Providence Health Fall 2013

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Providence

FALL 2013

A GUIDE TO HEALTHY LIVING AND QUALITY CARE PROVIDENCEHEALTHONLINE.ORG

The Leading Edge in Cancer Care

Find out how the world-class care at Providence helps patients win the fight against cancer

HOME TO STAY

Our home-health specialists aid patients in the transition from hospital to home

FIND YOUR BEST HEALTH PLAN

Master open enrollment with our step-by-step guide

BEATING THE BLUES

How to recognize seasonal depression— and stop it in its tracks

Providence Holy Cross Medical Center Mission Hills

Providence Little Company of Mary Medical Center San Pedro

Providence ittle Company L of Mary Medical Center Torrance

Providence Affiliated Medical Groups

Providence Saint Joseph Medical Center Burbank

Providence Tarzana Medical Center Tarzana

Providence TrinityCare Hospice


Thoughts from Your Chief Executives

Sharing Our Stories

IN THIS ISSUE Place 6 No Like Home

Home health helps you recover where you’re most comfortable.

an 8 Keep Open Mind

We demystify open enrollment—so you can choose the right health plan.

It’s hard to believe we’re nearing the end of another year—one we hope has been a healthy one for our readers and their families. In the pursuit of good health, we devote this issue’s cover story to the leading-edge cancer care you’ll find at Providence. If you or a loved one has been diagnosed with this disease, you’ll want to learn about the exciting developments, treatments and tools we offer. In addition to new technology, tradition is at the forefront of the Providence mission. We are eager to share stories of the patients who are part of our history. Learn how to share your Providence experience on page 3. As open-enrollment season is upon us, we offer a guide to simplify what can be a very complex task: choosing the best health coverage for you and your family. At Providence, we coordinate care among each patient’s primary care physician, specialists and our hospitals to help ensure high-quality care. This is also, of course, the beginning of the holiday season. Colorful decorations are

already appearing on store shelves, but what you don’t hear much about are the holiday blues. Read on to learn how to recognize depression, which may escalate as the holidays approach, particularly among the elderly. For those in middle age and beyond, we feature our expertise in minimally invasive joint replacement, offered at all five Providence medical centers. Home health is a growing specialty for all ages, providing expert care in the comfort of home. The Providence Home Health program offers care from the South Bay to the Valley and beyond, helping patients who have been hospitalized return to life on their own. Lastly, in the spirit of the season, we urge you to consider giving to Providence Health & Services, Southern California, to help us continue enhancing our care through new technology, professional education and outreach programs to help those most in need. We wish you all a safe, happy and health holiday season!

10 Leading-Edge Cancer Care In the fight against a deadly disease, Providence provides the latest treatments.

14 Seasonal Blues? IN EVERY ISSUE  3 Community Connections 15 Foundation Focus 16 Providence Medical Institute 17 Calendar of Classes and Events 2 | Providence Health

fall 2013

Gerald Clute Chief Executive Providence Tarzana

Elizabeth Dunne Chief Executive Providence Little Company of Mary Torrance

Bill Gil Chief Executive Medical Foundations

Bernie Klein, MD Michael Rembis Chief Executive Chief Executive Providence Holy Providence Saint Joseph Cross

Terri Warren Chief Executive Providence TrinityCare Hospice

PROVIDENCE HEALTH Produced by Marketing & Communications at Providence Health & Services, Southern California

Senior Content Editor: Kat Johnson

Providence Health Editor-in-Chief: Nancy Franklin

Art Director: Andrea Heser

Providence Health Managing Editors: Patricia Aidem Jennifer Fagnani Connie Matthews Kirk McDonald Diana Reynar Natasha Shows

Production Technology Specialist: Sonia Fitzgerald

Contributors: Ann Beurskens Tiffany DeVall Brenda Goettemoeller Gail Malloy Juanita Perea Kathryn Sprague Ellen Wise

Imaging Specialist: Dane Nordine

The material in Providence Health is not intended for diagnos­ing or prescribing. Consult your physician before undertaking any form of medical treatment or adopting any exercise ­program or dietary guidelines. If you wish to be removed from the mailing list, please tear off the shipping label and mail it to Remove Me, PO Box 17910, Phoenix, AZ 85011 or go to acd.mcmurry.com.

Production Manager: Shannon Cross Providence Health is published four times annually by McMurry/TMG, 1010 E. Missouri Ave., Phoenix, AZ 85014. Volume 5, Number 3 © 2013 McMurry/TMG, LLC

Printed on recycled paper.

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PHOTO AND COVER PHOTO BY ©2013 INTUITIVE SURGICAL INC.

How to recognize the signs of holiday depression—and why seniors are often at risk.

Nancy Carlson Chief Executive Providence Little Company of Mary San Pedro


Community Connections OUR MISSION AS PEOPLE OF PROVIDENCE, WE REVEAL GOD’S LOVE FOR ALL, ESPECIALLY THE POOR AND VULNERABLE, THROUGH OUR COMPASSIONATE SERVICE.

Share Your Story

CORE VALUES

Compassion

 Caring for each person as part of our family.

Justice
 Working for a fair and equitable society.

Respect
 Affirming the God-given dignity and worth of each person.

Excellence Continually improving all that we do.

PHOTO BY THINKSTOCK

Stewardship
 Wisely caring for and sharing human, environmental and financial resources held in trust.

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Everyone has a story to tell. We want to hear yours. In fact, it might just get published here, in the new “Share Your Story” section that will appear in each issue of Providence Health. From the Valley to the South Bay, we know that your health stories hold power for others who are “just like you.” Did you take a class at Providence that helped you elevate your lifestyle? Have you benefited from Providence’s state-of-the-art cancer treatment or advanced cardiac care? Did a routine visit to a Providence doctor help you discover— and treat—a health condition earlier rather than later? Let us know. We want to hear our patients’ stories of how healthcare affected their lives. We want to hear about the strategies you used

Your Story Starts Here If it’s been a while since you’ve seen the doctor, our online physician finder makes it easy! Visit california.providence.org, click the “Find a Doctor” tab and then search by insurance, specialty or ZIP code.

to lose weight. Or cope with illness. Or try a treatment that at first seemed scary. And we want to reassure others that they are not alone. So, what are you waiting for? “Share your Story” today. Visit providence.org/share to contribute your Providence experience.

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Community Connections BACK TO SCHOOL

A Joint Effort

Today’s tiny incisions and advanced techniques are transforming joint replacement, and with fellowshiptrained orthopedic surgeons in your neighborhood, Providence Health & Services is leading the way. In fact, Patrice Hallak, regional director, orthopedics and neurosciences, says Providence Southern California medical centers are coordinating to offer the same level of quality, expertise and customer satisfaction. “We are sharing our proven techniques for getting people back to a productive lifestyle as quickly as possible,” she says. All five Providence medical centers offer minimally invasive hip, knee and shoulder replacement, with total ankle replacement also available at Providence Holy Cross Medical Center. From free preoperative seminars to advanced paincontrol techniques to rehabilitation, Providence is with you every step of the way. “Because of advances in surgical techniques as well as pain management, patients have less pain, faster healing and a faster return to normal function than they used to with conventional methods,” says Ramin Ganjianpour, MD, chief of the division of orthopedic surgery at Providence Holy Cross Medical Center. Find out more by calling 1-888-HEALING today.

Achy joints? Learn the signs of—and latest treatments for—joint deterioration. Visit california.providence.org and click “Health Education & Tools,” then “Symptom Checker.”

On the Web

Prepare for open enrollment. Choosing the right physician can be challenging, but it’s a decision that will benefit you and your family this year and beyond. For guidance on choosing a physician and hospital that best suit your needs, as well as information on Providence’s affiliated physicians, medical groups and contracted health plans, visit california.providence.org.

Providence High School in focus Summer is over, and for many parents, the best time of year has begun— school is back in session! This year, Providence High School is operating under a block schedule with longer class periods but fewer classes in a day, similar to the way college courses are instructed. With the change in schedule comes an addition of five new Advanced Placement courses, bringing the total of AP courses to 17. Prospective students are invited to campus on Thursday, Oct. 3, for Providence in Focus, a hands-on workshop for students in grades 6–8 that highlights the Media, Medical and Technology Focus Programs. New this year is a parent-education component featuring topics such as student success, technology as a research tool and the importance of parent involvement. Experience all that PHS has to offer at its annual Open House on Sunday, Nov. 3, from 1 to 4 p.m. For more information, call 818-846-8141 ext. 14501, or visit providencehigh.org. YOU BELONG HERE.

World-class care, close to home. Providence Medical Institute and Facey Medical Group provide a full range of medical services for the South Bay, San Fernando Valley and Santa Clarita Valley communities with nearly 400 physicians. In addition to primary care, urgent care and preventive care services, they provide a wide range of specialty care services. Learn more at providencemedicalinstitute.org and facey.com. A special delivery for new and expecting parents. Having a baby? Discover the trusted resource that guides Providence parents through pregnancy, labor and delivery, and newborn care. Baby Steps, our free weekly pregnancy and parenting email, boosts your baby IQ with news, tips and information—including announcements from our parent-education staff and information on hospital classes and tours—all delivered to your inbox. Learn more at providence.org/baby.

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Community Connections

Explore your Alternatives When it comes to battling cancer, patients are reassured when their healthcare providers pull out every weapon in the arsenal. At the Roy and Patricia Disney Family Cancer Center at Providence Saint Joseph Medical Center, our evidence-based Integrative Medicine program taps into complementary therapies in addition to the conventional cancer treatments of surgery, radiation therapy and chemotherapy. Among these treatments are:

Acupuncture • Massage • Herbal medicine and nutritional counseling •

Yoga • Tai chi • Therapeutic touch • Meditation • Qi gong •

“We are committed to healing the mind, body and spirit of every patient,” says Maria Gonzalez, BS, MPHc, administrator of the Roy and Patricia Disney Family Cancer Center. By helping them connect to a broad range of proven therapies, we ultimately give them more control over their own destinies.”

TOUR OUR FACILITY Our Integrative Medicine program is housed on the second floor of the Disney Cancer Center. For a virtual tour, visit triumphovercancer.org and select “Videos.”

Living Well with Diabetes

PHOTOS BY THINKSTOCK AND PROVIDENCE HIGH SCHOOL

If you’ve been diagnosed with diabetes or are pregnant and have developed gestational diabetes, Providence Southern California’s diabetes self-management programs can help you prevent long-term complications and lead a full, active life. In fact, our diabetes experts can help calm your fears while teaching you the skills necessary to monitor your blood glucose (sugar), manage your medications, eat healthfully, increase your physical activity and cope with a chronic disease. “This is true even if you’ve lived with diabetes for 20 years. Lifestyle changes are difficult to make and things in our life are always changing,” says Geri Harmon, RN, BS, CDE, diabetes education supervisor

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at Providence Little Company of Mary Medical Center Torrance. “Treatments are changing and improving rapidly. Our Providence diabetes educators not only offer comprehensive education, but we also help with problem-solving and ongoing support,” Harmon says. Whether you’re in the Valley or the South Bay, please call 1-888-HEALING (432-5464) or refer to the calendar on page 19 to find out about diabetes-management classes and support groups near you. And if you’re in the South Bay, please note that the Providence Little Company of Mary Medical Center Torrance Diabetes Management Center has moved to the Douglas & J. Glass Family Center, 5315 Torrance Blvd., Suite B2. fall 2013 Providence Health | 5


No Place Like Home Providence’s home care agencies can help you recover where you’re most comfortable

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The First Step

In Jean Ann’s case, her wound extended from knee to thigh and required consistent monitoring and maintenance. The prospect of leaving the hospital and caring for herself was intimidating. “I was terrified of never healing,” she says. Providence Home Care nurses came every other day to bandage the wound, using a new, absorbent dressing to speed healing. Her physical therapist helped her relearn how to walk without a limp. And after just two months of home care, Jean Ann is back on her feet, climbing stairs, bathing and even shopping on her own. “When the final bandage came off, it felt like a miracle,” she says. providencehealthonline.org

MODEL DEPICTED. PHOTO BY GETTY IMAGES/WAVEBREAK MEDIA

A

fter being hospitalized for weeks with a bout of cellulitis that resulted in a deep leg wound, 66-year-old Burbank resident Jean Ann Mattis learned she would finally get to go home. The thought was alternately welcome and terrifying. How would she care for her wound? What if she couldn’t? What if it got worse at home? Thanks to Providence Home Care, Jean Ann healed with the help of home health nurses who tended to her needs every step of the way. And similar stories unfold every day for patients recovering from heart attacks, strokes, cancer and other conditions— right in their own homes.


A Meaningful Mission

Jean Ann’s story illustrates the main objective of Providence Southern California’s two home health agencies: to help patients return to life on their own. “We want patients to become as independent as possible in their homes,” says Belinda Condit, MSN, RN, NE-BC, administrator for Providence Home Care, which serves the San Fernando and Santa Clarita Valleys. Little Company of Mary Home Health serves the South Bay. The first step is a “start of care” visit, in which a nurse will go over medication instructions and perform a safety assessment of the home. “Medication mistakes and falls are the major causes of rehospitalizations,” Condit says.

Available Services

Providence Home Care and Little Company of Mary Home Health offer a wide array of nursing services, including: • IV therapy • Wound care • Catheter care • Pain management • Injections Depending on a patient’s needs, physical therapists can work on mobility, and occupational therapists help patients reassume daily activities, such as dressing and meal preparation. Additional home care services include speech therapy, assistance with bathing and help finding community resources. Specialty services are also available, including a special cardiac team that works with heart failure, post-op heart surgery and heart attack patients. In the Valleys, Providence Home Care offers pediatric care for children on tubes, vents or central lines for chemotherapy. In the South Bay, Little Company of Mary Home Health also has a mental-health team. Manager Bo Erwin says some of his home health nurses have additional psychiatric training, equipping them to add an extra layer of expertise for patients who may have psychiatric needs in addition to other diagnoses, such as heart disease or diabetes.

Benefits of Home

At Providence, we understand that home is the place where patients are most at ease. That’s why we’re being proactive to help you stay there. Providence Home Care is participating in a study with Health Services Advisory Group, a Medicare-contracted organization that focuses on healthcare quality. “It’s an enhanced home health program to try to keep patients where they are providencehealthonline.org

most comfortable—home,” Condit says. “We’ll be doing things as simple as providing more visits at the beginning of care, when patients are most vulnerable, and calling patients on Fridays to make sure they are OK heading into the weekend.” Research supports these efforts: Condit cites a recent Johns Hopkins study that shows home healthcare decreases hospital readmissions by 25 percent.

Meeting Your Needs

Most patients, including Jean Ann, utilize home care for an average of 60 days. Others need only a few visits, while some require weekly or monthly care on a long-term basis. Jean Ann can’t imagine having tended to her serious leg wound alone. “I couldn’t have put my mind in the right place without Providence Home Care’s help,” she says. “Not only did my nurses give me the courage to face my wound, but they were caring, compassionate caregivers while they helped me heal.”

SIX STEPS FOR A SUCCESSFUL TRANSITION While physicians, families, friends and facilities (such as skilled nursing or rehabilitation facilities) can refer patients for home care, most patients transition from a hospital inpatient setting. Here’s how Providence helps smooth the transition from hospital to home: 1. We make sure you’re going home on schedule. 2. We call you before discharge. 3. We make sure before your first visit that you understand insurance coverage and copays. (With most Medicare Advantage plans, there is no copay.) 4. We ask you to have all your medications ready for the nurse to review. 5. We try to schedule your first home visit within 24–48 hours of discharge. 6. We develop a plan of care and maintain coordination of care by entering everything we do into your electronic medical record so it’s available to your physician.

WELCOME HOME

Would home health benefit you or someone you love? Learn more about Providence Home Care by calling 818-953-4451 or Little Company of Mary Home Health by calling 310-543-3450. fall 2013 Providence Health | 7


LeadingEdge

Providence offers some of the latest technologies and treatments in the fight against cancer

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PHOTO BY Š2013 INTUITIVE SURGICAL INC.

Cancer Care


N

o one ever wants to hear the words, “It’s cancer.” But if you do, Providence Health & Services is poised to help you battle back with some of the latest treatments and technology.

From robotic instruments that work more precisely than a surgeon’s hands to radiation that targets the disease while sparing surrounding healthy tissue, Providence mobilizes the expertise of our physicians with advanced technology to treat cancer. And we never lose sight of the compassion that every patient deserves. “We can put the bells and whistles on this and use robotics on that, but really listening to the patient and providing comprehensive care for the patient and family—from prevention to survival to palliative care—that’s how the philosophy of cancer care is changing,” says Vijay Trisal, MD, a City of Hope surgical oncologist who treats patients at Providence Holy Cross and Providence Saint Joseph Medical Centers. Here are some of the advanced treatment options and expertise patients find at Providence.

Robotic Surgery

Providence Saint Joseph and Providence Little Company of Mary Medical Center Torrance utilize the da Vinci Si robotic surgical system, which broadens the range and precision of cancer surgeries available to patients in the Valley and South Bay. Garrett Matsunaga, MD, a board-certified urologist who is fellowship-trained in robotic oncology, says the No. 1 case he performs in Torrance is robotic-assisted removal of the prostate for cancer. “With laparoscopic instruments—tiny, 1-centimeter instruments that have 270-degree articulation—you can operate with a lot more ease and accuracy,” Dr. Matsunaga says, adding that surgeons properly trained in robotics have high levels of success in sparing nerves in these very delicate procedures. Robotic partial-kidney removals are his second most common robotic procedure. “When we are taking out small tumors, we’re able to leave 80 percent or more of a healthy kidney,” Dr. Matsunaga says. This compares with traditional surgery, which sacrifices nearly 50 percent of the kidney, he says. At Providence Saint Joseph, surgeons are trained to use robotics for prostate, cardiothoracic, kidney and gynecologic cancers. And most recently, Dr. Trisal, surgical oncologist at City of Hope, has offered nerve-preserving resection for rectal cancer at Providence Saint Joseph. “We have been pioneers in rectal resection and we were the first ones to do the procedure with the robot,” he says.

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Targeted Treatments

GOODBYE, GUESSWORK

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Specialized Care

Providence Health & Services places high priority on attracting skilled surgeons and clinicians whose expertise set them—and us—apart. In the South Bay, surgical oncologist Moshe Faynsod, MD, brings expertise to the most complex breast cancer cases. “Breast-specific oncologists keep up with the latest treatments, which are changing all the time. Treatment is very fluid,” he says. In fact, when it comes to breast surgery, he urges women to see a breast surgeon or a surgical oncologist rather than a general surgeon. “Studies show that survival rates are simply better,” he says. Lana D. Louie, MD, FACS, a new breast surgeon at Providence Tarzana, brings to the role a passion for helping patients understand the bigger genetic picture related to certain breast and ovarian cancers. providencehealthonline.org

PHOTO BY DUNE MEDICAL DEVICES

The new breast MarginProbe System, which may significantly improve a surgeon’s ability to remove cancer during lumpectomy, is being used by Providence Saint Joseph Medical Center. In many cases, the probe can help breast cancer patients avoid a second surgery. Deanna J. Attai, MD, FACS, a breast surgeon on staff at Providence Saint Joseph Medical Center, explains: “In every lumpectomy, we’re trying to take out the tumor with a rim of surrounding normal breast tissue. The problem is, these are microscopic cells, so there’s a little bit of guesswork.” That’s where the probe comes in. The technology analyzes surgically removed breast tissue, quickly detecting differences in cell properties that could indicate the presence of cancer in the margins, or edges. “If we have cancer at the margin, we know there is a higher risk of cancer returning. The goal is always to have a clean margin,” Dr. Attai says. If the probe indicates the presence of cancer, the breast surgeon can remove a larger area of tissue right then. Without the probe, surgeons must send the removed tissue to a lab to see whether any cancerous cells remain on the margins. The probe is not 100 percent accurate, and it does not replace lab analysis. It does, however, increase a breast surgeon’s ability to remove cancer in one operation. “A second surgery can mean a second anesthesia, more removal of breast tissue, more anxiety, more time off of work and a potentially delayed start to radiation,” Dr. Attai says. “Anytime we have a tool that can help us get clean margins in one operation, that’s a good thing.” At press time, Providence Saint Joseph was one of only two facilities in California—and five in the country— using the breast MarginProbe, which was approved by the Food and Drug Administration in December 2012.

While surgical advances represent one new frontier in cancer treatment, the ability to target treatments through chemotherapy and radiation is another front line in innovation. “In medical oncology, the treatment approach has changed,” Dr. Trisal says. “Previously we used chemotherapy to kill all the cells. Now we only target the ‘unhealthy’ cells, and this often involves radiation techniques that can pinpoint the bad cells and spare the good ones in the surrounding area.” The Roy and Patricia Disney Family Cancer Center at Providence Saint Joseph is equipped with the latest in targeted radiation treatments, including image-guided radiation therapy (IGRT), which improves precision and accuracy, and intensitymodulated radiation therapy (IMRT). Providence Little Company of Mary Torrance also offers targeted treatments such as IMRT, IGRT and respiratory gating, which tracks moving tumors. Critical organs such as the brain, spinal cord and lungs can be protected while radiation beams are aimed more accurately at the cancer and targeted tissue. Providence Holy Cross has a partnership with Vantage Oncology, which gives patients access to IMRT as well as cutting-edge 3-D image-guided radiation therapy and other targeted radiation techniques. Providence Little Company of Mary Medical Center San Pedro and Providence Tarzana Medical Center also offer advanced oncology services, with top medical oncologists, radiation oncologists and surgeons who provide the latest in chemotherapy and radiation therapy.


“When Angelina Jolie had a double mastectomy, she highlighted surgical management for her type of genetic mutation. Unfortunately, very few made the connection with ovarian cancer, which is more deadly than breast cancer and also is a concern for the BRCA1 and BRCA2 genetic mutations,” she says. “In these individuals, screening for ovarian cancer is extremely important.”

Partnership with City of Hope

Benjamin Paz, MD, a City of Hope surgical oncologist, explains the partnership between City of Hope and Providence Saint Joseph and Providence Holy Cross Medical Centers. “For some time, City of Hope has been committed to expanding our services outside our own doors. We partner with community hospitals in order to complement services they already provide,” Dr. Paz says. The relationship helps strengthen Providence’s already high level of cancer care, as evidenced by the skill Drs. Paz and Trisal bring to advanced cancer surgeries for complicated pancreatic, liver, stomach and esophageal cancers. “This brings Providence’s level of expertise up to the level of a specialized cancer center like City of Hope,” Dr. Paz says.

PHOTO BY ©2013 INTUITIVE SURGICAL INC.

Looking Ahead

At Providence Saint Joseph, Richard Friedman, MD, has become one of the leading surgeons in Los Angeles County for single-incision laparoscopic surgery (SILS) hysterectomies. “If you want a singleincision hysterectomy in the L.A. area, it’s pretty clear: We’re one of the best places to go,” he says. While he currently applies the technique only to benign hysterectomy or uterine fibroid cases, he is trained on the da Vinci surgical system for gynecologic cancer surgeries, and anticipates the day when robotic instruments will be suited for single-incision work. “We’re readying for the next generation of technology that will allow us to do single-incision robotic surgeries for cancer,” he says. Meanwhile, Dr. Louie believes the day is coming soon when genetic testing clarifies risks—and screening and treatment options—for a broader range of women at high risk of breast cancer and ovarian cancer. No matter what cancer diagnosis you or a loved one faces, Providence Southern California is dedicated to leading the charge into next-generation frontiers—both in terms of acquiring the latest technologies and partnering with physicians who have the training, expertise and skill to use them. providencehealthonline.org

YOUR BEST DEFENSE

If you’re facing cancer, Providence Health & Services offers aggressive, compassionate care close to home. Learn more by visiting california.providence.org/pages/services-cancer.aspx.

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Senior Health

Seasonal Blues? With the holidays soon upon us, watch for signs of depression in those you love It seems earlier every year that the familiar hues of red and green begin to appear wherever we look. Maybe these early seasonal cues can remind us to watch for the holiday blues—a condition that often goes undetected among the seniors in our lives. Here’s what to look out for and how to help.

What It Is

It’s important to understand the difference between the “holiday blues” and biochemical depression, says James S. Brust, MD, chairman of the department of psychiatry at Providence Little Company of Mary Medical Center San Pedro. One is situational, while the other is internal. “The holidays are supposed to be a happy time, but the expectation of cheer may make some feel worse,” Dr. Brust explains, adding that lost loved ones, lost independence or lost mobility can contribute to holiday blues. “Meanwhile, those with biochemical, depressive illness are more vulnerable to experiencing full-on episodes during this time.”

What to Watch For

While Dr. Brust says most people associate depression with feeling sad, there are several other hallmark signs, including inactivity, hopelessness, negative outlook and loss of energy, enthusiasm or appetite. “Everything just kind of slows down and gets negative,” he says.

What to Do

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Age Your Best The Center for Optimal Aging

offers a geriatric assessment that covers everything from nutrition to cognitive performance—and then connects seniors to specialists and resources to help. Please visit california.providence.org/san-pedro or call 1-888-HEALING (432-5464) to learn more. PHOTO BY THINKSTOCK

For seasonal depression, Dr. Brust recommends a robust effort by friends and family. “If the depression seems to be related to a loss, you encourage people, get families around them, get them into activities,” he says. “Show them that life is worth living.” In cases of biochemical depression, medication—either by itself, or in conjunction with psychotherapy—can be extremely effective. “If depression is truly an internal event, you’ve got to go in there with something to smooth it over,” Dr. Brust says. A Mental Health America survey reveals that depressed seniors are more likely than any other group to “handle it themselves.” Don’t be afraid to offer help, opening a discussion with a statement such as: “I’ve noticed you don’t seem yourself. What’s going on? Let’s get you in to see a doctor.” “If they say, ‘Oh, no, I’m fine,’ you might have to leave it alone for a few days,” Dr. Brust says. “But keep your eyes open. Bring it up again. Show them you care and want to help.”

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Foundation Focus

Cultivate Your Legacy Planned giving to a Providence Foundation can yield a harvest of health and hope In her 65 years of life, Bonnie Jue was known as a loving wife, a devoted friend, an animal lover and a community advocate. She complemented her love of animals and volunteerism with her skill as a master gardener—growing vegetables at the Sepulveda Basin Community Garden Center for primates at the Los Angeles Zoo. The zoo even asked her to create and maintain “Bonnie’s Garden” on-site. Unfortunately, Bonnie was diagnosed with cancer, which weakened her to the point where her husband, Phil, needed help with her care and comfort. He turned to Providence TrinityCare Hospice. “They were caring, but they also were honest and direct— which I wanted,” Phil says. “The hospice staff who came to this house, no matter what time of day, were always gentle and respectful, and they never left too soon. They were wonderful.” In response to the care and dignity that Providence TrinityCare Hospice offered to Bonnie during her final months, Phil was moved to pledge their estate through planned giving. Gifts like his—and yours—evoke the gardening principles that Bonnie so loved. Here’s how to “grow” your own legacy.

where to plant 1 Choose

Phil chose Providence TrinityCare Hospice Foundation to ensure that the loving assistance his wife received carries on for future generations. Providence Foundations in Southern California support five regional medical centers and hospice care. Learn more about them at providencepowerofgiving.org.

patients,” says Robin Steen, director of individual giving for Providence TrinityCare Hospice Foundation.

3 Till the soil

Talk to your loved ones about what is important to you as you plan for the future. You may want to talk to your financial or legal advisor as you consider the form and timing of your gift.

PHOTO BY THINKSTOCK

your garden’s size and shape 2 Plot 4 Plant the seeds Planned gifts can include an entire estate or a set dollar amount—or anything in between. “Whether it’s a dollar amount, property, an insurance policy or an annuity, these gifts directly help Providence families and providencehealthonline.org

Phil has made his intentions known to pledge his entire estate to Providence. “What’s exciting is that, since he’s telling us about this now, we have time to honor this estate gift during his lifetime,” Steen says.

your harvest 5 Imagine

Through proper planning, your estate can leave a legacy of love and care, not only to your family and friends, but to many others in need of the excellent and compassionate care offered through Providence medical centers and hospice care in Southern California.

PLAN A SPECIAL GIFT

Consider making a planned gift to Providence. Visit providencepowerofgiving.org and contact a Providence planned-giving expert to learn more about your options. fall 2013 Providence Health | 15


Providence Medical Institute

Rx for Safety How—and why—to take your medicine as directed Mary Poppins made it sound like child’s play in “A Spoonful of Sugar,” but the truth is that nearly three out of four Americans don’t take medicine as directed. Considering nearly 4 billion prescription drugs were filled at retail pharmacies in 2011—nearly 400 million in California alone—that’s a whole lot of medicine not being used the right way. To make sure you’re getting the most out of your medications, two internal-medicine physicians with Axminster Medical Group, a Providence-affiliated medical group, weigh in on the issue.

CROSSBORDER CAUTION

Doing Your Part

Fill your prescription. Sometimes patients just don’t want to be on a drug or can’t afford it. In other cases, they fear side effects. “Most side effects are annoying or bothersome, but they will go away,” says Susannah Ehret, MD. Get tough. Swallow the pill. The effects of not taking medication can be severe— especially if the drug is designed to control blood pressure, diabetes or cholesterol. “Over time, vital organs can be damaged,” she says. Take all your medication. “Sometimes people stop taking antibiotics as soon as they feel better. This only allows bacteria that escaped the initial treatment to become resistant,” Dr. Ehret cautions.

Doing Our Part

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HELP IS HERE

Have questions about a prescription? Call 1-888-HEALING (432-5464) and ask to be connected to a Providence pharmacy.

know the things that patients fear. Sometimes they fear medication more than the disease. “I always tell my patients, the reason you’re on a strong medicine is you’re up against a strong enemy. There’s a fight going on,” he says. “And it’s worth it to win.”

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PHOTO BY THINKSTOCK

Both Dr. Ehret and Spencer Wenger, MD, view clear communication as their top tool in ensuring patient safety. Direct patient-to-doctor email helps. “Patients may be concerned about side effects, and now they can write me with their concerns directly,” Dr. Ehret says. Both doctors are bilingual, speaking English and Spanish, which aids in crosscultural communication for Spanish-speaking patients. “While knowing other languages is useful, what helps even more is knowing the culture,” Dr. Wenger says. “It’s important to

Need a prescription drug? While a trip across the border or a visit to an international online pharmacy might be tempting, Spencer Wenger, MD, and Susannah Ehret, MD, urge patients to put their safety first. Don’t DIY: Self-prescribed discount drugs from Mexico or Canada might seem smart, but cutting your physician out of the equation can spell danger. “A doctor will know which medication is truly appropriate,” Dr. Wenger says. Beware of bad combinations: Some international and online pharmacies may sell drugs in combinations—for example, ibuprofen and prednisone— that can be disastrous if used together. Consider the consequences: Unregulated drugs can be dangerous. For example, Neo-Melubrina “treats” high fever but has been banned in the U.S. for good reason. “It causes terrible immune suppression,” Dr. Ehret says. “It fights fever by knocking down white blood cells,” which weakens the body’s ability to fight infection.


Calendar October–December

Community Classes and Events From support groups to fitness classes, our Providence medical centers provide the programs you need to live healthfully. For more information on any of the classes, events and screenings listed below, visit providenceclasses.org or call 1-888-HEALING (432-5464). Not all classes available at all medical centers. SUPPORT GROUPS Support groups offer patients and families a chance to share experiences of learning and healing. For those who have experienced health issues, we offer the following support groups: Alzheimer’s/Other Dementia* *Spanish-language group available Bereavement Better Breathers Club Breast Cancer Cancer Cardiac Rehabilitation Caregivers Congestive Heart Failure Diabetes Early Memory Loss* *For individuals with a memory loss or neurological condition Grief Heart Disease Liver and Pancreatic Cancer

Live Wires* *For Parkinson’s disease patients who have undergone deep brain stimulation Lymphedema Osteoporosis Stress Reduction Stroke Survivors After Suicide Traumatic Brain Injury Valley Pumpers Women’s Cancer FITNESS Arthritis Friendly Exercise Program Chair Exercises for Strengthening and Flexibility Exercise Safely with Guidance & Support Get Physical Lively Lungs Kundalini Yoga Burbank Mall Walkers

South Bay Galleria Gaitors Walking Program Call 818-847-4535 for more information. WELLNESS CLASSES AND SCREENINGS Asthma Education Caregiver Education and Training* *Spanish-language class available Nutrition Roundtable Outpatient Nutritional Counseling Pre-Operation Total Joint Replacement Education Pulmonary Education Program Pulmonary Rehab Self-Training DIABETES CLASSES Basic Diabetes Education Class Diabetes 101 & Self-Care Diabetes and Pregnancy Diabetes Self-Management Program Healthy Living with Diabetes Individual Sessions with a Diabetes Specialist

Childbirth and Parent Education All Providence medical centers offer a full schedule of classes to prepare parents-to-be for pregnancy, birth and parenting. For more information or to download a copy of our 2013 schedule of classes, visit providence.org/baby or call 1-888-HEALING (432-5464). PREPARE FOR BIRTH Maternity Tour Big Kids and Babies Sibling Maternity Tour PREPARE FOR BABY The Amazing Newborn Anesthesia and Cesarean Section Baby Care Breastfeeding Childbirth Preparation Lamaze Classes* *Spanish-language classes available Childbirth Preparation Intensive Course, one-day intensive class Childbirth Refresher Course Parents Expecting Multiples providencehealthonline.org

Preparing for Your Newborn, four-part series Transition to Parenthood CLASSES ABOUT BABY Baby Signs Basics, baby sign language for hearing babies Infant Safety and CPR, a class for expectant and new parents; newborn to age 1 Infant/Child Safety and CPR*, a class for parents who have children from newborn to age 8 *Spanish-language classes available

SUPPORT GROUPS Breastfeeding Leeza’s Care Connection* *a place for family caregivers, located at Providence Saint Joseph Medical Center, Burbank MommyWise, a weekly support group for new mothers and their infants Perinatal Loss AFTER BABY IS BORN Safe Sitter/Super Sitter, a program that teaches young adolescents how to care for children Sign, Say and Play Continuing Program, six-week baby sign language program

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acupuncture, tai chi, therapeutic touch, sonic healing and guided imagery. Meets: Various days and times. Visit triumphovercancer.org for a full schedule. Location: All classes held at the Roy and Patricia Disney Family Cancer Center, 181 S. Buena Vista St., Burbank Info: 818-748-4701 CHILDBIRTH PREPARATION Learn what to expect during labor, delivery and recovery. Certified childbirth educators will also share breathing and relaxation techniques. Meets: Mondays, Tuesdays or Wednesdays; 6:30–9 p.m. Location: Providence Tarzana Medical Center, 18321 Clark St., Tarzana Info: 1-888-HEALING (432-5464)

Online Calendar

FEATURED EVENTS LEEZA’S CARE CONNECTION: A PLACE FOR FAMILY CAREGIVERS This community gathering place and resource center is committed to providing free support services, resources and programs for family caregivers taking care of a loved one with a memory disorder or any chronic and/or progressive illness. Our programs educate, empower and, most important, connect caregivers to one another. Location: Leeza’s Care Connection, Providence Saint Joseph Medical Center, 1-South Tower, 501 S. Buena Vista St., Burbank Info: 818-847-3686 (English); 818-347-3728 (Spanish) ARE YOU AT RISK FOR COLON CANCER? One in 20 people will develop colon cancer in their lifetime. Don’t become a number. Schedule your colonoscopy. Location: All Providence hospitals Info: 1-888-HEALING (432-5464) 18 | Providence Health

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Go to providenceclasses.org for class descriptions, times and locations, and to register.

WEIGHT-LOSS SURGERY Are you ready to restart your life? Learn more about our minimally invasive options, including LapBand, gastric bypass and gastric sleeve procedures. Location: Providence Saint Joseph Medical Center, 501 S. Buena Vista St., Burbank Info: Visit restartlife.org. TAKE CONTROL OF YOUR BREAST HEALTH Schedule your low-cost mammogram today. Weekend and evening appointments available. Location: All Providence hospitals Info: 1-888-HEALING (432-5464) YOGA, MEDITATION AND MORE Numerous classes are open to the public, including yoga, acupressure, meditation, massage, qi gong,

YOGA TUNE UP® Move through a distinctive set of poses and exercises to build strength, relieve pain and stress, and improve balance. Meets: Tuesdays, 10:30–11:45 a.m.; Thursdays, 2–3:15 p.m. Location: Providence Holy Cross Health Center at Porter Ranch, 19950 Rinaldi St., Mission Hills Fee: $15 per class Info: 1-888-HEALING (432-5464) MEDITATION Learn to use breathing techniques and guided imagery to reduce stress and combat depression. Meets: Tuesdays, noon–12:30 p.m.; Thursdays, 3:30–4 p.m. Location: Providence Holy Cross Health Center at Porter Ranch, 19950 Rinaldi St., Mission Hills Fee: $7 per class Info: 1-888-HEALING (432-5464) PRE-OPERATION TOTAL JOINT REPLACEMENT EDUCATION This class covers everything you need to know to prepare for joint replacement surgery. Get instructions for the night before and learn how to prepare your home for recovery. Meets: Thursdays; 10:30 a.m.–12:30 p.m. Location: Providence Little Company of Mary Medical Center Torrance, providencehealthonline.org


4101 Torrance Blvd., Torrance Info: 1-888-HEALING (432-5464) CARDIAC SUPPORT GROUP Cardiac patients, family and friends meet to provide mutual support and discuss solutions to common problems. Meets: Once a month from 5–6:30 p.m.; call for specific dates. Location: Providence CardioPulmonary Rehab Center, 20929 Hawthorne Blvd., Torrance Info: 310-303-7070 DIABETES SELF-MANAGEMENT PROGRAM This comprehensive approach to diabetes self-management education will help you gain control of your diabetes, improve your health and help you feel your very best. The program is customized to meet your unique needs. Doctor referral is required to schedule an appointment. Location: Douglas and J. Glass Building, 5315 Torrance Blvd., Torrance Info: 310-543-7280 Location: Providence Holy Cross Medical Center, Outpatient Diagnostic Center, 11570 Indian Hills Road, Mission Hills Info: 818-496-4310

PHOTOS BY THINKSTOCK

BRIDGES PSYCHIATRIC OUTPATIENT DAY PROGRAM This program offers psychiatry, group therapy and socialization. A wide range of topics is covered, from depression and anxiety to coping skills and healthy relationships. Meets: Mondays, Wednesdays and Fridays; 10 a.m.–2 p.m. Location: Providence Little Company of Mary Medical Center San Pedro, 1300 W. Seventh St., San Pedro Info: 310-241-4325 AARP DRIVER SAFETY PROGRAMS This two-part AARP/Driver Safety Program is for people 55 or older who want to reduce their automobile insurance premiums. You must attend both four-hour sessions to receive providencehealthonline.org

your AARP certificate. $12 for AARP members; $14 for nonmembers. Meets: Sept. 11 and 18; Oct. 9 and 16. No classes in November and December. Location: Providence Occupational Health Center, 3413 Pacific Ave., Burbank Reservations: 818-847-4535 BURBANK MALL WALKERS Join the Burbank Mall Walkers for information that can help your health. Light refreshments served. Presentations are from 9–10 a.m. and include: Sept. 11–“Maintaining Your Health,” by Renata Stankovic, MD Oct. 9–“The Doctor-Patient Relationship,” by Boyd Flinders, MD Nov. 13–“How to Avoid Misuse of Your Power of Attorney and Trust Documents,” by Mitchell Karasov, Esq.

Dec. 11–“Hospital Services Update, 2014,” by Linda Gaul, Manager Senior Health Care, San Fernando and Santa Clarita Valley Service Area Manager Location: Burbank Town Center, Food Court, third level, 201 E. Magnolia Blvd., Burbank Info: 818-847-4535 GALLERIA GAITORS WALKING CLUB Join the Galleria Gaitors for group exercises and quarterly presentations. Galleria doors open to members at 7 a.m., seven days a week. Applications are available at Guest Services, first level, in the Nordstrom wing. Meets: Thursdays, 8 a.m. Location: South Bay Galleria, Food Court, third level, 1815 Hawthorne Blvd., Redondo Beach Info: 310-371-7546

SAVE A LIFE! DONATE BLOOD!

Blood can be the most precious gift you ever give. By donating today, you can save lives in the future. We need your help! WHERE: Providence Blood Donor Center, 501 S. Buena Vista St., Burbank WHEN: Monday and Wednesday, 8:30 a.m.–3:30 p.m.; Thursday, 12:30–7:30 p.m.; Saturday, 8:30 a.m.–3 p.m. For more information or to schedule an appointment, call 818-847-4433 or visit psjmc.givesblood.org.

MONTHLY CPR & SAFETY CLASSES •B asic Life Support for Health Care Providers •B asic Life Support, Part 2: Skills Evaluation •H eartsaver CPR and AED (automated external defibrillator) •H eartsaver First Aid with CPR and AED (automated external defibrillator) •H eartsaver, Part 2: Skills Evaluation • Infant/Child CPR • Super Sitter Call 1-888-HEALING (432-5464) or visit providenceclasses.org to register.

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