Crowdfunding for Small Business Is Still an Unclear Path

Joshua Bright for The New York Times

Candace Klein, chief of SoMoLend, in Midtown Manhattan. In starting her crowdfunding site, she sought out institutional investors that don’t face the same limits that individual investors do.

RYAN CALDBECK was stumped. A director at a private equity firm, he was taking part in a panel discussion at a consumer goods conference last summer in New York when an entrepreneur raised his hand with a question: Where could a young company with just a few million dollars in sales go for money to grow?

Librado Romero/The New York Times

Zak Normandin expanded his Little Duck Organics food company with financing found through CircleUp.

Mr. Caldbeck and his peers on the panel fumbled for a response. The fact is, most private equity investors and venture capitalists won’t touch a consumer products company until it has surpassed $10 million in sales — anything else is too small to bother with.

The best advice the panel could offer was for the entrepreneur to tap his credit cards.

“The purpose of the panel was to help entrepreneurs raise money, but we had no answers,” Mr. Caldbeck remembers. “That’s when I knew that there is a big issue here.”

That big issue caused Mr. Caldbeck to leave his job to start CircleUp, a company that aims to connect up-and-coming consumer products companies with investors.

Right now, the people allowed to invest through CircleUp must be accredited, meaning they have a high net worth. CircleUp hopes that soon not just the wealthy few, but the general public — whether friends, family members, customers, Facebook friends, or even total strangers — will be able to invest in deserving companies through a hot new area of finance known as crowdfunding.

To its advocates, crowdfunding is a way for capital-starved entrepreneurs to receive financing that neither big investors nor lenders are willing or able to provide. To others, it represents a potential minefield that could help bad businesses get off the ground before they eventually fail, and in some cases could even ensnare unsophisticated investors in outright fraud.

Those fears are partly why the Securities and Exchange Commission has delayed rules allowing crowdfunding that were supposed to take effect this month as part of the JOBS Act (Jump-Start Our Business Start-Ups), signed by President Obama last April. The S.E.C. is wary of loosening investor protections that have been in place since the 1930s.

Despite the uncertainty, the outlines of a new industry are emerging as a few crowdfunding start-ups have found ways to raise money within current rules. They include companies like CircleUp and SoMoLend, which lends money to small, Main Street-type businesses that typically wouldn’t interest private investors.

By themselves, of course, a few start-ups can’t completely democratize finance. But they begin to illuminate what the future of crowdfunding could look like, as the debate continues over a vast widening of the private investor pool.

Mr. Caldbeck formed CircleUp last fall along with Rory Eakin, a former business school classmate who was working for a philanthropic foundation. Through their start-up, the two men seek to finance food, personal care, apparel and pet-related companies, often with an environmental or social bent.

CircleUp considers applications from companies with $1 million to $10 million in revenue. Companies whose applications are accepted make their pitches to investors behind a firewall on the CircleUp Web site, offering equity stakes in return for capital. CircleUp, which helps companies raise up to $3 million, takes a small cut of the money.

Under current federal regulations, CircleUp wouldn’t be able to arrange such deals on its own. But it struck a partnership with W. R. Hambrecht, a registered broker-dealer that can handle investments from accredited, or high-net-worth, individuals whom the S.E.C. considers sophisticated enough to invest in private companies.

“Living here in Silicon Valley, a lot of people don’t understand the need,” Mr. Caldbeck says. “If you’re a tech company with a good idea, you can raise money. But it’s a different story for food, agriculture, retail and other consumer-oriented businesses.”

Mr. Caldbeck sees a big opportunity. Consumer goods companies account for a sizable portion of the nation’s businesses, yet very little capital — from private equity funds or from accredited investors — flows to them, he says.

What’s more, only a tiny percentage of those who qualify as accredited investors actually invest in private companies, he says. (These are people with a net worth of at least $1 million, not including their primary residence, or who have earned more than $200,000 — $300,000 for couples — in each of the last two years.)

Amy Cortese is the author of “Locavesting: The Revolution in Local Investing and How to Profit From It.”

Read More..

Despite New Health Law, Some See Sharp Rise in Premiums

Health insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest objectives of the Obama administration’s health care law was to stem the rapid rise in insurance costs for consumers.

Bob Chamberlin/Los Angeles Times

Dave Jones, the California insurance commissioner, said some insurance companies could raise rates as much as they did before the law was enacted.

Particularly vulnerable to the high rates are small businesses and people who do not have employer-provided insurance and must buy it on their own.

In California, Aetna is proposing rate increases of as much as 22 percent, Anthem Blue Cross 26 percent and Blue Shield of California 20 percent for some of those policy holders, according to the insurers’ filings with the state for 2013. These rate requests are all the more striking after a 39 percent rise sought by Anthem Blue Cross in 2010 helped give impetus to the law, known as the Affordable Care Act, which was passed the same year and will not be fully in effect until 2014.

 In other states, like Florida and Ohio, insurers have been able to raise rates by at least 20 percent for some policy holders. The rate increases can amount to several hundred dollars a month.

The proposed increases compare with about 4 percent for families with employer-based policies.

Under the health care law, regulators are now required to review any request for a rate increase of 10 percent or more; the requests are posted on a federal Web site, healthcare.gov, along with regulators’ evaluations.

The review process not only reveals the sharp disparity in the rates themselves, it also demonstrates the striking difference between places like New York, one of the 37 states where legislatures have given regulators some authority to deny or roll back rates deemed excessive, and California, which is among the states that do not have that ability.

New York, for example, recently used its sweeping powers to hold rate increases for 2013 in the individual and small group markets to under 10 percent. California can review rate requests for technical errors but cannot deny rate increases.

The double-digit requests in some states are being made despite evidence that overall health care costs appear to have slowed in recent years, increasing in the single digits annually as many people put off treatment because of the weak economy. PricewaterhouseCoopers estimates that costs may increase just 7.5 percent next year, well below the rate increases being sought by some insurers. But the companies counter that medical costs for some policy holders are rising much faster than the average, suggesting they are in a sicker population. Federal regulators contend that premiums would be higher still without the law, which also sets limits on profits and administrative costs and provides for rebates if insurers exceed those limits.

Critics, like Dave Jones, the California insurance commissioner and one of two health plan regulators in that state, said that without a federal provision giving all regulators the ability to deny excessive rate increases, some insurance companies can raise rates as much as they did before the law was enacted.

“This is business as usual,” Mr. Jones said. “It’s a huge loophole in the Affordable Care Act,” he said.

While Mr. Jones has not yet weighed in on the insurers’ most recent requests, he is pushing for a state law that will give him that authority. Without legislative action, the state can only question the basis for the high rates, sometimes resulting in the insurer withdrawing or modifying the proposed rate increase.

The California insurers say they have no choice but to raise premiums if their underlying medical costs have increased. “We need these rates to even come reasonably close to covering the expenses of this population,” said Tom Epstein, a spokesman for Blue Shield of California. The insurer is requesting a range of increases, which average about 12 percent for 2013.

Although rates paid by employers are more closely tracked than rates for individuals and small businesses, policy experts say the law has probably kept at least some rates lower than they otherwise would have been.

“There’s no question that review of rates makes a difference, that it results in lower rates paid by consumers and small businesses,” said Larry Levitt, an executive at the Kaiser Family Foundation, which estimated in an October report that rate review was responsible for lowering premiums for one out of every five filings.

Federal officials say the law has resulted in significant savings. “The health care law includes new tools to hold insurers accountable for premium hikes and give rebates to consumers,” said Brian Cook, a spokesman for Medicare, which is helping to oversee the insurance reforms.

“Insurers have already paid $1.1 billion in rebates, and rate review programs have helped save consumers an additional $1 billion in lower premiums,” he said. If insurers collect premiums and do not spend at least 80 cents out of every dollar on care for their customers, the law requires them to refund the excess.

As a result of the review process, federal officials say, rates were reduced, on average, by nearly three percentage points, according to a report issued last September.

Read More..

Despite New Health Law, Some See Sharp Rise in Premiums

Health insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest objectives of the Obama administration’s health care law was to stem the rapid rise in insurance costs for consumers.

Bob Chamberlin/Los Angeles Times

Dave Jones, the California insurance commissioner, said some insurance companies could raise rates as much as they did before the law was enacted.

Particularly vulnerable to the high rates are small businesses and people who do not have employer-provided insurance and must buy it on their own.

In California, Aetna is proposing rate increases of as much as 22 percent, Anthem Blue Cross 26 percent and Blue Shield of California 20 percent for some of those policy holders, according to the insurers’ filings with the state for 2013. These rate requests are all the more striking after a 39 percent rise sought by Anthem Blue Cross in 2010 helped give impetus to the law, known as the Affordable Care Act, which was passed the same year and will not be fully in effect until 2014.

 In other states, like Florida and Ohio, insurers have been able to raise rates by at least 20 percent for some policy holders. The rate increases can amount to several hundred dollars a month.

The proposed increases compare with about 4 percent for families with employer-based policies.

Under the health care law, regulators are now required to review any request for a rate increase of 10 percent or more; the requests are posted on a federal Web site, healthcare.gov, along with regulators’ evaluations.

The review process not only reveals the sharp disparity in the rates themselves, it also demonstrates the striking difference between places like New York, one of the 37 states where legislatures have given regulators some authority to deny or roll back rates deemed excessive, and California, which is among the states that do not have that ability.

New York, for example, recently used its sweeping powers to hold rate increases for 2013 in the individual and small group markets to under 10 percent. California can review rate requests for technical errors but cannot deny rate increases.

The double-digit requests in some states are being made despite evidence that overall health care costs appear to have slowed in recent years, increasing in the single digits annually as many people put off treatment because of the weak economy. PricewaterhouseCoopers estimates that costs may increase just 7.5 percent next year, well below the rate increases being sought by some insurers. But the companies counter that medical costs for some policy holders are rising much faster than the average, suggesting they are in a sicker population. Federal regulators contend that premiums would be higher still without the law, which also sets limits on profits and administrative costs and provides for rebates if insurers exceed those limits.

Critics, like Dave Jones, the California insurance commissioner and one of two health plan regulators in that state, said that without a federal provision giving all regulators the ability to deny excessive rate increases, some insurance companies can raise rates as much as they did before the law was enacted.

“This is business as usual,” Mr. Jones said. “It’s a huge loophole in the Affordable Care Act,” he said.

While Mr. Jones has not yet weighed in on the insurers’ most recent requests, he is pushing for a state law that will give him that authority. Without legislative action, the state can only question the basis for the high rates, sometimes resulting in the insurer withdrawing or modifying the proposed rate increase.

The California insurers say they have no choice but to raise premiums if their underlying medical costs have increased. “We need these rates to even come reasonably close to covering the expenses of this population,” said Tom Epstein, a spokesman for Blue Shield of California. The insurer is requesting a range of increases, which average about 12 percent for 2013.

Although rates paid by employers are more closely tracked than rates for individuals and small businesses, policy experts say the law has probably kept at least some rates lower than they otherwise would have been.

“There’s no question that review of rates makes a difference, that it results in lower rates paid by consumers and small businesses,” said Larry Levitt, an executive at the Kaiser Family Foundation, which estimated in an October report that rate review was responsible for lowering premiums for one out of every five filings.

Federal officials say the law has resulted in significant savings. “The health care law includes new tools to hold insurers accountable for premium hikes and give rebates to consumers,” said Brian Cook, a spokesman for Medicare, which is helping to oversee the insurance reforms.

“Insurers have already paid $1.1 billion in rebates, and rate review programs have helped save consumers an additional $1 billion in lower premiums,” he said. If insurers collect premiums and do not spend at least 80 cents out of every dollar on care for their customers, the law requires them to refund the excess.

As a result of the review process, federal officials say, rates were reduced, on average, by nearly three percentage points, according to a report issued last September.

Read More..

Crowdfunding for Small Business Is Still an Unclear Path

Joshua Bright for The New York Times

Candace Klein, chief of SoMoLend, in Midtown Manhattan. In starting her crowdfunding site, she sought out institutional investors that don’t face the same limits that individual investors do.

RYAN CALDBECK was stumped. A director at a private equity firm, he was taking part in a panel discussion at a consumer goods conference last summer in New York when an entrepreneur raised his hand with a question: Where could a young company with just a few million dollars in sales go for money to grow?

Librado Romero/The New York Times

Zak Normandin expanded his Little Duck Organics food company with financing found through CircleUp.

Mr. Caldbeck and his peers on the panel fumbled for a response. The fact is, most private equity investors and venture capitalists won’t touch a consumer products company until it has surpassed $10 million in sales — anything else is too small to bother with.

The best advice the panel could offer was for the entrepreneur to tap his credit cards.

“The purpose of the panel was to help entrepreneurs raise money, but we had no answers,” Mr. Caldbeck remembers. “That’s when I knew that there is a big issue here.”

That big issue caused Mr. Caldbeck to leave his job to start CircleUp, a company that aims to connect up-and-coming consumer products companies with investors.

Right now, the people allowed to invest through CircleUp must be accredited, meaning they have a high net worth. CircleUp hopes that soon not just the wealthy few, but the general public — whether friends, family members, customers, Facebook friends, or even total strangers — will be able to invest in deserving companies through a hot new area of finance known as crowdfunding.

To its advocates, crowdfunding is a way for capital-starved entrepreneurs to receive financing that neither big investors nor lenders are willing or able to provide. To others, it represents a potential minefield that could help bad businesses get off the ground before they eventually fail, and in some cases could even ensnare unsophisticated investors in outright fraud.

Those fears are partly why the Securities and Exchange Commission has delayed rules allowing crowdfunding that were supposed to take effect this month as part of the JOBS Act (Jump-Start Our Business Start-Ups), signed by President Obama last April. The S.E.C. is wary of loosening investor protections that have been in place since the 1930s.

Despite the uncertainty, the outlines of a new industry are emerging as a few crowdfunding start-ups have found ways to raise money within current rules. They include companies like CircleUp and SoMoLend, which lends money to small, Main Street-type businesses that typically wouldn’t interest private investors.

By themselves, of course, a few start-ups can’t completely democratize finance. But they begin to illuminate what the future of crowdfunding could look like, as the debate continues over a vast widening of the private investor pool.

Mr. Caldbeck formed CircleUp last fall along with Rory Eakin, a former business school classmate who was working for a philanthropic foundation. Through their start-up, the two men seek to finance food, personal care, apparel and pet-related companies, often with an environmental or social bent.

CircleUp considers applications from companies with $1 million to $10 million in revenue. Companies whose applications are accepted make their pitches to investors behind a firewall on the CircleUp Web site, offering equity stakes in return for capital. CircleUp, which helps companies raise up to $3 million, takes a small cut of the money.

Under current federal regulations, CircleUp wouldn’t be able to arrange such deals on its own. But it struck a partnership with W. R. Hambrecht, a registered broker-dealer that can handle investments from accredited, or high-net-worth, individuals whom the S.E.C. considers sophisticated enough to invest in private companies.

“Living here in Silicon Valley, a lot of people don’t understand the need,” Mr. Caldbeck says. “If you’re a tech company with a good idea, you can raise money. But it’s a different story for food, agriculture, retail and other consumer-oriented businesses.”

Mr. Caldbeck sees a big opportunity. Consumer goods companies account for a sizable portion of the nation’s businesses, yet very little capital — from private equity funds or from accredited investors — flows to them, he says.

What’s more, only a tiny percentage of those who qualify as accredited investors actually invest in private companies, he says. (These are people with a net worth of at least $1 million, not including their primary residence, or who have earned more than $200,000 — $300,000 for couples — in each of the last two years.)

Amy Cortese is the author of “Locavesting: The Revolution in Local Investing and How to Profit From It.”

Read More..

IHT Rendezvous: Hints of Taiwan Leading the Way on Same-Sex Marriage in Asia

BEIJING — Will Taiwan become the first place in Asia to legalize same-sex marriage in 2013?

Perhaps, judging from recent developments on the island, where the legislature has held its first hearings on the issue, a move that signifies “a major step towards becoming the first Asian territory to approve marriage equality,” the Shanghai-based Web site Shanghaiist reported, citing Gay Star News.

In another sign that change may be on the way for Taiwan, senior judges recently asked for advice from the country’s constitutional court, the Grand Justices, on whether to legalize same-sex marriages after two men from Taiwan, Nelson Chan and his long-term partner, Kao Chih-wei, filed an administrative lawsuit last year following the rejection by a local registration office in Taipei of their application to marry.

As The Taipei Times reported late last month, the Taipei High Administrative Court had been expected to hand down a decision on Mr. Chen and Mr. Kao’s case, “but instead said it was seeking a constitutional interpretation while holding further debates before making a judgment.”

To Mr. Chen, that was a victory. “I think this is a good decision. I’m happy to see it,” he told The Taipei Times. “I am confident and hopeful of the outcome of the constitutional interpretation, because the world is changing. I hope Taiwan would be the first Asian country to recognize same-sex marriages through a judicial ruling.”

The moves come as more states in the United States have legalized gay marriage – Maine and Maryland becoming the latest, with Maryland’s new law taking effect Jan. 1. Same-sex marriage is now legal in nine states and Washington, D.C.

One of the most socially and politically progressive societies in Asia, “Taiwan is moving closer to allowing same-sex marriage,” predicted Gay Star News, though it pointed out that top judges in Taiwan had said that the proposed changes did not go far enough and that legislation needed to be rewritten and expanded before that could happen – and that it would not be a simple matter.

Current proposals for change affect only the articles of the Civil Code that pertain to marriage in gendered language, and propose “altering the words from ‘male’ and ‘female’ to gender-neutral language,” Gay Star News reported.

It quoted a senior judge, Hsu Li-ying, from the Supreme Court’s Juvenile and Family Department (the court is known in Taiwan’s complex political-legal system as the Judicial Yuan) as saying that the new legislation might “need to be more comprehensive.”

The deputy justice minister, Chen Ming-tang, said it was not just the Civil Code that would have to change, but also laws regarding parentage, taxes and health insurance. That means the Justice Ministry could not do it alone, the report said.

Others believed the road ahead will be long and same-sex marriage difficult to achieve, with the decision to seek advice from the constitutional court a way of avoiding making a decision.

Taiwan has a flourishing civil society and a gay community that has long been pressuring the government to legalize gay marriage. Many believe it is a matter of time. Taiwan hosts Asia’s biggest gay pride parade, with the one held last October drawing more than 50,000 participants from across the region.

Taiwan even has its own gay god – the Taoist Rabbit God, to whom homosexuals can pray for love and good fortune (there is a small temple to the Rabbit God near Taipei). As The Taipei Times reports, the rabbit deity is based on the real-life figure of Hu Tianbao, an official in 18th-century Qing dynasty China.

And last year, two women in Taiwan were “married” in a Buddhist ceremony by a Buddhist master, Shih Chao-hwei, who is also a professor at Hsuan Chuang University. Homosexuality is not prohibited in Buddhism, the professor said: “It’s difficult enough to maintain a relationship,” the professor said in a telephone interview with The Taipei Times. “How could you be so stingy as to begrudge a couple for wanting to get married, regardless of their sexual orientation?”

A poll in September by The United Daily News found that 55 percent of those surveyed approved of gay marriage laws, with only 37 percent against. But the poll also found that 61 percent could not accept their children being gay, with only 37 percent saying they could.

Read More..

Media Decoder Blog: New York Observer Makes Ken Kurson New Editor

It will come as no surprise to those who follow the Manhattan media scene that The New York Observer has picked a new editor. After all, the newspaper has already had five editors in the seven years since Jared Kushner, a New York real estate developer, acquired the newspaper at the age of 25 in 2006.

Now it has a sixth. Ken Kurson, an author and editor who once worked with Rudolph W. Giuliani, the former mayor of New York, was named editor in chief of The Observer and editorial director of the Observer Media Group on Friday.

Mr. Kurson, 44, a longtime friend of Mr. Kushner’s, takes over from Aaron Gell, who has served as interim editor since Elizabeth Spiers resigned last August.

In a letter to The Observer staff, Mr. Kushner said: “Ken knows the ideas, stories and voices that make up New York better than anyone. He is a journalist and an author and through his years as a consultant observed the figures who create the framework of business, politics, media, tech, culture and real estate in our city.”

As Mr. Kushner has churned through editors and financial losses, he has struggled to find a landing place for The Observer, which faces increased competition from a revitalized New York Magazine and any number of Web sites staffed by young writers cracking wise and sometimes wisely about current events in New York.

“I took a company that was losing a lot of money and run as a hobby and turned it into a business,” Mr. Kushner said in a telephone interview Friday. “If you take a conventional approach in the media business, you are going to get slaughtered. It’s true that I’ve broken some eggs along the way, but in the process I’ve preserved an important editorial voice, not just in New York but in the rest of the country.”

Mr. Gell was surprised by the move, but was aware that editorial changes have become common at the weekly.

“I have loved every minute of editing the Observer, and I’m really proud of what we’ve done here, especially in terms of boosting readership to our web properties and our coverage of Hurricane Sandy,” Mr. Gell said. “I know Ken. He’ll do a great job, and I look forward to helping him out however I can.”

Mr. Kurson has been a contributing editor at Esquire magazine since 1997 and has written a column there. He was an intern at Harper’s Magazine, started and sold a personal finance magazine, and has written four books.

Still, one of those books was “Leadership,” which he co-wrote with Mr. Giuliani. Mr. Kurson worked at Giuliani Partners in 2002 after completing the book and then joined Mr. Giuliani’s failed campaign for president in 2008. Since then Mr. Kurson has worked at Jamestown Associates, a New Jersey political and communications firm, where he ran media operations for a number of Republican House and Senate candidates.

Given his close ties to Mr. Giuliani and the former mayor’s keen interest in advancing the candidacy of Joseph J. Lhota, the former head of the Metropolitan Transportation Authority, Mr. Kurson says he knows he will be closely watched.

“People will think what they want,” he said in an interview. “I will have to earn their trust. I have had a long and honorable journalistic career, calling it like I see it and being a straight shooter.”

A version of this article appeared in print on 01/05/2013, on page B3 of the NewYork edition with the headline: The New York Observer Names Author as Editor.

Read More..

The New Old Age: Murray Span, 1922-2012

One consequence of our elders’ extended lifespans is that we half expect them to keep chugging along forever. My father, a busy yoga practitioner and blackjack player, celebrated his 90th birthday in September in reasonably good health.

So when I had the sad task of letting people know that Murray Span died on Dec. 8, after just a few days’ illness, the primary response was disbelief. “No! I just talked to him Tuesday! He was fine!”

And he was. We’d gone out for lunch on Saturday, our usual routine, and he demolished a whole stack of blueberry pancakes.

But on Wednesday, he called to say he had bad abdominal pain and had hardly slept. The nurses at his facility were on the case; his geriatrician prescribed a clear liquid diet.

Like many in his generation, my dad tended towards stoicism. When he said, the following morning, “the pain is terrible,” that meant agony. I drove over.

His doctor shared our preference for conservative treatment. For patients at advanced ages, hospitals and emergency rooms can become perilous places. My dad had come through a July heart attack in good shape, but he had also signed a do-not-resuscitate order. He saw evidence all around him that eventually the body fails and life can become a torturous series of health crises and hospitalizations from which one never truly rebounds.

So over the next two days we tried to relieve his pain at home. He had abdominal x-rays that showed some kind of obstruction. He tried laxatives and enemas and Tylenol, to no effect. He couldn’t sleep.

On Friday, we agreed to go to the emergency room for a CT scan. Maybe, I thought, there’s a simple fix, even for a 90-year-old with diabetes and heart disease. But I carried his advance directives in my bag, because you never know.

When it is someone else’s narrative, it’s easier to see where things go off the rails, where a loving family authorizes procedures whose risks outweigh their benefits.

But when it’s your father groaning on the gurney, the conveyor belt of contemporary medicine can sweep you along, one incremental decision at a time.

All I wanted was for him to stop hurting, so it seemed reasonable to permit an IV for hydration and pain relief and a thin oxygen tube tucked beneath his nose.

Then, after Dad drank the first of two big containers of contrast liquid needed for his scan, his breathing grew phlegmy and labored. His geriatrician arrived and urged the insertion of a nasogastric tube to suck out all the liquid Dad had just downed.

His blood oxygen levels dropped, so there were soon two doctors and two nurses suctioning his throat until he gagged and fastening an oxygen mask over his nose and mouth.

At one point, I looked at my poor father, still in pain despite all the apparatus, and thought, “This is what suffering looks like.” I despaired, convinced I had failed in my most basic responsibility.

“I’m just so tired,” Dad told me, more than once. “There are too many things going wrong.”

Let me abridge this long story. The scan showed evidence of a perforation of some sort, among other abnormalities. A chest X-ray indicated pneumonia in both lungs. I spoke with Dad’s doctor, with the E.R. doc, with a friend who is a prominent geriatrician.

These are always profound decisions, and I’m sure that, given the number of unknowns, other people might have made other choices. Fortunately, I didn’t have to decide; I could ask my still-lucid father.

I leaned close to his good ear, the one with the hearing aid, and told him about the pneumonia, about the second CT scan the radiologist wanted, about antibiotics. “Or, we can stop all this and go home and call hospice,” I said.

He had seen my daughter earlier that day (and asked her about the hockey strike), and my sister and her son were en route. The important hands had been clasped, or soon would be.

He knew what hospice meant; its nurses and aides helped us care for my mother as she died. “Call hospice,” he said. We tiffed a bit about whether to have hospice care in his apartment or mine. I told his doctors we wanted comfort care only.

As in a film run backwards, the tubes came out, the oxygen mask came off. Then we settled in for a night in a hospital room while I called hospices — and a handyman to move the furniture out of my dining room, so I could install his hospital bed there.

In between, I assured my father that I was there, that we were taking care of him, that he didn’t have to worry. For the first few hours after the morphine began, finally seeming to ease his pain, he could respond, “OK.” Then, he couldn’t.

The next morning, as I awaited the hospital case manager to arrange the hospice transfer, my father stopped breathing.

We held his funeral at the South Jersey synagogue where he’d had his belated bar mitzvah at age 88, and buried him next to my mother in a small Jewish cemetery in the countryside. I’d written a fair amount about him here, so I thought readers might want to know.

We weren’t ready, if anyone ever really is, but in our sorrow, my sister and I recite this mantra: 90 good years, four bad days. That’s a ratio any of us might choose.

---

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

Read More..

The New Old Age: Murray Span, 1922-2012

One consequence of our elders’ extended lifespans is that we half expect them to keep chugging along forever. My father, a busy yoga practitioner and blackjack player, celebrated his 90th birthday in September in reasonably good health.

So when I had the sad task of letting people know that Murray Span died on Dec. 8, after just a few days’ illness, the primary response was disbelief. “No! I just talked to him Tuesday! He was fine!”

And he was. We’d gone out for lunch on Saturday, our usual routine, and he demolished a whole stack of blueberry pancakes.

But on Wednesday, he called to say he had bad abdominal pain and had hardly slept. The nurses at his facility were on the case; his geriatrician prescribed a clear liquid diet.

Like many in his generation, my dad tended towards stoicism. When he said, the following morning, “the pain is terrible,” that meant agony. I drove over.

His doctor shared our preference for conservative treatment. For patients at advanced ages, hospitals and emergency rooms can become perilous places. My dad had come through a July heart attack in good shape, but he had also signed a do-not-resuscitate order. He saw evidence all around him that eventually the body fails and life can become a torturous series of health crises and hospitalizations from which one never truly rebounds.

So over the next two days we tried to relieve his pain at home. He had abdominal x-rays that showed some kind of obstruction. He tried laxatives and enemas and Tylenol, to no effect. He couldn’t sleep.

On Friday, we agreed to go to the emergency room for a CT scan. Maybe, I thought, there’s a simple fix, even for a 90-year-old with diabetes and heart disease. But I carried his advance directives in my bag, because you never know.

When it is someone else’s narrative, it’s easier to see where things go off the rails, where a loving family authorizes procedures whose risks outweigh their benefits.

But when it’s your father groaning on the gurney, the conveyor belt of contemporary medicine can sweep you along, one incremental decision at a time.

All I wanted was for him to stop hurting, so it seemed reasonable to permit an IV for hydration and pain relief and a thin oxygen tube tucked beneath his nose.

Then, after Dad drank the first of two big containers of contrast liquid needed for his scan, his breathing grew phlegmy and labored. His geriatrician arrived and urged the insertion of a nasogastric tube to suck out all the liquid Dad had just downed.

His blood oxygen levels dropped, so there were soon two doctors and two nurses suctioning his throat until he gagged and fastening an oxygen mask over his nose and mouth.

At one point, I looked at my poor father, still in pain despite all the apparatus, and thought, “This is what suffering looks like.” I despaired, convinced I had failed in my most basic responsibility.

“I’m just so tired,” Dad told me, more than once. “There are too many things going wrong.”

Let me abridge this long story. The scan showed evidence of a perforation of some sort, among other abnormalities. A chest X-ray indicated pneumonia in both lungs. I spoke with Dad’s doctor, with the E.R. doc, with a friend who is a prominent geriatrician.

These are always profound decisions, and I’m sure that, given the number of unknowns, other people might have made other choices. Fortunately, I didn’t have to decide; I could ask my still-lucid father.

I leaned close to his good ear, the one with the hearing aid, and told him about the pneumonia, about the second CT scan the radiologist wanted, about antibiotics. “Or, we can stop all this and go home and call hospice,” I said.

He had seen my daughter earlier that day (and asked her about the hockey strike), and my sister and her son were en route. The important hands had been clasped, or soon would be.

He knew what hospice meant; its nurses and aides helped us care for my mother as she died. “Call hospice,” he said. We tiffed a bit about whether to have hospice care in his apartment or mine. I told his doctors we wanted comfort care only.

As in a film run backwards, the tubes came out, the oxygen mask came off. Then we settled in for a night in a hospital room while I called hospices — and a handyman to move the furniture out of my dining room, so I could install his hospital bed there.

In between, I assured my father that I was there, that we were taking care of him, that he didn’t have to worry. For the first few hours after the morphine began, finally seeming to ease his pain, he could respond, “OK.” Then, he couldn’t.

The next morning, as I awaited the hospital case manager to arrange the hospice transfer, my father stopped breathing.

We held his funeral at the South Jersey synagogue where he’d had his belated bar mitzvah at age 88, and buried him next to my mother in a small Jewish cemetery in the countryside. I’d written a fair amount about him here, so I thought readers might want to know.

We weren’t ready, if anyone ever really is, but in our sorrow, my sister and I recite this mantra: 90 good years, four bad days. That’s a ratio any of us might choose.

---

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

Read More..

App City: Taking Stock of Mobile Apps

Testing apps from week to week, it’s easy to fill my phone with a seemingly endless number of theoretically helpful programs. But how many of them do I actually use? To start off 2013, I decided to take stock of my apps, with a focus on those that relate to my life as a New Yorker. Here are my favorites, many — but not all — of which I reviewed for App City. — JOSHUA BRUSTEIN

Christoph Hitz

Embark NYC

Free for iOS and Android

For directions, the default is Google Maps. But Embark, which helps you chart a trip on the New York City subway, is the other transportation app I use regularly, largely because it can generate directions without a data connection. After all, plans can change while you are underground. Offline, you can get only directions between stations, not for street addresses, but it’s a start.

Instapaper

$3.99 for iOS; $2.99 for Android

Instapaper is not new, but the idea of setting aside articles that I see online so that I can read them when I get stuck on the subway never gets old.

---

Seamless

Free for iOS and Android

This tool for placing orders for delivery or takeout food through a smartphone app has drastically increased the likelihood that I will order in on any given day. I do not know if this is a good thing, but it is certainly a testament to its effectiveness.

Christoph Hitz

Immaculate Infatuation

Free for iOS

Apps for finding restaurants are plentiful, but most of them leave me feeling overwhelmed. I want someone to choose for me, and I trust the authors of this app to do that. Their taste has never led me astray — although unlike them, I have no problem with the immense popularity of brussels sprouts.

Christoph Hitz

Taskrabbit

Free for iOS

One of the neatest things to come from the current generation of tech companies are informal communities where strangers do things for one another, like share a ride or a spare room. Taskrabbit allows people to hire one another for odd jobs. These jobs can be pretty much anything, but for tasks like taking in clothing for donation, I would much rather give $20 to a neighbor with a car than figure it out myself. Getting tasks done may be easy, but becoming someone who does the tasks isn’t: there are 1,500 people on the waiting list in New York City.

Songkick

Free for iOS and Android

It analyzes the music you listen to and tells you when bands you may like are playing nearby. It has successfully kept me away from Seamless on a number of nights. But being constantly reminded of great shows has the potential to be somewhat expensive.

---

Nike+ Fuelband

Wristband $149, app free for iOS and Android

This setup serves as a pedometer for the digital age, keeping track of your physical activity 24 hours a day. The app’s graphical representations of miles walked and calories burned are addictive. While the Fuelband does not do a good job of measuring exercise in a gym, it is a great way to keep a tally of all the walking you do. And if I’m going to spend my life wandering around the city, I might as well get credit for it.

Christoph Hitz

Craft Beer New York

$1.99 for iOS

This app is great when deciding which bars to visit. Of course, it works only for beer drinkers; good bars without good beer selections do not make the cut. There is a nice coffee app designed by the same team, and I use it in essentially the same way, although a bit earlier in the day.

Read More..

Plane Carrying Vittorio Missoni Lost Near Venezuela

A small plane carrying four Italian tourists, including the head of the Missoni fashion business, disappeared off the coast of Venezuela on Friday morning, prompting a sea and air search mission that continued Saturday.

Vittorio Missoni, 58, an owner of the family-run label famed for its zigzag knitwear, and his wife, Maurizia Castiglioni, were aboard the plane, which was missing after takeoff from the island resort of Los Roques, the company confirmed in a statement on Saturday. The plane was bound for the international airport near the Venezuelan capital, Caracas, normally a half-hour trip.

Venezuelan officials said that four passengers and two crew members were aboard.

The interior minister, Nestor Reverol, said Friday night on Venezuelan television that the plane, a BN2 Islander, took off from Los Roques at 11:29 a.m. and that its last known position was 10 nautical miles south of Los Roques, an archipelago that is a popular destination among wealthy Europeans, particularly Italians.

The Missoni family is widely revered in the Italian fashion industry for its kaleidoscopic knits applied over the years to sweaters, home furnishings, beach towels and even water bottles. A wildly popular collaboration with Target in 2011, which revitalized interest in the label internationally, included a Missoni print bicycle.

The company was founded in the 1950s by Ottavio and Rosita Missoni, who by the 1970s were among the most prominent designers in Italian fashion. Their three children — Vittorio, Angela and Luca — took over the company in the 1990s, when the family business had lost some of its appeal, and are credited with turning it around.

Missoni’s sales have been reported as modest, around $100 million annually, but the label holds the prominence of a far bigger business as a result of the family’s dashing personalities. Mr. Missoni spearheaded the brand’s global expansion, first as general director of marketing and then as the company’s top executive in the United States and Italy.

A spokeswoman for Missoni said that the family had been informed by the Venezuelan Consulate that the plane had disappeared, but that they had not given up hope as the search continued. Italian news media staked out the company headquarters in Sumirago, Italy, in the foothills of the Alps, where the management met on Saturday. The news agency Ansa reported that family members had congregated in their nearby villa, while Luca Missoni had flown to Venezuela.

The company’s offices in Milan were closed on Saturday, but an employee, who declined to give her name, was answering the phones “because a lot of employees are calling to get information,” she said. “But we have very little news to tell them.”

Several Italian news broadcasts led with the disappearance of Mr. Missoni, noting that another plane, carrying eight Italians, disappeared after leaving Los Roques five years ago, on Jan. 4, 2008.

Mr. Missoni, an avid sports fisherman, and his wife were on vacation with friends, according to the company. The other passengers have been identified in Italian news reports as Elda Scalvenzi and Guido Foresti.

The Missoni siblings jointly own the company. Vittorio has managed the company’s commercial and manufacturing operations; Angela is the designer; and Luca the creative director.

Part of Mr. Missoni’s strategy has been to focus on the Missoni lifestyle, opening about 40 stores around the world and creating ad campaigns featuring many of the family’s glamorous members. In one image, Margherita Missoni, a daughter of Angela, appears with Ottavio and Vittorio, who are relaxing on a zigzag weave couch. The family’s compound in Sardinia has been featured in countless articles.

In 2005, the company created a successful fragrance business with Estee Lauder and, under Mr. Missoni’s direction, expanded into the hotel business with the Rezidor Hotel Group. The first Hotel Missoni opened in Edinburgh in 2009.

William Neuman contributed reporting from Caracas, Venezuela, and Elisabetta Povoledo from Rome.

Read More..