Freedom Home Health and Hospice

Diana Cazier Shares: Deseret News Articles: How Will I Die?

2012-03-05T05:28:00.003-08:00

Diana Cazier

Haveyou ever said something and then thought back on it and wondered what you werethinking when that came out? Well, Ilooked back on my story from last week and realized that you didn’t have theback story on it. The story was told byGrandpa himself who was very much alive and enjoying his grandson. I hope that I didn’t offend anyone. At least no one called me out on it.

Thisweek in the Deseret News there was aseries called “Life’s Final Journey”, this was a five-part series which startedlast Sunday. It can still be accessed onthe Deseret News website. I truly wisheveryone would read it. Even with theamount of time I have spent the last while thinking about these issues Ilearned things and had other things reinforced.

Thefirst article was entitled How will Idie: Preparing your family, directing your care. All five articles address preparing yourfamily and yourself before the final decisions need to be made. This first one discusses advance directivesand making sure that your loved ones know what your wishes are so that theyhave something on which to base their decisions should the need arise.

How will I die: Finding hope in hospicewas the second article. This articlesupported much of what we have discussed in this forum. The point I wish to bring up here is thegreat benefit to be found in hospice. “We're not going to give up hope, we're going to change the focus ofhope.” This statement had a great impacton me. End of life care should beginearlier than the very end. As a process,hospice can truly impact lives.

Thethird article entitled How will I die: Agood life, a young death emphasizes that death comes to not only those thathave lived a long life.

Thefourth and fifth articles entitled Negotiatingdeath’s details and The high cost ofdeath deal with the decisions that come with the end of life. Pre-planning can go a long way to avoidproblems in the end.

Thisnote was included at the end of each article:

Editor's Note: Advance directiveand end-of-life planning is an important and neglected topic. Families oftenshy away and when crisis comes, relatives are left trying to guess what someonewould have wanted. This week, Deseret Media Companies have joined a coalitionto raise awareness about the issue, in conjunction with passage of SCR2, whichasks Utahns to consider making their own decisions, appointing an agent andhaving those tricky conversations.

I would like to encourage everyone to read thesearticles. There is also a link above todownload advance directive forms that can help you make decisions about thehealth care you would like to receive.

Deseret news link:

http://www.deseretnews.com/author/42/Lois-M.-Collins.html

Diana Cazier Shares: We All Need A Little Help Sometimes

2012-02-27T05:12:00.003-08:00

Diana Cazier

I heard a great story the otherday. There was a young boy visiting withhis grandparents. He was running aroundpretending to be an announcer. He had a “microphone” and was giving a play-by-play ofwhat everyone was doing. Coming toGrandma he said, “this is Grandma, she has a lovely hairdo”. Turning to Grandpa he said, “this isGrandpa….he is old…..and nearly blind….and almost dead”. His mom told him that was not very nice andhe replied with an innocent look, “but it’s true”. Some days, I’m sure, we feel a lot likeGrandpa even though we would rather be like Grandma with the “lovely” hair.

The “truth” may not be what we wantto hear but I want to share one truth that I have come to learn. No matter how self-sufficient we feel we are,there are times when we need help. Somany of us are so ready to give help at a moment’s notice but when itcomes to asking for help we have a hard time doing it. Sometimes with age or illness we may findourselves in need of extra help. Thatneed may be for ourselves or for someone we care for. A full-time caregiver may need a break; thereare caregiver support groups and respite care offered through Mountainland Agency on Aging (801-229-3800) andother groups.

When full time care is needed andyou or your family are simply not able to give the full-time care necessarythere are assisted living facilities available that can provide as much or aslittle assistance as needed.

Home health services are availablewhen there are specific health care needs. When it is end-of-life care that is needed we can look to Hospice.

The main focus of all of theseservices is making the most of what we are able to do with our lives, that wehave the best quality of life possible as we age.

Let’s not be reluctant to seek outhelp when needed, for us and for our loved ones.

Diana Cazier Shares: Definitions for Caregivers

2012-02-22T06:51:00.001-08:00

Diana Cazier

Just a few definitions;

Caregiver: A person who cares for someonewho is sick or disabled, generally a family member or significant other.

Hospice: A facility or program designed to provide acaring environment for meeting the physical and emotional needs of theterminally ill and their families.

Palliative Care: Treatment to relievesymptoms without curing the disease.

Somany times we will use these terms, forgetting that there are people that arenot familiar with them. What we need toknow is what kind of questions are needing to be answered. What can we do as educators to help you (thereader) understand these topics more fully. Let us know in a response to this blog and we can address your concerns.

Atruly good litmus test for a good teacher is a passion and enthusiasm for theirsubject. Those who have a passion for Hospice know they offer something specialand enthusiasm comes about when one has a sincere desire to tell the worldabout something wonderful. Let us knowhow we can more effectively help to answer your questions.

The Alzheimer's Hamster Within You

2012-02-20T06:21:00.000-08:00

One of the most difficult tasks an Alzheimer's caregiver faces is the development of a new set of communications skills. Sooner or later the caregiver needs to come to an understanding that the way they have communicated in the past, before Alzheimer's, won't work in a world filled with Alzheimer's disease.

By Bob DeMarco
Alzheimer's Reading Room

Change is difficult under any circumstance. It is even harder when you need to change something that you have been doing all day long throughout your life.

Every Alzheimer's caregiver I ever met has talked about their need to vent. Venting is a good thing. You get the monkey off your back. However, at some point you need to make a decision to put that monkey in the closet and get off the hamster wheel.

If you have gone years complaining about the same behavior over and over you must ask yourself, how do I change this dynamic?

Two of the behaviors that drive the Alzheimer's caregiver crazy are repeatedly hearing the same question over and over, and hearing mean spirited words.

We all face this. In the real world when someone says something mean it usually starts an argument. Even if the person didn't really mean what they said. If someone engages in a behavior that you find unsettling, you will usually respond with harsh words or in a mean tone of voice.

When an Alzheimer's caregiver responds harshly to someone suffering from Alzheimer's disease they usually regret doing so. This in turn makes them feel guilt and remorse. When you start living a life full of guilt and remorse it is likely that your whole world is going to turn negative. Negativity breads more negatively.

One of the things that drove me crazy was when my mother would say over and over -- I'm hungry, I'm starving. Compare this to how many times she asked me what day is it, and I can tell you, this is like comparing a tornado to a rain storm in the way that it made me feel.

Of course, like just about every Alzheimer's caregiver, I would respond by trying to tell my mother she just ate, or maybe say something even worse (the correct word here might be dumber).

I knew I had to do something. I understood that I had to change. I understood that I would need to develop an entirely new set of communication skills. I knew it wouldn't be easy, and it wasn't. It took years, and I a still working on it.

In the article Communicating in Alzheimer's World, I discussed how I started building a new model of communication to better understand Alzheimer's.

Today, I am going to discuss how I developed a simple Imagraph (image/graphic) that allows me to switch seamlessly from communicating in real world to communicating in Alzheimer's world in an instant.

This is how I got myself off the Alzheimer's Hamster wheel.

It all started when I started thinking of myself as a hamster. No matter how hard I tried I couldn't stop communicating in a way with my mother that only made matters worse. When I made matters worse, my mother would go into her room and curl up into a ball in bed. I would go out in the living room, and I took my stomach ache with me. I would just sit there and feel worse and worse. Unlike in the real world, where you might be able to apologize or reason with a person and dismiss the bad feelings, this rarely works in Alzheimer's world.

I just kept thinking to myself, I am like a hamster on a hamster wheel. I kept running and running until I got exhausted and when I was done, I realized I went no where fast. Over and over, I went no where fast. I just couldn't accept this and I wanted to change.

When it would all start, the meanness, the repeating of the same words over and over, I would bring up the image of the hamster on the wheel in my mind. If you read the comics and you have seen those clouds over the head of the character with the the words in them that is how I did it. I just imagined that cloud with the hamster right above my head. I saw the hamnster running and running around the wheel. Going no where fast.

After a while, I changed the Imagraph slightly, instead of the hamster running on the wheel, it was me running on the wheel. There I was, right above my head going no where fast.

And then it happened. I brought up the hamster that was me in the cloud and my communication changed. It was subtle at first, I had finally convinced myself that I didn't want to be a hamster any more. I guess you could also say, there came a time when I refused to be an Alzheimer's hamster.

I bring up my Imagraph whenever I need to, and I then cross coolly and calmly into Alzheimer's World. I am not bent out of shape, I am not feeling those uncontrollable emotions. Instead of acting just like my mother, I get calm. Very calm. I speak in a low, confident voice. I bring her around slowly but surely. Although, I sometimes think it is me bringing me around slowly.

The bottom line, I take control of the situation instead of allowing the situation to take control of me over and over and over.

I believe changing behavior, understanding what is happening, and a willingness to change the communication dynamic are the first steps to Alzheimer's caregiver happiness.

You can read my previous articles to get a better understanding of how I changed the communication dynamic and learned how to communicate effectively in Alzheimer's World.

If you are an Alzheimer's hamster right now, don't feel bad. There are about ten million Alzheimer's hamsters, or X-hamsters wandering around in the world right now.

Here is the good news. You are the ONE that gets to decide. Stay on, or get off the wheel. The hamster has no choice. You do.

Glen Campbell On Alzheimer's

2012-02-14T05:14:00.000-08:00

In his new album's liner notes, Glen Campbell writes, "Ghost on the Canvas is the last studio record of new songs that I ever plan to make."

That's because he's now living through the early stages of Alzheimer's. A man whose music history spans six decades is slowly losing his own history — his memories of being one of L.A.'s top session guitarists, playing on everything from "Strangers in the Night" to "Good Vibrations," with an outfit called The Wrecking Crew.

"I got to play with the best musicians that I had ever played with. I'll just go ahead and say it," Campbell says, laughing, "they were the best musicians in the world!"

Of course, Campbell's memories also include a solo career and songs, such as "Wichitaw Lineman" and "Rhinestone Cowboy," that made him a household name.

"Everything is fine," Campbell maintains. "I'm cool. It's just a period I'm going through in my life, you know. I've hurt big toes worse than that."

At 75, Glen Campbell still retains his signature charm, his sense of humor. But more and more, he relies on his wife, Kim, for the details of his life. Kim and Glen have been married for more than 25 years. She's his fourth wife — and the one credited with getting him off of the drugs and alcohol that derailed his once stellar career. Kim says that Glen's decision to share his diagnosis with the public didn't surprise her.

"Glen's always been really open about his life and his ups and downs, his struggle with drugs, finding God. This is just a natural thing for him to do, to let his fans know what's going on with him in his life," Kim says.

"It took us two and a half years to make Ghost on the Canvas, just because we were really careful to find the right songs to say what he wanted to say," says Julian Raymond, Campbell's co-producer and co-writer on the album. "We really wanted it to be indirectly kind of a life story.

"It's sad knowing that he probably won't be doing this anymore. He won't be able to play that amazing guitar that he does and sing with that beautiful voice. But he's an upbeat, happy guy, and we didn't really think too much about it other than trying to make the best record that we could."

Raymond helped write five of the album's songs. He says Campbell has never considered himself a songwriter — more of a "song doctor," as he puts it, who works with writers to bring out that Glen Campbell sound. Occasionally, as with the song "There's No Me Without You," the lyrics fall out of him without his even knowing it.

"Funny thing happened," Raymond recalls. "We were standing in the kitchen of the studio one day, and we were talking about his wife Kim. And she walked in the room while we were talking, and he goes, 'You know what? There's no me without her.' So I mean, he always comes up with these little sayings, these little things, and I wrote them down."

The album took a long time to record, but Raymond says that had more to do with acquiring the right cover songs than with Campbell's condition.

"We never had to stop a session because he wasn't on it. He did it. He just occasionally would get frustrated with himself: 'Why am I doing this? Why can I not remember this? This is so easy!' You know? He just got tough on himself sometimes."

Glen Campbell is taking his new music on the road for a concert tour — perhaps for the last time — in spite of his advancing memory loss.

"There were people in his inner circle that were concerned that if this information came out, people wouldn't book him for fear that he would have bad shows," says Raymond. "There were concerns that it would it would hurt him. And since he decided to make the diagnosis public, it's been nothing but the opposite."

Doctors say that playing show after show could actually help. Playing guitar, singing, constantly flexing those muscles may improve Campbell's memory retention. Another benefit to life on the road: Many of Campbell's children perform in his backing band.

"It's great playing with the kids 'cause, you know, I showed 'em how to play," Campbell says. "And all of them are just good, good players. So I look forward to going out on the road with them."

Kim adds, "I think they're really cherishing being out there with Glen too, 'cause, you know, this could be his farewell tour. They try to be strong for each other."

Ghost On The Canvas lyrics

I know a place between life and death for you and me
Let's take hold on the threshold of eternity
And see the ghost on the canvas
People don't see us ghost on the canvas
People don't know when they're looking at souls

In between here and there there's a place that we can grow
Spirits make love in a wheat field with crows
Like a ghost on a canvas people don't see them
Ghost on a canvas no oh oh oh
They never see souls
Ring around the rosary pocketful of prosary
Ashes to ashes we all fall in love
With ghost on the canvas

We dream in colour others they colour their dreams
Takes one to know one a Spirit always knows when it's seen
Like a ghost on a canvas never can happen
Ghost on a canvas
It's the soul that makes them go
People don't know When they're looking in souls
Better take hold
I'm the ghost on the canvas

Diana Cazier Shares: Department of Aging and Family Services

2012-02-13T06:13:00.000-08:00

Diana Cazier

MountainlandAssociation of Governments is a voluntary association of local governmentsin Utah, Wasatch and Summit Counties. Their Department of Aging and Family Services runs programs such asMeals on Wheels, caregiver support, and legal assistance for seniors.

Anotherservice they offer is a community resource guide for senior citizens. This guide has listings for many of theservices that senior citizens might need, including the contact information for31 different Hospice agencies. Mountainlandalso has a caregiver program to “assist caregivers in their care of individuals60 years of age and older who are unable to perform routine activities to carefor themselves (Mountainland, 2006-2011).” As a service of this program they offerclasses and support groups.

Supportgroups and classes are a great way to get information that is important for thecare of your loved one. These groupsalso provide a circle of people who can relate to your concerns.

Iwould like to think that I am the only person who didn’t know aboutMountainland and its services, but I’m probably not. If you are familiar with what they have tooffer, please pass the word. If you are in need of these types of servicesgive them a call. Many of these servicesare at little to no cost depending on need. Too many times we don’t find out about something until we are told. Please pass the word!

Mountainland.(2006-2011). Aging and Family Services. Retrieved 2011 21-June fromMountainland Association of Governments:http://67.137.116.245/site/departments/view/2

The Art of Caregiving

2012-02-07T06:00:00.000-08:00

I hear the word 'Art' and think of my darling niece, Darci Bertelsen, who has been trained in art since the tender age of three. She has always been creative and disciplined. I remember her making jewelry or finger puppets for her friends and cousins. I remember being on a four-wheeler ride with her on the back of my vehicle. We were in Bullion Canyon on the Paiute Trail in Marysvale, Utah. We had stopped on the trail to wait for others to catch up and there on the side of the trail was a thistle. Most people would look at a thistle and possibly try to avoid it because of the rough exterior. Darci looked at it and said, "I love thistles. Most people think they are just purple but they have so many different colors in them to make them purple." Pretty wise for a 12 year old.

Darci continued her study of art at Utah State University in Logan where she graduated last year with her degree. She recently entered a piece of her art to be considered for the Springville Museum of Art Spring Salon 2011. More than 1,000 entries were received and of those, 250 pieces were selected for the show. She was one of the privileged few. She also received an Award of Merit by the judging committee. All the work, the training, the studying, is paying off for her and her career will surely be successful.

Self portrait by Darci Bertelsen

Looking at the many illnesses of the elderly and what is required of family, friends and caregivers when dealing with a loved one with an illness, I realize that caregiving is also an art. Many times, because of the behaviors associated with Alzheimer's or other Dementias, your loved one can resemble part of that thistle; a very rough exterior. But with study, creativity and discipline, you will be able to appreciate the many colors that make up the beauty of caregiving.
Please find a caregiver support group that you feel comfortable with and attend regularly. You will find so many wonderful ideas to help you make the best of your caregiving situation.

A perfect way to start preparing for caregiving is to attend the UCARE classes through Mountainland Agency on Aging and The Red Cross. Lots of information is covered in this 9 week course. Class begins March 29th at Parkway Health Center, 55 South Professional Way in Payson (Just East of Mountain View Hospital). They will be every Thursday at 7 PM. I will have all of the info you need to get started on your caregiving journey. Hope to see you there!

Diana Cazier Shares: Personal Hospice Experiences Part 2

2012-02-06T06:15:00.000-08:00


Diana Cazier

For some, turning to a Hospice organization is tantamount to “giving up”. It is a difficult decision to decide that the best course of treatment is to forego treatment that will prolong life and just let the disease run its course. An example of this is Mrs. P who was on dialysis due to a complication of diabetes. On the morning of December 23, 2008 she was scheduled to have another dialysis session. She had been feeling poorly for quite a while and decided that she didn’t want to continue dialysis. After discussing the matter with her family it was decided to start her on Hospice. Without that life-sustaining treatment she only lived another two weeks but she did it in the manner and at the time she preferred. Fighting the illness or condition may not always be the best option for some patients, especially those who have lived a long life and are ready to move on. The services that Hospice offers help not only the patient but also the family come to terms with the impending death.

Mrs. P’s time on hospice was relatively short but in that time she and her family (she was living with her daughter and her family) benefited greatly from Hospice. Her daughter told me that one of the best things about the Hospice care was how much it freed her to be able to focus on just being with her mom and not have to fight with her to get some of the daily living tasks that she was doing previously. Her best memory was having the whole extended family together for New Years Day. Her mother was alert and able to visit with everyone.

Mrs. P. passed away on Jan 7 and her son-in-law was with her and called the Hospice nurse at that time. Hospice called the mortuary and sent their CNA. The CNA cleaned her up and gave the family time to say their goodbyes. The mortuary then came, covered her in a nice quilt and took her away.

When she spoke to me the daughter commented on the contrast between this experience and what they went through with her father. When he died the family called the mortuary, who then came and placed him in a bag and left with him. She said that the peace they had with her mother was not there with him and she felt that the difference was the care they received from the Hospice Agency.

The care didn’t end there. The day after her mom’s passing Hospice came in and cleaned up all her medical supplies and medications. The Hospice nurse and CNA were there for the funeral. Since then they have received several phone calls to see how they are doing.

Hospice is not giving up! It is truly getting the best care possible when that care is needed

Alzheimer's Myths

2012-02-03T06:15:00.000-08:00

From www.alz.org

Myth 1: Memory loss is a natural part of aging.

Reality: In the past people believed memory loss was a normal part of aging, often regarding even Alzheimer’s as natural age-related decline. Experts now recognize severe memory loss as a symptom of serious illness.
Whether memory naturally declines to some extent remains an open question. Many people feel that their memory becomes less sharp as they grow older, but determining whether there is any scientific basis for this belief is a research challenge still being addressed.

Myth 2: Alzheimer’s disease is not fatal.

Reality: Alzheimer's disease has no survivors. It destroys brain cells and causes memory changes, erratic behaviors and loss of body functions. It slowly and painfully takes away a person's identity, ability to connect with others, think, eat, talk, walk and find his or her way home.

Myth 3: Only older people can get Alzheimer's

Reality: Alzheimer's can strike people in their 30s, 40s and even 50s. This is called younger-onset Alzheimer's. It is estimated that there are as many as 5.4 million people living with Alzheimer’s disease in the United States. This includes 5.2 million people age 65 and over and 200,000 people under age 65 with younger-onset Alzheimer’s disease.

Myth 4: Drinking out of aluminum cans or cooking in aluminum pots and pans can lead to Alzheimer’s disease.

Reality: During the 1960s and 1970s, aluminum emerged as a possible suspect in Alzheimer’s. This suspicion led to concern about exposure to aluminum through everyday sources such as pots and pans, beverage cans, antacids and antiperspirants. Since then, studies have failed to confirm any role for aluminum in causing Alzheimer’s. Experts today focus on other areas of research, and few believe that everyday sources of aluminum pose any threat.

Myth 5: Aspartame causes memory loss.

Reality: This artificial sweetener, marketed under such brand names as Nutrasweet and Equal, was approved by the U.S. Food and Drug Administration (FDA) for use in all foods and beverages in 1996. Since approval, concerns about aspartame's health effects have been raised.
According to the FDA, as of May 2006, the agency had not been presented with any scientific evidence that would lead to change its conclusions on the safety of aspartame for most people. The agency says its conclusions are based on more than 100 laboratory and clinical studies. Read the May 2006 FDA statement about aspartame.

Myth 6: Flu shots increase risk of Alzheimer’s disease

Reality: A theory linking flu shots to a greatly increased risk of Alzheimer’s disease has been proposed by a U.S. doctor whose license was suspended by the South Carolina Board of Medical Examiners. Several mainstream studies link flu shots and other vaccinations to a reduced risk of Alzheimer's disease and overall better health.

A Nov. 27, 2001, Canadian Medical Journal report suggests older adults who were vaccinated against diphtheria or tetanus, polio, and influenza seemed to have a lower risk of developing Alzheimer’s disease than those not receiving these vaccinations. The full text of this report is posted on the journal’s Web site.
A report in the Nov. 3, 2004, JAMA found that annual flu shots for older adults were associated with a reduced risk of death from all causes. The abstract of that report is posted on PubMed.

Myth 7: Silver dental fillings increase risk of Alzheimer's disease

Reality: According to the best available scientific evidence, there is no relationship between silver dental fillings and Alzheimer's. The concern that there could be a link arose because "silver" fillings are made of an amalgam (mixture) that typically contains about 50 percent mercury, 35 percent silver and 15 percent tin. Mercury is a heavy metal that, in certain forms, is know to be toxic to the brain and other organs. Many scientists consider the studies below compelling evidence that dental amalgam is not a major risk factor for Alzheimer's. Public health agencies, including the FDA, the U.S. Public Health Service and the World Health Organization, endorse the continued use of amalgam as safe, strong, inexpensive material for dental restorations.

March 1991, the Dental Devices Panel of the FDA concluded there was no current evidence that amalgam poses any danger.
National Institutes of Health (NIH) in 1991 funded a study at the University of Kentucky to investigate the relationship between amalgam fillings and Alzheimer's. Analysis by University statisticians revealed no significant association between silver fillings and Alzheimer's. The abstract for this study is posted on the Journal of the American Dental Association Web site.
October 30, 2003, a New England Journal of Medicine article concluded that current evidence shows no connection between mercury-containing dental fillings and Alzheimer's or other neurological diseases. The abstract for this study is posted on the New England Journal of Medicine Web site.

Myth 8: There are treatments available to stop the progression of Alzheimer's disease

Reality: At this time, there is no treatment to cure, delay or stop the progression of Alzheimer's disease. FDA-approved drugs temporarily slow worsening of symptoms for about 6 to 12 months, on average, for about half of the individuals who take them.

Diana Cazier Shares: Personal Hospice Experiences Part 1

2012-01-30T10:04:00.000-08:00

I can think of few things more devastating than dealing with the imminent death of a loved one. During this stressful time, who can we turn to to answer our questions and to relieve some of our burden? Research has found that Americans want to have a say in how we approach death, if given the opportunity. We want a certain amount of say in a time where everything feels as if it is not in our control. While Hospice cannot make all of the problems go away, it can be that support and that shoulder to lean on when it is needed.
Over the last year I have had the chance to visit with many different people and discuss with them their experiences with Hospice. Over the next couple of weeks I would like to share a few of these experiences.
One young woman was a teenager and the oldest of her siblings when her mother was diagnosed with terminal cancer. This was a devastating time for her family. She remembers well the Hospice workers that were there for them. The nurses and aids helped them to understand what was happening to their mother and how best to help her. They were also there just to talk. One of her strongest memories was working on a Christmas tree for Festival of Trees. They used as a theme their mother’s favorite things and were able to visit with her to get ideas. While this was an incredibly difficult time she treasures the memories of the time spent doing this for and with her mother and siblings.
If you ever find yourself in need of Hospice services don’t feel that you have to go it alone. Hospice is run on a unique philosophy that is based on the care of the dying patient, not the cure. Curative measures are bypassed. The goal of Hospice is the comfort and well-being of the patient (palliative care) and support for the family. Hospice provides a special kind of care for the dying;
1. It treats the physical, emotional and spiritual needs of the patient.
2. It takes place in a homelike setting—most often within the home itself.
3. One major goal is to make the patient as free of pain as possible, helping them to make the most of the time left to them.
4. An essential part of the care is support for the patient's significant others.
5. Believes that the quality of life is just as important as the length of life.
Remember, “…turning to Hospice is not giving up on care but sometimes getting the best care possible” Dr. Abe Tomco.

What Makes Freedom Home Health And Hospice Different From All The Other Agencies?

2012-01-24T06:40:00.001-08:00

Many time during interviews with potential clients I am asked, "What can you do that other agencies can't?" The truth of the matter is this; ALL Home Health and Hospice agencies are regulated by the Federal Government and can only offer what is allowed by the government. In short, we ALL provide the EXACT same services. So what makes us different from a company that is owned by someone on the East coast whose bottom line seems to be the most important thing? A few things set us apart from the rest:

We are locally owned, kind of like the mom and pop gas station or grocery store that used to be on the corner but has been pushed out of business by big box stores and chains. We have always been locally owned and plan to stay that way. We believe it gives us a better outlook on the needs of the patient and their family because we live here too!

100% of our past clients would recommend us to others. I love the fact that our team has provided excellent care, educates the patient and family about the process they are going through and, in many instances, gone above and beyond the call of duty such as checking on family members at home when a loved one has a hospital stay, attending Doctor appointments with the patient to understand and communicate with the Doctor about the patients care and taking the time to get to know each patient individually.

We serve,educate and support the community. Next to excellent patient care, our primary focus lies in serving, educating and supporting our community. We spend many hours each month providing movement activities for residents in facilities across the county. (Check out our article on our Freedom Fun Girls.) The residents who participate look forward each week to having our high energy Community Activity Liaisons spend an hour with them using movement and music. We don't call it exercising because....who would show up?;) I have had staff from every facility we serve rave about the service and in some facilities we have more residents show up for that activity than any other activity the facility presents.

We educate groups at every opportunity about services and resources that are available to them or their loved one whether it be Home Health, Hospice, Private Duty, Medicaid and Medicare or other topics important to caregiving.

I facilitate 4 different caregiver support groups throughout Utah County sharing information, resources and my own personal experiences to help rejuvenate and energize caregivers who may be suffering from caregiver burnout. Click the CARE meetings tab at the top of the page for a list of meetings. These are free and you may come to one or all.

I realize that there are many choices....and who serves you is YOUR choice...but I hope that you will consider Freedom when you are in need of Home Health or Hospice Services.

After all....it is the American thing to do;)

Hospice: It's All About Living-- Diana Cazier Shares

2012-01-23T06:48:00.000-08:00

Diana Cazier

When faced with the diagnosis of a terminal illness we often feel as if everything has been taken out of our control. With so many decisions facing us as well as the stresses of knowing a life is coming to an end we need to feel that we have some handle on what is happening to us. Research conducted by the National Hospice Foundation show that the top concerns of Americans for loved ones that have less than six months to live are:

Make sure that the wishes of the person are honored.
That they have some choice in the types of services they can receive.
Pain control is tailored to the patient’s wishes, and
Emotional support is available for the patient and the family.

Hospice care can give us the means to take control of what is happening, we can be a part of the team. Supported by the employees and volunteers of the Hospice organization, the primary caregiver in the home is the key team member. This person may be a family member or a friend but will be the person responsible for round-the-clock care of the patient. The Hospice organization will give training and support to the primary caregiver and others involved in the care of the patient.

Care begins when the patient is admitted to the program. A Hospice team member visits the home to learn about the situation and needs of both the family and the patient. Return visits are set up so that the needs of both the patient and primary caregivers can be re-evaluated regularly. To handle around-the-clock patient needs or crises, Home Hospice programs have an on-call nurse who answers phone calls day and night, makes home visits, or sends a team member that may be needed between scheduled visits. Medicare-certified Hospices must provide nursing, pharmacy, and doctor services around the clock. The Hospice team is specially trained to provide medical assistance and to deal with the loneliness and fears experienced by both the patient and his or her loved ones.

The Hospice team works with the patient and primary caregiver to develop a personalized care plan. The team respects patient wishes and helps to foster communication amongst family members. Through working with this team of experts we can not only have the control over the care of our loved one but can control how involved we want to be in that care. Hospice organizations have a wealth of resources available to help us through this difficult time.

I was recently visiting with a man who had Hospice in his home to care for his wife as she was dying of cancer. He told me that the hospice workers made all the difference in how well he handled the experience. He spoke of the support they were for him and how much he appreciated having someone to call when he needed someone who understood what he was going though. He was especially appreciative of the continuing support he received after her death. He felt that Hospice gave him the opportunity to focus on what was truly important; enjoying what time he had remaining with his wife and knowing that she was receiving the best care possible.

Caregivers Need Respite

2012-01-20T04:15:00.000-08:00

“Good enough” is enduring 25 minutes of mean and nasty and unrelenting remarks on the drive to an adult day program twice each week.

By Pamela R. Kelley
Alzheimer's Reading Room

Those of us who turn to The Alzheimer’s Reading Room as caregivers are making every effort we can to do right by our loved ones afflicted with dementia.

We sacrifice much in pursuit of the goal. We’re focused on trying to provide loving care, and trying to create some ease and contentment for someone we love who needs a lot of assistance.

Respite is essential. We’re in it for the long haul, and we have to last.

When our tank runs to empty, we simply cannot perform our roles with the same kind of enthusiasm or grace that we try to bring to the effort. We need to be able to restore our spirits so that we can bring our best efforts to bear.

Respite revives us. Without it, we display our exhaustion in our expressions, in our voices, in our tones and in our moods. And our loved ones often mirror what we display.

In our house, no respite leads to an irritable Pam. Irritable Pam leads to very unhappy Audrey. It infects everyone.

That’s why we’re often our most discouraged when our respite plan falls apart. It happened to me last month. And then this morning I read the article Bob posted, asking us what advice we had for the caregiver whose ten hours of weekly respite care just evaporated. I wrote a little comment then, and it felt familiar – as though I was talking to myself.

The caregiver who’d put in the time to reach a rapport with my suspicious and unwelcoming mother had to leave the state. A new caregiver needed to be brought on board. We were looking to fill ten hours of time, two five-hour shifts. We have been working on restoring the balance for three weeks now. We’re not there yet.

We’ve been through three potential caregivers in that time. The first showed promise, but then didn’t show up to cover her shift twice in the same week. Dependability grade: F. Back to the drawing board.

The second caregiver could not tolerate the ethnic name-calling that is part of my mother’s Alzheimer’s influenced vocabulary. She notified me of this one-hour into her first shift.

Today we’re trying the third, and she seems to be making a very valiant effort.
I’m concerned that her accent is impenetrable to my hard-of-hearing mother
though.

It’s the respite challenge. How can I reclaim the hours I need every day to keep my spirits up, to keep my enthusiasm high, to maintain my good cheer? I start from this point: Respite is not optional. I know how much I need, and I’ll invest as much energy as I must to maintain the base.

I have an idea about what’s optimum for us. And I know that I live with my mother in Alzheimer’s World, where the optimum rarely occurs. It remains the goal, a kind of organizing principle. Right below optimum resides “good enough”. And that’s normally where we operate.

Here’s an example. It’s good for my mom to have more people in her life than just me. “Optimum” would be that my mother would willingly be in the company of someone other than me. Truth is, she’s not willing. But her unwillingness can’t be a barrier to my getting respite. Her objections need to be white noise to me.

“Good enough” is enduring 25 minutes of mean and nasty and unrelenting remarks on the drive to an adult day program twice each week.

Sometimes when I return to the car after our drop off, I really do sit behind the wheel and wipe tears. Then: Deep breath, start the engine, and reminder to myself that it’s “good enough.” The message is validated when I pick her up at the end of the day, and she’s beaming. Those are the days when she proudly introduces me around to the amazing women who staff the program. She chats amiably the entire drive home. This occurs more often than I ever expected.

“Good enough” is pretty darned good. But we don’t achieve “good enough” without respite.

What is Alzheimer's Disease?

2012-01-19T05:00:00.000-08:00

What is Alzheimer's Disease?

Alzheimer's disease is a physical illness that causes radical changes in the brain. As healthy brain tissues degenerate persons suffering from Alzheimer's experience a steady decline in memory and the ability to use their brain to perform tasks.

How Alzheimer's Spreads
Throughout the Brain(Video)

In order to be an effective Alzheimer's caregiver or to communicate with someone suffering from Alzheimer's disease, you must build a solid foundation of understanding.

Understanding Alzheimer's is an essential part of this foundation.

Alzheimer's disease is the most common form of dementia.

Alzheimer's disease affects a person's memory, mood, and behavior.

Over time, a person with Alzheimer's disease has trouble remembering, speaking, learning, making judgments, and planning.
Persons suffering from Alzheimer's are often moody, restless, and sometimes mean.
Alzheimer's disease affects almost all aspects of brain functioning, including personality, and the ability to perform the most basic activities of daily functioning.

Memory difficulties and behavior changes can be early signs of Alzheimer's disease.

Alzheimer's disease is a an irreversible brain disorder with no known cure.

The cause of Alzheimer's disease is not yet known.

Alzheimer's disease is always fatal.

Alzheimer's disease is the most common form of dementia, accounting for as much as 70% of all cases of dementia.
Age is one of the most important risk factors for Alzheimer's disease. The percentage of persons suffering from Alzheimer's disease doubles every 5 years beyond the age of 65.
Women are more likely to develop the disease than men are – in part, because women live longer.
People who have a brother, sister, or parent suffering from Alzheimer's disease have a slightly higher chance of developing the disease. Right now about 3 percent have a proven hereditary link (genetics).
Heredity plays a much larger role in early-onset (before age 65) Alzheimer's. About 500,000 Americans suffer from early onset Alzheimer's. The number is growing.

From Alzheimer's Reading Room

Clearing Up Alzheimer's Misconceptions

2012-01-18T05:11:00.000-08:00

Are there any common misconceptions about Alzheimer’s at all that you would like cleared up?

By Carole Larkin
Alzheimer's Reading Room

Oh boy, I’ll say! But in the interest of brevity I’ll just list five of them. (There are a number of books out that go into further depth in answering this question.)

Dementia is another word for Alzheimer’s light.

Dementia is not a disease (although we use the word like it was one).

Dementia means a set of symptoms some of which are common to a number of diseases (over 70 diseases, at least).

Symptoms like, memory loss, confusion, changes in personality and others. Alzheimer’s is just one of those diseases. It apparently is the largest (the most number of people have it) .
Newer research has found that many times it does not exist by itself. It can and does exist with other types of dementias in the same brain. Dementias like vascular dementia, Lewy body dementia, fronto-temporal dementia and even Parkinson’s dementia, among others.

Most people have been “properly” diagnosed.

No, the minority of people with a form of dementia have been “properly diagnosed”, even if they’ve been to a doctor.

A proper diagnosis is not a 5-10 minute screening test (most common is the MMSE) and the doctor handing the person or family member a prescription for Aricept or one of the other cholinesterase inhibitors.

A “proper” diagnosis includes Neuropsychological testing (3-4 hours), a picture of the brain (MRI, PET scan) and specialized blood tests. Some people get spinal fluid testing as well.

One reason that a proper diagnosis is preferred is because some dementias are treatable ( a small percentage), and a proper diagnosis can lead to treatment if it is discovered the person has one of those. Additionally, it allows the family to get their legal work in order (Powers of Attorney, living wills or directive to physicians,) while the person is still deemed to be competent, thus saving strife and unneeded stress later in the person’s life.

Alzheimer’s and related Dementias are curable.

Not yet. The best that we can do is slow the progression of Alzheimer’s down for some people.

There are 4 FDA approved drugs that may work on some people. The first 3 are cholinesterase inhibitors with the names of Aricept, Exelon and Razadyne. They work on one type of neurotransmitter in the brain to keep it pumped up.

The last one is Namenda. It works on a different neurotransmitter in the brain, again to keep it pumped up.

They are expensive (except Aricept- its gone generic) and have lots of side effects (especially gastro) for some people. For those people it’s probably worth it to use them in the early stages of Alzheimer’s. The problem is, you don’t know if they are working until you take them off of them and the person’s cognition takes a big step downward.

Restarting them will usually pick the person back up, but not all the way up to where they were before they were taken off the meds. It’s a kind of roll the dice proposition.

People with Alzheimer’s are being mean and nasty, paranoid and suspicious and lie on purpose.

Actually, it’s the exact opposite. Their brain cells are dying in varying portions of their brains, so those portions no longer function like an undiseased brain does. Those people are prone to misunderstanding what we call “reality”.

Their brains can’t process things (stimuli) as fast or as correctly as before. They can many times feel that something is wrong with their brains early in the disease. Some tell their knowledge out loud. Some keep that knowledge to themselves. At any rate it is very scary to think that you are losing your mind.

Fear is with them day and night. People generally react to fear one of two ways; Fight or Flight.

Fight comes out as anger, paranoia, agitation and other “negative” behaviors. Flight comes out as withdrawal inward. Sometimes people do both Fight and Flight.

One of the things a caregiver can do to tamp down these behaviors is assure the person with Alzheimer’s that they are safe and loved. No one wants to be alone and in fear.

People with the disease are trying to communicate their feelings and their communication skills are growing less and less.

They get frustrated at this. Wouldn’t you? A constant positive feeling directed towards them is the way to quell their fears, at least for the moment.

Treat Alzheimer’s patients like you have always treated them, before their disease and they’ll straighten up.

No they won’t. Their brains are dying. They are doing the best they know how to do. Really.

Be compassionate and forgiving to them.

Keep them safe, but encourage them to do everything they possibly can for themselves in that safe environment.

It keeps up their dignity and self esteem. Engage them with things that they like to do and that they can succeed at. Hold them, touch them gently and give them love.

Those With Dementia Go To The Hospital More Often

2012-01-17T05:05:00.000-08:00

Persons With Dementia Have Higher Rate of Hospitalizations

Elizabeth A. Phelan M.D., M.S.
Compared to individuals without dementia, persons who developed dementia subsequently had a significantly higher rate of hospital admissions for all causes and admissions for ambulatory care-sensitive conditions for which proactive care may have prevented hospitalizations, according to a study in the January 11 issue of JAMA.

“Nonelective hospitalization of older people, particularly those with dementia, is not a trivial even.

Among older persons without dementia, hospitalization for serious illness is associated with subsequent cognitive decline, and frail elders, including those with dementia are at increased risk of delirium, functional decline, and iatrogenic [induced by a physician's activity, manner, or therapy] complications during an inpatient stay.

Identifying conditions that precipitate hospitalization of elderly individuals with dementia could focus clinical priorities on secondary and tertiary prevention in the outpatient setting and improve health care for this vulnerable and increasing population,” according to background information in the article.

Elizabeth A. Phelan

Elizabeth A. Phelan, M.D., M.S., of the University of Washington, Seattle, and colleagues conducted a study to determine whether dementia onset is associated with higher rates of or different reasons for hospitalization, particularly for ambulatory care-sensitive conditions (ACSCs), for which proactive outpatient care might prevent the need for a hospital stay.

The study included an analysis of hospitalizations among 3,019 participants in Adult Changes in Thought (ACT), a study of adults ages 65 years or older enrolled in an integrated health care system.

All participants had no dementia at the beginning of the study and those who eventually had a dementia diagnosis as part of dementia screening contributed nondementia hospitalizations until their diagnosis.

Automated data were used to identify all hospitalizations of all participants from time of enrollment in ACT until death, disenrollment from the health plan, or end of follow-up, whichever came first. The study period was from February 1994 to December 2007.

During the study period, 494 individuals eventually developed dementia and 427 (86 percent) of these persons were admitted to a hospital at least once; 2,525 remained free of dementia and 1,478 (59 percent) of those were admitted at least once. Admissions totaled 5,328.

Among those who developed dementia, there were 689 admissions prior to diagnosis and 714 after dementia diagnosis. Of ACSC admissions for this group, 121 occurred before dementia diagnosis and 198 after. Forty percent (n=196) of the dementia group had at least 1 ACSC admission compared with 17 percent (n = 424) of the dementia-free group.

Among participants with dementia, the average annual admission rate was more than twice that of those without dementia. In the fully adjusted model, admission rates for 5 types of disorders (circulatory, genitourinary, infectious, neurological, and respiratory) were significantly higher among participants with dementia compared with those without dementia.

The crude admission rate for ACSCs was higher among those with dementia.

“Three ACSCs, bacterial pneumonia, congestive heart failure, and urinary tract infection, accounted for two-thirds of all potentially preventable admissions, and admission rates among those with dementia were significantly higher for all 3 conditions.

Admission rates for dehydration and duodenal ulcer, though low overall, were also significantly higher among those with dementia. Admissions for ACSCs accounted for 28 percent of all hospitalizations among those with dementia vs. only 19 percent of all admissions among those who remained dementia free,” the authors write.

“Knowledge of the ACSCs most likely to lead to hospitalization is important, as this information may help clinicians focus their differential diagnostic considerations and thereby permit proactive, early management for these conditions among patients with dementia.

Early detection and outpatient management of acute illness when it is still in its early phases might minimize the need for hospitalization for these conditions and help health care organizations reduce their rates of ACSC admissions and associated costs.”

“In summary, our findings that persons with dementia have higher rates of hospitalizations for most categories of medical illness and for ACSCs suggest that there may be important opportunities for improving care of demented older persons, including developing better strategies for delivering anticipatory, proactive primary care to this population.

The characteristic feature of late-life dementia—cognitive impairment in the face of multiple other comorbidities—presents a special challenge not currently addressed in models of chronic disease care,” the researchers conclude.

Hazard In The Home For Alzheimers Patients

2012-01-16T05:04:00.000-08:00

Monica Heltemes on Alzheimers Reading Room

Did you know that for elderly persons, there is a structural hazard in their home that they encounter daily?

What do you think it is?

The bathroom. It is the riskiest room in the home.
According to the Centers for Disease Control and Prevention, every year about 235,000 people over age 15 visit emergency rooms because of injuries suffered in the bathroom, and almost 14 percent are hospitalized.

More than a third of the injuries happen while bathing or showering. More than 14 percent occur while using the toilet. Injuries increase with age, peaking after 85, the researchers found.

So what can be done to improve bathroom safety for older persons and more specifically, for persons with dementia?

Add Supports – Grab bars by the toilet and in the shower or tub area are important. Make sure the supports are installed properly, to ensure their stability when used. For those who sit in the bottom of the tub, there are rails available that clamp-on to the side of the tub. Also, consider a raised toilet seat and/or safety frame that provides “arms” directly around the toilet. The Home Depot is offering free workshops this month to learn how to install grab bars and raised toilet seats. See www.homedepot.com/workshops.

Reduce the risk of slipping – The very nature of showers and baths with water everywhere, makes this task inherently risky. Steps you can take to minimize the risk include:

A non-skid surface inside the shower or bath, such as a rubber mat or non-skid, stick on strips that can be applied to the floor of the shower or tub.
A bath mat with a non-skid back outside the shower or bath to step onto when exiting.
A towel set-up beforehand and readily accessible from the shower or bath. A hook right by the shower with a towel here may work well for those who may forget beforehand to set out a towel.
Drying off feet well or slipping into sturdy slippers before stepping onto the tile.
Consider a bath chair to sit on while washing the feet or if balance is unsteady.

Special considerations for those with memory loss – As mentioned previously, persons with dementia may forget to set-up needed supplies before entering a shower or bath. Then there is the risk of slipping when they step out to get what is needed from the cupboard, sink, etc. Some strategies to avoid this include:

Placing a towel on a hook or shelf that is right by the shower or bathtub, as mentioned previously.
A tub or shower wall organizer that will hold needed shampoo, soap, washcloth, etc.
A hook in the bathroom for their robe.

If the person is having more difficulty finding the bathroom, missing the toilet, forgetting to flush, forgetting toilet paper, or other oversights:

Try to organize the bedroom so that the bathroom is in plain sight from the bed, for the person who has trouble finding the bathroom or having accidents in the night.
Have a nightlight in place for nighttime trips to the bathroom.
Hang a sign on the bathroom with a photograph of a toilet and the word “Bathroom” or whatever the person calls it (I had one patient who called it the “pit”!)

White toilet seats, flush handles, towel bars, and grab bars on white backgrounds can be difficult for persons with dementia to distinguish, as their perception of objects in their environment diminishes.

Try to make the items they are missing stand out, to increase the odds they may see it.

For instance, a wood colored toilet seat against a white toilet base will stand out more. Similarly, you can take black or red electrical tape and wind it around grab bars and on the toilet flusher. I have definitely noted increased use of the grab bar when this strategy was employed.

Last, try a dark-colored towel hanging on the rod against a white wall (or a white towel against a dark-colored wall). Note these same modifications work well for those with visual impairments.

See if you can encourage the person to bring along a cordless phone when showering, if they are doing this task alone, just in case of emergency. A reminder note on the wall may help. Or if the person has a lifeline system, speak to the manufacturer to see if it can be worn while in the shower. Often times they can.

These are some bathroom safety tips that occupational therapists teach to our clients. I hope they are helpful to improve the safety for the person you care for or maybe even yourself!

Don't Be A Statistic When It Comes To Being A Caregiver

2012-01-11T07:18:00.000-08:00

Don't be a statistic when it comes to being a caregiver. Find a Caregiver Support Group TODAY!! Click on the CARE Meeting tab above and find a meeting near you.

Caregiving Population

More than 65 million people, 29% of the U.S. population, provide care for a chronically ill, disabled or aged family member or friend during any given year and spend an average of 20 hours per week providing care for their loved one.

Caregiving in the United States;
National Alliance for Caregiving in collaboration with AARP; November 2009

The value of the services family caregivers provide for "free," when caring for older adults, is estimated to be $375 billion a year. That is almost twice as much as is actually spent on homecare and nursing home services combined ($158 billion).

Evercare Survey of the Economic Downturn and Its Impact on Family Caregiving;
National Alliance for Caregiving and Evercare. March 2009

The typical family caregiver is a 49-year-old woman caring for her widowed 69-year-old mother who does not live with her. She is married and employed. Approximately 66% of family caregivers are women. More than 37% have children or grandchildren under 18 years old living with them.

Caregiving in the United States;
National Alliance for Caregiving in collaboration with AARP. November 2009

1.4 million children ages 8 to 18 provide care for an adult relative; 72% are caring for a parent or grandparent; and 64% live in the same household as their care recipient. Fortunately, most are not the sole caregiver.

National Alliance for Caregiving and the United Hospital Fund, Young Caregivers in the U.S., 2005.

20 hours per week is the average number of hours family caregivers spend caring for their loved ones while 13% of family caregivers are providing 40 hours of care a week or more.

Caregiving in the United States;
National Alliance for Caregiving in collaboration with AARP. November 2009

Family caregivers are the foundation of long-term care nationwide exceeding Medicaid long-term care spending in all states.

Evercare Survey of the Economic Downturn and Its Impact on Family Caregiving;
National Alliance for Caregiving and Evercare. March 2009

51% of care recipients live in their own home, 29% live with their family caregiver, and 4% live in nursing homes and assisted living.

Caregiving in the United States;
National Alliance for Caregiving in collaboration with AARP. November 2009

36% of family caregivers care for a parent and 7 out of 10 caregivers are caring for loved ones over 50 years old.

Caregiving in the United States;
National Alliance for Caregiving in collaboration with AARP. November 2009

14% of family caregivers care for a special needs child with an estimated 16.8 million caring for special needs children under 18 years old. 55% of these caregivers are caring for their own children.

Caregiving in the United States;
National Alliance for Caregiving in collaboration with AARP. November 2009

78% of adults living in the community and in need of long-term care depend on family and friends as their only source of help.

Thompson, L. Long-term care: support for family caregivers. 2004

Caregiving and Work

Six in 10 family caregivers are employed.

MetLife Study of Working Caregivers and Employer Health Costs;
National Alliance for Caregiving and MetLife Mature Market Institute. February 2010

73% of family caregivers who care for someone over the age of 18 either work or have worked while providing care; 66% have had to make some adjustments to their work life, from reporting late to work to giving up work entirely; and 1 in 5 family caregivers have had to take a leave of absence.

Caregiving in the United States;
National Alliance for Caregiving in collaboration with AARP. November 2009

64% of working parents caring for a special needs child believe that caregiving responsibility has negatively impacted their work performance.

Care.com and National Family Caregivers Association: State of Care Index. 2009

American businesses can lose as much as $34 billion each year due to employees' need to care for loved ones 50 years of age and older.

MetLife Caregiving Cost Study: Productivity Losses to U.S.
MetLife Mature Market Institute and National Alliance for Caregiving Business. July 2006

Caregivers caring for elderly loved ones cost employers 8% more in health care costs estimated to be worth $13.4 billion per year.

MetLife Study of Working Caregivers and Employer Health Costs;
National Alliance for Caregiving and MetLife Mature Market Institute. February 2010

Over 65% of employers believe that health benefits improve employees' health. Sixty percent (60%) believe it increases moral and 39% believe it increases productivity.

Job-based Health Insurance in the Balance: Employer Views of Coverage in the Workplace.
Collins, S.R. et al, The Commonwealth Fund,
Commonwealth Fund Supplement to the 2003 National Organization Study. March 2004

Caregiver Burnout.....How To Recognize The Symptoms And Get Help

2012-01-10T05:30:00.000-08:00

Are you a caregiver for an aging loved one? Are you just about to pull your hair out with frustration? You may be approaching Caregiver Burnout (if you aren't there already!).

Gena Bertelsen, Community Liaison Specialist for Freedom Home Health and Hospice facilitates Caregiver Support Groups throughout Utah County. Call her today @ 801-623-9595 to find one near you or click on CARE Meetings at the top of the page for a schedule of available support groups.

Caregiver Burnout by Dr. M. Ross Seligson

Being able to cope with the strains and stresses of being a Caregiver is part of the art of Caregiving In order to remain healthy so that we can continue to be Caregivers, we must be able to see our own limitations and learn to care for ourselves as well as others.

Burnout isn't like a cold. You don't always notice it when you are in its clutches. Very much like Post Traumatic Stress Syndrome, the symptoms of burnout can begin surfacing months after a traumatic episode. The following are symptoms we might notice in ourselves, or others might say they see in us. Think about what is being said, and consider the possibility of burnout.

Feelings of depression.
A sense of ongoing and constant fatigue.
Decreasing interest in work.
Decrease in work production.
Withdrawal from social contacts.
Increase in use of stimulants and alcohol.
Increasing fear of death.
Change in eating patterns.
Feelings of helplessness.

Strategies to ward off or cope with burnout are important. To counteract burnout, the following specific strategies are recommended

Participate in a support network.
Consult with professionals to explore burnout issues.
Attend a support group to receive feedback and coping strategies.
Vary the focus of caregiving responsibilities if possible (rotate responsibilities with family members).
Exercise daily and maintain a healthy diet.
Establish "quiet time" for meditation.
Get a weekly massage
Stay involved in hobbies.

By acknowledging the reality that being a Caregiver is filled with stress and anxiety, and understanding the potential for burnout, Caregivers can be forewarned and guard against this debilitating condition. As much as it is said, it can still not be said too often, the best way to be an effective Caregiver is to take care of yourself.

M. Ross Seligson, Ph.D., P.A., is a Licensed Psychologist in Ft. Lauderdale Florida. He has supported Caregivers in his community for a number of years, including participation in AIDS, Mental Health, Cancer and Educational organizations.

Diana Cazier Shares: Hospice Care Serves Patients AND Family

2012-01-09T05:19:00.000-08:00

Diana Cazier

Hospice care is only appropriate for the terminally ill patient who is no longer seeking curative measures. A great number of Hospice patients are dying of cancer, the reason being that it is easier to give a timeframe to the life expectancy, but it is available for any terminal illness. A physician certifying a medical diagnosis of a life expectancy of 6 months or less is required for the Medicare Hospice Benefit

. Although supported by the employees and volunteers of the organization, the primary caregiver in the home is the key team member. This person may be a family member or a friend but will be the person responsible for round-the-clock care of the patient. The Hospice organization will give training and support to the primary caregiver and others involved in the care of the patient. Care begins when the patient is admitted to the program. A Hospice team member visits the home to learn about the situation and needs of both the family and the patient. Return visits are set up so that the needs of both the patient and primary caregivers can be re-evaluated regularly. To handle around-the-clock patient needs or crises, Home Hospice programs have an on-call nurse who answers phone calls day and night, makes home visits, or sends a team member that may be needed between scheduled visits. Medicare-certified Hospices must provide nursing, pharmacy, and doctor services around the clock. The Hospice team is specially trained to provide medical assistance and to deal with the loneliness and fears experienced by both the patient and his or her loved ones. The Hospice team works with the patient and primary caregiver to develop a personalized care plan. The team respects patient wishes and helps to foster communication amongst family members.

The most important thing to understand about Hospice is that it is all about taking care of the patient. What better peace of mind could a family have than to know that they have the support needed to give their loved one the best care possible. Hospice provides the resources to relieve suffering and provide comfort during the final stages of life.

Next week we will discuss the impact that Hospice has on the family of the Hospice patient

Setting Goals Like Superman

2012-01-04T07:01:00.000-08:00

1. Be Specific and Realistic

If you are like me, you have probably resolved to lose some weight or get in shape during the next year, again. Instead of selecting such an ambiguous goal, focus on something more concrete that you can realistically set your sights on. For example, you might commit to losing 10 pounds or running a mini-marathon. Choosing a concrete, achievable goal also gives you the opportunity to plan exactly how you are going to achieve your goal over the course of the year.

2. Pick Just ONE

Hertfordshire University, suggests that you should pick just one and focus your energies on it rather than spreading yourself too thin among a number of different objectives.

3. Make A Plan

Planning is an integral part of achieving any goal. Experts suggest that you should spend some time planning out how you will tackle a major behavior change. The best way to start is by writing down your goal, making a list of things you might do to achieve that goal and noting any obstacles that might stand in your way.

4. Start Small

Taking on too much is a common reason why so many New Year's Resolutions fail. Dramatically slashing calories, over-doing it at the gym or radically altering your normal behavior are sure-fire ways to derail your plans. Instead, focus on taking tiny steps that will ultimately help you reach your larger goal. If you've resolved to run a marathon, start out by going for a jog two or three times a week. If you are trying to eat healthier, start by replacing some of your favorite junk foods with more nutritious foods. While it may seem like a slow start, these small changes make it easier to stick to your new habits and increase the likelihood of long-term success.

Diana Cazier Shares:Patients Can Initiate Hospice Conversation

2012-01-03T05:07:00.000-08:00

Diana Cazier

For many who find themselves in need of hospice services the first contact they have is through their physician or the health care system. A physician who understands the importance of Hospice as a treatment option would do well to present that as an option to their patients as well as the more aggressive treatments. In speaking to individuals who had Hospice in their home to care for a loved one, common concerns expressed were, “I wish I had known earlier that I had an option” and “why didn’t my doctor tell me?” The problem arises when the physician will continue to treat a condition that might have very little chance for full recovery and the patient will follow the physician without realizing that there may be alternatives.

Dr. Abe Tomco, a family practice physician in Orem, Utah, graduated from the St. Louis University School of Medicine in 2006. As a recent graduate Dr. Tomco had many opportunities to learn about Hospice. One of his instructors had recently gone through a hospice experience with her husband who died of cancer. Her passion about the value of Hospice helped him to understand what it could do for his patients. The St. Louis medical school curriculum focused on treating the whole patient; physically and emotionally. It has only been in about the last ten years that medical schools have even taught much about Hospice. His feeling is that many physicians do not know how to approach the more emotional issues such as death and Hospice, and find themselves relying on the clinical aspects of patient care. He said, “doctors and patients both need to realize that turning to Hospice is not giving up on care, but sometimes getting the best care possible” (Tomco, 2011).

This is where Hospice education for the general population would be advantageous. Dr. Tomco said he thinks that if a patient were to first bring up the topic of Hospice that more doctors would talk about it. How would the interaction with the physician be different if the patient had some information about Hospice before speaking with the physician? We might want to think about this.

The Origin of Hospice; Diana Cazier Shares

2011-12-27T06:56:00.000-08:00

Diana Cazier

While I was doing some research for my paper I came across some info that I didn’t know about the origins of Hospice. I thought that I would share them with you.

Did you know that the origin of the word hospice is host or hospitality? The term can be traced back to medieval times when it referred to a place of shelter and rest for weary or ill travelers on a long journey. The definition in healthcare terms is; a facility or program designed to provide a caring environment for meeting the physical and emotional needs of the terminally ill (Merriam-Webster, 2010). Hospice as a concept has been around throughout history. Families have long taken care of their loved ones through the end of life. The modern concept of Hospice was developed in England by Dame Cicely Saunders, who founded the first modern Hospice—St. Christopher’s Hospice—in a residential suburb of London in 1967 (NHPCO, 2010). The United States followed the Saunders model of giving support and palliative care to the dying.

In 1969 Dr. Elisabeth Kubler-Ross published a book entitled On Death and Dying which was based on interviews with 500 dying patients. In her book Kubler-Ross makes a plea for a more home based care as opposed to care in an institutional setting. Throughout the 1970s the subject was debated by Congress to provide funding for Hospice programs and in 1982 Congress included a provision to create a Medicare Hospice benefit. In 1986 the Medicare Hospice Benefit was made permanent by Congress. States are given the option of including Hospice in their Medicaid programs (NHPCO, 2010). The Medicare and Medicaid funding of Hospice care was important in that it was now affordable for the majority of patients through either those two entities or private insurance.

The thing that I find the most interesting is how new all of this is. Let’s face it, health care in some form or another has been around for a long time. Hospice as a health care option is relatively new. So many times hospice is the best form of care a person can and should have but they don’t even realize that it is out there. This is where all of us can help. We can all learn about hospice and share what we know with others. In this way we can make sure that the terminally ill patient can receive the best care possible.

Why Don't People Use Hospice? Diana Cazier Shares

2011-12-19T05:46:00.001-08:00

*Diana Cazier will be sharing a weekly post on Hospice on our blog. Please check back every Monday for her informative articles.

Death, although an inevitable end for each of us, is often a difficult subject to discuss. The prospect of a terminal disease or knowledge that the end of a life is coming faster than we would have planned is probably one of the most stressful times we will face in our lifetime. Research has shown that the top concerns of Americans for loved ones that have less than six months to live are: 1. Make sure that the wishes of the person are honored. 2. That they have some choice in the types of services they can receive. 3. Pain control is tailored to the patient’s wishes, and 4. Emotional support is available for the patient and the family.

Research has also shown that 80% of those polled, if given the opportunity would want to die at home rather than in a hospital or other health care facility. Out of the 2.4 million people that die in America each year only 25% actually die at home. In contrast to that, of the 700,000 patients who receive Hospice care, over 75% of them will die at home (National Hospice and Palliative Care Organization).

Why don’t more people turn to Hospice?

1. Expense – Many people, when faced with medical concerns will automatically ask themselves, “How are we going to pay for this?” While this should not be a factor when trying to determine a treatment plan for a loved one, it still is. Medical costs can be daunting, and when faced with a catastrophic disease, can be impossible. The thought of adding one more medical bill to the number of bills already accumulated is something some may not want to consider.

What many people do not realize is that there has been a Medicare Hospice benefit since 1983. This benefit enables the patient to be on Hospice with no out-of-pocket expenses.

2. Giving up – For some, turning to a Hospice organization is tantamount to “giving up”. It is a difficult decision to decide that the best course of treatment is to forego treatment that will prolong life and just let the disease run its course. Fighting the illness or condition may not always be the best option for some patients. Especially those who have lived a long life and are ready to move on. The services that Hospice offers help not only the patient but also the family come to terms with the impending death. Turning to Hospice is NOT giving up on care.

3. Do not want to “take from” or “rely on” the Government – This is a statement that many Hospice organizations hear. These same people who choose not to take advantage of the Medicare Hospice Benefit are still using Medicare and Social Security. If these same people have been working during their lifetime they have been paying into the system the entire time. It should be understood that this benefit is a vital part of the Medicare program and something that has been earned.

4. Not aware of available services – Many people simply are not aware that Hospice is even an option. Unless they have experience with or know someone who has knowledge of Hospice they may not know of it. Hospice, by definition is for those who have a condition where the physician can determine that they have less than six months to live if their condition were to follow its natural course. Most people find out about Hospice when told about it by a physician or other health care worker. If not informed by the health care system they might not realize that this is an option.

The support that Hospice can provide fills the needs of the patient requiring the services as well as the family of the patient. Hospice truly does answer the concerns of those facing the death of a loved one.

Respite Care Part Two: Golden Living 960 South Geneva Road in Orem

2011-12-14T08:11:00.000-08:00

Respite Care Part Two: Golden Living 960 South Geneva Road in Orem

In an effort to help caregivers get the assistance they need (and sometimes don't even know is available), I am sharing some resources for Respite Care.

I am constantly aware of the incredible demands of caregivers and am a firm believer in Respite Care, a type of vacation for the caregiver wherein a trained professional provides the care needed while the caregiver is away. The amount of time for respite care can be as little as an hour or two or a week or two, depending on the needs of the caregiver

Respite Care can occur at home or in a facility and is generally paid for privately, meaning not covered by insurance. Prices vary depending on whether you choose private duty, in-home care or care in an assisted living facility or even a skilled nursing home.

This week I will give you many option for respite care and would love to hear your thoughts and/or experiences on any services you have tried. The options I will give you are trusted partners with Freedom Home Health and Hospice and come with our highest recommendations for service:

The staff at Golden Living Assisted Living is amazing. They love the people they serve and each resident becomes a part of their community and family. Activities are offered daily, wonderful meals prepared on site and attention to even the smallest need of each and every resident.

Golden Living is offering one day FREE with a three day respite stay through the holiday season. They have two levels of care available; Level one, in the South building is for residents requiring some assistance with their activities of daily living such as bathing, grooming, medications management and meals. Level Two, in the North building, is perfect for those who may have memory loss, dementia, Alzheimer's or need more assistance daily. The daily rate for level one is $70 and level two is $107.
Please call Warren @ 801-349-3870 for a tour and to make your reservations. There is a three day minimum stay and 24 hour notice of reservation required for this offer.

What Is Respite Care? Who Offers It?

2011-12-12T06:09:00.000-08:00

I am constantly aware of the incredible demands of caregivers and am a firm believer in Respite Care. Respite Care is a type of vacation for the caregiver wherein a trained professional provides the care needed while the caregiver is away. The amount of time for respite care can be as little as an hour or two or a week or two, depending on the needs of the caregiver

Respite Care can occur at home or in a facility and is generally paid for privately, meaning not covered by insurance. Prices vary depending on whether you choose private duty, in-home care or care in an assisted living facility or even a skilled nursing home.

This week I will give you many option for respite care and would love to hear your thoughts and/or experiences on any services you have tried. The options I will give you are trusted partners with Freedom Home Health and Hospice and come with our highest recommendations for service:

Bel Aire Assisted Living with locations in

Orem and American Fork

You will find lovely, homelike accommodations in each of these buildings as well as staff that are compassionate, caring and very well trained. Keep in mind, this is what they do EVERY day, caring for the elderly, providing the assistance they need and enjoying every minute of it. They are offering 3 hours of FREE respite care through the holidays with every hour after that at $20 per hour. You can choose any time between 7 AM and 10 PM. Meals are an additional $5 per meal. Because space is limited you must call and reserve in advance by speaking with Cala or Jennifer @ 801-763-0622. Tell them Gena sent you!

Is It A Cold Or The Flu??

2011-12-07T07:33:00.000-08:00

Are you wondering if you have flu? Although seasonal flu symptoms often mimic a cold, a common cold rarely causes a fever over 101 degrees Fahrenheit. Let's learn more about flu symptoms so you are fully prepared if you get sick.
Seasonal flu is a contagious respiratory infection caused by different flu viruses. It's important to understand flu symptoms so you can seek immediate treatment, especially if you have a chronic medical condition.
The earlier you recognize that you have the flu can also make a difference in how long it lasts. Prescription medications called antiviral drugs -- Relenza and Tamiflu -- are most effective when given within 48 hours of the onset of flu symptoms. These flu drugs are effective against the typical strains of seasonal flu. They can decrease the duration of the flu by one day if used within this early window. These antivirals may also provide benefit if given even after two days, especially in people who are very sick.

How Will I Know if Flu Season Has Started?

Seasonal flu follows a fairly predictable pattern, starting in the fall and ending in the spring. A good sign that seasonal flu season has started is the sudden increase in the number of school-aged children sick at home with flu-like illness. This initial flu outbreak is soon followed by similar infection in other age groups, especially adults.

How Are Flu Symptoms Different From Cold Symptoms?

Unlike symptoms of a common cold, flu symptoms usually come on suddenly. It often starts with the abrupt onset of fever, headache, fatigue, and body aches. Here's a list of flu symptoms you might feel:

fever (usually high)
severe aches and pains in the joints and muscles and around the eyes
generalized weakness
ill appearance with warm, flushed skin and red, watery eyes
headache
dry cough
sore throat and watery discharge from your nose

Seasonal influenza is not usually associated with gastrointestinal symptoms, like diarrhea and vomiting, at least not in adults. However, these symptoms appear with stomach flu, which is a popular but inaccurate term for gastroenteritis.

Information from WedMD

How Can You Manage Stress?

2011-12-06T05:31:00.000-08:00

December is arguably one of the highest stress inducing months in the entire year! Planning. Spending. Wrapping. Cooking. Family. Work. Beyond reasonable expectations of yourself and others...... Sound familiar?

The facts is, there is a December in EVERYONE's year. No getting around it. So, how can we manage the stress that is just waiting on the other side of the door? Here are some techniques and tips from Web MD:

If you are one of the millions of stressed-out Americans, there's good news. People can learn to manage stress. Start with these stress management tips:

Keep a positive attitude.
Accept that there are events that you cannot control.
Be assertive instead of aggressive. "Assert" your feelings, opinions, or beliefs instead of becoming angry, defensive, or passive.
Learn and practice relaxation techniques.
Exercise regularly. Your body can fight stress better when it is fit.
Eat healthy, well-balanced meals.
Get enough rest and sleep Your body needs time to recover from stressful events.
Don't rely on alcohol or drugs to reduce stress.
Seek out social support.
Learn to manage your time more effectively.

Check the blog tomorrow for more info on stress and the holidays.

What Is Stress Doing To You?

2011-12-05T06:37:00.000-08:00

Stress is the body's reaction to any change that requires an adjustment or response. The body reacts to these changes with physical, mental, and emotional responses.
Stress is a normal part of life. Many events that happen to you and around you -- and many things that you do yourself -- put stress on your body. You can experience stress from your environment, your body, and your thoughts.

How Does Stress Affect Health?

The human body is designed to experience stress and react to it. Stress can be positive, keeping us alert and ready to avoid danger. Stress becomes negative when a person faces continuous challenges without relief or relaxation between challenges. As a result, the person becomes overworked and stress-related tension builds.
Stress that continues without relief can lead to a condition called distress -- a negative stress reaction. Distress can lead to physical symptoms including headaches, upset stomach, elevated blood pressure, chest pain, and problems sleeping. Research suggests that stress also can bring on or worsen certain symptoms or diseases.
Stress also becomes harmful when people use alcohol, tobacco, or drugs to try and relieve their stress. Unfortunately, instead of relieving the stress and returning the body to a relaxed state, these substances tend to keep the body in a stressed state and cause more problems. Consider the following:

Forty-three percent of all adults suffer adverse health effects from stress.
Seventy-five percent to 90% of all doctor's office visits are for stress-related ailments and complaints.
Stress can play a part in problems such as headaches, high blood pressure, heart problems, diabetes, skin conditions, asthma, arthritis, depression, and anxiety.
The Occupational Safety and Health Administration (OSHA) declared stress a hazard of the workplace. Stress costs American industry more than $300 billion annually.
The lifetime prevalence of an emotional disorder is more than 50%, often due to chronic, untreated stress reactions.

SOURCE:
Jerome F. Kiffer, MA, Department of Health Psychology and Applied Psychophysiology, The Cleveland Clinic Foundation.

Medicare Open Enrollment....Time's A Wasting!!

2011-11-30T07:02:00.000-08:00

Medicare Open Enrollment: Your Time Is Valuable

November 29

By Jonathan Blum, Deputy Administrator and Director for the Center for Medicare
Have you ever gotten a great deal to try a new restaurant or dry cleaner, only to realize that it just wasn’t worth the hassle? Maybe it was on the other side of town, or the hours weren’t convenient, or there were too many exceptions. We all like to get a good deal, but convenience is a big part of the value.
The same is true when it comes to choosing a health plan: convenience matters. So in addition to cost, coverage, and benefits, here are some other things you may want to consider as you compare Medicare options this year:
Doctor and hospital choice
You want to be comfortable with the people you’re working with, especially when it comes to something as private as your health. Do the doctors you know accept your coverage? Where are the doctors’ offices? What are their hours? Do they often keep you waiting?
Pharmacy access
Is the pharmacy you use included in your drug plan’s network? Do they use e-prescribing? Can you get refills by mail? Remember that plan networks can change from year to year. If it’s important to you to stay with the same pharmacy, it’s worth checking to make sure they’ll still be in your plan’s network.
Travel
Maybe you travel a lot, or spend part of the year in a different state. If you do, make sure you know whether your coverage will travel with you.
Quality
Ask yourself whether you’re truly satisfied with your medical care. Not all health care is created equal, and the doctors, hospitals and facilities you choose can impact your health. Look for plans with a 5‑star performance rating — the right expertise and care may help speed your recovery and improve your outcomes.
Your time is valuable — and so is your health. The health care law brought more benefits and better choice to the Medicare program, but only you know what mix of coverage and convenience is most important to you and your family.
That’s why we’re working hard to make sure you have choice and control over the Medicare benefits you’ve earned. Look around for all the Medicare information out there. And visit our Open Enrollment center, where we’ve gathered everything you need, including a video on how the Medicare Plan Finder works, to walk through your options.

Holiday Blues and Seniors

2011-11-29T06:49:00.000-08:00

The holiday season is supposed to be a season of happiness and joy, nestled in the loving bosom of family and friends. It is a wonderful picture, but for many seniors it is far cry from reality. For many, feelings of sadness, loneliness and isolation are their holiday companions.
I had the pleasure of speaking with Dr. Harry Croft recently. Dr. Croft is a board-certified psychiatrist practicing in San Antonio TX. He is also Director of Education for Covenant Behavioral Health. Interestingly Dr. Croft tells me that he doesn't see more people coming to see him during the holidays, contrary to popular belief. In fact his office visits have traditionally dropped during the last 2 weeks of the year. He then has an increase of patients seeking his help after the holiday season is over. Many of them tell him that they felt depressed and sad during the holidays, but hid those feeling from friends and family. They don't want to worry family by displaying these feeling or try to deny them.
There are many factors that contribute to those feelings of sadness that seniors may feel. Many seniors are widowed, have lost close friends as they age, are separated from family and may be suffering from ill health. They may feel guilty for have feelings of sadness which may in turn intensify those feelings of sadness.
Dr. Croft also shared with me many of the strategies he gives to his patients to help them cope with the holiday blues. Using these suggestions will help to prevent or lessen those feelings of sadness and help to restore the joy of the season.

Don't isolate yourself. If you can't be with family, invite some close friends over to share the holidays.
Volunteer your time. Many churches or civic groups would be glad of your help. Helping others is a great way to forget your own troubles.
Try to avoid alcohol. Many seniors develop alcohol dependence after retirement or loss of a loved one. Alcohol is a depressant and will intensify those feelings of sadness.
Watch your finances. Most seniors are on a fixed income. Set a budget for gift giving and stick to it. Don't feel guilty if you can't afford to by those grandchildren an expensive gift, its you they will remember not the gifts. Overspending will cause worry over bills after the holidays are over.
Don't deny or try to hide your feelings of sadness. Very often just being able to share your feelings with someone can help To help cope with post holiday letdown, spend some time organizing and mounting photographs taken during the holiday. Take time to relive the fun and friendship.

These same coping strategies can be useful for seniors suffering from clinical "major" depression as well.

From Marian Anne Eure, former About.com Guide

Could Your Prescription Drug Be Causing Your Falls?

2011-11-28T05:27:00.000-08:00

From Alzheimer's Reading Room

Falls are the leading cause of both fatal and nonfatal injuries for adults sixty-five and older, and research suggests that those taking four or more medications are at an even greater risk than those who don’t—perhaps two to three times greater. -- Susan Blalock, UNC Eshelman School of Pharmacy

Research studies indicate that falling is a leading cause of injury deaths for people 65 and older --

More than one third of adults 65 and older fall each year in the United States
Twenty percent to 30% of people who fall suffer moderate to severe injuries such as bruises, hip fractures, or head traumas.
Men are more likely to die from a fall.
The risk of being seriously injured in a fall increases with age.
People 75 and older who fall are four to five times more likely to be admitted to a long-term care facility for a year or longer.

The drugs older people take can make them more susceptible to falling.

Have you considered these facts? Asked your personal care physician if the drugs he or she is prescribing increase the chances of falling? Ever had a pharmacist warm you that a drug can increase the chances of falling?

When you are getting a prescription filled has the pharmacist every told you -- be careful this drug can increase falling?

Stefanie Ferreri offered the following advice to patients and practitioners:

For Patients
If patients see a drug they are taking on the list, they should not stop taking it. Next time they see their doctor, talk about the risk of falling and possible alternative medications.

For Doctors
Physicians should look for medications that have been proven safe and effective in older adults and look for medicines that have less of a sedating effect. Physicians should be especially wary of anticholinergics, a class of drugs that affect nerve cells and used to treat a wide range of conditions.

For Pharmacists
Pharmacists should be alert for patients sixty-five and older who are taking four or more drugs and be sure the patients know about the additional risk of falling created by their medications.

Here are some popular drugs that are on the list Celexa, Effexor, Wellbutrin, Prozac and Risperdal.

Please consider sharing this information with family and friends. Or your doctor.

Prescription Medications that Increase the Risks of Patient Falls

Alprazolam (Xanax)
Amitriptyline (Elavil)
Amobarbital (Amytal)
Generic Name (Brand Name)
Amoxapine (Asendin)
Aripiprazole (Abilify)
Baclofen (Lioresal)
Bupropion (Wellbutrin, Wellbutrin SR)
Buspirone (Buspar)
Butabarbital
Carbamazepine (Tegretol, Tegretol XR, Carbatrol)
Chloral hydrate
Chlorazepate (Tranxene)
Chlordiazepoxide (Librium, Limbitrol, Librax)
Chlorpromazine (Thorazine)
Citalopram (Celexa)
Clidinium-chlordiazepoxide (Librax)
Clomipramine (Anafranil)
Clonazepam (Klonopin)
Clozapine (Clozaril)
Codeine (Tylenol with Codeine)
Desipramine (Norpramin)
Diazepam (Valium)
Digoxin (Lanoxin)
Disopyramide (Norpace)
Divalproex sodium (Depakote, Depakote ER)
Doxepin (Sinequan, Zonalon, Prudoxin)
Duloxetine (Cymbalta)
Escitalopram (Lexapro)
Estazolam (Prosom)
Olanzapine (Zyprexa, Zyprexa Zydis)
Oxazepam (Serax)
Oxcarbazepine (Trileptal)
Oxycodone (Percocet)
Oxymorphone (Numorphan)
Paraldehyde (Paral)
Paroxetine (Paxil)
Pentobarbital (Nembutal)
Perphenazine (Trilafon)
Phenelzine (Nardil)
Phenobarbital
Phenytoin (Dilantin)
Pimozide (Orap)
Pregabalin (Lyrica)
Primidone (Mysoline)
Propoxyphene (Darvon, Darvocet)
Protriptyline (Vivactil)
Quazepam (Doral)
Ethosuximide (Zarontin)

*Do not stop taking medications without the consultation and direction from your Doctor.

Hospice 101: What Services Are Provided By Hospice?

2011-11-16T06:00:00.000-08:00

Let's review what we have learned in the last two posts:

1- Hospice is Nursing Care provided for the terminally ill as certified by a physician. It is intended to keep the patient comfortable while controlling pain as well as providing social services and spiritual support.

2- A person qualifies for Hospice when a doctor has certified that, given the natural progress of the admitting diagnosis, the patient has a life expectancy of approximately 6 months. Admitting diagnoses can include terminal diseases as well as declines in health in the aged.

Our team of professionals are trained in end-of-life care and work together with the client, their family and their physician to meet the medical, physical and emotional needs of the terminally ill patient and their loved ones.

Hospice Care is not 24 hour care but it does provide nursing, aides, social services, volunteers and spiritual support for patients through the end-of-life process as well as for their families for a year after the loss of their loved one.

Hospice care can take place in your home, a nursing facility or even a hospital.

I have personally witnessed the positive change that can take place in a situation where Hospice care is needed. Caregivers are educated and supported in providing the cares and comfort for their loved ones.

Our Nurses provide skilled services for pain management and comfort. They let the family be as involved as possible in making the decisions about the care for their loved one.

Aides can provide assistance with bathing, grooming and even some light housekeeping.

A Social Worker will visit with the patient and the family to alleviate any concerns or questions and can guide you to valuable resources and programs that could also be of assistance.

A Chaplain is a non-denominational, spiritual component of our team. He is able to provide the spiritual support that is so often needed at this time of life.

Our team also offers Volunteers for various patient needs.

All of these services are available but are not required to be used by the patient and family.

Hospice 101: What Qualifies Someone For Hospice?

2011-11-15T06:00:00.000-08:00

In an effort to continue to educate everyone about Hospice care I would like to talk about things that would qualify someone for Hospice. Keep in mind that Hospice is regulated by the government and ALL Hospice agencies offer the EXACT sames services. There is not an agency that can legally offer

As a reminder from the last post, Hospice care is skilled nursing, social services and spiritual support for a terminally ill patient who is not seeking curative treatment for their admitting diagnosis. This care also helps support the patients family during, and after, the loss of their loved one.

A doctor must certify that, given the natural process of the illness, the patient's life expectancy is approximately 6 months. Many times there is not a terminal illness diagnosis but an elderly patient will still qualify under the Medicare guidelines for services. Caregivers may be so close to the situation that they do not see the subtle changes on a day to day basis but their loved one could be receiving services and the caregivers load could be lightened.

Here are some signs to watch for:

Has the patient
Been hospitalized or taken to the emergency room several times during the past 6 months?
Been making more frequent phone calls to physicians?
Been taking medication to lessen physical pain?
Been spending most of the day in a chair or bed?
Fallen several times over the past 6 months?
Needed help from others for :

Bathing
Cooking
Eating
Dressing
Getting out of bed
Walking

Experienced noticeable weight loss?
Started feeling weaker or more tired?
Noticed shortness of breath, even while resting?

If you answered "yes" to four or more of the questions above, your loved one could likely qualify for services. Remember that we will still need a Doctor's order for Hospice care but giving our company a call would get the ball rolling. We can, with your permission, contact your primary care physician and work hand in hand with him to get needed services started and help "make the most of every minute that is left."

Hospice 101: What Is Hospice?

2011-11-14T05:50:00.000-08:00

Hospice is one of those topics that seems to have a negative connotation for many and I believe it is due, in great part, to lack of information about Hospice. I hope to help clear this up with the next few blog posts.

A few years back I was talking to a family about Hospice services for their loved one. The family was very distraught about the situation and very apprehensive about starting Hospice services. As the conversation went on I learned that their understanding of Hospice was that we actually ended the life of the individual. I can clearly see why they were hesitant and I can assure you that Hospice, in NO uncertain terms, assists ANYONE in ending their life.

Hospice in the United States has grown from a volunteer-led movement to improve care for people dying alone, isolated, or in hospitals, to a significant part of the health care system. In 2008, 1.45 million individuals and their families received hospice care. Hospice is the only Medicare benefit that includes pharmaceuticals, medical equipment, twenty-four hour/seven day a week access to care and support for loved ones following a death. Hospice care is also covered by Medicaid and most private insurance plans. Most hospice care is delivered at home. Hospice care is also available to people in home-like hospice residences, nursing homes, assisted living facilities, veterans' facilities, hospitals, and prisons

Hospice Care is a service intended to care for those who have a terminal illness and are no longer seeking curative treatments. A doctor must first certify that, with the natural process of the illness, the patient is probably looking at a 6 month or less life expectancy. Some patients will surpass this time frame, some will pass away before the 6 months. The 6 month life expectancy is just an estimation by the Doctor. I have seen many patients live well beyond a year after qualifying for hospice care.

I find that many families call for Hospice services when their loved one is suffering great pain and is in the last days of their life. I encourage everyone to consider the difference Hospice can make even before this situation. To keep someone out of pain, not drugged and "out of it", but truly comfortable, is one of the biggest blessings of hospice. When pain is decreased, "living" is increased. When a terminal patient has pain relief, the quality of life is much better. Hospice also serves the family of the patient providing social services and spiritual support during, and after, losing their loved one.

So, what is Hospice? Nursing care intended to provide comfort, dignity, and improved quality of life for terminally ill patients as well as social services and spiritual support for the patient and their family. In short, we make the most of every minute that is left.

I would love to hear your experiences with or questions on Hospice services.

Who Won the Hospice 101 Drawing?????

2011-11-11T15:15:00.000-08:00

I am so amazed at the OVERWHELMING response by so many people who faxed, emailed, facebooked and commented their answers to have a chance at winning the $25 Applebee's giftcard. In fact, we were so excited about it that we picked FOUR winners!!!

Jodi Mitchell who works at the office of Dr. Reissen, Dr. Von Welch and Shelly Ebert FNP, in American Fork!

Joanna Sumsion at Central Valley Medical Center in Nephi!

Kathryn Healey at Central Utah Clinic in Provo!

and......

Lisa Williams, Activity Director at Parkway Health Center in Payson!
I will be delivering your prizes over the next week!

Congratulations everyone and thank you so much for helping us understand what people know about hospice! This will really help us in our effort to educate everyone!!!

Take Our Hospice 101 Quiz to WIN!!

2011-11-07T14:28:00.000-08:00

*Many of you are having a difficult time leaving your answers here. Wish I knew why:/ Feel free to go back to the Facebook link and leave your answers there to make sure you are in the drawing! Thanks for your efforts!

Would you like to be entered into a drawing for a $25 Gift Card to Applebee's? Just take our Hospice 101 quiz, leave a comment with your answers and a way to contact you, email, phone, etc., then POOF! you are entered. We won't use your info for anything but this quiz as we are trying to find out what people know about hospice and how we can better educate the public on what it offers. Good Luck...and remember, you don't have to have the correct answer, we just want to know what you know.

1. What is Hospice care?

a. A really cold place inside the hospital

b. Nursing care focused on comfort and quality of life for terminally ill patients

c. Also known as Palliative Care

d. Both b and c

2. What qualifies someone for Hospice?

a. A doctor certifies that patient probably has about 6 months of life expectancy

b. Patient has terminal illness and is not seeking curative treatments

c. Elderly patient who has increased decline, weight loss and/or hospital visits

d. All of the above

3. How is Hospice care paid for?

a. Medicare and most insurance have a Hospice Benefit and it does not cost the patient anything.

b. Private pay

c. A patient’s savings or checking account

4. What does Hospice care offer?

a. Nursing, Aides, Social Services, Spiritual Services and Volunteers specifically trained in end-of-life care

b. Improves quality of life for terminally ill

c. Comfort, compassion and dignity during end-of-life process

d. All of the above

Thanks for participating and check back on November 10th to see who the lucky winner is!!

(Don't forget to put your answers and a way to contact you as a comment!!)

Families Urged to Watch for Dementia Warning Signs During Holidays

2011-11-07T06:49:00.000-08:00

Look out for dementia warning signs, families urged

By Jane Hughes Health correspondent, BBC News

820,000 people in the UK have dementia

Families are being urged to look out for the warning signs of dementia when they visit their elderly relatives during this holiday season.

It is part of a government advertising campaign in England aimed at encouraging early diagnosis.
Experts believe the holiday period is a time when many people realize family members may have a memory problem.
They are now being warned to act on it and seek help by the Department of Health, which is launching a TV and national press campaign on the issue.
The government advert tells the story of a man in the early stages of dementia, and his daughter, who feels she is losing her father.
It highlights the importance of contacting a GP if you have symptoms like memory loss, confusion and anxiety.
"People are afraid of dementia," said care services minister Paul Burstow.

Alzheimer's sufferer Derek Wilson: ''I knew that there was something wrong with me''

"Rather than face the possibility someone we love has the condition, we can wrongly put memory problems down to 'senior moments'," he said.
"Don't wait until a crisis. Being diagnosed with dementia won't make the condition worse, but leaving it untreated will."
Christmas alert
A lot of relatives first notice problems when they visit family members over Christmas, prompting a big increase in calls to the Alzheimer's Society's helpline. This January it had a 43% rise.
Chief executive Jeremy Hughes said: "It's when you see someone you perhaps haven't seen for a while that you can see the difference."
"If their memory is going, if they're getting confused, if they have sudden mood changes, that's the time to say 'maybe you should see your doctor'."
More than 800,000 people in the UK have dementia - and many are never diagnosed. There is no cure, but with the right treatment, the symptoms can be slowed down.

Dementia signs

Struggling to remember recent events
Problems following conversations
Forgetting the names of friends or objects
Repeating yourself
Problems with thinking or reasoning
Confusion in familiar places

"Getting a timely diagnosis is vital," said Professor Alistair Burns, the national clinical director for dementia.

"Knowing about their condition helps people gain control, and allows them and their families to seek the support and services they need."
But GPs say those services are not always available to their patients, and that growing financial pressures in the NHS could mean cuts to the level of support they can offer.
Dr Clare Gerada, of the Royal College of GPs, said: "GPs need to have access to a wide range of resources, such as memory clinics, so they can support people beyond diagnosis, and help them live healthy independent and productive lives for as long as possible."
"We have to make sure we're not simply extending the time someone lives with a dementia diagnosis, without giving them the support they need," she added.

Handwashing 101: Preventing the Common Cold

2011-11-02T07:26:00.000-07:00

Common Cold Prevention

If you've had it with cold misery, then you need to learn some common cold prevention techniques. Common cold prevention is not difficult. You just need to learn some new behaviors and lifestyle habits and use these new behaviors and habits every day -- year round. When you do, you can avoid coming in contact with a contagious cold virus. Here is what you need to know for common cold prevention.

Prevent Colds With Frequent Hand Washing

Your best protection from the common cold and flu is frequent hand washing. Amazingly, about 80% of contagious diseases are transmitted by touch. But the simple friction that occurs when you rub skin against skin while using warm water and soap and then follow that with thorough rinsing and drying gets rid of potentially harmful germs.

While germs are often transferred to others through household objects -- telephones, doorknobs, toothbrushes, and faucet handles -- the biggest transportation center for germs is your hands. That's why frequent hand washing gets rid of the illness-causing germs and helps to prevent the spread of some diseases -- especially if a family member, friend, or classmate has a cold or flu virus.

The CDC estimates that 36,000 people die from the flu or flu-like illness each year. The CDC also says the simple act of hand washing is the single most important means of preventing the spread of viral and bacterial infections. Yet some studies reveal that many Americans using public restrooms don't wash their hands before leaving. People also forget to wash their hands before preparing meals, and they grab snacks without thinking of hand washing as well. If you want to prevent colds, just stop -- and wash your hands.

How Should I Wash my Hands for Cold Prevention?

Many of us get so busy, we simply forget to wash our hands properly. Here's the rundown:

First, wet your hands with water. Then apply soap.
Now, rub your hands together vigorously for 20 seconds. Make sure to rub the wrists, between the fingers, and under the fingernails. When you have time, use a nailbrush, as bacteria often hide under nails.
Rinse your hands thoroughly and dry with a clean paper towel or air dryer.
If you are in a public restroom, shut the faucet off with a paper towel. Try to push the door open with your shoulder, or use another paper towel to turn the knob.

From WebMD Articles

7 Common Mistakes to Avoid When Choosing Assisted-Living Services

2011-10-31T08:14:00.000-07:00

My friends at Bel Aire Senior Living in American Fork and Orem shared this with me and I believe it is a very valuable tool for families who are contemplating a place for their loved one. I hope it helps make the decision a bit easier and I also hope you will make an effort to call Rob @ 801-763-0622 and schedule a tour of Bel Aire to see what they have to offer.

7 Common Mistakes to Avoid When Choosing Assisted-Living Services

Not all assisted-living facilities operate in the same manner. Unfortunately, many families make some common mistakes when making this important decision. These mistakes can actually increase a family’s stress and workload, if not carefully avoided. While there are many potential hazards to be aware of, here is a list of some of the more common mistakes that you can avoid.

PRICING:
Most assisted-living facilities operate in one of two pricing formats: “Al a Carte”, and “All Inclusive”. A la Carte pricing usually charges a seemingly low base price per month for very basic services. However, additional fees are added if the resident needs help with laundry or medication management, etc. While this pricing plan may appear to be lower initially, these extra fees can quickly escalate far beyond a family’s ability to pay.

For families seeking a way to consistently maintain their budget, All-Inclusive pricing may be a better option. All-inclusive pricing programs charge a single monthly fee. This fee covers every service provided to the resident. From meals to medication management to activities, the single fee covers everything.

FACILITY APPEARANCE vs. RESIDENT APPEARANCE:Everyone is attracted to a nice-looking building. It can appear comfortable and inviting. However, the exterior is not where your loved one will spend most of their time. As you tour a potential facility, be particularly mindful of the appearance of the residents themselves. Do they appear disheveled or unkempt? Are their rooms untidy? Are their beds unmade? Do you notice any odors? These tell-tale signs can reveal much to you about how your own loved one will be treated if they move in.

FOOD SERVICE and CNA’s vs. HOME-COOKED MEALS and a KITCHEN STAFF:Many assisted-living facilities offer meals that are trucked in from food-service companies. While nutritionally adequate, these meals may go uneaten if they do not taste and smell good to the residents. Because an assisted-living center may be your loved one's home for a period of time, meals should be homemade. The process of preparing meals from scratch, not only preserves dietary quality, it enhances the overall meal experience. The smells of a freshly prepared meal, floating from the kitchen, invite residents to not only eat their meals, but to savor them.

An additional concern regarding meals is kitchen staff. Many facilities do not have a separate kitchen staff. They require the care personnel to stop supervising the residents and go prepare the meals. For facilities with 16 beds or less, this practice should not be a concern. However, for larger facilities, having a separate, professional kitchen staff allows your loved one to receive the care they need and the quality meals they deserve.

RESIDENT TO STAFF RATIO:
Making sure that the facility you choose has adequate staffing is critical to your loved one’s well being. Many assisted-living facilities focus more on profit margins than the quality of care their residents receive. Some facilities will assign only one CNA to take care of 15 residents. A 1:15 ratio may increase profit margins, but it may also leave residents underserved. When selecting an assisted-living facility, look for facilities that have a ratio of 1 CNA for every 10 residents as a minimum standard.

PROGRESSIVE CARE:
Moving to a new home with a new set of friends is trying on anyone, especially the elderly. Therefore, moving your loved one as little as possible is ideal. However, as we age, the level of care we need often increases. Some assisted-living facilities only offer one level of service. Having to move your loved one to a new facility each time their level of care increases, can be costly and traumatic. It is more beneficial to choose a multi-service facility right from the start. This way, your loved one can still remain in the same facility with the friends and staff they have grown accustomed to, even as their needed level of care increases.

ALZHEIMER’S CARE:
As we age, memory and cognitive abilities often begin to decline. Additionally, diseases such as Alzheimer’s further complicate matters by requiring additional, secure care. Where Alzheimer’s is present, basic assisted-living facilities may not be sufficient. As many Alzheimer victims are prone to wandering, secure memory care is often required to keep the resident safe. A secure memory care facility has all of the amenities of regular assisted-living. It also includes specially-trained staff and security code locks on external doors. Some facilities may simply put a bracelet on a resident, which sounds an alarm if they get too close to a door. However, this is not a secure facility. A security coded facility offers Alzheimer’s residents with the greatest level of care and safety. If your loved one requires Alzheimer’s services, make sure the facility, truly is secure.

MEDICATION MANAGEMENT:Modern medicine has extended our lifespans, as well as our quality of life. As we age, we often find ourselves requiring more medication to maintain that quality of life. An individual that requires assisted-living services may not be able to consistently manage their medication needs effectively. Assisted-living facilities will often manage the medication of their residents. However, to increase profit margins, some facilities will assign one person to manage the medication needs of every single resident. This can potentially increase the risk of mistakes being made when those medications are distributed. When you tour a facility, ask questions to determine who will be handling your loved one’s medications, and how many other residents’ medications that person is handling.

TRANSPORTATION:While many residents of assisted-living centers may have mobility difficulties, almost every resident enjoys the opportunity to get out once in awhile. Trips to various attractions, and transportation to needed medical appointments, are essential to the health and well-being of the elderly. In choosing an assisted-living center, be careful to evaluate the transportation resources of the facility. Is the resident responsible for scheduling their own transportation? Does the facility have its own vehicle(s) and provide the residents with transportation?

CONCLUSION:
Assisted-living offers us the hope of our loved ones receiving the care they need to enjoy a higher quality of life in their later years. Choosing an assisted-living facility is an important decision and one that should not be made haphazardly. Because not all assisted-living facilities operate in the same manner, selecting the correct facility for your loved one is critical. By knowing some of the common mistakes families make when choosing an assisted-living facility, you can more effectively avoid the pitfalls, and ensure that your loved one’s assisted-living experience is a blessing for them and your own family.

Because each family’s situation is unique, individual consultations are available to help you evaluate which type of assisted-living services are right for your loved one’s specific needs. If you would like a complimentary in-home evaluation for your loved one, simply give us a call. We are committed to helping you make the right decision for your loved one’s needs. Please consider calling Bel Aire Senior Living home for you or your loved one.

Meet The Freedom Home Health and Hospice Nurses!

2011-10-25T06:19:00.000-07:00


Gena Bertelsen Community Liaison Specialist

We recently had a wonderful photographer take some pictures of our nursing team and I wanted to share the information with you.

Freedom Home Health and Hospice knows how important it is to have professional, caring and compassionate people caring for you or your loved one in your home. We hire only qualified, experienced staff who treat each client as if they were their ONLY client.

If you have to opportunity of meeting any of these amazing nurses, say hello, and thank them for the wonderful job that they do.

Merrie Parrish RN, Director of Nursing - Home Health

Merrie Parrish, RN,

Director of Nursing - Home Health

Merrie specializes in Rehabilitation Nursing, Medicare Regulations and Requirements Staff Education and Management. Merrie has worked extensively with clients of all ages, especially the elderly.


Jody Pierce RN, Case Manager

Jody Pierce, RN, Case Manager

Jody specializes in Wound Cleaning and Care and

Rehabilitation Nursing. The rehabilitation of Jody’s patients is so important to her that she regularly attends medical appointments with her clients so that she understands the whole picture.


Blake Erickson RN, Case Manager

Blake Erickson, RN, Case Manager

Blake has had a great deal of experience with Critical Care Clients, Trach Care, GI Feedings and IV Therapy. Blake always takes the time to educate his clients about the disease process they are experiencing.

Crystal Miller RN, Case Manager

Crystal Miller, RN, Case Manager

Crystal’s compassion and care is phenomenal and brings high praise from her clients. She specializes in IV Therapy and Client Education as well as being an effective and efficient Liaison with Family, Medical Partners and Staff

CARE Meeting at Lehi Beehive Home Thursday 1 PM

2011-10-25T06:15:00.000-07:00

Did you know that caregivers are 50% more likely to suffer from depression!! The stress and overwhelming nature of being a caregiver can actually make the caregiver so ill that they can't take care of their loved ones any longer!
PLease join me at our CARE meeting today at the New Lehi Beehive Home, 322 North 2375 West, Lehi Utah, at 1 PM.
We will have tips and techniques for rejuvenating yourself as well as an open discussion of caregiver questions and concerns. Hope to see you there!

Feel free to call me if you get lost... Gena Bertelsen...801-623-9595.

Improving the Journey: Alzheimer's Association Dementia Care Conference October 28th. REGISTER NOW!

2011-10-24T07:47:00.000-07:00

Improving the Journey: Alzheimer's Association Dementia Care Conference

Register now for the only Conference devoted solely to Dementia Care in the state - with a professional track as well as family, friends and caregiver track. This conference is for the entire Wasatch Area. It will be held at the UVU campus, Sorensen Center, just off I-15 in Orem. Transportation and respite will be provided for family caregivers.

"Improving the Journey"

Dementia Care Conference of the Alzheimer's Association

October 28, 2011, UVU Campus, All Day

Speakers and topics for the conference include:

Dr Richard King on early detection and the latest in Alzheimer's research

Dr David Yells on eliminating the stigma of Alzheimer's disease

Matt Townsend on Improving the Journey of persons with Alzheimer's and related dementia

Lori Giovannoni on the Art of Caregiving

Dr Dennis Genebach on the "doctor is in" panel

Teresa Dieringer on compassion fatigue

Kathy Moran on dementia caregiver resources

Pat Jacubiec, foremost expert on the Allen Cognitive program for long term care

Dr Gary Garner on end-of-life Alzheimer's care

Dr Rand Rupper of the VA and GRECC on integrating pharmacology with non-pharmacological care

Todd Cope, Mindy Hill and LuAnn Lundquist on best practices with validation and redirection

And there is more. More speakers, panels, a luncheon, exhibitors and prizes.

In all, 7 CEU's are offered for professionals. CEU registration is $80 by October 1. Cost for registration to others is $20 by October 1. Conference capacity is 300; we are currently 20% enrolled. Please register during the early bird registration period. Costs go up October 3.

Josh Barlow

Program Services Coordinator

Alzheimer's Association

Utah Chapter

801-265-1944 (office)

801-979-7299 (mobile)

800-272-3900 (toll free)

Improving the Journey: Alzheimer's Association Dementia Care Conference

2011-10-11T06:10:00.000-07:00

"Improving the Journey"

Dementia Care Conference of the Alzheimer's Association

October 28, 2011, UVU Campus, All Day

Speakers and topics for the conference include:

Dr Richard King on early detection and the latest in Alzheimer's research

Dr David Yells on eliminating the stigma of Alzheimer's disease

Matt Townsend on Improving the Journey of persons with Alzheimer's and related dementia

Lori Giovannoni on the Art of Caregiving

Dr Dennis Genebach on the "doctor is in" panel

Teresa Dieringer on compassion fatigue

Kathy Moran on dementia caregiver resources

Pat Jacubiec, foremost expert on the Allen Cognitive program for long term care

Dr Gary Garner on end-of-life Alzheimer's care

Dr Rand Rupper of the VA and GRECC on integrating pharmacology with non-pharmacological care

Todd Cope, Mindy Hill and LuAnn Lundquist on best practices with validation and redirection

And there is more. More speakers, panels, a luncheon, exhibitors and prizes.

Josh Barlow

Program Services Coordinator

Alzheimer's Association

Utah Chapter

801-265-1944 (office)

801-979-7299 (mobile)

800-272-3900 (toll free)

Caregiver Stress: Symptoms and Skills to Cope

2011-10-10T06:28:00.000-07:00

Caregiver Stress

Alzheimer caregivers report that they frequently experience high levels of stress. Too much stress can be damaging to both a caregiver and the person with Alzheimer’s. If you experience some of these signs of stress on a regular basis, consult your doctor. Ignoring them can cause your physical and mental health to decline.

Symptoms of caregiver stress

Denial
Anger
Social withdrawal
Anxiety
Depression
Exhaustion
Sleeplessness
Irritability
Lack of concentration
Health problems

Be a healthy caregiver

Taking care of yourself is one of the most important ways to be a healthy caregiver.

Know what resources are available. Adult day care, in-home assistance, visiting nurses and Meals-on-Wheels are just some of the services that can help you.
Become an educated caregiver. As the disease progresses, new caregiving skills are necessary. Find information on alz.org or contact your local Alzheimer's Association.
Get help. You are not failing as a caregiver by asking others for assistance. Seek the support of family, friends and community resources. Alzheimer's Association support group meetings are a good source of comfort and reassurance.
Take care of yourself. Watch your diet, exercise and get plenty of rest. Make time for shopping, lunch with friends or even a golf outing. Take advantage of community services such as adult day care or in-home companion services to care for your loved one while you take a break.
Manage your stress level. Stress can cause physical problems and changes in behavior. If you experience symptoms of caregiver stress, use relaxation techniques that work for you, and consult your doctor.
Accept changes as they occur. People with Alzheimer's change and so do their needs. They often require care beyond what you can provide on your own. Look into care services such as in-home caregiver services and residential care.
Do legal and financial planning. Consult an attorney to discuss legal, financial and care issues. If possible and appropriate, involve the person with Alzheimer's and other family members.
Be realistic. Many of the behaviors that occur are beyond your control and the control of the person with Alzheimer's. Grieve your losses, but also focus on the positive moments.
Give yourself credit, not guilt. You are doing the best you can. Don't feel guilty because you can't do more. Your loved one needs you, and you are there – that should make you feel proud.

UCARE Week 3 Review: Home Safety

2011-10-07T06:03:00.000-07:00

I remember preparing for the birth of my first daughter, Dani. We put covers on all unused outlets, safety latches on cupboard doors and those annoying doorknob covers that stop even the most talented adult from exiting the premises! The good news is....she continues to live, as an adult, because of our efforts:)

Most of us don't think about making these efforts when we are caring for a loved one until the need arises. Here are some ideas to help you provide a safer environment for you and your loved one:

*If your loved one is in a wheelchair, sit at that level in each room to see what is and is not within their reach.
*Make sure doorways and floors are free from clutter and obstruction.
*Use a signal system so that your loved one can call for help in an emergency if left alone at times. I have a friend whose loved one wears a whistle as a necklace.
*Keep a nightlight on in the hallway, bathroom and, if desired, in your loved ones room.
*Set the hot water heater to low or set no higher than 120 degrees.
*Rugs can be tripping hazards. Remove any that will prevent your loved one from safely walking throughout the house.
*A shower chair and handheld shower head make bathing safer and easier.
*If your loved one uses a wheelchair to get around, make sure you lock the brakes after placing them in desired location.

These, and other safety ideas, are available on the Red Cross website, www.redcross.org

CARE Meeting @ Provo Beehive 2 PM TODAY!!

2011-10-06T06:00:00.000-07:00

CARE Meetings are support for caregivers of aging or ill loved ones. Resources, information and open discussion helps caregivers rejuvenate and energize.

If you have questions please call Gena at 801-623-9595.
Hope to see you there!

Freedom Fitness Club Today @ Payson Senior Center 11:30!!

2011-10-05T06:15:00.000-07:00

Our Fitness Club at the Payson Senior Center isn't an exercise program. It isn't always about dieting. It isn't even a weight loss club. It IS a combination of mind, body and soul fitness. When you bring your focus on these things together, everything just seems to get better in your life!

Come meet with us today as we discuss: Apples and Pears May Reduce Stroke Risk.
Hope to see you there!!

Gena

UCARE Week 2 Review: General Caregiving Skills/Healthy Eating

2011-10-04T06:19:00.000-07:00

The UCARE week 2 class focused on healthy eating and how important it is for you and the loved one you are caring for.

To the left you see the new "My Plate" from the USDA. This is intended to guide your decisions on choosing what to put on your plate. It's a great way to teach others about the daily recommendations for optimum nutrition.

Many times, when caring for a loved one, you will find that they lose their appetite and nothing seems to sound good to them. It is okay to provide something that does sound good to them, even if it doesn't show up on the plate to the left.

Keep in mind the struggles that your loved one may have with eating and/or feeding themselves. If your loved on has had a stroke and you need to assist them with eating, place small bites on the opposite side of the mouth that the stroke has affected. Make sure there are plenty of liquids available to wash the food down. Stay with your loved one throughout the meal to ensure the safety and prevent choking. After a meal, assist your loved one with oral hygiene such as rinsing mouth and brushing teeth.

If your loved one has poor eyesight, you can help them know what is on their plate by referring to it as a clock. For instance. you may say, "Mashed potatoes are at 3 o'clock."

There are adaptive utensils and plate guards available at medical supply stores that can also help your loved one at meal times.

Remember to make meals as pleasant and calming as possible. Meals are a "social" event and every effort should be made to make them enjoyable for everyone.

Paige Mulliner Life Enhancement Coordinator @ Golden Living in Orem is the Winner of the Drawing!!

2011-10-03T08:19:00.000-07:00

Paige Mulliner (I found this on her fb page;))

Paige Mulliner is the Life Enhancement Director at Golden Living Assisted Living in Orem. She is described by her co-workers as "very giving, loving, patient, kind and all-around amazing!"

Paige is responsible for several programs that enrich the lives of the residents living at Golden Living including the Need To Be Needed and Life in Motion activities.

Need To Be Needed lets the residents plan and complete projects for school children and other members of the community. They have made quilts, participated in a food drive and made treat bags for Halloween visitors. Life in Motion is a weekly movement activity that brings lots of fun and laughter to the residents as they bowl, play indoor badminton with balloons and even make and enjoy homemade bread.

We invite you to visit Golden Living, take a tour and congratulate Paige on her winnings! You can check Golden Living out on the right side of our blog or give Stephanie a call at 801-349-3870 to schedule a tour.

UCARE Week 2 Tonight @ Parkway Health Center 7 PM

2011-09-29T06:15:00.000-07:00

If you are caring for a friend or family member who is aging, chronically ill, has a disability or mental illness, you should come to the UCARE classes!
The UCARE Caregiver classes provide hand-on training on a variety of topics to help you. Classes are held at P
Parkway Health Center, at 7 PM. Parkway is at 55 South Professional Way in Payson, just East of Mountain View Hospital.

The schedule of classes is as follows:

Week 1: Community Support for Remaining at Home/ Managing Personal Assistants
Week 2: General Caregiving Skills/Healthy Eating
Week 3: Home Safety/The Accessible Home
Week 4: Positioning your Loved One/Assisting With Personal Cares
Week 5: Assistive Technology
Week 6: Alzheimer's & Dementia/Mental Illness
Week 7: Legal and Financial Issues
Week 8: Caring for the Caregiver
Week 9: Review

Hope to see you there!

I'm Worried That You Worry Too Much!

2011-09-26T06:13:00.000-07:00

I am a worrier. I freely own that. Nothing I do seems to change it. I fully realize that worrying about something does not fix or change the problem, but that does not stop me from worrying about it.

What do I worry about? Obviously, the same things you do!! I worry about job stability in our economy, the price of gas that seems to float higher and higher and the ongoing government problems in Washington.

I worry about my Aunt in Texas who is now living alone with four beagles and 40 pigeons in a large home (dogs and pigeons outside:))without any family close by to help.
I worry about my two daughters and one son-in-law, even though they don't live at home any longer. As a parent, you really never stop worrying.

I worry about my hubby who has been a police officer for almost 24 years and what could possibly happen to him while at work.

I worry about bad hair days, am I wearing the right accessories with my outfit, did I get something out of the freezer for dinner and did I remember to put my dog Buddy outside when I left for work. (Bad things have happened when I have forgotten this.)

Did I mention I am a worrier?

So....why do we worry? I was reading an article about worrying and thought it had some really good points in it that I want to share with you.

Dr. William Sanderson PhD and Director of the Cognitive Therapy Center of Long Island stated this:

What is Worry?
"Worry is something that nearly everyone is familiar with. Worry can best be defined as a chain of negative thoughts that have to do with fears about the future. Typically, when you worry there is a concern that something you desire might not happen -- for example, you may get turned down for a raise -- or that something terrible might occur -- for example, you might lose your job. A typical worry pattern might be something like: "That important job at work, what if I can't meet the deadline? I might not get the promotion I want. I might get fired! How can we afford to live if I get fired? How will I make the payments on the car? That car already needs transmission work. I've got to call the mechanic about that. What if there are other things wrong with the car? I will have to spend more money when I should be saving for my children's education......"

Why do people worry?
"Worry can be useful. Worrying can be a method to resolve problems and anticipate and prepare for future events. For example, worrying about a test will cause you to study, because by studying, you will reduce the negative feeling accompanying the worry. However, rather than solving problems, chronic worriers often simply generate more and more worries."

How do you know when worry gets out of hand?
"Excessive worry can become a significant problem. Since worry is often accomplished by a mixture of negative emotions, for example tension, fear, apprehension; and physical sensations such as muscle tension, heart palpitations, upset stomach -- worrying can have a substantial impact on how you feel both emotionally and physically. Excessive worry can lead to impaired functioning -- for example, excessive worry can distract someone from their work, or decrease enjoyment of good things that are happening. Approximately 15% of the population spend eight hours a day worrying. Among people presenting for psychological treatment, many of them report feeling worried nearly all of the time."

What can be done to decrease worry?

"Distracting yourself from your worries will not solve what causes the worries. To overcome worry you must confront it. I recommend strategies that we use in cognitive therapy . In my opinion the best way to deal with your worries is to focus on them and learn to analyze the accuracy of your thinking. Often, the thoughts associated with worry are unrealistic or extreme. You end up worrying about things unnecessarily. If you can train yourself to be more realistic you may find that many of your worries are not as bad as your originally thought. Here are three simple steps from a cognitive therapy technique called Logical Analysis that one can take to reduce their worry:

1) Since we are often unaware of what we are thinking, the first step is to write down the thoughts that go through your mind when you are worrying. Be as specific as possible. For example: If I miss the deadline at work I will lose my job.

2) The next step is to examine how realistic your thought is. Be like a trial lawyer examining your thoughts, looking for ways to find distorted, inaccurate thoughts. Do you have evidence to support or refute your thought? Is your thinking based on logic? Are you paying attention to all the details of a situation or just the negative ones? For example: Have you missed deadlines before? Have others? What happens?

3)Now come up with a new thought -- a rational response -- that is more realistic than the original thought. For example: missing the deadline at work is not something I want to happen, but it is very unlikely that I will lose my job because of this one event, even if your boss is angry.

Another strategy that can be effective is Decatastrophizing. Worriers are catastrophizers. They can turn almost any situation into a potential catastrophe -- one minor worry can snowball into several other major worries. For example, a worrier will think that she will be alone forever if her boyfriend ended their relationship. Instead of repeatedly worrying "What if ...," by Decatastrophizing

Finally, some people find the following process useful to reduce worry, something that we call Stimulus Control. This technique comes from the learning-theory branch of psychology. We know that when people do something in one situation, they are likely to do it again the next time they are in that situation. Because one can worry nearly any time and any place, it becomes associated with many situations. So to reduce its frequency, a person attempts to limit where and when worry occurs. For example,
1) Set a 30 minute worry period, to take place the same time and in the same place each day.
2) Learn to identify when you start worrying. Postpone your worrying, as soon as you do catch yourself, until your worry period. If you are worried you will forget write it down and make a list for your worry period.
3) To stop worrying during non worry times, replace worrisome thoughts by distracting yourself with something else, like listening to music. The goal is to focus on something else.
4) When your worry time comes, close your eyes and force yourself to think in detail about all the things you worry about. Try to fill up the entire 30 minutes. The goal is that you don't worry all the time -- just in one spot at one time. This can reduce your worries a lot."

Well...I hope this has helped you....I know you are a worrier too;) Feel free to leave your comments on the things you worry about and, as always....if there is anything I can do to help you or a loved one, let me know.

UCARE Week 1 Review: Community Support and Managing Personal Assistants

2011-09-23T05:28:00.000-07:00

In the early 1900's members of society lived an average of 47 years. I am 46 and pretty happy that I live in this century! As time has passed we have been blessed with research, inventions, medicines and comforts that have extended the average mortality rate to almost 80 years old in 2010. What an improvement!

With people living longer we see that the need for caregiving is much greater and sometimes can be very overwhelming. In an effort to help caregivers understand the resources that are available to them I have come up with a Bullseye of Care.

The very center of the bullseye, in this case, the yellow, represents the loved one you are caring for. The red ring is family and friends who help support and care for the loved one. This could be children, grandchildren, extended family and close friends. Part of there support may be stopping by to check in on their loved one. Maybe bringing a meal or picking up needed items at the store.

When the care of the loved one becomes slightly greater, reaching out to the next level, purple, would include church organizations, community resources such as senior programs and services. These not only provide stimulating activities but excellent socialization. Many community programs have a bus that can pick up and drop off your loved one at their home.

As needs increase and the loved one requires more help, we move to the next level of the bullseye, the white circle. This level would include hiring a personal assistant that can help your loved one with activities of daily living such as grooming or light housekeeping. Hiring a personal assistant is not covered by Medicare or Mediaid but can provide some well needed relief for loved ones who may be experiencing caregiver burnout. In this level is also Home Health or Hospice services, if the loved one qualifies. These services are generally paid for through Medicare or other insurance providers. Many caregivers don't realize that if your loved one has a fall, that would qualify them for a home health evaluation. If they would benefit from Home Health services they could have a Physical Therapist come in and do exercises with them, right in their own home, to help them restrengthen and regain a former level of functioning allowing them to stay in their home longer.

Hospice services are for those who have a terminal illness and their doctor has decided that, given the disease and the natural progression, the loved on has possible 6 months to live. This is a perfect time to call in a Hospice agency to start supporting the loved one and their family through nursing, medications, social and spiritual services. Many clients surpass the six month mark because of the added one-on-one care they receive through Hospice.

The last circle in the bullseye represents assisted living or skilled nursing care. This may be needed when the needs of the resident are so great that they cannot be cared for in their own home any longer. In an assisted living facility, residents can still take advantage of Home Health services and in both assisted and skilled nursing facilities, Hospice can provide services.

I hope this information helps you as you care for a loved one. If there is anything I can do to help please call:)

UCARE Week 1 Class Tonight @ Parkway Health Center 7 PM

2011-09-22T14:24:00.000-07:00

Rosalyn Carter said it best: “There are only four kinds of people in the world – those who have been caregivers, those who are currently caregivers, those who will be caregivers and those who will need caregivers.”

Although caregiving can be very rewarding, it can also be stressful. There may be times when you feel squeezed by the demands of providing care, balancing family obligations, working, and taking care of yourself. At times you may not know where to go for answers, emotional support and practical advice, or how to get a break from your caregiving responsibilities. Caregiver classes and support groups can help provide the answers and support you are seeking.

Week one starts tonight at Parkway Health Center 7-8:30 PM.

CLASSES:
"UCARE" Classes
If a loved one leans on you, lean on the UCARE Caregiver Guide Classes which provide hands-on training on a variety of topics to help you. All classes provide contact information for local services, websites, and publications that will help caregivers.
TOPICS
Week 1: Community Support for Remaining at Home; Managing Personal Assistants
Week 2: General Caregiving Skills; Healthy Eating
Week 3: Home Safety; The Accessible Home
Week 4: Positioning and Helping Your Loved One Move; Assisting with Personal Care
Week 5: Assistive Technology
Week 6: Alzheimer's & Dementia; Mental Illness
Week 7: Legal & Financial Issues
Week 8: Caring for the Caregiver
Week 9: Review
Participants this Fall have said the following about the UCARE classes:
“Thank you for having prepared yourselves to lift and teach us and so many others. It is a new world - this care-taking business, for so many of us. Who would have known that life just doesn't come to a rainbow end for our loved ones, but rather, we have to travel a very different road than we ever have before in order to help them finish with grace and dignity and proper care.”
“Our class instructor was great – always appreciated that she was ready to go with her lesson material and I was happy for the class discussions. The discussions helped me feel like I am not alone. I feel more empowered to be a caregiver. I loved the guest speakers they brought answers and comfort and expertise. Thank you for a great experience and for a break from the stress at home and for help with knowing how to better deal with the changes that my [loved one] is facing.”
For questions, please call Adam Frary (801)229-3818 Send Email
Online registration for Fall 2011 classes is now open. Classes will begin the week of September 19th.
Register Now

First CARE Meeting at New Lehi Beehive TODAY 1 PM!!!

2011-09-22T07:27:00.000-07:00

Caregiver Burnout: Do I Have It?

2011-09-21T07:27:00.000-07:00

The following article is from www.caregiver.com.

Caregiver Burnout

By Dr. M. Ross Seligson

It is important for all of us to make the effort to recognize the signs of burnout, In order to do this we must be honest and willing to hear feedback from those around us. This is especially important for those caring for family or friends. Too often Caregivers who are not closely associated with the healthcare profession get overlooked and lost in the commotion of medical emergencies and procedures. Otherwise close friends begin to grow distant, and eventually the Caregiver is alone without a support structure. We must allow those who do care for us, who are interested enough to say something, to tell us about our behavior, a noticed decrease in energy or mood changes.

Burnout isn't like a cold. You don't always notice it when you are in its clutches. Very much like Post Traumatic Stress Syndrome, the symptoms of burnout can begin surfacing months after a traumatic episode. The following are symptoms we might notice in ourselves, or others might say they see in us. Think about what is being said, and consider the possibility of burnout.

Feelings of depression.
A sense of ongoing and constant fatigue.
Decreasing interest in work.
Decrease in work production.
Withdrawal from social contacts.
Increase in use of stimulants and alcohol.
Increasing fear of death.
Change in eating patterns.
Feelings of helplessness.

Strategies to ward off or cope with burnout are important. To counteract burnout, the following specific strategies are recommended

Participate in a support network.
Consult with professionals to explore burnout issues.
Attend a support group to receive feedback and coping strategies.
Vary the focus of caregiving responsibilities if possible (rotate responsibilities with family members).
Exercise daily and maintain a healthy diet.
Establish "quiet time" for meditation.
Get a weekly massage
Stay involved in hobbies.

Activities for Those with Alzheimer's or Dementia

2011-09-19T07:14:00.000-07:00

Over the past week I have been able to make suggestion to several caregivers who are caring for a loved one with Alzheimer's or Dementia. One of their biggest struggles is "I can't get anything done! Mom follows me everywhere!" I have experienced this while being a caregiver as well hear about it in almost every CARE meeting. What I realized from these situations is that it is human nature to be needed. In fact, as soon as that feeling of being needed is gone, one can feel as if there is no reason to continue living. We all need to be needed.

How do you help your loved one feel needed, especially when their activities of daily living are limited? Have activities, that are appropriate for their activity level, set aside to do. I like to ask the caregiver what their loved one was interested in. Did they crochet or do handiwork? Did they work with wood or tools? Can they still read? After finding their interests, I suggest very simple tasks that you ask them to "help" you with. It is very important to phrase it in this way..."Mom, I need some help with __________. Could you help me?" You have now given them a sense of being needed as well as something to keep their mind and hands busy.

Here are some ideas for activities to keep your loved one engaged. Keep in mind their level of cognition when choosing an activity. You don't want them to be frustrated because they can't remember how to accomplish the task. Also, if your loved one doesn't seem to connect to the activity, don't force it...have plan B available.

*Have a basketful of many pairs of socks and have them match socks up.

*Rolling skeins of yarn into balls of yarn.

*Putting puzzles together.

*Sorting pictures or papers.

*Sorting any small objects such as buttons or loose change.

*Clipping pictures out of magazines (maybe all pictures of children or animals).

*Polish silver.

*Write letters or cards to family members.

*Put together nuts and bolts.

*Shredding papers (by hand)

Of course, only utilize activities that are appropriate for your loved one. If they have a habit of putting things in their mouth, don't have them sort buttons or change!

One resident of a facility I visit often, was and engineer and was always busy with his hands. I have been so impressed when I stop in to say hello that family and staff have realized how much a part of his life this is and they supply him with an engineering magazine and a large bolt with a nut that he is constantly manipulating with his fingers. He doesn't actually read the magazine but I am sure it is a comfort for him to have it in his reach.

On the last suggestion of shredding paper, I had a caregiver tell me that he had his dad shred all paper, by hand, into a trash can while he watched old movies. He had told him he was concerned about identity theft and needed the papers shredded quite small. This was a daily activity that kept dad very busy.

I would love to hear your ideas on activities that could be utilized so I can share them with others! Leave a comment or send me an email!

CARE Meeting @ Bel Aire in American Fork 3PM

2011-09-15T06:00:00.000-07:00

CARE stands for Caregivers Allowed to Rejuvenate and Energize and that is exactly what we want to help you do!
Meet with us at Bel Aire Senior Living in American Fork at 3PM.
Call Gena at 801-623-9595 for questions or more info.

CARE Meeting tonight @ Payson Senior Center

2011-09-14T07:00:00.000-07:00

Come join us for Caregivers Allowed to Rejuvenate and Energize!! Meeting starts promptly at 6 with a light dinner and presentation from Stephanie Barrick with Golden Living Assisted Living. We will then take time to visit as a group about challenges and solutions for today's caregiver.
Let me know if you have any questions....801-623-9595.
Make sure you call Tammy at the senior center to let her know you are coming at 801-465-5215.
Hope to see you there!

Assisted Living: Philosophy of Consumer Choice

2011-09-13T07:00:00.000-07:00

I wanted to share this information with you that I found on the American Health Care Association National Center for Assisted Living website. It has some great articles for those who are trying to find out more about Assisted Living for themselves or a loved one.I have put a link to their site at the end of this post for your convenience.

Choosing an assisted living facility can be a heart-wrenching experience if you don't have a clear concept of what is offered and what it can do to help retain the dignity and emotional well being of the resident. Being able to have your own furniture, decorations, and maybe even your pet can make a world of difference to the physical and mental well being for someone who needs some assistance throughout the day. Assisted Living is a perfect choice for those who need a small amount of assistance with their activities of daily living.

Philosophy Of Consumer Choice

The philosophy of assisted living is to emphasize the right of the individual to choose the setting in which he/she would like to have care and services provided. In choosing an assisted living residence, you should expect to:

Be treated with dignity and respect;
Be informed of services available and the limitations of those services;
Manage your personal funds;
Retain and use your personal possessions;
Interact freely with others both inside the residence and in the community;
Have freedom of religion;
Control your health-related services;
Maintain your privacy;
Be free to exercise your rights and responsibilities as a resident; and,
Have the right to voice or file grievances.

Most residences post a listing of residents’ rights in a visible place and/or provide new residents with a copy.
In addition to observing the personal rights of those that live there, assisted living residences usually have guidelines for visitors. Most residences also establish house rules pertaining to, for instance, pets, the use of personal furnishings, weapons, tobacco and alcohol.

Remember to check out the local Assisted Living facilities in our area and tell them Freedom sent you!!

http://www.ahcancal.org