If Only Our Pet Could Talk

I think for most pet owners, there are days when we wish we could know what our pet was thinking. This is especially true when it comes to medical decision making. We adopt our pets when they are young and healthy and it doesn’t cross our mind that someday, they might get sick or die. The same thing is true for humans. We want to pretend that we will all live forever.

In my work as a clinical bioethicist, I help families who are struggling to make the right medical and end-of-life decisions for their seriously ill loved ones. I never imagined that I would be having these conversations about my beloved kitty, BooBoo. BooBoo had been living with chronic renal failure for over 9 years. She had outlived every expectation and broken all the records for survival at the vet clinic. This sense of my cat being unstoppable and able to overcome every challenge blinded me to the reality that even a cat, who was a medical miracle, could die.

As her health began to change, certain decisions had to be made. I was lucky because I know how to use one of the tools from my work called the Best Interest Standard. Here is how it works.

Step 1. Ask plenty of questions regarding your pet’s medical condition, treatment options including the option of doing nothing, and the risks and benefits of the different options.

Step 2. Ask quality-of-life questions to understand how your decision will be experienced by your pet.

Step 3. After the decision is made, keep checking in to see how your choice is working. If the decision is not working out, then re-evaluate the situation and make a new decision.

The second step is the step that is often missed. When we ask quality-of-life questions, we are asking what it will feel like for our pet. If your beloved pet has to have surgery, what kind of pain will she be in after the surgery? How long will your pet be in pain? What can be done to make the process easier on your pet?

Here is an example of how I made sure I kept BooBoo’s experience in mind.

The vet said that he could run a special thyroid test to see if she was deficient. It was a simple blood test but before I agreed, I asked, “If she does have a problem with her thyroid, what will you do about it?” The doctor said, “I won’t be able to do anything about it because the medicine that would help her thyroid would harm her kidneys.” So I asked him, “Why put her through the needle stick if it won’t help.” He replied, “Some people just want to know.”

Here is where I had to remind myself that what I might want may not be what is best for my kitty. Sure I would like to know, but I didn’t want to put her through the stress of one more blood test when there was no benefit. When we ask about the risks and benefits we are asking, “What are the good things that could happen from the treatment and what are the bad things that could happen?” This doesn’t mean that we shouldn’t choose the treatment, we just have to be responsible pet owners and to understand there can be bad outcomes.

BooBoo got to a point where she had to have daily sub-cutaneous injections, I had to pill her 5 times a day and her quality of life had deteriorated. The doctor told me that he could put in a feeding tube and I could put all of her fluids and medications down the tube so she her quality of life would improve. No more shoving pills down her mouth or sticking her with a needle. It sounded like a perfect solution. Even though I knew it might not make her live any longer, it would sure improve the quality of her remaining days. So I agreed. Unfortunately, BooBoo had a stroke after the procedure and died a few days later.

Did I make the right decision?

I think I did. I asked lots of questions, thought through my choices and did the best I could. Even though it didn’t turn out right, I have peace of mind knowing I gave her the best quality of life possible. Even when I knew she was dying, instead of leaving her at the vets, I brought her home for the last two days of her life so she could have quality time with me. These were precious moments for both of us. When the end was very near, I returned to the vet so she could have a peaceful end. In life and in death, I did right by her by thinking about her needs first.

For a list of questions you can use when making medical decisions for your pets or your humans, go to the resource page on TheCaregiversPath.com

Have a kind and respectful day.

The Gardens at Park Balboa will be hosting a presentation on 9/8/10 from 7-8:30pm PST

Viki will be giving a presentation at the Gardens at Park Balboa on 9/8/10 from 7-8:30pm PST

The Gardens at Park Balboa, an Assisted Living residence in Van Nuys, California is a recently remodeled building located in the heart of the San Fernando Valley. They believe in encouraging the growth of their residents as individuals, while offering personalized assistance and support when needed or desired. Residents experience the benefits of belonging to an engaging community with amenities, activities and companionship, yet all the while knowing that assisted services are available around the clock, every day of the year.

Residents and their families have the added security of knowing that Safe Haven, their secure unit for Alzheimer’s and dementia care is just steps away on the same property. In addition, residents have convenient geographical access to distinguished physicians and services at Valley Presbyterian Hospital, Sherman Oaks Hospital, and other acute care hospitals located in the SFV.

Have a kind and respectful day.

How to Deal with Change for Aging Parents!! Dale Carter’s new book

New Book Addresses Issues and Solutions for a Peaceful Transition

SOUTH BEND (August 26, 2010) – According to the U.S. Census Bureau, there are 77 million Baby Boomers. Many Boomers are dealing with the challenge of the changing needs of an aging parent – or they soon will. The experts advise not waiting for a crisis to become educated and prepared.  Where to start?

Eldercare advocate, speaker and coach Dale Carter presents the ADAPT method in her newly published book, Transitioning Your Aging Parent: A 5 Step Guide Through Crisis & Change.  Developed from her personal and professional experience, Carter created the ADAPT method as a clear-cut process for families to follow in time of transition to ensure the needs of the parent, the family and their own are met. Whether an aging parent is facing a health crisis, an unsafe living situation or isolation, the ADAPT method provides a straightforward process that allows caregivers to understand the parent’s needs. It also helps to get family members on the same page, find the right resources and make the needed changes, all while respecting the needs of the parent and self.

While the ADAPT method is the core element of Carter’s book, examples and personal stories are woven throughout and includes an extensive list of references and resources.  One of the key features of the book is its concise presentation and usefulness as a reference book.  “This is a book you can read in one sitting, and then refer to it on numerous occasions as questions arise,” notes Michael Allard, Director of Operations, Principal Senior Living Group.

“My experience helping my own mother through a major health/life crisis was overwhelming.  I drew upon my experience as an educator and project manager to put structure around the situation, find the right resources and support, and involve all of our family members,” notes Dale Carter, founder of TransitionAgingParents.com and author of  Transitioning Your Aging Parent.  “I later realized it was my approach and process that helped us make the right decisions, and I was inspired to share my experience in my book.”

In Transitioning Your Aging Parent, readers will learn how to:

• “Actively” listen to your parent and clearly understand your parent’s situation.
• Measure your own capacity.
• Know who to involve in decision making.
• Reach consensus.
• Create a plan for transition.
• Find experts and resources that will help your plan succeed.
• Help carry out the plan and help your parent adjust to the changes.

Transitioning Your Aging Parent is not a quick fix for problems with an aging parent.  Even though the ADAPT method appears clear and straightforward, each step involves a lot of hard work.  “None of this is easy,” says author Carter. “But, know that each transition is an opportunity to meet the needs of your aging parent and help your bond grow stronger.”

For more information on Transitioning Your Aging Parent, visit www.transitionagingparents.com. The book is available online. To order directly from the publisher, contact: www.lulu.com.  Transitioning Your Aging Parent retails for $14.95.

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ABOUT THE AUTHOR

As eldercare advocate, author, speaker and coach, Dale Carter is an advocate for our elderly by reaching out to their adult children. In 2009, she founded Transition Aging Parents (TransitionAgingParents.com). In providing relevant information and insight to adult children, she enables them to help their aging parents “thrive and find joy in every stage of life.” Through her radio show, e-courses, articles, and presentations, Dale helps family caregivers respond to the challenges of caregiving, as well as find purpose and fulfillment in what is truly some of the most important work of their lives.

Dale is a member of the American Society on Aging and the Gerontology Consortium of Michiana.  She holds an MBA from Indiana University, a Bachelor of Science degree in Education from North Carolina State University, and certification as a project management professional.

She resides with her husband in South Bend, Indiana.  Besides eldercare advocacy, her other passion is Board service with the Bridge of Hope St. Joseph County, a program serving single mothers in need.

TRANSITIONING YOUR AGING PARENT

A 5 Step Guide through Crisis & Change

Dale Carter

ISBN: 978-0-557-44740-4

$14.95

May 2010

MEDIA NOTE: ADAPT Fact Sheet, Tip Sheets, and Interviews/Book Photography are Available Upon Request.

North Valley Jewish Community Center presents “Empowering Caregivers Making the Difficult Life and Health Decisions

North Valley Jewish Community Center will present “Empowering Caregivers – Making the Difficult Life and Health Decisions” in three lecture events on August 24th, October 6th, and November 8th from 7:00-8:30pm PST.

North Valley Jewish Community Center, NVJCC, is the center for educational, recreational, social and cultural activities for the San Fernando and Santa Clarita Valley communities. The center accommodates a preschool, a senior program, and events and activities for adults.

North Valley Jewish Community Center, Inc. (NVJCC) is a non-profit organization, founded upon Jewish ethics and values. They are committed to meeting the ever changing needs of the entire Jewish Community, to strengthening Jewish identity and to enrich the quality of Jewish life. Their objective is to facilitate programs that benefit children, families, adults, and seniors, and in so doing to support the entire community for generations to come.

Location: Temple Ramat Zion, 17655 Devonshire St., Northridge
Cost: Center, TRZ, TBT, TBA members free; Non-members $10.00

Please call (818) 360-2211 to make a reservation.

Have a kind and respectful day.

Join Viki as she will be speaking at Aegis of Granada Hills – Assisted Living and Memory Care on Thursday, August 19th from 6:30-8:00.

Join Viki as she will be speaking at Aegis of Granada Hills – Assisted Living and Memory Care on Thursday, August 19th from 6:30-8:00.

About Aegis:

Five-star service is what sets Aegis of Granada Hills apart from the competition. Our beautifully designed retirement community was built with the needs of seniors in mind, while still being visually pleasing to everyone. Conveniently located near shopping, recreation, health facilities and freeway access, we have accommodations to suit a variety of needs – from a senior who simply doesn’t want to cook and clean any longer, to someone who needs total care because of mental or physical decline. And we do it all with dignity, love and attention to the finer details that make life better. Come see our retirement community’s studio, one- or two-bedroom, independent-style apartments and sample a lunch by our fantastic chef, Jose. Or call and ask about respite, a short-term option for those who only need a couple of weeks to a month-long stay.
Visit Aegis of Granada Hills today to sample our meals or take a tour of our retirement community for active seniors and for those needing additional care. Aegis of Granada Hills also provides care for residents with Alzheimer’s Disease and other dementias.
Please call if you would like to schedule a personalized visit at Aegis, including sampling a meal, taking a tour, or participating in our daily activities program.
10801 Lindley Ave Granada Hills, CA 91344 Phone: 818-492-4077 Fax: 818-363-1933

Have a kind and respectful day.

Leeza’s Place will be hosting an End of Life presentation on 7/29/10 from 6-7:30pm PST

Viki will be giving an End of Life presentation at Leeza’s Place in Sherman Oaks, CA on 7/29/10 from 6-7:30pm PST

Leeza Gibbons develped Leeza’s Place for both family caregivers and the recently diagnosed with chronic illness or disease, that integrates educational programs, connective social activities, emotional support, and intergenerational programming designed to help you navigate through your community’s continuum of care.

Leeza’s Place was designed to ensure that others would have access to new, supportive settings created for the purpose of educating, empowering and energizing.

The cornerstone of each Leeza’s Place is a specially trained “Leeza Care Advocate” whose primary responsibility is to guide caregivers and their loved ones through the emotionally charged maze of memory disorders: educationally, supportively, and confidently.

Each Leeza’s Place has been carefully crafted to empower both the caregiver and the recently diagnosed by offering services that create self esteem, relieve symptoms, impart knowledge, reduce stress, promote inclusion, and ultimately improve the quality of life while helping you to acquire advocacy, coping and care-related skills.

All of the programs at Leeza’s Place are the direct result of listening to and understanding the unique needs, values, pressures and goals of caregivers and their loved ones. Programs have been designed to provide educational and empowering strategies that are not currently available.

Although services may vary from site to site, each Leeza’s Place locale will provide programs that offer support on three levels – emotional, educational and social – for caregivers, families and their recently diagnosed loved ones.

Leeza’s Place is the signature program of the Leeza Gibbons Memory Foundation. For a list of Leeza’s Place locations across the country, please click HERE.

Have a kind and respectful day.

Autumn View Gardens in St. Louis will be hosting a lecture on Caregiving on 7/22/10 from 6:30pm to 8:30pm.

Autumn View Gardens in St. Louis will be hosting a lecture on Caregiving on 7/22/10 from 6:30pm to 8:30pm.

Autumn View Gardens is a beautiful assisted-living community located on Schuetz Road in Creve Coeur, a suburb of St. Louis, MO. They have a total of 90 private apartments, including companion suites, with a choice among six apartment styles. All apartments feature private bedrooms, kitchenettes, individual thermostats, large closets, and balconies or patios. Apartments range from 300 to 600 square feet.

Have a kind and respectful day.

Congratulations Winners!!!

Congratulations Winners!!!

Terri Murray
Mitch Feigenberg
Susan Hughes
Laurie Brown
Patricia Raymond
(I will be contacting you for your shipping address.)

Thank you to all the people who wrote and shared your stories with me. You are exactly why I wrote this book. So many people are struggling having to make these tough decisions. My heart is with you.

If you would like to order The Caregiver’s Path to Compassionate Decision Making, the book is available online and at your local bookstore. You can also ask your local library to carry it. (It will take a while for it to get onto the library’s shelf, so if you need it right away, then you should order it for yourself.)

http://www.amazon.com/Caregivers-Path-Compassionate-Decision-Making/dp/1608320413

Have a kind and respectful day.

Long Term Care Ombudsman of St. Louis will be hosting a presentation on empowering Caregivers to Make Better Decisions on July 22, 2010

Long Term Care Ombudsman of St. Louis will be hosting a presentation on empowering Caregivers to Make Better Decisions on July 22, 2010 from 10am to 12pm.

The Long Term Care Ombudsman Program of Saint Louis (LTCOP), a United Way agency, is part of a nationwide program which began in 1971 in response to public outcry over abuse and neglect in long-term nursing home facilities. Since its inception there are now over 500 Ombudsman Programs across the United States. LTCOP is the area’s most comprehensive resource that serves residents of licensed long-term care nursing homes and their families.

The St. Louis Long-Term Care Ombudsman Program is comprised of professional and specially trained staff and volunteer ombudsman who are assigned to long term care nursing home facilities weekly, getting to know residents and providing advocacy, support, and education about their rights. When requested, ombudsmen act as a voice for resident treatment and care. Ombudsmen can help mediate resolution of grievances and disputes, make referrals and monitor the referrals to see that the problems are resolved. Ombudsman listen to nursing home residents concerns and complaints and work to educate residents about their rights while working with families and facility staff in resolving care and treatment plan issues.

Their mission is “To preserve the quality of life for long-term care residents by empowering residents and their families through education, advocacy and support.”

Have a kind and respectful day.

Lecture at Young at Heart Adult Day Care in St. Louis, MO on July 21, 2010 from 5-7pm

Viki will be speaking at Young at Heart Adult Day Care in St. Louis, MO on July 21, 2010 from 5-7pm.

Research shows that there are thousands of seniors living in our community who do not need a nursing home, but do need help, especially during the day to continue living safely at home.

Young at Heart Adult Day Care provides high quality care for an aging senior, or a family member with a cognitive or physical disability that limits their safety at home. Young at Heart is a good alternative to a nursing home for many people who are not ready to leave their home; and a great option for family members getting worn down with worry and the round the clock commitments of time to provide in-home support.

Owned and operated by Peter Nicolazzi and Laura Bone, Young at Heart Adult Day Care is licensed by the State of Missouri and is a Medicaid Provider. They are also members of the Missouri Adult Day Services Association. Pete has a history of over 20 years in a variety of social work settings. Most recent experience in the past 8 years has been working as a geriatric medical social worker in long term care. Voted Best Customer Service Award of 2003 from Barnes-Jewish Extended Care for superior performance and service to Patients, Families, Visitors and Staff. Laura brings 20 years of nursing experience with a specialty in Rehabilitation Nursing. Voted Nurse Manager of the Year of 2001 from Rehab Care Group. Clinical experience include medical/surgical, acute rehabilitation and Emergency Medicine. Laura is a member of the Association of Rehabilitation Nurses. Laura is currently serving as Vice President on the Missouri Adult Day Services Board.

Have a kind and respectful day.

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