The New Old Age Blog: Training Needed for Home Care Is Lacking

“H” from Chicago, I heard you when you joined a lively discussion over hospice at home here a couple of weeks ago and asked, “where can family members get the training to do all the nursing tasks?”

In the comments section, many readers wrote in to say that caring for relatives at the end of their lives was a duty and a privilege. Others said they were unprepared for the physical and emotional burdens of doing so.

Your question stood out because of its practical character. Do caregivers have to figure out how to handle all these complicated medical issues on their own? Or is some help out there?

For an answer, I called two of the authors of “Home Alone: Family Caregivers Providing Complex Chronic Care,” put out by the United Hospital Fund and the AARP Public Policy Institute. That study recently made headlines by reporting that 46 percent of the nation’s 42 million caregivers handle medical and nursing tasks such as giving injections, caring for wounds or administering I.V.s.

Susan Reinhard, senior vice president and director of the AARP Public Policy Institute, sighed when I reached her, and said “this is a huge gap,” referring to a notable absence of available training in demanding caregiving tasks.

To the extent training exists through local agencies on aging, disease-specific organizations or social service groups, it deals mostly with so-called “activities of daily living” — helping someone bath, dress, eat, or use the bathroom — not the demands of nursing-style care, Ms. Reinhard observed.

Really, this kind of training should be the responsibility of health care providers, but doctors and nurses often give only cursory, unsatisfactory explanations of complex tasks that fall to caregivers, said Carole Levine, director of the Families and Health Care Project of the United Hospital Fund.

That leaves the burden on caregivers to be assertive and ask for help, these experts agreed. If someone is hospitalized and ready to return home, they suggest asking a nurse or another provider “show me what you are doing so I can learn how to do it,” and then asking “now, watch me do it and tell me if I am doing it wrong or right.”

Don’t give up after the first time if you feel awkward or uncomfortable. Ask to do the task again, and ask again for feedback.

No videos or written manuals, can substitute for this one-on-one, hands-on instruction. If you don’t get it to your satisfaction before a loved-one is ready to go home, don’t sign the form that says you have been given instructions on what to do, Ms. Reinhard advised. The hospital is legally obligated to ensure that discharges are safe, and this operates in your favor.

The same goes for the pharmacy: don’t sign that sheet that the pharmacist hands you indicating that you have been adequately informed about the medications you are purchasing. If you are concerned about the number of prescriptions, what they are for, their possible side effects and whether all are necessary, ask the pharmacist to sit down with you and go over all this information. Again, don’t leave until you are satisfied.

Often, caregiving tasks will change as someone with a chronic condition like Parkinson’s disease or heart failure becomes more frail. Should this happen, consider calling a home care agency and asking for a nurse to come out and teach you how to administer oxygen or help transfer someone safely from a bed to a wheelchair, Ms. Reinhard said.

You may want to videotape the session so you can view it several times; most of us don’t pick these skills up right away and need repeat practice, Ms. Levine said.

Be as specific in your request for help as possible. Rather than complaining that you are overwhelmed, say something along the lines of, “I want to make sure I know how to clean this wound and prevent an infection” or “I need to know what texture the food should be so I can feed mom without having her choke,” Ms. Levine suggested.

Her organization has prepared comprehensive materials for caregivers called “Next Step in Care.” While the focus isn’t on nursing-style caregiving tasks, three might be useful: a self-assessment tool for family caregivers, a medication management guide, and a guide to hospice and palliative care.

Other helpful materials are few and far between. Ms. Levine’s staff identified a $24.95 American Red Cross training manual for family caregivers that has a DVD explaining the mechanics of transfers and a few other complicated tasks. Also, some videos are available for free at www.mmlearn.org, a Web site that says its mission is to provide caregivers with online training and education.

Asked about model programs, Ms. Reinhard said she knew of only one: the Schmieding Home Caregiver Training Program in Arkansas, operated by the Donald W. Reynolds Institute on Aging of the University of Arkansas for Medical Sciences. The Schmieding program trains family caregivers as well as professional caregivers who work in people’s homes or nursing homes.

On the family side, it offers eight hours of instruction in “physical needs” associated with caregiving — managing incontinence, skin care, turning someone regularly in bed, using adaptive equipment, transfers from a bed to a wheelchair, helping patients remain mobile, and more. Classes are offered at five sites and four more are planned in the next several years, said Robin McAtee, associate director of the Reynolds Institute on Aging. If people, churches or senior centers want the instruction, which is free, Schmieding nurses will take the program to them. One-on-one instruction for tasks is also available on request.

A separate eight-hour program is available for caregivers dealing with dementia, who have additional concerns.

At a Web site called Elder Stay at Home, Schmieding sells a package of materials (three DVDs and a booklet, for $99) summarizing the content of its family caregiver training program. Separately, it has begun selling its curriculum for paid caregivers, and programs in California, Hawaii and Texas are among the first buyers. The University of Arkansas for Medical Sciences also has received a $3.7 million innovation grant from the government to expand the caregiver training program more broadly and develop online training materials.

Ms. Reinhard said AARP would like to see Schmieding-style programs rolled out across the country and begin to offer structured, reliable support to caregivers now providing nursing-style care in homes with little or no assistance.

What else am I missing here? Do you know of resources or other organizations providing intensive caregiver training along the lines of what I’ve been discussing? Where would you suggest people turn for this kind of help?

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Huawei to Open Research Center in Finland

PARIS — Huawei, a Chinese maker of telecommunications equipment, said Monday that it planned to open a research and development center in Helsinki next year, accelerating the company’s investments in Europe, where its business is expanding rapidly.

The move emphasizes a trans-Atlantic difference in attitudes toward Huawei, a company that has been largely shut out of the U.S. market for network gear because of congressional concerns about possible security threats — fears that the company insists are unfounded.

While Huawei has faced difficulties in some European markets, like France, it has done better elsewhere. Huawei employs more than 7,000 people in the region, and it says that total could double within the next three to five years. Huawei already has a research center in Italy and is studying the possibility of opening one in Spain. It also recently announced a $2 billion investment in Britain.

The planned center in Helsinki, involving an investment of €70 million, or about $90 million, will work on smartphone development, including things like user interfaces and power management, the company said. When the center opens next year, it will employ 30 people, but this number could grow to 100 over the next five years, the company said.

The announcement is a shot in the arm for the Finnish technology sector, which has been suffering from the woes at Nokia. The company, once the biggest mobile phone manufacturer in the world, has suffered a precipitous fall in market share in recent years.

Although Huawei has been known mostly for its network equipment, the company is pushing to make a name for itself with its handsets. Mobile devices accounted for 22 percent of its revenue last year, growing 37 percent. That compares with growth of 12 percent for the overall business.

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Memo From Italy: In Italy, Mario Monti Morphs From Technocrat to Politician

ROME — For months, he had flirted with the idea of staying out of politics, but in the end former Prime Minister Silvio Berlusconi just could not resist. His statement on Saturday that he would seek office again out of a sense of “responsibility” for Italy effectively ended the mandate of Prime Minister Mario Monti, who said he would step down after Parliament passes a budget bill this month.

Mr. Monti’s surprise announcement on Saturday raised the prospect of more political uncertainty and market turmoil for Italy, Europe’s fourth-largest economy, in what is expected to be a gloves-off political campaign. But it also increased the possibility that Mr. Monti might run as a candidate — a shift from the role of an apolitical leader — who is open to governing if no clear winner emerges from elections expected as soon as February.

Three years into Europe’s debt crisis, the new developments in Italy underscored the clash between the economically sound and the politically sustainable. While Mr. Monti, an economist and a former European commissioner, has reassured investors and helped keep Italian borrowing rates down, the tax increases and spending cuts passed by his Parliament have eroded lawmakers’ standing with voters.

Mr. Monti’s grasp of economics and experience in European politics made him a power broker who took regular calls from the White House and worked with France and Spain to wring euro-zone concessions from a reluctant German chancellor, Angela Merkel.

“He’s ushered in a turning point in Italian politics and has been a major influence in Europe,” said Thomas Klau, director of the Paris office of the European Council on Foreign Relations. “He has helped turn Italy into a serious country again in the eyes of foreign investors and also many of its own citizens.”

Even if Mr. Monti decides not to run as a political candidate, his decision to step down sets the stage for a battle that pits him — a subtly ironic technocrat who attended Wagner’s “Die Lohengrin” at La Scala on Friday — against Mr. Berlusconi, who made his announcement at the training site of his soccer team, A. C. Milan.

“The war will be between Monti and Berlusconi,” said Massimo Franco, chief political commentator for the newspaper Corriere della Sera. “The moderate votes are in play, not the leftist ones.”

Although Mr. Berlusconi said he was motivated by a sense of responsibility, European leaders and market analysts immediately accused him of the opposite. Martin Schulz, president of the European Parliament, called his return to politics “a threat for Italy and Europe,” the ANSA news agency reported.

With the aid of Mario Draghi, president of the European Central Bank, Mr. Monti calmed the financial markets this year, but investors and European leaders now worry that many of Mr. Monti’s initiatives could be undone by future governments.

In an interview with the business newspaper Il Sole 24 Ore, José Manuel Barroso, president of the European Commission, said that Italy was at risk of being hit by deeper financial problems. “The next elections must not serve as a pretext for putting in doubt how indispensable these measures are,” he said. “The relative calm on the markets does not mean we are out of the crisis.”

Analysts said that Mr. Monti’s decision to step down ahead of schedule was aimed at preventing Mr. Berlusconi from running a campaign that undermined him. Mr. Berlusconi, always attuned to the national mood, even of voters increasingly weary of him, now looks poised to run a populist campaign that will criticize Mr. Monti for foisting unpopular measures on Italians and that may attack the adoption of a single currency for eroding Italian sovereignty.

Stepping down now, rather than early next year, as was expected, also puts Mr. Monti in the fray. “Monti becomes a politician at this point,” said Stefano Folli, a political columnist for Il Sole 24 Ore. “If Monti helps create a space on the ballot for an electoral alliance that recognizes the seriousness of what has been achieved, this could create a new political balance. That’s the challenge.”

Polls show that the center-left Democratic Party is likely to place first in elections, but without enough votes for a majority. But the party remains divided over which ally to choose to form a government.

Mr. Berlusconi is expected to secure enough votes to stay in Parliament and keep his immunity from prosecution in various trials, but not enough votes to govern.

“It is extremely unlikely that we will see a dynamic unfolding which would bring Mr. Berlusconi back to power,” Mr. Klau said. “So even if Mr. Monti were to leave the political stage for good, we would not go back to the political situation we were in before.”

Although Parliament has blocked some of the measures on Mr. Monti’s agenda — in recent weeks, lawmakers have proposed more than 1,500 amendments to the budget bill — the budget is likely to be approved, as is a law that requires Italy to balance its budget each year.

But analysts said that other changes aimed at improving Italy’s competitiveness were at risk. And before the end of the legislative session this month, lawmakers must also vote on a bill that would simplify the tax code, another meant to streamline the cumbersome bureaucracy and a measure that to allow the Ilva steel plant — a major economic engine for Italy — to stay open while it modernizes to meet environmental standards.

As the debt crisis has lingered, such local issues, as well as Italy’s chaotic political system, have taken on international importance.

On Sunday, Ferruccio de Bortoli, the editor in chief of Corriere della Sera, offered his review of the political drama: “The ‘Lohengrin’ at La Scala ended in applause. The Italian tragedy continues. The libretto still needs writing, so does the music. The guaranteed audience is international, but unfortunately not terribly forgiving about the cast. The curtain never falls.”

Reporting was contributed by Elisabetta Povoledo from Rome, Stephen Castle from London and Jack Ewing from Frankfurt.

This article has been revised to reflect the following correction:

Correction: December 9, 2012

An earlier version of this story stated that the the Ilva steel plan was responsible for 8 million euro. The correct number was 8 billion euro.

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Changes to Agriculture Highlight Cuba’s Problems

HAVANA — Cuba’s liveliest experiment with capitalism unfolds every night in a dirt lot on the edge of the capital, where Truman-era trucks lugging fresh produce meet up with hundreds of buyers on creaking bicycle carts clutching wads of cash.

“This place, it feeds all of Havana,” said Misael Toledo, 37, who owns three small food stores in the city. “Before, you could only buy or sell in the markets of Fidel.”

The agriculture exchange, which sprang up last year after the Cuban government legalized a broader range of small businesses, is a vivid sign of both how much the country has changed, and of all the political and practical limitations that continue to hold it back.

President Raúl Castro has made agriculture priority No. 1 in his attempt to remake the country. He used his first major presidential address in 2007 to zero in on farming, describing weeds conquering fallow fields and the need to ensure that “anyone who wants can drink a glass of milk.”

No other industry has seen as much liberalization, with a steady rollout of incentives for farmers. And Mr. Castro has been explicit about his reasoning: increasing efficiency and food production to replace imports that cost Cuba hundreds of millions of dollars a year is a matter “of national security.”

Yet at this point, by most measures, the project has failed. Because of waste, poor management, policy constraints, transportation limits, theft and other problems, overall efficiency has dropped: many Cubans are actually seeing less food at private markets. That is the case despite an increase in the number of farmers and production gains for certain items. A recent study from the University of Havana showed that market prices jumped by nearly 20 percent in 2011 alone. And food imports increased to an estimated $1.7 billion last year, up from $1.4 billion in 2006.

“It’s the first instance of Cuba’s leader not being able to get done what he said he would,” said Jorge I. Domínguez, vice provost for international affairs at Harvard, who left Cuba as a boy. “The published statistical results are really very discouraging.”

A major cause: poor transportation, as trucks are in short supply, and the aging ones that exist often break down.

In 2009, hundreds of tons of tomatoes, part of a bumper crop that year, rotted because of a lack of transportation by the government agency charged with bringing food to processing centers.

“It’s worse when it rains,” said Javier González, 27, a farmer in Artemisa Province who described often seeing crops wilt and rot because they were not picked up.

Behind him were the 33 fertile, rent-free acres he had been granted as part of a program Mr. Castro introduced in 2008 to encourage rural residents to work the land. After clearing it himself and planting a variety of crops, Mr. Gonzalez said, he was doing relatively well and earned more last year than his father, who is a doctor, did.

But Cuba’s inefficiencies gnawed at him. Smart, strong, and ambitious, he had expansion plans in mind, even as in his hand he held a wrench. He was repairing a tractor part meant to be grading land. It was broken. Again.

The 1980s Soviet model tractor he bought from another farmer was as about good as it gets in Cuba. The Cuban government maintains a monopoly on selling anything new, and there simply is not enough of anything — fertilizer, or sometimes even machetes — to go around.

Government economists are aware of the problem. “If you give people land and no resources, it doesn’t matter what happens on the land,” said Joaquin Infante of the Havana-based Cuban National Association of Economists.

But Mr. Castro has refused to allow what many farmers and experts see as an obvious solution to the shortages of transportation and equipment: Let people import supplies on their own. “It’s about control,” said Philip Peters, a Cuba analyst with the Lexington Institute, a Virginia-based research group.

Other analysts agree, noting that though the agricultural reforms have gone farther than other changes — like those that allow for self-employment — they remain constrained by politics.

“The government is not ready to let go,” said Ted Henken, a Latin American studies professor at Baruch College. “They are sending the message that they want to let go, or are trying to let go, but what they have is still a mechanism of control.”

For many farmers, that explains why land leases last for 10 years with a chance to renew, not indefinitely or the 99 years offered to foreign developers. It is also why many farmers say they will not build homes on the land they lease, despite a concession this year to allow doing so.

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New Taxes to Take Effect to Fund Health Care Law

WASHINGTON — For more than a year, politicians have been fighting over whether to raise taxes on high-income people. They rarely mention that affluent Americans will soon be hit with new taxes adopted as part of the 2010 health care law.

The new levies, which take effect in January, include an increase in the payroll tax on wages and a tax on investment income, including interest, dividends and capital gains. The Obama administration proposed rules to enforce both last week.

Affluent people are much more likely than low-income people to have health insurance, and now they will, in effect, help pay for coverage for many lower-income families. Among the most affluent fifth of households, those affected will see tax increases averaging $6,000 next year, economists estimate.

To help finance Medicare, employees and employers each now pay a hospital insurance tax equal to 1.45 percent on all wages. Starting in January, the health care law will require workers to pay an additional tax equal to 0.9 percent of any wages over $200,000 for single taxpayers and $250,000 for married couples filing jointly.

The new taxes on wages and investment income are expected to raise $318 billion over 10 years, or about half of all the new revenue collected under the health care law.

Ruth M. Wimer, a tax lawyer at McDermott Will & Emery, said the taxes came with “a shockingly inequitable marriage penalty.” If a single man and a single woman each earn $200,000, she said, neither would owe any additional Medicare payroll tax. But, she said, if they are married, they would owe $1,350. The extra tax is 0.9 percent of their earnings over the $250,000 threshold.

Since the creation of Social Security in the 1930s, payroll taxes have been levied on the wages of each worker as an individual. The new Medicare payroll is different. It will be imposed on the combined earnings of a married couple.

Employers are required to withhold Social Security and Medicare payroll taxes from wages paid to employees. But employers do not necessarily know how much a worker’s spouse earns and may not withhold enough to cover a couple’s Medicare tax liability. Indeed, the new rules say employers may disregard a spouse’s earnings in calculating how much to withhold.

Workers may thus owe more than the amounts withheld by their employers and may have to make up the difference when they file tax returns in April 2014. If they expect to owe additional tax, the government says, they should make estimated tax payments, starting in April 2013, or ask their employers to increase the amount withheld from each paycheck.

In the Affordable Care Act, the new tax on investment income is called an “unearned income Medicare contribution.” However, the law does not provide for the money to be deposited in a specific trust fund. It is added to the government’s general tax revenues and can be used for education, law enforcement, farm subsidies or other purposes.

Donald B. Marron Jr., the director of the Tax Policy Center, a joint venture of the Urban Institute and the Brookings Institution, said the burden of this tax would be borne by the most affluent taxpayers, with about 85 percent of the revenue coming from 1 percent of taxpayers. By contrast, the biggest potential beneficiaries of the law include people with modest incomes who will receive Medicaid coverage or federal subsidies to buy private insurance.

Wealthy people and their tax advisers are already looking for ways to minimize the impact of the investment tax — for example, by selling stocks and bonds this year to avoid the higher tax rates in 2013.

The new 3.8 percent tax applies to the net investment income of certain high-income taxpayers, those with modified adjusted gross incomes above $200,000 for single taxpayers and $250,000 for couples filing jointly.

David J. Kautter, the director of the Kogod Tax Center at American University, offered this example. In 2013, John earns $160,000, and his wife, Jane, earns $200,000. They have some investments, earn $5,000 in dividends and sell some long-held stock for a gain of $40,000, so their investment income is $45,000. They owe 3.8 percent of that amount, or $1,710, in the new investment tax. And they owe $990 in additional payroll tax.

The new tax on unearned income would come on top of other tax increases that might occur automatically next year if President Obama and Congress cannot reach an agreement in talks on the federal deficit and debt. If Congress does nothing, the tax rate on long-term capital gains, now 15 percent, will rise to 20 percent in January. Dividends will be treated as ordinary income and taxed at a maximum rate of 39.6 percent, up from the current 15 percent rate for most dividends.

Under another provision of the health care law, consumers may find it more difficult to obtain a tax break for medical expenses.

Taxpayers now can take an itemized deduction for unreimbursed medical expenses, to the extent that they exceed 7.5 percent of adjusted gross income. The health care law will increase the threshold for most taxpayers to 10 percent next year. The increase is delayed to 2017 for people 65 and older.

In addition, workers face a new $2,500 limit on the amount they can contribute to flexible spending accounts used to pay medical expenses. Such accounts can benefit workers by allowing them to pay out-of-pocket expenses with pretax money.

Taken together, this provision and the change in the medical expense deduction are expected to raise more than $40 billion of revenue over 10 years.

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You for Sale: Company Envisions ‘Vaults’ for Personal Data

Peter DaSilva for The New York Times

Michael Fertik, the founder and chief executive of Reputation.com, at its offices in Redwood City, Calif., where he has amassed a database of information collected on millions of consumers.

“YOU are walking around naked on the Internet and you need some clothes,” says Michael Fertik. “I am going to sell you some.”

Naked? Not exactly, but close.

Mr. Fertik, 34, is the chief executive of Reputation.com, a company that helps people manage their online reputations. From his perch here in Silicon Valley, he views the digital screens in our lives, the smartphones and the tablets, the desktops and the laptops, as windows of a house. People go about their lives on the inside, he says, while dozens of marketing and analytics companies watch through the windows, sizing them up like peeping Toms.

By now many Americans are learning that they are living in a surveillance economy. “Information resellers,” also known as “data brokers,” have collected hundreds to thousands of details — what we buy, our race or ethnicity, our finances and health concerns, our Web activities and social networks — on almost every American adult. Other companies that specialize in ranking consumers use computer algorithms to covertly score Internet users, identifying some as “high-value” consumers worthy of receiving pitches for premium credit cards and other offers, while dismissing others as a waste of time and marketing money. Yet another type of company, called an ad-trading platform, profiles Internet users and auctions off online access to them to marketers in a practice called “real-time bidding.”

As these practices have come to light, several members of Congress, and federal agencies, have opened investigations.

At least for now, however, these companies typically do not permit consumers to see the records or marketing scores that have been compiled about them. And that is perfectly legal.

Now, Mr. Fertik, the loquacious, lion-maned founder of Reputation.com, says he has the free-market solution. He calls it a “data vault,” or “a bank for other people’s data.”

Here at Reputation.com’s headquarters, a vast open-plan office decorated with industrial-looking metal struts and reclaimed wood — a discreet homage to the lab where Thomas Edison invented the light bulb — his company has amassed a database on millions of consumers. Mr. Fertik plans to use it to sell people on the idea of taking control of their own marketing profiles. To succeed, he will have to persuade people that they must take charge of their digital personas.

Pointing out the potential hazards posed by data brokers and the like is part of Mr. Fertik’s M.O. Covert online profiling and scoring, he says, may unfairly exclude certain Internet users from marketing offers that could affect their financial, educational or health opportunities — a practice Mr. Fertik calls “Weblining.” He plans to market Reputation.com’s data vault, scheduled to open for business early next year, as an antidote.

“A data privacy vault,” he says, “is a way to control yourself as a person.”

Reputation.com is at the forefront of a nascent industry called “personal identity management.” The company’s business model for its vault service involves collecting data about consumers’ marketing preferences and giving them the option to share the information on a limited basis with certain companies in exchange for coupons, say, or status upgrades. In turn, participating companies will get access both to potential customers who welcome their pitches and to details about the exact products and services those people are seeking. In theory, the data vault would earn money as a kind of authorization supervisor, managing the permissions that marketers would need to access information about Reputation.com’s clients.

To some, the idea seems a bit quixotic.

Reputation.com, with $67 million in venture capital, is not making a profit. Although the company’s “privacy” products, like removing clients’ personal information from list broker and marketing databases, are popular, its reputation management techniques can be controversial. For instance, it offers services meant to make negative commentary about individual or corporate clients less visible on the Web.

And there are other hurdles, like competition. A few companies, like Personal, have already introduced vault services. Also, a number of other enterprises have tried — and quickly failed — to sell consumers on data lockers.

Even so, Mr. Fertik contends Reputation.com has the answer. The company already has several hundred thousand paying customers, he says, and patents on software that can identify consumers’ information online and score their reputations. He intends to show clients their scores and advise them on how to improve them.

“You can’t just build a vault and wish that vendors cared enough about your data to pay for it,” Mr. Fertik says. “You have to build a business that gives you the lift to accumulate a data set and attract consumers, the science to create insights that are valuable to vendors, and the power to impose restrictions on the companies who consume your data.”

THE consumer data trade is large and largely unregulated.

Companies and organizations in the United States spend more than $2 billion a year on third-party data about individuals, according to a report last year on personal identity management from Forrester Research, a market research firm. They spend billions more on credit data, market research and customer data analytics, the report said.

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Stalled Adoption Program in Guatemala Leaves Families in Limbo

Rodrigo Cruz for The New York Times

Amy and Rob Carr in Guatemala with Geovany Archilla Rodas, whom they have been trying to adopt since 2007. More Photos »

GUATEMALA CITY — The little boy flies like an airplane through the hotel, his arms outstretched. Then he leaps like a superhero, beaming as the red lights on his new sneakers flash and flicker, while the American couple he is with dissolve in laughter.

He calls them Mamá and Papi. They call him Hijo — Son. He corrects their fledgling Spanish. They teach him English. “Awe-some,” he repeats carefully, eyeing his new shoes.

To outsiders, they look like a family. But Geovany Archilla Rodas, an impish 6-year-old boy with spiky black hair, lives in an orphanage on the outskirts of this capital city. The Americans — Amy and Rob Carr of Reno, Nev. — live a world away. They are the only parents he has ever known.

They have been visiting him every year, usually twice a year, since he was a toddler, flying into this Central American city for a few days at a time to buy him clothes and to read him stories, to wipe his tears and to tickle him until he collapses in giggles at their hotel or in the orphanage.

Yet half a decade after agreeing to adopt him, the Carrs still have no idea when — or if — they will ever take Geovany home.

“There’s this hope in you that doesn’t want to die,” said Mrs. Carr, who arrived here last month with her husband, more determined than ever to cut through the bureaucracy. “In my heart, he’s my son.”

The Carrs are among the 4,000 Americans who found themselves stuck in limbo when Guatemala shut down its international adoption program in January 2008 amid mounting evidence of corruption and child trafficking. Officials here and in Washington promised at the time to process the remaining cases expeditiously.

But officials and prospective parents say that bureaucratic delays, lengthy investigations and casework hobbled by shortages of staff and resources have left hundreds of children stranded in institutions for years. Today, 150 children — including Geovany — are still waiting in orphanages and foster homes here while the Guatemalan authorities weigh whether to approve their adoptions to families in the United States.

Stalled adoptions are not unique to Guatemala. Concerns about fraud, including allegations of kidnappings and baby selling, have held up American adoptions for months, and sometimes years, from Ethiopia, Kyrgyzstan, Vietnam and Haiti. The State Department currently refuses to approve adoptions from Cambodia and Vietnam to pressure those countries to install safeguards so that children with biological relatives who can care for them are not shipped overseas, officials say.

But the problem of delayed adoptions is particularly acute in Guatemala, a country of about 14 million people, which in 2007 ranked second only to China in the number of children sent to the United States.

As officials here have spent months, and then years, trying to distinguish legitimate adoptions from fraudulent ones, many hopeful couples who had painted nurseries, hosted baby showers and bought brand new cribs began to despair as the infants they had hoped to adopt took their first steps and spoke their first words without them.

Faced with a seemingly endless process, scores of prospective parents quietly abandoned their efforts to adopt the children they once considered their own, officials say.

Guatemalan officials said they never intended for the children to remain institutionalized for so long. They say they have had to thoroughly investigate the cases, some of which are complicated by inconsistencies, false documents and questionable stories, to ensure that the children were not bought or stolen from impoverished rural women.

“These are very vulnerable people, who can be easily taken advantage of,” said Elizabeth Orrego de Llerena, president of the board of directors of the National Adoption Council, which is processing the adoption cases once they have been cleared by the child welfare investigative branch. “At times, they have not had the opportunity to make a complaint or to seek solutions.”

Ms. Orrego de Llerena said that the investigations, which typically include searches for biological relatives, were necessary to ensure that children were given up voluntarily.

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DealBook: Private Equity Firm to Buy Stake in Aston Martin

LONDON – Aston Martin, the maker of luxury cars made famous by James Bond movies, said on Friday that it had secured crucial financing by selling a stake to a Milan-based investment firm.

The private equity firm Investindustrial agreed to pay £150 million, or $241 million, for a 37.5 percent stake in Aston Martin, which is privately held.

Investindustrial has experience in investing in the motor industry after it sold Ducati, the Italian motorcycle maker, to Volkswagen’s Audi for more than $1 billion earlier this year.

The investment firm beat Mahindra & Mahindra, an Indian automaker, in a competition for the stake. The rest of Aston Martin continues to be owned by a Kuwaiti company, Investment Dar, and a group of individual investors.

The cash injection is critical for the iconic car brand, whose financial struggles have forced it to defer investing in new technology and models just as competition in the luxury market heated up. Aston Martin said Friday that it planned to invest more than £500 million to upgrade its production and technology.

Andrea C. Bonomi, senior principal at Investindustrial, said in a statement that at Aston Martin the investment firm plans “a similar transformation and rejuvenation that we achieved with Ducati, by expanding the model range and strengthening the dealership network, throughout the world.”

Investindustrial has about €3.1 billion, or $4 billion, of assets under management, including investments in an Italian retail company, a perfume company and a firm offering hair loss remedies. The investment firm was founded in 1990 by the Bonomi family, one of Italy’s well-known dynasties that amassed their wealth in the construction and industrial sectors. Investindustrial employs more than 50 people and is mainly investing in companies in Southern Europe.

Aston Martin, which was founded in 1913, is the only major luxury car maker that remains independent from the world’s largest car companies. Ford Motor sold the company to Investment Dar in 2007. A decline in consumer demand because of the economic crisis and a lack of funds to keep up with brands like Fiat’s Ferrari had hurt earnings at the firm, which produces all its models at a single plant in Britain..

Despite the difficulties, Aston Martin cars continue to be a fixture in James Bond movies, including the latest film “Skyfall.” The character of James Bond started to drive Aston Martins in the 1964 film “Goldfinger,” the third movie in the series.

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DealBook: S.E.C. Weighs Suit Against Netflix

Reed Hastings, the chief executive of Netflix, congratulated his team for a job well done in early July. On his public Facebook page, he crowed about the one billion hours of video that subscribers watched the previous month. The message was just 43 words.

Now, Netflix and its chief may be in deep trouble for that brief post.

On Thursday, Netflix disclosed that the Securities and Exchange Commission was considering taking action against the company and Mr. Hastings for its Facebook communication. The agency, in a so-called Wells notice, warned that it may file civil claims or seek a cease-and-desist order.

The S.E.C. is concerned that the post violated the Regulation Fair Disclosure rule, commonly known as Reg FD, which requires a company to announce information that is material to its business to all investors at the same time.

A Wells notice signaled that investigators planned to recommend charges against a company or executive. But recipients have a chance to object, and in some instances, the agency will close the case without taking action.

The move by the S.E.C. comes at a difficult time for Netflix, which has been trying to regain its footing after a series of setbacks. The company’s plan to cleave its movie-rental service into online streaming and mail delivery of DVDs led to a subscriber revolt last year. In October, the activist investor Carl C. Icahn took a 10 percent stake in the company, though he hasn’t outlined his plans.

Shares in Netflix were down 1.3 percent in after-hours trading on Thursday, at $85.02.

“We remain optimistic this can be cleared up quickly through the S.E.C.’s review process,” Mr. Hastings wrote on Facebook, a post that was filed with regulators.
A spokesman for Netflix declined to comment beyond Mr. Hastings’s post. A spokesman for the S.E.C. declined to comment.

On July 3, Mr. Hastings dashed out a quick Facebook post to his more than 200,000 followers. In it, he gave kudos to Netflix’s chief content officer, Ted Sarandos, about hitting a major milestone.

“When House of Cards and Arrested Development debut, we’ll blow these records away,” Mr. Hastings wrote, referring to the two television programs. “Keep going, Ted, we need even more!” Mr. Hastings seemed to mention the viewership statistics only in passing.

In the usual social media fashion, the post was forwarded by his followers. Bloggers picked up on it. Media reports cited it.

Regulation Fair Disclosure is intended to prevent the selective release of important information to some investors, depriving others of knowledge that would affect a company’s stock. A pharmaceutical company, for instance, can’t restrict news about a government investigation into one of its drugs to only a handful of shareholders.

Since the S.E.C. adopted the rule 12 years ago, companies have generally made announcements through news releases or regulatory filings. But the interpretation of that rule may be changing in an age of blogs, Facebook and Twitter.

Technology companies, in particular, tend to eschew news releases for all but the biggest announcements, instead sharing information on any number of Web outlets. The rule already allows for some exceptions, including information that is disclosed via news articles.

Mr. Hastings’s main defense is likely to be that the age of social media has redefined the concept of public disclosure. His Facebook feed is public, and the information was disseminated by his followers and the media.

It’s also possible that Netflix did not view the information as material. Mr. Hastings noted that on June 4, a Netflix vice president wrote on the corporate blog that subscribers “are enjoying nearly a billion hours per month of movies and TV shows” from the service. While Netflix’s stock rose on July 3, it was already getting a boost from a positive analyst note published the night before, Mr. Hastings wrote in Thursday’s post.

“We use blogging and social media, including Facebook, to communicate effectively with the public and our members,” Mr. Hastings wrote on Thursday.

A version of this article appeared in print on 12/07/2012, on page B1 of the NewYork edition with the headline: S.E.C. Warns Netflix Over a Post on Facebook.

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DealBook: Daimler Sells Half Its Stake in EADS for $2.2 Billion

LONDON – The German carmaker Daimler sold half of its stake in the aerospace giant European Aeronautic Defense and Space on Thursday in deal worth 1.7 billion euros ($2.2 billion).

The move is part of an overhaul of the ownership structure of EADS, the parent company of Airbus, which failed to complete a multibillion-dollar merger with the British aerospace company BAE Systems in October. The deal was aborted because of political divisions involving Britain, France and Germany.

Daimler said on Thursday that it had sold half of its 15 percent holding in EADS to a number of investors, including the German state-owned bank KfW. The automaker added that it had sold the stake at 27.23 euros a share, the closing price of EADS on Wednesday.

Shares in EADS rose 7.6 percent, to 29.25 euros, in morning trading in Paris on Thursday.

The share sale is an effort by the French and German governments to realign their stakes in the company, dissolving a decade-old arrangement that gave Paris and Berlin an effective veto over strategic management decisions at EADS.

Lagardère, a French conglomerate that currently owns a 7.5 percent stake in EADS, also plans to reduce its holding in the company through a share buyout program.

The ownership structure will eventually result in KfW acquiring a combined 12 percent stake in EADS, while France is expected to reduce its voting rights to 12 percent from 15 percent. A Spanish government holding company will also reduce its holding to 4 percent from about 5.5 percent.

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