Your Choice for Home Health Care, Therapy, and Hospice

Stay Positive

My mother was diagnosed with Alzheimer’s dementia when she was in her late 60’s. I am like many adult children who have a parent who was diagnosed with dementia – I wonder at some point if this will be me. At 58 I find myself being very conscious about remembering people’s names and paying close attention to everything said during a conversation. When I can’t remember, I think “oh boy, here it comes.”

I read an article in “Science Daily” titled: Think Memory Worsens with Age? Then Yours Probably Will. A team of researchers from North Carolina University did a research project with older adults. The study showed older adults who think they will perform poorly on memory tests actually scored much worse than seniors who don’t buy into the stereotype about aging and memory loss. What this means is an older adult’s ability to remember suffers when negative stereotypes are “activated” in certain situations.

When older adults were preparing to take a test for their memory they actually performed poorly when they were told in advance ‘they shouldn’t be surprised if the outcome would not be good.’ Memory suffers if older adults feel they are being looked down on because of their age. Unfortunately, this situation might be a part of an older adult’s everyday experience. Being concerned about what others think can have a negative effect not only on test performance but how we live our lives.

The positive side is older adults who felt good about aging and didn’t buy into the stigma of aging performed well on the test. In other words, if you are confident aging will not ruin your memory, you are more likely not only to perform well on a memory-related test, but to live in the same manner.

While there is no guarantee I will not inherit the disease my mother suffered, I can live my life in a positive manner by not letting the stigma of aging interfere with how I live my life. These wellness steps certainly cannot hurt – in fact; they may help quite a bit.

Kathleen Weston
Director of Hospice

STARTING THE CONVERSATION

Have you seen the bumper sticker that reads: “Be nice to your children, they’ll pick your nursing home?” Although this saying might seem funny to our young grandchildren or other family members, it’s not so funny to older adults or caregivers. However, when you notice your parents or loved ones need more help than you ever imagined, you need to know how to start the conversation.

There is a long list of red flags that can tip you off when the time has come to have the conversation. A few of them are as follows: A gradual or sudden change in mood or behavior, a decline in health or increased trips to the doctor or emergency room, not enough food or rotting food in the house, a change in personal appearance or increased confusion.

This is the time to call a family meeting. It is important to have everyone involved with your parents at this meeting. Have an agenda and appoint someone to take notes. Ask questions and find out what others might be concerned about. Their responses might surprise you.

After the meeting, pick a spokesperson to lead the conversation with your parents. Explain it is your responsibility as an adult child to see that they are safe and healthy. Be respectful and explain you’re being realistic while being loving and practical, trying to avoid a crisis.

Talk about your feelings. Look for body language and facial expressions – are you hearing your parents? Are you reading them correctly? Encourage them to share their own feelings. Many older adults feel a loss of independence and are worried about their declining health and the emotional changes they are experiencing. Maybe they don’t want to be a burden to their children or caregiver. Be a good listener and be patient. Do your best to hear what they are saying – and not saying. Expect there might be some negativity in the conversation.

Take small steps. Don’t overwhelm them with too much action at once. Tackle one or two small issues such as helping around the house, gathering their important documents or offering assistance with paying their bills. Allow them to participate in the solution to whatever is going on that causes concern.

Once they accept help, do your homework. Knowing available resources is important. In the past I have stressed the importance of knowing your parent’s doctors and other vital information (Social Security number, life insurance, Medicare, bank accounts, financial investments, power of attorney documents). Start a notebook or file with this information.

You can also get expert advice from a professional geriatric care manager who can help you navigate through the system. Collaborating with a geriatric care manager can save you time and provide you with information, recommendations and serve as an advocate for you and your parents. Geriatric care management is privately paid, but also cost efficient when you think of the decreased stress and anxiety, and time away from work or your own family, while at the same time providing a valuable service to the family.

Kathy Weston
Director of Hospice Operations

The Many Faces of Caregiving

Carol Bradley identifies a caregiver as a person who takes at least some part of the responsibility for the welfare of someone sick, elderly or disabled.

There is not one specific definition of a caregiver, every individual situation is unique. Some caregivers start off by assisting a loved one with their finances, cleaning their house, or helping them get to and from their doctor’s appointments. A caregiver might immediately take over assisting with bathing, getting dressed and going to the bathroom.

A caregiver could live in the same house or reside miles away. Caregivers could be taking care of aging parents, an ailing spouse, or their children and a parent at the same time.

I read an article suggesting there are four main caregiver categories. Each has its own opportunities. Which type of caregiver might you be?

Long-distance Caregiver
These caregivers assist their elderly loved ones – but live in a different city and sometimes a different state. However, just because the caregiver lives far away doesn’t mean they aren’t often responsible for their family member’s finances, medical care and personal needs. One of the most difficult aspects of being a long-distance caregiver is figuring out how to keep an eye on your loved one from far away.

The Sandwich Generation
These caregivers created their own “buzzword” for the type of caregiving they provide. These caregivers are sandwiched between taking care of their younger children, sometimes their grandchildren, and looking out for their own aging parents.

The Spousal Caregiver
The vow, “in sickness and in health” takes on a new meaning when a person finds themselves taking care of a spouse with a serious illness. When a life partner becomes a patient, the caregiver is faced with a host of new situations that could include anything from memory loss to role reversal in the relationship.

The Working Caregiver
The dilemma the working caregiver is faced with is considering if they should quit their job to care for their loved one. We are in an era where adults – both male and female – are in the workforce. In turn, the number of working caregivers is on the rise. The working caregiver is holding down a part-time or full-time job while making sure their loved one is cared for.

There is no cookie-cutter formula for the endless roller-coaster ride that is caregiving. However, Adult/Geriatric Care Management programs are available to provide suggestions and recommendations to all types of caregivers. Care managers become partners with caregivers and their loved ones. These programs can help families manage the many issues associated with aging and healthcare. Your local Aging and Disability Resource center (ADRC) is a great resource to find an Adult/Geriatric Care Management program in your area. To find an Aging and Disability Resource Center (ADRC) in your area click here:

https://www.dhs.wisconsin.gov/adrc/consumer/index.htm

Kathleen Weston
Preceptor Director of Hospice

A Good Fit – Living Wills, Health Care Power of Attorney, and Do Not Resuscitate Orders

Just like peanut butter and jelly or green and gold, living wills and do not resuscitate orders go well together. A living will is a written document that allows you to tell your doctor about the type of life-sustaining treatment you want when you are near death or in a vegetative state. This document is created as part of your advanced directives. A living will reflects your wishes as your health situation changes. By making your wishes known, you are taking responsibility for how you want to be cared for. The State of Wisconsin has a template on their website

http://www.dhs.wisconsin.gov/forms/advdirectives/index.htm

which can be downloaded, printed and reviewed. Once you make your decisions and sign your living will, give a copy to your primary physician, your hospital and your family.

A Healthcare Power of Attorney allows people who become unable to make their own decisions to exercise their beliefs and wishes regarding medical procedures. The person’s agent can communicate on behalf of the sick or injured person, preventing unwanted treatment or making necessary decisions in the event that the individual is unable to do so. The process of denoting a Health Care Power of Attorney is fairly straightforward and the privilege can be revoked at any time by filling out a new form and destroying the old copies of the previous form. The website noted above has the form for Healthcare Power of Attorney. This form can also be downloaded, printed and reviewed. Once you make your decisions, sign the document in front of two people who are not relatives and provide a copy to your primary physician, hospital, and family.

A Do Not Resuscitate order (DNR) is a State of Wisconsin statute that encourages a conversation with your doctor. A DNR is for adults over the age of 18 who either have a terminal illness or a medical condition where CPR would be unsuccessful in restoring your heart or breathing functions. Becoming a DNR is a decision your doctor must agree is appropriate for you based on your health. If your doctor agrees, you and (s)he sign the document and a bracelet is worn identifying you as a DNR. The purpose of wearing the DNR bracelet is to alert medical professionals including EMTs, doctors, nurses, etc. that you are not to be resuscitated if you are no longer breathing, do not have a heartbeat or a pulse. There are different types of bracelets available, a plastic bracelet bearing your personal information and your doctor’s signature or a metal bracelet with your personal information and the international symbol of the Staff of Aesculapius.

If a person has a life threatening event, the DNR bracelet informs a medical provider that they should do the following to help you:
– Clear airways
– Administer oxygen
– Position for comfort
– Splint
– Control bleeding
– Provide pain medication
– Provide emotional support
– Contact hospice or home health agency if either has been involved in the patient’s care, or patient’s attending physician
– Heimlich maneuver or similar procedure used to expel an obstruction from the throat

The DNR bracelet also informs a medical provider if you are not breathing, do not have a pulse or heartbeat, they will not:
– Perform chest compressions
– Insert an airway
– Administer cardiac resuscitation drugs
– Provide ventilator assistance
– Use a defibrillator

Having a DNR in place and wearing the bracelet ensures in an emergency everyone knows your wishes. A living will confirms your wishes about end-of-life care are honored.

We all know conversations about what should be done in an emergency and as your health changes can be difficult. Everyone who cares about you has their opinion. It is a valuable gift you can give to your family when you make your wishes known about the care that is important to you. A good way to ensure your wishes will be honored is by pre-planning with your loved ones and by involving your doctor.

Kathleen Weston
Director of Hospice Operations

How can we help seniors make a successful transition back home?

The day a senior finally gets to return home after a hospital or rehabilitation stay is an exciting time in the recovery process. However, it is also a critical transition that requires advance planning and adequate care assistance once home to avoid readmission and ensure a successful recovery.

As family members, we do everything we can to set our loved ones on a path toward recovery. How can we ensure our loved one’s safety once they return home, and are there costs for these services? Preceptor Home Health can assist and prepare patients and their families for a successful transition home. Home health services are a benefit provided by Medicare and Medicare Advantage plans.

Home health care provides nursing, therapy and other specialized services in the privacy and comfort of your home. The goal is to help you continually improve, manage your illness, and keep you at home – where you most wish to be.

Your Preceptor home health partners include:

  • Our team of nurses who provide health assessments, patient and family education, IV therapy, enteral feedings, catheter or ostomy care, injections, medication management, nutrition teaching, and much more.
  • Our team of rehabilitation professionals helps bring out your best as you recover from illness or injury, or adapt to a chronic condition. Specialty programs include, but are not limited to, wound care, incontinence management and lymphedema treatment. We also have therapists who are certified in the Parkinson’s BIG and LOUD therapy programs.
  • Physical therapists help you improve strength, flexibility, balance, mobility and endurance.
  • Occupational therapists provide one-on-one assistance with daily living tasks and teach adaptations to make life at home a little easier.
  • Speech therapists help with swallowing, communication difficulties and problem-solving.
  • Our social workers will help guide you and your family members in making short- and long-term plans. They also help you connect with resources to meet your needs and goals.
  • Our home health aides provide extra help with personal care and assistance.

Who is eligible for Preceptor Home Health services? Medicare guidelines include individuals who:

  • have a physician’s order for home health services
  • have difficulty leaving their home
  • need skilled nursing services or physical, occupational or speech therapy

If you have questions about Preceptor Home Health services please call Jennifer Wooten at 262-257-9757 (email Jennifer.Wooten@preceptorhhh.com) or Shelly Darmody at 262-257-9804  (email Shelly.Darmody@preceptorhhh.com)

What Hospice is All About

I read an article published in the AARP Office of Academic Affairs (edited by Harry (Rick) Moody) about an experience someone had with hospice.  It is a touching testimony to the power of hospice care:

“This past month saw the passing of one of my oldest and dearest friends, Charles, age 89. During the last weeks of his life, I was directly involved in care-giving, along with others, including the wonderful work of Hospice of Boulder, Colorado.

“Charles was bedbound while we had an unexpected snowstorm, covering the world in white. He looked out his window and said, ‘What a beautiful day to be disabled!’ It reminded me of George Vaillant’s work on lifespan development. He was quoted as saying that successful aging doesn’t depend on health or wealth, but rather on forgiveness and gratitude. Forgiveness and gratitude is what Charles displayed in the last weeks of his life.

“When I visited Charles he wondered why it took so long to die. I replied that maybe it was needed to give time for all the people he had helped in his life to call and visit him to give him thanks. He smiled and said that was a point of view he hadn’t thought.”

These insightful moments might not have been possible without the comfort and support hospice care facilitates. I would like to remind readers hospice is a special health care option for patients and families facing a terminal illness. A team including a doctor, nurses, social worker, chaplain and volunteers works together to address the physical, social, emotional and spiritual needs of each patient and family. Hospice is not about giving up hope or waiting to die; it is about living and experiencing comfort.

Preceptor Hospice can help you live your life to the fullest by providing care and compassion to help you and your family with the many questions and concerns that come at end-of-life. Hospice is an experience of care and support, different from any other type of care.

If you have questions about hospice, please email me at Kathleen.Weston@preceptorhhh.com or call me at 262-257-9824.

Kathy Weston

Preceptor Health Care

Director of Hospice Operations

Is Humor and Laughter Really the “Best Medicine?”

Humor is infectious. How many times have you been in a conversation, someone begins to laugh and you start laughing yourself? How many times have you heard a group of people laughing and a smile came to your face? When laughter is shared, it brings people closer and increases happiness. Studies have shown laughter triggers healthy physical changes in the body. Laughter and humor can strengthen your immune system, boost your energy, lessen pain and protect you from the damaging effects of stress.

According to Paul McGee, PhD, laughter is a powerful antidote to stress, pain and conflict. Nothing works better or is more reliable to bring your mind and body back into balance than a good laugh. Humor lightens your load, inspires hope, connects you to others and keeps you grounded, focused and alert. According to Dr. McGee, “Your sense of humor is one of the most powerful tools you have to make certain your daily mood and emotional state support good health.”

There are also social benefits to laughter and humor. Lively communication can strengthen a relationship by triggering positive feelings and connecting you with someone on an emotional level. When we share laughter with someone special it is one of the most effective tools for keeping relationships fresh and special. Laughter makes us feel good, and the feeling you get when you laugh remains with you – even after the laughter subsides.

More than just a break from feeling sadness, laughter gives you the courage and strength to find new sources of meaning and hope. Even when times are difficult, a laugh or a simple smile can go a long way toward making you feel better. Laughter is contagious.

As laughter, humor and play become an integrated part of your life, your creativity will bloom and you may discover involvement with friends, loved ones and acquaintances will happen almost every day. Humor takes you to a place where you can see the world from a more relaxed, positive, creative, joyful and balanced perspective. Maybe the saying “laughter is the best medicine” holds true. Until next time…live, love and laugh,

Kathy Weston
Preceptor Health Care
Director of Hospice Operations

Commemorative Butterfly Release 2019

In July each year, families and friends come together to honor their loved ones during our Annual Butterfly Release. Taking place at our Germantown Preceptor Health Care courtyard, dozens of beautiful butterflies are awakened and released to commemorate the spirit and strength of those who passed.

Sarah Martel, Preceptor Executive Director, welcomed families on July 24, 2019. Chaplain Eric Boon opened the ceremony with a prayer. Luke Edgewood and Tom Wood presented a moving rendition of Amazing Grace. Jessica Gray then invited families to share memories of their loved ones.

Linda Davis shared a poem, “An Angel Like the Butterfly”, written by Mae Stein. The reading of the names of our loved ones lost by Kathy Weston, Director of Hospice Operations, followed. Then it was time to release the butterflies.

The ceremony ended with the song “Hymn of Promise”. The song opens: “In the bulb there is a flower; in the seed, an apple tree. In cocoons, a hidden promise; butterflies will soon be free!”

It is an honor and privilege to be with families and patients as they make the journey of death and dying. Thank you for trusting us. Thank you for being with us as we remember those lost during the last year.

Butterfly Release

Caregiving

On an airplane, an oxygen mask descends in front of you. What do you do? As we all know, the first rule is to put on our own oxygen mask before you assist anyone else. Only when we first help ourselves can we effectively help others. Caring for yourself is one of the most important – and one of the most forgotten – things you can do as a caregiver. When your needs are taken care of, the person you care for will benefit.

Providing care to someone who needs your assistance can be very rewarding. However, it can also be taxing, and caregiver stress is common. Caregiver stress is the emotional and physical strain of caregiving. Individuals who experience the most caregiver stress are the most vulnerable to a decline in their own health. If you don’t take care of yourself and stay well, you won’t be able to help anyone else.

Some of the common signs of caregiver stress include the following:
– Feeling sad or moody
– Having low energy level
– Feeling like you don’t have any time to yourself
– Seeing your friends or relatives less often than you used to
– Losing interest in your hobbies or the things you used to do with friends or family
– Having trouble sleeping, or not wanting to get out of bed in the morning
– Becoming easily irritated or angered

The emotional and physical demands involved with caregiving can strain even the most capable person. That’s why it’s so important to take advantage of available help and support. These tips have helped others deal with caregiver stress:
– Geriatric care management. Geriatric care managers specialize in aging related issues. They can help families by assessing their needs and identifying the best services available to meet those needs. This could include information on respite care, help in the home, connections to community resources, financial management, advocacy, living arrangements and support groups.
– Contact your local Aging and Disability Resource Center (ADRC) for information on resources in your area.
– Accept help. Prepare a list of ways others can help you, and let the helper choose what they would like to do. One person might offer to grocery shop and another might take your loved one for a walk.
– Stay connected. Make an effort to stay in touch with family and friends. Set aside time each week to socialize, even if it’s just for a walk. Whenever possible, make plans to get out of the house.
– Commit to staying healthy. Find time to be physically active and don’t neglect your need for sleep. See your doctor and tell him or her that you’re a caregiver. Don’t hesitate to mention any concerns or symptoms you might have.
– Avoid feeling guilty. Feeling guilty is normal, but no one is a “perfect” caregiver. You’re doing the best you can at any given time. Don’t feel guilty about asking for help.

If you are like many caregivers, you have a hard time asking for help and feeling like you have to do everything yourself. Unfortunately, this attitude can lead to feeling isolated, frustrated and even depressed. Don’t make that mistake. Take advantage of the many resources and tools available. Remember, if you don’t take care of yourself, you won’t be able to care for anyone else.

Kathy Weston
Preceptor Health Care
Director of Hospice Operations

Author

Choosing To Be Happy

Many of you may not be aware that I do a lot of reading. I do the required reading for my position and in my spare time, I read books and I have my favorite magazine articles. I visit a website “Inspired” www.seniorlivingmag.com for people who are 55+. I found an article about happiness and choosing to be happy. The article touched me, and I’d like to summarize the article for you.

You do not need to deserve happiness. Happiness is free. There are no conditions.

What do you think about the first sentence? Compare the first sentence to the next two sentences. Happiness and being able to focus on happiness is important – your happiness, the happiness of your friends and family and the happiness of the people around you.

Happiness is a gift to you and no others. What happens when you are happy? What happens around you? Think about it. When you are happy, the people around you are happy. Things seem to lighten up and the atmosphere changes.

On a scale of one to 100 percent how open are you to happiness? Challenge yourself. What would it take for you to be 100 percent open to happiness? Let’s start today. Set your intentions. I will be happier and I want to ensure those around me will be aware of the possibility that they, too, can be happy. Can you become a “happiness agent?”

The article challenges us in four area of happiness: being accepting, receptive, grateful and present. Today, I will be more accepting of myself or others and of my life. Today, I will be better at receiving help, love and support from others. Today, I will be grateful for everything that is happening in my life right now. Sometimes this one can be difficult. Today, I will be open to the idea that I am really in the right place at the right time.

Are you up for the challenge to experiment with happiness? I am. After all, happiness is not a search, it’s a choice. Choose to be happy!

Kathy Weston
Director of Hospice Operations