Elders Living Alone – Making Sure They Eat

 

 

UPDATE: I’ve made a couple of corrections below, where I mangled Debi’s intent on her suggestions. Sorry about that. Also, an addition at the bottom.

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Since my mother is in a skilled nursing facility, I don’t have to worry about meals. But for many adult children of older parents, a big concern is making sure Mom  or Dad is eating enough of the right foods. If you live nearby – close enough to visit at least a couple of times a month – there are steps you can take to help.

The following suggestions come from Debi Boggs (Thanks, Debi!):

While visiting, cook in large batches – enough for a meal and at least two servings of leftovers. Freeze the leftovers in single-serving portions. Use resealable bags if washing dishes is a hardship, or something your older relative just doesn’t want to deal with. You can be extra green in your own home to make up for this.

Pizza “kits” make an easy meal. Buy one or two balls of pizza dough at the store, quarter them, stretch them into pizza rounds, and place each round on a sheet of parchment paper. Each quarter will fit into a gallon-sized resealable bag. Take two small bags for each large, pouring the correct amount of sauce in one and the correct amount of shredded cheese in the other. Place these in the larger bags. With a marker, write assembly and baking instructions on the outside of the gallon bags. These kits will stack easily in the freezer.

Roasted vegetables also freeze well and are easy to microwave.

Make a grocery trip and stock the kitchen with a significant inventory of low-prep or no-prep food items: oatmeal, fruit cups (look for the ones packed in real fruit juice), low-sodium soups, coffee, tea, yogurt with the latest possible expiration date, pre-chopped salad, frozen brown rice, canned vegetables. Of course, fresh is healthier, but canned veggies keep for a long time and are a much better option than going hungry.

Whether Mom or Dad is doing the grocery shopping, or having someone else do it for them, a standard grocery list is a good idea. Print and laminate a list of items they consume on a weekly basis. This way, the list can be carried in a purse and re-used.

For those on a budget, check out Aldi’s if there’s one in your area. They usually have the best prices on plain yogurt, canned goods and oatmeal.

The idea is to make it as easy as possible to get good nutrition.

Anyone else have handy tips? Feel free to share in the comments.

Christmas on the Couch

It’s Christmas afternoon and I’m still in my pajamas. On the couch. Coughing up a lung. This holiday isn’t going as planned. But then I’ve always heard the way to make the Universe laugh is to make a plan. It must be chuckling up a storm. I’m trying to laugh along and make the best of it. For instance, right after typing that sentence I added to the gaiety by accidentally dumping out the contents of a nearly-full economy-sized bag of cough drops. Ha ha ha!

After my mother spent several hours at our house on Thanksgiving, it became obvious she can no longer handle so much disruption in her day. Her back problems flared worse than ever and she was exhausted. It took her days to recover. I had a little moment when my husband, kids and I were decorating our Christmas tree, our ornaments including a few vintage ones that survived my childhood. I experienced a wave of sadness knowing my mom will never decorate a tree with me again. She’ll likely never come to our house again. I also had a few seconds of irritability over the fact that humanity hasn’t developed teleportation technology yet, because it would solve this problem. She could beam in for a few minutes and then beam back to the nursing home. I settled for taking a photo of the tree to show her.

The best Christmas tree. We got a spectacular one this year.
The best Christmas tree. We got a spectacular one this year. Not many ornaments down low because three cats.

I asked Mom if she thought she could handle a short outing to a restaurant. She believes she can, so our plan was to pick her up on Christmas Eve and go to IHOP, her favorite. For today, I thought I’d make a lasagna and some sides to have at home and at some time during the day pop over to visit Mom again. But over the weekend I developed a tickle in my throat, the same tickle reported by some of my local acquaintances before they fell all-out sick. Yep, I caught the thing that’s going around. Also, over the weekend, one of my molars broke and I managed to acquire a second-degree burn on my arm while removing a dish from the oven. At some point, my life started to resemble a sit-com plot. However, if I’ve learned anything from my mother, it’s to make the best of the situation, whatever it is.

Though I’m sad not to be with my mom on Christmas, I’m reminded once again how blessed I am with family, both immediate and extended. My husband and my 15-year-old son went over yesterday to see my mom (the 18-year-old caught what I have, so stayed home) and take her gift plus the staff gift bag I put together.

Let me go off the rails here, and recommend this idea for nurses, aides and housekeeping staff at skilled nursing facilities. Since there are so many of them, I put together a bag of items for the break room: hot cocoa mix, including regular and sugar-free, a variety of teas, popcorn, mixed nuts, snack crackers, etc. It’s easy and covers everyone.

For the staff break room at the nursing home.
For the staff break room at the nursing home.

Back to family now – my two guys had a good visit with my mom. Plus I put out the word to far-flung relatives that I couldn’t see her on Christmas, so she might appreciate some phone calls. When I called her about an hour ago, she was thrilled to report her phone had been ringing all yesterday and today. This cheers me up.

Also, my spouse and kids make the holiday fun. We’re a geeky crew who all like a good joke. After my two teens went on errands without me the other day, a package appeared under our tree with a gift tag saying it was to the whole family, and from:

We are favored by the Marvel superheroes.
We are favored by the Marvel superheroes.

The kids come by this creative packaging honestly. Here’s what my husband gave me this year:

My husband gave me a box of rocks.
My husband gave me a box of rocks.
No really, it's a box of rocks.
No really, it’s a box of rocks.
Oh wait, there was something underneath the rocks. Michelle Obama arms, here I come!
Oh wait, there was something underneath the rocks. Michelle Obama arms, here I come!

It’s hard not to have fun when the people around you are putting so much effort into making the event enjoyable.

Our three cats have helped, too, taking turns sitting on my lap.

Top Seniority Cat - my 15-year-old kid doesn't remember life without her.
Top Seniority Cat – my 15-year-old kid doesn’t remember life without her.
Cat who is on a diet, but sneaks the other cats' food if we're not careful.
Cat who is on a diet, but sneaks the other cats’ food if we’re not careful.
Cat who showed up and adopted us a few months ago.
Cat who showed up and adopted us a few months ago.

Then there’s the Pandora Christmas station for holiday cheer, and Netflix to give me a chance to watch some of those movies I’ve been meaning to watch over the years. I finally saw “White Christmas” with Bing Crosby and Danny Kaye. Not much of a story, after all, but the singing and dancing is wonderful. I tried watching “National Lampoon’s Christmas Vacation” and now take comfort in the knowledge I haven’t been missing much. After 15 minutes, I switched to “Men in Black.” Much more entertaining. I’ll have to dial up the sequels.

While I languish on the couch, my family members have been foraging in lieu of a Christmas dinner appearing for them. Macaroni and cheese has been cooked, and we’ve wiped out the back stock of canned soup. Meanwhile, IHOP awaits for the day when we’re all well again. And I still have the ingredients for lasagna.

Death by a Thousand Paper Cuts

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I’ve seen a recurring theme in my life lately. I find myself with a responsibility to get something done, but not the authority. It always comes down to dealing with bureaucracy. Three examples:

1. After more than a year of frustration in dealing with Social Security on my mom’s behalf, I finally decided I needed to go ahead and have myself appointed her Representative Payee. Power of Attorney gets you nowhere with Social Security. Occasionally, if you get a sympathetic person on the other of the phone, that will get you somewhere. But for the most part they want only to speak to the person herself and not her daughter or anyone else, even if she’s given that person Power of Attorney to act on her behalf.

I kept waffling on the Representative Payee thing because it means Mom’s money will be paid to me and I’ll have more forms to fill out accounting for it. However, it’s gotten to the point that I simply have to do this. Mom can’t even make a phone call without help any more. I did get her permission; I didn’t want to feel I was doing it on the sly.

First I had to get a letter from her physician stating she’s not competent to make her own decisions. This was an emotional wrench, let me tell you.  I took the letter plus all of her personal papers down to the local Social Security office, where a very kind woman asked me 20,000 required questions. (Okay, only about a dozen really.) She typed a bunch on her computer and said my application had been submitted. Meanwhile I was supposed to go to the bank and change my mom’s account – my name is on it, too – to reflect the new status, and send proof of this change to Social Security. That’s the only way they’ll be authorized to send her checks there. My understanding was that I was to do this immediately.

I toodled on down to the bank, only to be told they can’t make the change without something from Social Security stating I already am the Representative Payee. Okay then. Thank goodness for patient customer service type folks. The bank guy actually called Social Security while I was sitting there to make sure we were doing things in the right order. Yep, I had to wait.

The letter came a couple of days ago naming me as RP. So I went back to the bank and got the account changed. Now, hopefully, the government peeps will talk to me next time I have to call about her Medicare or something.

2. This one isn’t about my mom. It’s about my phone service. We still have a landline in our house, with the same phone number we’ve had for 19 years. Our phone company is also our internet service provider. I did, however decide to drop the long distance service we had (through a different company) because we use our cell phones for that now, so why keep paying the monthly fee?

I called the long distance company and everything was fine there. They advised me I’d need to call – okay I’ll name them – CenturyLink as well to make sure we were good and cancelled. I called CenturyLink and was told I was not an authorized user on the account. Only my husband held that status, so he personally would need to call to make any changes. Hoo boy.

Here’s some background. I have always handled all of our household bills and utilities. I have always put everything in both of our names. I remember personally walking into the phone company office way back when we moved to town and setting up our account. We’ve always been listed in the phone book under both names. Through the years, the name of the phone company changed and we added internet service through them, but we kept the same phone number and I was always the one who dealt with them. We’ve moved four times with this phone number and I personally switched it to our new residence each and every time. I was the one who originally dropped long distance with them and switched to a different long distance provider. My husband has called tech support a couple of times for internet issues. Otherwise, I have handled everything with them for 19 years. Until, suddenly, in the year 2013, they tell me I have to get my husband’s permission to speak with the phone company.

I sent an email stating all of this, plus asking if they were operating from a 1950s policy manual. They said they’d send a form so I could be added to the account. Meanwhile, my husband called and gave his say-so to put my name on there. But I’m still upset because he shouldn’t have had to do this. I should not need my husband’s permission to do grown-up stuff.

3. Medicaid. I’ve been helping my mother apply for Medicaid. And by helping, I mean doing everything because she can’t. Yesterday, she received a letter, care of me at my address, saying both that she’d been approved for Medicaid coverage and it was retroactive to April and that she was ineligible for Medicaid at this time. I kid you not. I certainly didn’t see that one coming. At the bottom of the letter is a name and a phone number to call if you have any questions.

This morning, I called. And got a recorded message telling me to dial a different number. I called the different number. Did you know that having Power of Attorney and also being Representative Payee through Social Security for someone does not mean that Medicaid will talk to you in order to help that person? It’s true. Missouri Medicaid has their own form, specific to their agency, that you have to fill out and get signed in order to be authorized as a representative for someone else. They won’t accept the Power of Attorney form plus the physician’s letter plus the authorization from Social Security plus an immediate family relationship plus the fact that you’re the one who has provided every piece of information to them so far as evidence that you have any right to find out from them what the letter means that they sent to your parent in care of you at your home address.They also won’t answer general questions, phrased as “Say a hypothetical person got a letter from you saying thus and such. What would that mean?” So now I await the form to be mailed to me so I have will have authorization to call them to find out whether “yes and no” means yes or no.

To some extent, I get it. I really do. I know privacy is a huge issue. I know identity theft happens and older folks are particularly vulnerable. I appreciate the fact that they won’t let any random citizen call up and get personal information about my mother. But she has signed a legal document stating she wants me to handle her affairs. If I have a signed and notarized form to this effect, plus my name on her bank account, a birth certificate showing I am really her child…why can’t they let me help her? Why is it so complicated? And as for the phone company, I cut them no slack.

Dealing with bureaucracy – death by a thousand paper cuts.

Extra Medicare Help for Low Income Seniors

Well, it’s happened. My mom has reached the end of her money. Her Medicaid application is in process. I’ve also discovered that low-income seniors can get extra help with Medicare prescription drug premiums. It’s easy to apply on-line. I wish I’d realized sooner that she qualified.

The hard part comes when the Social Security office double checks with the bank and gets inaccurate information. When my mom moved to town, one of the first things I did was open a checking account for her at the bank I already use. My name is on her account, as well, because I take care of her bills.

My name is on five accounts at this particular bank, in fact: a joint checking account with my husband, a joint savings account with my husband, my daughter’s savings account, my son’s savings account and my mom’s checking account. Despite the number of accounts, it doesn’t add up to all that much somehow. But enough to disqualify my mom from help with her premiums when the bank erroneously reports the sum total to Social Security as *all* belonging to my mother. Hello. Her name is on exactly one account, the tiniest one. Her account is not even tied to the others; it’s not like I can transfer money back and forth.

I think I have it straightened out now and have her application moving forward again. Nothing’s ever simple, I tell you.

Postcards – a Practical Suggestion

Armchair travel and education - as easy as it gets.
Armchair travel and education – as easy as it gets.

 

My sister-in-law loves to send postcards. In addition to picking up new cards when traveling, she finds vintage stock at antique stores. My kids have enjoyed getting mail over the years, and examining the pictures on the front sides. Now she sends cards to my mom.

We’re fortunate to have a large extended family, even if none of them live in town. So a lot of people send cards to my mom. It’s sweet and picks up her spirits, knowing she’s not forgotten.

However, her fine motor skills and finger strength have degraded over time, so that even the act of opening an envelope can pose a challenge for her. She’s been known to save mail for a day or two until I visit, so I can open it for her. Postcards don’t present this problem. They arrive ready to read and enjoy the artwork.

True, there’s a lack of privacy, with the words there for anyone to see. But most of the cards Mom receives have no private information included anyway. And to be honest, not much is private in a skilled nursing setting.

I suggest more folks start sending postcards to their elderly relatives, especially the ones in poor health. They’re less expensive than greeting cards, both for the product and the postage. They often include a scene and a piece of information about it that can be a topic of interest and new information for the recipient. And they’re easy to tape or pin up for decoration.

As soon as I have time, I plan to hit a local antique store myself to see if I can score a handful. My mom’s not the only senior citizen amongst my relatives.

If at First You Don’t Succeed…Calling Medicare

I have no poignant anecdotes to include in this blog post. Only a piece of advice about dealing with Medicare over the phone.

If at first you don’t succeed, then try calling again to speak with a different representative. This is the lesson I’ve learned as I’ve been on the phone with Medicare a few times on my mom’s behalf. Long story short on my most recent issue, I was simply trying to make sure her prescription drug coverage didn’t lapse.

Nobody seems to have a whole picture of what’s going on. Sometimes I call and the person says they can only speak to her and not to me, even though I did both mail and fax a form she signed giving me permission. Other folks, as long as I can supply her Social Security number, place of birth, etc., they’re good with it. Doesn’t mean they can tell me what I need to know, but they will try. I’ve gotten transferred a lot. I think everything’s good now. She has her new prescription drug cards.

And I figured out something. If the representative I’ve reached seems unable or unwilling to help, I shouldn’t accept that answer as the end of the matter. I simply say, “Thanks for your time. Goodbye.” Then I hang and up and immediately redial. The person with whom I was just speaking has moved on to a different call, and I get someone new. Possibly someone who knows more or is more willing to work with me. This strategy has solved my problem more than once. And, magically, they never seem to realize I have already called and talked to someone else who told me they couldn’t help. I’d assumed they would put a not in the record, a note the next person would see, but apparently not.

So if you’re getting the run-around with Medicare, just keep calling back. It works for me.

Voting for Shut-Ins

I helped my mom vote today. She’s probably the reason I’ve never skipped an election since I turned 18. I’m following her example. She always, always voted. I remember going into the booth with her when I was little, back when they had the machines with levers.

I don’t know how it works other places, but I discovered that in my county, they will send poll workers out with ballots to allow shut-ins to vote. Pretty nifty and civic. Still, she wanted me there to help her read and fill out the ballot. Possibly she didn’t trust the election ladies (?)

I admit I had to bite my tongue on a couple of her selections. But I managed not to try to influence her vote. With tremendous self-discipline, I only marked what she wanted me to without comment. As if she’d let me. She still reads the newspaper, and she’s allowed to vote differently from me if she wants to. I wasn’t there to tell her how to vote, only to help her exercise her right as a citizen.If nothing else, it’s extra motivation for me to get out to the polls next Tuesday, so I can cancel her out on those couple of ballot items. Since I also believe in a secret ballot, I won’t mention which things or people we disagree on. I’m happy to share my opinions, but not hers.

It made me very happy to know my local government is serious in helping people cast their votes.And the poll workers were as nice as could be.

Trying to Be Home for the Holidays

Thanksgiving will be here before we know it. Not to panic anyone. My oldest brother and his wife will be coming in from out of state, and we will bring my mom out from the nursing home for part of the day. It should be great. I’m looking forward to it. There’s only one slight major problem: accessibility.

Front entrance to our house.
A different view of the front entrance

 

 

 

 

 

 

 

 

 

 

 

We also have a side door, but once you step inside it, you immediately have to go up stairs to get to the main level. And our parking area is behind the house. What we really need is a back door.

We could use a back door, about here.

 

 

 

 

 

 

 

 

 

And a wheelchair ramp from the there to where we park.

We could use a ramp along here.

 

 

 

 

 

 

 

 

 

So we’re having it done. Dispensing with our usual do-it-yourself mode that can make projects stretch out for months, we’re hiring a contractor my husband knows to put in a back door and build a ramp. He says he can have it done in plenty of time for Thanksgiving.

Putting aside my anxiety dreams about Thanksgiving arriving to find a half-finished project and unusable guest room in a still-inaccessible house because something’s sure to go wrong, we have to pay for this thing. Since the contractor is a friend, we’re getting a good price, but I’ve discovered nobody wants to loan you $4,500. They’ll happily loan us ten times that much, however. It’s crazy.

So we’re refinancing the whole shebang, trading in our old mortgage and rolling the cost of the project into a new one. Man alive, has that meant a lot of form filling out and information tracking down.The good news is how much interest rates have dropped. Our payments will be a lot lower.

The construction materials should arrive Friday, and work begins next week. We’ve talked about making the house accessible since we moved in nine years ago, but it’s never risen to the top of the to-do list until now. I’m happy to know we’ll have an ADA compliant entrance.

Oh, about the back room where the door is going – I mentioned it’s our guest bedroom. My son helped me move out the furniture already. It’s scattered in other places throughout the house. There’s a tight squeeze to get to my home office at the moment, but I can still make it.

Temporary bed storage

Chutes and Ladders

Dealing with Social Security and Medicare is like playing Chutes and Ladders, except with extra chutes and no ladders. You move along the spaces thinking you’re getting somewhere and then you land on the chute that takes you back to the beginning.

After many spins of the spinner when my mom first moved to town, we were told verbally that her address had been changed with Social Security. I assumed this was true because her checks starting showing up in the bank account I opened for her here. But then I discovered Mom’s Medicare statements were still being mailed to my sister in Ohio, where my mom had lived previously. Not only that, but Medicare is changing her prescription drug plan and it’s based on her Ohio address.

After working through several layers of sub-menus and many minutes on hold, I managed to talk to a live person at Medicare who required me to answer about a dozen questions before she was authorized to tell me she could do nothing for me. They get all changes of address from Social Security and they’ve never received one for my mom. Also, she couldn’t tell me what prescription drug plans are available in Missouri. I’ll have to call back between October 15 and November 15 for that information.

So I called Social Security and found out that, nope, they have no record of an address change, after the same sub-menus/dozen questions journey. But they do have it changed now. The guy promised me.

We’ll see if I hit the top of another chute on October 15.

Did I mention my mom got a jury summons? This actually made me laugh. The fun never ends.

Highway 504: Next Leg of the Journey

My son starts 9th grade tomorrow, and my daughter begins community college classes next week. I have many feels (as my daughter would say.) I have started and deleted a couple of blog posts. There are so many different things on my mind and I can’t seem to settle on one as a focus. Finally, I decided to give a piece of advice to parents of kids who have IEPs or 504 plans.

My son has a 504 plan due to auditory processing difficulties. The process of diagnosis, plan development and interaction with various school staff will make for a book some day when I have time to write it. Right now, I’d like to share one of the most important things I’ve learned through hard experience.

Get. It. In. Writing.

Let me put that another way for emphasis: GET IT IN WRITING!

When you’re sitting by yourself as your child’s sole representative in an IEP or 504 meeting, it can be hard to steel your nerve and speak up. You want to seem reasonable. You want these people to like you and your child. But when a staff member says a specific item doesn’t need to be written into the plan “because it’s a service we can offer to any child,” this means they’re not going to do it. Unless you get in in writing and they’re legally obligated to. If it’s something your child needs, don’t worry that they’ll call you a helicopter parent or that they’ll think you’re too demanding, or not nice. Be polite, of course, but also firm that you want it in writing. If it’s something that’s no problem to offer, then why can’t they put it in writing?

My hard experience came with the verbal promise that a teacher would be assigned in my son’s eighth-grade year to go over his agenda with him each day to make sure he knew what his homework assignments were. This has been something that nearly drove me mad in his middle school years – trying to help him figure out what homework he needed to do and whether he’d done it. Often the assignments are told to the students at the end of class when everyone is packing everything away, creating lots of distracting noise – noise my son can’t filter, so he needs another way to know what’s going on. Some teachers were great about communicating and posting everything on-line. I love them. Others posted almost nothing. One teacher repeatedly posted things on-line and then changed the instructions verbally in class, so my son was spending time working on stuff that got him no class credit. I was literally in tears a couple of times from the frustration.

So when the junior high counselor sat in our 504 meeting and said, “We can designate a teacher to collate his assignments and check in with him each day to make sure he knows what they are and whether they’re getting done,” I felt as if I’d been handed a winning lottery ticket. I saw hours of work and worry lifting from my shoulders. When the counselor asked if it was something I’d like them to do, I didn’t hesitate. I said, “Yes, let’s put it in the plan.”

Hmmm…I should have been more suspicious when a different school staff member jumped in with “We don’t even have to put it in writing because…(chorus) it’s a service we can offer to any child.” They assured me they did it for lots of students and they’d do it for my son. They’d let me know if he was getting behind.

The school year started, and it was such a relief not to have to be an inadequately informed micro-manager any more. I kept thinking, “I really can let go of some things. It’s okay. I don’t have to do *everything.* Sometimes I really can leave it to the people who get paid to do it.”  I did ask my kid sometimes if he knew what he was supposed to be doing, and he’d say “I’m pretty sure I do.”  I did see him doing homework. I was tempted to check in at the school and ask, but didn’t want to be called names, you know, like “helicopter mom.” I figured I hadn’t heard anything and they’d let me know if he was behind.

Then, about four weeks into the year, I casually asked him which teacher was doing the homework check for him. And he was all like “What are you talking about?”

“You know, they said they’d assign a teacher to check in with you every day whether you know what your homework is from all the classes and whether you’re doing it?” I prompted.

Nope, nobody was doing anything like that. It hadn’t been done once. So I went to his 504 case manager (one of the school counselors) and asked what was up. And she was all doe-eyed innocence, like “We do that for some students, but it’s not in his plan anywhere.”

And I was all like “But you guys promised.”

And she was all like, “He does have all sorts of accommodations. I just don’t see that one written down in the plan anywhere.”

And then I realized the verbal promise wasn’t worth the paper it was written on. And the “all sorts of accommodations” remark? Intended to deflect attention away from the issue of them breaking a promise by making me feel bad about being overly demanding. Suddenly the “service we can offer to any student” had been transformed into a request for the sun and the moon. I haven’t asked for the sun nor the moon, I’m here to tell you. I’m starting to think maybe I should.

To get on with the story –  I checked in with all of his teachers and discovered he was missing at least some work in every single class, a significant amount in a couple of classes. And then I had to negotiate terms of catching up.  The process of catching up consumed every evening and weekend of our lives for the next month or so. And then I was back to sitting down next to him every afternoon with his school binders and the computer logged in to his school account, trying to help him figure it all out.

I have since talked to enough parents in similar situations to find out empty promises are distressingly common. I don’t want to paint with a broad brush, because we’ve dealt with some truly wonderful teachers over the years. But there are a few school personnel who, with no intention of following through, will promise almost anything in a meeting (verbally) simply to get you to stop talking about it.

This year, at least, I’m not lulled into a false complacency. My son was doing a better job by the end of the school year last year of knowing how to get the information he needed on his own, and I hope he’ll continue to improve and move toward independence this year. But I know I need to be right in there right away to help him get off to a successful start. At least this year I know.

One more point. I’ve decided the use of terms such as “helicopter parent” is nothing more than an attempt to control parents through humiliation. Keep us in our place. I’m not falling for it any more. I’m doing the best I can to help my kids grow into independent adults. But even independent adults sometimes need advocates. I’m going to do what I believe is best, without being cowed by the fear of a label.

And I’m getting all promises in writing.