue surged 80 percent to $292 million.

Europe has been a particular problem for Groupon, partly because the sovereign debt crisis there has hurt demand for higher-price deals. Groupon was also offering steeper discounts, disappointing some merchants.

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Advertising: Help Remedies Tries to Cure Ailments in Small Doses

DISAPPOINTED voters, runners with blisters and headache sufferers alike are getting some unexpected relief from a pop-up pharmacy that opened this week in the nation’s capital.

The “help shop,” which offers low-dose drugs for everyday woes, is the idea of Help Remedies, a start-up company that sells minimalist white packets directed at single medical issues like nausea, headache or insomnia.

The company, the collaboration of two marketers, is creating quirky scenes including a high-heel wearing model walking on a treadmill to market its “Help, I have a blister” packet of bandages, or a performer sleeping in a store window to drum up interest for its “Help, I can’t sleep” caplets.

This week, shoppers and passers-by attracted by the napper, for example, could go inside the temporary pharmacy to investigate its 10 over-the-counter remedies for conditions like body aches and allergies.

The store’s team fanned out to polling stations on Tuesday to hand out its headache packets, and then on Wednesday to the nearby Republican National Committee to share nausea relief. Their marketing may be seen as fun and zany, but the company founders, Richard Fine and Nathan Frank, say they have a serious message.

“We want people to see that there are simple solutions,” said Mr. Fine, who said his straightforward approach was influenced by his parents, who are medical professors specializing in epidemiology.

“Most people shop by brand or product, and it’s difficult to know what you should be buying and taking,” he said. “It is a confusing space for people who are not experts.”

Mr. Fine and Mr. Frank, who met while working in branding and advertising, decided to try to streamline what they see as an antiquated and cluttered pharmaceutical market.

“We wanted to take what’s basic and works, and make it human,” Mr. Fine said. Their strategy of providing single ingredients in low dosages is aimed at basic medical conditions that do not require hospitalization.

After starting the company in 2008, they consulted pharmaceutical sources to zero in on the drugs and dosages to use. Their “Help, I have a headache” formulation, for example, contains 325 milligrams of acetaminophen per caplet.

“That is less than the amount in an extra strength caplet,” said Mr. Fine. “If you need more, you can take more. But this is what pharmacists recommend.”

By that summer, Help Remedies was distributing its packets in some high-end hotel chains and business conferences. In 2009, the two men quit their jobs and started the company Web site, helpineedhelp.com, which includes a link to drug facts for each product.

To carve a niche in the crowded pharmaceutical market, Mr. Frank, who handles the company’s creative efforts, said he focused on offbeat marketing, including tactile packaging and performance windows, and viral videos that mixed up the serious, the absurd and even the goofy.

For the packaging, Mr. Frank settled on a flat, white, textured box that opens like a tin. Taking a page from product designers like Apple, he settled on a simple font called century schoolbook, in various colors.

The graphic work was originally done by ChappsMalina and Little Fury, design firms in New York, and was since updated by another firm, Pearlfisher.

Help Remedies, a privately held company, did not disclose its advertising spending, which was $400 in 2010 and $12,500 last year, according to figures from Kantar Media, a WPP unit.

With a small budget, the company has focused on spinning out lighthearted solutions to situations — like countering boredom by focusing on a bouncing ball or hangovers by staring at a rag — on its Web site, videos, bus shelters and other advertising and in the store windows of Ricky’s, a New York beauty supply company.

Help Remedies set up “living windows” like “Help, I’ve never been kissed,” with models on hand to give hugs and kisses in Ricky’s storefronts. There were also serious problems like “Help, I want to save a life,” that provided registration kits from the bone marrow donor center DKMS.

To expand, the company is adapting the living window approach to its first pop-up pharmacy, in Washington, which was delayed by Hurricane Sandy and got under way as the election results were unfolding.

In addition to giving “Help, I have a headache” packets to anyone who asked, the store manager, Melinda Welch, and her staff distributed 2,000 packets — for blisters and for body aches — to participants in the annual High Heel Race.

The company’s products are found in major pharmacy outlets like Duane Reade and CVS, as well as Target and Walgreens. Last year, the company reached $4 million in sales and is set to expand after Washington to San Francisco; Seattle; Portland, Ore.; Austin, Tex.; Chicago; and Miami.

As part of its expansion, the Washington store plans to hold a “Help, I am Insecure” event on Saturday with a life coach to provide support and advice, and a manicurist for those insecure about their nails, Ms. Welch said.

Other events at later dates include “Help, I am Lonely,” with an online dating site consultation, and “Help, I’m in an Argument with my Spouse,” with a relationship judge to settle differences.

William G. Daddi, the president of Daddi Brand Communications, said Help Remedies’s distinct packaging was well suited to compete in the crowded health and beauty market.

But he warned that tying so many products to whimsical marketing carried risks because “there will be consumer confusion and the remedies will be seen as novelty products.”

“To build a true brand, the consumer needs to see that the product is effective,” Mr. Daddi said. “There needs to be a link to tangible outcomes so people see that the product works.”

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