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Saturday, September 9, 2017

Patient Advocacy


The Important Role of the Patient Advocate
by Lisa Stockdale

The health care system continues to grow more complex and difficult to navigate. As complexity swells, consumers are increasingly reaching out to private, independent patient advocates to get the help they need.  Patient advocates offer a wide array of services ranging from accompanying clients to their doctors’ appointments, being present during a hospital stay, providing information to help make decisions about treatment options, reviewing and negotiating medical bills – and everything in between.

Who Can Be a Patient Advocate?
A family member, a close friend or relative, or even a trusted co-worker can act as a patient advocate.   If you find yourself in need of someone with a working knowledge of the healthcare system or perhaps more of a clinical background, it might make sense to look at professional advocacy services.  Consider the following local (central Ohio) providers:

·       IKOR is a Dublin-based company offering healthcare and financial advocacy plus life management services.  IKOR is operated by Dublin resident Melanie Hankinson who has a degree in Physical Therapy, is a Certified Senior Advisor and an Aging Life Care Professional™ with support from Sandy Miller, BSN, RN, graduate of the Ohio State University College of Nursing with 40 plus years serving central Ohio patients. 

·       Guided Patient Services (GPS) is a Westerville-based company specializing in patient advocacy and navigation to clients of all ages facing new or challenging healthcare issues.  GPS was founded and is operated by Annette Ticoras, MD, graduate of Wright State University Boonshoft School of Medicine.  GPS is a member of The Alliance of Professional Health Advocates. 

Who pays for the advocates’ services?
Professional patient advocates are usually paid directly by the client. A few employers have begun providing patient advocacy support to their employees, but private health insurance companies do not pay for these services.

Not everyone can afford to hire an advocate, but many can and do.  Many of us would not attempt to purchase a home without the advice and guidance of a realtor. Fewer would consider walking into a courtroom without the expertise of a lawyer, and many Americans have come to rely on a financial planner to help them manage their wealth and safeguard their financial well-being. As the healthcare system continues to evolve, patient advocates will become more common. Research is already starting to demonstrate the valuable role a patient advocate can play in improving patient outcomes and experience.    

Sunday, July 23, 2017

Practice Prevention to Stay Hydrated and Healthy



It’s official!  We are now in the midst of the dog days of summer.  This year the dog days commence on Saturday, July 22nd and end of Tuesday, August 22nd.  The “dog days of summer” refer to those sultry, humid, long, hot summer days that are said to be the most uncomfortable part of the season.  The concept dates back to the ancient Egyptians who believed the energy from the star Sirius combined with the sun’s energy to produce heat waves, drought, thunderstorms, fever, mad dogs and bad luck. 

After being cooped up all winter, it’s tempting to spend as much time as possible outside despite the heat and humidity.  Still, we need to practice prevention to stay healthy and hydrated.  Too much exposure can lead to dehydration, heat exhaustion and even heat stroke.  Heat stroke is less common but obviously more serious. 

The key is to stay hydrated.  Consuming at least 64 ounces of fluid per day is the best way to ensure proper hydration.  Water is the best choice but it certainly isn't the only option that counts towards the 64 ounces per day guideline.  Most fluids (except alcohol) and many foods also count.  Foods with high water content include the following:  

Oranges
Watermelon
Yogurt
Strawberries
Blueberries
Grapefruit
Broth-based soups
Pineapples
Cucumbers
Tomatoes
Grapes
Bell peppers
Cantaloupe
Apples

How do you know if you’re dehydrated?  Understanding the signs and symptoms of dehydration is important.  One sure way to monitor hydration is to pay attention to the color of your urine.  Generally speaking, the lighter the color, the more hydrated you are. 

·         Pale yellow to clear indicates that you are well-hydrated. 
·         A yellow, cloudy color means you need water.
·         A darker yellow-amber color means you are dehydrated.
·         Orangish-yellow and darker means you are severely dehydrated.  Contact your physician immediately.


Sunday, June 18, 2017

Choose Hospice - Because Every Chapter Counts


Choosing hospice is a personal decision that depends on the patient’s individual values, preferences and priorities.  It means transitioning from one set of goals (working to extend life) to another set of goals (working to ensure quality of life for the time remaining).  Hospice is about alleviating suffering so that the focus can be on more personal aspects of dying like one’s legacy, relationships and achieving a sense of closure.  Too many people wait to receive hospice care until the last few weeks or days causing them to miss out on months of helpful care and quality time.  Most all insurance plans, including Medicare and Medicaid, cover the cost of hospice. 

  • Where is hospice?


Hospice is a philosophy of care, not a place.  You can receive hospice services in an assisted living community, at a nursing home, at the hospital or wherever you call home.  We bring the care to you.  We understand that most people prefer to be at home in the days leading to end of life. 


  • How do I qualify for hospice?


Two physicians must certify that you have a life-altering diagnosis with an expected prognosis of six months or less. 

  • Can my primary care physician continue to see me?


Absolutely!  Your personal physician is welcome and encouraged to continue your direct care. 

  • Does hospice hasten death with the use of pain medications? 


No.  There is no evidence that opioids like morphine hasten the dying process.  In fact, research suggests that using opioids to treat pain or shortness of breath may help a person live a bit longer.  Pain medications provide relief and comfort improving quality of life during the dying process. 

  • What if I accept hospice services and then change my mind? 

It is always your choice to enter or leave hospice.  If you find that your illness improves or you decide to seek curative treatment or you are unhappy with services, you may leave hospice care at any time, returning if and when you choose.  

Sunday, June 11, 2017

Dementia Capable Providers Make the Joy Rides Possible




There are two types of people in the world, those who would take a dementia patient for a joy ride and those who would say it’s a waste of gas.

Healthcare providers who are serious and committed to caring for Alzheimer's and dementia patients should want to make the joy rides possible.  The focus should be on optimizing quality of life and working to make memorable moments possible. 

Dementia Specialty Programs should be purpose-driven, structured, holistic, visionary and evidence-based.  Taking the time to get to know patients and clients in the present and in the past is necessary because it makes developing holistic plans of care based on client’s individual values, preferences and priorities possible.    Dementia care involves the whole person – body, mind, spirit and emotions. 

Objectives should include:  

·         Identifying the disease-specific needs of individuals and families
·         Specifying the roles and responsibilities of members of  inter-disciplinary teams
·         Providing on-going education and integrating best practices in the delivery of care
·         Engaging in community outreach to help combat misconceptions and the stigma

Begin by screening and selecting experienced caregivers that exemplify qualities like patience, the ability to solve problems, kindness, creative-thinking and respectfulness.  Focus on education including Certified Dementia Practitioner training, cultural sensitivity training and other on-going educational opportunities.  The success of any program hinges on continuous learning and adaption as the disease progresses. 



Tuesday, April 25, 2017

Telehealth & Home Safety Equipment to Make Aging at Home Possible


Your best opportunity to stay home safety is to receive the extra support and care you deserve. Telehealth and home safety equipment make it possible for seniors to remain at home with increased confidence and peace of mind.  

Telehealth is a way of delivering health care remotely by means of telecommunications.  It includes a wide variety of technologies to deliver virtual medicine and health care.  The types of technologies utilized include live video, secure electronic communications, remote patient monitoring and communication supported by mobile devices such as cell phones, tablets and laptops.  Telehealth is not a specific service, but rather a collection of means to deliver care, monitoring and education.  

Telehealth is most often used to deliver the following range of health care services and information:  

  • Dentistry 
  • Counseling 
  • Physical and occupational therapy 
  • Home health 
  • Chronic disease monitoring and management 
  • Disaster management 
  • Consumer and professional education 
Telehealth & Home Safety Services for Consideration    

ü  Personal Emergency Response System
This portable emergency call system can be set up through a landline or cellular phone line. This system sends an alert out in an emergency to notify the designated first responder.

ü  Medication Monitoring
The medication monitoring unit organizes and dispenses medications according to the physician-prescribed schedule.

ü  Fall Detection Button Fall                    
Fall detection is an additional safeguard for
situations when an individual falls and is
unable to push the help button.  


ü  Mobile Care / GPS Tracking                                 
This discrete, wearable device makes GPS
tracking & location, available alongside two
way automated and hands-free 
communication, from virtually anywhere via
cellular networks.    

Home Safety Equipment for Consideration

·         Riser for the toilet seat
·         Grab bars for the bathroom
·         Hand-held shower head
·         Bath bench
·         Bedroom products (hospital beds, over-bed tables, pads)
·         Medicine droppers and spoons
·         Button loopers and zipper pulls for easier dressing
·         Single-lever faucets for kitchen and bath
·         Touch-tone telephones, calculators and clocks with large numbers
·         Kitchen tools to make opening cans, peeling, cutting and dicing food easier
·         Reachers to eliminate bending and help offset a weak grasp or limited mobility

Sunday, April 2, 2017

Aging in Full Bloom: Three Empowering Aspects of Aging


by Lisa Stockdale 

Enough with all the negativity!  It's high time we learned to celebrate, honor, respect, cherish and embrace the aging process.  Put away your anti-aging mindset and open your eyes to possibility of living out loud instead of accepting the so-called reality of getting old.  Know that you have survived every challenge that life has delivered to your doorstep thus far, and look to the future with the confidence and know-how that experience brings.  Make decisions that bring you peace and happiness and strength. Continue to takes chances, create, learn, engage and explore. 

If you are reading this, your ending has not been written. You owe it to yourself to live with your eyes and arms wide open greeting each new day as your own personal opportunity for growth, happiness and new beginnings.   

Growing old is one thing but getting old is out of the question. To grow old is to continue to pave a path through learning and leadership in the family, workplace and community.  To get old is to stand by and watch things happen as if you are powerless in the experience. The challenges that aging presents are admittedly obstacles associated with aging, but there have always been obstacles associated with aging from puberty to adolescence to young adulthood to mid-life crisis and beyond. We are constantly evolving and making adaptations along the way. 

What are the benefits of aging?  

A NEW KIND OF FREEDOM COMES WITH AGING...

Freedom from the grind of all the demands associated with earlier stages of life like the challenges of building a career or being a caregiver.  Consider the following quote from an email entitled Aging and Friendship submitted to the Echo Press:

"Whose business is it if I choose to read, or play on the computer, until 4 a.m., or sleep until noon?  I will dance with myself to those wonderful tunes of the 50s, 60s and 70s, and if I, at the same time, wish to weep over a lost love, I will.

I will walk the beach, in a swim suit that is stretched over a bulging body, and will dive into the waves, with abandon, if I choose to, despite the pitying glances from the jet set. I know I am sometimes forgetful.  But there again, some of life is just as well forgotten. And, eventually, I remember the important things."  

A RETURN TO HAPPINESS COMES WITH AGING...

Research indicates that people report being happiest in their youth and then again in their 70s and early 80s. People report being least happy during those years associated with mid-life.  Why?  Maybe it’s because older people have come to understand the value of happiness, and they have learned how to be happy along the way.  They know that happiness is a personal choice.  It is not contingent upon circumstances or the things that have happened in life.  It’s a way of thinking and knowing.  It is closely connected to one’s ability to appreciate the small pleasures like taking a warm bath or a watching the sun set.  It is also closely connected to purposeful living which generally includes maintaining close social ties and engaging in meaningful activities that promote the greater good. 

These days everyone seems to be researching happiness.  There’s even a Happiness Research Institute, which is an independent think tank, working to improve quality of life by exploring human happiness.   Scholars and universities are also focusing on the topic.  According to Acacia Parks, Assistant Professor of Psychology at Hiram College, who researches and teaches on the science of happiness, happiness is not about feeling good all the time but instead is associated with a more even-keeled mood.  Parks cites recent research that indicates that those who focus on feeling good all the time actually undermine their ability to be happy by trying to achieve an unrealistic goal.  Parks writes, “You have the ability to control how you feel – and with consistent practice, you can form life-long habits for a more satisfying and fulfilling life.”  It seems the researchers are working hard to confirm or prove what many older adults already know.  


NEW OPPORTUNITIES COME WITH AGING...

Many seniors report the opportunity to focus on hobbies and talents that had to be put on hold in their earlier years.  Some return to the university to earn advanced degrees or audit classes without the pressure of exams and assignments.  Others discover hidden talents they never knew they had.  For example, my own mother discovered that she is a talented painter late in life.  Some are blessed with grandchildren and describe being a grandparent very differently than being a parent.   Eva Figes wrote in It's a Nan's World that the difference between being a mother and a grandmother is like the difference between marriage and a love affair.  Apparently, she is enjoying being a grandmother quite a lot.  Others report becoming more assured in their faith or spirituality.  One of my favorite articles on the opportunities associated with aging comes from Loren Olson, a retired psychiatrist, entitled The Opportunities for Aging: Freedom from the Tyranny of Ambition.  

Consider the following excerpt:  

 “We can either measure time or we can experience time.  For me, time still carries a sense of urgency, but the urgency of time has been transformed from a seemingly endless series of appointments and moving from one goal to the next to an urgency for experiencing every moment and not wasting the time that remains.  I decided to stop wearing neck ties.  I promised never to sit through a boring meeting or lecture.  I stopped going to cocktail parties to ‘network’ with people I didn’t really like but who might do something for me.  I moved things from my bucket list to my un-bucket list and began to get rid of things I once treasured but increasingly felt like just some burdensome ‘stuff.’

I stopped doing what I thought I should do to meet someone else’s expectations of me.  I deconstructed my old value system and reconstructed one of my own.  I realized that good relationships are always U-shaped, and to hang on to them sometimes requires a lot of work to get to a richer place. 

I stopped seeking relationships based on what the other person could do for me.  I discovered that whom I dined with was more important than what is on the menu.  I began to shed myself of stuff that had lost its meaning.  I have learned to appreciate my experiences and the wisdom that has come from my successes but also from the mistakes I’ve made” 





Sunday, March 26, 2017

Helping Seniors Understand and Achieve Wellness


The importance of proper nutrition cannot be overstated.  It is vital for older adults looking to stay healthy and maintain their varying degrees of independence. 

Older adults are negatively impacted by poor eating habits and a lack of nutritional understanding for seniors.  Understanding the changing nutritional needs of older adults is critical due to the overlap of several age-related challenges.  Seniors have higher rates of chronic diseases like diabetes, hypertension and heart disease.  Others live with chronic pain, osteoporosis and various forms of arthritis.   Many face daily challenges of managing complicated medication regimes.

Studies show that proper senior nutrition reduces the risk of the following:
·         Compromised immune system
·         General muscle and body weakness leading to more falls
·         Osteoporosis
·         High blood pressure
·         Diabetes
·         Heart disease
·         Certain types of cancer
·         Certain types of arthritis

But making dietary changes is difficult.  It can be especially overwhelming for older adults who are set in their ways and resistant to change.  What can be done to encourage change? 

·         Incorporate changes slowly. 
·         Be mindful of medication side effects that by alter appetite. 
·         Plan to share meals as often as possible. 
·         Know the signs of constipation.
·         Address signs of dysphagia or difficulty swallowing. 
·         Be sure dentures are in good repair and fit properly.
·         Consider other dental issues like gum disease.
·         Understand sudden or on-going weight loss as cause for concern. 

Do not hesitate to consult a physician. Your doctor will help identify the underlying causes of loss of appetite, weight loss or malnutrition.  He or she can test for a number of treatable culprits including ulcers, sinusitis, zinc deficiency, thyroid disease, dementia and depression. 

In the meantime, here are three helpful hints: 
ü  Choose a variety of healthy foods.  Eating the same foods day after day is boring and monotonous. 
ü  Become better informed.  Understanding senior nutrition includes taking the side effects of medication into consideration, and it empowers seniors to tailor a nutritious plan with their special needs in mind. 
ü  Stay hydrated.  Staying hydrated will require a conscious effort because as we age, we tend to get thirsty less often even though we still require the same amount of liquids as we ever did.  

Saturday, March 11, 2017

Eight Ways to Help Seniors Achieve Nutritional Wellness


The importance of proper nutrition cannot be overstated.  It is vital for older adults looking to stay healthy and maintain their varying degrees of independence. 

Making dietary changes is difficult.  It can be especially overwhelming for older adults who are set in their ways and resistant to change.  What can be done to encourage change? 

·         Incorporate changes slowly. 
·         Be mindful of medication side effects that by alter appetite. 
·         Plan to share meals as often as possible. 
·         Know the signs of constipation.
·         Address signs of dysphagia or difficulty swallowing. 
·         Be sure dentures are in good repair and fit properly.
·         Consider other dental issues like gum disease.
·         Understand sudden or on-going weight loss as cause for concern. 

    Do not hesitate to consult a physician. Your doctor will help identify the underlying causes of loss of appetite, weight loss or malnutrition.  He or she can test for a number of treatable culprits including ulcers, sinusitis, zinc deficiency, thyroid disease, dementia and depression.  Doctors can also screen for loss of taste and smell which diminish at variable rates with aging.  Taste and smell affect the desire to eat and impact thirst mechanisms.  

Mindset Matters


Did you know that positive people live longer, happier, healthier lives?  According to our trusted friends at the Mayo Clinic, the benefits of positive thinking include: 
·        Increased life span
·        Lower rates of depression
·        Lower levels of distress
·        Greater resistance to the common cold
·        Better psychological and physical well-being
·        Reduced risk of death from cardiovascular disease
·        Better coping skills during hardships and times of stress

Most experts agree that these benefits are connected to the positive person’s ability to better manage and cope with hardship including everything from daily stress to grief and/or trauma. 

We are all capable and worthy of making positive changes in our lives regardless of age or circumstance.  We each have the power to change or modify our own dispositions.

·        We can start by counting our blessings instead of focusing on our disappointments. 
·        We can commit to being more active and involved in our communities. 
·        We can practice positive self talk until our words become our realities. 
·        We can grant forgiveness instead of continuing to harbor ill-will or guilt.
·        We can practice kindness and appreciation until they become habits.  

Sunday, March 5, 2017

The Love of a Grandmother...I thought she walked on water!



I don't recall the first time I met my grandmother, but I'm sure it was a precious moment smothered in energetic admiration as only she could deliver.  As a child, I lived on the assumption that all good grandmothers were seven feet tall with high check bones, strength of character and the mesmerizing ability to tell a story. She could turn an activity of daily living into a celebration of monumental portions.  I call them monumental because today those stories are guarded memories tucked away deep in my being. She was willful and a bit of a worry wart when it came to family matters.  I always enjoyed her tendency to fret without regard to the toll it must have taken on her because it prompted her to share what I believed at the time to be adult secrets.  She was also a woman worthy of respect. That realization, like many other truths about my grandmother, never occurred to me until I was grown and she was gone. What I did understand about her from the very beginning was that she loved me.  

On Saturdays the two of us made our weekly trip to the local A&P Supermarket to shop.  Our primary purpose was to buy groceries and I usually ended up with an "unexpected" treat, but the real excitement was in the walk to the bus stop.  We would put our Sunday clothes on a day early, lock arms, throw our heads back and march to the bus stop.  We walked with purpose and pride.  It was my grandmother who first convinced me of my own special beauty.  Those walks were our chance to practice the confidence and poise she claimed we deserved.  

My family moved back to Texas when I was about four-years old and those months away from my grandmother in Kentucky were torturous for me.  I cried for her nightly.  I still remember the day I was reunited with her after almost a year away.  We picked up right where we left off and reminisced about the old days like two old friends at a high school reunion.  I made my father promise never to take us back to Texas.  

When I started school, my grandmother lived in the apartment over top of ours.  After school, I was permitted to visit for one hour daily.  She had a desk in her bedroom and the first half of the hour was spent doing homework and discussing the events of the day.  She always prepared an after-school treat and we shared it during the second half of the hour while we watched a cartoon together on her black and white television that has since become quite famous - Spider Man.  The treat itself was always simple, usually salted cucumbers or red ripe tomatoes. When she could afford it, she would buy a melon or the occasional apple or orange. I have no idea how my grandmother made those salted cucumbers and red ripe tomatoes taste so scrumptious.  That is the magic of a grandparent.  

Grandparents play a unique role in the lives of their grandchildren. They generally represent stability in the face of hardship or change.  They are instrumental in handing down habits of the heart and faith.  They work as watchdogs and advocates.  Please feel free to celebrate your own grandparent by offering a comment.