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June 2010
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Caregiver eLetter
Because We Choose
The gauntlet was passed to us and we accepted it. Therefore we will cope, and in so doing, set an example for our children, and the generations to follow.
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June 2010
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Volume 13, Number 5
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In This Issue:
· Palliative Care
· May 18, “MS, the Disease with Nerve.”
· Health Care Reform
· June Calendar
· Mental Aerobics
Contact Kay
kay@kaypaggi.com
972.839.0065
Fax: 972.907.3799
Directions to the Support Group
The group meets at 421 Custer in Richardson, the Episcopal Church of the Epiphany. This is on the west of Central. Take the Arapaho exit; turn left at the first light (Custer). Stay on Custer, go past condos on both sides, pass 1st Methodist on the left, and turn right into the parking lot at Epiphany. There are 2 main buildings. We do not meet in the sanctuary; we meet in the other one. Come in the double doors, not the glass door off the patio (the note on the note that says otherwise is for daytime visitors when the secretary is there) We are usually the only meeting in the building. Look for the large room with a circular sofa and fireplace. See you at 7PM.
This site was recommended by Joe Roche. The Commonwealth Fund is a private foundation working toward a high performance health care system.
“By an overwhelming majority, leaders in health care and health policy think the new reform law will successfully expand access to affordable health insurance to millions of Americans. The latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders survey also found that virtually all key features of the health reform law are supported by a large majority of opinion leaders.”
MENTAL AEROBICS
“TEXT TWIST”
Make as many words as possible using the letters given, including the one word that uses all 6 letters.
IYNTUM
(Answer below)
If you enjoy this, Goggle Text Twist, and download a version to your hard drive. It’s great while you are on Hold.
ELDERHUMOR
Below is an actual job application that this 75 year old senior citizen submitted to Walmart in
California . They hired him because he was funny.....
NAME: Kenneth Way (Grumpy Old Bastard)
SEX: Not lately, but I am looking for the right woman (or at least one who will cooperate)
DESIRED POSITION: Company President or Vice President. But seriously,
whatever's available. If I was in a position to be picky, I wouldn't be
applying here in the first place
DESIRED SALARY: $185,000 a year plus stock options and a Michael Ovitz style severance package. If that's not possible, make an offer and we can
haggle.
EDUCATION: Yes
LAST POSITION HELD: Target for middle management hostility.
PREVIOUS SALARY: A lot less than I'm worth.
MOST NOTABLE ACHIEVEMENT: My incredible collection of stolen pens and
post-it notes.
REASON FOR LEAVING: It sucked.
HOURS AVAILABLE TO WORK: Any.
PREFERRED HOURS: 1:30-3:30 p.m. Monday, Tuesday, and Thursday.
DO YOU HAVE ANY SPECIAL SKILLS?: Yes, but they're better suited to a more
intimate environment .
MAY WE CONTACT YOUR CURRENT EMPLOYER?: If I had one, would I be here?
DO YOU HAVE ANY PHYSICAL CONDITIONS THAT WOULD PROHIBIT YOU FROM LIFTING UP TO 50 lbs.?: Of what?
DO YOU HAVE A CAR?: I think the more appropriate question here would be
'Do you have a car that runs?'
HAVE YOU RECEIVED ANY SPECIAL AWARDS OR RECOGNITION?: I may
already be a winner of the Publishers Clearing House Sweepstakes, so they tell me.
DO YOU SMOKE?: On the job - no! On my breaks - yes!
WHAT WOULD YOU LIKE TO BE DOING IN FI VE YEARS?: Living in the Bahamas with a fabulously wealthy dumb sexy blonde supermodel who thinks I'm the greatest thing since sliced bread. Actually,
I'd like to be doing that now.
NEAREST RELATIVE: 7 miles
DO YOU CERTIFY THAT THE ABOVE IS TRUE AND COMPLETE TO THE BEST
OF YOUR KNOWLEDGE?: Oh yes, absolutely.
***Old People Rock! ***
Answer to Mental Aerobics:
Nit
Nut
Tin
Tiny
Unit
Mint
Unity
Minty
Mutiny
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Next Support Group Meeting is Monday, June 14
7- 8:30 PM
421 Custer, Richardson
The Episcopal Church of the Epiphany
NOTES FROM THE WAITING ROOM:
Managing a Loved one’s End-of-Life Hospitalization
by Bart Windrum
The author’s parents both died in a hospital, unexpectedly, at separate times. The first chapters of this book are a rant by an angry adult child. By the end of the book, he channeled his frustration into productive ideas that may improve the quality of ANY hospital experience for readers, not just end-of-life.
· 50% of Americans die in the hospital
· The patient/family should be the unit of care during a hospitalization, but usually it is not
· Time-based trial – time allowed for a specified medical treatment that has been agreed upon before it is implemented. If it does not work, it is stopped.
· Families are not informed of alternative care options
One of the book’s themes is that hospitals do not provide ‘care’ as lay people understand the term. Rather, hospitals provide “bodily repair services”. “Hospital treatment is the application of science and technology to inhibit, reverse, or cure bodily ailments.” The ailment (diagnosis) becomes the focus of hospital attention while the person with the condition and his family become ‘peripheral’. The medical diagnosis is translated into a billable code to send to the insurance company. If there is no code, insurance does not pay. This means that people do not die of old age in a hospital because old age is not curable and cannot be assigned a billable code.
The lay person’s concept of ‘care’ differs significantly from the hospital’s use of the term care. Understanding this difference helps the family be a better advocate for the patient. ‘Care’ to patients and families implies compassionate attention. Notice the hospital billboards and ads. They are intended to make us think that this kind of ‘mom and pop’ care is provided at their institution; however, they are actually part of a marketing campaign. What families expect, especially after seeing hospital ads, is round the clock compassionate attentiveness, the same type of care the family provides for loved ones. This is not the type of care patients receive in hospitals.
Families of patients suffer painful emotional and psychological shocks as a result of their confusion over expected care versus the care received. For example, hospital food service brings in a tray and sets it on a table; later they pick up the tray. If your loved one cannot feed themselves, or if they are asleep, they may not eat unless there is a family member present.
Hospital care for critically ill patients is complicated by modern technology. Dying is no longer allowed to be quick; it is “protracted”. There are ethical issues surrounding life support and resuscitation.
The other theme that runs throughout the book is the lack of communication with the patient’s family. Families and patients expect to be kept informed of the diagnosis, progress, and treatment options, but this communication is not the norm.
In an ideal hospitalization, there is one physician that manages the case. Specialists treat the organ of their specialty rather than the whole patient. Attending physicians talk to each other but rarely with the family. It is almost impossible for a family member to know how the loved one’s case is being coordinated. ‘Discontinuity of care’ is a major problem in the current hospital ‘system’, according to medical ethicists.
Most hospital physician care is now provided by hospitalists; these are doctors hired by the hospital, who generally do not have a private practice. They work on shifts like all hospital staff. This means that medical information about the loved one must be passed on along to the next doctor several times a day. Hospitalists do not have a prior relationship with their patients, and may never see them after discharge. They may rotate, such as one physician in the practice sees patients one week, and another sees those same patients the following week.
You as the patient advocate need to get some basic information when your loved one goes into the hospital.
· What time do the doctors make their rounds? Usually rounds are done early in the morning. Make sure that someone is there to speak with the doctors while they are there.
· What are your attending physician’s relationships with the hospital and each other? Which are hospitalists, and which are specialists with a private practice? Which doctor is actually in overall charge of your loved ones’ case?
· How are weekends and holidays staffed? How does this change of staff affect treatment? For example, there may be no physical therapy on weekends and many tests re not run on weekends. This affects the length of stay.
As your loved one’s advocate, keep a written journal that you can bring into any meeting with names, dates, and details.
Prognosis is the medical term for forecasting; i.e., Will the patient recover? Or, Will she have permanent disability? Forecasting includes what is likely to happen and what might happen. Forecasting is vital to patient care. It is impossible to make treatment decisions without knowledge of what might happen if you make any of the various choices for treatment. Forecasting also lets the family know that their loved one may be terminal. Without forecasting, the family may be completely in the dark and suffer shocks when medically expected outcomes occur.
No doctor has a crystal ball. Most physicians are extremely reluctant to make any kind of forecast. Asking for exact predictions is unrealistic, especially if your loved one is frail. Remember that hospitals do bodily repair. If your loved one’s body is damaged beyond a reasonable hope of repair, the family needs to be informed of that. Unfortunately, many families find out their loved one is dying only moments before the event but the medical staff knew it was inevitable much earlier. Families miss last opportunities to spend quality time with dying loved ones because of the lack of communication with the hospital staff.
Hospital time. Thursdays are important. Any tests that have not been ordered by Friday morning probably will not happen until Monday. You will be charged for being in the hospital over the weekend but there may be nothing happening. Most senior personnel have weekends and holidays off, leaving the less experienced staff in charge. Hospital pharmacies have the same staffing issues. This can cause delays in getting new medications started.
Resuscitation is the application of potentially life saving procedures. The patient can sign a DNR statement that prohibits resuscitation under certain conditions. In contrast to public expectations, only 1-3% of resuscitation attempts in real life are successful. Of these, about ½ suffer significant functional impairment after resuscitation. Perhaps 5% of resuscitation recipients make it to hospital discharge.
Time-based trials are a good alternative to the black-and-white language of most DNR’s. These time-limited trials allow an intervention to be tried, such as intubation or medication. If at the end of the allotted time, the treatment is not working, as defined before the treatment is started, then it is discontinued.
‘Heroics’ is the term for actions implemented during resuscitation, the efforts to extend life. It also applies to all the weeks of treatment in a final hospitalization. Why engage in heroics? Because we don’t want to die. “But why not, if we have already lived full lives?” The author suggests that heroics start at the first crisis, the first life-shortening emergency, the first heart bypass, the first stroke, the beginning of dialysis. After this initial event, the patient lives heroically with deficits and treatments and assistive devices, often for many years. These are heroic actions that “satisfy the human imperative to fight for life and to sanctify we life we are given by Creation by not giving up on it” But one day, every person engaged in these heroic life-saving actions will fail. They will change from living with the disease to dying from the disease. That day usually leads to hospital, where the decision must be made whether to continue curative treatment, no matter how futile, or to choose to die in peace “in a humane environment under nurturing conditions.”
Dying in a Hospital and Palliative Care. Dying in a hospital involves the hospital experience, where the patient as a whole person is not the focus of treatment; rather, the diagnosis drives treatment. Death in a hospital occurs unexpectedly; dying is not diagnosable or billable, only curative activity is. The hospital experience is subject to the values of a high-tech medical system that is very uncomfortable with the reality of death. Dying outside the hospital can be more humane.
The goal of palliative care is the mitigation of pain. This type of care can be given in a hospital, once the focus changes from cure to comfort. Curative interventions often cause discomfort. Palliative care offers pain relief. There is a movement now to recognize pain as the fifth vital sign. If successful, pain would be assessed along with blood pressure, pulse, respiration and temperature.
Hospice focuses on palliative care. Admittance to hospice care requires a terminal diagnosis with death expected within 6 months. The focus of treatment changes from “doing to to doing for.” Patient families whose loved one fails during a hospitalization have zero time to plan for the end-of-life or say final good-byes. Entering a hospice program can give the family and the patient time to make decisions. Unfortunately most patients are on hospice less than a week. This is because patients may agree to hospice only at the end of an exhausting hospital experience, after they are already actively dying. Typically it takes several days to die after curative efforts have ended.
Recommended Reading
Kaufman, …And a Time to Die: How American Hospitals Shape the End of Life. Kaufman is a medical ethicist.
Kiernan, Last Rights, Rescuing the End of Life From the Medical System
– Dartmouth Atlas Project is funded by the Robert Woods Johnson Foundation)
HAPPINESS MAY COME WITH AGE
www.nytimes.com/2010/06/01/health/research/01happy.html?src=me&ref=general
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This is a very positive article. I hope you will be able to open it and that it gives you encouragement as you grow older and happier.
Caregiving can lead to psychological and physical health problems
www.cnn.com/2010/HEALTH/05/20/caregivers.health.risks/index.html?hpt=Sbin
Researchers found someone was six times more likely to develop dementia if his or her spouse had dementia.
It's not entirely clear why caregiving can make you sick, but researchers believe depression and chronically high levels of the stress hormone cortisol, both of which often accompany caregiving, take a toll on the body's immune and cardiovascular systems
One of the best ways to relieve caregiver stress is to attend a support group. There are studies that demonstrate that attending a support group can delay placement by 2 years, partially by relieving caregiver burden. Try it – You’ll like it!
JUNE CALENDAR
Monday, June 14, 7-8:30PM, Caregiver Discussion group meets at 421 Custer in Richardson (the Episcopal Church of the Epiphany). There is always chocolate to help us cope. Bring anything else you need plus encouragement for others.
Thursday, June 17, 3:00 – Dallas Area Gerontological Society presents Bonnie Resnick-Destruel speaking on "Assessing Outcomes Vital to Independent Living in Late Life". Our host this month is Buckner Retirement Village, (214) 381-2171
4800 Samuell Blvd, Dallas, TX 75228
Everyone is invited to attend this FREE event.
Tuesday, July 6, Laugh for the Health of it! by renowned Dallas speaker Rosemary Rumbley. This FREE morning seminar will be held at Richland College in Fannin Performance Hall. There is FREE Breakfast, too! For more information or to register, go to www.richlandcollege.edu/emeritus
Richland College
12800 Abrams
Dallas 75243
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If you wish to be added or subtracted from the mailing list for this eLetter, please contact kay@kaypaggi.com.
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April 2010
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Caregiver eLetter
Because We Choose
The gauntlet was passed to us and we accepted it. Therefore we will cope, and in so doing, set an example for our children, and the generations to follow.
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April 2010
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Volume 13, Number 3
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In This Issue
· Stress
· April Calendar
· Mental Aerobics
Contact Kay
kay@kaypaggi.com
972.839.0065
Fax: 972.907.3799
Directions to the Support Group
The group meets at 421 Custer in Richardson, the Episcopal Church of the Epiphany. This is on the west of Central. Take the Arapaho exit; turn left at the first light (Custer). Stay on Custer, go past condos on both sides, pass 1st Methodist on the left, and turn right into the parking lot at Epiphany. There are 2 main buildings. We do not meet in the sanctuary; we meet in the other one. Come in the double doors, not the glass door off the patio (the note on the note that says otherwise is for daytime visitors when the secretary is there) We are usually the only meeting in the building. Look for the large room with a circular sofa and fireplace. See you at 7PM.
www.familycaregiversonline.net
They are worksheets, to-do lists, and legal forms for use in TX on this website. There are a number of resources and educational materials about ElderCare, also.
MENTAL AEROBICS
What do these words have in common? No, it is not that they all have at least 2 double letters.
Banana
Dresser
Grammar
Potato
Revive
Uneven
Assess
(Answer below)
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ELDERHUMOR
A man and his ever-nagging wife went on vacation in Jerusalem . While they were there, the wife passed away. The undertaker told the husband, "You can have her buried here in the Holy Land for $150, or we can have her shipped back home for $5000.”
The husband thought about it, and told the undertaker he would have her shipped back home. The undertaker asked him, "Why would you spend $5000 to have her shipped home when you could have a beautiful burial here, and it would only cost $150???"
The husband replied, "Long ago, a man died here, was buried here, and three days later, rose from the dead. I just can’t take that chance!"
Answer to Mental Aerobics:
If you take the first letter and place it at the end of the word, then spell the word backwards, it will be the same word.
Banana – removed B from front of word and place it on the end,
ananaB – is Banana spelled backwards.
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Next Support Group Meeting is Monday, April 12
7- 8:30 PM
421 Custer, Richardson
The Episcopal Church of the Epiphany
Everyone who attends will get a BioDot!
STRESSED? Have a BioDot
Providing assistance for a parent is stressful, and its challenges create a stress reaction in the caregiver. Stress affects your whole body. Stress is intended to be a good thing. You are confronted with a Saber Tooth Tiger. In order to survive, your body needs to mobilize its defenses for either running or fighting; we call this mobilization ‘stress reaction’. Your muscular system tenses and your jaws clench as your body readies for Action. The autonomic nervous system reacts to the threat by accelerating your heart rate. As your breathing rate increases to get more oxygen into your system, your blood sugar level increases as adrenaline flows to become immediate energy. Your digestive system shuts down (there is no point in digesting your breakfast if you are going to be breakfast). Your central nervous system narrows your perception so you can focus on the threat; your memory becomes imprecise and new learning is harder to acquire (because who needs it while escaping from the danger of being attacked) and your expectancies may be more negative. Your body shuts down any process that is not needed to respond to and survive the threat. Other physiological effects that are part of the stress response are increased levels of lipids, depressed immune response, and increased risk of blood clotting (in case you are bitten by the beast). Now your body is ready for the Saber Tooth Tiger!
The way this response to stress, i.e., threat, is supposed to work is that you either elude the Tiger or defeat it (or get eaten). In any case, the threat is over in a relatively short time, and your body returns to its normal functioning. Your metabolism slows, heart rate decreases, blood pressures decreases, breathing slows, and your muscles relax.
The problem is that your body doesn’t know the difference between the Saber Tooth Tiger and your mother.
The tiger, poor thing, looks elsewhere for breakfast. Your mother, the modern cause of your stress response, is always with you, so your body remains on alert indefinitely. Most caregivers have chronically tense muscles, often in the nape of the neck or in the back. You complain of not being able to remember anything and wonder if you are losing your mind. Caregivers are more likely to get sick because your immune system is shut down. Caregivers are at higher risk to have an accident, either in the car or at home because your focus is on the potential threat, i.e., mother. They often have digestive problems, such as chronic diarrhea, constipation, or stomach cramps. They may be at higher risk for stokes or heart attack because of the tendency for blood clots, and they may be more likely to have blood sugar disorders like diabetes.
I heard Angela Payne, LCSW, from the Medical Center of Lewisville, speak recently about stress. She suggested that if you put your hand in front of your face, very close to your eyes, all you can see is your hand. This is the stressor. You can’t see anything but your hand, you can’t see beyond it, you can’t see a way out or a way to remove it because it is too close. What caregivers need is a way to pull the hand a little farther from their eyes. This is the Relaxation Response.
The Relaxation Response gives your body a chance to return to a more normal function, to ‘stand down’ from being on alert. One way to achieve a relaxed state is to sit quietly and give your mind something to focus on (something that is not your current situation with your care receiver). Do this for just a few minutes while you consciously breathe normally. The goal is to improve your health by changing your physiology.
A significant difference between the stress response and the relaxation response is that the stress response is automatic – it happens whether we want it or not. It is your body’s automatic biological response to preserve itself. The relaxation response, on the other hand, is conscious. You have to make it happen. Practicing helps.
Try deliberately relaxing once or twice a day for only 10-20 minutes at a time. Find something for your mind to focus on, such as a thought, phrase, sound, prayer, or muscular activity. Return to this repetition when other thoughts intrude. The more you do it, the easier it will be for you to relax. What do you have to lose? It’s free.
What is a BioDot? It’s a tiny thermometer that monitors skin temperature and changes colors accordingly. When the person wearing a BioDot is stressed, he/she can see the color change and make a deliberate effort to calm down and relax. It’s fun.
www.biodots.net
“The Remember Song” by Tom Rush
http://www.youtube.com/watch?v=9yN-6PbqAPM
Enjoy!
Study Reveals What Americans Pay for Long-term Care Insurance
What individuals pay for long-term care insurance can range significantly from about $700 a year to as over $13,000 per year according to a study from the American Association for Long-Term Care Insurance.
http://www.infozine.com
APRIL CALENDAR
Monday, April 12, 7-8:30PM, Caregiver Discussion group meets at 421 Custer in Richardson (the Episcopal Church of the Epiphany). There is always chocolate to help us cope. Bring anything else you need plus encouragement for others.
Thursday, April 13, 10:00 – 12:00, Terry Warner, our local insurance guru, will present a free seminar on the Medicare supplement changes. RSVP to Terry at 972-437-0598.
Place: Richardson Community Room at First Community Bank
429 Belle Grove Dr., Richardson, TX 75080
First Community Bank is adjacent to the post office south of Richardson Civic Center.
terry.warner@tx.rr.com www.agencyofterrywarner.com
Topics: 10:00 Medicare Basics with supplement changes that begin on 6/1/2010
11:00 End of Life Decision Making- Part One
Coming Up:
Monday, May 3, Belle Tones, a community handbell choir, plays at The Legacy. If you are nearby, please join us for a remarkable performance!
10:30 AM 6101 Ohio (becomes Hillcrest as it gets closer to Dallas), Plano 75024
Monday, May 10, the Belle Tones play at Treemont Retirement Community
5550 Harvest Hill, Dallas (just south of LBJ off of Preston)
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If you wish to be added or subtracted from the mailing list for this eLetter, please contact kay@kaypaggi.com.
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March 2010
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Caregiver eLetter
Because We Choose
The gauntlet was passed to us and we accepted it. Therefore we will cope, and in so doing, set an example for our children, and the generations to follow. |
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March 2010 |
Volume 13, Number 2 |
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In This Issue
· Book Review: Stages of Senior Care
· Medicare Physician Pay Cut
· Challenges in Treatment and Care at Life’s End, Lecture presented by Robert L. Fine
· March Calendar
· Mental Aerobics
Contact Kay
kay@kaypaggi.com
972.839.0065
Fax: 972.907.3799
Directions to the Support Group
The group meets at 421 Custer in Richardson, the Episcopal Church of the Epiphany. This is on the west of Central. Take the Arapaho exit; turn left at the first light (Custer). Stay on Custer, go past condos on both sides, pass 1st Methodist on the left, and turn right into the parking lot at Epiphany. There are 2 main buildings. We do not meet in the sanctuary; we meet in the other one. Come in the double doors, not the glass door off the patio (the note on the note that says otherwise is for daytime visitors when the secretary is there) We are usually the only meeting in the building. Look for the large room with a circular sofa and fireplace. See you at 7PM.
The National Family Caregivers Association (NFCA) educates, supports, empowers and speaks up for the more than 50 million Americans who care for loved ones with a chronic illness or disability or the frailties of old age. NFCA reaches across the boundaries of diagnoses, relationships and life stages to help transform family caregivers' lives by removing barriers to health and well being. Visit NFCA at www.thefamilycaregiver.org.
MENTAL AEROBICS
What Do You Know about MONEY?
The missing element is each phrase below is a coin or a unit of currency.
1. Brother, can you spare a ______?
2. _______ from Heaven.
3. _____ ______ legs.
4. Shave and a haircut, ______.
5. Not worth a plugged _____.
6. ______ of flesh.
7. Baby _____ piano.
8. _______ Rogers.
9. March of ______.
10. ______ wise and _____foolish.
11. What this country needs is a good ______ _______ cigar.
12. _______ master.
13. The Almighty ______.
14. I found a ____ ____ baby in the _____ & _____ ____ store.
15. _____ante.
(Answers below)
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ELDERHUMOR
A woman went to the emergency room, where she was seen by a young, new doctor. After about 3 minutes in the examination room, the doctor told her she was pregnant. She burst out of the room and ran down the corridor screaming.
An older doctor stopped her and asked what the problem was. After listening to her story, he calmed her down and sat her in another room.
Then the doctor marched down the hallway to the first doctor's room. "What the hell's wrong with you?" he demanded. "This woman is 63 years old, she has two grown children and several grandchildren, and you told her she was pregnant?"
The new doctor continued to write on his clipboard and without looking up said,
"Does she still have the hiccups?"
Answer to Mental Aerobics:
1. Brother, Can you spare a DIME?
2. PENNIES from Heaven.
3. MILLION DOLLAR legs.
4. Shave and a haircut, 2 BITS.
5. Not worth a plugged NICKEL.
6. POUND of flesh.
7. Baby GRAND piano.
8. BUCK Rogers.
9. The March of DIMES.
10. PENNY wise and POUND foolish.
11. What this country needs is a good 10 CENT cigar.
12. GRAND master.
13. The Almighty DOLLAR.
14. I found a MILLION DOLLAR baby in the 5 – 10 CENT store.
15. PENNY ante. |
Next Support Group Meeting is Monday, March 8
7- 8:30 PM
421 Custer, Richardson
The Episcopal Church of the Epiphany
ELDERCARE SEMINAR BEGINS ON MARCH 24
This is a 4-week non-credit course at Richland College taught by Kay Paggi. The course is designed to prepare adult children for future eldercare, or enhance current caregiving knowledge. It covers types of information you need to be more comfortable with the role of caregiver, and how to find more information quickly as you need it, and strategies on reducing Guilt.
In the first class you will receive a Glossary of ElderSpeak that defines terms used among eldercare professionals and concepts involved in aging, as well as suggestions for improving communication with your care receiver to improve the caregiving relationship for both of you. You will also be given a template for a basic eldercare assessment.
The second week covers normal physiological aging so you can distinguish between normal age-related changes and those that are NOT normal. You will pick up some tips on how to affect your own aging. This class will have information about fall prevention, and a basic housing assessment. You will be given a facility rating sheet to use as you visit communities that will help you make the best choice the first time; this can save you money by preventing a poor choice.
The third session covers medical conditions, and medications that are not recommended for older adults. It continues with how to find a physician for an older person, and discussion of financing medical care with Medicare, Medicaid, MediGap insurance, and HMO’s and Advantage plans. You will take home a medical assessment.
The last week covers information on legal documents and financial information. You will take home a check list of needed documents. The class ends with a discussion of end of life care, DNR's, and suggestions on how to say good-bye.
To enroll, call the Emeritus Dept at Richland College at 972-238-6147, or go online www.rlc.dcccd.edu/boomers. You can view the Spring Class Schedule on the left panel and find ‘Concerned About Your Aging Parents’ Course # EMEZ 1000 83905. To register for the course online, you must have previously taken a class at Richland. The cost is $40 for everything - What a Deal!
Richland College is located at 12800 Abrams Rd in Dallas, 75243. This is north of 635 on Abrams, or south of Walnut, east of Greenville. There is a map and driving directions on their website.
Stages of Senior Care: Your Step-by-Step Guide to Making the Best Decisions,
by Paul & Lori Hogan
This book will be helpful to those providing care to older adults across a wide spectrum of needs. It is a basic caregiving guide that could ease the burden of care for many years and in many differing care situations. The authors had previously developed a concept called the ‘40-70 Rule’ a guide to how to start the conversation about future care needs. This guide is available free online at www.4070talk.com. After initial introductory chapters, the book begins with a chapter set at the beginning of the caregiving journey with the care receiver living independently in the community. There are suggestions about how to make the environment safer and guidelines about the costs of these safety measures, and a discussion about the pros and cons of remaining in one’s home. At the end of the chapter there are valuable online resources.
The book follows this format of discussion of issues, pros and cons, cost, and resources for caregiving scenarios as they become progressively more challenging from assisted living to the end of life. The Hogan’s’ are the founders and owners of the home care agency Home Instead. I expected the book to be biased in favor of remaining at home with in-home assistance. I was wrong. The book fairly presents the problems and expenses involved in staying in one’s home alongside other options and their problems and costs, with discussions of the advantages and disadvantages of each possibility. The resources at the end of chapters are thoroughly researched.
The book continues with discussions of funeral options and expenses that may be especially valuable for families of modest means or with family members living far from the care receiver. There are chapters on financing care, complicating issues, and an excellent chapter on taking care of the caregiver.
I highly recommend this book, and will include it as a resource for everyone in my Eldercare/ Caregiver classes. It is available at Amazon for $12.89, with a 4 1/2 star rating.
MEDICARE PHYSICIAN PAY CUT PUT INTO EFFECT
A 21.2% pay cut for Medicare physicians takes effect today after a Senate bill that would have prevented it failed to gain enough bipartisan support. The House had passed the bill the day before.
The bill contains a 30-day delay of the Medicare physician pay cut, as well as a number of provisions extending unemployment benefits that also expired over the weekend. During negotiations, retiring Sen. Jim Bunning (R-KY) repeatedly blocked the bill, arguing that its $10 billion price tag was too much of a burden on the already massive federal budget deficit, according to the Associated Press. The Centers for Medicare & Medicaid Services could choose to withhold payments to Medicare physician until a solution can be found. It would be a remedy that physician groups favor because they then would avert having to later refile claims that were paid at a lower rate if a fix to the payment formula is decided upon soon, which many observers expect.
If this bill goes into effect, many physicians who currently see older adults may decide to withdraw from Medicare.
MARCH CALENDAR
Monday, Mar 8, 7-8:30PM, Caregiver Discussion group meets at 421 Custer in Richardson (the Episcopal Church of the Epiphany). There is always chocolate to help us cope. Bring anything else you need plus encouragement for others.
****Tuesday, Mar. 9, 6:00 Reception, Lecture begins at 7PM. ‘Challenges in Treatment and Care at Life’s End, Lecture presented by Robert L. Fine, M.D., F.A.C.P., Director, Office of Clinical Ethics and Palliative Care, Baylor Health Care System.
Do NOT miss the opportunity to hear Dr. Fine. His last name is not a misnomer. He is an outstanding physician who not only is direct and kind, but:
Improves planning for life’s end,
Assists in analyzing the right time to let go of medical technology,
Addresses the possibility of a sweeping change in attitude by accepting death as a spiritual experience,
Human condition tells us to run away at the end of life. However, there are alternative paths for consideration. Experts in the palliative care field:
Assist patients and families in exploring options,
Offer planning tools to overcome challenges,
Bring healing and focus on comfort,
Meet goals and wishes of the patient.
This FREE event is sponsored by C.C. Young as part of the Mind Body & Spirit Series. Location: The Point, Center for Arts and Education n the Campus of C. C. Young, 4847 W. Lawther Dr., Dallas, TX 75214
Seating is limited. Please register today, (214) 841-2834 or ccy@ccyoung.org
Thursday, Mar 11, 2:30-3:30PM, BRAIN PLAY begins at Richland College for a 6-week session. This course is designed to help stamp out Flabby Brains. Join the class for some Mental Aerobics and grow a few new dendrites. To enroll go to http://www.richlandcollege.edu/emeritus/ and click on the Registration Info on the left panel or call 972-238-6146 or 6147. Fee is $18.
** Remember that Texas citizens over age 65 may get a tuition waiver for 6 credit hours per semester! There are plenty of excellent credit courses at Richland that you can take for free. To get on the mailing list for Emeritus booklets, call 972-238-6958 (Janie) or send an email to ricemeritus@dcccd.edu.
Thursday, Mar 18, 3:00PM, Dallas Area Gerontological Society presents ‘Urogynecology’ by Dr. Shayzreen Roshanravan hosted by
Treemont Retirement Community, 972-661-1856
5550 Harvest Hill Road, Dallas, TX 75230
Saturday, Mar 20, 3:30-5:00PM, Tea 4 TWO at the Chocolate Angel. Please invite your friends and family members to attend. All proceeds will benefit the Texas Women's Outreach (TWO). TWO serves the community and women of diversity by assisting them in their time of need, while maintaining their dignity. Registration is available online www.texaswomensoutreach.com. $25 per person.
Chocolate Angel Cafe
635 W. Campbell Road, Suite 310, Richardson, Texas (at Nantucket)
For more information call Barb Gatti at 214-909-3448.
Wed, Mar 24, 7-9 PM, Eldercare Seminar begins at Richland College
Coming Up:
Monday, May 3, Belle Tones, a community handbell choir, plays at The Legacy. If you are nearby, please join us for a remarkable performance!
Monday, May 10, the Belle Tones play at Treemont Retirement.
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If you wish to be added or subtracted from the mailing list for this eLetter, please contact kay@kaypaggi.com. |
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September 2008
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Caregiver eLetter from Aging Care Solutions
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September 2008 Because we choose Volume VIII, Number 9
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The gauntlet was passed to us and we accepted it. Therefore we will cope, and in so doing, set an example for our children, and the generations to follow.
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In This Issue
· ElderCare Seminar begins Oct.2
If you have a parent who is 70 or older, this seminar will save you time and heartache
· September Calendar
· Medicare D premiums rise in 2009
· Medication MIS-Management
· Mental Aerobics: Presidential Trivia!
kay@kaypaggi.com
972.839.0065
Fax: 972.907.3799
ElderCare Seminar at Richland College
This 4-week seminar begins on Thursday, Oct.2. It will help you prepare for future eldercare, or enhance your current caregiving knowledge.
We will discuss care-giving issues, types of information you need, and how to get it. We will also talk about how to improve communication with your parents and how to open a conversation with them about their future, or current, needs.
The seminar is in 4 sections. The first session includes a Glossary of ElderSpeak, defining terms you will encounter as you provide care for an older adult. We’ll also cover improving communication and reducing Guilt.. You will take home a basic assessment.
The 2nd session covers normal aging, so you can distinguish what is NOT normal, and some tips about your own aging. This session includes fall prevention and a housing safety assessment. You will take home a rating sheet to help you make the best choice of facilities if one is needed.
The next session covers medical conditions, medications, how to find a physician for an older person, Medicare, Medicaid, and HMO’s. You will take home a medical assessment.
The final class includes information on legal documents and a check list of necessary legal documents. We will discuss end of life care, DNR’s, and saying goodbye.
To enroll in this Seminar, call the Emeritus dept. at Richland College at 972-238-6972 or 972-238-6958, or go online
http://www.rlc.dcccd.edu/boomers,
Course # 523487. The cost is $40 for everything – What a deal!
MENTAL AEROBICS
Presidential Trivia
1. More Presidents have been born in one state than any other. Which one?
2. What is the most common Presidential first name?
3. Throughout its history, the White House has been known as the "President's Palace," the "President's House," and the "Executive Mansion."
What president gave the White House its current name?
4.Six Presidents were professional soldiers. Which ones?
5.Which President delivered his inaugural Address without using the word ‘I”?
Answers at the bottom of the Newsletter
ELDERHUMOR
An elderly gentleman had serious hearing problems for a number of years. He went to the doctor and the doctor was able to have him fitted for a set of hearing aids that allowed the gentleman to hear 100% .
The elderly gentleman went back in a month to the doctor and the doctor said, 'Your hearing is perfect. Your family must be really pleased that you can hear again.'
The gentleman replied, 'Oh, I haven't told my family yet. I just sit around and listen to the conversations. I've changed my will three times!'
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September Support Group Meeting is Monday, Sept. 8
We will have an ElderCare Attorney speak
and answer questions during the first half hour.
Here is a synopsis of her presentation.
If You Don’t Have a WILL,
The State of Texas Has One for You!
Estate planning has become increasingly complex with tax changes, multiple marriages, blended families, aging parents, and an increasing divorce rate. Attorney Lorie Burch will help you become familiar with the basics including wills, trusts, guardianships, powers of attorneys, and living wills.
· Discover the importance of preparing yourself and your loved ones with these vital documents.
· Learn the scary truth of what will happen if you don’t have a will.
· Learn the “do’s” and “don’ts” of writing your will and living will.
Estate Planning is a very misleading term as many people associate it with large ‘estates’. Estate Planning is the area of law that encompasses wills, trusts, guardianships, powers of attorneys, living wills, etc. If someone has a house, or a bank account, or a life insurance policy, they have an "estate" for the purposes of this type of planning.
Lorie will speak for the first few minutes of the meeting. Please come to hear what she has to tell us, and bring your questions. After she is finished, we will have a group discussion as usual.
Lorie L. Burch, Attorney & Counselor At Law
7920 Belt Line Road, Suite 750, Dallas, Texas 75254
Phone: 972.385.0558
Fax: 972.331.8897
lorie@burch-law.com
www.burch-law.com
Medicare Prescription Drug Premiums to Rise in '09
According to a story in The Washington Post on August 15th, the average monthly premium for Medicare's prescription drug plan will increase by $3 to an estimated $28 in 2009. The Part D program offers prescription drug benefits to Medicare beneficiaries. One reason for the premium increase is that the cost of prescription drugs is increasing. Another is that drug distributors participating in Part D have found coverage for catastrophic care to be higher than anticipated.
Full story: http://www.washingtonpost.com/wp-dyn/content/article/2008/08/14/AR2008081402994.html
MEDICATION MIS-MANAGEMENT
According to an analysis in the Baltimore Sun, up to one-half of all older adults will mismanage at least one of their medications. This accounts for about 23 percent of nursing home admissions. Older adults are at a significantly higher risk of hospitalization due to drug safety issues. This "noncompliance" with medication instructions can lead to an increased number of health problems, loss of independence and, in extreme cases, death.
The over-65 population takes roughly one-third of all prescription medicines, and with so many medications being taken, it is easy for seniors to become confused and mismanage their prescriptions, the report notes.
One solution to the problem, according to experts cited in the article, is to move to electronic health records. EHRs would help doctors coordinate medications for their patients who, according to the report, could receive prescriptions from up to eight different doctors at a time.
Thanks for Seasons Seminars for this information. http://www.seasonsseminars.com/
Guiding Principles For Assisted Living Communities
The National Center for Assisted Living (NCAL) recently unveiled a comprehensive set of guiding principles for assisted living communities. These focus on individual-centered care as the foundation to develop and improve services.
"These principles establish a strong philosophical foundation for the myriad policy and operational issues facing the assisted living profession today and in the future." stated David Kyllo, executive director of NCAL. "Our intent is to provide a framework to help assisted living communities to provide assistance with physical activities and health-related needs, while also striving to meet the social, emotional, cultural, intellectual and spiritual needs of their residents."
http://www.ahcancal.org/News/news_releases/Pages/10Mar2008.aspx
Thanks to Seasons Seminars for this article, also.
SEPTEMBER CALENDAR
Monday, Sept 8, 7-8:30PM, Caregiver Discussion group meets at 421 Custer in Richardson (the Episcopal Church of the Epiphany). There is always chocolate to help us cope. Bring anything else you need plus encouragement for others.
Thursday, Sept.11, 6-7:30 PM Discussion Group for Dementia Caregivers, meets at Prestonwood Court, 7001 West Plano Parkway, Plano, Texas 75093, (972) 306-2200. This is a warm, caring group. Wine, beverages, and snacks are served. Everyone is welcome. Come to the lobby and the receptionist will direct you to the meeting room.
Thursday, Sept. 18, 3-4:30 PM, Dallas Area Gerontological Society (DAGS) meeting. Peggy Glenn-Summit, Director of Programs at The Senior Source will be speaking.
"How To Access Programs at The Senior Source". This FREE program is open to everyone. The host changes every month. This month the meeting will be held at Life Care Center of Plano, 3800 West Park Boulevard, Plano 75075, (972) 612-1700
Please join us
Looking Ahead
Thursday, Oct.2, 7-9 PM, ElderCare Seminar at Richland College
This 4-week seminar will help you prepare for eldercare. It is a personalized class with local as well as national information. If you have a parent who is 70 or older, this seminar will save you time and heartache. To register, call the Emeritus dept. at Richland College at 972-238-6972 or 972-238-6958, or go online. Course # 523487, $40
http://www.rlc.dcccd.edu/boomers
The seminar suggests solutions to make your role as an elder-caregiver more effective. We will discuss care-giving issues, types of information you need, and how to get it. We will also discuss how to improve communication with your parents and how to open a conversation with them about their future needs. The seminar covers medical conditions, medications, how to find a physician for an older person, Medicare, Medicaid, and HMO’s. The class includes information on legal documents, end of life instructions and DNR’s. You will be given assessment tools to help you identify environmental hazards in the home, suggestions for safety modifications, and a rating sheet to use when you visit congregate facilities. We will talk about reducing guilt, siblings, making time for yourself and parent death.
This is not a ‘canned’ course, the same for everyone. It will address your specific concerns and provide you with a forum for getting answers to your current dilemmas. Presenter: Kay Paggi, Nationally Certified Gerontological Counselor and Geriatric Care Manager
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Answers to Mental Aerobics: 1. Virginia; 2. James; 3. in 1901, Theodore Roosevelt; 4. Washington, Jackson, William Henry Harrison, Taylor, Grant, and Eisenhower; 5. Theodore Roosevelt was the only U.S. president to deliver an inaugural address without using the word "I." Abraham Lincoln, Franklin D. Roosevelt, and Dwight D. Eisenhower tied for second place, using "I" only once in their inaugural addresses.
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To be added or deleted to the email list, please send a message to kay@kaypaggi.com
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Contact Information
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Kay Paggi, Eldercare Consultant
Licensed Professional Counselor
National Certified Gerontological Counselor
Care Manager, Certified
Phone: 972-839-0065 E-Mail: kay@kaypaggi.com
Advanced Professional Member of the National Association of Professional Geriatric Care Managers
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