Healings in Motion Caregiver Guide

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Central Valley Caregiver Resource Guide 2015 Edition


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Caregiver Resource Guide 2015 Edition

Disclaimer This handbook is not an all-encompassing guide. It is a useful tool for reader’s to delve further into the wealth of resources that currently exist for balance and support. All of the information compiled in this guide was valid and accurate at the time of printing. Use this tool at your discretion. It is now part of your Caregiver Toolkit.

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Caregiver Profile, Mary Nicholson. . . . . . . . . . . . . . . . . . . . . . . 2 Understanding the Process of Caregiving, Linda Lowe . . . . . . . 9 Our Unsung Heroes, Bettie Lee Laird. . . . . . . . . . . . . . . . . . . 11 Caregivers-Are You Taking Care of Yourself?, Carolyn Brent. . 12 Long Distance Caregiving, Liza Berger . . . . . . . . . . . . . . . . . 14 Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Make Self-Care A Priority!, Harriet Tubman Wright . . . . . . . 25 Caregiver Support, Local, Regional and National . . . . . . . . . . 27 Caring for Seniors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Holistic Medicine, WELLBeing Resources. . . . . . . . . . . . . . . . 41 911-The Importance of the Numbers, Cliff DeBaugh. . . . . . . 51 Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52


Mary Nicholson, PCC, BA, Founding Director, Healings in Motion November is “National Caregiver Appreciation Month.” In addition, San Joaquin County’s Board of Supervisors declared November 15, 2014 “Caregiver Appreciation Day”. At some point in our life the majority of us will become a caregiver. As loved ones age, debilitating disease, chronic health conditions or simple frailties can follow. We may end up caring for someone permanently injured from an accident. Many young couples sealed their commitment to one another before one of them went to serve in the war. Upon returning, the couple may face the need for care giving and support with both physical and mental challenges. While some employ paid providers, most rely on unpaid assistance from families, friends and neighbors. Notably, caregivers give over $450 billion worth of uncompensated care to loved ones. 1 out of every 5 homes has someone serving as a caregiver. Family caregivers continue to be the largest source of long term care. Every caregiver’s situation is different, but there are some commonalities that allow for a profile. Many caregivers feel lonely. Here are some numbers to help you understand that you are not alone. • There are 65.7 million caregivers in the U.S. • 29 percent of the adult U.S. population are caregivers • 66% of caregivers are woman, but more men are having to step up and serve in this capacity. • 52 is the average age of a female caregiver • 51% of caregivers are between the ages of 18 and 49 • 63 is the average age of a person caring for someone 65 or older. One-third of these caregivers also are in poor health. – Source: Family Caregiver Alliance Many people who are caregiving know little or nothing about the term “Caregiver”. All they know is that a loved one is sick and he or she is doing what someone should do to care for someone in need. Discovering that Caregivers have multiple forms of assistance and services usually listed under this title of “Caregiver” opens the gate for some relief. Not only are there national resources, there are local county services available to assist you. There are additional services available to caregivers caring for veterans and now there is assistance for the growing number of grandparents who are taking care of their grandchildren for a variety of reasons. ☙


Across the United States, almost 7.8 million children are living in homes where grandparents or other relatives are the householders, with more than 5.8 million children living in grandparents’ homes and nearly 2 million children living in other relatives’ homes. These families are often called “grandfamilies.” More than 2.5 million grandparents are taking on the full responsibility for their grandchildren. Many grandparents and other relative caregivers and the children they are raising are often isolated. They lack information about the range of support services, resources, programs, benefits, laws and policies available to help them successfully fulfill their care giving role. In addition, to better serve children, families and older adults, educators and program practitioners need access to information.

Resources:

AARP Grandparent Information Center, 601 E. Street, NW Washington, DC 20049 (202) 434-2296 | www.aarp.org The Grandfamilies State Law and Policy Resource Center serves as a national legal resource in support of grandfamilies within and outside the child welfare system. Grandfamilies of America 6525 Fish Hatchery Road, Thurmont, MD 21788 (301) 898-8023 | (866) 203-8926, ext. 8103 http://www.grandfamiliesofamerica.com/ | www.grandfamilies.org Grandparent Advocacy Network of Northern California Contact: Sandy Weiss | Phone: 530-756-0183 | Email: WeissSBK@comcast.net Service Area: Northern California counties | Description: Monthly informal lunches for grandparents Grandparent Project – Senior Legal Hotline of Legal Services of California, Phone: 1-800-222-1753 (toll-free) | www.seniorlegalhotline.org Service Area: Statewide; some services Sacramento County only San Joaquin County Human Services Agency, Aging and Community Services Manuel Lopez (See ad Page 4) Stanislaus County - Family Partnership Center - Rhonda Parker (See ad Page 10) ☙


Income

• Each state administers federal funds that provide cash assistance to families in need. • Temporary Assistance to Needy Families (TANF) • Cash assistance may be available to eligible children and their relative caregivers. • California’s Cal Works Program • California Department of Social Services | 916-657-2128 Email: piar@dss.ca.gov | www.cdss.ca.gov/calworks • Social Security: A multigenerational program, Social Security provides income benefits to adults, older adults and children. In addition to Retirement and Disability benefits, Survivor’s Benefits are based on a child’s parent’s earnings and may help if a child’s parent(s) die. • The Supplemental Security Income (SSI) program pays benefits to disabled adults and children who have limited income and resources. SSI benefits are also payable to people 65 and older without disabilities who meet the financial limits.


FREE Online Workshop Provides Information and Support It’s called Building Better Caregivers and it is a free six-week online workshop for family caregivers of veterans. If you are taking care of a veteran, this workshop will help you learn a variety of skills like time management, healthy eating, exercise and dealing with difficult emotions. This program was developed by Stanford and has proven to reduce stress and depression while increasing your overall wellbeing. To register for the on-line 6-week program, go to www.caregiver.va.gov National Resource Directory - Connecting Wounded Warriors, Service Members, Veterans, Their Families and Caregivers with Support https://www.ebenefits.va.gov/ebenefits/nrd

Resources:

VA Caregiver Support American Foundation for Suicide Prevention (AFSP) (888)-333-2377 | www.afsp.org Anxiety Disorders Association of America (240) 485-1001 | www.adaa.org Freedom from Fear 308 Seaview Avenue | Staten Island, NY 10305 (718) 351-1717 | http://freedomfromfear.org National Resource Directory | www.nrd.gov Connecting wounded warriors, service members, veterans, their families and caregivers with those who support them. Tributes | www.tributes.com FREE tributes celebrating the lives of a loved one and reach on-line support during your period of grieving. VA Caregiver Support | (855) 260-3274 | www.caregiver.va.gov Veterans Benefits Administration | www.VBA.VA.gov Veterans Home Care 548 Market Street #71697 | San Francisco, CA 94104 (877) 878-4248 | www.veteranshomecare.com

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Catholic Charities | www.ccstockton.org STOCKTON OFFICE 1106 North El Dorado | Stockton, CA 95202 | 209-444-5900 MODESTO OFFICE 400 12th Street, Suite 4 | Modesto, CA 95354 | 209-529-3784 MOTHER LODE 88 Bradford St. | Sonora, CA 95370 | 209-532-7632 San Joaquin - www.sjgov.org/veterans Human Services Agency - Aging & Community Services Veteran’s Services, Virginia Wemmer, Director 105 South San Joaquin Street, First Floor | Stockton, CA 95202 | 209- 468-2916 Get other helpful resources through San Joaquin’s Directory for Seniors, Disabled, Caregivers and Providers www.sjaging.org/pdf/HSA_Directory_%20 2013_2014_Final_Copy.pdf Stanislaus - www.agingservices.info/care-giving.shtm Aging & Veterans Services 121 Downey Ave, Suite 102 | Modesto, CA 95354 | 209-558-8698 Get other helpful resources through the Caregiver Information, Services and Resources Booklet www.agingservices.info/pdf/caregiver-booklet.pdf

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“Not only are their contributions the foundation of the nation’s long-term care system, they are an important component of the U.S. economy.” (Valuing the Invaluable: A New Look at the Economic Value of Family Caregiving, a study led by Mary Jo Gibson, AARP Public Policy Institute, 2006) The good news is that we are living longer. The bad news is that we are living longer with chronic diseases. There are health fairs regularly, more assisted living and home health care businesses are opening up because caregiving has become a new norm for many households. The “baby boomer” generation, the largest age segment in America, is aging, and diseases, like Alzheimer’s, are estimated to increase in California by as much as 30%. The challenges of the Caregiver have reached a crisis state. Caregivers are primarily taking care of parents, a spouse or significant other, friends, parent-inlaw and others, including grandparents, sons, daughters, and extended family. The contributions of America’s family caregivers, along with many friends and neighbors, often go unrecognized in public policy discussions about the costs of health care and long-term services and support. Yet unpaid caregivers provide by far the majority of long-term services and support received by persons with chronic illnesses and disabilities. Caregivers are more at risk for infectious diseases, such as colds and flu, and chronic diseases, such as stroke, heart problems, diabetes, and cancer. Depression is twice as common among caregivers compared to non- caregivers.

Business Impact

• Absenteeism costs the U.S. economy an estimated $25.2 billion in lost productivity. [Gallup Healthways Wellbeing Survey, Caregiving Costs U.S. Economy $25.2 Billion in Lost Productivity, July, 2011] -Updated: November 2012 • Of those providing care, 24% say caring for an aging family member, relative, or friend has an impact on their work performance, and it keeps them from working more hours. [Gallup Healthways Wellbeing Survey, Caregiving Costs U.S. Economy $25.2 Billion in Lost Productivity, July 2011] -Updated: November 2012 7


• Caregivers overall reported missing an average of 6.6 workdays per year. Approximately 17% of full-time workers missed 126 million workdays each year. 36% of caregivers missed 1-5 days per year while 30% reported missing 6 or more days in the past year. [Gallup Healthways Wellbeing Survey, More Than One in Six American Workers Also Act as Caregivers, July, 2011] - Updated: November 2012 • Caregiving has shown to reduce work productivity by 18.5% and increase the likelihood of leaving the workplace. [Coughlin, J., (2010). Estimating the Impact of Caregiving and Employment on Well-Being: Outcomes & Insights in Health Management, Vol. 2; Issue 1] - Updated: November 2012 • One third of working caregivers are working professionals and another 12% are in service or management roles. • The cost of informal caregiving in terms of lost productivity to U.S. businesses is $17.1 to $33 billion annually. [MetLife Study of Working Caregivers and Employer Health Costs: National Alliance for Caregiving. 2010] - Updated: November 2012

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Linda Lowe, Stanislaus County Area Agency on Aging Caregiving may be the most important job in our society. Everyone needs care as infants and most of us will need some kind of care at the end of our lives. At both ends of our lives caregiving is most often done in the family setting. Effective caregiving varies with the needs of each person, and can involve technical skills that need to be supplied by someone from outside the home, such as a physical therapist, home health aide, or a nurse. Under the best circumstances, caregiving is a partnership between the caregiver, care receiver, medical personnel, and any assisting agencies. Caregivers can be the biggest encouragers for seniors, helping them understand what is possible and what part of their condition requires acceptance, involving lifestyle changes to maintain the most optimal quality of life. In Stanislaus County, the Area Agency on Aging is available by calling 209-558-8698 or through the website, www.agingservices.info. The staff assists caregivers identify and use resources like respite, home health assistance, housecleaning, home repair, support groups, care referral services, or care management. Information is available about a wide variety of programs. The Family Caregiver Support Program is available to pay for respite for caregivers and some assistive devices. Respite assistance is available through a certified home health agency, or through volunteers, giving the caregiver the opportunity to “recharge his or her batteries”, helping them better care for their loved one in the home. Sometimes the most loving thing that a caregiver can do for his or her loved one is to find a competent care facility. Relinquishing the day-to-day responsibilities to trained and caring staff members can give the caregiver the opportunity to interact better with the care receiver. Professional caregivers can handle personal care, or other areas the caregiver may not be capable of accomplishing. Care referral services that are free to the consumer can help find an appropriate facility, and make the transition to a higher level of care easier for both the caregiver and the care receiver. The “Caregiver Information, Services and Resources in Stanislaus County” booklet includes descriptions of services, websites and phone numbers of various agencies that can help with caregiving. Find it at the www.agingservices.info website or call 209-558-8698. ☙ 9


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Bettie Lee Laird, LCSW, Clinical Social Worker The 2013 statistics from the Family Caregiver Alliance reflect there are over 5.88 million unpaid family caregivers in California alone. This forms the largest long term care work force in the country. It has been estimated that these family caregivers provide $47 billion in unreimbursed services! Caregiving is more often than not a juggling act! Fifty six percent of these caregivers are mostly adult children of the care receiver. They are generally between the ages of 45 and 65 with other career and family responsibilities. Three quarters of these California caregivers were female and found to be more likely to step out of the work force to provide care. The squeeze and tug of various roles and responsibly is not without cost. Family caregivers can suffer dearly from financial, psychological, and physical consequences resulting from caregiver burden. Few are adequately prepared to assume increasing caregiver responsibly over time. Caregivers often need help to cope with this stress. Be mindful of caregiver self-care strategies and survival tips* such as the following: plan ahead, learn about available resources, take one day at a time, develop contingency plans, accept help, be good to yourself, make YOUR health a priority, get enough rest, eat properly, make time for leisure, share your feelings with others . To find more peer support for caregivers visit http://dmc-modesto.staywellsolutionsonline.com. Feed your spirit, stay social, watch for any signs of anxiety or depression and seek professional help if it is indicated. Remember that good patient care BEGINS with good self-care! ☙

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Carolyn A. Brent, MBA, Author After going through the journey and heartache of being the family Caregiver for my father for twelve years, and then enduring pain of legal conflicts with my siblings, I ultimately asked myself a key question: What would I do differently if I could do it all over again? My answer was simple: I would take better care of myself. Looking back, I do not regret my decision to be my father’s caregiver. I did it for love. It was rewarding to have the opportunity to give of myself to my father in his time of need, as he had given so much to me. Even so, it was exhausting. It took a very real physical toll on my body. Caregivers are notoriously run-down. A common thread is how beaten up they feel. They’re trying to help someone they love and they’re falling to pieces in the process. My first book, Why Wait? The Baby Boomers’ Guide to Preparing Emotionally, Financially and Legally for a Parent’s Death contains new and updated information and provides a road map to guide the family caregiver. In my new book, THE CAREGIVER’S COMPANION: Caring for Your Loved One Medically, Financially and Emotionally While Caring for Yourself, also explores the toll that caregiving exacts on caregivers and the myriad ways in which you can take better care of yourself as a caregiver. ☙ Make A Commitment, Embrace Your LIFE Today; Work Your Health Plan, Win Your Life Back! I am 57 years old, and I have learned “The Art of Aging Gracefully.” And so can YOU! Visit my website, CareGiverStory.com

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Reprint with Permission By Liza Berger, Staff Writer, Caregiver Magazine It usually starts with a call: A father casually informs you he’s been diagnosed with congestive heart failure. Your mom’s neighbor says she’s noticed that Mom hasn’t been herself lately. A sibling tells you it’s about time you came down South to visit Dad. Caregiving is often triggered by a crisis. And all of a sudden, an adult child is forced to come to grips with a newfound new role as a long-distance caregiver. Thankfully, caregivers can take certain steps to help ease the stress of the task. Collecting valuable information on a loved one, assembling a support team and staying in touch with the people involved are a few ways that caregivers can take charge from afar. A Growing Phenomenon It is not uncommon today for children to live far from their parents. Baby Boomers are now learning what it is like to care for their parents from far away. Approximately seven million adults, including more than three million Baby Boomers, provide or manage care for a relative or friend over the age of 55 who lives at least an hour away. That is according to the “Handbook for Long-Distance Caregivers” from the Family Caregiver Alliance and its partner, the National Center on Caregiving. Like the changing patterns of living, gender roles have evolved too. Men now represent more than 40 percent of caregivers, the National Institute on Aging reports. Meanwhile, a study by MetLife Mature Market Institute in conjunction with the National Alliance for Caregiving indicated that 23 percent of long-distance caregivers are the sole primary caregiver. Whether primary or secondary, man or woman, caregiving from afar is loaded with anxiety-producing questions: How do I make sure Mom or Dad receives the proper care? Where do I find the necessary care services? How do I balance my life here with caring for him there? 14


Gathering Information To help lessen the load of long-distance caregiving, organizations recommend doing your homework. That includes finding out who you can count on to take care of mother on a regular basis and who you can turn to for questions, support and help if an emergency arises. As you continue to manage care for your loved one, it may help to have a Care Notebook—a three-ring binder to keep track of all the information you collect, the Family Caregiver Alliance handbook says. Assessing your family member’s condition is the first step toward getting a handle on the situation, caregiving organizations say. It should include both a medical diagnosis and an evaluation of the individual’s need for assistance, according to the guide “Long Distance Caregiving” from MetLife in cooperation with the National Alliance for Caregiving. Making regular visits is probably the best way to appropriately determine a loved one’s limitations and needs. Ask such questions as: Is there a change in personal hygiene? Does he or she appear unsteady when getting up or down from a chair? And does he or she seem to be increasingly forgetful? These help to determine the type and amount of care that a loved one may require. Also, a caregiver shouldn’t forget to always spend some quality time with a loved one during a visit. Research is key in learning about the types of services that are available in your loved one’s community. One good idea is to use the phone or computer to find out what the resources and options are before a visit. Then a caregiver can set up appointments to meet providers during the visit. Caregivers should make a point of meeting their family member’s doctors and others who help their family member. Services in the community to consider include: meal delivery, adult day care, in-home aides, transportation, help with Medicare claims and telephone checkins. A long-term care facility, such as an assisted living facility or nursing home, may also be an option. The Administration on Aging’s Eldercare Locator helps find aging services in a particular community. To find out more, call 800-677-1116, or visit www.eldercare.gov. (More resources for long-distance caregivers are at the end of the story.) A geriatric care manager (GCM) may be just the person a long-distance caregiver is looking for to help assess a loved one’s needs and coordinate services. Often trained as gerontologists, social workers or nurses, they can suggest care options, provide referrals to local resources and help guide you through the complex system of long-term care. 15


A Team Effort One of the most essential parts of caring for a parent long-distance is to develop a core group of people you can rely on to help care for your parent. That team could include nearby siblings, other family members or close friends; neighbors who know your relative well; those people your loved one sees often, such as a housekeeper; and care professionals. Make sure to keep a list of names, telephone numbers and e-mail addresses for all the people on your team. It may be helpful to hold a conference with siblings and others to discuss each person’s caregiving role. This may be done face-to-face, on the phone or through e-mails. Family conflicts often erupt when a parent becomes sick. In such a situation, it may be helpful to bring in a therapist or objective thirdparty to mediate family conferences. It’s also important to involve the loved one in the decision-making process. Documentation Part of the information-gathering process is keeping a family member’s important documents and medical information at hand. This information includes a loved one’s date of birth, Medicare and/or Medicaid number, Social Security number and health insurance information. (Consider copying and laminating these key documents and keeping them in your Care Notebook.) It’s important that caregivers tend to their own physical and emotional health. Recognize what you can and can’t do. Forgive yourself for not being perfect, according to the “Long-Distance Caregiving” guide. Don’t become isolated from your friends, families and activities. Support groups may offer a way for caregivers to share their feelings with others who are in similar situations. If a caregiver is experiencing signs of depression, sleeplessness or feelings of helplessness, it may be a good idea to seek help, experts say. It takes a special person to be a caregiver. Those who are doing it should recognize that they are doing a valuable, loving and caring act—and for this they should be proud. There are many places long-distance caregivers can turn to for help. Here are a few: 16


Administration on Aging’s Eldercare Locator Helps to find local resources for the elderly. Phone: 800-677-1116 Website: www.eldercare.gov Children of Aging Parents Provides information, referral service and educational outreach. Phone: 800-227-7294 Website: www.caps4caregivers.org Family Caregiver Alliance Provides information, education, services, research and advocacy for caregivers. Phone: 800-445-8106 Website: www.caregiver.org National Association of Professional Geriatric Care Mangers. Locates geriatric care managers in your area. Phone: 520-881-8008 Website: www.caremanager.org National Council on Aging Benefits Check-Up. Checks eligibility to receive benefits. Web site: www.benefitscheckup.org. National Family Caregivers Association A support organization for caregivers. Phone: 800-896-3650. Website: www.nfcacares.org

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Services Adaptive/Assistive Equipment Alert Medical Response 3012 S. Soderquist Road Turlock, CA 95380 (209) 262-4685 www.alertmedicalresponse.com Assistive Technology | www.assistivetech.net Deaf and Disabled Telecommunications (DDTP) 1333 Broadway Street, Ste 500 Oakland, CA 94612 (510) 302-1100 (800) 806-1191 http://ddtp.org Durable Medical Equipment | www.rediscoverwalking.com Lifeline - St. Joseph’s Medical Center 1800 N. California Street Stockton, CA 95204 (209) 467-6468 www.dignityhealth.com Shield Health Care (800) 765-8775 www.shieldhealthcare.com

Advocacy

Organizations that promote the health, dignity, rights and quality of life for seniors and those with disabilities. AARP (886)872-2277 www.aarp.org Adversity to Advocacy (415)672-9050 www.adversity2advocacy.com 19


American Civil Liberties Union (212)549-2500 American Rights Coalition 800-823-6060 Consumer Complaints (800)782-1110 Disability Resource Agency for Independent Living - DRAIL The Disability Resources Agency for Independent Living (DRAIL) is dedicated to increasing the independence of individuals with disabilities through resources, advocacy and services. Modesto Office 920 12th Street Modesto, CA 95354 Stockton Office 501 W. Weber Avenue, Suite 200-A Stockton, CA 95203 www.drail.org National Alliance of Mental Illness (NAMI), California NAMI California is a grass roots organization of families and individuals whose lives have been affected by serious mental illness. NAMI educates and advocates for quality and respect, without discrimination and stigma to provide leadership in advocacy, legislation, policy development, more support for mental illness throughout California. 1851 Heritage Lane, Ste 150 Sacramento, CA 95815 (916) 567-0163 www.namicalifornia.org California Health Advocates 5380 Elvas Avenue, Suite 221 Sacramento, CA 95819 (916)231-5110 www.cahealthadvocates.org

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Disability Rights California (DRC) DRC is a non-profit organization which advances human and legal rights for persons with disabilities, providing legal assistance to protect those rights. Services and issues dealing with special education, Lanterman Act, benefits (i.e. Social Security, Medi-Cal, In-Home Supportive Services), housing rights, employment rights, access to services and more. 1831 K Street Sacramento, CA 95811-4114 916-504-5800 www.disabilityrightsca.org San Joaquin Pride Center 109 N. Sutter Street Stockton, CA 95202 (209) 466-SJPC (7572) www.sjpridecenter.org

Aphasia Aphasia Foundation Get the Aphasia Handbook | (800) 922-4622 | www.aphasia.org Aphasia Foundation | www.aphasiahope.org

Benefits Benefits Check Up | www.benefitscheckup.org Clinical Trials | www.clinicaltrials.gov Medicaid | www.CMS.gov/home/medicaid.asp Medicare | 7500 Security Boulevard | Baltimore, MD 21244 (800) 633-4227 | www.medicare.gov Office of Minority Health, California Regional Office Christina Perez, FNP, MN, RN,RMHC | christina.perez@hhs.gov 90 7th Street | Suite 5-100 | San Francisco, CA 94102 (415) 437-8124 | www.hhs.gov 21


Patient Assistance for Prescription Drugs | www.patientassistance.com Senior Medi-Benefits | 3195 Adeline Street | Berkeley, CA (510) 420-0550 (888) 789-4589 | www.seniormedi-benefits.org Social Security (Disabilities) | (877) 803-6314 www.social-security-disability.org U. S. Government Benefits | www.benefits.gov

Brain Related Alzheimer’s & Memory Center | www.fresno.ucsf.edu/alzheimer 6137 N. Thesta Avenue, Suite 101B | Fresno, CA 93710 (559) 227-4810 Alzheimer’s Association of Northern CA | www.alz.org/norcal 1455 Response Road | Sacramento, CA | (916)930-9080 (800)272-3900 American Foundation for Suicide Prevention (AFSP) | www.afsp.org (212) 363-3500 Anxiety Disorders Association of America (240) 485-1001 www.adaa.org Association for Behavioral and Cognitive Therapies (212) 647-1890 ww.abct.org BeHaveNet A comprehensive resource guide for psychological illnesses. www.nextstepincare.org Brain Aneurysm Foundation 269 Hanover Street Hanover, MA 02339 781-826-5556 . 888-272-4602 www.bafound.org 22


Brain and Behavior Research Foundation 60 Cutter Mill Road, Ste 404 Great Neck, NY 11021 (800) 829-8289 www.bbrfoundation.org B.R.A.I.N. Brain Rehabilitation and Injury Network 5267 Warner Avenue Huntington Beach, CA 92649 (714) 318-6076 www.thebrainsite.org The Healing Brain Trust 459 Broadway, Suite 302 Everett, MA 02149 (877) 252-8480 www.braintrust.org American Stroke Association 272 Greenville Ave. Dallas, TX 75231 888-4-STROKE 888-478-7653 www.strokeassociation.org Healings in Motion 56 S. Lincoln Street Stockton, CA 95203 (209)234-2802 www.healingsinmotion.org Twitter @Brain2Retain National Stroke Association 9707 E. Easter Lane, Suite B Centennial, CO 80112 800-STROKES 1-800-787-6537 www.stroke.org

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Brain Injury (866) 882-7246 www.braininjury.com Brain Injury Association of CA 888-662-4222 www.biaca.org Brain Resource Center 263 W. End Ave. #1D New York, NY 10023 (212) 877-2130 www.brainresourcecenter.com Head Injury 206-621-8558 www.braininjury.com Post-Traumatic Stress Disorder (PTSD) (262) 567-6600 www.anxietydisordersfoundation.org Traumatic Brain Injury of CA Two Commerce Square 2001 Market Street, Suite 2900 Philadelphia, PA 19103 www.traumaticbraininjury.com

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Harriet Tubman Wright, MS, MA

Are you caring for others at the expense of your own well-being? • Does everyone and everything else take priority over caring for yourself? • Is it time to recharge your batteries or replenish your reserves?

Self-Care is not selfish. Self-Care is Self-Love. It is the mindset of, “I love myself enough to take care of myself first.” When you learn and practice self-care, you free yourself from undue stress, potential burnout and illness. You free yourself from the feelings of overwhelm and exhaustion that rob you of the energy to care for the person or persons who count on you. By making self-care a priority, you lovingly prepare yourself to serve and support others from a wellspring of vigor and vitality. You empower yourself to be and do your best in service to your loved ones and family, your colleagues, clients and community.

What are some key principles of self-care?

a. Implement daily BodyMindSpirit practices such as regular exercise, sound nutrition and proper rest; b. Cultivate positive beliefs, thoughts, attitudes, words and behaviors that create healthy, empowering results in your life; c. Maintain healthy boundaries by learning when and how to say “No”, “No, thank you,” or “No, not at this time,” without guilt, shame or apology; d. Take “time-out” for pampering, play and quality time in nature; e. Celebrate wins, successes and achievements!

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If you feel guilty or uncomfortable with self-care, remember the instructions of airlines attendants to “put your oxygen mask on first before attempting to help others.” (You can’t help if you can’t breathe.) The same is true for us as caregivers. Maintaining healthy boundaries is one of the most challenging principles to accept. Putting yourself first usually means you have to say “no” to someone or something else in order to say “yes” to yourself. However self-care, which is tending to and nurturing your own bodymindspirit first and foremost, is essential for your health and well-being. How can you begin tending to your bodymindspirit?

Begin with a small daily ritual. For example, begin your morning by: • Doing gentle stretching for 10 minutes or walking in a nearby park. End the day with a foot massage or soak in the tub • Saying an affirmation, such as: “Today, I am gentle, compassionate and loving with myself.” “I am balanced, centered, grounded and relaxed here and now.” • “Today, I take quality time-outs to refresh myself.” • Meditating, praying or chanting. End the day by making a list of everything for which you are thankful in your Gratitude Journal These are a few easy, practical tools to begin making self-care a priority. Find more effective tools, strategies and practices in my book, Releasing Stress, Creating Serenity A BodyMindSpirit Self-Care Primer for Busy Women, available at: http://www.thewrightresort.com/releasing-stress-creating-serenitybook Imagine if you were making self-care and pampering practices a priority, functioning from a place of balance, peace and joy, being and doing your best in service to others, and making a positive difference in the lives of those you serve… “With daily self-care practices, you’ll release stress, create serenity and restore BodyMindSpirit alignment, balance and circulation for optimal health and well-being.”- Harriet Tubman Wright ☙ 26


Caregiver Support Central Valley Senior Services 178 West Adams Street Stockton, CA 95204 (209) 890-1300 | www.centralvalleyseniorservices.org Del Oro CRC Serving Alpine, Amador, Calaveras, Colusa, El Dorado, Nevada, Placer, Sacramento, San Joaquin, Sierra, Sutter, Yolo and Yuba Counties 8421 Auburn Blvd, Suite 120 Citrus Heights, CA 95610 (916)728-9333 | www.deloro.org Valley CRC Serving Fresno, Kern, Kings, Madera, Mariposa, Merced, Stanislaus, Tulare and Tuolumne Counties 3845 North Clark Street, Suite 201 Fresno, CA 93726 www.valleycrc.org

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Eldercare at Home www.healthinaging.org Elder Law Answers G. Archer Bakerink, A Professional Corporation 215 North San Joaquin P.O. Box 204 (95201) Stockton, CA 95202 (209) 598-7774 www.elderlawanswers.com Family Caregivers Alliance (800)445-8106 www.caregiver.org/caregiver Home Care: A Family Caregiver’s Guide www.nextstepincare.org Rosalynn Carter Institute for Caregiving 800 GSW Drive Georgia Southwestern State University Americus, Georgia 31709-4379 (229) 928-1234 www.rosalynncarter.org The National Alliance for Caregiving 4720 Montgomery Lane, 2nd Floor Bethesda, MD 20814 (301) 718-8444 www.caregiving.org California’s Advance Health Care Directive http://www.sos.ca.gov/ahcdr/forms.htm

Dental Care University of the Pacific Dental Care Clinic A program providing comprehensive, quality dental care at reasonable prices. Dental Residents treat patients by integrating all phases of dentistry, with an emphasis on advanced comprehensive treatment. Denti-Cal and other insurance accepted. 28


757 Brookside Road Stockton, CA 95207 (209) 946-7404 www.dental.pacific.edu

Disability Support Arc-San Joaquin Stockton, CA 95202 (209) 955-1625 Fax: (209) 955-1627 www.thearcsj.org RSC of San Joaquin, Inc. 2339 W. Hammer Lane, Suite C, PMB #233 Stockton, CA 95209-2368 209-403-8878 www.rscofsanjoaquin.org United Cerebral Palsy 333 W. Benjamin Holt Drive Stockton, CA 95207 (209) 956-6379 www.ucpsj.org

Food Artesian Natural Foods 145 Lincoln Center Stockton, CA 95207 (209)952-8787 www.artesiannaturalfoods.com Green’s Nutrition & Health Food Store 1906 Pacific Avenue Stockton, CA (209) 464-5738 www.greensnutrition.com 29


Hospice Bristol Hospice 2140 Professional Drive, 210 Roseville, CA 95661 (916) 782-5511 www.bristolhospice.com Community Hospice 4368 Spyres Way Modesto, CA 95356 (209) 578-6300 www.hospiceheart.org Hospice of San Joaquin 3888 Pacific Avenue Stockton, CA www.hospicesj.org Optimal Hospice Care 4568 Feather River Drive, Ste C Stockton, CA 95219 (209) 670-8000 www.optimalcares.com VITAS Hospice Services 16956 S. Harlan Road Lathrop, CA 95330 (209)858-2409 www.vitas.com National Hospice Foundation www.nationhospicefoundation.org

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2015 2015 Caregiver Caregiver College College Schedule Schedule 2015 Caregiver College Schedule 2015 Caregiver College Schedule 2015 Caregiver College Schedule February February 1212 - Taking -- Taking Care Care of of February 12 Taking Care of thethe Caregiver Caregiver February 12 Taking Care of of the Caregiver February 12 - Taking Care the Caregiver the Caregiver April April 9 -99Make -- Make Your Your Wishes Wishes April Make Your Wishes Known! Known! Your Your April 9 -Completing Your Wishes April 9Make -Completing Make Your Wishes Known! Completing Your Advance Advance Health Health Care Care Directive Directive Known! Completing Your Known! Completing Your Advance Health Care Directive Advance Health Care Directive Advance Care Directive June June 1111 - VA -Health VA Benefits Benefits June 11 - VA Benefits June 1111 - VA Benefits August August 13 13 Caring - Caring forfor Someone Someone June --VA Benefits August 13 - Caring for Someone with with Alzheimer’s Alzheimer’s Disease Disease August 13 Caring for Someone August 13 - Caring for Someone with Alzheimer’s Disease with Alzheimer’s Disease October October 8 -8When - When Remaining Remaining with Alzheimer’s Disease October 8 - When Remaining at at Home Home Becomes Difficult, Difficult, October 8 Becomes -8When Remaining October -Options When Remaining at Home Becomes Difficult, Know Know Your Your Options at Home Becomes Difficult, at Home Becomes Know Your OptionsDifficult, Know Your Options Know Your Options call For For more more information, information, call For more information, 209.477.6300 209.477.6300 For more information, callcall For more information, call 209.477.6300 209.477.6300 209.477.6300

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In-Home Support Services (IHSS) IHSS is a state program administered by your county that provides homecare assistance to eligible aged, blind or disabled individuals. To be eligible for IHSS, you must be on Medi-Cal, be blind, disabled, or 65 years of age or older, and unable to live at home safely without help. IHSS-Merced 708 W. 20th Street Merced, CA 95340 (209)385-3105 http://www.co.merced.ca.us/index.aspx?NID=1488 IHSS-San Joaquin County PO Box 201056 Stockton, CA 95201 (209) 468-1104 http://www.sjaging.org/IHSS/IHSS.htm

Hospitals (See your phone book for total listing) Briggsmore Specialty Center 1409 E. Briggsmore Specialty Center Modesto, CA 95355 Central Valley Specialty Hospital For patients who still need Acute Rehabilitation and Skilled Nursing Services. 730 17th Street Modesto, CA 95354 (209)248-7700 www.centralvalleyspecialty.org Dameron Hospital | STEMI Center Bariatric Surgery 525 West Acacia Street Stockton, CA 95203 (209)944-5550 www.dameronhospital.org 32


Kaiser Permanente, Modesto Certified Stroke Center 4601 Dale Road Modesto, CA (209) 557-1000 http://kp.kaiserpermanente.org/ St. Joseph’s Medical Center Certified Stroke Center STEMI Center MAKOplasty Surgery 1800 North California St Stockton, CA 95204 (209) 943-2000 www.stjosephscares.orgt San Joaquin County General Hospital Certified Stroke Center/ Trauma Center 500 West Hospital Road French Camp, CA 95231 (209) 468-6000 www.sjgeneralhospital.com Sutter Gamma Knife Center 2800 L. Street Suite 630 Sacramento, CA 95816 (888)287-2270 www.sutterneuro.org Sutter Gould Foundation 600 Coffee Road Modesto, CA 95355 (209)835-1500 www.suttergould.org Sutter Tracy Community Hospital 1420 N. Tracy Blvd. Tracy, Ca 95376 (209)835-1500 www.suttertracy.org 33


Valley Choice Fertility Clinic 1409 E. Briggsmore Avenue (209)550-4720 www.suttergould.org/services/infertility-clinic.html Valley Heart Institute Part of Doctors Medical Center 4016 Dale Road Modesto, Ca 95356 (209) 577-5557 www.valleyheartinstitute.com

Housing Franco Center Apartments-Senior Community. Provides low-income, subsidized housing for senior citizens in the Stockton area. The complex offers studio apartments as well as one and two bedroom apartments. The community center is available to all seniors living in San Joaquin County 7 North San Joaquin Street, Suite 40 Stockton, CA 95202 (209) 466-3577 (209) 460-502102 Email: tquintero@hacsj.com www.hacsj.com

Indian Health Indian Health Service www.ihs.gov/california CA Health Care Services http://www.dhcs.ca.gov/services/rural/Pages/IndianHealthProgram.aspx Bay Area Indian Health Clinic www.indianhealthcenter.org

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Journals www.eCareDiary.com A great place to connect with other Caregivers, including Caregiver Radio.

Rehabilitation California Department of Rehabilitation Vocational Services Clients must have documented disabilities. California Department of Rehabilitation assists Californians with disabilities to obtain and retain employment and maximize their ability to live independently in their communities. Eligible individuals are assisted in finding employment and/or independent living. Vocational training and counseling are also available. 1507 East March Lane, Suite A Stockton, CA 95210 (209) 473-5900 Fax: (209) 473-6511 www.dor.ca.gov

Mental Illness Asian Americans for Community Involvement (408)975-2730 | www.aaci.org Behavioral Health Services, San Joaquin County 1212 N. California Street Stockton, CA 95202 (209) 468-8750 | www.sjcbhs.org National Alliance of Mental Illness (703) 524-7600 | (209)468-3755 | www.nami.org

Pain Management For Those in Pain (650) 968-2323 www.forthoseinpain.org 35


Respite and Day Care Respite offers a few hours of relief from your Caregiving duties. Respite affords the Caregiver time to refresh and include time for valuable self-care. Jene Wah, Inc. Jene Wah, Inc. is a comprehensive community services agency that enables elderly citizens to live independently and enhance their quality of life. This multi-service agency also provides nutrition information for seniors, transportation to doctor visits, interpretation services and assistance with tax preparation. In addition, they offer congregate meal services, homemaker services, personal care and telephone assurance. The agency is open to new immigrants. They provide naturalization classes in English and Chinese, as well as ESL. 238 East Church Street Stockton, CA 95203 (209) 463-7654 genewah@clearwire.net Catholic Charities | www.ccstockton.org Provides personal care and homemaker services to low income seniors who are not eligible for In-Home Supportive Services (IHSS). In addition, Catholic Charities contracts to provide the following services: Caregiver Respite, Caregiver Chore, Home Modification, Telephone Reassurance and Caregiver Training. 1106 N. El Dorado Street Stockton, CA 95202 (209) 444-5951 El Concilio 1755 W. Hammer Lane, Suite #8 Stockton, CA Family Caregiver Alliance 785 Market Street, Suite 750 San Francisco, CA 94103 (415) 434-3388 (800) 445-8106 www.caregiver.org 36


Family Caregiver Support Program-San Joaquin County 102 S. San Joaquin Street Stockton, CA 95201 (209) 468-3814 www.sjaging.org Lodi Memorial Hospital operates a State-licensed Adult Day Services Program at Hutchins Street Square for older and disabled adults who cannot fully care for themselves. The Adult Day Services Center helps fill the gap between senior centers and full time residential care. The Adult Day Program provides a safe, stimulating environment, and includes meals, supervised exercise, music therapy, computer memory skills programs, entertainment, and arts and crafts. Supportive services are available to assist caregivers. (209) 369-4443 www.lodihealth.org/html/adult_day_care.html Respite Care Locator http://www.archrespite.org United Cerebral Palsy of San Joaquin 333 W. Benjamin Holt Drive Stockton, CA 95207 (209) 956-0290 http://www.ucpsj.org

Seniors AARP | www.aarp.org Aging & Veterans Services 121 Downey Ave, Suite 102 Modesto, CA 95354 (800)510-2020 | (209) 558-8698 www.agingservices.info/ Fall Prevention Center of Excellence www.homemods.org National Institute on Aging | www.nia.nih.gov 37


San Joaquin County Department of Aging | www.sjaging.org Family Caregiver Support 102 South San Joaquin Street Stockton, CA 95201 U.S. Senate Special Committee on Aging | www.aging.senate.gov

Speech National Center for Voice and Speech 136 South Main Street, Suite 320 Salt Lake City, UT 84101-1623 (801)596-2012 www.ncvs.org

Massage Therapy Choku-Rei Center 2028 West Orangeburg Avenue Modesto, CA 95350 (209) 450-6896 http://chokureicenter.com Music Therapy with Melody 9767 Deep Water Stockton, CA 95219 (209)482-4470 www.musictherapywithmelody.com

Travel/Transportation Access-Able Travel Source | www.access-able.com American Cancer Society The American Cancer Society presents the Road To Recovery Transportation Program. It provides transportation to and from treatment for people who have cancer who do not have a ride or are unable to drive themselves. 38


(800) 227-2345 www.cancer.org/treatment/caregivers/index Environmental Travel Companions | www.etctrips (415) 474-7662 San Joaquin County RTD P.O. Box 201010 Stockton, CA 95201 (209)467-6659 www.sanjoaquinrtd.com Wheelchair Get- Aways (800) 642-2042 www.wheelchairgetaways.com

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Holistic medicine is the art and science of healing that addresses care of the whole person - body, mind, and spirit. The practice of holistic medicine integrates conventional and complementary therapies to promote optimal health, and prevent and treat disease by addressing contributing factors. Holistic healthcare practitioners strive to meet the patient with grace, kindness, acceptance, and spirit without condition, as love is life’s most powerful healer. In practice, this means that each person is seen as a unique individual, rather than an example of a particular disease. Disease is understood to be the result of physical, emotional, spiritual, social and environmental imbalance. Healing, therefore, takes place naturally when these aspects of life are brought into proper balance. The role of the practitioner is as guide, mentor and role model; the patient must do the work - changing lifestyle, beliefs and old habits in order to facilitate healing. All appropriate methods may be used, from medication to meditation. Holistic Terms From WellBEING Resource, with Permission Acupressure – A type of Asian healing art based on ancient Japanese and Chinese medicine. A practitioner puts pressure on specific points on the body with his or her fingers in order to relieve pain and discomfort, prevent tension-related ailments, and promote good health. Acupuncture – The Chinese practice of gently inserting fine needles into the body at specific points to cure disease, relieve pain and balance the energy systems in the body. Anthroposophic Medicine – A holistic and human-centered approach to medicine that uses all of the tools of conventional medicine, as well as aspects of spiritual science to assess each individual as a whole entity–physical body, life force, spirit and individual soul quality. The treatment process is based upon the uniqueness of the individual. All anthroposophic treatments are designed to stimulate the patient’s powers of self-healing, with emphasis on restoring the 41


balance of bodily functions and strengthening the forces of individuality and autonomy in the organism. Applied Kinesiology – A method of testing muscles to find imbalances in the body. Rebalancing using massage of lymphatic areas, holding neurovascular points, running acupuncture meridians, holding acupuncture points, finding the proper nutritional support and addressing emotional aspects that are involved. Aromatherapy – The use of essential oils extracted from plants and herbs to treat conditions ranging from infections and skin disorders to immune deficiencies and stress. Essential oils are widely used throughout Europe and a system of medical Aromatherapy is currently practiced in France. Ayurvedic Medicine – Practiced in India for the past five thousand years, Ayurvedic, meaning “science of life’ is a comprehensive system that combines natural therapies with a highly personalized approach to treatment of disease. Ayurvedic medicine places equal emphasis on body, mind and spirit, and strives to restore the innate harmony of the individual. Biofeedback – Quantum biofeedback is a computerized energetic device that detects and assesses imbalances in the body, then emits healthy, balancing frequencies back to the body. It works by reducing the stresses on a body at the electro-magnetic level caused by food, toxins, hormones, nutrient deficiencies, allergies, parasites, emotions, environment, genetics, and lifestyle. The system searches for stress patterns in the body and then administers appropriate therapies to help the body correct any imbalances found. Bodywork – The term bodywork refers to therapies such as massage, deep tissue manipulation, movement awareness, and energy balancing, which are employed to improve the structure and functions of the human body. Bodywork in all its forms helps to reduce pain, soothe injured muscles, stimulate blood and lymphatic circulation, and promote deep relaxation and enable the body to rally its own recuperative powers. Bowen Therapy – A series of gentle, simple non-invasive moves performed across muscle fibers and connective tissue, in a succession with waiting periods, incorporated into the session. The resting time allows the brain to assimilate, correlate and create a positive response to the area being treated. All body systems are accessed allowing muscle and nerve tissue to relax, toxins shed, circulation increased. 42


Breath Work – The human breath has long been honored as a powerful pathway within the self to relieve pain, release blocked emotions, and deepen states of spirituality. Indian “prana,” Chinese “chi” and Japanese “ki” refer to the power of breath and its basic life force energy which enable all living things. When we restrict this life force we create disharmony and disease. Breath Work uses the full dynamics of our natural breathing path to open restricted patterns to access both the inner world and the higher self for personal healing and well-being. Practices such as Rebirthing, Hypnosis, Yoga, Chi Kung and Shamanic healing are all forms of this transformational tool. Brennan Healing Science (BHS – BHS practitioners charge, clear and repair the human energy field which is the foundation of physical, emotional, and spiritual health. It was developed by former NASA scientist, Barbara Brennan, author of Hands of Light and Light Emerging. Chi Nei Tsang (CNT) – A healing touch modality of Chinese Taoist origin. Soft touch and gentle massage on the abdomen stimulates the organs to work better and creates beneficial change in all the systems of the body: the digestive, lymphatic, cardiovascular, respiratory, nervous, endocrine, reproductive, urinary, muscular-skeletal, and the acupuncture meridian system that is the pathway for ‘chi’ or energy. A Chi Nei Tsang treatment releases deep-seated tensions and restores vitality. The modality’s holistic approach integrates the physical, mental, spiritual and emotional aspects of our being. Cranial Sacral (CranioSacral)Therapy – A holistic, hands-on technique involving gentle manipulation of the bones of the skull, the underlying meningeal membranes, which surround the central nervous system to add an additional layer of protection beneath the bones of the skull and spine), and the nerve endings in the scalp. A practitioner is able to “listen” with their hands to what is called the cranial rhythmic impulse, which runs throughout our bodies. Colon Hydrotherapy – The absorption of nutrients is enhanced when the colon is cleansed. This safe and painless process involves infusing filtered and temperature regulated water into the large intestine to dislodge impacted material and dilute bacteria and toxic concentrations. Colon Hydrotherapy to improves muscle tone and facilitate peristalsis action. Doctor of Chiropractic (D.C.) – Through adjustments of the spine and joints, chiropractors can influence the body’s nervous system and natural defense mechanisms in order to alleviate pain and improve general health. Because of its effectiveness in treating back problems, headaches, and other injuries and traumas, 43


chiropractic has become the second largest primary health care field in the world. Dreamwork – Dreams contain metaphorical, symbolic, and archetypal language and images. Many are multilevel, with messages relevant to various aspects of one’s being: physical health, emotional well-being, and soul level. Dreams may contain literal information about potential future paths. Dreamwork explores meanings of dreams and reveals how the different layers relate to one’s life. The dreamer is the authority on the meaning(s) of the dream; the dreamworker(s) offer insights using the “if this were my dream” format. Shamanistic dreamwork includes shamanic journeying on the dream images. EMDR (Eye Movement Desensitization & Reprocessing) – An advanced, rapid therapy approach for stress-related symptoms, traumatic memories, and to shift core beliefs. With bi-lateral stimulation of both sides of the brain, EMDR allows the brain to reprocess the experience and go for a healthy resolution. The eye movements process the unconscious material like what is happening in REM or dream sleep and unlock the nervous system which allows re-integration of positive information and outcome. Your own brain with this technology does the healing and you are in control. Emotional Freedom Techniques (EFT) – Uses elements of Cognitive Therapy and Exposure Therapy, and combines them with Acupressure, in the form of fingertip tapping on 12 acupuncture points. Over 20 clinical trials published in peer-reviewed medical and psychology journals have demonstrated that EFT is effective for phobias, anxiety, depression, post-traumatic stress disorder, pain, and other problems. Eurythmy Therapy – Eurythmy Therapy is a movement therapy that harmonizes the whole human being by balancing the physical body with the life forces and soul forces, drawing upon the formative forces of the creative World Word, the planets and constellations, and the four elements. A key modality in Anthroposophical medicine, Eurythmy Therapy has been successfully practiced for more than 90 years, with application used for many indications from small children to senior citizens. These are non-aerobic exercises done in standing, wearing normal street clothes. Feldenkrais Method® – A unique body and brain improvement system designed by the physicist Dr. Moshe Feldenkrais to help those with physical problems & chronic pain, as well as to improve movement for athletes, musicians, actors, dancers. This method allows muscles to center bones, clarifies orientation in time and space, and activates new neural pathways. 44


Feng Shui – The ancient Chinese art of intentionally arranging the spaces in which we live and work so that they are energetically balanced, so that they comfort and nurture and fully support and help us manifest what we need and want. Following the principles of feng shui, we place our furniture, introduce color and accessories, apply cures, and use our intention to create abundance, joy, and harmony in our lives. Guided Imagery – Guided Imagery uses the power of the mind to bring about healing. It is in the body-mind where we hold perceptions of the past, in the form of emotions and images. Our beliefs are different because our perceptions of the past are unique. Though imagery we can disengage beliefs that interfere with a healthy life. Healing Touch – an energy (biofield) therapy that encompasses a group of non-invasive techniques that utilize the hands to clear, energize, and balance the human and environmental energy fields. With some similarities to Reiki, Healing Touch offers more techniques for physical, emotional and spiritual balancing. Herbal Body Wraps – An excellent detoxifying treatment. A fleece sheet is soaked in an infusion of blended herbs then wrapped around the body. The body is then kept very warm with the addition of additional heated blankets for 20 minutes letting the herbs draw out impurities. Herbalism – Western herbalism, like the much older system of traditional Chinese Medicine are forms of the healing arts that draw from the herbal traditions of Europe, the Americas and Asia. Both Western and Eastern forms of herbalism emphasize the study and use of naturally occurring substances in the treatment and prevention of illness. Holistic Counseling – A counseling approach which focuses on the whole person including feelings, thoughts and how they are connected to the body. Homeopathy – A natural pharmaceutical science that utilizes substances from the plant, mineral, and animal kingdoms and is based on the premise that these naturally occurring substances can cure disease symptoms similar to those they produce if taken in overdose. Each medicine is individually prescribed according to how it stimulates the immune and defense systems of the sick person. Sometimes it is called the “royal medicine.” Hypnotic Techniques – can induce everything from a light to a heavy hypnotic state to help a client overcome psychological or physical problems. From helping people to overcome a craving for cigarettes to managing chronic pain from an 45


illness or accident, trained hypnotherapists work with a wide variety of problems. Hypnotherapy – Hypnotic techniques can induce everything from a light to a heavy hypnotic state to help a client overcome psychological or physical problems, overcome a craving for cigarettes or overeating, managing chronic pain from an illness/accident, reducing or eliminating fears, and a wide variety of other issues to be overcome. Integrative Medicine – offers a personalized approach to care using evidencebased medicine that integrates contemporary biotechnical approaches with personalized holistic care. This approach goes beyond symptom treatment, serving the whole person to facilitate the body’s innate healing response. Here are some of the Jin Shin Jyutsu – Brings balance to the body’s energies, which promotes optimal health and well-being, and facilitates our own profound healing capacity. It is a valuable complement to conventional healing methods, inducing relaxation and reducing the effects of stress. Kundalini – Divine spiritual energy that lies coiled at the base of the spine. Once awakened, it travels upward through the chakra system, until it reaches the crown chakra. Once stabilized in the crown, the individual self merges into the supreme self, (enlightenment) and the cycle of reincarnation comes to an end. Lapa’au – a Hawaiian healing art practiced for thousands of years in Polynesia. During the healing session the practitioner becomes a bridge for healing, connecting the spirit of one or more Lapa’au Kahunas, the client, and the energies of the client’s Aumakua (personal guardian spirits). The client’s energy is balanced, distorted thought forms (that may result in illness) are removed, and energy links draining the client are disconnected. When the client is a healer, the work takes place under the guidance of a higher level of Aumakua on multiple planes at the same time. The healer’s energy level is optimized for their own unique characteristics and abilities. Lomilomi Massage – Hawaiian for “rub rub”, Lomilomi is a massage technique that’s been handed down from ancient Hawaiian healers. The stroke used are similar to the shiatsu technique of Japan but are gentler and shorter. Pressure wit the fingers at certain points is also part of the technique, but is it of shorter duration than most acupressure. Two identifying techniques of authentic Lomilomi are the emphasis on spirit-body connection and the use of the forearm and elbow as a massage tool. 46


Manual Lymph Drainage Therapy – A hands-on technique designed to attain and sustain proper functioning of the human fluid system. The proper functioning of the lymphatic system is critical to our body’s ability to drain stagnant fluids, detoxify, regenerate tissues, filter out toxins and foreign substances, and maintain a healthy immune system. Medical Intuitive – Medical Intuition is a tool to give an accurate portrait of what is going on in a client’s body by paying close attention to gain accurate insight into the presenting symptoms of a client. The body offers much information to be shared such as the roots and influences of the present condition, what it wants and does not want and a physical, emotional/spiritual portrait of what is currently going on. Myofasical Release – Fascia is a tough connective tissue which spreads throughout the body in a three dimensional web from head to foot without interruption. Trauma, posture or inflammation can create a binding down of the fascia resulting in excessive pressure on nerves, muscles, blood vessels, osseous structures, and/or organs. The Myofascial Approach consists of the gentle application of sustained pressure into the fascial restrictions which relies on feedback received by the Therapist through the patient’s tissue. Myofascial Release can help by addressing the cause of the problem to eliminate the symptoms and allow the body to make permanent changes resuming a healthy active life style. Naturopathic Medicine, Natauropathic Doctor, N.D. – Naturopathic medicine is a distinct and comprehensive system of primary health care practiced by a naturopathic doctor for the diagnosis, treatment, and prevention of human health conditions, injuries, and disease. Naturopathic doctors are state-licensed practitioners who perform physical exams, order lab testing, and prescribe a variety of natural treatments, including clinical nutrition, botanical medicine, homeopathy, physical medicine, exercise, and hormone replacement therapy. Naturopathy – a system of Natural Healing which, only through natural methods, assesses and cares for the health of the patient. Naturopathy is concerned with both a healthy lifestyle and the prevention of disease, and also with the use of natural therapeutics in the treating of human conditions such as: Pain, Injury, and any Physical, Chemical or Mental conditions. Naturopathy uses a philosophy of practice which bases its treatments of physiological functions and conditions, upon where the natural laws governing the human body have not been adhered to. Neurofeedback – a process that enables an individual to bring about an enduring improved state of function or being. Feedback is instantly and consistently given 47


to the brain through audio and/or visual cues according to EEG (brainwave) measurement. Over time, the learning endures without continued use of an instrument. The first use of neurofeedback enabled people to be free of seizures without medication or surgery. Subsequent studies with humans with conditions including ADHD, Tics, Depression, Anxiety, Sleep Problems, Headaches, and other brain disregulations found that those conditions could also be remediated by brainwave feedback. NLP – Neuro-Linguistic Patterning is a useful model of beliefs and techniques that offer a way to use the mind and body to achieve excellence in learning, business, counseling, relationships, sports and other experiences of life. Numerology is a necessary component of astrology, though often not combined. It is the stand-alone science of numbers—in one’s birth blueprint, year cycles, dates, and names. By understanding how to read the map of your blueprint, you’ll have the self-empowerment to steer your life much more efficiently. Osteopathic Medicine- A form of conventional medicine that, in part, emphasizes diseases arising in the musculoskeletal system with an underlying belief that all of the body’s systems work together, and disturbances in one system may affect function elsewhere in the body, Some osteopathic physicians (sometimes known as DO or osteopath) practice osteopathic manipulation, a full body system of hands-on techniques to alleviate pain, restore function, and promote health & well-being. Raindrop Therapy – The application of therapeutic-grade essential oils using massage and vita flex techniques. Raindrop Therapy aids in the healing of physical and emotional injuries, strengthens the immune system, detoxifies the body, and helps to bring the body into physical and electrical alignment. Reconnective Healing® utilizes new frequencies to allow for the healing of the body, mind, and spirit. These energies, currently being researched by Dr. J. Schwartz at the University of Arizona, are highly palpable and continue working long after the healing session has ended. Initiated without specific intention they result in the healing your body truly needs, not necessarily what you requested or expected. After the initial one to three sessions, there is no need to return for additional work on that particular issue or illness. The Reconnection™ – Originally the meridian lines, sometimes called acupuncture lines, on our bodies were connected to the grid lines that encircle the earth. These grid lines were designed to continue outward and connect us 48


to a vastly larger grid, tying us into the entire universe. Over time, we became disconnected from these lines. The Reconnection brings in “new” axiatonal lines that reconnect us to these grid lines. The unique vibratory levels and frequencies they bring in contribute to healing through the reconnection of DNA strands, and ultimately our personal evolution by providing the means to reconnect with our purpose. Reflexology – The application of pressure, stretch and movement to the feet and hands to effect corresponding parts of the body. Reflexologists view the feet, ears and hands as a mirror image of the body. By applying technique a reflexologist can break up patterns of stress in other parts of the body. Stress is a barrier to the body’s return to a normal state of equilibrium. Reiki – A therapy based on Eastern concepts of energy flow and the seven energy centers in the human body. The purpose of treatment is to heal emotional, spiritual, and physical, pain through the transmission of universal life energy, called “ki” in Japanese. It is believed that “ki” flows throughout the universe, and that Reiki connects humans in a more direct way to this universal source. Reiki is used for the healing of animals as well as people. Rolfing® Structural Integration – Rolfing is a holistic, hands on, deep tissue modality that manipulates and changes the myofascial system throughout the body. Through educated touch and movement education, a client’s posture and structure, their whole being is reorganizes within the field of gravity. Shamanism – A system of healing based on spiritual practices present in most indigenous cultures. The shaman acquires knowledge, wisdom and spiritual power from personal helping spirits encountered on journeys into other realities. They return with vital information about healing. Shamans are considered “walkers between the worlds” and retrievers of souls. Shiatsu – A Japanese form of physical therapy and therapeutic massage, based on traditional Chinese medicine. It combines massage, gentle physical manipulation, and pressure along channels or rivers of energy called meridians. Somatic experiencing (SE) – A therapeutic model designed for the treatment of trauma and associated symptoms, developed by Dr. Peter Levine. SE uses gentle self-awareness techniques to direct the energy of the nervous system in a way that corrects imbalances and restores it’s natural equilibrium. This results in reduced activation in the body and mind, bringing a greater sense of ease, balance and aliveness. SE is effective in the treatment of emotional, mental and physical 49


symptoms of trauma including anxiety, depression, post-traumatic stress disorder, chronic pain and syndromes such as fibromyalgia. SE is used around the world to assist people recover from trauma, including accidents, disasters, and war. Sound Therapy / Vibrational Healing – A range of therapies in which sound is used to treat physical and mental conditions based on the theory that all of life vibrates, including people’s bodies. Treatment by sound waves is believed to restore that healthy balance to the body. The healing sound is transmitted to the affected area of the body and may be produced by any number of methods including voice, chanting bowls, drums, bell, tuning forks and/or music. Tai Chi – Tai Chi combines movement, meditation and breath regulation to enhance the flow of vital energy in the body, improve blood circulation, and enhance immune functions. Tai Chi is one of the most broadly applicable systems of self-care in the world. In China, it is estimated that 200 million people practice Tai Chi everyday. T’ai Chi Chih® – a set of movements completely focused on the development of an intrinsic energy called Chi consisting of 19 stand-alone movements and one pose. It is completely non-violent. Therapeutic Touch – A non-invasive, holistic approach to healing which stimulates the receiver’s own recuperative powers. It is a modern form of laying-onof-hands and is based on principles of an energy exchange between people. It is most useful to reduce or eliminate pain, promote healing, and elicit a relaxation response. ThetaHealing® – A powerful Energy Healing modality using Theta brainwaves and the creative power of the Universe to heal the physical body and to clear negative beliefs & fears held in the muscular tissue and organs. Other techniques facilitated by this process include seeing and speaking with your Guardian Angels, viewing inside the human body, remote viewing, healing and speaking with plants and animals, manifesting your Soul Mate, and more. Watsu – Aquatic bodywork involving stretching and Shiatsu which is applied while being floated in warm water. The water temperature (95° – 97° F) is ideal for experiencing a sensation of deep relaxation. Gentle stretching increases flexibility and strengthens muscles. Yantra – A geometric image based in the tantric yoga tradition. One can use a it for meditation, inspiration, concentration, energy alignment, and transformation. A yantra creates an opening into sacred space. The vibrational qualities of the yantra will resonate with the vibrational aspects of one’s body, mind, and consciousness. 50


Yoga – A general term for a range of body-mind practices used to access consciousness and encourage physical and mental well-being. Forms of “physical” Yoga include Hatha (Iyengar, Bikram, Ananda, Astanga Vinyasa/Power, Phoenix Rising, etc.) and Kundalini. Yoga Therapy – A one-on-one application of the philosophy and practices of yoga to directly and holistically facilitate healing. Techniques are chosen according to the individual client to resolve pain and blockages by supporting and nurturing the spine, nervous system, muscles, bones, joints, subtle channels, and the mind. While therapeutic approaches vary by yoga style, all promote non-invasive techniques that utilize yoga poses, breath, and wisdom for increasing prana (life force), tejas (energy) and ojas (resilience).

By Cliff DeBaugh Have you ever thought about your house numbers for any reason, especially as a life saving device? Most likely this has not occurred to you or anybody else. Once 911 is called, the location information verified, the wait begins. The thought not occurring is about the condition, location, and visibility of your house numbers. At least not until the responder passes by, making a U-turn to arrive at the impending crisis. What happened? The house numbers were not visible in the day or especially at night. That small delay of 45-90 seconds can make a huge difference, sometimes life or death. Yet, it’s the number one reason for delays by responders locally and nationally, the simple inability to read or find the house numbers. House numbers come in many styles, sizes, colors, wood, brass, plastic, non-reflective, reflective, even lighted, it’s the home owners’ choice. So choose wisely. However, in speaking with responders there is a preference for highly visible reflective numbers, no electricity needed. They are always ready! The state fire code requires a minimum four inch size for house numbers. Now think stop sign, bigger is better. There is increased surface area to grab the sunlight or headlights of a responding unit. Larger more visible reflective numbers can decrease response time by seconds as the responders can see your home from a greater distance enabling a faster arrival. Remember, if you cannot see your house numbers at night, either can 911.

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Many people caring for a loved one never even heard of the term, “Caregiver”. Not knowing that simple reference, blocks them from having a huge amount of information that could save time, alleviate stress and open the door for Caregivers to communicate. To support your loving and/or professional caregiving journey, here are some of the words used in health care that may help you navigate better.

Acute Care Acute care is usually given in a hospital’s Emergency Department. Medical care for health problems that are new can quickly get worse, or result from a recent accident. Advance Directives Written instructions to health care professionals about the amount and type of medical care and treatment a person wants. Advance directives are used when people are too ill or injured or are unable for other reasons to state these wishes for themselves. There are two types of advance directives. One describes the type of care a person wants. The other names someone else (health care proxy or agent) to make medical choices, if needed. You can fill this form out on line by going to the Secretary of State website. Adult Day Care Social and recreational activities offered in a group setting. Adult day care does not offer health services that require a nurse. Adult Day Health Care Programs that provide social and recreational activities and health services to adults who are physically (body) or cognitively (mind) impaired. These take place in supervised and structured settings. Adult Protective Services (APS) State and local agencies that investigate reports of abuse or neglect. They also offer services to adults (18 years and older) who are physically, sexually, financially, or emotionally abused by someone involved in care. These abuses 52


include neglect, exploitation, or abandonment. Alzheimer’s, a form of Dementia Alzheimer’s disease is a condition in which nerve cells in parts of the brain start to die. It is progressive, which means that mental and physical functions decline in stages. Ambulatory Care Medical care given in an outpatient setting (where the patient is not admitted to a facility). This is usually a doctor’s office or clinic, but may be a hospital. It includes diagnosis, observation, treatment, and rehabilitation. Aphasia Aphasia is an acquired communication disorder that impairs a person’s ability to process language, but does not affect intelligence. Aphasia impairs the ability to speak and understand others, and most people with aphasia experience difficulty reading and writing. Area Agency on Aging (AAA) Agency that gets state and federal funding to plan and coordinate services for people over age 60 within a local area. In some cities, towns and states, the AAA is also known as Department of Aging (DOA). Assisted Living or Assisted Living Facility (ALF) A residence for people who do not want to, or cannot, live independently (on their own) but do not need nursing home care. ALFs offer different kinds of services, including social activities, supervision, and some health care services (but not as many as in a nursing home). ALFs are privately owned, prices vary. Assistive Technology or Equipment Any device that helps you live independently or “assists” you to live functioning better. There are both high tech and low tech adaptive or assistive devices, including high tech devices include wheelchairs (powered and manual), electronic magnifiers, vehicle modifications, telephones with enhanced amplification (for those who are hard of hearing), special kitchen supplies, computer programs, and other types of technology. Attending Doctor Senior doctor at a teaching hospital. This doctor is often in charge of (responsible for) a patient’s care. The attending doctor supervises fellows (postgraduate doctors in a specialty), residents (house staff or doctors-intraining), and medical students. 53


Balance Disorder A balance disorder is a condition that makes you feel unsteady or dizzy, as if you are moving, spinning, or floating, even though you are standing still or lying down. Balance disorders can be caused by certain health conditions, medications, or a problem in the inner ear or the brain. Bed Hold Policy A term used in skilled nursing facilities to define the length of time the facility will hold a patient’s bed in case he or she has to leave the facility for care elsewhere, such as hospital, or for any other reason. There is a fee for holding a bed and each facility has its own policies and fees. If a patient has to leave the facility and did not secure a bed hold, there is no guarantee that he or she will be able to return to that facility for continuation of care and treatment. Bed Sores Bed sores, also known as pressure ulcers, are the painful condition that occurs when constant pressure is applied to soft tissue. They are most often the result of a patient being bedridden and unable to change positions of their own volition. Besides being extremely painful, bed sores can lead to many dangerous complications for sufferers, including osteomyelitis (a bone infection), sepsis (whole-body inflammation), anemia, and gangrene. Beneficiary Listed as the recipient of an individual’s belongings after death. Usually the beneficiary is listed on an insurance policy. Blood Pressure Blood pressure rises with each heartbeat and falls when your heart relaxes between beats. While BP can change from minute to minute with changes in posture, exercise, stress or sleep, it should normally be less than 120/80 mm Hg (less than 120 systolic AND less than 80 diastolic) for an adult age 20 or over. About one in three (33.5%) U.S. adults have high blood pressure. Blood Type There are eight different common blood types, which are determined by the presence or absence of certain antigens – substances that can trigger an immune response if they are foreign to the body. There are four major blood groups determined by the presence or absence of two antigens – A and B – on the surface of red blood cells: Group A – has only the A antigen on red cells 54

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(and B antibody in the plasma) Group B – has only the B antigen on red cells (and A antibody in the plasma)Group AB – has both A and B antigens on red cells (but neither A nor B antibody in the plasma)Group O – has neither A nor B antigens on red cells (but both A and B antibody are in the plasma) O positive is the most common blood type. Not all ethnic groups have the same mix of these blood types. Hispanic people, for example, have a relatively high number of O’s, while Asian people have a relatively high number of B’s. Brain The amazing brain is an organ that serves at the center of the nervous system. It has the centralized control over all of the body’s organs. Brain Attack Blockage to the brain; a stroke. Everyone is familiar with referring to blockage of the heart as a “heart attack. When that happens to the brain, it too is an attack. See Stroke.

SCCMM

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Specialized Care Management affords of mind busy family not systems live in close proximity their aging loved ones. We are nationally certiied, professional carepeace managers thattofacilitate localmembers resourceswho and may support for seniors andtodisabled adults, including are nationally certiied, professional managers that facilitate resources andcannot. supportIt systems seniors the andservices disabledofadults, including placement options. We are your local,care experienced professionals tolocal be here when you is simplefor to engage Shelton Care placement options. We are yourtolocal, experienced to be here whentelephone you cannot. It is simplethorough to engageassessment, the servicesand of Shelton Care Management. We are available provide you withprofessionals a 30 minute complimentary, consultation, ongoing Management. We speciic are available toindividual provide you withWe a 30 minuteancomplimentary, telephone consultation, thorough and ongoing management, to your needs. evaluate individual’s level of functioning, their overall health,assessment, medications, medical care care management, speciic state to your needs. We evaluate an individual’s level of functioning, their your overall health,and medications, medical providers, safety, emotional andindividual legal//nancial needs. A professional Care Manager guides you through concerns offers detailed, providers, emotional state and legal//nancial needs. A professional Care Manager guides you through your concerns and offers detailed, timely, andsafety, practical solutions. timely, and practical solutions.

Can We Help You? Can We Help You?

Are your care needs becoming more complex? Are your care needs becoming more complex? Do you need continuity of care between physicians, pharmacy, and support providers? Do you need continuity of care between physicians, pharmacy, and support providers? Are medical and support care costs spiraling out of control? Are medical and support care costs spiraling out of control? Do you have impared communication between family members Do youservice have impared communication between family members and/or providers? and/or service providers? Is distance keeping you from providing the best care for your loved Is distance keeping you from providing the best care for your loved one? one? Are you limited by time constraints to oversee care for your loved Are you limited by time constraints to oversee care for your loved one? one? Are you overwhelmed? Are you overwhelmed?

Be Proactive Be Proactive

Start with a Comprehensive Assessment conducted by a Start with a Comprehensive conducted by a Nationally Certiied ProfessionalAssessment Care Manager. Nationally Certiied Professional Care Manager. Utilize the assessment plan to identify speciic, practical, and local Utilize the assessment to identify speciic, practical, and local solutions for your medical,plan safety, and social concerns. solutions for your medical, safety, and social concerns. Retain ongoing monitoring and assistance through transitions in Retain ongoing monitoring and assistance through transitions in life, by professional Care Managers who respect your autonomy life,dignity. by professional Care Managers who respect your autonomy and and dignity.

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Capacity In health care settings, “capacity” refers to a patient’s ability to understand and use medical information (such as treatment options, risks, and benefits) when making decision and choices about medical care. Capacity varies; a person may have the capacity to make some choices, but not others. A “health care proxy” can act as the patient’s decision maker if the patient loses capacity due to illness. Care or Case Manager Nurse, social worker, or other health care worker who plans and coordinates services for a patient’s care. This person usually works for an agency or facility. Caregiver “Caregiver” can mean family members, friends, and neighbors who provide on-going help and assistance to people who are ill, frail, or disabled. Doctors, nurses, and social workers may use the term “caregiver” when talking about themselves. Caregiver Assessment This is a way to gather information to determine what level and kind of care a caregiver is able to provide. It assesses the caregiver’s own health and other responsibilities, resources and strengths (such as experience or special skills) as well as what he or she is willing and able to do. It also considers the caregiver’s own need for support and/or other services. Caregiver Coaches A professionally trained health or personal mentor to help Caregiver maintain a program for self-care, maintain goals and balance to prevent burn-out and minimize stress. Caregiver Support Group A group of people who meet regularly to help each other by discussing feelings, common problems, ways of coping, available resources, and many other issues related to caregiving. Support groups may be for caregivers of patients who have certain diseases (such as Alzheimer’s, stroke and cancer. Some support groups meet in person while others are only online or by telephone. Care Plan A detailed written plan that includes needed tasks for patient care. It likely includes services provided by nurses, therapists, home health aides, and attendants. A good care plan should also list the tasks that family caregivers 56


(who often do many of the tasks) do. A Caregiver Coach helps with the development and execution of a care plan. Certified Nursing Assistant (CNA) Person trained and certified to assist patients with non-clinical tasks such as eating, walking, and personal care (like taking a bath). This person may be called a “nursing assistant” in the hospital. Chronic Illness Physical or mental disability that lasts a long time or recurs (goes and comes back again). Treatment goals are to manage the illness and its symptoms, not cure them. Cognitive Brain Form a logical, plausible thought after considering the circumstances. Attention, Working Memory, Processing Speed, Long Term Memory, Visual Processing, Auditory Processing, Logic and Reasoning, Multi-Tasking and Decision Making Cognitive Impairment After a stroke, Traumatic Brain Injury or another illness, problems may occur that affect how clearly a person thinks, learns a new task, and remembers events and timelines or the speed at which it occurs. Community (Out-of-Hospital) DNR An order (signed by a doctor) that says that the patient should not be resuscitated (given Cardiopulmonary Resuscitation, or CPR to restart a heartbeat) if he or she is at home when the heart stops beating. If emergency services are called, this order must be given to the medical team. Competence A legal term, usually used in a guardian hearing, means that a person is able to make decisions for themselves. To do that, he or she has to be an adult (18 years of age or older) and have capacity, which means the ability to understand and use information when making decisions. A judge is the only one who can declare a person “incompetent” (lacking the ability to make decisions). Chronic Illness According to the Centers for Disease Control and Prevention (CDC), 70 percent of all deaths in the United States are due to chronic diseases. Lack of physical activity, tobacco use, not consuming enough fruits and vegetables and drinking too much alcohol are common causes of chronic disease. According 57


to the CDC, heart disease, cancer and stroke are the most common types of chronic diseases. With the exception of genetic risk factors, these chronic diseases can be prevented. Custodial Care Also called personal care. It is the kind of help or supervision people need with daily tasks such as getting dressed, eating, taking a shower or bath, going to the bathroom, and getting into a bed or chair. Custodial care may be given at home by family members or by home care aides or personal care attendants. This care is not paid for by insurance unless the patient also needs skilled care from a nurse or therapist.

Dementia A loss of brain function that disrupts or impairs a person’s memory, ability to think or speak clearly, and ability to perform everyday tasks. It can also affect a person’s personality, mood, social interaction (how he or she relates to others), and judgment. Discharge Planner Nurse, social worker, or other health care worker who coordinates a patient’s transition (move) from one care setting to the next, such as from hospital to home. DNA Do Not Intubate (DNI) Order A DNI order instructs health care workers not to insert a breathing tube through the patient’s nose or mouth into the throat once breathing has stopped. A DNI order is part of an advance directive and is separate from a DNR order. Do Not Resuscitate (DNR) Order A DNR order instructs health care workers not to perform cardiopulmonary resuscitation (CPR) or other actions to restart a person’s heart or breathing once it has stopped. By law, a DNR order must be offered to patients and families. Signed DNRs must be part of the patient’s medical chart. A DNR order is part of an advance and is separate from a DNI order. Dual Eligible People who financially and medically qualify (meet the requirements) for both Medicare and Medicaid. 58


Durable Medical Equipment (DME) Medical equipment that can be used more than once. It includes crutches, knee braces, wheelchairs, hospital beds, and prostheses. Durable Medical Power of Attorney A type of advance directive. It names a person to make health care choices for someone else if he or she becomes incompetent or cannot express wishes. Durable Power of Attorney A document which names a person who can make financial (money) decisions on behalf of someone else. This power of attorney remains in effect even when a person is disabled or incapacitated. Durable power of attorney covers financial (money) matters, not medical decisions.

Elder Law Attorney A lawyer who specializes in the rights and issues of older adults and their health, finances, and well-being.

Family Caregiver Any family member, partner, friend, or neighbor who provides or manages the care of someone who is ill, disabled, or frail. There may be more than one family caregiver involved in a person’s care. Types of care include: Eldercare, Stroke Care, Cancer Care , Dementia (Alzheimer’s being the most common), Diabetes Care, Visible and Invisible Disabilities and Caregivers to Veterans Family Caregiver Support Program (FCSP) The family caregiver is the person(s) considered to be the primary source of support and routine assistance, and who may or may not be related by blood or marriage. This federal program, run by the U.S. Administration on Aging, offers support services to family caregivers who are: 60 years and older; adults of any age with dementia; Grandparents 55 years and older caring for grandchildren under age of 18 and adults with developmental disabilities aged 19 to 59. Services include counseling, information and referral, respite, and some funding for certain home modifications or emergency response systems. Each 59


FCSP is under the direction of its local Area Agency on Agency (AAA) or Department of Aging (DOA). Formal Caregivers This term usually refers to professionally trained caregivers. They usually work under the employment of for-profit Home Care Agencies that often gain contracts to provide respite service or scheduled care. Many formal Caregivers belong to SIEU, the largest national union speaking for formal Caregiver rights http://www.seiu.org/seiuhealthcare Del Oro Caregiver Resource Center | www.deloro.org/ 8421 Auburn Blvd, Citrus Heights, CA 95610 | 916- 728-9333 Serving San Joaquin, Sierra, Sutter, Yolo and Yuba Counties Valley Caregiver Resource Center | http://www.valleycrc.org/ 3845 North Clark Street, Suite 201 | Fresno, CA 93726 | 559-224-9154 Serves Modesto

Geriatrician A medical doctor with special training in the diagnosis, treatment, and prevention of disabilities in older adults. Gerontologist A health care professional trained to work with older adults and their families. He or she may have an MS or PhD degree. Guardian There are times when individuals, such as children or the elderly, are forced to rely on other people for assistance in their daily lives because they lack the capacity to make decisions on their own. They require outside help in the form of surrogate decision makers, who have the legal authority to act on their client’s behalf in all matters. Usually, these people are family members; however, if a family member is not available, or a third-party is requested for representation, a court-appointed guardian is assigned. Guardianship The process in which the guardian gets named by a judge.

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Health Care Disparity Health disparities refer to differences between groups of people. These differences can affect how frequently a disease affects a group, how many people get sick, or how often the disease causes death. Many different populations are affected by disparities. These include • • • •

Racial and ethnic minorities Residents of rural areas Women, children, the elderly Persons with disabilities

HIPAA HIPAA, the American Health Insurance Portability and Accountability Act of 1996, is a set of rules to be followed by doctors, hospitals and other health care providers. HIPAA helps ensure that all medical records, medical billing, and patient accounts meet certain consistent standards with regard to documentation, handling and privacy. HIPAA requires that all patients be able access their own medical records, correct errors or omissions, and be informed how personal information is shared OR used. Other provisions involve notification of privacy procedures to the patient. HIPAA provisions that have led in many cases to extensive overhauling with regard to medical records and billing systems. Home-delivered Meals (Meals on Wheels) Meals brought to people who cannot prepare their own meals or are homebound (cannot leave their homes). Home Care, also referred to as Custodial Care Includes assistance with the activities of daily living such as light housekeeping, assistance with bathing and dressing, preparation of nutritious meals, help with walking and getting in / out of bed, medication reminders, conversation and companionship, and transportation to name a few. Home care services are generally not covered by insurances such as Medicare or HMO’s, however there are some private and long term care insurance policies that may cover services. Home Health Aide (HHA) A person trained to provide basic health care tasks for those who are elderly or 61


disabled. Tasks include taking vital signs (such as heart rate and blood pressure) or helping with “dry dressing� for wounds. Tasks also include personal care, light housecleaning, cooking, grocery shopping, laundry, and transportation. Home Health Care Home Health Care, also referred to as Skilled Nursing or Paraprofessional Care, covers a broad range of services including: Nursing Care, Physical Therapy, Occupational Therapy, Speech Therapy, Medical Social Work, and Respiratory Therapy. Skilled Nursing care is provided by a registered nurse (RN), nurse practitioner (NP), or a licensed practical nurse (LPN). Paraprofessional care is provided by home health aides, personal care assistants, physical therapy assistants, or certified occupational therapy assistants (COTA). Hospice A program of medical and social services for people diagnosed with terminal (end-stage) illnesses. Hospice services can be given at home, in a hospital, hospice residence, or nursing home. They are designed to help both the patient and his or her family. Hospice care stresses pain control and symptom management. It also offers emotional (feelings) and spiritual (faith) support.

Incontinence Loss of bladder (urine) or bowel movement control. Informed Consent Legal term meaning that a person with mental capacity has given permission for medical treatment. Consent comes after a full disclosure (talk) of treatment risks and options. Intern A doctor who has finished medical school and likely in the first year of special training. Interns are supervised by attending doctors and residents. Insurance The Patient Protection and Affordable Care Act (Affordable Care Act) is the federal law passed in 2010 that provides affordable health insurance to more Americans. The historic law has changed the way health insurance companies provide coverage, as well as the way consumers get coverage. Health insurance plans also must cover preventive care services, like 62


mammograms and colonoscopies, for free. All plans being sold in the Covered California marketplace, as well as those sold outside it, will be required to include these benefits. Fines for No Insurance Coverage. In January 2014, most adults will be required to have public — such as Medi-Cal or Medicare — or private health insurance or pay a fine. The fine becomes more costly over a three-year period. In 2014, the fine will be 1 percent of yearly income or $95 per person, whichever is greater. For adults with children, the fine for lack of coverage for the child is $47.50. By 2016, the fine will be 2.5 percent of income or $695 for an individual, $2,085 for a family, whichever is greater. Covered California is managed by the California Health Budget Exchange. For more information go to www.hbex.ca.gov

Joint Commission The Joint Commission is an independent, not-for-profit organization that accredits and certifies more than 20,000 health care organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards

Legal Matters and End-of-Life Issues • Legal Zoom | www.legalzoom.com • Do –It-Yourself Will | will.preparecase.com • Learn the difference between a will and a living trust • www.estateplanningorganizer.com • Legal Guardianship | nationalfamilysolutions.com • Probate – How to Avoid It | www.usa.gov • Power of Attorney | www.rocketlawyer.com LGBT LGBT are the initials for lesbian, gay, bisexual and transgender. The L refers to Lesbian, which means a woman who is attracted to other women. 63


The G refers to Gay, which means a man who is attracted to other men. Bisexual is identified with the B, and transgendered with the T. A bisexual is someone who is attracted to both genders, and a transgendered person is someone who feels they are another gender. Living Will A type of Advance Directive that outlines a person’s treatment wishes if he or she is too ill or injured to make such choices. Laws about living wills vary from state to state. Licensed Practical Nurse (LPN) A health care worker who provides basic bedside care such as checking vital signs (temperature, blood pressure, and pulse). LPNs can also prepare and give injections and enemas, monitor catheters, apply wound dressings, treat bedsores, Long-Term Care (LTC) A term used to describe the care needed by someone who must depend on others for help with daily needs. LTC is designed to help people with chronic health problems or dementia live as independently as possible. While many people think that long-term care happens only in a nursing home, in fact most long-term care is given by family caregivers in the patient’s home. Long-Term Care Insurance Private insurance designed to cover (pay for) long-term care expenses at home or in a facility other than a hospital. There are many long-term care insurance policies with a wide range of benefits (services they pay for). Lyme Disease An infection caused by a kind of germ carried by deer ticks (found in the northeastern and north-central United States) and western black-legged ticks (found mostly on the Pacific Coast). These ticks can spread the disease to animals and humans through tick bites. These ticks are typically about the size of a sesame seed.

Managed Care Plans Health care system that includes financing (paying for) and delivering health care services. Many are Health Maintenance Organizations (HMOs) that offer a package of health care benefits to those insured. 64


Meals on Wheels Association of America A national organization with a mission to support local programs and to end senior hunger and is operated through local agencies. Medicaid Health insurance program for people with low incomes. Medicaid is financed by both the federal and state government. States set their own rules about who can get Medicaid and what services it covers (pays for). Medicare A federal health insurance program for people aged 65 or older, or for those aged 64 or younger who have certain disabilities. You can learn more about Medicare terms by visiting the Department of Health & Human Services’.

Nurse Practitioner (NP) NP is a registered nurse with advanced training and experience. NPs can diagnose and manage most common, and many chronic, illnesses. They do so alone or along with the health care team. Today, NPs can prescribe medications and provide some services that used to be done only by doctors. Nursing Home or Skilled Nursing Facility (SNF) Facility that provides 24-hour care (all day and night) to patients who are chronically ill or disabled. Patients must be unable to care for themselves in other settings or need extensive (a lot of) medical care.

Occupational Therapist (OT) Licensed health care professional who helps patients learn again how to do activities for daily living. OTs can also help plan ways to adapt (change) a person’s home so he or she can be as independent (do tasks alone) as possible.

Palliative Care Palliative care means keeping a patient as comfortable as possible during an illness. Palliative care may come into play at any point after a physician diagnoses a life-threatening condition. When patients find the side effects of 65


treatment too much to bear and physicians have determined that the disease is incurable, palliative care may become the only focus of medical care. At this time, some patients opt for hospice services, during which health care workers give only palliative care. In the last months of life, hospice workers including physicians, nurses, clergy and social workers, concentrate on keeping the patient comfortable. Paratransit Special transportation for people with mobility (walking) problems. It may be a taxi or special van. Sometimes paratransit runs on a fixed schedule (as for shopping). Other times, people must call to for a reservation. Patient Assessment A way to gather patient information so as to assess functional needs (what tasks people need help with) and eligibility for services (what services they can get). Information may include health status, financial (money) status, mental status, and living situation. Patient Bill of Rights Listing of ways a health care facility will treat patients with dignity and respect. It includes how patients can fully participate (take part) in making health care choices. Personal Emergency Response System (PERS) Electronic device that allows a person to call for emergency help at home. The device connects to the patient’s phone and is programmed to signal a response center when the “help” button is pressed. The patient may also wear a “help” button as a necklace or bracelet. This allows the person to move freely around his or her home. Lifeline is a company that provides this service. Physical Therapist (PT) Licensed professional trained to treat people with impaired motor function (such as problems walking). PTs use exercise, massage, and other ways to help improve a person’s function and strength. Power of Attorney (POA) Legal term that allows one person to act as someone else’s attorney (lawyer) or agent. POA can be just for certain, specific responsibilities or it can be for more broad issues having to do with financial (money) affairs. Primary Care Provider (PCP) This term almost always refers to doctors, nurse practitioners, or physician 66


assistants who provide preventive care (before people are sick). PCPs diagnose and treat common medical problems, assess how urgent these problems are, and may refer patients to other specialists if needed. PCPs practice in the community, not a hospital or other health care facility. Provider Often used to describe a person or agency that delivers health care or social services. Providers can be individuals (doctors, nurses, social workers, and others) or facilities (hospitals), or agencies (home care), or businesses that sell services or equipment.

Registered Nurse (RN) A person who has graduated from a formal nursing education program and is licensed to practice by the state board. RNs assess, plan, implement (carry out), and evaluate patient’s nursing care along with the rest of the health care team. Rehabilitation (“Rehab”) Services to help people get back their mental (thinking and feeling) and physical (body) functions lost due to injury or illness. Rehabilitation may be given at the hospital or in a nursing home, special facility, or the patient’s home. Resident A person who lives in a long-term care setting (such as a nursing home). Resident Doctor A medical doctor who has finished medical school and internship and now is being trained in a specialty (such as surgery, internal medicine, or geriatrics). Respite Care Temporary (a few hours or up to a few days) care to offer relief for the family caregiver. Respite care may be given in the patient’s home or the patient may have a short stay somewhere else. It can be scheduled regularly (for example, two hours a week) or provided only when needed. Restorative Potential The level of function (ability to move or do activities of daily living) that a patient is likely to regain, based on the patient’s condition and diagnoses. This is used by Medicare and other insurances to determine rehabilitative needs and the continued pay for treatment. 67


Robotics More and more procedures are being done on an outpatient basis using robotic.. Hospitals use Robotics for surgical procedures or diagnostic studies that do not require an overnight stay. This medical device help hospitals eliminate life-threatening drug and diluent exchange errors, improve drug potency, decrease other medical mistakes and sterility risks, reduce waste and controlled substances’ diversion and diminishes the gap between the rising patient volume/acuity and scarce nursing and pharmacy staff.

Senior Centers Centers that provide services to senior citizens, aged 60 and over. They may offer social activities (like music or crafts), meals, health screenings (such as blood pressure checks), learning programs, and exercise classes. Skilled Care Nursing care given in a patient’s home or in a facility. It may include injections (shots), tube feeding, and changing sterile wound dressings. Most insurance plans require patients to need at least some skilled care before they can get other home care services. Speech Therapist Licensed health care professional who diagnoses and treats people with speech, language, or hearing problems. State Health Insurance Program (SHIP) State program that helps older adults with concerns about insurance, benefits, and claims. Stroke A stroke occurs when blood circulation to the brain fails. Brain cells can die from decreased blood flow and the resulting lack of oxygen. There are two categories of stroke: Ischemic, caused by a blockage of blood flow and Hemorrhagic, caused by bleeding. 800% of the strokes are Ischemic stroke, is the most frequent cause of stroke and is responsible for about 80 percent of strokes. Many of these stroke are preventable, while hemorrhagic strokes are more fatal. Stroke Disabilities Although stroke is a disease of the brain, it can affect the entire body. Some of the disabilities that can result from a stroke include paralysis, cognitive deficits, 68


speech problems, emotional difficulties, daily living problems, and pain. Paralysis: A common disability that results from stroke is paralysis on one side of the body, called hemiplegia. A related disability that is not as debilitating as paralysis is one-sided weakness or hemiparesis. The paralysis or weakness may affect only the face, an arm, or a leg or may affect one entire side of the body and face. A person who suffers a stroke in the left hemisphere of the brain will show right-sided paralysis or paresis. Conversely, a person with a stroke in the right hemisphere of the brain will show deficits on the left side of the body. A stroke patient may have problems with the simplest of daily activities, such as walking, dressing, eating, and using the bathroom. Motor deficits can result from damage to the motor cortex in the frontal lobes of the brain or from damage to the lower parts of the brain, such as the cerebellum, which controls balance and coordination. Some stroke patients also have trouble eating and swallowing, called dysphagia. Cognitive Deficits: Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory. If the cognitive problems are severe, the stroke patient may be said to have apraxia, agnosia, or “neglect.� In the context of stroke, neglect means that a stroke patient has no knowledge of one side of his or her body, or one side of the visual field, and is unaware of the deficit. Language Deficits: Stroke survivors often have problems understanding or forming speech. A deficit in understanding speech is called aphasia. Trouble speaking or forming words is called dysarthria. Language problems usually result from damage to the left temporal and parietal lobes of the brain. Emotional Deficits: A stroke can lead to emotional problems. Stroke patients may have difficulty controlling their emotions or may express inappropriate emotions in certain situations. One common disability that occurs with many stroke patients is depression. Post-stroke depression may be more than a general sadness resulting from the stroke incident. It is a clinical behavioral problem that can hamper recovery and rehabilitation and may even lead to suicide. Post-stroke depression is treated with antidepressant medications and therapy. Pain: Stroke patients may experience pain, uncomfortable numbness, or strange sensations after a stroke due to many factors including damage to the sensory regions of the 69


brain, stiff joints, or a disabled limb. There may be uncommon causes for pain as well. Subacute Care Care or monitoring (watching) after a hospital stay. This can be in a less intensive setting (such as a rehabilitation service) or in a special unit in a hospital. Subacute care is usually short-term. Surrogate Decision Maker Person chosen by a patient to make choices if he or she cannot do so and advocate on the patients behalf.

Telemedicine Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status. Telemedicine includes a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology. Transition A move from one care setting (hospital, nursing home, or home) to another. Care during transitions involves coordination and communication among patient, providers, and family caregivers.

Ventilator A machine that pushes air into the lungs through a breathing tube inserted into the patient’s throat. Also called a respirator or “vent.” Visiting Nurse A term often used for a nurse who visits patients in their homes. The job of a visiting nurse includes checking vital signs (such as heart rate and blood pressure) and physical health. The visiting nurse follows a doctor’s treatment plan.

Will and Will Support Legal written document stating what a person wishes to be done with his or her belongings (property) and assets (money) after death. 70


The 2015 Central Valley Caregiver Guide was printed with the support of our advertisers. We encourage you to be reciprocal and utilize their services. Our goal is to develop partnerships with caring businesses and services within our community. All Health Integrative Care Center (Page 40) Community Hospice (Page 31) Creekside Care Home (Page 18) Daniger Furniture (Page 39) Delta Blood Bank (Page 10) Ezekiel’s Way (Page 8) Five Star-Rio Las Palmas (Page 31) Green’s Nutrition (Page 40) Health Plan of San Joaquin (Page 80) Hospice of San Joaquin (Page 27) Kelly’s Kitchen & Bath (Page 6) Law Office of June D. Jantz (Page 13) Mid Valley Storage & Delivery (Page 18) Premier Community Credit Union (Page 1) Rainbow Clean & Pure Solutions (Page 13) Ready4Rescue (Page 51) San Joaquin General Hospital (Page i) San Joaquin Human Services Agency (Page 4) Seniors Helping Seniors (Page 10) Shelton Care Management, Inc. (Page 55) St. Joseph’s Medical Center/A Dignity Health Member (Page ii) Stanislaus County Aging & Veterans Services (Page 10) University of the Pacific (Page 27)

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Healings in Motion in partnership with Dameron Hospital and Genentech offers a monthly Lunch and Learn program aimed at uplifting and empowering those who have had a life altering event by equipping them with education and tools to help them maintain a satisfying quality of life.

LUNCH

E

LEARN WHEN

E

WHERE COST

E

REGISTER

CV-RAPS is a unique program that brings survivors, caregivers, experts in the medical field and related agency representatives together to discuss issues that face survivors of strokes and other brain related injuries and their caregivers. Every 4th Tuesday of the Month Time: 12 noon to 2pm Dameron Hospital – Annex 525 W. Acacia Street Stockton, CA 95293 FREE http://www.eventbrite.com/e/central-valley-recoveryawareness-preventing-strokes-program

Healings in Motion is committed to providing programs such as CV-RAPS to ensure that all who need care knows where to go and what to do to get the care and support they need. In addition we are committed to making sure they everyone knows the signs of a stroke.

F-A-S-T Face drooping – Arms slouching – Speech slurred – Time –call 9-1-1


United to Increase Stroke Awareness in Our Community!




More people choose the plan with more

choices.

hpsj.com|888.896.PLAN (7526)


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