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The problem of ethnic and elderly

Posted by hamiltongardener CAN 6a (My Page) on
Fri, Jul 13, 12 at 11:32

Making the news recently in our area is the problem of nursing homes in an increasingly diverse ethnic mosaic. Many elderly immigrants either do not speak english or french, or they are losing their second language skills as they age.

This is a time when over 50% of Toronto's population is born outside of Canada, there are over 140 different languages and dialects spoken, and we are an aging society.

So how can one city provide nursing homes that are sufficiently staffed by that wide a variety of ethnic language speakers? This is the struggle highlighted recently when the family of a 105 year old woman who only speaks Russian could not find a nursing home with open spots staffed by Russian speakers.

This has touched off a debate on whether the nursing homes should provide the interpreters, or whether the family should provide them if they need them for family members.

About half of Toronto�s 2.6 million residents are born outside of Canada, speaking a first language other than English or French. With over 140 languages and dialects spoken in the GTA, the city is a language mosaic. Toronto already has a number of long-term care facilities that cater to specific cultural groups such as Yee Hong and Mon Sheong for the Chinese population, Hellenic Home for the Greek community, Villa Colombo in North York for those with Italian heritage, Suomi-Koti in Leaside for the Finnish population and Baycrest Centre for the Jewish community, just to name a few. Yet seeking a home according to language and ethnospecific care is still challenging because demand is greater than availability.

The waiting lists at Yee Hong and Hellenic Home are so long, it can take years until a spot is available. Helen Chan, a retired school teacher, is currently looking for a home for her 92-year-old aunt. She counts her lucky stars that both her parents were able to get into Yee Hong in the beginning. With specialized facilities, including a Snoezelen room, otherwise known as a controlled multisensory environment that both stimulates and relaxes, Yee Hong can be especially helpful for residents with dementia. "We are lucky in Toronto because [Yee Hong has] four centres, but we are still short on beds," says Chan. "The wait time is really crazy. I need a backup plan."

Here is a link that might be useful: Ethnic nursing homes


Follow-Up Postings:

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RE: The problem of ethnic and elderly

Interesting issue... in Canada, one might think an avenue to explore would be an interpreter that perhaps could float within a specific, designated area, covering a few nursing homes, but provided either in whole or in part by the state? I don't know... what do you think?


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RE: The problem of ethnic and elderly

perhaps could float within a specific, designated area, covering a few nursing homes

I think the problem with that would be in an emergency situation. What do they do? Call the interpreter and put them on the phone together? I believe off site interpreter services are already available to nursing homes.

I think the issue is more that they want in-house staff to be available full time who can speak to their loved ones. For example, the Russian woman has been offered nursing home spots in the past, but the family turned them down because there wasn't a Russian speaker on staff.


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RE: The problem of ethnic and elderly

I had the occasion to see a lone Farsi-speaking resident in a nursing home in West Los Angeles. There was one Farsi-speaking nurse, but assigned to a different area. The nurse worked regular shifts and so translation was not available outside of that time frame. The patient also had advanced dementia, and appeared not to be saying much of anything when the nurse happened by. Otherwise the staff spoke a variety of languages.

Given that some 80+ languages are spoken by students in the Los Angeles Unified School District, there will be elderly that won't be understood by institutional caregivers.


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RE: The problem of ethnic and elderly

Why not give those high school students part time jobs to come in and interpret for the elderly in the institution.


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You would think that this problem has always existed but people in the past didnt expect the same degree of assistance. Perhaps the answer will be voice recognition programs that translate? They have certainly come a long way in the past few years. I bet you can get an app for your phone!


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RE: The problem of ethnic and elderly

This is a very complex issue. I think that in years gone by most immigrant families kept their aging relatives with them until they passed.

However, we are now onto second and third generations who have adopted the North American ways even though there elders have not. It's a real problem but I don't believe it's one we can solve through the public purse. It can only be solved by volunteers and family members.

Actually I find this less of an issue than the incredible numbers of the aged in these homes with no advocates whatsoever. Even if they can communicate they have no voice. I saw it first hand when my DDMIL was in a nursing home, if I had not been there darn near every day she would have been "mistreated" regularly. The number of elderly who have no one to speak for them is alarming.

There were two residents nearby her room who never had anyone come see them. I took them "under my wing" and began speaking up to the staff about their complaints and issues....things changed. My MIL is gone now and I haven't been back to see those two for a long while. I often wonder about them and feel terrible that I perhaps didn't do enough.


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RE: The problem of ethnic and elderly

Chase, I think you did more than a lot of people might have done...

I realize there are instances where it's simply not possible to have elderly relatives living with the family, as in certain types of illnesses that require constant care or supervision, medical assistance that the average person can't do, etc... but in cases where the elderly are simply elderly, I couldn't imagine confining them to a nursing home. How sad...

I'm glad we were able to take care of our own... and I have no doubt that we'll be with our son when we are too old to live alone, should we make it that far...

Today's disconnect bothers me greatly.


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RE: The problem of ethnic and elderly

Indeed a very interesting issue. I like the idea of getting youth involved to help if possible, and some of them may have to learn another language to do it (another plus).


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RE: The problem of ethnic and elderly

It is an interesting issue, but a much more pressing issue, as chase alluded to, is that of elder abuse and related problems.

The elderly really do have no voice sometimes, and it is almost like people just dump them in these homes to purposely forget about them. I don't get it. Personally, I am planning on taking care of my Mom until she literally has to go to a nursing home, and even then, I will visit all the time.

It seems to me that baby boomers, being the greedy generation that they are, seem to think it's OK to dump their parents in a nursing home without a second thought.

I now work for a health care company - we do mobile radiology and ultrasound. I did a ride-along with the technicians and the quality of the facilities and care takers is very large. Some of the homes were excellent, with caring staff. Others not so much. I don't even think it necesssarily depends on how expensive the home is...it's the culture and employees.


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RE: The problem of ethnic and elderly

Kind of off topic, but along the same home care lines, and the disconnect of people...

Only today, a dear friend of ours was telling us about his uncle who is in need of major lung surgery, a transplant. He has excellent insurance, and everything was a go for the surgery... until his wife was interviewed to help him with after care. Because she couldn't handle something as simple as picking up the phone to summon a home care nurse that would help with the equipment he'd need in case anything happened, they turned him down for the surgery, and are giving the lungs to the next person in line on the list.

Could anyone here imagine being married to someone, for 30 years, who was so lazy and uncaring that she would rather allow her husband to die than to help him post surgery? My mind is still blown on this one. I simply could not imagine.

What has happened to the human condition? Where did empathy and care disappear to? When did humans become so disconnected from one another, so cold, so self involved and selfish?


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RE: The problem of ethnic and elderly

"What has happened to the human condition? Where did empathy and care disappear to?"

It bothers me to NO END that you believe humans were just awesome and caring in the past. What history books have you been reading? Because obviously I missed them. It is just recently, maybe the last century or so, when humans starting acting like civilized people instead of barbarians that kill, rape, pillage, and live only 40 years. Even in this last century, we witnessed the Holocaust, human beings being denied civil rights in our own "enlightened" country, and tens of millions of people dying due to Communist dictators.

The human condition, in the past, has been much worse.

There have always been selfish, self-involved, disconnected people.

I am not sure which "time" it is that you constantly refer to.


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RE: The problem of ethnic and elderly

Krycek, what you say is very thought-provoking.

"It seems to me that baby boomers, being the greedy generation that they are, seem to think it's OK to dump their parents in a nursing home without a second thought."

"There have always been selfish, self-involved, disconnected people."

And so is what Jodi said: "When did humans become so disconnected from one another, so cold, so self involved and selfish?"

Most of us probably know of (or we are those people) who have helped to place a (sometimes formerly) loved one in a "home". For whatever reason.

I wonder how many of these same folks are very vocal in support of various and several "charity" programs, government or otherwise, which benefit people who are strangers to them.

I suspect that it's easier to proclaim (and sincerely mean it) that the helpless need our help on a very grand scale, while failing to acknowledge the need for charity in one's own family, one's own neighborhood.


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RE: The problem of ethnic and elderly

Very interesting post Elvis...makes a lot of sense.


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RE: The problem of ethnic and elderly

I agree, a salient post.

Thanks, Elvis.


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RE: The problem of ethnic and elderly

But of course...

It's more often that I see people allow a door to slam on the person behind them... more often that I see neglect and lack of compassion... condescension, selfishness, impatience, and the like...

And though it's there in dwindling numbers, some people do still care deep down.

It still cannot be denied that a portion of humanity is impatient, morally bankrupt, bereft of anything resembling empathy... call me a cynic, but that's what our world shows me quite clearly.


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RE: The problem of ethnic and elderly

  • Posted by ohiomom 3rdrockfromthesun (My Page) on
    Sat, Jul 14, 12 at 10:44

While some may see the boomers as "being the greedy generation that they are" I have also read (on this forum) how the current generation have an "entitlement attitude".

Could be broad brushes are used in stereotyping entire generations.

1/2 penny


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RE: The problem of ethnic and elderly

Yes, elvis, thanks for expressing such wise views on these issues. My paternal side has gone the route of keeping the elderly among them but the current generation is too challenged by life and personal expectations to take on extended care of its elderly.

I used to manage landscape and help "entertain" for a small private extended care facility. The clients were well treated and mostly from well-to-do circumstances. The sad part was watching some of the folks struggling with loneliness for the lack of family and other personal visitations.

I recall one client whose language skill was limited to
Russian complicated by severe hearing loss and very poor eyesight. She was always agitated, demanding, and difficult. By then most of the small staff were Hispanic, caring but barely conversant in English, much less Russian.


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Its an interesting thought that all these problems with old folks may well change back to the more traditional model, with 3 -4 generations in the same household.

By far and away, the largest chunk of medicaid is spent taking care of old, indigent people in nursing homes. That is, frankly, unsustainable.

For those better off, an example would be my folks are just moved from one retirement facility to a less-expensive one, but still are paying $3,500 a month.


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RE: The problem of ethnic and elderly

Focusing solely on a big picture pushes back having to consider what might be your (generic) role somewhere down the line. Especially now if you're young enough to have young parents or relatives showing no signs of any decline.

Just ask someone who is named executor(trix) or who has financial power of attorney or who is able bodied with a car how much time and energy is expended - no matter how willingly and lovingly - on keeping loved ones "independent" and in their own homes.

I took care of my Mother for the better part of 7 years as she slid into Alzheimer's. Despite everything, oftentimes there comes that critical event when you know home care is impossible. Do you think the sudden reality of long term care wasn't an agony? The caregiving didn't stop with her placement and I was still her best advocate.

I don't know - just never say never, I suppose. Trust your children will take you in, build a hospital suite onto the house and attend to your every need. Trust everyone you love will never age or become infirmed so decisions will never have to be made.

I do wish that for you because making some choices on behalf of others is extremely anguishing.


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RE: The problem of ethnic and elderly

The truth is that only a very small percentage of the population ever ends up in a nursing home in spite of every one believing elsewise. It is only about 5 or 6%. Most people live at home usually cared for by some relative or other. Is their care as good as they would get in a good nursing home? That would depend on the person. Getting visitors will definitly improve care but I am not sure it does much to alleviate the loneliness-it can only be such a tiny part of their day. As for caring for you own-remember in the past that women mostly worked at home making it easier to care for relatives and they had in home help-while washers and dryers can substitute for so me of the labor of servants they cant help you turn a person over. Life changes and people are living to be older and older.


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RE: The problem of ethnic and elderly

I agree with Duluth and Patricia.

There comes a point when the caregiver must think of her/himself if s/he is to continue being an effective advocate. Stressed out, and mentally and physically exhausted, the caregiver is less effective, if not totally out of service. People are working for more years before retiring, and with two wage earners that means that caregivers must be hired. And, of course, the elderly are living longer, with physical and personality changes due to afflictions, illness, medicines, and simply advanced age. I can't see a seventy-something woman being physically capable to care for ninety+ mother - getting her out of bed, bathing, dressing, preparing meals, feeding, plus the usual household chores. If there are personality changes, as with dementia, causing recalcitrance, woe to the caregiver.


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RE: The problem of ethnic and elderly

My grandmother placed my grandfather in a nursing home that specialized in Alzheimers patients years ago. Unfortunately, my grandfather was a large man who was beginning to get physical when he was confused... which was most of the time.

We helped her care for him as much as we could, but we knew she was not only exhausted, but she was in physical danger.

Lucky for us, my grandmother has always been a very practical woman and knew that it was time for professionals to care for him. She did not try to keep him at home.

My grandfather passed away just a couple months ago, after spending 20 years with Alzheimers and living the last 7 years unable to speak, eat, move himself or communicate in any way with others. The last year he was, for all intents and purposes, in a coma...unable to open his eyes or respond even to touch.

My grandmother views his passing as a blessing. I agree, he deserved to finally be released.

My grandmother also recently placed herself in a retirement home. Mind you, this is not a nursing home... my grandmother is probably in better physical shape than some people on this forum. In spite of numerous offers from family members for her to stay with them, she would not take the offers. The home she has moved into also houses two of her cousins and a couple of friends she went to school with so has known for years.

They take care of her meals, her cleaning, her chores... she socializes with her friends and still lives in the same city as most of her family, so she sees everyone often. She just prefers not to live with us. Maybe one day that will change. I don't know.


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RE: The problem of ethnic and elderly

Here in Wisconsin, it's called "Assisted Living". In the right situation, it's a Godsend. Our retirement community is very large, and there are many, many Assisted Living centers available; in various assistance levels and price ranges. This is for people who need some assistance, including company, and is strictly voluntary. The resident remains a participant in the community. Of course, you need at least one foot in the present to do this.


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RE: The problem of ethnic and elderly

"But of course...
It's more often that I see people allow a door to slam on the person behind them... more often that I see neglect and lack of compassion... condescension, selfishness, impatience, and the like..."

Either you live in a horrible area, or you concentrate unconsciously on the bad.

I see good deeds and good things happen every single day. People hold the door for me all the time, people have picked things up that I've dropped, when I get in a crash when I was 20 some guy stopped to make sure I was OK, people have offered me their spot in line when I had only a few items. Maybe I concentrate on the good instead of the bad, or maybe I just live in an area where people are nicer? I don't know.

I have seen many acts of love and kindness at nursing homes, assisted living centers, and in older people's general lives.

Don't concentrate on the bad things and you'll find life more fulfilling.

*****************

Sometimes sending someone to a nursing home is the only feasible option. Many nursing homes and AL centers are quality places that care about their patients and can often provide better care (in advaancted stages) than anyone could at home.


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RE: The problem of ethnic and elderly

Either you live in a horrible area, or you concentrate unconsciously on the bad.

It could be the area she lives in. I've noted that same thing before Kry but I can't rule out that she is not in very good surroundings.

I'm in agreement with you though, on the goodness and kindness of people. Sure, I see a few miserable or bad eggs, but the majority of people I see are good from the smaller gestures like holding doors to the large ones like stepping in to help someone who needs it.

THIS is the everyday occurance around me. The majority of humanity is basically kind, compassionate and helpful.


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RE: The problem of ethnic and elderly

Ditto, Hamilton. I find people are usually kind, even in France. Kidding you, but really--they were very nice to us.


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RE: The problem of ethnic and elderly

Krycek is right about those who concentrate on the bad. I think some people are so miserable on the inside, they cannot see the good in people, their misery is all encompassing.


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RE: The problem of ethnic and elderly

Well, I'll agree with Krycek, Hamiltongardener, Elvis and Lavenderlver. By FAR, most people are extremely helpful and polite. That has been true everywhere I've ever traveled, and yes, most certainly in France, but I would say friendliest in the south. It drove me nuts when we first retired back here because people "wasted" time in my view chatting with the person ahead of me that was checking out. Now I am accustomed to it and don't mind it a bit. It lends humanity to everyday activities.

Every day I let people in and out of traffic and they let me in and out--it doesn't matter if they are old or young, black or white, driving a Mercedes or a beat up Chevy, we do it for one another here in Louisiana. Same with holding doors and letting people ahead of you in line if they only have an item or two to check out.

It's seldom you see a woman stopped on the side of the road without someone in a pickup helping them jump off their car or getting gasoline for them.

I do think that your attitude about life can make a difference in whether the glass is half empty or half full.

I would love to build some retirement duplexes or fourplexes for older people that aren't ready for nursing home care, but could use a maid and someone to bring meals or come in and cook a few days a week, run errands, take them to the doctor, check blood pressure, etc.

It's a growing problem and a great business for someone with the energy and patience to fight red tape, and desire to be around 24 hour days, 7 days a week!

I will never judge anyone for putting a loved one in a nursing home. I know my mother cared for her mother, her mother in law, and my dad when he was bedridden for a year due to an accident, and worked as well. It about did her in, and she finally put her mother in a nursing home and my other grandmother had to go live with her other son (my folks kept her for eight years).

The one grandmother, closest to me, died six weeks after entering the nursing home, the other was sent to a nursing home after living with her other son for only a year. She lived eight more years and fell in love in the nursing home after losing a leg to diabetes. It was a nice place as far as nursing homes go.

I would not want to put anyone I love in a nursing home, but caregivers are sometimes just up against a wall and have no other choice if they want to retain their own health.

As I think it as Patricia that pointed it out, a small percentage of people actually go to nursing homes, and of those that do, generally don't live for years.


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RE: The problem of ethnic and elderly

Posted by demifloyd 8 (My Page) on Sat, Jul 14, 12 at 22:17

"I would love to build some retirement duplexes or fourplexes for older people that aren't ready for nursing home care, but could use a maid and someone to bring meals or come in and cook a few days a week, run errands, take them to the doctor, check blood pressure, etc."

That's a great idea. Louisiana is a nice mild climate for it, too. Could be a lotta work, though.


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RE: The problem of ethnic and elderly

Locally, lack of common courtesy is regional and seasonal in nature.

For example, it's pretty common to have people that don't hold doors open in Fulton and Montgomery Counties, but not Saratoga county.

During the tourist season, traffic is crazy, so tempers and behavior changes.

Many people also witness much more bad human behavior since they're out and about while others are sitting in offices, or sitting at home.

If you want to see a lack of common courtesy and common sense, just go to a public boat launch on a weekend during the summer. Bring some popcorn...


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RE: The problem of ethnic and elderly

Posted by markjames (My Page) on Sun, Jul 15, 12 at 8:55

"If you want to see a lack of common courtesy and common sense, just go to a public boat launch on a weekend during the summer. Bring some popcorn..."

I'm laughing with you, Mark. This is also a tourist area, and while the "flatlanders" are bread & butter for many, they are a little more demanding and impatient than us locals. Usually though, they are pretty okay.

Except sometimes at public boat landings...


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RE: The problem of ethnic and elderly

"It is an interesting issue, but a much more pressing issue, as chase alluded to, is that of elder abuse and related problems."

Actually, it's equally as likely to be the other way around - where caregivers are being abused by the elderly. For every abused elderly person, there is an abused caregiver. It's becoming such a problem that many care-giving advocacy groups are finally waking up and publishing information about this problem.

"Sometimes sending someone to a nursing home is the only feasible option. Many nursing homes and AL centers are quality places that care about their patients and can often provide better care (in advaancted stages) than anyone could at home."

I completely agree with this. I know people who are actually thriving in such an environment.

Only extremely selfish and self-centered people would think that there is never a condition under which they should be put in a nursing home.

Whatever possesses us to think that having our children give up their lives to wipe our butts is equivalent to bestowing a great honor upon them? Some folks think that no imposition is too great as long as it serves them. This a terrible thing to do to another person, especially a child.

An additional problem with keeping people's bodies alive for a long time is that their offspring are also no longer spring chickens either. Someone in there 90s can easily have "children" who are in their 70s with their own health problems, assuming they are even still alive.


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RE: The problem of ethnic and elderly

From my limited experience, I distinguish three kinds of "retirement" facilities: true retirement communities with various levels of assistance, extended care facilities with broad ranges of assistance, and hospice facilities for the terminally ill. I have friends who have bought into retirement communities where they have their food, house keeping and medical needs met by in-house staff as needed or desired. My experience is mostly with an extended care facility where clients were mostly unable to take care of themselves and were allowed out only on the grounds or if away, with staff or family.

I got much joy out of creating garden settings enjoyed by the elders including wheel-chair accessible gardens and a hydroponic system for fresh herbs and some vegetables. A big treat for some was to be able to pick strawberries out of the raised beds or to dead-head flowers or even lightly weed.


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Posted by marshallz10 z9-10 CA (My Page) on Sun, Jul 15, 12 at 12:17

"I got much joy out of creating garden settings enjoyed by the elders including wheel-chair accessible gardens and a hydroponic system for fresh herbs and some vegetables. A big treat for some was to be able to pick strawberries out of the raised beds or to dead-head flowers or even lightly weed."

Many eldercare facilities around here have pet dogs for the residents to share. I imagine it's much the same sort of satisfaction for the residents to do a little "gardening". Good for you. :-D


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RE: The problem of ethnic and elderly

"So how can one city provide nursing homes that are sufficiently staffed by that wide a variety of ethnic language speakers?"

Surely the folks who signed you up for this have the answers. It's not your job to figure it out. Ask the experts to share their plan with you common folks.


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RE: The problem of ethnic and elderly

Posted by nikoleta (My Page) on Sun, Jul 15, 12 at 19:11

Hamilton: "So how can one city provide nursing homes that are sufficiently staffed by that wide a variety of ethnic language speakers?"

Nik: "Surely the folks who signed you up for this have the answers. It's not your job to figure it out. Ask the experts to share their plan with you common folks."

What does this mean? I don't get it. But maybe that's just me?


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RE: The problem of ethnic and elderly

I think Nik may be a bit confused and thinks all the nursing homes are run by the government. It's the socialism fear-mongering popping it's head up again.

Just to clear things up, nursing homes are usually privately owned.

When I said "How can one city", I meant how can we fit enough nursing homes in one city to cover the linguistic needs of such a diverse population.


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RE: The problem of ethnic and elderly

Okay; thanks. I don't think you can "fit enough nursing homes in one city to cover the linguistic needs of such a diverse population." Bummer.

It's not just impractical, sometimes it's impossible to accomodate every need, even when it's important. I don't know if this example makes sense to anyone else, but my work involves trying to accomodate disabled persons at public recreation sites. It's not always possible.


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RE: The problem of ethnic and elderly

It's not just impractical, sometimes it's impossible to accomodate every need, even when it's important.

I think I agree that it's impossible to accomodate every need, especially in this case when we are talking about so many different languages. But being able to communicate with someone who is in your care seems to be a pretty important need... how can you care for them properly otherwise?

Canada has two official languages, english and french. Finding a multitude of homes for english and french speakers is not difficult. In my area, there are also a lot of Italian and Chinese speakers and nursing homes for those languages are also common.

But in Toronto, there is a much more diverse need... I'm really not sure if it's feasible to provide for them all.


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RE: The problem of ethnic and elderly

If you speak Croatian or Farsi and no one else in a 150-mile radius speaks that language, you have a problem. And your family has a problem. But it is the family's problem and it's not incumbent on anyone else to solve it, especially if the language is not one normally encountered in immigrant populations.

Assuming the diagnosis is one of the dementia diseases (it was stated that the patient was already losing language ability), then being in a facility that specializes in those patients would allow that person to be put in with other non-communicative patients. Facilities that specialize in Alzheimer's and other cognitive diseases of aging already know how to read and handle such patients, because many of their patients can't communicate in any language.

Having to understand someone that doesn't speak your language is pretty much the same as dealing with someone who speaks gibberish, which is what happens in most dementia cases. A gibberish translator does not exist.

My uncle had dementia and you couldn't understand a word that was coming out of his mouth. He used words that didn't go together and didn't have any relationship whatsoever to any question you asked him. Health care staff who deal with this all of the time know that they have to rely on other cues and that they can't rely on "normal" communication.


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