Public Health & Reform will be one of the biggest medical programs we will ever experience and the direct affects will touch all of us. What this will mean to the public is important for us to be made aware of.
Interview: Public Health and ReformTuesday, 29 December 2009 15:17
In the early morning on Christmas Eve, the U.S. Senate convened to hold a vote on a landmark measure of health reform—H.R. 3590, or The Patient Protection and Affordable Care Act.
Following a strict party-line vote of 60-39 the bill passed as the most comprehensive public health reform effort since the creation of Medicare in 1965.
Now slated for debate following the new year, the bill, or some form of it, will likely pass in January. This week, Case In Point Weekly sat down with Dr. Georges C. Benjamin, executive director of the American Public Health Association, to explore the potential ramifications of the bill, what it means for public health, and where the APHA stands on some of its key measures.
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Richard Scott: Recently the APHA urged Congress to move forward with health reform. Why the urgent call now?
Georges Benjamin: Each over year 44,0000 people die prematurely because they do not have health insurance, over one half of all individual bankruptcies are due to health care costs, and about 100,000 people die unnecessarily because of medical errors. We pay twice as much as other industrialized nations and get poorer results for our population as a whole. The irony is, for many in the system we give the best care in the world but for others it is fractured and most inefficient. We also have a system that is unevenly balanced toward sick care and not prevention. Congress must act now to stop this national tragedy.
RS: Is the Senate bill fit for passage? If so, why [was] it being held up?
GB: The Senate Bill is overall a good bill. However there are some provisions we do not like at all, like the increased restrictions on women’s rights to choose and others that can be strengthened like the affordability provisions and the absence of a real mechanism to force competition with the insurance industry (a public plan). It was being held up because of profound ideological differences between and within the parties, the opportunity for political deal making by some, and the complexity of the legislative process in the Senate (requirement to get a super majority, i.e. 60 votes).
RS: Does passing a grand-scale bill outweigh the quibbling of minor clauses/provisions?
GB: This legislation is important. Because health care is so complex, even minor clauses/provisions can have profound effects. While it is best to get it as right in the first place as possible, the old adage of “not having the perfect be the enemy of the good” is an excellent guide. People are dying while we are quibbling and we should remember that as well. The “sausage making” is a normal but often painful part of our democratic process. In the end we will get something that is enduring, imperfect but a platform we can build upon to perfect.
RS: What are the strongest portions of the bill for controlling costs? For providing public health resources and services?
GB: There are several important provisions that control costs. First getting 30 million people in the system of coverage will reduce costs by getting people care earlier, cheaper and reduce the cost shift to others. It has been estimated that $1,000 is added to everyone’s insurance premium because of the cost shift from the uninsured.
A similar type of cost shift occurs to businesses that cover their workers from businesses that do not. The effort to pay for quality and not volume, the research that will occur to identify things that do not work will incentivize providers to do more of what works and less of what does not (will improve quality and safety); payment bundling, move to accountable care organizations, and efforts to move to electronic medical records will save billions and is understated in the savings estimates.
We believe that the public health and prevention components of the bill will enhance value and in some cases save money. Recent studies in Massachusetts concerning the public health tobacco provisions of their universal health care legislation has shown significant savings because they invested in public health and medical efforts to address tobacco, the nation’s leading preventable cause of death. A recent study by the nonpartisan Trust for America’s Health showed that an investment in targeted community-based interventions would save billions in federal health insurance programs.
There are several important provisions that support the population health system. They include:
•Workforce provisions to enhance the primary care and public health workers through loan repayments and scholarships. [Ed note: Read about the importance of workforce policy here.]
•Increasing support for community health centers.
•Requiring better data collection to allow the improvement in efforts to eliminate health disparities.
•Enhancing school based health care services.•Supporting research for public health and prevention programs.
•The inclusion of a public health investment fund for community grants and public health infrastructure
The strong support for workplace wellness programs.RS: What issues, if any, would the APHA like to address with the bill?
GB: The legislation leaves out components we think will further reduce costs like the public option or the Medicare buy in and allowing the safe importation of prescription drugs. It should not reduce women’s reproductive rights, nor put in place additional burdens to the process. There are areas where affordability can be strengthened as well.
RS: Where does the bill stand now?
GB: The Senate bill will go to conference in early January.
RS: How much of the passed bill will be open for alterations?
GB: The final legislation will get made in conference. We hope it will include the best ideas from both houses; note that a lot of the concepts are the same in both the House and Senate bills. The overall structure will remain the same. That being:
•For people under age 65 it will:◦Use Medicaid to cover the lowest income Americans (Somewhere between 133% - 150% FPL)◦Give federal support to subsidize workers up to around 400% FPL ($88,000 for a family of four)
•For everyone it will:◦Make major insurance reforms for all of us to prevent common insurances practices that undermine access to care and coverage. Numerous insurance reforms such as: Prohibiting retroactive rescissions; extending COBRA; prohibiting denials based on preexisting conditions; eliminating annual or lifetime limits.◦Make insurance more affordable
•For Medicare eligible & those over age 65) It will:◦Strengthen Medicare by improving efficiency and quality.◦Make prescription drugs more affordable.The final debate will focus in five main areas: abortion language, the public plan, immigrant coverage, ensuring affordability, and balancing the identified revenue streams to pay for it.
RS: In the APHA’s view, what most directly targets and creates affordable care within the bill?
GB: Bringing down the costs for everyone is an important goal. The bill accomplishes this by covering 30 million more people and reducing the cost shift to everyone. This will reduce the growth in premium costs for all. Insurance subsidies for individuals/families and small businesses that will reduce individual costs is a major affordability provision; the individual mandate will stop the cost shift from those that should be covered to those that are as well. First dollar coverage of prevention services is an important tool to shift the system toward prevention.
Tuesday, December 29, 2009
Monday, December 28, 2009
Healthy Joints Keep Seniors Active in Palm Springs, Caifornia
An active life for seniors begins with healthy joints
(ARA) - The new year often means resolutions like being healthier or exercising more often. What many people don't know is that our joints are the critical part of the body that allows us to be active and do the activities we most enjoy.
Approximately one-third of Americans 35 and older say their joints prevent them from doing their favorite sport or activity in the last year and more than 50 percent of them just accepted that as part of the aging process, according to a recent study. The good news is there are simple and effective steps you can take to strengthen and protect these "forgotten soldiers" - ensuring your joints a healthy kick-off to an active year.
Dr. Kevin R. Stone, an orthopedic surgeon at the Stone Clinic and founder of the Stone Research Foundation and Joint Juice, a San Francisco-based joint health beverage company, offers five tips for helping to maintain healthy joints:
1. Manage your weight - You won't just look better - you'll feel better. Every extra pound puts four times the stress on your knees and other weight-bearing joints. Even a small amount of weight loss will give your joints relief.
2. Be supplement savvy - Dietary supplements like glucosamine have been proven to help maintain joint function and mobility. Glucosamine is produced naturally in the body, but due to the physical demands of everyday life (let alone running, tennis or even walking), our body's supply is often not enough. Joint Juice beverages provide an easy way to drink your daily supply of glucosamine and avoid having to swallow two big horse pills a day.
3. Stretch - Stretching isn't just for workouts. Take breaks throughout the day, especially at the office, to get re-energized. Range-of-motion exercises are a good way to keep muscles and ligaments flexible and strong.
4. Use good technique - When sitting, standing and especially when lifting, using the proper technique will prevent fatigue and injury. Ask an expert if you don't know how to do it, but be sure to assess your technique for these simple daily activities.
5. Make a date with your doctor - See a physician for a routine check-up at least once a year. Request an examination of your joints - from head to toe - and ask for tips on protecting your joints from daily stress.
Courtesy of ARAcontent
Visit us at www.palmspringsca.comforcare.com or www.ltcep.com/blaskie2 for help with an aging senior in the area.
(ARA) - The new year often means resolutions like being healthier or exercising more often. What many people don't know is that our joints are the critical part of the body that allows us to be active and do the activities we most enjoy.
Approximately one-third of Americans 35 and older say their joints prevent them from doing their favorite sport or activity in the last year and more than 50 percent of them just accepted that as part of the aging process, according to a recent study. The good news is there are simple and effective steps you can take to strengthen and protect these "forgotten soldiers" - ensuring your joints a healthy kick-off to an active year.
Dr. Kevin R. Stone, an orthopedic surgeon at the Stone Clinic and founder of the Stone Research Foundation and Joint Juice, a San Francisco-based joint health beverage company, offers five tips for helping to maintain healthy joints:
1. Manage your weight - You won't just look better - you'll feel better. Every extra pound puts four times the stress on your knees and other weight-bearing joints. Even a small amount of weight loss will give your joints relief.
2. Be supplement savvy - Dietary supplements like glucosamine have been proven to help maintain joint function and mobility. Glucosamine is produced naturally in the body, but due to the physical demands of everyday life (let alone running, tennis or even walking), our body's supply is often not enough. Joint Juice beverages provide an easy way to drink your daily supply of glucosamine and avoid having to swallow two big horse pills a day.
3. Stretch - Stretching isn't just for workouts. Take breaks throughout the day, especially at the office, to get re-energized. Range-of-motion exercises are a good way to keep muscles and ligaments flexible and strong.
4. Use good technique - When sitting, standing and especially when lifting, using the proper technique will prevent fatigue and injury. Ask an expert if you don't know how to do it, but be sure to assess your technique for these simple daily activities.
5. Make a date with your doctor - See a physician for a routine check-up at least once a year. Request an examination of your joints - from head to toe - and ask for tips on protecting your joints from daily stress.
Courtesy of ARAcontent
Visit us at www.palmspringsca.comforcare.com or www.ltcep.com/blaskie2 for help with an aging senior in the area.
Sunday, December 27, 2009
Susceptible to Seasonal affective disorder (SAD)? In Rancho Mirage, CA
The holiday season is a time that can provide much joy and togetherness — but it can also be a period of great loneliness and even depression for certain people.
Seasonal affective disorder (SAD) is a cyclical form of depression that can affect people at specific times during the year, mostly in the fall and winter, and its symptoms can be severe.
In your interactions with the seniors in your care, be careful not to ignore potential SAD symptoms. The individual might even brush off his or her own symptoms, attributing them to temporary “winter blues” or a “seasonal funk.” But such temporary down moods can be persistent and quickly resist improvement. Turning your back to such signs can lead to more serious problems, including thoughts of suicide.
Be sure to watch for the following symptoms of SAD:
•anxiety and irritability
•sadness
•lack of energy and increased fatigue
•social withdrawal and feelings of isolation
•hopelessness, discouragement and feelings of worthlessness
•changes in appetite/weight gain
•concentration/memory problems
•problems sleeping
•confusion
•suicidal thoughts
SAD seniors
People of all ages can experience SAD, but seniors represent a particular challenge. It can be difficult to properly diagnose older people who might be exhibiting symptoms of depression that actually result from other serious medical conditions, such as cancer, stroke or heart disease. Seniors are also susceptible to vascular depression, which occurs when blood vessels harden and constrict over time. This loss of flexibility in the vessels can disrupt normal blood flow to the brain. And certain medications can have side effects that resemble depressive symptoms.
Indeed, depressive symptoms can arise from a number of factors closely associated with growing older. A general biological slowdown can lead to decreased energy, increased health risk, fewer opportunities for social interaction and a loss of independence. Because these factors are so common, seniors or their caregivers might be inclined to believe the symptoms of depression are not serious.
However, although depression isn’t a normal component of the aging process, it is quite common among seniors. Studies have shown that about 6 million Americans age 65 and older suffer from depression — and a mere 10 percent of those receive proper treatment.
White males age 85 and older have the highest suicide rate of any age group, and the main cause is untreated depression. Many have a depressive illness that their doctors might not detect.
What causes SAD?
The cause of SAD is unclear, but it might result from several factors related to age, genetics and body chemistry. In particular, drops in levels of the natural hormones melatonin and the brain chemical serotonin might lead to SAD symptoms. Both chemicals play a role in mood, but it’s the connection of sunlight with serotonin — and the reduced level of sunlight in fall and winter — that provides perhaps the biggest clue. It’s well known that these darker seasons can disrupt the body’s biological clock or circadian rhythm.
Put simply, SAD might very well be caused by the body’s reaction to light deprivation — a lack of sunlight.
Treatment
Typically, older adults suffering from depression show improvement after receiving treatment such as antidepressants and psychotherapy. In fact, psychotherapy alone might be particularly effective in addressing mild forms of depression. But perhaps the most effective way to handle SAD is a combination of psychotherapy, medication and phototherapy (light therapy).
Caregivers should already be encouraging the seniors in their care to bring more sunlight (and Vitamin D) into their lives. During the shorter, colder days of fall and winter, it can be more of a challenge to seek the sun; even something as simple as opening the blinds or taking a walk outside can help.
In the absence of such opportunities, doctors can prescribe phototherapy (or light therapy) to treat SAD. There are two types of light therapy:
•Bright light treatment — The individual sits in front of a special fluorescent lamp (a “light box” or “sunbox”) for a specific length of time.
•Dawn or sunshine simulation — In the morning, a light box gradually brightens from dim to brilliant, like a sunrise, while the individual is still asleep.
It’s amazing what a little sun can do! Light therapy has a high success rate, typically bringing relief from SAD within days. But the individual needs to keep up with the treatment. Adding other simple, proactive measures — getting regular exercise, keeping a strict sleep schedule and eating a healthy diet — can further enhance the person’s mood.
If a depressed person does not respond to lifestyle changes such as increased light and exercise, it’s important to seek the help of a health care professional promptly. With proper attention, SAD is a very treatable condition!
Seasonal affective disorder (SAD) is a cyclical form of depression that can affect people at specific times during the year, mostly in the fall and winter, and its symptoms can be severe.
In your interactions with the seniors in your care, be careful not to ignore potential SAD symptoms. The individual might even brush off his or her own symptoms, attributing them to temporary “winter blues” or a “seasonal funk.” But such temporary down moods can be persistent and quickly resist improvement. Turning your back to such signs can lead to more serious problems, including thoughts of suicide.
Be sure to watch for the following symptoms of SAD:
•anxiety and irritability
•sadness
•lack of energy and increased fatigue
•social withdrawal and feelings of isolation
•hopelessness, discouragement and feelings of worthlessness
•changes in appetite/weight gain
•concentration/memory problems
•problems sleeping
•confusion
•suicidal thoughts
SAD seniors
People of all ages can experience SAD, but seniors represent a particular challenge. It can be difficult to properly diagnose older people who might be exhibiting symptoms of depression that actually result from other serious medical conditions, such as cancer, stroke or heart disease. Seniors are also susceptible to vascular depression, which occurs when blood vessels harden and constrict over time. This loss of flexibility in the vessels can disrupt normal blood flow to the brain. And certain medications can have side effects that resemble depressive symptoms.
Indeed, depressive symptoms can arise from a number of factors closely associated with growing older. A general biological slowdown can lead to decreased energy, increased health risk, fewer opportunities for social interaction and a loss of independence. Because these factors are so common, seniors or their caregivers might be inclined to believe the symptoms of depression are not serious.
However, although depression isn’t a normal component of the aging process, it is quite common among seniors. Studies have shown that about 6 million Americans age 65 and older suffer from depression — and a mere 10 percent of those receive proper treatment.
White males age 85 and older have the highest suicide rate of any age group, and the main cause is untreated depression. Many have a depressive illness that their doctors might not detect.
What causes SAD?
The cause of SAD is unclear, but it might result from several factors related to age, genetics and body chemistry. In particular, drops in levels of the natural hormones melatonin and the brain chemical serotonin might lead to SAD symptoms. Both chemicals play a role in mood, but it’s the connection of sunlight with serotonin — and the reduced level of sunlight in fall and winter — that provides perhaps the biggest clue. It’s well known that these darker seasons can disrupt the body’s biological clock or circadian rhythm.
Put simply, SAD might very well be caused by the body’s reaction to light deprivation — a lack of sunlight.
Treatment
Typically, older adults suffering from depression show improvement after receiving treatment such as antidepressants and psychotherapy. In fact, psychotherapy alone might be particularly effective in addressing mild forms of depression. But perhaps the most effective way to handle SAD is a combination of psychotherapy, medication and phototherapy (light therapy).
Caregivers should already be encouraging the seniors in their care to bring more sunlight (and Vitamin D) into their lives. During the shorter, colder days of fall and winter, it can be more of a challenge to seek the sun; even something as simple as opening the blinds or taking a walk outside can help.
In the absence of such opportunities, doctors can prescribe phototherapy (or light therapy) to treat SAD. There are two types of light therapy:
•Bright light treatment — The individual sits in front of a special fluorescent lamp (a “light box” or “sunbox”) for a specific length of time.
•Dawn or sunshine simulation — In the morning, a light box gradually brightens from dim to brilliant, like a sunrise, while the individual is still asleep.
It’s amazing what a little sun can do! Light therapy has a high success rate, typically bringing relief from SAD within days. But the individual needs to keep up with the treatment. Adding other simple, proactive measures — getting regular exercise, keeping a strict sleep schedule and eating a healthy diet — can further enhance the person’s mood.
If a depressed person does not respond to lifestyle changes such as increased light and exercise, it’s important to seek the help of a health care professional promptly. With proper attention, SAD is a very treatable condition!
Sunday, December 20, 2009
How to Find the Right Home Health Care Agency in Palm Springs, California
Here is a great article for anyone in need of Home Care for a loved one. Visit us at www.palmspringsca.comforcare.com if you need help for an aging loved one in the area.
How to Find the Right Home Health Care Agency
by Marlo Sollitto, Editor
Marilyn is a 72-year-old widow who recently underwent heart angioplasty surgery. She is preparing to leave the hospital soon. But recovering from open-heart surgery is a long process, and her family knows she will need continued medical assistance once she gets home. The family must find a reputable home health care agency that can provide licensed nurses as well as aides to tend to Marilyn on a daily basis.
Finding the right agency can be a daunting task, but not impossible, says Tilly Gambill, Manager of Marketing and Communications for the American Association for Homecare.
Wednesday, December 16, 2009
Who Was Supposed To Be taking Care Of Grandma In Rancho Mirage, CA
December 16th, 2009 | Author: lisa
There is a popular tune played this time of year called “Grandma Got Run Over by A Reindeer” which relates that Grandma — after drinking too much eggnog — went out into the winter cold to get her medication and was run over by a reindeer. The question is, “Who was supposed to be watching Grandma?”
Though this little tune is just for fun, it may very well raise alarms to many caregivers of the elderly. Caregivers know that even at a holiday party they cannot let down their diligent watch over their elderly loved one. As far-fetched as it may sound, with all the people and noise, an elderly family member with dementia or Alzheimer’s may be enjoying the family gathering and then suddenly become confused and walk to the door and leave.
For family caregivers the added stress of the holidays with decorating, shopping, parties and keeping up with all the family traditions is an overwhelming quest. Feelings of isolation, depression and sadness come with this added stress. There are millions of Americans who are caring for elderly frail loved ones and most of these caregivers will go through some of these emotions, especially this time of year.
There are some things you can do as a caregiver to help you and those you care for enjoy the holiday season.
First take care of yourself. Try to eat right, get plenty of sleep and exercise. This will help reduce stress and strengthen your ability to cope with caregiving responsibilities.
Prioritize your holiday traditions. Perhaps instead of cooking a large family dinner, have everyone bring his or her favorite dish. Use paper plates. Forfeit the traditional outside light decorating for a lighted wreath on the front door. Choose one or two parties or concerts to attend instead of trying to do it all.
Arrange for help. Call on other family members to help with the caregiving while you do your shopping or go out for the evening. If family is not available, ask your church group or a neighbor if they would donate a few hours.
Use community services. Many senior centers provide meals for the elderly and supervised activities, onsite, at no charge or a minimal charge. For locating senior services in your state, call your state Area Agency on Aging or check the national locator website at http://www.n4a.org/
Use adult day care services. Some assisted living facilities provide day activities and meals for seniors on a day by day basis. Other organizations called “adult day service providers” specialize exclusively in this sort of care support at a reasonable cost. These support services provide respite for caregivers from their caregiving responsibilities as well as social interaction for their elderly family members. There is a cost for adult day services, but the benefit for all is worth it.
For example:
Jean had brought her mother into her home to care for her when mom’s Alzheimer’s made it impossible for her to be alone. When the Christmas season approached, Jean realized she had to make some choices. She did not want to give up the traditions she had set with her daughters in shopping and lunches, but it wouldn’t be possible with her caregiving responsibilities. In searching for a solution, Jean visited an adult day services facility near her home. She found she could schedule the days she needed off for her mother to come in. The adult day services company also provided transportation and would pick up mom and bring her home in the evening.
Although Jean’s mother was not sure she would like to go at first, she found she enjoyed the programs, meals and conversation with new friends and the activities provided.
The time it gave Jean to have for herself was worth the extra cost for the day care.
Technology to the rescue. Here is a solution that would have kept “Grandma” from going out in the winter cold and getting run over by a reindeer. Companies that have created monitoring systems, security alarms and other safety equipment are “tweaking” them to adapt to the needs of seniors and their care givers.
Here are a few examples:
•Ankle or wrist bands that monitor location and alert the provider when a person has gone beyond the designated perimeter, such as out the front door of the house.
•Motion detectors. Set throughout the home, motion detectors allow someone outside the home to follow a senior as he or she moves through the house.
•Smart medication dispensers. Live monitoring and dispensing of pills.
•Emergency response alert. At a touch of a button on a desktop monitor, bracelet or necklace, emergency help is summoned.
Whether providing care in your home or helping senior family members in their own homes, your use of monitoring and “tech” help aids can provide extra safety for your loved ones, and peace of mind for you.
You are not alone. Join a caregiving help group. Your local senior center may have one or go on the internet to find one. Hearing about other caregivers’ problems and solutions and being able to share your own and ask questions is a great way to relieve stress and gain a new perspective. Check out websites like the National Family Caregivers Association at http://www.nfcacares.org/
Work with a Senior Care Professional. Recognize that you are doing the very best you know how. You are not a geriatric health care practitioner, geriatric care manager, home care nurse or aide, hospice provider or family mediation counselor, nor do you have the years of training and experience these professionals have, but you can definitely use their experience. In fact, using a senior care specialist will make caregiving easier for you and more beneficial for your elderly family member.
As an example:
Mark stopped by his father Dan’s home every night after work to help with any errands or things he needed around the house. He began to notice that Dan was not showering, dressing or even fixing meals some days. Another concern was his father’s growing confusion and disorientation. A trip to the family doctor only brought more concern to Mark, since the doctor claimed it was just the aging process that caused the confusion.
Wanting a second professional opinion on what was best for his father, Mark hired Shelly — a Professional Geriatric Care Manger — to do an assessment. Shelly arranged for Mark and Dan to see a geriatrician, who advised that proper meals and an increase in some vitamins, would help clear up the confusion and disorientation. Shelly arranged for a home care company to come in daily to help with personal needs and prepare meals.
Soon Dan was back to his old self and able to function on his own.
You can find a wide variety of care professionals in your area on the National Care Planning Council website at www.longtermcarelink.net.
One more thing to remember. As a family caregiver, the greatest gift you are giving this holiday season is “Love.”
There is a popular tune played this time of year called “Grandma Got Run Over by A Reindeer” which relates that Grandma — after drinking too much eggnog — went out into the winter cold to get her medication and was run over by a reindeer. The question is, “Who was supposed to be watching Grandma?”
Though this little tune is just for fun, it may very well raise alarms to many caregivers of the elderly. Caregivers know that even at a holiday party they cannot let down their diligent watch over their elderly loved one. As far-fetched as it may sound, with all the people and noise, an elderly family member with dementia or Alzheimer’s may be enjoying the family gathering and then suddenly become confused and walk to the door and leave.
For family caregivers the added stress of the holidays with decorating, shopping, parties and keeping up with all the family traditions is an overwhelming quest. Feelings of isolation, depression and sadness come with this added stress. There are millions of Americans who are caring for elderly frail loved ones and most of these caregivers will go through some of these emotions, especially this time of year.
There are some things you can do as a caregiver to help you and those you care for enjoy the holiday season.
First take care of yourself. Try to eat right, get plenty of sleep and exercise. This will help reduce stress and strengthen your ability to cope with caregiving responsibilities.
Prioritize your holiday traditions. Perhaps instead of cooking a large family dinner, have everyone bring his or her favorite dish. Use paper plates. Forfeit the traditional outside light decorating for a lighted wreath on the front door. Choose one or two parties or concerts to attend instead of trying to do it all.
Arrange for help. Call on other family members to help with the caregiving while you do your shopping or go out for the evening. If family is not available, ask your church group or a neighbor if they would donate a few hours.
Use community services. Many senior centers provide meals for the elderly and supervised activities, onsite, at no charge or a minimal charge. For locating senior services in your state, call your state Area Agency on Aging or check the national locator website at http://www.n4a.org/
Use adult day care services. Some assisted living facilities provide day activities and meals for seniors on a day by day basis. Other organizations called “adult day service providers” specialize exclusively in this sort of care support at a reasonable cost. These support services provide respite for caregivers from their caregiving responsibilities as well as social interaction for their elderly family members. There is a cost for adult day services, but the benefit for all is worth it.
For example:
Jean had brought her mother into her home to care for her when mom’s Alzheimer’s made it impossible for her to be alone. When the Christmas season approached, Jean realized she had to make some choices. She did not want to give up the traditions she had set with her daughters in shopping and lunches, but it wouldn’t be possible with her caregiving responsibilities. In searching for a solution, Jean visited an adult day services facility near her home. She found she could schedule the days she needed off for her mother to come in. The adult day services company also provided transportation and would pick up mom and bring her home in the evening.
Although Jean’s mother was not sure she would like to go at first, she found she enjoyed the programs, meals and conversation with new friends and the activities provided.
The time it gave Jean to have for herself was worth the extra cost for the day care.
Technology to the rescue. Here is a solution that would have kept “Grandma” from going out in the winter cold and getting run over by a reindeer. Companies that have created monitoring systems, security alarms and other safety equipment are “tweaking” them to adapt to the needs of seniors and their care givers.
Here are a few examples:
•Ankle or wrist bands that monitor location and alert the provider when a person has gone beyond the designated perimeter, such as out the front door of the house.
•Motion detectors. Set throughout the home, motion detectors allow someone outside the home to follow a senior as he or she moves through the house.
•Smart medication dispensers. Live monitoring and dispensing of pills.
•Emergency response alert. At a touch of a button on a desktop monitor, bracelet or necklace, emergency help is summoned.
Whether providing care in your home or helping senior family members in their own homes, your use of monitoring and “tech” help aids can provide extra safety for your loved ones, and peace of mind for you.
You are not alone. Join a caregiving help group. Your local senior center may have one or go on the internet to find one. Hearing about other caregivers’ problems and solutions and being able to share your own and ask questions is a great way to relieve stress and gain a new perspective. Check out websites like the National Family Caregivers Association at http://www.nfcacares.org/
Work with a Senior Care Professional. Recognize that you are doing the very best you know how. You are not a geriatric health care practitioner, geriatric care manager, home care nurse or aide, hospice provider or family mediation counselor, nor do you have the years of training and experience these professionals have, but you can definitely use their experience. In fact, using a senior care specialist will make caregiving easier for you and more beneficial for your elderly family member.
As an example:
Mark stopped by his father Dan’s home every night after work to help with any errands or things he needed around the house. He began to notice that Dan was not showering, dressing or even fixing meals some days. Another concern was his father’s growing confusion and disorientation. A trip to the family doctor only brought more concern to Mark, since the doctor claimed it was just the aging process that caused the confusion.
Wanting a second professional opinion on what was best for his father, Mark hired Shelly — a Professional Geriatric Care Manger — to do an assessment. Shelly arranged for Mark and Dan to see a geriatrician, who advised that proper meals and an increase in some vitamins, would help clear up the confusion and disorientation. Shelly arranged for a home care company to come in daily to help with personal needs and prepare meals.
Soon Dan was back to his old self and able to function on his own.
You can find a wide variety of care professionals in your area on the National Care Planning Council website at www.longtermcarelink.net.
One more thing to remember. As a family caregiver, the greatest gift you are giving this holiday season is “Love.”
Sunday, December 13, 2009
Caregivers and Multi-tasking During the Holidays in Palm Springs, California
Here is a great article from agingcare.com for caregivers who are struggling this holiday season. Visit us at http://palmspringsca.comforcare.com and www.ltcep.com/blaskie2 if you need help with a senior loved one in the area.
Caregivers and Multi-tasking: Holidays Can Push People Caring for Elderly Parents to the Max
Carol Bradley Bursack
If one can believe the old Westerns, frontier women multitasked by rocking a cradle with their foot to quiet a squalling baby, while pounding out bread dough with her fists, bossing a full crew young kids and maybe dodging a few bullets. Oh, yeah, since it was just days before Christmas, she would also be trying to knit a scarf for her husband during odd bits of time.
That scenario sounds like a walk in the park to some modern caregivers, especially those known as the sandwich generation because they are raising children while caring for their parents. At this time of the year, nearly every parent has one, if not several, school holiday programs to attend, plus church or other religious programs they want their children to participate in. Many have a full-time job, which often requires attendance at office functions outside of work hours, not to mention festivities during work time that pretty much require a big smile and a batch of home-made cookies. Is this your story?
Tuesday, December 8, 2009
Dementia: The Fate My Father Did Not Deserve in Palm Springs, CA Area
Here is a story that will touch your heart...there by the grace of God we may go.
Scott Mendelson, M.D.: Dementia: The Fate My Father Did Not DeserveDecember 6, 2009
My father, Harry Mendelson, was no big shot. He certainly never made much money. I recall, as a young Jewish boy growing up in goyishe Prairie Village, Kansas, occasionally hearing people talk about “the Jews”, and how they had all the money. It confused me. I remember wondering if they were talking about some different sort of Jews.
Though he never got rich, my father was a good man. He went to trade school and became a draftsman. He worked at the Colgate-Palmolive plant drawing blueprints for construction of assembly line machinery. He worked there for nearly 40 years. The job didn’t pay enough to meet the expenses of raising three boys, at least not in the fashion that my mother expected, so he took extra work when he could. Things were often worse than I knew, but we never went hungry and we never did without. That is, not without too much.
His pleasures were the simple ones. He had a wonderful sense of humor, he loved a hearty meal on the table, and he possessed the uncanny ability to sniff out the perfect fishing hole. On television, he preferred the Ernie Kovaks Show to Playhouse 90. He was the kind of guy that perfect strangers would strike up conversations with in a ticket line or at a bus stop. He was honest and dependable. When he said he would do something, you knew that he would do it.
On warm summer nights, the Kansas City A’s ball game would be on the radio as he grilled some chicken or hamburgers for our supper in the backyard. The lilting, yet emphatic radio voice of Merle Harmon would float through the twilight, mingling with the chirping of the crickets, and the hissing and popping of the meat on the hot grill. At those times he seemed most at ease. Not Madeline cakes and lime blossom tea, but rather the peppery aroma of grilled meat blended with the scent of newly mowed, summer grass evoke Proustian memories of my father and my childhood.
My father was athletic. As a young man he boxed and practiced judo. I remember him doing push-ups every morning. But all his life he suffered high blood pressure and high cholesterol. It led to heart disease, and at age 65 he underwent coronary artery bypass surgery. The surgery saved his heart, but he was never the same. It is not unusual for this surgery to loose showers of tiny fragments of arterial plaque into the blood coursing to the brain, and I suspect that some lodged in areas of his frontal cortex. It is not clear whether the surgery did the damage, or if it accelerated a more subtle pathological process already in motion. I suspect it was both. In any case, he began to change.
I recall one telling incident that occurred a few years after the surgery at a large family reunion. After our meal, cousins, uncles, and aunts stepped up to the microphone at the front of the banquet hall to say a few words. One of our cousins rose from his seat and lumbered over to the microphone. This cousin could kindly be described as “odd”. However, as a member of the family, his eccentricity, obesity and ill-fitting clothes were always given some allowance. As he stood before us and fumbled with the paper upon which he had written his speech, my father let loose a loud, prolonged, and heartfelt, “Oh, my God!” Although most of us were thinking the same thing, my father’s outburst broke the rules of social engagement and gave embarrassing testimony to the early stage of his illness.
Over the next few years my father had increasing difficulty expressing himself. His word choices sometimes made no sense. A sad, but undeniably humorous example arose when a couple my parents knew invited them to tour the Nelson Gallery of Art in Kansas City. The old gallery is built of stone, with high ceilings and long hallways. In unrestrained fashion my father passed gas loudly and forcefully in one of the exhibition rooms. The report echoed down the spacious corridors.
That lapse in social grace was another byproduct of his dementia. However, for days afterward he perseverated in reporting his troubling perception that their friends were very angry with him “because I fluctuated at the art gallery.” Even when challenged about his choice of the word, “fluctuate”, he simply looked puzzled then continued on using the word to express his annoyance with himself and his friends.
As is often the case in dementia, some of his living skills seemed to remain intact, but only deceptively so. Like many with the illness, he continued to drive his car far longer than he should have. That ended the afternoon he took a right turn into what he thought was a driveway, but was actually a wide walking path in a neighborhood park. He drove its entire length, looking for the parking lot he had expected to find at its end. The strollers were irate and the police were not sympathetic.
My mother kept and cared for him as long as she could at home, but episodes of confusion, incontinence, and falls finally forced her to place him in a care facility. There, his social disinhibitions and indelicacies gradually faded into long silences and social withdrawal. Finally, he drifted into apathy and a complete inability to speak at all. Not too many months after he lost his speech, he suffered the loss of his ability to swallow. That unfortunate man, who so dearly loved to eat, was thus deprived of his last pleasure. Eventually a tube was inserted through his abdomen and into his stomach to provide him with nourishment.
The last time I saw my father, he was propped up in a chair staring impassively, neither moving nor speaking. I remember a painful sense of disbelief at how old and diminished that once bright and physically powerful man looked. He turned his eyes toward my face and let them linger for the briefest of moments, which served as the only evidence of any recognition of who I was. Not many months later he died in his sleep.
The progression of my father’s illness was frightening to watch. The look of bewilderment that would fall across his face from time to time leads me to suspect that it was frightening for him as well. A mind in pieces does not easily harbor peace of mind. As we have aged, my brothers and I have grown justifiably more concerned about our own potential for developing dementia. Though it was certainly nothing he would have planned, in journeying down the dreadful path of dementia right before our eyes, my father shouldered yet another burden for his sons.
He revealed to us our vulnerability, and he prepared us for what might happen if we did not care for ourselves. We understand our lives and our selves differently from him having been ill. As a psychiatrist, I have been able to learn from this experience and help other individuals and their families through the heartache of being diagnosed with dementia. I have learned and written about how to avoid the illness, which, of course, is the best of all possibilities. In many respects, I owe my book, Beyond Alzheimer’s, to my father. I dedicated it to him.
It is now ten years since my father died. It saddens me that he was never able to enjoy the little bit of money he had set aside for his retirement. It saddens me most that he was never able to be a grandfather for my children. My nine year old twin girls, who never knew him, only giggle when they hear his name, which they interpret as, “Hairy Mendelson”. He would have enjoyed that. My father was a decent, hardworking family man, and he did not deserve the fate of dementia that he suffered. But, in all honesty, not the worst of us does.
Dr. Mendelson is the author of the new book, Beyond Alzheimer’s.
Scott Mendelson, M.D.: Dementia: The Fate My Father Did Not DeserveDecember 6, 2009
My father, Harry Mendelson, was no big shot. He certainly never made much money. I recall, as a young Jewish boy growing up in goyishe Prairie Village, Kansas, occasionally hearing people talk about “the Jews”, and how they had all the money. It confused me. I remember wondering if they were talking about some different sort of Jews.
Though he never got rich, my father was a good man. He went to trade school and became a draftsman. He worked at the Colgate-Palmolive plant drawing blueprints for construction of assembly line machinery. He worked there for nearly 40 years. The job didn’t pay enough to meet the expenses of raising three boys, at least not in the fashion that my mother expected, so he took extra work when he could. Things were often worse than I knew, but we never went hungry and we never did without. That is, not without too much.
His pleasures were the simple ones. He had a wonderful sense of humor, he loved a hearty meal on the table, and he possessed the uncanny ability to sniff out the perfect fishing hole. On television, he preferred the Ernie Kovaks Show to Playhouse 90. He was the kind of guy that perfect strangers would strike up conversations with in a ticket line or at a bus stop. He was honest and dependable. When he said he would do something, you knew that he would do it.
On warm summer nights, the Kansas City A’s ball game would be on the radio as he grilled some chicken or hamburgers for our supper in the backyard. The lilting, yet emphatic radio voice of Merle Harmon would float through the twilight, mingling with the chirping of the crickets, and the hissing and popping of the meat on the hot grill. At those times he seemed most at ease. Not Madeline cakes and lime blossom tea, but rather the peppery aroma of grilled meat blended with the scent of newly mowed, summer grass evoke Proustian memories of my father and my childhood.
My father was athletic. As a young man he boxed and practiced judo. I remember him doing push-ups every morning. But all his life he suffered high blood pressure and high cholesterol. It led to heart disease, and at age 65 he underwent coronary artery bypass surgery. The surgery saved his heart, but he was never the same. It is not unusual for this surgery to loose showers of tiny fragments of arterial plaque into the blood coursing to the brain, and I suspect that some lodged in areas of his frontal cortex. It is not clear whether the surgery did the damage, or if it accelerated a more subtle pathological process already in motion. I suspect it was both. In any case, he began to change.
I recall one telling incident that occurred a few years after the surgery at a large family reunion. After our meal, cousins, uncles, and aunts stepped up to the microphone at the front of the banquet hall to say a few words. One of our cousins rose from his seat and lumbered over to the microphone. This cousin could kindly be described as “odd”. However, as a member of the family, his eccentricity, obesity and ill-fitting clothes were always given some allowance. As he stood before us and fumbled with the paper upon which he had written his speech, my father let loose a loud, prolonged, and heartfelt, “Oh, my God!” Although most of us were thinking the same thing, my father’s outburst broke the rules of social engagement and gave embarrassing testimony to the early stage of his illness.
Over the next few years my father had increasing difficulty expressing himself. His word choices sometimes made no sense. A sad, but undeniably humorous example arose when a couple my parents knew invited them to tour the Nelson Gallery of Art in Kansas City. The old gallery is built of stone, with high ceilings and long hallways. In unrestrained fashion my father passed gas loudly and forcefully in one of the exhibition rooms. The report echoed down the spacious corridors.
That lapse in social grace was another byproduct of his dementia. However, for days afterward he perseverated in reporting his troubling perception that their friends were very angry with him “because I fluctuated at the art gallery.” Even when challenged about his choice of the word, “fluctuate”, he simply looked puzzled then continued on using the word to express his annoyance with himself and his friends.
As is often the case in dementia, some of his living skills seemed to remain intact, but only deceptively so. Like many with the illness, he continued to drive his car far longer than he should have. That ended the afternoon he took a right turn into what he thought was a driveway, but was actually a wide walking path in a neighborhood park. He drove its entire length, looking for the parking lot he had expected to find at its end. The strollers were irate and the police were not sympathetic.
My mother kept and cared for him as long as she could at home, but episodes of confusion, incontinence, and falls finally forced her to place him in a care facility. There, his social disinhibitions and indelicacies gradually faded into long silences and social withdrawal. Finally, he drifted into apathy and a complete inability to speak at all. Not too many months after he lost his speech, he suffered the loss of his ability to swallow. That unfortunate man, who so dearly loved to eat, was thus deprived of his last pleasure. Eventually a tube was inserted through his abdomen and into his stomach to provide him with nourishment.
The last time I saw my father, he was propped up in a chair staring impassively, neither moving nor speaking. I remember a painful sense of disbelief at how old and diminished that once bright and physically powerful man looked. He turned his eyes toward my face and let them linger for the briefest of moments, which served as the only evidence of any recognition of who I was. Not many months later he died in his sleep.
The progression of my father’s illness was frightening to watch. The look of bewilderment that would fall across his face from time to time leads me to suspect that it was frightening for him as well. A mind in pieces does not easily harbor peace of mind. As we have aged, my brothers and I have grown justifiably more concerned about our own potential for developing dementia. Though it was certainly nothing he would have planned, in journeying down the dreadful path of dementia right before our eyes, my father shouldered yet another burden for his sons.
He revealed to us our vulnerability, and he prepared us for what might happen if we did not care for ourselves. We understand our lives and our selves differently from him having been ill. As a psychiatrist, I have been able to learn from this experience and help other individuals and their families through the heartache of being diagnosed with dementia. I have learned and written about how to avoid the illness, which, of course, is the best of all possibilities. In many respects, I owe my book, Beyond Alzheimer’s, to my father. I dedicated it to him.
It is now ten years since my father died. It saddens me that he was never able to enjoy the little bit of money he had set aside for his retirement. It saddens me most that he was never able to be a grandfather for my children. My nine year old twin girls, who never knew him, only giggle when they hear his name, which they interpret as, “Hairy Mendelson”. He would have enjoyed that. My father was a decent, hardworking family man, and he did not deserve the fate of dementia that he suffered. But, in all honesty, not the worst of us does.
Dr. Mendelson is the author of the new book, Beyond Alzheimer’s.
Sunday, December 6, 2009
Visiting With Aging Loved Ones During the Holidays in Palm Springs, California
The holiday season is an ideal opportunity to check up on your aging parents. Here is a great article from agingcare.com. For help with a loved one, visit us at palmspringsca.comforcare.com and www.ltcep.com/blaskie.
Holiday Visits: A Time When Adult Children May Notice a Decline with Their Aging Parents
As the holidays approach, many long distance caregivers are now planning visits to their aging loved ones – perhaps the first opportunity in several months to personally observe older relatives.
And the number of caregivers considered long distance is significant. According to a study conducted by the National Alliance of Caregiving, in collaboration with AARP, 15% of the estimated 34 million Americans who provide care to older family members live an hour or more away from their relative.
Friday, December 4, 2009
If I Failed I’m Sorry… In Palm Springs, CA
December 4th, 2009 Author: lisa
By Traci Wennerholm on December 2, 2009 11:17 AM
Planning menu’s for someone with diabetes is not easy and this article brings home some of the frustrations. This should help us that struggle with these issues.
If I Failed You, I’m Sorry…
When we got married nine years ago, carb counting was still relatively new and difficult for my husband. He had only been doing it for a couple of years prior to my marrying him. And he really struggled with it at times.
He only asked me one thing when he got married. That if I made a meal for him, to please try to count the carbs for him.
Carb counting easy? Buzzer please.
It’s a lot harder than I thought. I attended classes from a diabetes dietitian with other people newly diagnosed with diabetes and their spouses. Never being good at math made carb counting so hard for me! And it wasn’t made any easier by the fact that the dietitian only used easy carb counts like a piece of bread or a cup of rice. How do you account for sauces, casseroles, subbing lower fat ingredients and the works? Her explanations only confused me more. I often reminded her that most people combined things like rice with a meal or casserole and nothing was in easy proportions.
I went home and tried my best to carb count. But it often left me frustrated when my husband got sick several hours later after a meal, or extremely low from giving himself too much insulin. And that led to a lot of guilt on my part. Guilt that I was responsible for him going low. Soon frustration led to throwing my hands up in the air and letting my husband fend for himself on the dinnertime carb count.
But the most frustrating part to me was that I just gave up. And I don’t do that! I let him fend for himself for nine years until our kids reached an age that I could start to help him out again.
I’ve been impressed by the tools that are now available to make carb counting easier on both of us. Recipezaar is a favorite of mine. I’ve been able to type in my recipes including modifications I make by substituting lower carb or lower fat ingredients in my recipes. The carb count is pretty accurate, but I have to determine how many servings, and that is often the difficult part for me, especially on recipes handed down to me by his mom that don’t state how many servings a particular meal may have.
Life has gotten crazier, and I’ve found myself heading to Dream Dinners on occasion to ensure that we eat healthier meals on months I may be tempted to stray. I love that they have the carbs, calories, and all the nutrition information for me on each meal. I take a Sharpie marker and write the number of carbs the meal has right on that meals baking dish. Now I just tell him how many carbs a meal has before we sit down to eat.
But it’s funny that I’ve noticed a pattern. Since I’ve done a better job of helping him with his dinner time carb counts, I’ve noticed less low blood sugars in the middle of the night. I didn’t know how much of an impact miscounting a dinner time meal could have on his blood sugars for the rest of the evening. As a spouse, I realized I do have an impact on helping him. As he often reminds me, there is no ”I” in team. While he manages most of the day to day of his diabetes, I play a role in it too. Not always a significant one, but one nonetheless.
**Do you have carb counting tools that you use for your favorite recipes? If so, which ones? I’m always looking for good ones!**
By Traci Wennerholm on December 2, 2009 11:17 AM
Planning menu’s for someone with diabetes is not easy and this article brings home some of the frustrations. This should help us that struggle with these issues.
If I Failed You, I’m Sorry…
When we got married nine years ago, carb counting was still relatively new and difficult for my husband. He had only been doing it for a couple of years prior to my marrying him. And he really struggled with it at times.
He only asked me one thing when he got married. That if I made a meal for him, to please try to count the carbs for him.
Carb counting easy? Buzzer please.
It’s a lot harder than I thought. I attended classes from a diabetes dietitian with other people newly diagnosed with diabetes and their spouses. Never being good at math made carb counting so hard for me! And it wasn’t made any easier by the fact that the dietitian only used easy carb counts like a piece of bread or a cup of rice. How do you account for sauces, casseroles, subbing lower fat ingredients and the works? Her explanations only confused me more. I often reminded her that most people combined things like rice with a meal or casserole and nothing was in easy proportions.
I went home and tried my best to carb count. But it often left me frustrated when my husband got sick several hours later after a meal, or extremely low from giving himself too much insulin. And that led to a lot of guilt on my part. Guilt that I was responsible for him going low. Soon frustration led to throwing my hands up in the air and letting my husband fend for himself on the dinnertime carb count.
But the most frustrating part to me was that I just gave up. And I don’t do that! I let him fend for himself for nine years until our kids reached an age that I could start to help him out again.
I’ve been impressed by the tools that are now available to make carb counting easier on both of us. Recipezaar is a favorite of mine. I’ve been able to type in my recipes including modifications I make by substituting lower carb or lower fat ingredients in my recipes. The carb count is pretty accurate, but I have to determine how many servings, and that is often the difficult part for me, especially on recipes handed down to me by his mom that don’t state how many servings a particular meal may have.
Life has gotten crazier, and I’ve found myself heading to Dream Dinners on occasion to ensure that we eat healthier meals on months I may be tempted to stray. I love that they have the carbs, calories, and all the nutrition information for me on each meal. I take a Sharpie marker and write the number of carbs the meal has right on that meals baking dish. Now I just tell him how many carbs a meal has before we sit down to eat.
But it’s funny that I’ve noticed a pattern. Since I’ve done a better job of helping him with his dinner time carb counts, I’ve noticed less low blood sugars in the middle of the night. I didn’t know how much of an impact miscounting a dinner time meal could have on his blood sugars for the rest of the evening. As a spouse, I realized I do have an impact on helping him. As he often reminds me, there is no ”I” in team. While he manages most of the day to day of his diabetes, I play a role in it too. Not always a significant one, but one nonetheless.
**Do you have carb counting tools that you use for your favorite recipes? If so, which ones? I’m always looking for good ones!**
Tuesday, December 1, 2009
What It's Like To Have Dementia In Palm Springs, California
It can be very helpful to try to understand what it is like for our loved ones who suffer from dementia. If you have any questions, or need help for an aging senior in the area, visit us at www.palmspringsca.comforcare.com and www.ltcep.com/blaskie
What It's Like to Have Dementia
Understanding dementia symptoms from the inside can make you a better caregiver – and bring you closer to your loved one.
You know how frustrating and heartbreaking dementia symptoms are from the point of view of a caregiver. You know the pain of slowly seeing a loved one slip away. But what is it like for her? What is it like for a person to slowly -- or sometimes quickly -- forget almost everything she ever knew?
Continue reading article HERE.
What It's Like to Have Dementia
Understanding dementia symptoms from the inside can make you a better caregiver – and bring you closer to your loved one.
You know how frustrating and heartbreaking dementia symptoms are from the point of view of a caregiver. You know the pain of slowly seeing a loved one slip away. But what is it like for her? What is it like for a person to slowly -- or sometimes quickly -- forget almost everything she ever knew?
Continue reading article HERE.
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