Signs of Distress

SUBHEAD: The data is telling us that from here, the extreme changes the world is experiencing will only accelerate.

By Chris Martinson on 11 August 2017 for Peak Prosperity -
(https://www.peakprosperity.com/blog/110096/signs-distress)


Image above: Stress cracks from shearing forces on door frame and through plaster wall from loss of structrural integrity. From (http://ths.gardenweb.com/discussions/2595490/holy-crack).

The need to change is becoming more obvious than ever. The world is edging closer to the final moments after which everything will be forever changed. Grand delusions, perpetuated over decades, will finally hit the limits of reality and collapse in on themselves.

We’re over-budget and have eaten deeply into the principal balances of all of our main trust accounts. We are ecologically overdrawn, financially insolvent, monetarily out past the Twilight Zone, consuming fossil fuels (as in literally eating them), and adding 80,000,000 net souls to the planet’s surface -- each year! -- without regard to the consequences.

Someday there will be hell to pay financially, economically, and ecologically as there simply isn’t any way to maintain these overdrafts forever. Reality does not renegotiate. Its deal terms aren't compromisable.

For those who have the neural plasticity to actually see what's happening around us, the changes are already here, blatant and frightening. Younger folks, with their fresher eyes and fewer ties to the past, can see them a lot easier than their elders.

The prosperity enjoyed by the past few generations -- especially the Baby Boomers -- was stolen from future generations. All the while, they pretended as if their borrowing-heavy standards of living were the result of sheer genius and intelligence; like trust fund babies who mistake being born on third base for hitting a triple.

Young people have sussed this out; and are now pulling back from many of the principal occupations of their forebears -- like marriage, babies and buying homes and cars. This perplexes older folks, who are beginning to find themselves increasingly at odds with the generations following after them.

Humans can be very very smart, but the flip-side of our ingenuity is our capacity for self-delusion. We’ve very consistently preferred to look past our faults. That can work for a while, but eventually an incomplete view will lead to a complete disaster.

For example: depleting our topsoils today to grow more eventually leads to a collapse of our food system tomorrow.

Similarly, increasing societal complexity ultimately drains the resources out of an empire, until it withers and fails. Such is what we can learn from history. Each of these examples is rooted in the self-delusion that today's actions don't have real consequences.

Monetary printing experiments like those currently being run by the world’s central banks are the ultimate form of self-delusion. Money is the most potent form of social communication, underlying all contracts and agreements. Violate those and literally everything falls apart, as we are seeing happen in real-time in Venezuela right now.

Money printing and its other historical debasement equivalents, serve to cover up (barely) critical signals. Derelict ideas that should die a quick death, instead, persist.

Mis-priced money leads mal-investment (e.g., Italian junk debt selling with the same yield as ten year US Treasury debt!!). Extremely unfair redistributions of wealth from the bottom to the top result. Every. Single. Time. This time is no different.

If you cannot see this madness in the chart below, I strongly suggest you keep staring at it until you can. It shows the exploding balance sheet of the central bank of 'the floating retirement colony' known as Japan:


Image above: Note between 2001 and 2006 there was a small crest in financialization in Japan, but after the Fukushima Daiichi Meltdown occurred there as been a tidal wave of money printing. From original article.

The Japanese money printers have gone hog-wild over the past decade. And they've had company. The other major central banks of the wold have been printing $trillions and $trillions, too, over the same time period. What will the repercussions be? The world is about to find out.

But it’s actually far worse than that. For those who can bear to look, the signs of illness are as startlingly obvious as gangrene on a necrotic limb.

• Species are going extinct at an unprecedented rate. 
• Glaciers are fast disappearing. 
• Frogs and insect populations are mysteriously collapsing.
• Massive destruction of the landscape as we chase the last low-EROEI fuels remaining (tar sands, and shale wells). 
• Miles-deep mining efforts. 
• Enormous human migrations away from economically and ecologically ruined areas (see: the MENA region).

But the average citizen remains largely blind and/or numb to these. Again, much of this has to do with self-delusion that broken signals enable. People worry less as long as the stock markets are showing higher values, which is precisely why we don’t trust them anymore – they have become the most important signaling devices for The Powers That Be.

They are far too important to leave to the vagaries of investors, and must be rescued/controlled/manipulated so that the “right” outcomes can be achieved.

If we’re lucky when these financial delusions finally break, we’ll hopefully avoid a global war. That’s the usual route by which the politicians and bankers seek to avoid having to be held accountable for the colossal mistakes they made in the past.

They drag everyone to in a manufactured confrontation, whooping up the populace into a fever pitch by inventing hobgoblins -- exactly as has recently happened in the US with the recent rash of Russia-phobia; a case study in how easily public perception can be manipulated (as well as proof-positive that critical thinking skills are no longer requirements for today's journalists).

But if we’re unlucky, war may destroy much of what we take for granted and hold dear. Living standards will drop. The veil covering today's massive financial deception will be yanked off, revealing the shriveled, cold promises of past decades as being wholly incapable of meeting their obligation to fund millions of promised retirements.

And if we’re really unlucky, that war could involve some horrendous new weapons that could cripple our nation's electrical grid (e.g., EMP, cyber attack). In which case, all of our individual attention and effort in the northern hemisphere will focus down to one simple task: surviving the first winter.

Signs Of Distress

In ways conscious and subconscious, we're becoming aware of the signs of growing instability around us. Like a flock of sheep catching the scent of an unseen predator, right now we’re collectively becoming increasingly nervous and stressed.

People’s tempers are short with each other, criticisms fly easily, and stances are becoming hardened to ludicrous levels.

Many don’t know why they're unhappy. And because they're unable to identify the source, they blame themselves. Instead of acting out, they act in.

Heavy drinking is on the rise:

More U.S. adults are drinking, and more heavily
Aug 9, 2017
The United States has a serious drinking problem. Since 2001, heavy drinking and alcohol use disorder have risen dramatically, according to a new study that surveyed tens of thousands of adults.The numbers reveal “a public health crisis,”the authors say.

The increases were especially large among those 65 years and older, minorities and women, researchers report online August 9 in JAMA Psychiatry. Alcohol is a risk factor for many potentially life-threatening injuries and health problems, including cardiovascular diseases, type 2 diabetes and liver cirrhosis.

In 2012‒2013, an estimated 29.6 million American adults reported high-risk drinking, up from 20.2 million in 2001‒2002.
(Source)

Alcohol is not enough for some people. Their need to numb themselves to the bleak existence of their lives leads them to opioids, both legal and illegal:

Opioid Crisis: The Awful Arithmetic of America’s Overdoses May Have Gotten Worse
Aug 7, 2017
The deadly drug overdose epidemic that has been ravaging the nation may be even worse than we realize. A new University of Virginia study says the numbers of deaths due to heroin and opioid overdoses have actually been severely underreported.

Dr. Christopher Ruhm revisited thousands of death certificates from 2008 through 2014 and concluded the mortality rates were 24 percent higher for opioids and 22 percent higher for heroin than had been previously reported.

Ruhm’s awful arithmetic emerged just days after the presidential opioid commission, led by New Jersey Gov. Chris Christie, urged President Donald Trump to “declare a national emergency” to deal with the crisis.

Nearly 35,000 people across America have died of heroin or opioid overdoses in 2015, according to theNational Institute on Drug Abuse.
(Source)

Records are being broken:

Opioid deaths in US break new record
Aug 8, 2017
The first nine months of 2016 saw a sharp increase in opioid drug overdoses in the US compared to the prior year, according to new data by the National Center for Health Statistics (NCHS). The government is struggling to respond to the crisis.

Deaths due to drug overdose peaked in the third quarter of last year – 19.7 cases for every 100,000 people, compared to 16.7 in the same period the year before,according to newly released numbers from the NCHS, which is part of the US Centers for Disease Control and Prevention (CDC).
(Source)

That is a startling rate of increase. 3/16.7 = 18% An 18% increase in one year is profound. What’s going on? We won’t go into the really dark side of this story which is that certain pharmaceutical companies make a ton of money off of addicted people, and those same companies donate a lot of money to the US political system. Suffice it to say that the worship of money and power is so profound that some activities of late cannot really be distinguished from those of a death cult.
For those who are not into opioids other avenues towards relieving the pain exist,

One in 6 Americans Take Antidepressants, Other Psychiatric Drugs
One in six Americans take some kind of psychiatric drugs — mostly antidepressants, researchers reported Monday.

They also found that twice as many white people take those drugs as do African-Americans or other minorities, and fewer than 5 percent of Asian-Americans do. And most people who take them are taking them long-term, Thomas Moore of the Institute for Safe Medication Practices in Alexandria, Virginia and colleagues found.

"Overall, 16.7 percent of 242 million U.S. adults reported filling one or more prescriptions for psychiatric drugs in 2013,” they wrote in the Journal of the American Medical Association’s JAMA Internal Medicine.
(Source)

If one in six Americans is being medicated for depression and/or anxiety, and another significant chunk are checking out via opioid numbing, perhaps we need to consider an alternative explanation for these facts: There’s something wrong with the world these people are inhabiting -- not with the people themselves.

Charles Eisenstein really caught my mind’s attention with a piece he wrote long ago entitled The Mutiny of the Soul. In it he argues that perhaps those most in need of medicinal help are actually those who are most attuned to the actual state of the world. He explains the rise in depression and anxiety like this:

The answer is staring us in the face. When our soul-body is saying No to life, through fatigue or depression, the first thing to ask is, "Is life as I am living it the right life for me right now?" When the soul-body is saying No to participation in the world, the first thing to ask is, "Does the world as it is presented me merit my full participation?"
What if there is something so fundamentally wrong with the world, the lives, and the way of being offered us, that withdrawal is the only sane response?

I have met countless people of great compassion and sensitivity, people who would describe themselves as "conscious" or "spiritual", who have battled with CFS, depression, thyroid deficiency, and so on. These are people who have come to a transition point in their lives where they become physically incapable of living the old life in the old world.

That is because, in fact, the world presented to us as normal and acceptable is anything but. It is a monstrosity. Ours is a planet in pain. If you need me to convince you of that, if you are unaware of the destruction of forests, oceans, wetlands, cultures, soil, health, beauty, dignity, and spirit that underlies the System we live in, then I have nothing to say to you. I only am speaking to you if you do believe that there is something deeply wrong with the way we are living on this planet.

So if you suffer from anxiety, maybe you don't have a "disorder" at all — maybe the house is on fire. Anxiety is simply the emotion corresponding to "Something is dangerously wrong and I don't know what it is." That is only a disorder if there is in fact nothing dangerously wrong. "Nothing is wrong, just you" is the message that any therapy gives when it tries to fix you.

I disagree with that message. The problem is not with you. You have very good reason to be anxious. Anxiety keeps part of your attention away from your tasks of polishing the silverware as the house burns down, of playing the violin as the Titanic sinks.
Unfortunately, the wrongness you are tapping into might be beyond the cognizance of the psychiatrists who treat you, who then conclude that the problem must be your brain.
(Source)

Does that all ring a bell of truth for you as it does for me?

Perhaps the sanest response to being in a world that does not merit your full participation is to check out. Drinking, drugs, video games and Netflix binges (while not advised or endorsed) are much more understandable when viewed through this lens.

(Full disclosure, these past few years have not been easy on me, either. I prefer action and constructive motion, so the past few years have been like one of those dreams where you're desperate to move but your body remains frozen in place.

I’ve wanted things to finally come to a head so we can at least begin the process of acknowledging our predicaments and facing them head on.

Beneath it all is my dread at the prospect that all these years of delaying and denying will amount to a larger and more painful correction when it comes.)

It really begs the question: What if there’s nothing wrong with the people who are anxious or depressed, but the exact opposite is true; those who are cheerful and chipper are missing the plot?

If you were an astronaut and your one-and-only spaceship was leaking oxygen into the infinite void of Space, would you medicate those expressing concern while rewarding those with positive attitudes and power drills who continue to punch more holes in the hull? Of course not. Why should we think any differently in the case of spaceship Earth?

The truth is that the lifestyle we're living today is vastly distant from the one humans evolved to value. Sebastian Junger explained to us in a podcast that returning veterans commit suicide at the rate of 22 per day largely because they experience such 'emptiness' upon reintegrating into civilian life. Unit cohesion in the military was so much more fulfilling and enriching that the prospect of a permanent return to what we call “US culture” leads many of them to conclude that suicide is the better option. If there's a more damning indictment of the current culture in the US, I don’t know of it.

The data is clear: in the US, people are as unhappy, overmedicated and overweight than ever before.

Our society's current plan is just not working. So why not square up to that reality, take charge and fix things while we still can? Why would we agree to persist in this dangerously broken state of affairs?

We, each of us and all of us, have the power to pursue a different path. A better path. We can and we should change everything that needs changing. We must rebel against this state of affairs, and withdraw our consent from a toxic system rather than let that system break us down.

The time for a quiet revolution has arrived. One that begins with, and within, you.

In Part 2: Joining The Quiet Revolution, we explain how the signs of distress detailed above can be used to add urgency in making investments in your life that will make you happier, healthier, more engaged, and prosperous -- both today and tomorrow.

The data is telling us that from here, the extreme changes the world is experiencing will only accelerate.

Those who can see this and adapt will fare far better than those who cannot, will not, or won’t.

Some will thrive, some will survive, many will do neither.

Click here to read the report (free executive summary, enrollment required for full access)


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Films of Harold Ramis

SUBHEAD: The politics of his films advanced the interest of the neo-conservatives over the old guard money interest.

By Thomas Frank on 2 March 2014 for Salon.com -
(http://www.salon.com/2014/03/02/baby_boomer_humors_big_lie_ghostbusters_and_caddyshack_really_liberated_reagan_and_wall_street/)


Image above: Ronald Reagan (Twilight's Last Gleaming) meets computer generated "Ghostbusters" from 1984, all together in Juan Wilson's computer mashup machine.Harold Ramis front and center, with Dan Aykroyd, Bill Murray, Ronald Reagan and Ernie Hudsom (l-r). Click to embiggen.

Harold Ramis was a master of subversive comedy, but the politics of his films backfired, and really liberated Reagan and Wall Street baby boomers.

I am going to start with three beloved movies of my childhood, and end with a suggestion of why liberals will probably never be able to come to grips with what they winningly call “inequality.”

The three movies I have in mind—”National Lampoon’s Animal House,” “Caddyshack,” and “Ghostbusters”. They were all written or directed, in whole or in part, by the great Harold Ramis, who died last week, and whose work was eulogized by President Obama as follows:

When we watched his movies . . . we didn’t just laugh until it hurt. We questioned authority. We identified with the outsider. We rooted for the underdog. And, through it all, we never lost our faith in happy endings.

That seems about right, doesn’t it? Each of the films I mentioned features some prudish or strait-laced patriarch who is spectacularly humiliated by a band of slobs or misfits or smart alecks. With their dick jokes and cruel insults, these movies represented, collectively, the righteous rising-up of a generation determined to get justice for the little guy.

That’s why a group of prominent Democrats showed up at Ramis’ funeral. It’s why articles about Ramis’ movies routinely speak of their liberating power.

So, the political equation is obvious, right? We of the left own the imagery of subversion and outsiderness. It’s ours. Every time a stupid old white guy gets humiliated in a TV commercial for choosing Brand X, we know it’s because the people at Brand Y secretly support universal health insurance and a nice little pop in the minimum wage. Right?

Well, no. And with that acknowledgement, let me advance to my bold hypothesis: The dick joke is not always what it seems to be. The dick joke is not always your friend.

Start with the first really great movie Ramis had a hand in writing, “National Lampoon’s Animal House.” Watching it again today, I didn’t think so much of righteous defiance, or underdogs and outsiders; I thought of Wall Street.

This particular iteration of Ramis’ martinet vs. slob theme pits—as everyone knows—a prissy, militaristic college fraternity against a fraternity where the boys like pleasure, which is to say, where they drink beer and throw parties and actually enjoy getting laid.

If this basic formula doesn’t strike you as particularly rebellious or even remarkable, that’s because it isn’t: in its simple anarchic assertion of appetite, it’s the philosophy of the people who rule us.

Everyone is a fraud in this world; learning is a joke; sex objects are easily conned; Kennedy-style idealism is strictly for suckers; and in one telling moment, fratboy 1 remarks to fratboy 2, who is crying over the trashing of his borrowed automobile by fratboy 1 and company, “You fucked up. You trusted us.”

What popped into my mind when I heard that line was that other great triumph of the boomer generation: the time-bomb investments of 2008; Goldman Sachs peddling its “shitty deals” to the naive and the credulous.

Drink, take and lie: translate it into Latin and it could be the motto of the One Percent. It is no coincidence that P. J. O’Rourke, who was editor of National Lampoon when “Animal House” was made and is currently a wisecracking critic of liberalism at the Cato Institute, recently declared that the release of the movie in 1978 marked the moment when his generation “took over” and started to make the world “better.” (That O’Rourke chose to write this for the American Association of Retired Persons is a particularly poignant detail.)

It is also no coincidence that the fraternity at Dartmouth which served as one of the models for “Animal House” has of late become a kind of pipeline into the investment-banking industry, nor should it surprise anyone that Wall Street is home to a secret Animal House-style fraternity of its own, a place where the anarchic captains of finance come together to slurp likker and howl their admiration for their beau ideal: the self-maximizing asshole . . . who got bad grades in college.

The second of the Ramis comedies eulogized by Obama was the 1980 cult classic “Caddyshack,” which took on the great movie theme of the Seventies—class antagonism—over a game of golf.

The martinet this time is a country-club grandee, depicted by veteran blowhard Ted Knight; the slob confronting him is a real-estate developer of hilariously garish taste played by Rodney Dangerfield; between them stands the American worker in all his nobility—meaning, specifically, a teenaged caddy at the country club who must decide whether to be true to his blue-collar self or to kiss the grandee’s ass in order to go to college.

The movie unfolds as a series of set pieces in which WASP prigs blow gasket after gasket upon beholding some infringement of their Prussian sensibilities—absorbing one of Dangerfield’s jokes, or seeing caddies frolicking in the pool, or hearing someone using the word “sucks,” or finding a car parked on the lawn, or picking up the saucy strains of a Journey song as it wafts across the greensward. Boom: Apoplexy! Watch the patriarchs go berserk!

And that makes for a pretty liberal film, right? I mean, who else makes fun of country club grandees except for us lefty authority-questioners?

Well, free-market conservatives do. Google the phrase “Country club Republican” and what you will find, by and large, are right-wing types using it as a synonym for “RINO”: fake Republicans who are in it for the snobbery—not out of faith in the relentless, disruptive forces of capitalism.

These same conservatives are also the most likely to understand class conflict in the way “Caddyshack” does: as a rivalry between WASP old money and differently pedigreed new money.

In fact, this is one of the themes of George Gilder’s 1981 book “Wealth and Poverty,” the manifesto of the “supply-side” revolution, and of countless wealth-celebrating books that followed. That’s why “Caddyshack” seems in retrospect like a piece of crypto-Reaganite social commentary.

Rodney Dangerfield’s character, for example, is a clear symbol of the crude power of markets—proudly showing off one of his tasteless billboards and announcing that he only cares about the “snobatorium” country club because he wants to build condos there.

The choice before the white, working-class caddy boils down to the Harvard-proud WASP snob and the earthy, joke-cracking businessman; the side he eventually chooses is the same one that millions of real-life blue-collar workers were also choosing in those confused days.

There is nothing “crypto” about Ramis’s 1984 hit, “Ghostbusters”: Its Reaganism is fully developed, as numerous critics have pointed out. Here the martinet is none other than a troublemaking EPA bureaucrat; the righteous, rule-breaking slobs are small businessmen—ghost-hunting businessmen, that is, who have launched themselves deliriously into the world of entrepreneurship.

Eventually, after the buffoon from the EPA gets needlessly into the businessmen’s mix and blunders the world into catastrophe, the forces of order find they must outsource public safety itself to the hired ghost-guns because government can’t do the job on its own.

Both Reagan and his closest advisers were transfixed by the film, Sidney Blumenthal tells us; “Ghostbusters” fit nicely into their idea of an America guided by “fantasy and myth.”

And while the film itself piled up its stupendous box-office returns in that summer of ‘84, Jack Abramoff and his College Republican pals got together a troupe of “Fritzbusters” to warm up the crowds at Republican events, mocking Democratic presidential candidate “Fritz” Mondale with an offensive take-off on the catchy “Ghostbusters” theme song.

And why not? What Mondale was promising—yes, promising—was to raise taxes, balance the budget, get responsible, and close down the party. What a Niedermeyer.

Harold Ramis was a sort of poet of the rude gesture, of the symbolic humiliation. Our reaction to his work, both now and when it was fresh, is almost mechanical: We see the square on the screen get shamed, and our mind shouts liberation. It is almost Pavlovian.

Our culture-masters have been gleefully triggering this kind of reaction for nearly fifty years now—since the rude gesture first became a national pastime during the 1960s—and in that time the affluent, middle-class society that produced the Boomer generation has pretty much gone the way of the family farmer.

These two developments are not unconnected. One small reason for the big economic change, I think, is the confusion engendered by the cultural change. The kind of liberation the rude gesture brings has turned out to be not that liberating after all, but along the way it has crowded out previous ideas of what liberation meant—ideas that had to with equality, with work, with ownership.

And still our love of simple, unadorned defiance expands. It is everywhere today. Everyone believes that they’re standing up against unjust authority of some imaginary kind or another—even those whose ultimate aim is obviously to establish an unjust authority of their own.

Their terms for it are slightly different than the ones in “Animal House”—they talk about the liberal elite, the statists, the social engineers, the “ruling class.”

But they’re all acting out the same old script. The Tea Party movement believes it’s resisting the arrogant liberal know-it-alls. So did Andrew Breitbart, in his brief career as a dealer in pranks and contumely.

So do the people who proposed that abominable gay marriage discrimination law in Arizona. Hell, so do the pitiful billionaires of Wall Street—even they think they’re standing bravely for Ayn Rand’s downtrodden job creators.

Maybe the day will come when we finally wake up and understand that insults don’t always set us free. But until that happens, my liberal friends, don’t ask for whom the bird flips: the bird flips for thee.

• Thomas Frank's most recent book is "Pity the Billionaire." He is also the author of "One Market Under God" and the founding editor of "The Baffler" magazine.


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Sex and Aging

SUBHEAD: Intimacy is the most natural, normal thing in the whole world. It keeps you young; it's something to look forward to.

By Bryan Gruley on 23 July 2013 for Bloomberg News -
(http://www.bloomberg.com/news/2013-07-23/sex-in-geriatrics-sets-hebrew-home-apart-in-elderly-care.html)


Image above: A homeless man in Seattle holds sign "Old Hippies Need Love Too". From (http://www.flickr.com/photos/lucky11studios/7116670991/).

The nurse was frantic. She’d just seen two elderly people having sex in a room at the Hebrew Home at Riverdale, New York. She asked Daniel A. Reingold, then the home’s executive vice president, what she should do.

“Tiptoe out and close the door so you don’t disturb them,” he told her.

Today, Reingold likes to recount the 19-year-old tale to show why the Hebrew Home broke with industry practice and encouraged sex and intimacy among its elderly residents, including those with Alzheimer’s and other forms of dementia.

In 1995, the home adopted a four-page policy -- considered the first of its kind -- stating that residents “have the right to seek out and engage in sexual expression,” including “words, gestures, movements or activities which appear motivated by the desire for sexual gratification.”

Beverly Herzog, an 85-year-old widow who recently moved to the Hebrew Home, said, “Intimacy is the most natural, normal thing in the whole world. It keeps you young, it gives you something to look forward to. It’s not easy to get into a cold bed.”

Said Reingold, now president and chief executive officer of the home: “We honor what remains in a person, not what’s gone.”

No one keeps track of how many of the nation’s 16,000 elderly care facilities have policies like the Hebrew Home’s. Greg Crist, a spokesman for the American Health Care Association, an industry trade group, said, “I’m not aware of anything that’s consistent.”

No Specific Policy
Instead of specific sexual-expression policies, some of the nation’s larger operators of nursing homes -- including Genesis HealthCare Corp. of Kennett Square, Pennsylvania, and Golden Living of Plano, Texas -- said they address the issue on a person-by-person basis, with training about sexual situations built into broader programs.

“This is an industry that is changing daily,” said Charlotte Patterson, a registered nurse who is vice president and associate general counsel of health care at Golden Living, which operates more than 300 nursing homes in 21 states. “We don’t have hard and fast rules because that could lock you into something you don’t want to be locked into. It’s important that we constantly keep that discussion going with our residents, our facilities and our staff.”

The $120.6 billion nursing home industry is expected to grow by an annual average of 3.6 percent to about $144 billion by 2018, according to industry research firm IBISWorld. The growth might be stronger if not for reductions in Medicare and Medicaid reimbursements and increased use of in-home services.

Sexually Freer
Hebrew Home’s sexual-expression policy is unusual, partly because many facilities lack the time, resources or inclination to confront the subject.

“There are still a lot of nursing homes that have their heads in the sand,” Reingold said.

That could change with the aging of the Baby Boom generation. By 2030, people 65 and over are expected to number more than 72 million, up from 40 million today, according to the U.S. Census Bureau. Baby Boomers, who started moving into that group in 2011, are sexually freer, living longer and using drugs such as Viagra.

Barring medical breakthroughs, the Alzheimer’s Association expects the number of those 65 and over with Alzheimer’s to grow to 7.1 million by 2025. Elderly-care residents with dementia can raise difficult legal, ethical and moral issues for caregivers who must determine whether those residents have the mental capacity to consent to sex.

Desire for Intimacy
In “To Be or to Exist,” a 2009 article in the Indiana Law Review, Evelyn Tenenbaum, a professor at Albany Law School in Albany, New York, wrote that, although desire for intimacy persists in people with dementia, “nursing homes cannot freely allow sexual relationships” between them. Homes “must intervene to ensure that unsafe and abusive relationships do not occur,” she wrote.

The Hebrew Home was founded in 1917. Today, the 870-bed facility sits on a 32-acre sprawl of brick pavilions atop a grassy slope along the Hudson River. The resident population counts 23 centenarians and has a median age of 86.

With an annual budget of almost $105 million, a staff of more than 1,000 and donors including famed lawyer David Boies and former American International Group chief Maurice Greenberg, the nursing home has greater resources than many in its field. (Bloomberg L.P., the parent company of Bloomberg News, also has donated to the Hebrew Home over the years.)

Questionnaire on Sex
Reingold, 58, started working at the home in 1990, when his father was CEO. He soon became aware that residents regularly had sex. In 1994, staffers filled out a questionnaire about their attitudes toward it. Some wanted the sex stopped altogether, some thought it was funny, some considered it disgusting.

“It reflected their personal backgrounds,” Reingold said.

A group of 11 staffers spent eight months writing a policy designed to reduce personal, religious, ethnic or other bias workers might bring to their interpretation of a sexual encounter.

“Generally,” the policy said, “it is the function and responsibility of staff to uphold and facilitate resident sexual expression.”

Intimacy Room
The policy gave residents rights to books, magazines, films and other materials with explicit sexual content, as well as to private space. Lack of privacy has often been cited in nursing home surveys as a primary obstacle to intimate relationships. Reingold recalled joking with a woman that maybe the Hebrew Home should offer an “intimacy room” for rental by the hour.

“She said, ‘Mr. Reingold, at our age, we’ll need it for more than an hour,’” he said.

The policy also was intended to comply with federal law giving residents essentially the same rights they’d enjoy outside the facility. Sex is as much a civil right as the right to vote, Reingold said.

The policy sets rules for guarding against non-consensual sex and public displays such as masturbation that could offend other residents. It also requires that the Hebrew Home maintain regular staff orientation and training programs in resident sexuality.

Staff members are taught to monitor people known to be in intimate relationships -- whether they involve simple handholding or intercourse -- for signs that either party is uncomfortable.

For instance, disruptions in eating, sleeping or bathroom patterns could prompt a nurse to ask a resident whether she or he is unhappy in a relationship. Where a relationship seems unwanted, the home can take steps to help end it, from counseling an overly aggressive resident to moving one to a different floor.

Family Involvement
The Hebrew Home has more than 250 beds assigned to residents with dementia. The home’s original policy acknowledged the sexual rights of those people while requiring, when one was known to be in an intimate relationship, that family be consulted. Staffers would counsel the family on the benefits of the relationship. If the family insisted on ending it, the home would comply.

In April, the Hebrew Home adjusted the policy to say that family members’ wishes wouldn’t necessarily be honored in all cases. Essentially, the home presumes that demented residents have the capacity to consent, absent evidence to the contrary, and works with families to accept the residents’ desires.

Even where a resident married to someone outside the facility has sex with another resident, the home could support the relationship if it’s healthy and consensual.

“This isn’t meant to be a hospital, it’s meant to be a home,” said Robin Dessel, 56, the Hebrew Home’s sexual rights educator. “A resident’s voice is foremost; it trumps everything.”

Once Consensual
Nevertheless, law professor Tenenbaum said, “Since dementia is a progressive disease, the staff must be vigilant to ensure that a once-consensual relationship does not become abusive. It may be difficult to determine when a consensual relationship between demented nursing home residents becomes non-consensual.”

Tenenbaum said more nursing homes should emulate the Hebrew Home. She wrote in the Indiana Law Review that elderly care facilities could provide “do not disturb” signs; set policies to discourage the spread of sexually transmitted diseases; make condoms, vaginal lubricants and Viagra readily available; and provide beauty salons and other cosmetic services to help residents feel physically and sexually attractive.

Herzog, the octogenarian Hebrew Home resident, looked pretty in red lipstick and gold bangles on a recent visit. She said she’d love to have someone special in her life.

“You want to have someone to pat you, someone to hold hands with,” she said. “Age should not be a barrier to anything.”

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