Finding the money to modify the senior’s home for safety.

From http://ageinplace.com. Thanks Mark Hager for these great resources.

Here are some places to research for help paying for aging in place home modifications or services:

• Use the Eldercare locator from the US Government ( http://www.eldercare.gov/ or 1-800-677-1116) to connect with your local Area Agency on Aging. They will have the most relevant information available.
• Local cities have CDBG (community development block grants) for home repair. And/or contact the local Mayor to find local funds.
• Rural Development is also a great resource for low-interest 1% loans/forgiveable loans and grants for home repair/home mod. http://www.rurdev.usda.gov/
• Sometimes community foundations will also fund a variety of start-up programs and may know where to turn locally.
• Habitat/Rebuild Together are also up in our neck of the woods Indiana/Michigan.
• Larger churches in our area volunteering, especially the men’s groups for some handyman/home fix up.
• Reverse mortgages. Not for everyone, but can help many.
• If you’re a veteran, try the Veteran’s Administration

For more help, contact:

http://www.ageinplacepros.com
Twitter: http://www.twitter.com/aging_in_place
Facebook: http://www.profile.to/aginginplace
mark@ageinplace.com

Have a kind and respectful day.

Interview with author, Lydia Burdick, “Wishing on a Star”, A read-aloud book for mentally challenged adults, on Nov. 10th, 4pm pacific

Interview with author, Lydia Burdick, “Wishing on a Star”, A read-aloud book for memory-challenged adults, on Nov. 10th, 4pm pacific.

Call in to listen live at (347) 945-5152 or listen online at blogtalkradio.com/kindethics

Have a kind and respectful day.

CONTEST!! Tell me about your favorite doctor’s office and how the staff have made a difference. I will send the person who submits the winning story and the winning doctor’s office a cake from BakeAWish.com. Ends Nov. 8, 2009

I have worked in a medical office and I know how difficult it can be to keep the doctor on schedule, deal with the patients that are suffering and to make sure the bills get sent to the insurance company on time. I would like to honor this month the great doctor office’s staff that go the extra mile to make sure that the patients get the care they need. I also know that this group of workers don’t always get the recognition they deserve. So here is what I would like to do this month.

Tell me about your favorite doctor’s office and why they have made a difference in your life. I will pick one story to feature on my blog and the person who submitted the winning story and the winning doctor’s office will each receive a cake from BakeAWish. (Of course, I can change your name if you don’t want to be mentioned on my site.) The last date to send in your story is Nov. 8, 2009. I will announce the winner on my blog on Nov. 12th.

Send your story to me at Viki@KindEthics.com

Bake Me A Wish: http://tinyurl.com/rylvyz

Have a kind and respectful day.

Celebrate the holidays today – Take a treat to your doctor’s office or the nursing home today

You may be thinking of doing something nice for your loved one’s doctor’s office, hospital staff, or long term facility where your loved one lives. But don’t do something in December. Everyone brings the staff food and treats in December and a lot of it goes to waste (waist). The staff would love to have your bring something in October or some other month when they can truly appreciate it. And, your efforts will be noticed because it is not just one more person bringing in a treat, but you thinking of them at a different time of the year.

Here are a couple of yummy places where you can order something to be delivered.

Chocolates Gifts: http://tinyurl.com/p8abol
Cakes: http://tinyurl.com/rylvyz
Tea: http://tinyurl.com/nt5gqc
Coffee: http://tinyurl.com/l6x2d5

Have a kind and respectful day.

Interview with Debra Joy from BCelebrated.com, Nov. 4th 10AM pacific, on BlogTalkRadio.com/kindethics

Interview with Debra Joy from BCelebrated.com, Nov. 4th 10AM pacific, on BlogTalkRadio.com/kindethics. Call in to listen live at (347) 945-5152 or listen online.

Debra Joy is founder of Bcelebrated.com. She and her husband developed the service after experiencing the loss of several loved ones over a short period of time.

We created this service so everyone would have a chance to determine how their life will be celebrated. To share their story, say their goodbyes, and comfort and support their loved ones.

Bcelebrated.com enables members to document their life as they are living it. They can write their story in their own words, adding pictures, videos, music and links to other sites. The site will become their permanent online memorial, including funeral and obituary information, at the time of their death. Members can create secure password-protected private pages to offer words to comfort, information about access codes or where important documents are kept. The site has an automatic notification system so the burden of tracking down contacts in a timely manner no longer rests on the shoulders of the grieving family. The notification will alert the community of the member’s death and invite them to the site where they can share their own stories, read about the member’s death in their own words, send a gift to the grieving family and access their private page if one has been created for them.

“Some of our friends knew they were going to die and had a chance to organize matters, tell people how much they love them, say their goodbyes. Those who died unexpectedly they never got that chance. Families were left scrambling to contact people, and make decisions and arrangements on behalf of their loved one, while they are going through their own grief.”

To read more about Bcelebrated go to http://www.huffingtonpost.com/geoffrey-dunn/bcelebrated—-a-revoluti_b_291536.html

Have a kind and respectful day.

Choosing a Nursing Home – A checklist

Visit Nursing Home Compare at www.medicare.gov/NHCompare for more information. This list can be found at http://www.medicare.gov/LongTermCare/Static/StepsOverview.asp

Name of Nursing Home:
Date of Visit:

Basic Information – Answer Yes or No

The nursing home is Medicare-certified.
The nursing home is Medicaid-certified.
The nursing home has the level of care you need (e.g. skilled, custodial), and a bed is available.
The nursing home has special services if needed in a separate unit (e.g. dementia, ventilator, or
rehabilitation), and a bed is available.
The nursing home is located close enough for friends and family to visit.

Resident Appearance

Residents are clean, appropriately dressed for the season or time of day, and well-groomed.

Nursing Home Living Spaces

The nursing home is free from overwhelming unpleasant odors.
The nursing home appears clean and well-kept.
The temperature in the nursing home is comfortable for residents.
The nursing home has good lighting.
Noise levels in the dining room and other common areas are comfortable.
Smoking isn’t allowed or may be restricted to certain areas of the nursing home.
Furnishings are sturdy, yet comfortable and attractive.

Staff

The relationship between the staff and the residents appears to be warm, polite,
and respectful.
All staff wear name tags.
Staff knock on the door before entering a resident’s room and refer to residents by name.
The nursing home offers a training and continuing education program for all staff.
The nursing home does background checks on all staff.
The guide on your tour knows the residents by name and is recognized by them.
There are licensed nursing staff 24 hours a day, including a Registered Nurse (RN) present at
least 8 hours per day, 7 days a week.
The same team of nurses and Certified Nursing Assistants (CNAs) work with the same resident
4 to 5 days per week.
CNAs work with a reasonable number of residents.
CNAs are involved in care planning meetings.
There is a full-time social worker on staff.
There is a licensed doctor on staff who is there daily and can be reached at all times.
The nursing home’s management team (including the Director of Nursing and the
Administrator) has worked together for at least 1 year.

Residents’ Rooms

Residents may have personal belongings and/or furniture in their rooms.
Each resident has storage space (closet and drawers) in his or her room.
Each resident has a window in his or her bedroom.
Residents have access to a personal telephone and television.
Residents have a choice of roommates.
Water pitchers can be reached by residents.
There are policies and procedures to protect residents’ possessions.
Hallway, Stairs, Lounges, and Bathrooms and Exits are clearly marked.
There are quiet areas where residents can visit with friends and family.
The nursing home has smoke detectors and sprinklers.
All common areas, resident rooms, and doorways are designed for wheelchair use.
There are handrails in the hallways and grab bars in the bathrooms.

Menus and Food

Residents have a choice of food items at each meal. (Ask if your favorite foods are served.)
Nutritious snacks are available upon request.
Staff help residents eat and drink at mealtimes if help is needed.

Activities

Residents, including those who are unable to leave their rooms, may choose to take part in a
variety of activities.
The nursing home has outdoor areas for resident use and staff help residents go outside.
The nursing home has an active volunteer program.

Safety and Care

The nursing home has an emergency evacuation plan and holds regular fire drills (bed-bound
residents included).
Residents get preventive care, like a yearly flu shot, to help keep them healthy.
Residents may still see their personal doctors.
The nursing home has an arrangement with a nearby hospital for emergencies.
Care plan meetings are held with residents and family members at times that are convenient
whenever possible.
The nursing home has corrected all deficiencies (failure to meet one or more Federal or state
requirements) on its last state inspection report.

This is just the beginning. Make sure you plan on visiting at different times of the day and night to make sure that this is the place you would want your loved one to live. And after the person moves in, make sure you keep visiting at random times so the staff knows you are watching out for your loved one.

Have a kind and respectful day.

Swine Flu Season – What to know when visiting a hospital or long term care facility

The restrictions on who can visit during swine flu season will include rules about what age visitors are allowed and how many people can visit patients this fall. Some hospitals are not allowing anyone under the age of 16 to visit a loved one unless the person is imminently dying. Or the hospital is limiting the total number of visitors to two. Before you go to visit someone in the hospital or in a long term care facility, call ahead to see what the rules are.

If you do visit, make sure that you wash your hands before you come into the building, before you touch the patient and as you leave so you don’t take any germs out with you. Many hospitals have the antibacterial gel at the entrance and in each person’s room. Use it often to protect yourself and your loved one. You may also want to bring a bottle of the antibacterial gel to leave at the bedside of your loved one. That way they can protect themselves.

The hospital doesn’t want you to get sick and they don’t want you to bring in any germs. Patients are very vulnerable to any infection and even if you didn’t mean to, you might be bringing a deadly infection to someone in the hospital. An infection that only makes you a little sick may be life-threatening to someone else. If you are sick, stay home.

I know that it would be difficult for me to stay home when my loved one was in the hospital. But I also know that I would be risking someone’s life by taking the chance of coming to the hospital when I am sick. I could not bear the thought that I brought something into the hospital that killed someone. So, I will do the right thing and stay home if I am in that situation. I hope you will too.

Have a kind and respectful day. KindEthics.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.

Laura Bramly, “Getting Alzheimer’s Diagnosed Early” on Oct. 6th, 9AM pacific

Laura Bramly, “Getting Alzheimer’s Diagnosed Early” on Oct. 6th, 9AM pacific.   Call in to listen live at or listen online at blogtalkradio.com/kindethics.com

Laura lives in Gilbert, Arizona with her husband and two children.  Her mother died at age 87 of vascular dementia in June 2008.  Her mom had been losing her short term memory for at least 7 years before that, but refused to be properly diagnosed.  Her mom had a major stroke in 2006 and lost most of her short term memory abilities, along with use of her legs and one arm. Laura had one week to find a nursing home.   Her mom was moved to the memory care unit of the facility in January 2007.

Laura created the book Life Scenes 1 out of desperation for a stimulating cognitive activity for her mother.  She liked to look through coffee table books and Laura would tell a story about each photo. These books were cumbersome and had no discussion questions for the weary mind who just can’t think of another thing to say to make conversation. So Laura created her own book with photos, large text and discussion questions. The book has many “access points” so that the reader can connect with the book in the way that appeals to them and their abilities best.  Laura was able to read the six-page prototype with her before she died and they spent a wonderful hour just going through those pages. The book was published in November 2008 (self-published) and Laura is putting together the next one: Sports Scenes. The book is a cognitive activity; it stimulates the ability to read (which many people think is lost when in fact it’s just that the reader can’t take in all of the information on the page or can’t read the small print, gets frustrated and gives up) and provides material for discussion and reminiscing.

Laura is a member of Aging With Grace’s (www.agingwithgrace.net) “Ask an Expert” panel. People can contact us for a free consultation on such topics as Alzheimer’s, senior strength-building, insurance, reverse mortgages, care situations… it’s quite diverse!). She is focusing in on diagnosis and activity, and living with dementia.

Laura’s blog:  http://eldercaretalk.blogspot.com

You can purchase Laura’s book on her website:   http://www.eldercareread.com

Have a kind and respectful day.

Cultural Communication Strategies, KindEthics Newsletter vol. 2

Quote of the Day:

Arguing is really saying, “If you were more like me, then I could like you better.”

Feature Article:

Cultural Communication Strategies

What I want to talk about today is the role of culture in our interactions both inside the healthcare system as well as in our daily life. What I want to focus on is our role in dealing with people from different cultures, religions and belief systems. So often we blame others as they are the problem or that they are making it worse when sometimes it is us. Today, I want to empower you to know that you can make a difference and you can make the interaction better. The communication strategies I will teach you will help with difficult relatives or co-workers as well as with your patients. For the next two paragraphs I will focus on the healthcare professional and then after that, everything I will discuss will be helpful to all of us.

Why should we be culturally aware in healthcare? When we ask questions about cultural and religious beliefs we can discover what treatments people are receiving outside of our care. Are they going to a healer, an herbalist, a shaman, an acupuncturist or someone else outside the healthcare system? If so, we need this information in order to protect them from harmful interactions with the treatments we are prescribing. We don’t have to like that they are going to see these people, just realize that they are. You can think what you like but be careful not to criticize them aloud because they will just hide the information from you in the future. If your patient is afraid to tell you the truth about alternative medicines, they may be in danger when they go into surgery.

We also want to know what their values are and how that affects their ability to choose the medical treatments we are offering. Many non-compliant patients are being non-adherent for very good reasons; reasons that are prescribed by their culture or religion. We don’t have to agree with their beliefs but it is important that we understand them so we can work together to find a way to get them to accept at least some of what we are offering them. And at the end of life, we definitely need to ask about how to respect their religion and culture during the dying process.

The most important reason though to be culturally respectful is because we’ve would want to be respected if we were the patient. It is very likely that your own doctor will be from a different religion or culture and you may find yourself in a cultural conflict as well. I would advise you to use “The Platinum Rule®” instead of the golden rule. This states that we should treat others as they wish to be treated, not as we would wish to be treated. (I have attached this article at the end of this newsletter.)

All cultures teach their members the preferred or right way of doing or being. We are each brought up in a family that teaches us the right way to behave. And because this training happens when were so young, we believe that what we’ve been taught is “normal” and “natural” and “right”. I am a Norwegian American, so what I believe is normal, natural and right is based on Norwegian values. So what I believe is normal and what you believe is abnormal. Yes, I just said that. Your beliefs are unnatural and not right unless you believe like I do. Of course this statement is ridiculous. This is a perfect example of the cultural anthropology concept of ethnocentrism. Ethnocentrism is the belief that the customs and practices of one’s own culture are superior to those of other cultures. With ethnocentrism in place, it will increase the differences between us and it will lead us to us versus the “other” thinking. The concept of the “other” is described as the “other” as being less than, less valuable or less intelligent. One might say, “There’s us and then there’s you, the other” in a derogatory manner. We need to realize that one culture is not better or worse, just different. If we were brought up in that other country or culture or religion, we would believe as they do. It just depends on where we were born. I know that there are valuable ideas and values to be found in all cultures even if they’re not exactly like mine. We all want our children to grow up and be happy and healthy. We all want to be able to pay our bills and to provide for our family. We are more alike than different. I encourage you to look for the positive similarities and focus on those during your interactions.

Most people who teach cultural sensitivity would tell you to not judge. I wouldn’t say that. I think it’s normal to make judgments and to have opinions. But we need to figure out how to acknowledge our judgments, then put them aside and not act on them, especially as professionals. Many times I walk into a situation and have a strong reaction to a person but I have to manage that reaction and rise above my bias or first impression. If you feel a judgment or criticism rise up in you, acknowledge it silently and then put it aside and treat the person with compassion and respect. You don’t have to agree with the person, just treat them well. Advocate for them as they may be vulnerable and unable to speak up for themselves because of the cultural or religious barriers. I tell healthcare providers that when you’re about to walk in the exam room or the hospital room, leave your biases or negative expectations outside the door and remember that this person still needs our expertise and support. We can do this anytime we are in an interaction which is getting us upset. We can control our actions and our words during the interaction.

Quite often people are experiencing “relocation stress” during their healthcare experience. Cultural anthropology defines “relocation stress” as the stress one feels when moving from one culture into another culture. Medicine is a culture. It has its own cultural rules, values and a hierarchy for communication. When people come into the healthcare system, unless they work in healthcare system, they don’t know the cultural rules and how to get what they need. And this creates stress on top of the stress they are experiencing about their illness or pending surgery. If you are new to the healthcare process, like my dad was when he went in for double bypass surgery, you need to ask more questions and bring an advocate with you.

So what can we do when we have to deal with people from cultures that we don’t understand or we don’t like. I’m here to tell you, you have a lot of power. Your expectations will affect the interaction. You may have something from communication theory called “selective perceptions”, which is where we only see what we want to see in order to justify our preconceived opinions. Let me give you an example. I have a relative I don’t like. (You probably do too.) Every time I interact with her, I look for things that will reinforce my belief that I don’t like her. So each time, I would find more and more things that confirmed this belief about her. And over time, my dislike grew. Well one day, I realized that I teach other people to have more power over their interactions, so maybe I should put it to the test. (I know, I should have done this a long time ago.) So the next time I interacted with her I looked for something positive about her. I found out that I really respected how well she feeds her children. She feeds them very healthy food and they willing eat it. As I left that interaction, I focused on the positive thing I had found about her and reinforced this new perception as I drove home. Each time I looked for and found more and more things to appreciate about her. Is she ever going to be my favorite person? No. But now I see her differently and in a more balanced and compassionate manner. Just like all of us, she has a combination of good and bad qualities.

The next communication concept I’m going to tell you about is the “halo effect” and the “reverse halo effect.” This is one of my favorites. If you see one positive thing about a person, you will then assume that everything about this person is positive. Or if you see one negative thing about a person, you will then assume that everything about them is negative. We see this with teenagers who begin dating. They will say, “He’s perfect or she’s perfect.” Well, you and I know that nobody’s perfect, but the teenager sees this person with the halo affect and don’t see that the person they are dating are a combination of good and bad qualities. And when we try to tell them differently, they defend that person. They are a victim of the halo effect. The same thing happens when we meet someone from a culture which we don’t like. We use the reverse halo affect and assume that just because they’re from a certain culture, we won’t like them. This is all or nothing thinking and it will get us into trouble. We need to see people as a balance of positive and negative characteristics. Even if there is something you don’t like about a particular culture or religion, it doesn’t have to dictate the whole picture of how you see the individual person. (There are plenty of people I don’t like, but you would never know it as I put aside my opinions and just treat people well.)

One more concept that comes into effect in our daily life is the concept of the “self-fulfilling prophecy”. This is when our negative expectation may lead to us to create that which we didn’t want to occur. Let me give you an example. Every time you go to work, there is a person there that annoys you. (And lots of people annoy me so I can relate.) So when you walk in, you greet everybody warmly but ignore that one person. Or maybe you greet them but choose to greet them in a cold manner. Then you are surprised when the person reacts to you and says, “Have a nice day” with a hostile attitude. This is when most of us will say, “See, look at them they’re always being rude.” But who really started it that day? You did by your attitude and the way you started the interaction. I would challenge you to try another way. The next time you go into work and interact with this person, I would encourage you to greet them warmly with a smile and say something personally kind. This person may be shocked and not know how to react, but over time, they will begin to warm up and your relationship will get better. It may not happen immediately, but if you stick with it, chances are it will get better. Of course it may never be perfect, but I could settle for better. How about you?

One final technique we can use is to realize that things may not always be as they may appear. We may have misunderstood or misperceived the situation. We may be wrong. We need to remember to allow in new information even if it contradicts your stereotype.

In fact, I would encourage you to look for information which breaks your stereotype. Challenge yourself to learn more about the group that you are uncomfortable with or dislike. You may be surprised how much good you can find in them. I would also caution you to be aware of relying on first impressions. Many times we meet people when they are in a crisis or in grief or are overwhelmed by their life. We need to treat them gently, as we would want to be treated if we were in a crisis. An example of this is the patient who comes to the front desk to check in for their appointment and is rude to the receptionist. My first assumption would be that this guy is a jerk. But I know better and don’t jump to that conclusion. (I try not to make assumptions or jump to conclusions because many times I am wrong because I don’t have enough information.) I realize that there might be something going on in his life that I don’t know about. Maybe his wife just died. Maybe he just found out that his son has cancer. Maybe he was just in a car accident. All I know about him is that in spite of his rudeness, he needs my care and support. I also find that when I treat people well and in a caring manner, their rudeness or anger dissipates and interaction goes better. When I treat them better, it gets better. People laugh at me when I say, “Happy Monday” when I come into work or go through the security gate at the airport. But I know that I’m setting a tone and trying to be a positive part of their day. Over time, I have seen offices change their attitude from negativity into optimism, just because I kept saying, “Happy Monday.” Again, I have power over these moments. I can make things better or worse depending on what I bring to the interaction. I have this power and I choose to use it. So can you.

Have a kind and respectful day.

Detailed article describing “The Platinum Rule®”:

What is “The Platinum Rule®” ? Let me tell you how it differs from the Golden Rule. The Golden Rule, which is found in almost every religion says, “Treat people as you would like to be treated or Do unto others as you would like to be done unto.” The Platinum Rule is even better. It says, “Treat people as they would like to be treated or Do unto others as they would like to be done unto.” It is actually a more respectful way of treating people. The Golden Rule assumes that everyone is the same and would want exactly what you would want. But we aren’t alike and we can get into trouble making this assumption. Let me give you an example.

When someone you know has died and people want to give you comfort, “Do you want people to hug you or do you prefer people to not touch you?” Well, I am a hugger so if I use the Golden Rule, then I am going to hug you whether you like it or not. But if I use the Platinum Rule, then I am going to ask you if you could use a hug and depending on what you tell me, I will respect your answer.

The Platinum Rule works really well in America. We are all different. We have different religions, cultures, values and basic preferences. What I personally believe in is respect. Therefore, I will ask how you like to be shown respect and try to honor it. That is why if you tell me you don’t want to have surgery, even though you might die without it, I will respect your answer. I won’t agree with it but it is not my body that has to go through the experience. It is yours. And you are the only one who can say what is right for your life and your body. Now I might ask you if you would consider changing your mind because I don’t want you to die, but ultimately, it is your decision.

I will respect you and I hope that you will consider asking me how I like to be shown respect too.

Have a kind and respectful day.

The Platinum Rule® is a registered trademark of Dr. Tony Alessandra. Used with permission. All other rights are reserved in all media.

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