Life’s Simple 7 from the American Heart Association – February is American Heart Month

February is American Heart Month.

The American Heart Association has a new feature and tool on their website called: Life’s Simple 7.

1. Get active
2. Eat better
3. Lose Weight
4. Stop smoking
5. Control cholesterol
6. Manage blood pressure
7. Reduce blood sugar

I would encourage you to take the 7 minute assessment to take control of your heart health.
http://mylifecheck.heart.org/PledgePage.aspx?NavID=5&CultureCode=en-US

Then take the pledge to embrace Life’s Simple 7 at “My Life Check” at
http://mylifecheck.heart.org/Default.aspx?NavID=1&CultureCode=en-US

Have a kind and respectful day.

Caregiver Heroes

The other day, my 7-year-old nephew said to my husband, “I wish I had a super power, even if it was a pathetic one like folding towels.” Of course we had a good laugh about it when he shared it with me later that day. This kid has always had a magic way of expressing himself.

Later that day, my husband said to me, “Everyday things can be super powers. Like being able to have a caring heart or feeling empathy for someone’s suffering.” I realized that this is the daily journey of caregivers. So many caregivers wish they had super powers to get through their days. When in reality, you don’t have to be a superhero; you are already an everyday hero.

Have a kind and respectful day.

Healthcare Quality and Efficiency Report – For those who are interested in real numbers and information about global healthcare issues

A new, “Healthcare Quality and Efficiency Report” has been released. This report contains information for those of you who are interested in real numbers and information about global healthcare issues. This is not a political piece of information but a factual reference guide discussing how healthcare is measured and the financial issues that healthcare is facing. You may want to forward this to your local and national politicians, insurance company, your healthcare providers and/or your local hospitals.

http://www.soa.org/research/health/research-quality-report.aspx

Executive Summary:

Healthcare quality and efficiency play an important role for both the overall economy and healthcare consumers. Affordable healthcare is crucial to the financial stability of many workers and retirees, making quality and efficiency of programs particularly relevant during periods of economic challenges. Moreover, quality and efficiency are likely to occupy a prominent position in any healthcare system reform effort. This is particularly true given the fundamental issues in the United States, such as the decentralized nature of the healthcare system, often poorly-aligned payment structures and the complexity of roles assumed by service providers.

In light of the current overlap of political, economic, and other environmental factors, the healthcare industry is changing rapidly. As a result, the Society of Actuaries Health Section and Solucia Consulting have co-sponsored this research project. This report reviews and inventories the wide range of quality and efficiency measures currently available for hospitals and physicians.

Choices: Senior Living Options’ Telesummit – Registration Open

Do you have an aging parent?

Are you a caregiver of an elderly person?

Are you thinking ahead to your own later years?

Four experts will be joining Dale Carter to discuss 4 varieties of senior living options.

Mark Hager, Jill Gilbert, Lisa Sneddon and Eleanor Feldman Barbera.

By the end of this Telesummit, you’ll walk away with a clear comparison and understanding of the following major senior living options.

• Aging in Place
• Continuing Care Retirement Community (CCRC)
• Assisted Living
• Nursing Home

Check your knowledge of Senior living options. Answer True or False.

1. You need to focus on selecting the one right Senior living option for your parent or yourself for the rest of their/your life.
2. “Aging in Place” is just about home modifications.
3. Continuing Care Retirement Communities are just for the wealthy.
4. Nursing homes are places of institutional care where physical needs are met. You should not expect much more.

All 4 statements are false. While these experts will dispel common myths and provide detailed information, they will provide so much more.

The four experts will share their positive vision of aging and how we can partner with our aging parents and families in making the right decision at this point in time in our parent’s life, as well as preparing for the future.

For dates/times… and to reserve your spot for this telesummit go to, http://www.transitionagingparents.com/choicesseniorlivingoptions/

Monday, November 2, 2009 8 pm Eastern
Tuesday, November 3, 2009 8 pm Eastern
Wednesday, November 4, 2009 8 pm Eastern
Thursday, November 5, 2009 8 pm Eastern

Although each session will feature Q&A at the end, feel free to email Dale questions in advance to dale.carter@transitionagingparents.com

Sample from the “Kindness Reminder” emails – Physical Affection

People used to laugh at me when I would arrive at the assisted
living and dementia unit to visit my aunt and my dad. They both
were in wheelchairs but that didn’t mean they didn’t get their
hugs. I would straddle the wheelchair, bend my knees so I was
almost sitting on their laps and then put my arms around them.
When people are in wheelchairs or in bed, we tend to stop touching
them. For some people, physical touch is the most comforting and
healing way to receive love. You will get a lot out
of this too because when you hug someone, you get hugged right back.

You don’t have to hug like I did but make sure you are giving them
some physical affection. People are very lonely and isolated when
they become dependent on a chair or a bed. So, sit and hold their
hand. Put your arm around their shoulder. Pat them on the back.
Even if it is just a hug from the side, make the effort to connect
with them physically. For some people, crawling into bed and
embracing them works well too. If your loved one doesn’t like to
be touched, then of course, don’t do this.

IF you would like more ideas for how to stay in contact with your loved ones,
sign up for the “Kindness Reminder” free weekly email on the top right side of my blog at Kindethics.com

Have a kind and respectful day.

This week is National Invisible Chronic Illness Awareness Week – September 14-20

I think about my niece and how nobody can tell she is suffering. She has Still’s Disease and some days, she looks just fine. But that isn’t what her body is saying. Her body is screaming in terrible pain, with raging fevers and a weakness that stops her from even lifting her arms. But you might not be able to tell unless the day you see her is one of her wheelchair days. I didn’t realize how bad it could get until I traveled with her. At the beginning of the day, she will be doing okay. Then as the day wears on, the symptoms ravage her body.

She is an example of what the Invisible Chronic Illness Week is about. We can’t tell from the outside what is going on inside for people. People with chronic illnesses still go about their day and still have to live their life. They have gotten used to coping. But that doesn’t mean that they aren’t suffering. They are just doing what they have to do to take care of their kids, provide for their families and keep the household going.

We need to be tender with people. You can’t assume anything about people because you aren’t inside their body or their life. People put on a brave face because they have to, not because they want to. The next time you see someone who is being grumpy or who is slow to get out of your way, remember that they may be doing the best they can. This may be the best day they have had all year. Or maybe today is their worst. We need to choose to be compassionate, polite and understanding. There may come a day when we will need someone to be gentle with us.

Sign up for free, “Kindness Reminders” – Remember to connect with your loved ones.

The “Kindness Reminder” is a brief weekly email to remind you to connect with your aging parent or other loved ones. The reminder is full of touching and fun ways to reach out and connect.

A colleague said to me, “I love my grandmother but I keep forgetting to call her.  Can you send me an email once a week to remind me to call her and can you include some ideas of things I can do for her?”  When he asked me to create these reminders for him, I realized I have been doing this type of thing all my life. I used to call my brothers and remind them to call our dad. It wasn’t that they didn’t care; it was just that like all of us, we get caught up in our own lives.

People think I am amazing because I remember to call on birthdays or to call in once a week to check on my elders. I am not amazing, I am organized. I pre-book recurring appointments in my calendar so I it sends me reminders to call, write or show I care. Otherwise, it would slip my mind and weeks would go by before I would make the effort.

These email reminders will give you a number of ways to show that you care. I will also give you ideas on how to thank those who are taking care of your loved one when you are either far away or unable to be there. The more you show appreciation for those who take care of your loved one, the better care they will get.

Just sign up in the box in the upper right section of my blog at KindEthics.com. Thanks for helping me make the world a kinder place. Please let others know about this free service.

Have a kind and respectful day.

When A Stranger Decides If You Should Live Or Die

There are so many things that happen behind the scenes in healthcare when it comes to dying. One of the hardest things for me to witness is when a patient has no one to speak for them at the end. We call this person the unrepresented patient or the unbefriended person. This is a person without any friends or family who can make sure they have a good death. So what happens to them? In some cases, a public conservator or guardian is appointed to make their decisions for them. This is a stranger making decisions for another stranger. There is nothing personal or meaningful in this process. The other thing that happens, if there isn’t a guardian available, is a group of people at the hospital will make the decision for this person. Sometimes we call this an advocate team and or a moral community. This group usually consists of a doctor, nurse, social worker, chaplain, members of the ethics committee and community members. As a group they will make the decision whether this person should live or die. Unfortunately this decision is based on very little information about who this person is or what would is important to them in their life. It is usually a medical decision instead of a human decision. Not that the advocate team doesn’t try to make it personal.

Let me tell you about one such patient who had this group of strangers make his decisions for him. This was an 83-year-old gentleman who had been living in a nursing home for the past 12 years. At the nursing home, he was able to eat and walk around, but he had severe dementia and could not communicate with the staff. In the 12 years he had been living there, nobody ever visited, nobody ever called and nobody sent him a letter. He had become invisible. The staff cared about him and took good care of him but they were not family. Just before I met this man, he had a massive stroke which left him paralyzed, in a coma, unable to eat or drink and dying. The social workers at the hospital did everything they could to try to find somebody who knew this man but nobody could be found. I live in Los Angeles and we don’t have enough people who are willing to be a public conservator or guardian. So now we use advocate teams to help make decisions for those who are completely alone and silenced by their disease.

I came into the hospital that day and I went to the patient’s bedside because I refuse to make a decision for somebody that I haven’t met or tried to connect with. I knew this person wasn’t going to be able to communicate back to me, but as I sat at his bedside, I held his hand and connected with the human inside this body in the bed. The only noise in the room was the sound of the machines breathing for him. His body was a shell and it seemed like he was already gone. I sat with him and talked to him and told him that I would try to do right by him. I cried a few tears as I realized he was already gone. These are the difficult moments in my job.

I went to the meeting and heard what the doctors had to say and listened to what the social worker had discovered about this man. This was a man who was dying and there was nothing we could do to change it. We asked all the questions we could think of about his medical condition and if there was any hope. We were told there was not. I then asked the social worker about who this person had been at the nursing home. Had he enjoyed his meals? Had he enjoyed interacting with others? What had brought him joy even in his limited condition? He had been living a life with small pleasures and not too much suffering. But now, he couldn’t feel anything. He couldn’t enjoy eating a cupcake, watching something on TV or going to the sing-along in the activity room.

In the advocate team meeting, we all have to agree on what we think we should do. In this team meeting, we decided that there was no way he was going to be able to return to enjoy any part of his life. He was dying and there was no turning back. Our team agreed that he should be made comfortable and be allowed to die a natural death. This included being taken off the ventilator and being allowed to die.

I wasn’t going to tell you his name because he had become invisible to the world. But I have changed my mind because he wasn’t invisible to me. His name was James and I was part of his life and his death.

These are really difficult decisions. These are decisions that should not be made by strangers. But people in hospitals all over the nation are having their life and death decisions made by committee. This is not how it’s supposed to be. People shouldn’t be dying alone and they shouldn’t be living for 12 years without one person visiting them.

Sometimes it’s hard to do the work I do. Sometimes it breaks my heart. But I have the courage to walk into the darkness with people. Whether it’s the family who is grieving at the bedside, the patient who is afraid of what is happening to their body or the health care professional who can’t bear to participate in one more death. I walk with people on this journey and ease their way.

Have a kind and respectful day.

The day my dad was shot in the dementia unit.

Let me reassure you before the story begins that everything turned out all right. My dad fluctuated from mild to moderate dementia. When he became confused, his delusions would frequently return him to World War 2. He lived in an Alzheimer’s/dementia unit, but he was quite high functioning. One day I got a call from my dad and he tells me that he’s been shot by a small caliber pistol. He sounded alright and in no pain on the phone, so I began to ask questions. “Where were you shot dad?” He replied, “I have been shot in the stomach but it is probably not too bad because they were bullets from a small caliber pistol.” (Well, I didn’t know what size bullets come from a small caliber pistol but since he wasn’t too concerned, then neither was I.) I asked him if the people who shot him were still in the building. “I think they’re in the hallway” he said with a very frightened voice. I asked him if it was okay if I got the nurse to come and check on his wounds. He said it was okay but that she should be careful. I called the nurses station and explained the situation. I said that I thought that my dad was okay but perhaps his description of being shot in his stomach meant that he was having stomach problems and just couldn’t report symptoms accurately. She said she would go right down and then call me after she checked on him. I got a call a few minutes later and she said that he seemed to be just fine but he had again mentioned that he had been shot by a small caliber pistol. I asked, “Could you do me a favor and take out the bullets?” There was silence on the other end of the phone. I explained that he wouldn’t rest comfortably if he still thought the bullets were in him and maybe she could just push on his belly and tell him that the bullets had popped out. She thought it was a great idea and went in and to remove the bullets. She came back to the phone and let me know the bullets were out and he was feeling better. At this point neither of us thought it was funny. Even the nurse was serious about taking out imaginary bullets and helping my dad. (Now I knew it was funny but at the same time, my dad was so afraid of the people lurking in the hallways, I wasn’t in a laughing mood.)

How did the story end? After the nurse left, he said he felt much better but he was still very frightened because the shooters were still in the building. I told him that I would send in the special forces and they would clear building of the enemy. I told him that the special forces were so stealth that he wouldn’t see them or hear them in the hallways. It would just be done. (I don’t know much about the military so I had to think fast and try to figure out something that sounded realistic for him.) I called back later to see if my dad was doing better and he was relaxed and comfortable. He felt better and was able to get a good night’s sleep because I had protected him as he had protected me throughout the years. Each time my dad would come out of his delusional state, which fortunately only lasted for a few hours at a time, he would say to me, “I think I was confused right?” And I would respond, “Yes you were, but you’re okay now.” I realized at that time that it was better to choose to comfort someone with dementia rather than to argue with them and make them wrong. I’m not saying we shouldn’t strive to get people more engaged in reality, but when they reach out and tell us they are suffering, we should do our best to support and reassure them. I love telling this story because it makes me think of my dad.  My dad was a wonderful person. He died five years ago this month and I would give anything to hear one of his crazy stories again.

Have a kind and respectful day.

TV Series and Website Seeking Stories on How We Die

I am posting an extra blog this week because this important and urgent.

I am helping with the How We Die Project and I think this might be something you might be interested in doing as well. They need stories about the good, the bad and the ethically complicated cases we have seen. This is an amazing opportunities for the public to understand the complexities of dying in hospitals, homes, nursing homes, etc. Please forward this to your nurses, physicians, social workers, chaplains, respiratory therapists, bioethics committee members, public and private guardians and the patients and families you serve. This is a national project so please forward this to anyone who might be interested across America. See below for more information. Thanks, Viki

TV Series and Website Seeking Stories on How We Die*:

A new website and TV series is looking for first-person stories from
patients, their families, loved ones, and health care professionals about
how personal experiences have shaped what we believe about death and dying.
Stories are about the decisions we make for ourselves, for loved ones, or
for patients at the end of life.
The series, tentatively titled “Stories,” is being developed by Marc N.
Weiss, creator of the long-running PBS series P.O.V. and Tom Yellin, a
veteran network news and public affairs producer.

Our pilot episode will explore experiences that tested or challenged
people’s values and beliefs about who decides when and how we die, and what
role, if any, government and healthcare institutions should play in those
decisions.

Please visit the site and submit your story! www.how-we-die.org

Have a kind and respectful day.

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