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If you or someone you know is in crisis, please call the National Suicide Prevention Lifeline at 988 or contact the Crisis Text Line by texting HOME to 741741.

The GoFundMe request jumped out at me as I was scrolling through posts on LinkedIn.

Nora Super, executive director of the 2015 White House Conference on Aging and former director of the Milken Institute’s Center for the Future of Aging, was seeking contributions after suffering a severe spinal cord injury.

This story also ran on The Washington Post. It can be republished for free. About ‘Navigating Aging’

Navigating Agingfocuses on medical issues and advice associated with aging and end-of-life care, helping Americas 45 million seniors and their families navigate the health care system.

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Right now, I have no feeling below the waist. I need lots of equipment to go home from the hospital and live safely and independently, she wrote in her appeal.

Since coping with disability and the cost of coping with disability is an enormously important issue for older adults, I wondered if Super would discuss her experiences and try to put them in perspective.

The Institute on Disability at the University of New Hampshire ran the numbers for me: About 19 million people 65 and older in the U.S. a third of that age group had some type of disability in 2021, the latest year for which data is available. This includes difficulty with hearing, vision, cognition, mobility, or activities such as bathing, dressing, or shopping.

Super agreed to talk to me, but her story was more complicated than I anticipated.

First, some context. Super, 59, has been open about her struggle with major depression, an issue shes written about. In mid-June, after being fired from the Milken Institute, she began slipping into another depression her fifth episode since 2005.

Supers psychiatric medications werent working, she said, and she sought electroconvulsive therapy (ECT), which had been effective for her in the past. But mental health services are difficult to get in a timely way, and Super couldnt get an ECT appointment until Aug. 7.

On July 30, convinced that her life had no value, she attempted to end it. This was the event that led to her injury.

After two weeks in intensive care and a recovery unit, Super was ready to leave the hospital. But no rehabilitation facility would take her because of her mental health crisis. Without psychiatrists on staff, they claimed they couldnt ensure her safety, said Len Nichols, her husband.

Nichols, 70, has held several high-level health policy positions during his career, among them senior adviser for health policy at the Office of Management and Budget during the Clinton administration and director of the Center for Health Policy Research and Ethics at George Mason University. 

Using every contact he could, Nichols searched for a facility in New Orleans where Super could get intensive rehab services. During the pandemic, the couple had moved there from their longtime home in Arlington, Virginia. New Orleans is where Super grew up and three of her sisters live.

It took six days to get Super admitted to rehab. And that was just one of the challenges Nichols faced. Email Sign-Up

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Over the next month, he prepared for Supers return home, at considerable expense. An elevator was installed in the couples three-story home (their bedroom is on the second floor) for $38,000. A metal ramp at the homes entry cost $4,000. A lift for their Jeep cost $6,500. A bathroom renovation came to $4,000. An electronic wheelchair-style device that can be used in the shower was another $4,000.

Supers privately purchased insurance policy covered a wheelchair, bedside commode, hospital bed, and a Hoyer lift (a device that helps people transfer in and out of bed) with a small monthly copayment.

Its been surprising how much stuff Ive needed and how much all of it costs, Super admitted when we spoke on the phone.

Even with all our education, resources, and connections, we have had a hard time making all the arrangements weve needed to make, Nichols said. I cannot imagine how people do this with none of those three things.

He showered praise on the physical and occupational therapists who worked with Super at the rehab facility and taught him essential skills, such as how to move her from bed to her wheelchair without straining his back or damaging her skin.

I dont think I ever appreciated how essential their work is before this, he told me. They explain what youll be able to do for yourself and then they help you do it. They show you a pathway back to dignity and independence.

Still, the transition home has been difficult. In the hospital, nothing was expected of me, everything was done for me. In rehab, youre very goal-oriented and there are still people to take care of you, Super told me. Then, you come home, and that structure is gone and things are harder than you thought.

Fortunately, Nichols is healthy and able to handle hands-on caregiving. But he soon needed a break and the couple hired home-care workers for four hours a day, five days a week. That costs $120 daily, and Supers long-term care insurance pays $100.

Theyre lucky they can afford it. Medicare typically doesnt pay for chronic help of this kind, and only about 7% of people 50 or older have long-term care insurance.

What does Supers future look like? She isnt sure. Physicians have said it could take a year to know whether she can recover function below her waist.

Im happy to be alive and to see how I can take where Ive ended up and do something positive with it, she said. I still have a voice, and I can help people understand what it is to live with physical limitations in a way that Ive never really understood before.

Hopefully, this sense of purpose will sustain her. But it wont be easy. After we spoke, Super became discouraged with her prospects for recovery and her mood turned dark again, her husband said.

Knowing her, I believe that she will make it her mission to help others better understand the enormous and multiple challenges associated with the onset of a disability, and she will press for changes in our health system to improve the lives of families who have to deal with disabilities, said Stuart Butler, a senior fellow at the Brookings Institution who has worked with Super in the past.

Persistent accessibility problems for people with disabilities are part of what Super wants to speak out about. I live in an old city with sidewalks that are very uneven, and just getting down the street in my chair is a big hassle, she said. Finding parking where we can open the door fully and get me out is a challenge. 

Nichols has been surprised by how many medical offices have no way of lifting Super from her wheelchair to the exam table. The default is, they ask me, Can you pick her up? Its stunning how poorly prepared they are to help someone like Nora.

Then, there are reactions Super encounters when she leaves the house. Going down the street, people look at me and then they look away. It definitely feels different than when I was able-bodied. It makes me feel diminished, Super said.

Nichols finds himself thinking back to something a neurosurgeon said on the day Super was injured and had her first operation. He told me, Look, theres more damage than we thought, and she wont be what she was. Youre not going to know for six to 12 months whats possible. But I can tell you to do as much as you can as soon as you can to move on to a new normal. Millions of people have done it, and you can too.

Were eager to hear from readers about questions youd like answered, problems youve been having with your care, and advice you need in dealing with the health care system. Visitkffhealthnews.org/columniststo submit your requests or tips.

Judith Graham: khn.navigatingaging@gmail.com, @judith_graham Related Topics Aging Health Care Costs Mental Health Navigating Aging Disabilities Louisiana Virginia Contact Us Submit a Story Tip

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Care whistleblower ‘who saw elderly resident being punched’ could face removal from Britain

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Care whistleblower 'who saw elderly resident being punched' could face removal from Britain

A care worker who reported the alleged abuse of an elderly care home resident, which triggered a criminal investigation, is facing destitution and potential removal from Britain after speaking up.

“Meera”, whose name we have changed to protect her identity, said she witnessed an elderly male resident being punched several times in the back by a carer at the home where she worked.

Sky News is unable to name the care home for legal reasons because of the ongoing police investigation.

“I was [a] whistleblower there,” said Meera, who came to the UK from India last year to work at the home.

“Instead of addressing things, they fired me… I told them everything and they made me feel like I am criminal. I am not criminal, I am saving lives,” she added.

Meera
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‘Meera’ spoke up about abuse she said she witnessed in the care home where she worked

Like thousands of foreign care workers, Meera’s employer sponsored her visa. Unless she can find another sponsor, she now faces the prospect of removal from the country.

“I am in trouble right now and no one is trying to help me,” she said.

More on Migrant Crisis

Meera said she reported the alleged abuse to her bosses, but was called to a meeting with a manager and told to “change your statement, otherwise we will dismiss you”.

She refused. The following month, she was sacked.

The care home claimed she failed to perform to the required standard in the job.

She went to the police to report the alleged abuse and since then, a number of people from the care home have been arrested. They remain under investigation.

‘Migrants recruited because many are too afraid to speak out’

The home has capacity for over 60 residents. It is unclear if the care home residents or their relatives know about the police investigation or claim of physical abuse.

Since the arrests, the regulator, the Care Quality Commission (CQC), carried out an investigation at the home triggered by the concerns – but the home retained its ‘good’ rating.

Meera has had no reassurance from the authorities that she will be allowed to remain in Britain.

In order to stay, she’ll need to find another care home to sponsor her which she believes will be impossible without references from her previous employer.

She warned families: “I just want to know people in care homes like these… your person, your father, your parents, is not safe.”

She claimed some care homes have preferred to recruit migrants because many are too afraid to speak out.

“You hire local staff, they know the legal rights,” she said. “They can complain, they can work anywhere… they can raise [their] voice,” she said.

Becky Johnson
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Sky’s Becky Johnson spoke to ‘Meera’

Sky News has reported widespread exploitation of care visas and migrant care workers.

Read more:
More than 100 migrants face being in UK illegally
Immigration crackdown will fuel ‘exodus’ of nurses
New English language and UK citizenship requirements for migrants

Currently migrants make up around a third of the adult social care workforce, with the majority here on visas that are sponsored by their employers.

As part of measures announced in April in the government’s immigration white paper, the care visa route will be closed, meaning care homes will no longer be able to recruit abroad.

‘Whole system is based on power imbalance’

But the chief executive of the Work Rights Centre, a charity that helps migrants with employment issues, is warning that little will change for the tens of thousands of foreign care workers already here.

“The whole system is based on power imbalance and the government announcement doesn’t change that,” Dr Dora-Olivia Vicol told Sky News.

She linked the conditions for workers to poor care for residents.

Dr Dora
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Work Rights Centre CEO Dr Dora-Olivia Vicol

“I think the power that employers have over migrant workers’ visas really makes a terrible contribution to the quality of care,” she said.

Imran agrees. He came to the UK from Bangladesh, sponsored by a care company unrelated to the one Meera worked for. He says he frequently had to work 14-hour shifts with no break because there weren’t enough staff. He too believes vulnerable people are being put at risk by the working conditions of their carers.

Migrant workers ‘threatened’ over visas

“For four clients, there is [a] minimum requirement for two or three staff. I was doing [it] alone,” he said, in broken English.

“When I try to speak, they just directly threaten me about my visa,” he said.

“I knew two or three of my colleagues, they are facing the same issue like me. But they’re still afraid to speak up because of the visa.”

Meera

A government spokesperson called what happened to Imran and Meera “shocking”.

“No one should go to work in fear of their employer, and all employees have a right to speak up if they witness poor practice and care.”

James Bullion, from the CQC, told Sky News it acts on intelligence passed to it to ensure people stay safe in care settings.

Additional research by Leah Adin

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Donald Trump may be denied privilege of addressing parliament on UK state visit

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Donald Trump may be denied privilege of addressing parliament on UK state visit

Donald Trump may be denied the honour of addressing parliament on his state visit to the UK later this year, with no formal request yet submitted for him to be given that privilege.

It comes after President Macron’s successful state visit this week, in which he was invited to speak in front of both Houses of Parliament.

Sky News has been told the Speaker of the House of Commons, Sir Lindsay Hoyle, hasn’t so far received a request to invite the US president to speak in parliament when he is expected to visit in September.

It was confirmed to MPs who have raised concerns about the US president being allowed to address both houses.

Kate Osborne, Labour MP for Jarrow and Gateshead East, wrote to the speaker in April asking him to stop Mr Trump from addressing parliament, and tabled an early-day motion outlining her concerns.

“I was happy to see Macron here but feel very differently about Trump,” she said.

“Trump has made some very uncomfortable and worrying comments around the UK government, democracy, the Middle East, particularly around equalities and, of course, Ukraine.

“So, I think there are many reasons why, when we’re looking at a state visit, we should be looking at why they’re being afforded that privilege. Because, of course, it is a privilege for somebody to come and address both of the houses.”

But the timing of the visit may mean that any diplomatic sensitivities, or perceptions of a snub, could be avoided.

Macron addressing Parliament
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France’s President Emmanuel Macron addressed parliament during his state visit this month

Lord Ricketts, a former UK ambassador to France, pointed out that parliament isn’t sitting for much of September, and that could help resolve the issue.

In 2017, he wrote a public letter questioning the decision to give Donald Trump his first state visit, saying it put Queen Elizabeth II in a “very difficult position”.

Parliament rises from 16 September until 13 October due to party conferences.

The dates for the state visit haven’t yet been confirmed by Buckingham Palace or the government.

However, they have not denied that it will take place in September, after Mr Trump appeared to confirm they were planning to hold the state visit that month. The palace confirmed this week that the formal planning for his arrival had begun.

With the King likely to still be in Scotland in early September for events such as the Braemar Gathering, and the anniversary of his accession and the death of Queen Elizabeth on the 8th September, it may be expected that the visit would take place sometime from mid to the end of September, also taking into consideration the dates of the Labour Party conference starting on the 28th September and possibly the Lib Dem’s conference from the 20th-23rd.

Donald Trump. Pic: Reuters
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Mr Trump has said he believes the trip to the UK will take place in September. Pic: Reuters

When asked about parliamentary recess potentially solving the issue, Ms Osborne said: “It may be a way of dealing with it in a very diplomatic way… I don’t know how much control we have over Trump’s diary.

“But if we can manoeuvre it in a way that means that the House isn’t sitting, then that seems like a good solution, maybe not perfect, because I’d actually like him to know that he’s not welcome.”

A message from the speaker’s office, seen by Sky News, says: “Formal addresses to both Houses of Parliament are not automatically included in the itinerary of such a state visit.

“Whether a foreign head of state addresses parliament, during a state visit or otherwise, is part of the planning decisions.”

The King and Mr Trump raising a toast in 2019. Pic: Reuters
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Mr Trump made his first state visit to the UK in June 2019 during his first presidency. File pic: Reuters

It’s understood that if the government agrees to a joint address to parliament, the Lord Chamberlain’s office writes to the two speakers, on behalf of the King, to ask them to host this.

It will be Mr Trump’s second state visit.

During his first, in 2019, he didn’t address parliament, despite the fact that his predecessor, Barack Obama, was asked to do so.

It was unclear if this was due to the fact John Bercow, the speaker at the time, made it clear he wasn’t welcome to do so.

However, it didn’t appear to dampen Mr Trump’s excitement about his time with the Royal Family.

Read more from Sky News:
Two women killed as BMW crashes into care home
Officers who confronted Southport killer win bravery award

Speaking earlier this year, he described his state visit as “a fest” adding “it’s an honour… I’m a friend of Charles, I have great respect for King Charles and the family, William; we have really just a great respect for the family. And I think they’re setting a date for September.”

It is expected that, like Mr Macron, the pageantry for his trip this time will revolve around Windsor, with refurbishment taking place at Buckingham Palace.

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Liverpool retires number 20 shirt at all levels in honour of Diogo Jota

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Liverpool retires number 20 shirt at all levels in honour of Diogo Jota

Liverpool have retired the number 20 shirt in honour of Diogo Jota – the first time it has made such a gesture.

The club said it was a “unique tribute to a uniquely wonderful person” and the decision was made in consultation with his wife and family.

The number 20 will be retired at all levels, including the men’s and women’s first teams and academy squads.

A statement said: “It was the number he wore with pride and distinction, leading us to countless victories in the process – and Diogo Jota will forever be Liverpool Football Club’s number 20.”

The club called it a “recognition of not only the immeasurable contribution our lad from Portugal made to the Reds’ on-pitch successes over the last five years, but also the profound personal impact he had on his teammates, colleagues and supporters and the everlasting connections he built with them”.

Jota's wife joined Liverpool players to view tributes at Anfield on Friday. Pic: Liverpool FC
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Jota’s wife joined Liverpool players to view tributes at Anfield on Friday. Pic: Liverpool FC

Pic: Liverpool FC
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Pic: Liverpool FC

Newly-married Jota died alongside his brother when his Lamborghini crashed in northern Spain on 3 July.

Police said this week that all the evidence so far suggests Jota was the one driving the vehicle.

Liverpool teammates joined members of Jota’s family, including his wife Rute, at a huge memorial site outside Anfield on Friday.

Read more from Sky News:
Mystery in space is most likely ‘oldest comet ever seen’
Trump may be denied privilege of addressing parliament

A fan looks at messages written onto a memorial wall created near Anfield Stadium. Pic: Reuters
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A fan looks at messages on a memorial wall near Anfield. Pic: Reuters


Liverpool's captain Virgil van Dijk and Liverpool's player Andrew Robertson arrive on the day of the funeral ceremony of Liverpool's Portug
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Virgil van Dijk and Andy Robertson were among players at the funeral. Pic: Reuters

The star’s funeral took place last weekend, with Liverpool colleagues and members of the Portuguese national team in attendance.

Reds captain Virgil van Dijk carried a shirt bearing the number 20 made from flowers.

Liverpool players returned to the club’s training ground for the start of pre-season on Tuesday.

Their first game since Jota’s death will be on Sunday when they play a friendly away against Preston North End.

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