The Wise Guide Fall/Winter 2019 by Jonnie Bradley

WINTER/SPRING 2020

A N I N S I G H T F U L A P P R O A C H T O H E A LT H

Opioids

Use, Abuse & Help

Diabetic Eye Disease

Building the Best You

Understanding Influenza

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Winter / Spring 2020

Features

Opioids

Building the Best You

34 Understanding Influenza

Wise Guide | Winter/Spring 2020

About the Cover....................................................................................5 Kalispel Park, Kalispel Tribe Shares Resources..................................6 What DO You Know About Opioids?................................................7 Opioid Overdose - Take Action!.......................................................10 Sandpoint Community Resource Center........................................13 WA State Officials Make it Easier to Access Overdose Reversal Drug.................................................................14 A Pain Medicine Doctor’s Thoughts About the Opioid Epidemic............................................................................16 Is It Time to Get Help for Your Addiction?......................................18 Addiction Does Not Discriminate....................................................20 Building the Best You.........................................................................22 Friends of Scotchman Peaks Wilderness - Winter Tracks...............24 70 Years Stronger - Bonner General Health ....................................26 When Should My Child Have Their First Eye Exam?.....................28 Mechanics for Your Back - How to Avoid a Disc Injury.................30 Understanding Influenza...................................................................34 Non-Medical Home Care Helps Adults Achieve the Quality of Life They Deserve.........................................................36 Successful Rehabilitation Requires Proper Nutrition.....................38 Parkinson’s Support Groups & Events.............................................41 Having a Conversation with Your Family About Their Estate Plan.............................................................................42 Urgent Care, What a Great Benefit for Veterans..............................45 Need to Get Around Better?..............................................................46 Blue Water Navy..................................................................................48 Real Self-Defense.................................................................................50 What is CBD?......................................................................................52 LightForce Laser..................................................................................54 Diabetic Eye Disease 101....................................................................56 Who Can You Trust to Reduce Stress of Estate Planning?...............58 Solving the Challenge of Loneliness................................................60 iN2L Proves - It’s Never Too Late!.....................................................62 Family Caregiving and Stress.............................................................64 Guardianship and Conservatorship: Affronting or Approachable?........................................................66 Medicare - Important Notes and Changes for 2020.......................68 Long-Term Care and Medicaid, Myths vs. Facts..............................70 Alzheimer’s & Dementia: Early Detection & Diagnosis is Key......72 Alzheimer’s Association Support Groups........................................73 Crossword and Sudoku......................................................................74 Descriptive Advertisers’ Directory............................................... 76-81 Community Cancer Services…Providing Emotional & Financial Support...........................................................................82 Run It By Tamara................................................................................84 Critical Hospice Care Meets Growing Demand..............................86

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About the Cover

The Wise Guide Winter/Spring 2020 Office: 208-255-5950 Email: info@thewiseguideonline.com www.TheWiseGuideOnline.com

Cover Artwork: “Bitterroot Bobcat” by Carol Hayes

About the Artist Carol Hayes has been drawing since she could hold a pencil in her hand. Her eye for wildlife is reflected in the exquisite artwork she produces.

Jonnie Bradley Editor The Wise Guide

Haz where she continued to explore art by creating works on fabric. She was hired to airbrush a 120-foot-long mural for a new bank in a town in Washington, and from that job Carol and her new partner started Swan Design, a mural business. They did several banks, homes, a 15’ x 60’ long mural “The Hot Springs”

wonderful adventure it has been to see such wonderful results from the gifts of the earth.” Carol’s artwork is displayed in a few galleries, shows and gift shops in

Although every precaution has been taken in the publication of this guide, the publisher and authors assume no responsibility for errors or omissions. This guide is not intended to be legal or medical advice or to endorse any product or service. The Wise Guide, LLC is not responsible for the contents of any websites referenced within this guide. No part of this guide may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by an information storage and retrieval system without the express written permission of the publisher, The Wise Guide, LLC.

Ducks in a Row Carol grew up in the wilderness of Alaska and Idaho spending her time observing nature. While raising her two boys, she took a few art classes at the College of Southern Idaho. Later, she continued taking classes from a local artist and was encouraged to start selling her art. In 1989, Carol started an airbrush business called Personal Selections by

at Vale, Oregon. After moving to Montana in 1993, Carol completed 8 more murals and began teaching oils and airbrushing privately and in-classroom instruction. She loves to teach and has painted many different subjects, but her favorite is to bring animals to life in their natural habitat. Carol and her husband, two dogs,

Quiet Confidence

Listening Elk

Wise Guide | Winter/Spring 2020

mules, and chickens reside in a small town tucked in the valley between the beautiful Bitterroot and Cabinet mountains. Carol is also a natural medicine educator and enjoys helping people with their health and wellness goals with essential oils, “What a

Trusting Partners Montana and Idaho. Many originals, limited edition prints (priced from $85-$95) of florals, wildlife, landscapes, still life, fantasy, and historical subjects are available. Burls are one of a kind and price varies by size. View more of her work and purchase originals and prints through her Facebook page: Carol Hayes Fine Art. Call Carol at 208-6106245 or email: hazyacres@ blackfoot.net

Squirrels

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Kalispel Park... the Kalispel Tribe Shares Resources with Everyone!

alispel Park opened to the public in the spring of 2019 bringing gaming, dining, and recreation to Cusick, WA, and travelers along the International Selkirk Loop. The park has been a long-term vision of the Kalispel Tribe in an effort to bring commerce and jobs to this historically underserved area. Tucked along the north-flowing Pend Oreille River and the Selkirk Mountains near Cusick, you’ll find the Kalispel Indian Reservation. The ten-mile-long, by one-mile wide reservation consists of about 4,600 acres of mostly flood plain and mountain foothills that are filled with blue Camas flowers each spring along with lush green meadows and forest. The reservation represents just a fraction of the Tribe’s vast ancestral lands that once encompassed millions of acres stretching from western Montana, across northern Idaho, and into eastern Washington. The first recorded census of the Kalispel people was in the few thousands, as recorded by a Jesuit missionary. As white settlers pushed their way west, a series of pandemics struck the Tribe, halving the population each time. By the late 1800s only 100 tribal members remained. President Woodrow Wilson issued an Executive Order in 1914, granting the Kalispel formal federal recognition. The ensuing years were not much better. In the 1960s the median annual family income was around $1,600. Only three homes on the reservation had running water, and the reservation shared one party-line telephone. The 1980s came, and there was little to no improvement. One in four pregnancies ended in miscarriage, and over two thirds of the tribe’s adult population struggled with alcoholism. Tribal leadership realized that in addition to federal grant resources, the Tribe needed to create lucrative business opportunities to increase services to the membership. Since little could be done on existing reservation lands due to the flood plain and mountainous slopes, the Tribal Business Council sought opportunity through the Department of Interior’s two-part determination process that allows tribes with limited land and economic development resources to build off-reservation gaming enterprises. The Tribal Business Council looked outward, to a 40acre parcel of land the Tribe purchased in 1988 in Airway Heights, WA, and the Department of Interior agreed that the Kalispel Tribe met the requirements. Then Governor Mike Lowry echoed the Interior’s sentiments, and in December of 2000, the Kalispel Tribe opened the doors to Northern Quest Casino. Today the Kalispel Indian Reservation is a bustling center of government administration, health and wellness services, and economic development. The Tribe is the largest employer in Pend Oreille County, and one of the top five employers in neighboring Spokane County. The Tribe’s Camas Center for Community Wellness, located on the reservation, opened to the public in 2009 and includes an aquatics center, childcare center,

Wise Guide | Winter/Spring 2020

by Afton Servas, Public Relations Coordinator Kalispel Tribe of Indians gymnasium, teen center, work out facilities, a rock-climbing wall, deli, and meeting space. It is home to a medical and dental clinic that accepts health insurance and Medicaid. Pend Oreille County is one of the poorest counties in the State, something the Tribe took into consideration when setting membership prices. “The price for a family membership is considerably less than what you would see at the YMCA,” said Executive Director of Public and Government Affairs, Curt Holmes. “The Tribe operates this facility at a $1.3 million-dollar annual loss because we want the entire community, not just tribal members, to be able to utilize everything the facility has to offer.” The Tribe’s giving community spirit goes beyond the Camas Center for Community Wellness. Since 2000, the Tribe has donated over a million dollars annually to nonprofit organizations in Washington State. Notable recipients include the Cusick Food Bank, Youth Empowerment Services (YES), the Pend Oreille River School, the Vanessa Behan Crisis Nursery and Sacred Heart Children’s Hospital. The Tribe’s Charitable Fund sets aside approximately ten percent of their annual budget to fund programs and services in Pend Oreille County. The logging and mining industries brought prosperity to Pend Oreille County, but that prosperity was short lived. US Census data shows 16% of county residents live below the poverty line, and the county has historically suffered high unemployment rates. Through strategic partnerships with local and state officials, and local organizations like the Economic Development Council, the Tribe is doing its part to change those statistics for the better. “A rising tide lifts all ships,” said Holmes. It’s our responsibility as stewards of this land to leave it better than we found it. If we can invest our resources into creating a sustainable economy, everyone wins.” Kalispel Park, a Tribal development featuring an RV Park, fresh market, an auto dealership, a storage facility and a small casino recently opened on reservation land west of the Pend Oreille River in Cusick, WA. The Tribe added about 80 employees to its payroll in the opening of the various businesses, and the new hires were all local. The Tribe is currently conducting feasibility studies to determine the next phase of development at Kalispel Park. When asked what the overall vision for future development looked like, Holmes had this to say, “We want our businesses to provide services that people in rural areas need, while preserving the natural resources and beauty that make this such a great place to live.” Treat yourself to a little get-away and experience Kalispel hospitality by staying in one of our cottages or visiting Kalispel Casino. To learn more bout the Kalispel Tribe, economic development, and the charitable giving program, please visit: https://www.kalispeltribe.com

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What DO You Know About Opioids? What is an Opioid?

he following are common types of opioids. A few brand names are also listed:

• Buprenorphine (Buprenex, Suboxone, Cizdol, Probuphine) • Codeine (Empacod, Mersyndol, Pinex, Tylenol) • Fentanyl (Actiq, Duragesic, Fentora, Lazanda) • Heroin • Hydromorphone (Dilaudid, Dicodid, Hydromorph, Palladone, Laudicon, Lorcet, Sophidone). • Methadone (Amidone, Biodone, Dolophine, Metadon, Physeptone, Symoron) • Morphine (Dolcontin, Duramorph, Infumorph, Maracex, Otamorph, Statex) • Opium • Oxycodone (Endocet, Oxycontin, OxyNorm, Percodan, Percocet, Roxipirin, Tylox). • Pethidine (Aldolan, AstraZeneca, Clopedin, Cluyer, Demerol, Meperidine) • Tapentadol (Nucynta, Palexia, Yantil, Tapenta, Tapal) • Tramadol (Conzip, Invodol, Larapram, Maxitram, Ryzolt, Tilodol, Tramulief, Zytram)

Opioid medications are sold under different brand names. Ask your doctor or pharmacist if you can’t tell by checking the ingredients on the packet.

Opioids come in different forms, including: • • • • • • • • •

Tablets Capsules Suppositories (inserted into the rectum) Soluble tablets and films Powders Syrups Cough medicines Liquids for injection Skin patches

How does an opioid affect you? Opioids don’t just slow down pain messages to the brain, they slow down other messages like those telling our body to keep breathing.

Why are opioids addictive? Opioids affect the brain’s reward system by releasing large amounts of dopamine which, when the effects subside, cause the user to want more. Continued on Page 8

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Opioids

Who is affected by opioids?

Continued from Page 7

Usually the person experiences physical symptoms physical symptoms but changes in behavior can also occur.

Anyone taking prescription opioids could become addicted. —75% of opioid misuse starts with people using medication that wasn’t prescribed for them – usually taken from a friend or family member. —One in four teens report having misused or abused a prescription drug at least once in their lifetime.

Signs of dependence & addiction include:

What can you do?

What are the signs of opioid dependence or addiction?

• Needing a higher dose to get the same effect • Taking more opioids or taking them for longer than planned • Spending increased time and effort getting opioids • Experiencing withdrawal if you stop taking opioids or reduce your dose • Reducing the amount of time you spend on other activities like work, sport or family • Continuing to take the medication even though it’s causing you problems.

Ask yourself the following questions if you think you might be becoming dependent on or addicted to your opioid medication: • Am I taking more than the prescribed dose? • Am I taking opioids for something other than for what they were prescribed? • Am I going to the doctor more frequently to get the amount of medication I need? • Am I getting opioids through methods other than my regular doctor? • Do I feel like my pain or mood get worse if I don’t take my medication? • Do I get anxious about the idea of not taking my medication? • Do I need the medication to function in daily life (beyond just relieving pain)? • Am I using different methods to take opioids (i.e. snorting, injecting)? If you answer YES to any of these questions, you may want to speak to your doctor.

Want more information? •GetTheFactsRX.com

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Many people don’t realize that they could become addicted to opioids. That’s why its so important to only take them under a doctor’s supervision and for the shortest amount of time possible. —Ask your doctor about other ways to manage pain. There are many good pain management alternatives to opioid that may work better and have fewer risks such as: • Acetaminophen (Tylenol) or ibuprofen (Advil) • Cognitive behavioral therapy • Exercise therapy • Medications for depression or for seizures —Do not share your prescriptions. Never use another person’s prescriptions. —Lock up your medications. —Safely dispose of unused medications at a take-back program or drop box location near you. Parents, grandparents and friends play an important role in preventing misuse by having honest conversations and sharing information. —Talk with your family and friends about the risks of opioid abuse. We need to destigmatize the idea that opioid abuse only happens by a certain group of people. It can affect anyone and is nothing to be ashamed of. The Community Prevention & Wellness Initiative represented by the Newport Youth Task Force Coalition, Cusick Panther Country Coalition and Selkirk Wellness Coalition want you to know:

•StopOverdose.org

•TakeBackYourMeds.org

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Opioid Overdose — Take Action! by Carrie McKinley, Prevention Services Program Manager Pend Oreille County Counseling Services Funded by the Washington State Health Care Authority

fter meeting with regional high school youth today, I was surprised and heartbroken to learn that heroin and opioids were not as uncommon as I thought among young people. I heard their stories of generational abuse and parents who offered opioids to their children. I learned of students who had the attitude of “I don’t care what happens to me if I use them.”

Did you know that teens have a slang word for heroin? They call it “Brown.” The teens we spoke with identified drugs as being a significant problem in their small rural towns and cities. They informed us that needles were found all around the community during their last community “cleanup day.” They said heroin was “easy to get.” They have friends they are trying to help get off heroin. They have friends who have died from suicide by taking “pills.”

The problem is very real, and it is right here in our own communities. The students recognize that it is time to act and they want to be involved in school outreach and educational projects. I am always inspired and impressed with their maturity and keenly interested to hear what our local youth have to say. We must give them a voice and we must respect their life stories and unique perspectives. I am blessed to work in the field of prevention, but the great news is, we can all be prevention specialists and help educate

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our families, friends, and neighbors. Please join me in learning more about the opioid epidemic and becoming an agent for change in your community. Our youth deserve our attention to this urgent matter and so do our families, friends and fellow community members.

Addressing Opioid Misuse and Abuse

Governor Inslee released Executive Order 16-09 Addressing the Opioid Use Public Health Crisis in 2016 citing these objectives: – Goal 1: Prevent inappropriate opioid prescribing and reduce opioid misuse and abuse. – Goal 2: Treat individuals with opioid use disorder and link them to support services, including housing. – Goal 3: Intervene in opioid overdoses to prevent death. – Goal 4: Use data and information to detect opioid misuse/abuse, monitor morbidity and mortality, and evaluate interventions. Prevention efforts included a directive to: “… develop a communications strategy geared toward preventing opioid misuse in communities, particularly among youth, to raise awareness about the risks of opioid use and focus on reducing the stigma of opioid use disorder. This communication strategy shall promote safe home storage and appropriate prescription pain medication disposal to prevent misuse…” The Washington State “Starts with One” and “Start Talking Now” campaigns were implemented to address these serious concerns of the opioid epidemic.

Opioids include:

—Heroin, and prescription pain medications: —Vicodin (hydrocodone), OxyContin (oxycodone), Dilaudid (hydromorphone), MS Contin (morphine). —Fentanyl Percocet Methadone ...and others. If someone takes more opioids than their body can handle, they can pass out, stop breathing, and die. Overdose can take minutes or even hours to occur. Anyone who uses opioids can overdose.

Opioid Overdose Risks:

1. Restarting opioids after a break. Tolerance drops within a few days. 2. Using opioids at the same with alcohol or sedating drugs like sleep aids and benzodiazepines (“benzos” like Valium and Xanax). Mixed together, they can slow breathing even more. 3. Taking prescription pain medicine more often or in higher doses than prescribed. 4. Any heroin use due to its wide range of purity. 5. Taking someone else’s pain medication. 6. Using long-acting opioids (like methadone) or powerful opioids (like fentanyl). 7. Heart or lung disease.

Be Prepared - Have Naloxone on hand.

Opioid Overdose Naloxone (Narcan®) is a prescription medicine that can temporarily stop the effect of opioids and Continued on Page 12

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Opioid Overdose Continued from Page 10

help a person start breathing again. It can be given as an injection into a muscle or as an intranasal spray. It is easy and very safe to use. Naloxone is available at local pharmacies and can help save a life in the case of an accidental overdose. We hope to reduce the stigma that may come from having Naloxone on hand. It is a way to save a life, please keep it handy if you take prescription opioids or live with someone who does. It can also be used for heroin overdoses.

How can I get Naloxone? In WA State, you can get a prescription for naloxone if you think you could overdose on opioids yourself, or if you are in the position to help someone else who has overdosed. Think about your friends or family members you may be able to help save. Go to stopoverdose.org to see if Naloxone is available from a pharmacy, doctor or health department near you.

Take Action in an Opioid Overdose! Ask yourself, “Could this be an opioid overdose?” Listen for: Slow or no breathing, gurgling, gasping, or snoring. Look for: Clammy, cool skin, blue lips or nails. Pill bottles, needles, or alcohol nearby. Try to wake them up: Shake them and call their name. Rub your knuckles hard over their chest bone.

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If they don’t wake up, you need to ACT FAST! • Call 911 — Say where you are and that the person isn’t breathing. You don’t need to say anything about drugs or medications. • Give Naloxone — Follow the instructions on the package or in the overdose rescue kit. • Start rescue breathing — If they don’t respond in 3-5 minutes, give a second dose of naloxone. Keep doing rescue breathing. Do rescue breathing even if you don’t have Naloxone. Oxygen is critical! • Stay with them — If they start to wake up and breathe, stay with them. Watch them until medical help arrives. Naloxone wears off in 30-90 minutes. When it does, the person can stop breathing again. If you must leave, put them into the recovery position and in a place they can be found.

Sandpoint Community Resource Center (SCRC) GET HELP. GET CONNECTED. GET INVOLVED.

WA State’s Good Samaritan Law If you get medical help for an overdose or alcohol poisoning, you and the victim cannot be charged for drug use, possession, or underage drinking. —WA RCW 69.50.315

Please visit our website www.SandpointCommunityResource.com or call

Resources: • http://www.starttalkingnow.org/ - Project of the WA Healthy Youth Coalition. Resources for parents and communities. • http://stopoverdose.org/ - Information on Naloxone, Overdose Education, Getting Help, and technical resources for specific professionals • http://www.governor.wa.gov/sites/default/files/exe_order/eo_16-09.pdf - Governor’s Executive Order • http://www.theathenaforum.org/ - a WA resource for prevention professionals

208-920-1840

to GET HELP, GET CONNECTED and GET INVOLVED!

erving both Bonner and Boundary counties SCRC offers help to those in urgent need or crisis. Our trained Resource Specialists demonstrate our mission with compassion and competence. Our mission statement is simply, “Dedicated to bringing hope to people who don’t know where to turn.” When we are called at the beginning of an urgent situation, we can often stop the spiral before it turns into a multi-need crisis, thus saving time and resources for the entire system of providers and allows us all to help more people. We will happily connect people in need with those who provide tangible services. There is a self-help directory online that is extensive and offers a degree of privacy to those who want to remain anonymous. We are growing our SPIN (Service Provider Information Network) and if you are a service provider who will accept our referrals please call us! Details of how you can be part of this network of over 200 service providers who are working together to strengthen our community can also be found on the website. Attend our quarterly SPIN meetings to address common issues and gaps in community services. Volunteer Idaho Panhandle (VIP) is a SCRC initiative to help other nonprofits and volunteers to create mutually satisfying connections. We make it easy to find the perfect place to share your time, talents and passions! We invite all nonprofits and volunteers or those who are new to volunteering, to attend our monthly VolunteerMatch Live! events. These “meet up opportunities” are designed to be fun as well as help you connect to just the right place.

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WA State Officials Make it Easier to Access Overdose Reversal Drug by Krisatin Maki, Strategic Communications Office

to distribute naloxone kits to programs statewide for distribution to their communities. Within the first year of the program, the department expects to deliver 11,000 naloxone kits. This work is funded in part by a federal opioid grant managed by the Washington State Health Care Authority. All of these efforts are part of the state’s comprehensive opioid response, which is focused on preventing opioid misuse, identifying and treating opioid use disorder,

ashington State Health Officer Dr. Kathy Lofy signed a statewide standing order for naloxone, a medication that can reverse an opioid overdose. The standing order works like a prescription and allows any person or organization in the state to get naloxone from a pharmacy. “Making it easier to access and distribute this lifesaving medication to people who need it is an important step in addressing the opioid crisis and reducing overdose deaths in our state,” said Dr. Lofy. “In 2018, 710 Washington residents died of an opioid overdose.” An overdose of opioid drugs like prescription painkillers, heroin and fentanyl can cause a person’s breathing to slow or stop. Naloxone can be given as an injection or a nasal spray to someone experiencing an overdose. It works by temporarily blocking the effects of opioid drugs. Naloxone is very safe and does not have serious side effects if accidentally given to someone who is not experiencing an opioid overdose. If you think someone is experiencing an overdose, but aren’t sure what kind of drugs

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preventing deaths from overdose and using data to monitor and support these efforts. You can help! Make sure you know the signs of overdose and what to do, and carry naloxone if you or someone you know might need it. The DOH website is your source for a healthy dose of information. Find us on Facebook and follow us on Twitter. Sign up for the DOH blog, Public Health Connection. You can contact Kristen Maki at 360-545-2944.

they may have taken, use naloxone. The Department of Health encourages anyone who is at risk of experiencing or witnessing an opioid overdose to carry naloxone. People who want to get naloxone can use the standing order at any pharmacy in the state without a prescription from a health care provider. It’s best to call ahead to make sure the pharmacy has naloxone available and check your insurance coverage. Most commercial health insurance plans cover at least one form of naloxone, but coverage and costs vary. Apple Health (Medicaid) clients can get naloxone at no cost. The standing order will also make it easier for organizations working with people who may need naloxone to get and distribute the medication. Organizations interested in getting naloxone under the standing order need to notify the department. The department will keep a list of organizations and notify them if there are changes to the order. Since February 2019, the department has also managed an Overdose Education & Naloxone Distribution Program

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A Pain Medicine Doctor’s Thoughts About the Opioid Epidemic

by Dr. Clinton M. Thome Pain Management of North Idaho

n this day and age its difficult to go through an entire day without hearing some mention of the opioid epidemic in the United States. Most recently it has been reported that Americans have a greater chance of dying by accidental opioid overdose than a motor vehicle crash. When you truly think about that statement it is incredibly alarming. What is even more concerning is despite the overwhelming presence of opioids and their risks in the national media, most patients do not understand how these numbers, statistics and risks directly affect them. Many patients who are on, and have been on prescription opioids, feel that these statistics and numbers do not apply to them. One of the most well known side effects of opioids is addiction. Most patients are aware of what addiction is to a degree. However, most are unfamiliar with two other severe side effects of opioids; dependence and tolerance. Dependence should be distinctly characterized from addiction because most patients who are on higher dose opioid regimens are dependent on their medications but not addicted. Dependence can simply be described as the body developing a need for the medication. When someone is exposed to opioids chronically at higher doses, the body makes adaptive changes to the medication. Once the body adapts to the medication abrupt reduction or discontinuation of the medication will result in withdrawal. Dependence is a normal side effect of prescription opioid use while addiction is a severe complication. Opioid addiction is a complex psychological and physical inability to stop opioid use even though it is causing psychological and physical harm. Typically this includes the inability to take the medication as prescribed and/or taking the medication for other reasons than prescribed, for example, to experience euphoria instead of pain relief. Lastly, tolerance is simply the human body becoming accustomed to the opioid medication. Patients who have been exposed to opioid medications for years will report

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Xanax or Klonopin and has untreated or undiagnosed cardiopulmonary disorder such as sleep apnea. Opioids naturally slow down the breathing, sleep apnea can obstruct the movement of air in to the lungs or depress the respiratory drive further, and sedatives exaggerate the slowed breathing effect of opioids. This is a perfect example of how someone can overdose even while taking the medication as prescribed. Fundamentally, it is important for all patients, whether they are on opioids or not, to understand the risks of the medication class. Minimizing your exposure to opioids and using them at the lowest dosage for the shortest duration necessary is one of the most important things you can do to decrease the long term risks of the medication. Employing the use of non-narcotic medicines and minimizing or eliminating the need for postoperative opioids can decrease your risk dramatically. Talk to your surgeon about non-narcotic options and preoperative regional anesthesia. If you suffer from chronic pain try to maximize non-opioid treatment options such as exercise, stretching, dietary changes, weight loss, physical therapy, aquatic therapy, chiropractic therapy, occupational therapy, acupuncture, massage, non-opioid pain medications, injection therapy and surgery. If you’re someone on opioid medications and require them for quality of life and activities of daily living make sure to take them as prescribed. Do not drink alcohol with the pain medication and avoid sedative use. Have a detailed

discussion with your provider or pain management specialist to try and find ways to minimize your risks to the medication but also treat your severe pain. If you’re on a high dose opioid regimen talk to your healthcare provider about naloxone (Narcan®) for potential accidental overdose. If you or someone you know would like to discuss your pain management options, contact our office at 208-765-4807 to set up an appointment with a provider at Pain Management of North Idaho. _____________________________________________________ Dr. Thome, a fellowship trained pain management physician, completed his anesthesiology residency and fellowship at the University of Texas Health Science Center, San Antonio and was chief resident during his final year of residency training. He had the opportunity to train under some of the most highly regarded individuals in the field of pain medicine. He and his wife, Amanda, moved to North Idaho in 2016. Dr. Thome takes great pride in his medical understanding, exceptional clinical skills and ability to compassionately connect with patients to provide extraordinary care. He believes in a comprehensive pain management approach emphasizing a patient’s physical and mental health in addition to their pain condition. Dr. Thome is highly skilled in multiple modalities including ultrasound and fluoroscopic guided injection therapies, spinal cord stimulation (SCS), peripheral nerve blocks, joint injections and pain medication management.

that the medication is no longer as effective as it used to be. Tolerance is one of the major issues with using opioids to treat chronic pain. One of the most common misconceptions of opioid prescription use is that if a patient takes the medication as prescribed they cannot overdose. Opioid medications have a side effect called respiratory depression, which means that the medication slows breathing. This effect by itself can be relatively harmless BUT it can also be the most intrinsically dangerous side effect of opioids. If you’re healthy, the body has many compensating maneuvers that help minimize this side effect. However, if you have sleep apnea, take sedatives, drink alcohol or really have any type of medical condition which adversely affects your body’s ability to absorb oxygen, pump oxygen, or breathe, you are at higher risk for overdose than someone who doesn’t, even when the opioid medication is taken as prescribed. The respiratory depression side effect for most opioids is also dependent on the dose of the medication, meaning, people who are on higher opioid dose regimens are higher risk for overdose than those on lower doses. One of the most dangerous scenarios is a patient who is on opioids for pain, takes a sedative such as

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Is It Time to Get Help for Your Addiction?

by Huston & Becky Stolz, Owners of Colonial Clinic, Spokane

Additionally, treatment members at Colonial Clinic most often stay at their jobs and continue to live at home while in treatment. This helps avoid family disruption and reduces costs. The increased frequency of treatment groups often prevents the need for inpatient treatment. Many of those referred to Colonial Clinic are referred by previous clients. Because substance use disorder has a genetic component, many family members refer relatives. Some clients are referred by co-workers, neighbors and

ne of the biggest obstacles for those seeking help with substance addiction and alcoholism, is the belief that, “Nobody understands. Nobody knows what its like for me. Nobody is going through what I am.” We, the owners of Colonial Clinic, are both in long term recovery ourselves and DO know and understand what clients are experiencing. The practice is exemplified in our slogan, “Recovery with Dignity” and our sole purpose is to help those suffering with addiction. Since 1985 Colonial Clinic has helped nearly 5,000 addicts and alcoholics overcome their addictions.

What makes Colonial Clinic unique? Both morning and evening treatment groups are held for the members to work and progress together in small therapeutic groups without unknown group members joining their closed group. This system called “Closed Group Therapy” promotes confidentiality, safety and comfort while eliminating the parade of strangers that most treatment programs have.

This system called “Closed Group Therapy” promotes confidentiality, safety and comfort while eliminating the parade of strangers that most treatment programs have. Colonial Clinic offers an intensive outpatient experience. The initial small outpatient closed group meets frequently during the first 5 weeks, unlike other outpatient programs that start treatment by meeting fewer times each week. For 34 years, the more frequent treatment, along with the closed groups, has helped treatment recipients establish and maintain abstinence from mood-altering substances.

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Faith & Hope They represent the slogan: Pugs Not Drugs!

friends. Many self-referred group members who have come to realize, “This is probably exactly what I need” seek help from us. The longer length of program increases success rates as does the closed group therapy system. We see greater

success rates also because we do not kick people out of treatment for exhibiting symptoms of the addiction. In conjunction with the addiction treatment, we help the loved ones with free family group therapy. Family members learn to understand the recovery journey necessary for themselves and their loved one. Because alcoholism and substance addiction harm close relationships, Colonial Clinic provides Family and Friends education and a process program that meets frequently and is absolutely free. A Women’s Group and a Relapse Prevention Therapy Group are some other services provided. Individual counseling is also a part of the group members’ treatment as well as Family Sessions. Colonial Clinic is a Dual Diagnosis facility licensed with the State of Washington. Dual Diagnosis means a person may have two diagnoses, such as alcoholism and depression or Opiate Use Disorder and anxiety. Mental health therapies are provided alongside the addiction treatment.

Colonial Clinic is a one-stop assessment and evaluation center.

up inpatient treatment and even detox if they are needed, and help outpatient clients with insurance and cost concerns over the phone. Costs are most often spread out into monthly payments to help make treatment affordable. And, we can report to outside entities for those who are mandated to do treatment. Please visit our website at ColonialClinic.com or call us at 509-327-9831 weekdays from 9:00 AM to 6:00 PM and we will gladly explain our programs and answer questions. We also provide a FREE “Consultation Appointment” for up to one hour during weekdays to learn how we can help you. __________________________________________________________________

Huston and Becky Stolz, Spokane residents for most of their lives, purchased Colonial Clinic in 2013. Huston was hired by the original owner in 2004 and worked at Colonial Clinic under both previous owners. He has actively been providing counseling at Colonial Clinic for 15 years. Huston is a Masters Level Therapist with a Master’s Degree in Clinical Mental Health Counseling from Whitworth University. Becky is a Certified Public Accountant (CPA) and handles all things financial at the clinic.

Evaluations are necessary to make diagnoses and to establish the recommended level of treatment. We can set

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Addiction Does Not Discriminate

by Christine Jensen, Author The Struggle Became My Strength: An Addict’s Journey in Recovery

t is nearly impossible to explain to those in society who do not struggle with the disease of addiction just how painful detoxing off opiates is. Those individuals may not comprehend, nor ever know, the severity of it. If you are an individual who has struggled with it, or has a friend or a family member who has struggled, you at least have some idea. There is desperation and a profoundly fundamental need for the substance. From the addicts point of view, they will do whatever it takes not to get sick. They may steal, lie and deceive to obtain the substance.

The Struggle Became My Strength by Christine Jensen

The Struggle Became My Strength can be purchased on Amazon: www.amazon.com/Struggle-Became-My-StrengthRecovery/dp/1093760079

20 Wise Guide | Winter/Spring 2020

When you hear news reports of robberies, burglaries, robbing of pharmacies, etc., take it from someone who has personally experienced it, being sick from withdrawals is intolerable. That family member does not want to steal your wallet or jewelry from you. They are in pain not only physically but emotionally. The addict’s mind focuses and obsesses on one thing only, how to get the next fix. Just because my drug was prescribed to me, doesn’t make a difference. Does that make me a classy drug addict because I got my drugs from medical centers? It makes no difference. In my own suburban neighborhood there were four other house moms, or you could call them soccer moms, who were addicted to pain pills. We used to supply the pills to each other when someone ran out, promising when we obtained our prescriptions, they would be returned. Believe me, this is happening in your neighborhood too right underneath your noses. They are your neighbors, coworker, best friend and the list goes on and on. I see on the news that our government has become aware of the opiate epidemic. They are seeing the tragedies in our towns with the incidence of overdoses tripling. In some states family members are able to obtain Narcan to reverse the effects of an overdose of opiates. Police officers, EMT’s and other first responders are saving lives left and right with it now. Most individuals who go in for a surgical procedure come out with their bodies dependent on opiate medications. That person trusted their physician to help them and ended up with an addiction or dependence to these drugs, something they never dreamed would happen. There are physicians who are abstaining from giving pain medications to someone who really needs it for fear of having the DEA on their backs. Somehow, the oath to “do no harm” that physicians take in medical school is now compromised. Now, they have to determine who needs help and who is seeking drugs to feed an addiction. I don’t envy the physicians and the tight spot they are in due to these drugs. Teens deaths are on the rise from themselves being prescribed Oxycodone. One asks why a physician would even consider prescribing these highly addictive medications to teens whose brains are not yet fully developed? How do we protect our kids from this? They can go over to a friend’s house and take it out of their parent’s medicine cabinet. Lock up your medications parents! Be aware of what you have in your home. Again an addict will do whatever it takes to obtain their next high. I have a friend who owns a business that has been robbed three times in the past year at gun point. When I asked her how this affected

Addiction does not discriminate folks. It hits all cultures, religions, and all levels of social status. It takes everything and runs through people’s lives with ferocious destruction.

her life the response was surprising. She told me she understood why these kids were robbing her; they were robbing her to obtain money for drugs. She revealed that her own family was affected due to drug use. Her son had been addicted to heroin for the past three years. She said she didn’t report the robbery, she just let it go because her own son steals from her and she just felt like giving up. Addiction does not discriminate folks. It hits all cultures, religions, and all levels of social status. It takes everything and runs through people’s lives with ferocious destruction. I recently received a message from a friend of an eventful weekend. She had to call the police due to her child’s outbursts of anger and drug use. Addiction is a family disease and affects those closest to the addict. How do you set healthy boundaries with your children about drug use when they have seen it in their own home, used by their parent? When these circumstances are occurring, intervention therapy is necessary. An outside view and counseling is therapeutic and has long term helpful effects. I felt for her and have experienced loss of relationships, my step children removed themselves due to my choices and use. It’s painful to describe. It is important for others to see that they are not alone when it comes to this struggle with addiction. It doesn’t matter if you are the addict, or someone you care about is. We, as a society, are all affected with or by this.

For years I held secrets that continued to manifest inside my being. It continued to destroy me and even though I saw destructive behaviors begin to creep up, I was unable to process them in a health manner. I try daily to not stand in judgement of others. I am not better than you, I am not the end all, and be all that my ego told me I was when I struggled with addiction. It was all about me. A book entitled, “A New Earth Awakening to Your Life’s Purpose” by Eckhart Tolle is one of my

favorites. It discusses the ego, and to me, it fully describes the addictive mind. It addresses how an addict’s obsessive thoughts about the past or the future, cause emotions that feed the ego. Living in the moment centers us and finding one’s passion in life is what life is all about. When we live to our full potential we can help change our lives and the lives of others around us. Know that we may never fully understand what others may be struggling with. Take an empathetic view and try to be kind. Lend a helpful hand to those who are less fortunate than you. Giving a kind word or a small amount of our time, is what matters and may be exactly what that person needs. That to me is a gift that we all possess. _____________________________________ Christine Jensen lives in the Idaho Mountains with her husband and dog. She worked in the medical field as a Medical Assistant from 2001 to 2008 and obtained her Substance Abuse Counseling Certificate for Addiction Studies from the University of the Pacific in 2010.

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Building the Best You

Caleb Orr, Licensed Professional Counselor The Human Connection

re you the best version of yourself? A simple question that can have us questioning our own self-image. You may think about the things that keep you from being your own best self: your depression, your anxiety, your struggling relationship, or the fact that you just arenâ&#x20AC;&#x2122;t satisfied with your life. The good news is that we all have the ability to create positive change in our lives and the lives of those we love. By investing time and energy into our mental health, we can achieve a better self. Across our population 19.1% struggle with an anxiety disorder, but less than half of those people receive help according to the National Institute of Mental Health (2017). Depression tells a similar story with 7.1% of adults diagnosed with major depressive disorder. Anxiety disorders and depression are considered highly treatable and several approaches have proven to be effective with people across many diverse backgrounds, yet many people are not reaching out to ask for help in these ways that are proven to be effective. In counseling we strive, as licensed professionals, to provide a space for you to come and express any struggles you are having. Struggling couples and families are given a safe space to work through issues without judgement from a third party. Rather, the counselor works to help everyone feel heard and

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understood while creating an example of how to continue communicating at home. Someone struggling with depression is given a space to feel supported, validated, and cared for. This allows them to begin taking steps out of their depression with confidence and proactively keep them out of future depressions. Those struggling with anxiety are given a safe space that supports them in examining their anxieties and collaboratively finding solutions or supports that create a more comfortable everyday life. Speaking from experience, I encourage everyone to ask for help in changing their lives. To start this process, it is important to find out what is offered in your area. If help is located more conveniently, you are more likely to utilize it. Finding a counselor that you feel comfortable with and feel a connection with is key. You have the right, at any point, to end your treatment in counseling for any reason. The connection between yourself and the counselor is one of the most important aspects of the helping relationship. Next, finding a way to make counseling financially possible will increase your likelihood of coming back until treatment has made substantial progress. Many counselors and counseling agencies will accept insurance and cash-pay, many even have the ability to adjust their prices based on your ability to pay. This means that you are more likely to afford quality services without breaking the bank. Finally, I encourage you to set up an appointment for a date that is soon. With less time to create reasons to back out, or forget about the appointment all-together, you will be more likely to show up to your first appointment and find out how beneficial counseling can be for you. Personally, I believe the most important piece of finding quality help in a counselor comes from the counselorâ&#x20AC;&#x2122;s ability to create a meaningful relationship with you. A counselor who is able to show you, without a doubt, that they care about your wellbeing unconditionally is one that will likely have the biggest impact on helping you become the best version of yourself. This is the power of genuine care that cannot be recreated outside of human connection. Search for counselors near you or ask friends if they have any recommendations today. Help building the best you is not far away and is more available than you might think. Start the change today! ____________________________________________________ Caleb Orr, Licensed Professional Counselor, Nationally Certified Counselor, holds a masters degree in counseling from Boise State University. Caleb is further certified in: Mindfulness Based Cognitive Therapy and is implementing Neurofeedback at The Human Connection in Sandpoint, Idaho. A North Idaho native, Caleb loves helping community members become better versions of themselves.

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Friends of Scotchman Peaks Wilderness Are Bringing Generations Together ~ FSPW Volunteers Close the Age Gap with Winter Tracks

aving the rugged and wild Scotchman Peaks of Idaho and Montana for future generations is part of the mission of Friends of Scotchman Peaks Wilderness (FSPW). A part of that is getting kids outside to “find their wild place.” A primer course in loving the out-of-doors is Winter Tracks, the FSPW outdoor education program. “It takes a village,” is a fitting expression for Winter Tracks. Volunteers from many walks of life bring expertise and a vital message to kids about loving wild things and places. It’s a way for one age group to pass knowledge and passion to another in a fun and safe setting. Winter Tracks instructors — many of them retired — teach students about tracking, leave no trace principles, avalanche safety, tree identification, map and compass, native mammals, winter survival and more. Jeff Pennick and Ed Robinson are retired foresters from the USFS and Idaho Department of Lands, respectively. They team up to teach about trees. Their passion for the subject is easy to detect. Students pay rapt attention as they

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are led through the forest. “One of my favorite things to do is to teach kids to be curious and go out and explore,” Pennick says. “If they are curious to explore wild places, it’s a wonderful thing.” Retired Libby teacher Gene Reckin brings his collection of bird and animal mounts to Winter Tracks, and a huge knowledge of wildlife. “Getting kids outside is fun for them and me,” he says. The transfer often goes both ways. When kids light up about an idea — especially a kid who seemed bored at the beginning of a session — it can make the instructor’s day. And the kid’s day as well. Plus, the natural curiosity of the students often bring things to light that might go unnoticed. The bond between volunteers and students was made clear in a survey sent out to volunteers and teachers. The volunteers’ answer to “What was your favorite part of the day?” was “interacting with the students.” A teacher’s response to “What was the most meaningful part of this experience for your students?” was, “Meeting great people with a genuine want to help students learn about the outdoors.” Teachers are enthusiastic partners in Winter Tracks. Clark Fork High School teacher Becky Haag has already contacted FSPW about a session for the coming season. “It’s a win, win situation,” says FSPW staffer Sandy Compton, who will run the Map and compass Winter Tracks instructor Robin program this Chisholm points a season. “Kids — student in the right direction at Round and teachers — Lake State Park. get turned on to the outdoors and

volunteers get turned on to the joys of teaching.” Winter Tracks returns this winter for its sixth season. Students between third grade and high school from Montana, Idaho and Washington will once again benefit by the knowledge Winter Tracks instructors. Most sessions consist of four modules of 40 minutes each with tenminute breaks between and a half-hour lunch, totaling about four hours, not including arrival, departure and travel time. Shorter sessions can be arranged for schools farther away. Not every Winter Tracks volunteer has to be an expert instructor. Retired phone company employee Howard Shay and his wife Connie help out as group guides and fire tenders. Holly Clemens, a former Spokane school employee, has staked out “hot chocolate provider” as her specialty. Veterinarian Celeste Boatwright Grace and retired nurse Mary Franzel often teach the mammal class. Retired Navy veteran Phil Degens, 80 years young, comes as a “general helper.” “It keeps me young,” Degens says with a laugh. Winter Tracks venues are picked for variety of habitat and access. Round Lake State Park south of Sandpoint sees the most action during any given

Everyone has fun when Dr. Celeste Grace and retired nurse Mary Franzel teach kids about native mammals.

winter. Sessions are held at the USFS Timberlane Campground northwest of Libby and Roosevelt Park in Troy. Sanders County sessions are held at USFS North Shore Campground near Trout Creek. Other session are held at the Trout Creek Wildlife Management area in the Pack River Delta and at Judy’s Place, a Kaniksu Land Trust property on the Idaho/Montana border east of Clark Fork. FSPW is now taking reservations from schools for the coming year. Most sessions are held on Fridays, though other arrangements can be made. FSPW invites anyone with an interest in teaching a module or enjoying a day of “keeping young” with the students to contact us at scotchmanpeaks.org/ volunteer. Teachers who want to engage their class in Winter Tracks should write to sandy@scotchmanpeaks.org

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70 Years Strong, Bonner General Health Celebrates Longevity and Growth

onner General Health was established as Bonner General Hospital on July 12, 1949, making 2019 our 70th Anniversary. The original hospital was the infirmary building used at Farragut Naval Training Station. The hospital has had many additions and renovations since, including significant additions in 1972, 1978, 1988, 1998, 2000 and 2015. In 2013, Bonner General Hospital added the “doing business as” name of Bonner General Health to better reflect what we do and the multitude of services we provide. We also wanted our name to reflect Bonner General’s commitment to improving the health of our community. Approximately 75% of our business is outpatient, much of which we provide outside of the main hospital building in the 11 clinic locations in the Sandpoint area, and one site in Priest River. In 2015 Sandpoint Women’s Health, the Wound Care Center, Anticoagulation clinic and one Performance Therapy Services clinics moved into the Health Services Building that is connected to the hospital by a sky bridge. This opened space in the main hospital building for other services to expand, including our Infusions and Procedures clinic, Hospice and Home Health services, and our Occupational Health department. Our mission to serve our community by providing excellent healthcare close to home is possible due to our talented staff of over 450 individuals, the 57 skilled physicians on active medical staff, our generous donors, and numerous volunteers. In 2019 we opened Bonner General Ear, Nose and Throat and hired Otolaryngologist, Dr. Susan Anderson. This clinic provides the residents of Sandpoint and surrounding communities access to ENT services promptly, which was much needed in our area. The Bonner General Health Foundation purchased the equipment for this clinic with a large donation from the proceeds of the 2019 Heart Ball. Our mental health services also expanded this year with the additions of psychologist Dr. Joe Wassif, Ph.D. and Psychiatric Mental Health Nurse Practitioner Natasha Splaine-Talbott,

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who joined psychiatrist Dr. Terry Johnson at Bonner General Behavioral Health. We added a fourth orthopedic surgeon at Bonner General Orthopedics, Dr. Jonathan Klaucke. Dr. Klaucke specializes in hand surgery, pediatric and adult trauma, and fracture care. He joined orthopedic surgeons Dr. Cipriano, Dr. Brent Leedle, and Dr. John Faggard. The services provided through our Performance Therapy Services rehabilitation clinics include but are not limited to aquatic therapy, cancer rehabilitation, physical therapy, speech therapy, occupational therapy, hand therapy, and Parkinson’s LVST Big and Loud therapy. We partner with Schweitzer Mountain Resort to operate a First Aid Station staffed by Registered Nurses in the Lakeview Ski Lodge during the ski season since the winter of 2012. Bonner General continues to grow and improve our technology; this May, a brand new state-of-the-art MRI was installed, decreasing time during the procedure and increasing patient comfort. Bonner General provides a multitude of other diagnostic imaging services including 3-D Mammography, the most superior form of breast cancer screening, CT, Nuclear Medicine, Echocardiogram, Fluoroscopy, Bone Mineral Density Tests (DEXA), Ultrasound, and X-ray. We look forward to 2020 and the addition of our newest clinic, Bonner General Ophthalmology, in January. Dr. Mark Torres joins Bonner General Health from the Madigan Army Medical Center, where he served as the Chief of Ophthalmology. Dr. Torres brings extensive training and experience to his new role at Bonner General Health. Bonner General Health continues to grow and change to meet the healthcare needs of our community as we strive to be the best place to receive care, and the best place to give care. For information on all of the services we provide, please visit BonnerGeneral.org.

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“When Should My Child Have Their First Eye Exam?”

by Dr. Chad Schobert, Pediatric Optometrist Eye Care For You

s an optometrist, one of the most common questions we are asked is, “What is the appropriate age for my child’s first eye exam?” There is a lot of conflicting information and I am constantly seeing patients whose parents were told a wide range of suggestions by family, friends and other healthcare providers. Some of this advice is more accurate, some is borderline terrifying in its inaccuracy. Clearly, this is a topic that could use some clarification and explanation. Before getting into the recommended timelines, a quick primer on how our visual system develops is helpful.

Understanding how our visual system progresses from birth to adulthood is important for understanding why the guidelines are what they are. These guidelines are based on the anatomical and physiological development of our eyes and brain. The first and primary lesson: vision is a learned process. This cannot be overstated. When we are newborn, our brain does not understand the information that the eyes are sending. Not only is our vision extremely blurred, initially it is not in color. On top of that, it is lacking stereopsis (3 dimensionality) and is often doubled as our brains cannot accurately aim both eyes at the same place at the same time. These are all things that must be learned in the first year of life. Thus, a lot of what we see in young babies is they are experimenting with their eyes and vision to learn how to control them. Ever notice how 3 month old babies often cross their eyes? They aren’t doing it as an intentional appeal to cuteness, this is the brain trying to figure out ‘how do I use these things?’ If vision is properly developing, infants will see great

First, it is important that BOTH eyes are able to see clearly at the same time. When children have a large difference in their prescriptions in either eye, this can lead to the brain playing favorites and only wiring into the eye that can see sharply with less effort. Glasses and other exercises are needed to ensure the brain wires into both eyes.

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improvements in detail and color in the first 5 months of life with stereopsis developing around 8 months of age, once the brain has figured out how to move the eyes in unison. As vision is a learned process, the number one role of pediatric eyecare providers such as optometrists and ophthalmologists, is to ensure nothing impedes children developing clear, comfortable 3D vision. There are several common issues found in young children that can derail this process. First, it is important that BOTH eyes are able to see clearly at the same time. When children have a large difference in their prescriptions in either eye, this can lead to the brain playing favorites and only wiring into the eye that can see sharply with less effort. Glasses and other exercises are needed to ensure the brain wires into both eyes. Second, the eyes must become comitant, i.e., work together. If not, what is called an “eye turn” can present leading to double vision that the brain deals with by shutting off or ‘suppressing’ one eye, leading to the brain again only wiring into the preferable eye. Third, the eyes must be able to focus easily at near. A toddler’s world is primarily within a few feet of them, if they have sufficiently high prescriptions that prevent them from easily seeing objects close to them, the brain will again not be able to develop clear, comfortable vision. In this case, neither eye will be wired into properly by the brain. So now knowing how vision can be impeded at this age, what is the recommended guideline for when a child should have their first eye exam? The standard of care for pediatric populations is that they should have their first eye exam at age one. Here the eye doctor will check for eye movement and tracking issues, accurate focusing for distance and near and that both eyes are tracking together. If this is all doing well, it is then recommended the next comprehensive vision exam occur before the child begins school, whether it be pre-school or kindergarten. This is to ensure that there are no visual issues that have developed that can impede a child’s learning. 80% of what we learn comes in visually! After starting school, yearly exams are recommended as vision can change very rapidly for children under the age of 12 and even if they are seeing well at age 5, that is not a guarantee they will still be seeing well at age 7. By following these guidelines, parents will be doing their best to ensure success for their child’s vision. At Eye Care For You, our pediatric optometrist is Dr. Chad Schobert and he would be thrilled to join in caring for your child’s vision. _______________________________________________________ Dr. Chad Schobert graduated from Pacific University College of Optometry in 2014 with a Doctor of Optometry degree. He received his Bachelors in Vision Science in 2011 from Pacific University, completing undergraduate classes at both NIC and EWU. Chad’s clinical experience includes primary care, medical co-management, oculoplastics, contact lens, and pediatrics.

Trusting Partners

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Mechanics for Your Back – How to Avoid a Disc Injury

by Ivanka Kuran, DPT Axis Spine Center

our back is an amazing structure, supporting thousands of movements and activities. Over time, everyone loses some height and this indicates wear to your discs and boney structures which is called “spondylosis.” Your discs provide cushion, determine the size of the holes (neural foramen) for

your ligamentum flavum can “backstop” the disc and keep it centralized. With a bulge, the more mobile center of the disc (nucleus pulposus) sits off center inside the outer rings (annulus fibrosus). This affects the ability of the facet joints to move symmetrically into extension with activities like walking. Bulges are a sign of aging and everyone over 30 starts to show wear of their discs. The progression of this injury with altered facet loading, is a protrusion. Now the annular rings are starting to get stress “cracks” which allows the center disc material to migrate into the annular rings. This condition starts to make it difficult to extend and bend backward on the side of the protrusion. The disc also pushes back closer to the nerve in the neural foramen, resulting in intermittent

ADAM MILLS, DC Chiropractor

IVANKA KURAN, DPT

E. JOE KENT, III, MD

Physical Therapist

Interventional Pain Physician

DANIEL BLIZZARD, MD Spine Surgeon

ROLAND KENT, MD Spine Surgeon

JESSICA JAMESON, MD

Interventional Pain Physician

COMPREHENSIVE SOLUTION TO SPINE CARE ; INTERVENTIONAL PAIN ; COMPLEX SURGICAL SPINE CARE ; CHIROPRACTIC CARE

your nerves and minimize loading to your facet joints. Every level of your back has a pair of neural foramen, and a pair of facet joints. The facet joints are the moving part of your back that allow you to flex, extend and bend. Your discs are like tires on a car – they have mileage. As you lift incorrectly, do a lot of compressive activities and eat poorly, you lose elasticity with your discs and they start to degenerate. Discs have three grades of injury; bulges, protrusions and herniations, listed from least to worst. Most disc injuries result from a combination of compression, bending and twisting. The key is to bend with your feet pointing in the same direction as the lift, so that

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radicular pain into your buttocks or leg. The third stage of a disc injury is a herniation. In this situation the center material (nucleus pulposus), migrates through the annular rings and extrudes outward into the neural foramen, making the hole for the nerve smaller. When this material touches the nerve at that level, you get “electric like” radicular symptoms into your leg in the region the nerve supplies. Nerves are like the electrical wires in your house, the outer casing protects the motor strength (inner) part of Continued on Page 32

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How to Avoid a Disc Injury Continued from Page 30

the nerve. The outer casing giving warning signals like hot, cold, tingling, or numbness when they are compressed or touched by disc material. Each nerve supplies different areas of your body in terms of sensation (outer casing), as well as supplying a nervous signal to your muscles to work (inner wire). Any of the above stated symptoms mean it is time to make changes to your spinal mechanics, before letting a disc injury progress. If the disc herniates or the nerve is further compressed, motor weakness to the muscles the nerve supplies occurs indicating you have pushed through the outer protective casing. The most common compressed nerves are the L4 and L5 nerves since they are at the bottom of your spine. Strength testing involves walking on your heels or pushing up on your toes. This results in tripping or slapping your foot down when you walk. The good news is, studies have found that 70% of the time discs respond well to conservative management. This means often consulting with members of your wellness team: a physical therapist, chiropractor and interventional pain management physician. The goal is to centralize the extruded disc material as soon as possible via a series of extension exercises, mobilization, manipulation and traction. The best extension exercise is walking and extension strength exercises with progression from supine (lying face up), to standing. Mobilization and manipulation restore joint mechanics to restore symmetrical extension which is critical to keeping your disc centralized. Interventional pain management treats nerve aggravations via ESI (epidural steroid injection) which serves to decrease

the inflammatory response and shrink the irritated nerve down to its normal size. This makes it take up less space in the boney neural foramen, so it is not the first nerve to be reaggravated. It is imperative to correct joint mechanics while an injection or steroid is working, so you are not in the same place when the medication wears off. When your disc centralizes, it heals via scar tissue. This is the same way it heals after surgery, but with surgery some disc material is removed which speeds degeneration and facet wear since disc height decreases. Reactive scar tissue post-surgery can recreate nerve encroachment. The primary indicator for surgery is persistent weakness of the compressed nerve. Motor strength deficits can become permanent if not addressed after a period of time. The takeaway is, you have about 20 years of performing tasks without regard for mechanics and your discs. As they wear, mechanics become more and more important like driving on high mileage tires. Avoid bending and twisting with compression (lifting). Try to pivot your feet in line with what you are lifting to get the protection of your ligamentum flavum behind your disc. Be good to your back via mechanics and you’ll get a lot of miles out of your discs. ________________________________________________________ Ivanka was born and raised in Canada where she received her Bachelor’s in Physical Therapy from the University of Alberta, and received her Athletic Trainer Certification from Mount Royal College. After moving to the US, she received her Doctorate in Physical Therapy from the College of St. Scholastica. She has achieved Level IV certification in manual therapy through NAIOMT in addition to Orthopedic Specialty Certification. Ivanka has worked in the Coeur d’ Alene area since 2001 and recently received additional training in IASTYM, cupping and dry needling in addition to manual therapy techniques to address advanced spine and orthopedic conditions.

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Understanding Influenza Especially if You Have Underlying Respiratory Issues: 5 Facts to Know This Flu Season

ccording to the Centers for Disease Control, the 20172018 flu season was one of the worst. Underlying lung conditions like Asthma, COPD or Pulmonary Fibrosis is not a known risk factor for flu, but flu infection can be more serious because of existing airway sensitivities. Influenza in the lungs can trigger worsening symptoms and make breathing more difficult. Understanding Influenza – how it’s spread, how to prevent it, and the symptoms of the flu – can help keep you, and your community healthy this winter. Below are five flu facts to know as we enter flu season.

Can a flu shot give me the flu? The Influenza vaccine is safe and cannot give you the Flu. It takes 2 weeks to build up your immunity, so you can contract the flu before developing the antibodies.

How is the flu spread? Influenza is a contagious respiratory virus that spreads when you are exposed to an infected person that coughs or sneezes. It can also be spread by touching your nose, mouth or eyes after touching a surface with the virus on it.

How can I prevent the flu? There are several things you can do to keep yourself flufree! The most important step you can take is to get a flu vaccine each year. You can also help prevent getting the flu by frequently using hand sanitizer or washing your hands. Try to avoid touching your nose, mouth or eyes. Avoid close contact with people who are already sick. Practice good health habits like getting plenty of sleep, exercising, managing stress and drinking plenty of fluids. Additionally, be sure to keep surfaces in your home clean.

Wise Guide | Winter/Spring 2020

What are the symptoms of the flu? Symptoms usually start 1-4 days after exposure and usually come on suddenly. You are most contagious in the first 3-4 days after the illness starts. However, you can infect others before you are symptomatic and up to a week after becoming sick. Flu symptoms can range from mild to severe. They can include fever, headache, fatigue, runny or stuffy nose, body aches, sore throat, cough and chills. Sometimes you recognize when you’re starting to feel under the weather. But in other cases, symptoms are so subtle that you may not realize you’re getting sick until you are in the thick of infection. Consider keeping a log and take measurements at the same time each day to document temperature, oxygen level and weight. Note if you have increased fatigue, increased cough (or changes in cough), or increased shortness of breath. Avoid taking a wait and see approach. A call to your doctor is not going to hurt and may help prevent complications.

What is the treatment for the flu? Rest, pain relievers and extra fluids will help to lessen your symptoms. While antibiotics are not effective for the flu, there are prescription antiviral medications that can help to lessen the symptoms and shorten the duration. But, they must be started within 48 hours after onset. ________________________________________________________ The author, Carolyn Camden, has worked in the healthcare field for 17 years, serving in both administrative and bedside nursing roles. Prior to becoming a nurse, she obtained a Business degree and was employed in the field of finance for many years.Carolyn is the Infection Preventionist/Employee Health Nurse at Vibra Hospital of Western Massachusetts – Central Campus. Additional information taken from www.cdc.gov/flu

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Diverse Home Care Solutions FirstLight’s non-medical home care solutions provide support to people with a wide range of needs and the resources necessary to help adults maintain quality of life. Personal Care aids with activities of daily living, such as bathing and hygiene, walking and mobility, transfer and posturing, special diets and meal preparation. Companion Care provides companionship through regular visits, as well as medication reminders, light housekeeping, laundry services, errands and transportation. Respite Care allows family caregivers to step out of their everyday routines and take time for themselves, while FirstLight professionals ensure loved ones are cared for. Dementia Care provides personalized care plans to help dementia sufferers and their families cope with the anxiety, confusion and isolation that are often associated with the disease. FirstLight Home Care is a leading provider of non-medical home care, helping individuals achieve the quality of life they deserve. Our professional caregivers can provide care at private residences, independent and assisted living communities and other healthcare facility settings. _____________________________________________________ This article is provided by Brad Leggat, Owner, FirstLight Home Care of Coeur d’Alene For more information, visit us online at CoeurdAlene.FirstLightHomeCare.com or call us at 208-758-8090

Non-Medical Home Care Helps Adults Achieve the Quality of Life They Deserve

egardless of age, background or location, most people today have something in common: They want independence, freedom and quality of life. FirstLight Home Care of Coeur d’Alene is designed to help adults achieve all those things. FirstLight provides quality, affordable non-medical home care not just for the older adult who is aging in place, but also for other adults who need assistance with activities of daily living. FirstLight is a lifeline for seniors; people with disabilities; those recovering from surgery, illness or injury; and new and busy mothers. “Non-medical home care fills the gap between medically skilled services and the everyday tasks that a person is able to complete for themselves,” said Brad Leggat, Owner of FirstLight Home Care of Coeur d’Alene. “Our services provide

Wise Guide | Winter/Spring 2020

FREE Brad & JennaLeggat, Co-Owners, FirstLight Home Care of Coeur d’Alene

the resources needed to sustain our clients’ independence and freedom and help family caregivers maintain flexibility and balance in their own lives.” Central to the FirstLight caregiving approach is a clientfirst philosophy that matches clients with caregivers who fit the personality, needs and vision of the client and family. Caregiving partnerships are built on trust, communication and an understanding of a client’s needs. “Our caregivers have been there, and they understand the challenges families face when caring for loved ones,” said the owner, Brad Leggat. “FirstLight caregivers are direct employees, not contractors. Plus, we conduct thorough screenings and background checks, and every caregiver must complete our rigorous care training.”

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Successful Rehabilitation Requires Proper Nutrition

by Kristy Harrington, Director of Marketing and Recruitment Life Care Center of Coeur d’Alene

ife Care Center of Coeur d’Alene has been providing skilled nursing and rehabilitative services to the Northern Idaho community for over 20 years. The success of both the facility and the patients who have been served is due largely to the holistic approach to health and rehabilitation the facility provides. Part of this approach is ensuring that the patient’s nutritional needs are met. What, when and how we eat are the major factors in living a healthy lifestyle and recuperating from an illness or injury. Life Care Center of Coeur d’Alene ensures that this is a focus by maintaining an on-staff, full-time Registered Dietitian (RD). The main role of an RD is to assess patients for nutrition risk, establish appropriate nutrition interventions, and educate patients about specialized diets, such as diabetic or cardiac diets. Specialty services such as speech therapy can often be used in conjunction with RD services to help support healthy nutrition and adequate intake when the need is identified. We also have seven day a week speech therapy services to meet our patients’ needs. Lenna Kamps, the RD for Life Care Center of Coeur d’Alene’s morning begins with checking in on new patients to determine their current state, preferences, goals for

Wise Guide | Winter/Spring 2020

rehabilitation and what their nutritional needs might be. Lenna completes nutritional assessments covering food allergies/intolerances, physician recommended food orders, current weight and height, intake, labs, and history to assess for nutritional risk. Lenna works with the nursing, dietary and therapy team members to identify the individual patient’s needs and to note any small changes that can impact their health. By completing routine assessments, the RD can determine if any changes need to be made to the patients’ plan of care to prevent any nutrition-related issue that will impact their overall quality of life and recovery. Because nutrition plays an important role in strength, skin integrity, and healing, monitoring and evaluating a patient’s nutritional status directly impacts their rehabilitation and their future success in maintaining their health when returning to the community.

Lenna Kamps, RD for Life Care Center of Coeur d’Alene

Continued on Page 40

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Successful Rehabilitation Continued from Page 38

Want to start a Parkinson’s support group in your community? And for Individualized Care, contact NW Parkinson’s Social Services Manager, Sarah Winter, MSW, LICSW at 206.946.6517 or sarah@nwpf.org

Tips from Lenna: • Focus on eating plenty of vegetables, fruits, lean protein, and whole grains. Maintaining a healthy diet will reduce the chances of getting diabetes, cardiac issues, and several other conditions associated with obesity. • Eat healthy snacks between meals to prevent extreme hunger, which leads to overeating at meal time. • Most importantly, learn to have a healthy relationship with food. By having a positive attitude about the way you eat, you can learn to balance the things your body needs with things you eat for enjoyment.

COEUR D’ALENE

Lake City Center, 1916 N Lakewood Drive 1st Friday of the month at 1 - 2:30 pm Contact: Beth Hatcher 208-635-5243 Email: cdapsg@hotmail.com Women with Parkinson’s Affinity Apartments, 3594 N. Cederblom Street 3rd Friday at 1 pm. A casual get-together. Free to people with Parkinson’s and their caregivers.

SANDPOINT

Bonner General Health, Annex Conference Room, 520 N 3rd Ave., 2nd Mondays at 2 - 3:30 pm. Contact: A.C. Woolnough 208-265-3325 Email: acwooly@gmail.com

SPOKANE

Lenna strongly believes the best way to stay healthy is to eat healthy! Should you find that you need to go to a skilled nursing facility for rehab, consider that your wellness and rehabilitation are directly correlated with adequate nutrition and a healthy outlook. Life Care Center of Coeur d’Alene offers Nutritional Classes monthly, held the 2nd Friday of each month. They are FREE and open to the public. Contact the facility at 208-762-1122 for more details on how you can participate and live your healthiest lifestyle. ____________________________________ Kristy Harrington is the Director of Marketing and Recruitment for Life Care Center of Coeur d’Alene. She has had many roles with Life Care including Assistant Business Office Manager, Receptionist and was recently promoted to Director of Marketing and Recruitment.

You Have a Choice! Auburn Crest Hospice has earned a reputation of doing more than is expected. Our compassionate team’s commitment to helping our patients live every moment is seen in every aspect of what we do. When choosing a hospice, choose to live every moment with Auburn Crest.

208-267-0579

6541 Main Street Bonners Ferry, ID 83805 www.AuburnCrestHospice.com

Wise Guide | Winter/Spring 2020

208-665-8111

1221 W. Ironwood Dr., Suite 102 Coeur d’Alene, ID 83815 www.AuburnCrestHospice.com

Caregiver Support Group Parkinson’s Resource Center | 1420 E Sprague Ave, Ste 103 3rd Wednesdays at 11:30 am - 1 pm Contact: Halle Goodwin, MSOL 509-443-3361 Email: halle@nwpf.org Women Affected by PD Support Group Riverview Retirement, Dining Room 1801 E Upriver Drive, 1st Thursdays at 1 - 2:30 pm Bring your lunch and join this group of remarkable women living well with Parkinson’s. Contact: Sally Sullivan 509-499-5113 Email: 22sullys@gmail.com

Parkinson’s Support Group Touchmark on South Hill, 2929 S Waterford Drive 3rd Wednesdays at 2:30 - 4 pm Contact: Lori McCormick 509-321-8130 Email: lori.mccormick@touchmark.com Parkinson’s Connect Parkinson’s Resource Center, 1420 E. Sprague Ave., Suite 103 Last Tuesdays at 4 - 6:30 pm Great for new to community or newly diagnosed. Friends and family welcome! Share experiences, ask questions of peers in a relaxed, unstructured fun social setting. Anyone with a Parkinson’s-like disorder is welcome. Contact: Halle Goodwin, MSOL 509-443-3361 Email: halle@nwpf.org

KALISPELL Gateway Community Center 1203 Hwy 2 West, United Way Conference Room Parkinson’s Disease Support Group of Flathead Valley 3rd Wednesday of the month at 3 - 4:30 pm Contact: Marjory McClaren 406-250-5577 Email: marjmccl@yahoo.com Contact: Lynnell Gravelle 406-756-7250 Email: lynnell@arspt.com 4th Wednesday of the month at 3 - 4:30 pm Contact: Lynn Woods 406-420-2321 Email: lynwoods@gmail.com This is a new group forming now to address the needs of Parkinson’s Care Partners. Please join us!

UPCOMING EVENTS YOU WILL WANT TO ATTEND! Check www.NWPF.org for details Follow us on Facebook! @NW Parkinson’s Foundation ALL Events are SUBJECT TO CHANGE. Please CALL 509-443-3361 (NW Parkinson’s Resource Center) to confirm.

Sandpoint “HOPE is Here!” Educational program. May 11th, 2-4 PM, Sandpoint Library Kalispell HOPE Community Resource Day March 28th, Flathead Community College Spokane Northwest Parkinson’s Day — Walk for Parkinson’s April 25th, location TBD

Having a Conversation with Your Family About Their Estate Plan

ntities (Corporations, LLCs) Merger, or Sale of a Business uccession Planning usiness Counsel e and Business Transactions

by Ryan J. Crandall, J.D., Crandall Law Group

state planning can be a difficult subject to address. For many, it brings up unpleasant topics of aging and death to the forefront of their minds, which can lead them to procrastinate or downplay the importance of having a will Ryan Crandall or trust. Sadly, when individuals fail to plan, it is the family who are impacted the most. ng andmembers most other matters. . get personalized information In 2008, Congress designated the third week of October own, private consultation. as National Estate Planning Awareness Week in an effort to es withhelp a Will or Trust.... the public understand the importance and benefits of imentary Consultation! estate planning. Despite this, as of a 2019 survey, 57% of adults in the United States do not have any estate planning documents such as a will or trust, even though 76% of respondents viewed them as important. Many said this was due to procrastination, while others mistakenly believed it was not necessary because they did not have many assets. The holiday season is a time when many families and loved ones are gathered together. These occasions present an excellent opportunity to talk to family members, especially elderly parents, about their estate plan. The topic can be uncomfortable, but having a proper estate plan can provide

| 208.772.7111

significant peace of mind for them and you by ensuring their life savings are protected, plans are in place in the event they become ill, and their property is passed down according to their wishes. Here are some important discussion points and a few tips to help you start the conversation. Be sensitive to your family members’ feelings. Put yourself in their shoes, and keep in mind that few people are eager to dwell on the subject of their own mortality. One way to begin the conversation is to talk first about the need to plan for illness and to provide instructions in the event they become too sick to communicate with doctors or manage their own finances. The conversation can naturally progress to the importance of having an estate plan that will enable their life savings to be transferred in the way they wish, provide for the care of any children or pets, and minimize taxes, court costs, and legal fees. Communicate that you are not trying to control their decisions, but only want to ensure that their wishes regarding their medical care and their property are known—and that their instructions are in writing to guarantee they are honored. Involve other family members in the conversation. If you plan to speak to your parents about estate planning, it is important to try to include any siblings in the discussion to avoid giving the impression that you are trying to influence or control your parents’ choices. You and your siblings should emphasize that none of you are asking about what you will inherit. You just want to make sure their wishes are known and honored.

• Estate Planning (Wills and Trusts) • Asset Protection • Medicaid and VA Benefits Planning • Probate and Estate Administration • Gun Trusts

• Business Entities (Corporations, LLCs) • Purchase, Merger, or Sale of a Business • Business Succession Planning • General Business Counsel • Real Estate and Business Transactions

NEED A SPEAKER FOR YOUR GROUP OR ORGANIZATION?

Give us a call!

Continued on Page 44

Jeff Crandall

Ryan Crandall

We offer complimentary consultations for Estate Planning and most other matters. So don’t sit through a seminar with a bunch of strangers ... get personalized information from an experienced estate planning attorney in your own, private consultation. To learn about protecting your wealth and loved ones with a Will or Trust....

Call Today to Schedule your No-Obligation, Complimentary Consultation! 42

Wise Guide | Winter/Spring 2020

8596 Wayne Drive, Suite B, Hayden, ID | 208.772.7111 Wise Guide | www.TheWiseGuideOnline.com crandalllawgroup.com

Having a Conversation with Your Family... Continued from Page 42

Address several key topics. • Ask if your family members have a last will and testament and/or a trust, and explain that if they do not have these important legal documents, state law will determine who receives their property—and it might not be the people they would have chosen. Also, a judge will decide who is entrusted with the management of their estate and the care of any surviving minor children or pets. Having their wishes spelled out in a will or trust can also help prevent confusion and potential conflict between family members. • A financial power of attorney will allow them to designate an individual to manage their finances and property if they are unable to themselves. Inquire about your family members’ powers of attorney, and encourage them to identify the best individuals for the job. • Make sure your family members have proper medical powers of attorney and advance directives in place. These documents contain their wishes regarding their medical care and enables them to designate a trusted person to make medical decisions on their behalf if they are unable to do so themselves. • Find out whether they have insurance and the location of the insurance policies. If your family member becomes incapacitated or dies, it is important to have this information so that claims can be filed for benefits and so other types of policies, such as homeowner’s or auto insurance, can be modified or terminated. • Ask them to compile a list of accounts and property and other important personal information which would be needed to wind down their affairs once they are

Wise Guide | Winter/Spring 2020

gone, including: bank and investment accounts, vehicle titles, deeds, credit card accounts, digital accounts and passwords, Social Security cards, passports and birth certificates. This information should be kept in a safe place and shared only with trusted family members or loved ones. • A list of legal, financial, and medical professionals who have worked with your family members is also important. Be sure they include doctors and care providers, financial advisors, insurance agents, CPAs or tax professionals, business partners, and others. The list should include the professionals’ contact information so they can be easily reached in the event help is needed. Consult an estate planning attorney. Once you have this important conversation with your family members, they might realize it is time to contact an experienced estate planning attorney who can help them create an estate plan tailored to meet their needs and carry out their wishes. They might also realize they need to update a plan that no longer fits their goals. At Crandall Law Group, we offer a complimentary estate planning consultation where we can review an existing estate plan or discuss creating a new one. Help bring yourself and your family members peace of mind, and call us today to schedule your complimentary consultation. _________________________________________________________________

Ryan Crandall is an attorney and estate planner with a passion for helping individuals and families prepare for the future. Ryan believes that one of a lawyer’s primary roles is to be an educator and counselor. At Crandall Law Group, he works hard to discover his client’s goals and explain, in easy to understand terms, the strategies that can be used to accomplish their objectives.

Urgent Care, What a Great Veteran Benefit!

by Bryan Hult, Bonner County Veterans Service Officer

ecently, on June 6, 2019, the VA ended the Choice program. As some veterans stated, “Just as the VA got the bugs worked out, the VA ended a good thing!” Choice WAS a good thing, but the new Mission Act is EVEN BETTER! Because of that choice, sacrifice and noble ambition, many do carry the scars of war. Fortunately, in the United States, there is support that government-elected officials have approved to assist combat veterans. One of those benefits is the Tax Fairness Act Claim of 2016. One aspect of the Mission Act is the new Urgent Care benefit. Yes, to use this program, the veteran must be enrolled in the Veteran Health Administration and have received VA care at a VA facility or a Community Provider (VA connected) within the past 24 months. Check with your nearest Veteran Service Officer to help you get enrolled, if you are not already! Urgent care is used when the veteran is seeking treatment for more pressing illnesses or injuries (but are not life-threatening), like splinting, casting, lacerations, or wound treatment. Services would also include treatment for colds, minor injuries, skin infections, ear infections, pink eye, or strep throat. When going to the VA designated Urgent Care location, he/she needs to inform the staff they would like to use their VA urgent care benefit to receive care and ask or verify the provider is part of VA’s contracted network. Veterans do not need to get an authorization code to go to the Urgent Care provider. If the Urgent Care provider is not in the VA network, the veteran will have to pay the full price of the care provided. Urgent care is not a replacement for emergency care. It is also not a replacement for preventative care. There are often co-pays, which depend on the assigned priority group and the number of times using an in-network urgent care provider in a calendar year. Generally, priority groups 1 to 3 are those veterans with a service-connected disability or who received the Medal of Honor, Purple Heart, or were a Prisoner of War. Priority groups 4 and 5 include those on housebound status, or catastrophically disabled, non-compensable 0% disabled, or on a VA pension. Priority 6 are those who served in Vietnam, the Gulf War, current theater of combat operations, Camp Lejeune for more than 30 days, or exposed to radiation.

Priority groups 7 and 8 are those below or above VA income limits and who agree to co-pays. For priority groups 1-5 there is no copay for the first three visits, but there is a copay of $30 for any other visit. For priority group 6 there is no copay if it is related to special authority or exposure. For any other visit the copayment is $30. For visits not related to a condition covered by special authority, the copay is $30 per visit. For priority groups 7-8, there is a $30 copayment for all visits. There is no copay for a flu shot. Finally, note that a veteran is not limited on the number of visits. A prescription can be filled at the VA pharmacy, a VA contracted pharmacy or a non-VA contract supplier for the first 14 days written by an Urgent Care provider. For prescriptions that last longer than 14 days, the VA pharmacy must provide that prescription for it to be paid. If it is acquired by a non-VA contracted supplier, the veteran must pay for the prescription and then file a claim with the VA pharmacy. In order to locate the nearest Urgent Care provider, check (or google) “VA Urgent Care Locator” and you can search by address or zip code. You can use the identifier: vaurgentcarelocator.triwest.com/locator/care. There are two Urgent Care facilities in Bonner County: • Urgent Care of Sandpoint 302 S 1st Ave Sandpoint, ID • Bonner General Immediate Care 400 Schweitzer Plaza Dr Ste 1 Ponderay ID I happened to need four stitches the other day and I had excellent service at the Urgent Care in Ponderay. I ensured the Urgent Care billed Triwest and then later checked with Triwest (866-606-8198) to ensure it was paid. The VA took a huge step forward with this new benefit. Give your local Veteran Service Officer a call if you have any questions. ________________________________________________________ Bryan Hult is the Bonner County Veterans Services Officer. He enlisted in the infantry, graduated from Officer Candidate School and Jump School from Fort Benning, Georgia and Flight School from Fort Rucker, Alabama. He then flew helicopters at Fort Hood, Texas. His military education included the Army War College in Carlisle, PA. After seminary, he served at every level of the Army chaplaincy in the Indiana National Guard and retired in 2010 as the Assistant Chief of Chaplains.

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Do You Need to Get Around Better? Have Short-term, Long-term or Changing Mobility Needs? Want More Than a Few Choices? Catering to our customers is our specialty and we know there’s nothing more frustrating than not being able to get where you want to go and to do it as easily as possible. Often the most difficult part of acquiring health care needs is having everything you might want or need in one place, and at fair prices. We carry medical supplies and durable medical equipment for both the general public as well as professionals — all in one place!

SALES, SERVICE & RENTALS — Our main goal is to help you with all your mobility needs. We maintain a HUGE inventory of new & used manual wheelchairs, power chairs, scooters, hospital beds, lifts, shower chairs & benches, walkers/ rollators and more. We also carry a wide array of medical supplies, first aid products, disinfectants as well as incontinence supplies for adults and children - at LOW PRICES - see our website for all the things we have: WesternMedicalSpecialties.com Or if your needs are short term, we RENT knee walkers, manual wheelchairs, scooters, power chairs and other items. Plan ahead! Far too often, we hear people tell us that when they returned home from their procedure, they had no idea what they would need and the first few days they struggle without assistive devices like shower chairs, raised toilets, incontinence supplies, canes or walkers because they didn’t think about needing those things at home. Or they were discharged earlier than expected. The very best way to avoid these potentially dangerous situations leading to falls or other problems is to plan ahead. Give us a call, or

Not only do we have New Electric Scooters, Power Chairs, Wheelchairs, Walkers/Rollators — we repair them too!

Just so you know…you don’t have to be embarrassed to buy incontinence supplies at the store - you can buy all your incontinence supplies from us and we’ll ship them directly to you in the privacy of your home. better yet, come in and let’s talk about what you may need so you can take it home and it will be there when you need it. It can take weeks to get the things you need once you’ve been approved by insurance. That’s why we don’t accept insurance. We know that most of the time, you need what you need NOW, not later. What most people don’t know is that sometimes you aren’t automatically approved for what you want, but rather what the insurance company thinks they will let you have. With Western Medical Specialties, we help you get what you want, for your own specific circumstances — and you can take it home that day!

Give us a call and come see what we can do to assist you! Not only do we have New Electric Scooters, Power Chairs, Wheelchairs, Walkers/ Rollators —

WE REPAIR THEM TOO! 46

Wise Guide | Winter/Spring 2020

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The Blue Water Navy Vietnam Veterans Act of 2019 Passed! Now What?

by Darryl Heisey State Veterans Service Officer Idaho Division of Veterans Services

re you a Vietnam Veteran who served on a ship in the territorial waters of Vietnam? If you are, there is some great news related to ships that were 12 nautical miles off the coast of Vietnam; The Blue Water Vietnam Act of 2019 was signed into law by the President of the United States on June 25, 2019. This Blue Water Vietnam Veterans Act of 2019 makes it possible for a veteran who served on a U.S. Navy or Coast Guard vessel in Vietnam “blue waters” between January 9, 1962 and May 7, 1975 to file for claims under the presumption of agent orange exposure. The Department of Defense and the Veteran Affairs are working together to establish the ships list and the current location to figure out if your ship falls under the blue water Act of 2019. You can review these websites to determine if your ship qualifies: https://www.va.gov/shiplist-agent-orange.pdf and at https://www.archives.gov/research/military/logbooks/navyonline and archives2reference@nara.gov Eligible survivors of deceased Blue Water Navy Veterans also may benefit from the new law and may file claims for benefits based on the Veterans’ service. This also affects veterans who served at the Korean DMZ from September 1, 1967 through March 31, 1968; the veteran will still need to provide evidence that shows proof of service on the Korean

DMZ during the appropriate times established by the Law. An estimated 420,000 to 560,000 Vietnam-era Veterans may be considered Blue Water Navy Veterans. To qualify under the new law, these Veterans must have a disease associated with herbicide exposure, as listed in 38 Code of Federal Regulations section 3.309(e). We are advising all veterans who may fall under this new law, if they have a current condition established as an herbicide presumptive condition, to contact their State or County Veteran Service Officer and file the claim. And, if a veteran has been previously denied for presumptive conditions we strongly suggest they reopen the claim! The State and County Veteran Service Officer can inform you of the conditions and will assist you in getting your claim filed on the appropriate forms. All claims received for blue water Vietnam Navy veterans will not be worked by the Veterans Affairs until January 1, 2020. Ultimately, IF you know someone who may qualify under this new Law we encourage you or them to make an appointment with your State or County Veteran Service Officer and get the claim submitted. ________________________________________________________ Darryl Heisey is the State Veterans Service Officer, Idaho Division of Veteran Services, Post Falls. Darryl served in the U.S. Army as 56M40H Chaplain Assistant Supervisor from 1982-2002. Army Duty Assignments: Fort Polk, LA, 588th Engineer Battalion, 5th Infantry Division (Mechanized); Fort Richardson, AK, 1st Brigade, 6th Infantry Division (LIGHT); Fort Carson, CO, 4th Infantry Division, Mechanized; Fort Monmouth, NJ, United States Army Chaplain Center and School; Fort Jackson, SC & Schofield Barracks, HI, 25th Infantry Division (LIGHT); Fort Huachuca, AZ, United States Signal Command. Darryl holds a B.S. degree in Human Resource Management from Madison University.

Veterans Service Officers (VSOs) are trained, certified and accredited to be ADVOCATES FOR YOU! They are NOT VA employees. Assistance is FREE. Contact them BEFORE you call the VA. It will save you a lot of grief.

These Veterans Service Officers are here for you: NORTH IDAHO Idaho State VSO

Darryl Heisey 208-446-1092/1094 120 E. Railroad Ave., Post Falls M-F 8:30 AM - 5:00 PM email: Darryl.Heisey@veterans.idaho.gov

MONTANA

Montana State VSO National Guard Armory • 406-755-3795 2989 Hwy. 93 North, Kalispell Appts. M & F, walk-ins welcome Wed., Tues. is outreach, Thurs. closed. Carolyn Collins

Bonner County Bryan Hult 208-255-5291 1500 Hwy 2, Ste. 122, Sandpoint M-TH 8-5 (call/email for appointment) email: bhult@bonnercountyid.gov

Boundary County Ronald Self 208-267-8611 6635 Lincoln St., Bonners Ferry Wednesdays and Thursdays 8:00 AM - 1:00 PM email: veterans@boundarycountyid.org

Kootenai County Scott A. Thorsness, Director 208-446-1090/1092 120 E. Railroad Ave., Post Falls M-F 8:30 AM - 5:00 PM email: scott.thorsness@veterans.idaho.gov

Shoshone County

Ryan Keeler

Bryan T. Zipp

Idaho Department of Labor - Veterans Reps. Benewah/Kootenai/Shoshone Counties

Robert Shoeman 208-457-8789 Ext. 3993 600 N. Thornton St., Post Falls email: robert.shoeman@labor.idaho.gov

Bonner/Boundary Counties

Justin Offerman 208-263-7544 Ext. 3713 613 Ridley Village Road, Ste. C Sandpoint email: justin.offerman@labor.idaho.gov

Susan Hendrixson • 208-752-3331 700 Bank St., Suite 120, Wallace M-Thurs. 9:00 AM - 5:00 PM email: commsec@co.shoshone.id.us

FYI—All states offer a Veteran Designator on Driver’s Licenses, making it easier for veterans to receive access to government benefits and discounts at restaurants and retailers. Proof of Honorable Discharge is required at time of application.

Wise Guide | Winter/Spring 2020

Real Self-Defense — Finding the Right School by Professor Michael M. Foley Hand to Hand Combat Training Center

ood day readers! I’m writing this article to help you better understand the variety of martial arts schools and what they are teaching in these troubling times. There are different types of schools and instructors offering training in the Asian-based systems of Karate, Taekwondo, Jiujitsu, Mixed Martial Arts (MMA) and Kickboxing. There is also an Israeli style growing in popularity called Krav Maga. Following is a brief explanation of the types of schools being offered.

1 - Kiddie Karate. These schools specialize in teaching young children. They do “Karate games,” “Stripe testing,” “Specialty Classes,” and hold monthly tests for the next belt, whether or not the child is ready to be tested. These schools often draw money from the unsuspecting parents and when all is said and done, you’re paying about $250 per month per child! At the end of the two to four year contract (legally binding) the student has no more chance of defending themselves from a bully or an assault than they did before they began. Sadly, these “schools” are an expensive way to keep a child entertained and provide poor outcome in the self-defense capabilities of the student. 2 - MMA or Mixed Martial Arts. These schools teach something known as Brazilian Jiujitsu which is a small piece of actual Japanese/Hawaiian Jiujitsu that focuses almost exclusively on ground fighting or wrestling. Then they throw in some punching and kicking they say is from the Muay Thai system of fighting from Thailand. Often times, the instructor of the school doesn’t have a Black Belt or even a Brown Belt in their chosen discipline. Can their students fight after a year of training? Yes, if they want to throw themselves on the concrete floor and wrestle. At that point you are committed to holding your opponent on the ground which means his buddies can easily pound on you and kick you in the head.

3 - Hand to Hand Combat Training. This type of training is all about real, actual self-defense. It can be a traditional Karate, Gung-fu, Taekwondo, Jiujitsu, Krav Maga, or combination of several styles school. As long as the emphasis is on hard, disciplined, focused training for self-defense. When a student in this type of school practices a block, punch or kick, they practice with speed and power

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so it will work when needed. If you are attacked, you will do a technique the way you practice it. So why would you practice it slowly or with no power? If the instructor says, “You’ll do it strong when you need it,” that’s hogwash! The “instructor” has obviously never been in an actual self-defense situation. You should always practice it the way you’ll use it! The Hand to Hand Combat Training Center teaches a combined Martial Art called Koden Kan. The students may learn a Karate block followed by a Judo sweep followed by a Jiujitsu arm lock and ending with a Kajukenbo dropping knee strike, all combined into one selfdefense technique. Many consider our style a mix of traditional Martial Arts and American Hand to Hand Combat. Hand to Hand Combat Training Center (H2HCTC) also offers SinkoSet Escrima, a martial art from the Philippine Islands that utilizes a 24” to 28” rattan or bamboo stick as a weapon. It is a striking art that incorporates blocks, parries, strikes, and pokes as instruments of self-defense. The class is structured to take the novice as well as experienced martial artist through specific techniques at each rank level all the way up to Black Belt. The class is great for just about anybody including Seniors, Men, Women, Teens, and people in wheel chairs that have full use of their arms and upper bodies. It is well worth your time to search for a good martial art school for yourself and children age 9+ years and higher. If you are serious about learning real self-defense and live near Hayden, Idaho, you should check out the Hand to Hand Combat Training Center on your right on Highway 95 north bound. The students at the H2HCTC train hard and believe in the three “D’s” of success: Desire, Dedication, and Discipline! Go to our website for more details: HandtoHandCombatTrainingCenter.com Call for a free trial class: 208-262-1410. Train to Fight, Fight to win!

Michael McLain Foley joined the US Army to train as a Military Policeman in 1976. During his first assignment in Hawaii, he pursued his real passion, the Martial Arts. In such a “melting pot” of martial arts, he was able to learn four different styles of Japanese Karate, Danzan-Ryu Jiujitsu, Aikido, Kickboxing, Japanese and Chinese weapons and Filipino stick fighting. He applied his martial arts working for the Military Police CID (Criminal Investigation Division). Michael joined the US Army’s Special Operations Command when he left Hawaii and was trained and assigned to units in every aspect of that command. He attended Ranger school, PSYOP schools, Civil Affairs schools, Special Forces training, as well as many specialty schools he needed to complete these unique missions all around the world. Later, Michael received an Associate in Arts Degree in Theatre Arts, a Bachelor’s and Master’s degree in Communications, and a PhD in Multi-Cultural Communications. He attended the Defense Language Institute for Japanese and Korean. He also picked up some language skills in Russian, Serbo-

Croatian, Albanian, Italian, and German. During a few years of Army Reserve Duty, Mr. Foley was able to pursue a career in the movie industry acting in several fulllength movies, four television programs and a handful of commercials for foreign clients utilizing his language skills. During this time he also wrote screenplays for motion pictures and sang professionally. No matter what he was doing or where he was assigned, Michael Foley always found a way to teach martial arts and learn from anyone with superior abilities in one form of martial arts or another. He has taught in Bosnia, Kosovo, Macedonia, Germany, Japan, Korea, Iraq, Afghanistan, and Rwanda Africa. Teaching became the life skill he embraced the most in many subjects with major emphasis being on Martial Arts, culminating in the development of his own system of personal combat known as Koden Kan Combined Martial Arts. This is the style he teaches today to his many students at the Hand to Hand Combat Training Center in the beautiful Northwest of the United States of America.

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What is CBD? Michael Pickens, Development Director and Co-Owner of North Spokane Hemp Co.

annabidiol (CBD) is a naturally occurring compound found in the resinous flower of cannabis and hemp, a plant with a rich history as a medicine going back thousands of years. Today the therapeutic properties of CBD are being tested and confirmed by scientists and doctors around the world. A safe, non-addictive substance, CBD is one of more than a hundred “phytocannabinoids,” which are unique to cannabis and endow the plant with its robust therapeutic profile.

Endocannabinoid System Cannabinoid receptors sit on the surface of cells and receive information about the conditions outside of the cell. They transmit information about changing conditions to the inside of the cell, triggering the appropriate cellular response. Endocannabinoids are molecules that bind to and activate cannabinoid receptors. Endocannabinoids regulate the adrenal response to stress, mediated primarily by the hormone cortisol, which is responsible for the “fight-or-flight” response. Endocannabinoids also regulate the production of dopamine in the brain, which is responsible for the motivation to sustain goal oriented effort over time. By curbing the excess production of cortisol and supporting adequate production of dopamine, endocannabinoids help prevent excess tension,

anxiety, burnout, and feelings of self-defeat and help support the confrontation of challenges with the attitudes necessary for success.

THC vs. CBD Both CBD and THC have significant therapeutic attributes. But unlike THC, CBD does not make a person feel “stoned” or intoxicated. That’s because CBD and THC act in different ways on different receptors in the brain and body. Many people want the health benefits of cannabis without the high – or with less of a high.The fact that CBD is therapeutically potent as well as non-intoxicating, and easy to take as a CBD oil, makes it an appealing treatment option for those who are cautious about trying cannabis for the first time. You also won’t fail a drug test with CBD.

This is why we only source hemp from local farms we can visit. We have exclusive contracts with 6 local farmers, many of them growing a potent medical strain of hemp called “Neo.” Neo is an original hybrid strain of industrial hemp combining feral ‘Hemp for Victory’ with ‘Harletsu.’ It is primarily grown in WA State and was created by Justin Martin of Serendipity Seeds. Neo full-spectrum oil offers 47.4% pure CBD content in conjunction with the full cannabinoid profile. This can be helpful to patients with various health challenges including: Parkinson’s, epilepsy, chronic pain, autoimmune disease, complications from chemotherapy and radiation, anxiety, insomnia, and much more. North Spokane Hemp Co. is currently selling products made from Neo locally grown in Northeast WA by hemp farmer and cannabis freedom activist Jordan Page of Dreamweaver Farms. Page cultivates a variety of hemp strains without pesticides or heavy machinery, using all natural organic growing practices. A Christian musician, Jordan Page regularly prays over and sings to his crops.

directly. Visiting the farms we source from allows us to ensure we are giving our friends, family, and customers some of the very best products on the market. Give us a call, visit our website, or stop by our store in person to see if CBD is a good fit for you. 509-919-3759 - 9323 N Division St., Spokane northspokanecbd.com ___________________________________________________________________

Michael Pickens, Development Director and Co-Owner of North Spokane Hemp Co. is a nationally recognized speaker, author of 2 books, a graduate of THC University, co-owner of an indoor cannabis grow operation in Washington State, husband and father of 3 children. His focus in the cannabis industry is to educate on the many benefits cannabis and hemp can provide.

Highest Quality, Lowest Prices At North Spokane Hemp Co., we don’t deal with middlemen or brokers who repackage and dilute CBD oil. We go straight to the growers to ensure we are getting the best prices and supporting the families of the growers

CBD Isolate vs. Full-Spectrum A CBD isolate is exactly what it sounds like; pure, isolated CBD compound, all by itself. Full-spectrum oil, on the other hand, contains other active plant compounds in addition to the CBD. This includes other cannabinoids such as CBN, CBL, CBCVA, CBG and others. CBD isolate contains zero THC, whereas full-spectrum oil contains trace amounts and is not recommended for people who must pass a drug test.

Locally Grown vs. Imported

Jordan Page and family from Dreamweaver Farms

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The U.S. is the biggest importer of hemp in the world. The total hemp imports of the U.S. amount to approximately $300 million, with the composition of the imports being between materials for raw hemp and hemp products for commercial use. The biggest exporters of hemp to the U.S. are Canada, Europe and China. The hemp plant has a highly absorbent stalk which soaks up nutrients and everything else that is present in the soil in which it has grown. This can very possibly include heavy metals, pesticides and other materials that are harmful for your body.

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LightForce Laser ~ Photobiostimulation Relieves Pain & Enables Healing

by Dr. Daniel L. Moore, Moore Chiropractic

am often asked to explain how the LightForce Laser works, therefore the following is the original article from the Spring 2017 edition of The Wise Guide. State of the art technology for acute and chronic pain relief doesn’t have to mean a trip to the big city! A few years back I suffered nerve injury to my left leg and had terrible radiating pain. Class IV laser therapy was recommended to me by a neurologist after medication and treatment failed. I had to travel to Boise to find the nearest facility offering Class IV laser treatment. It worked so well that I wanted to share it with my patients. Since then I have treated hundreds of patients with such great results that I have many health care practitioners stop in to see what deep laser therapy can do for their patients. For those suffering from chronic, nagging pain, inflammation and lack of mobility, Class IV laser therapy offers fast, healing relief. We encourage those who have tried other forms of treatment without success to try the technology. Class IV laser therapy allows my patients to return to the activities they love while maintaining their healthy lifestyle. Recovery from injuries is much faster, often avoiding surgery altogether, not to mention the time associated with post-op healing. One of the greatest benefits I’ve found is that Class IV laser therapy allows the body to heal without the use of prescription drugs. LightForce lasers are FDA approved, highly sought-after and endorsed by professional organizations such as The American Physical Therapy Association, The World Health Organization, and The International Organization for the

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Study of Pain. Many professional sports teams including the Seattle Seahawks use the LightForce laser. Lesley Paterson, a three time world triathlon champion and Dale Richardson, a professional golfer are users of the Class IV laser. This cutting edge, professional grade treatment is available to the public and I am very pleased to provide it in a small town environment where our lifestyles and day-to-day activities demand so much from our bodies.

The Science Behind Laser Therapy’s Benefits Peripheral neuropathy is a general term for diseases causing damage to the nerves outside of the brain and spinal cord. While diabetes is a frequent cause of neuropathy, it

is not an exclusive cause. Nutrition deficiencies, chemical exposure, pressure on the nerves, injuries, and medications (such as those used in chemotherapy or to treat AIDS) can cause painful neuropathy. In general, diabetic neuropathy is thought to be the result of chronic nerve damage caused by high blood sugars. Similar to how an electric wire is surrounded by insulation, our nerves are surrounded by a covering of cells called Schwann cells. One theory suggests that excess sugar circulating throughout the body interacts with an enzyme in the Schwann cells (called aldose reductase), transforming the sugar into sorbitol. This process draws water into the Schwann cells causing nerve swelling and damage resulting in pain. Unless the process is stopped and reversed, both the Schwann cells and the nerves

they surround will die. The application of photobiostimulation that the Class IV laser delivers to these cells prevents or reverses the biochemical processes that cause this damage. The increased circulation removes excess fluid from the Schwann cells removing any possible pressure necrosis (or death) to the rest of the nerve cell while providing a vehicle to remove cellular waste such as sorbitol. Laser therapy applied to the affected nerve cells stimulates the mitochondria within the cell and increases the respiratory rate of these individual cells. When this happens the intracellular metabolites do not have the opportunity to become depleted, and the production of any destructive protein kinases is halted. Laser therapy generates a photochemical response in damaged tissue by a process called photobiomodulation. This process stimulates healing on a cellular level by enabling cells to more rapidly produce energy (ATP). Deep tissue laser therapy is a non-invasive use of laser energy that promotes healing of damaged or dysfunctional tissue. This form of therapy helps your body use its own natural healing power by activating a positive cellular response, increasing microcirculation to reduce inflammation. Laser therapy can alleviate pain and accelerate recovery from a wide variety of acute and chronic issues such as arthritis, tendonitis, neuropathy and plantar fasciitis. Knee, hip, neck and back pain have also been shown to respond extremely well to treatment with laser therapy. Class IV lasers provide a deeper depth of tissue penetration unachievable with lower wattage lasers and are unrivaled by Class I, II, and III lasers. This is due to their ability to treat both superficial and deep tissue conditions. The LightForce Class IV Laser was developed by leading laser scientists and engineers and we are proud to offer one of the very few Class IV LightForce Lasers in North Idaho. We have already seen many of our patients benefit from this treatment with as few as two treatments. We are so confident that this exciting new treatment can help you that your first treatment is on us. Contact our office at 208-267-2506 to schedule your complimentary first treatment and start your road to a pain-free life today. Visit danmooredc.com to see a short video on how the Class IV Laser works. ___________________________________________________________________

Daniel L. Moore D.C. has been in private practice for more than 30 years. His career began in Los Angeles, California in 1984. While working with Olympic athletes under Dr. John Thie, he mastered cutting-edge techniques like kinetic taping and Kinesiology. Dr. Moore’s advanced rehabilitation and athletic training has served Bonners Ferry and surrounding communities in North Idaho and Western Montana for over 20 years. He has continually led his field in the application of ground-breaking technologies including the LightForce Class IV Laser used in the treatment of nerve-related pain.

a result of diabetic retinopathy. This occurs when the new growth of blood vessels that are trying to compensate for the damaged vessels, begin to block the eye’s natural ability to drain. This causes a buildup of pressure and fluid in the eye, known as glaucoma. Cataracts are not so much a part of the retinopathy process, but rather people with diabetes are more likely to develop them at an earlier age. According to the National Eye Institute, diabetic individuals are actually 2-5 times more likely to develop cataracts. The good news is they can be removed surgically if you are a candidate.

How Do You Know if You Are Having Symptoms of Diabetic Eye Disease?

Diabetic Eye Disease 101

Taking a preventative approach to your health care, why it’s important to get annual eye exams.

by Jalee Palmer, RN Diabetes Educator & Program Coordinator Camas Center Clinic

What is Diabetic Eye Disease?

iabetic eye disease is an encompassing term used for a group of eye complications that can impact people with diabetes. The most common of these complications is what we call “diabetic retinopathy.” This condition impacts the retina of the eye which is the part of the eye that gathers pictures and sends them to the brain. The brain then decides what these pictures are and we process them as what we see. If the retina is damaged it cannot send pictures to the brain causing decreased or loss of vision. Diabetic Retinopathy is the leading cause in vision loss in people with diabetes, and

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Fast changes in blood sugars, either decreases (hypoglycemia) or increases (hyperglycemia), can cause normally clear vision to become blurry. This change in vision is a sign that damage is occurring or has already occurred in the eye. Cataracts can also cause a blurred or hazy vision change. It is important to note that usually there are no vision changes or symptoms of diabetic eye disease until permanent damage has already occurred. This is why it is so very important to see the eye doctor at least once a year. They are able to run screenings and tests for diabetes related damage occurring in the eye, before onset of vision changes. When it comes to diabetic eye disease, prevention truly is the best medicine.

How to Prevent and Treat Diabetic Eye Disease? The following strategies are the most effective way of preventing Diabetes related eye disease. • Control blood sugars — closely monitor them at home • See your Ophthalmologist/eye doctor once a year and more frequently as recommended • Closely manage diabetes • Weight management and weight loss • Take medications as prescribed Cataracts can be surgically removed if you are a candidate. Glaucoma can often be treated with prescription eye drops and surgery, with advance cases, if you are a candidate. It is important to remember that there are no treatments for permanent diabetes related damage to the eye, therefore prevention and management of diabetes is the best strategy for protecting your eyesight. ___________________________________________________________________

Jalee Palmer, RN, grew up in Eastern Washington small towns. Her father is from Springdale and her mother is from Cusick. In pursuit of medicine, she double-majored in health sciences and nursing. Jalee has been working as an RN since 2013 and is honored to be working for the Kalispel Tribe as the Diabetes Educator and Diabetes Program Coordinator.

occurs when high blood sugars damage the blood vessels that nourish the retina of the eye. Retinopathy begins with small bleeds in the vessels that bring blood and oxygen to the retina. As it worsens, the vessels continue to balloon and become misshapen. This makes them unable to properly carry blood and nutrients to the retina. When these misshapen vessels increase, the affected part of the eye tries to compensate by re-growing new blood vessels in an attempt to nourish the retina. These new vessels are fragile, leading to more bleeding in the eye, which causes the formation of scar tissue. When a large amounts of scar tissue forms and contracts, it can pull on the retina and rip the retina from the eye tissue. This is known as retinal detachment and is very difficult to repair. It often leads to permanent vision changes or complete vision loss. Diabetic macular edema (DME) is another condition that is part of diabetic eye disease. This develops when there is a buildup of fluid/blood leaking from the damaged blood vessels in the eye. DME occurs in about 50% of all people suffering from diabetic retinopathy. Glaucoma is another disease process that can develop as

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by Ken Wood, Financial Advisor, Edward Jones

hen it’s time to do your estate planning – and it’s actually never too soon to begin – you may find the process, at first, to be somewhat bewildering. You’ll have many questions: What sort of arrangements should I make? Who should get what? And when? How can you address these and other issues? You’ll need to get some help. In drawing up your estate plan, you will need to work with an attorney. And for guidance on the investments that can help fund your estate planning arrangements, such as a living trust, you can draw on the help of a financial advisor. You also may want to connect with a trust company, which can help facilitate your estate plans and coordinate the activities of your legal and financial professionals.

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Of course, you might think that only the very wealthy need a trust company. But that’s not really the case – people of many income levels have long used these companies. As long as you have a reasonable amount of financial assets, you likely can benefit from the various services provided by a trust organization. And these services can range from administration of a variety of trusts (such as living trusts and charitable trusts) to asset-management services (bill-paying, check-writing, etc.) to safekeeping services (such as providing secure vaults for jewelry and collectibles). In short, using a trust company can make things a lot easier when it’s time to plan and execute your estate. A trust company can help you in the following ways: • Avoiding family squabbles – It’s unfortunate, but true: Dividing the assets of an estate can cause ill will and turmoil among family members. But a trust company can act as a neutral third party, thus minimizing any feelings of unfairness. • Providing greater control – When you establish an arrangement such as a living trust, administered by the trust company, you can give yourself great control over how you want your assets distributed. For example, you

can specify that a certain child receive portions of your estate spaced out over several years – a move that may appeal to you if you think this child might not be ready to handle large sums all at once. • Saving time and effort – As mentioned above, when you work with a trust company, you can let it do all the “legwork” of coordinating your plans with your financial professional, tax advisor and attorney. And these professionals are used to dealing with trust companies. • Gaining protection – Trust companies assume fiduciary responsibility for your financial well-being – which means that your best interests will always be considered in each service and transaction performed. You can choose from among a variety of trust companies, large and small. Before choosing one, you may want to check out the services and fees of a few different firms. In any case, as you move toward that time of your life when estate planning becomes more essential, talk to your attorney, tax advisor and financial professional about whether using the services of a trust company might be right for you. This article was written by Edward Jones for use by your local Edward Jones Financial Advisor. ________________________________________________________ Ken Wood joined Edward Jones as a financial advisor in 2014, opening the firm’s branch office in Ponderay. Ken’s office is focused on providing highly personalized service. Ken believe it’s important to invest his time into understanding what his clients are working toward before investing their money. For more information, please call his office at (208) 255-2613 or visit us at www.edwardjones.com. Edward Jones, its employees and financial advisors are not estate planners and cannot provide tax or legal advice. You should consult your estate-planning attorney or qualified tax advisor regarding your situation.

Lil’ Cowpoke

See more artwork by our cover artist, Carol Hayes, on page 5 Wise Guide | www.TheWiseGuideOnline.com

Solving the Challenge of Loneliness

by Bruce Weaver, MPA, PA-C Owner, AAging Better In-Home Care

t’s well recognized and has been for the past several decades that many Americans, especially seniors, experience loneliness on a daily basis. For seniors, their kids are grown or now busy raising their own children, retirement has come and gone and close friends or spouses may have passed away. Their alone moments stretch out seemingly into eternity with no end in sight. As it turns out, older age today is a huge challenge for many, if not all who find themselves in this situation. This problem is NOT unique to just the older generations. According to sociologists and medical researchers in this field, there appears to be a loneliness epidemic rapidly developing across our nation. Among the medical community, there is a growing consensus that loneliness—not obesity, cancer or heart disease—may be the nation’s number one health crisis. It’s been shown that persistent loneliness reduces longevity more than twice as much as does heavy drinking and more than three times as much as obesity. In fact, obesity can often be a consequence of loneliness itself. Among seniors, research has found that loneliness is as physically dangerous as smoking 15 cigarettes a day and contributes to cognitive decline, including more rapid onset and advance of Alzheimer’s disease. In the last quarter of the 20th century, the average number of times Americans entertained at home declined almost 50%. And whereas 70% of Americans watched the same shows on TV back then, such as I Love Lucy or Bonanza, today 93% of Americans have access to more than 500 channels but

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the most watched show, Hannity, only accounts for about 1% of viewers. Americans don’t appear to have much in common anymore as compared to earlier times when everyone knew the latest adventures of Lucy or the Cartwrights. We are now hyperconnected as a society but actually disconnected, with fewer live friends than at any point in decades—as opposed to the virtual “friends” we have on FaceBook and other social media. According to a recent PEW survey, most Americans with a smart phone check it every 4.3 minutes, and with nearly 40% of those 18-29 online almost every waking minute, you could say that Americans have become addicted to distraction amidst this loneliness epidemic. It seems we are longing for a genuine community of physical friends and family but don’t pursue it because of the convenience of texting or just following people on social media. Some few consciously buck this trend but many Americans and seniors today have no family nearby, no religious affiliations and few, if any, community connections. All this artificial “connectedness” may stimulate the highly educated among us and excite the socially nimble but for most Americans, including most seniors, losing their jobs to retirement, factory closings, automation or business closures, have left a void that’s been difficult to fill. Younger generations have the flexibility to find new jobs or move into entrepreneurism—the gig economy—but for older Americans and seniors, losing a job later in life or being forced to retire is a life-changing event. Being an Uber or Lyft driver was never their life’s ambition. _____________________________________________________ Bruce Weaver enlisted in the Air Force in 1973 and attended one of the first Air Force PA programs, spending 20 years of his Air Force career in Family Medicine, Emergency Room de-partments and Internal Medicine clinics across the U.S. From clinical care to command positions, Bruce finished his 30-year career as Chief, Health Promotions at the USAF Surgeon General’s office, Washington D.C. After retiring from the Air Force in 2003, he and his wife, Charlene, an RN, opened AAging Bet-ter In-Home Care. Together they built AAging Better In-Home Care into the largest home care agency in North Idaho with over 250 caregivers and nurses. With offices in Post Falls, Sandpoint and Spokane Valley, they offer a full spectrum of in-home services from post-acute care to longterm care including partnering with Hospice and Home Health agencies when needed. They take great pride in being able to care for virtually any client in their home, regardless of the complexity, disability or physical need of the client. The agency can be reached online at www.aagingbetter.com or Toll Free in Idaho at 866-464-2344 and in Washington at 844-814-8080.

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iN2L Proves — It Is Never Too Late!

by Tina Mouser, Executive Director The Renaissance Assisted Living

echnology is a normal part of our daily lives in this day and age. However, what role does technology play in the lives of older adults or those with Alzheimer’s or other forms of dementia? Often, individuals who are affected with some form of memory loss are considered disinterested in or incapable of interacting with technology. However, this is simply not the case. Today, we have an interactive technological system available for individuals and those in long term care (LTC) communities who are experiencing memory issues. iN2L is an acronym for the program, “it’s Never 2 Late” which promotes dignity through technology. This system is proving that technology can be utilized by all because it is never too late to learn.

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The innovative technology for the iN2L program began in 1999. Jack York, iN2L President and Co-Founder states, “It is dedicated to helping older adults realize the full benefits of today’s technology.” The picture-based, user-friendly, touch screen interface enables everyone to be capable of utilizing this system. The Renaissance at Coeur d’Alene Assisted Living Community has implemented an iN2L system in all five of their cottages. Having the iN2L program within each cottage enables residents to utilize and learn to navigate the system at their discretion. There are a multitude of applications available on the iN2L system. Applications such as memory games to assist with maintaining or improving memory, exercise videos to encourage physical activity, and even Skype capabilities to promote familiar relationships with family and friends, are just a few being utilized at The Renaissance Assisted Living Community. The iN2L program updates regularly, therefore providing new material for its users. With the wide array of interactive activities, residents can find something that appeals to them. The generational barrier that can often be found between care staff and residents within long term care is being bridged with each

use, particularly with the “My Page” tool. Within My Page, healthcare team members and residents are able to create a “My Story” which allows individuals to learn about those within the community (staff and residents) who are interacting with one another. This provides a wonderful opportunity for staff to gain far more knowledge about those for whom they are caring, and for residents to know the caregivers on a more personal level. With the influx of those experiencing cognitive issues, having the opportunity to provide interaction for these individuals through this innovative technology is astounding. Meeting residents’ needs is of the highest priority and it is apparent that utilizing such tools as the iN2L system is a valuable resource. It’s Never 2 Late offers a variety of systems to meet the needs of all concerned. The Renaissance at Cœur d’Alene is currently using iN2L’s mobile 27-inch system for personal use by residents and staff; in three of five cottages, there is a mobile 40-inch system; and in two cottages there is a mounted 60-inch system. While these are not the only systems available for use, they are an example of the array of systems available. More information can be found at iN2l.com. Being able to help individuals stay mentally and physically active is the key component to iN2L’s premise. Technology is going to continue to develop and iN2L is a leader in integrating technology and cognitive deficits. While

individuals learn to use interactive systems at all stages of memory impairment, it becomes apparent that it is never too late. ________________________________________________________ Tina Mouser, Executive Director of The Renaissance at Coeur d’Alene, has been providing healthcare services for over twenty years. Tina holds a Bachelor’s Degree in Social Work from Lewis Clark State College and is a Licensed Social Worker and Licensed Assisted Living Facility Administrator. Caring for the aged has been her focus for many years and she is an active community participant advocating for the dignity and respect for those she serves.

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Family Caregiving and

Stress

Better Hearing...Better Living.

Audiology Research Associates

by Jan Noyes, Associate Ombudsman Area Agency on Aging of North Idaho

since 1977

www.hearingtricities.com

Hear the difference we can make!

any caregivers report an increased purpose in their lives, a joy in giving personal, loving care to a loved one who can no longer live independently. But there’s another serious, and potentially dangerous, side to family caregiving…stress.

We provide the very best in hearing loss treatment. Experts in digital hearing aids • 30-day trial program. Reasonable pricing and hearing aids of most types and styles. 3-year warranties and 3-year free batteries with purchase of new digital hearing aids.

Caregiver Burnout No matter how willing, loving and efficient caregivers are, they can become so focused on the needs of their loved ones that they neglect their own needs. They may become exhausted, irritable, and anxious and run the risk of burnout. Sleep problems, mood swings, and depression need to be addressed before they turn into behavior or health issues. Burnout affects the health of the caregiver and the quality of care. The intensity of stress that often accompanies caregiving can promote physical and emotional problems for the caregiver. Prolonged stress is dangerous and can lead to high blood pressure and heart disease. Depression can lead to the inability to function and to thoughts of suicide. Burnout affects the health of the caregiver and the well-being of the one receiving the care. Caregivers may neglect their friends and forget what going to a movie or out to lunch feels like. Reading a book, getting a good night’s sleep, taking a leisurely walk, and tending the garden become just a memory…because all their energy and attention has gone into taking care of someone else’s needs. So, what is a stressed caregiver to do? Caregivers sometimes feel guilty about asking for help but seeking respite even for a short time, for either caregiver or care recipient, can be restorative and make a positive difference in the quality of care and the well-being of both caregiver and care receiver. There is help and support available.

Help ~ Information ~ Support Burnout can happen to anyone, so it is important to have a plan in place as early as possible. How will family and friends participate? Who can be called to help; where is respite provided; what services are available; what agencies can provide information and assistance?

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Area Agency on Aging of North Idaho........ 208-667-3179 Adult Protective Services.............................. 208-677-3179 Alzheimer’s Association............................... 208-666-2996 Disability Action Center.............................. 208-457-3891 Assistive Devices........................................... 208-364-4561 Idaho Commission for the Blind and Visually Impaired ...................................................................... 208-769-7077 Health and Welfare (Medicaid Services)..... 208-769-1567 Legal Aid........................................................208-215-3509 TESH (Opportunities for people with disabilities) .......................................................................208-765-5105 Relations as Parents...................................... 208-803-0944 Caregiver Alliance.......................... 800-445-8106 toll-free ....................................................... https://www.caregiver.org

Jan Noyes holds a degree in education and has used her teaching skills in public schools, adult education , workshops and seminars for church and civic groups, and corporations. Jan has been an ombudsman with the Area Agency on Aging for ten years, recruiting and training new ombudsmen. Jan also acts as an ombudsman, visiting facilities and advocating for their resident rights, quality of care and quality of life.

Kevin W. Hague, M.A. CCC-A Certified Audiologist

Karen Torosian, M.S. CCC-A Certified Audiologist

COEUR D’ALENE • 208-765-4961 • Interlake Medical 700 Ironwood Drive, Suite 220 SANDPOINT • 208-255-4389 • 123 S. Third Avenue

Important Documents A family caregiver often handles health care, financial and legal matters for the loved one. There are several documents to put in place. Consulting an elder law attorney to help with legal matters is an option. Legal aid is a good place to start. • Last Will and Testament • Advanced Directive or Living Will • Durable Powers of Attorney for Financial and Healthcare • Guardianship/Conservatorship (as a last resort) Being prepared is the best way to meet the challenges that are inevitable with caregiving.

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Guardianship and Conservatorship: Affronting or Approachable?

by Katherine M. Coyle, J.D., Certified Elder Law Attorney* Coyle & Wytychak Elder Law *Certified by the National Elder Law Foundation

he words “Guardianship and Conservatorship” can be scary for a family to hear. They evoke the image of an intimidating court process: the formidable judge, the mahogany courtroom, the aggressive attorneys, I could go on. Many of my clients have heard these words in a negative context or in terms of a “last resort.” I, on the other hand, see Guardianship and Conservatorship as a useful tool for families in navigating the disability or aging landscape. When navigating the complicated twists and turns of life, Guardianship and Conservatorship can be an important arrow to have in your quiver. In a nutshell, Guardianship and Conservatorship are legal cases in which a judge grants a person decision making authority over another person who is unable to make decisions on his or her own due to an incapacity of some sort. First, let’s get the vocabulary out of the way. In Idaho, our statutes speak to “Guardianship” of the physical person and “Conservatorship” of the financial affairs of a person. This differs from other state’s terminology, which makes it very confusing. Washington State has “Guardianship of the Person” and “Guardianship of the Estate.” California has “Conservatorship of the Person” and “Conservatorship of the Estate.” The important distinction to make in all states is the difference between the decisions for the physical person (for instance, where they live, what doctor they see, what medical interventions should be done, what prescriptions to take, etc…) versus the decisions for the financial affairs of that person (for instance: investment decisions for funds, the sale of real property, making an insurance claim, litigation, paying bills, etc…). For the purposes of this article, I will stick to Idaho’s terms of Guardianship of the physical person and Conservatorship of the financial affairs. There are three different types of guardianships and conservatorships:

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The first type is for minor children whose parents are unable to care for them. Often family members apply for a court guardianship and conservatorship to be able to make parental decisions for a minor child. • The second type is for adults who are developmentally disabled. Most often, these cases are the parents of a disabled child who has become eighteen years of age. Generally, when a person turns eighteen, he or she can make his or her own decisions. When this is not practical due to a developmental disability (in Idaho, “developmental disability” would be any incapacity diagnosed prior to age twenty-two), the parents (or other family member) can apply to the courts for a guardianship and conservatorship to be able to assist their child in decision making for the rest of his or her life. • The third type of guardianship and conservatorship is for an incapacitated adult, who has lost the ability to make reasonable health or financial decisions. This can be due to medical issues such as brain injury, stroke, dementia, psychosis, or any other diagnosis that can cause incapacity. As I stated before, many people think that guardianship and conservatorship is an extreme process and that it gives the guardian and conservator carte blanche authority to reign over the protected person. While there have certainly been some examples of abuse of the process, I find that Guardianship and Conservatorship is, for the most part, a collaborative, constructive process, where the heart of the issue is what is best for the protected person. Let’s get one thing straight — this process is for people who are truly disabled, not just someone who may be •

making questionable decisions in someone else’s eyes. I had someone come into my office looking to get guardianship and conservatorship over a parent who had taken up romantically with someone younger and now spends time traveling and going to casinos. When I pushed for more information about whether or not there has been some sort of medical diagnosis that made the person vulnerable or unable to understand the consequences of the decisions being made, I was told, “Oh no! Sharp as a tack!” I promptly educated the person as to the use of this process and told them to let their parent continue living the life they choose. In fact, Idaho’s laws were written to safeguard the proposed protected person’s rights as much as possible. Idaho defines “incapacity” as a legal, not a medical disability to refer to any person who has suffered, is suffering, or is likely to suffer substantial harm due to an inability to provide for his or her personal needs for food, clothing, shelter, health care, or safety, or an inability to provide for his or her property or financial affairs. Our statutes further preserve the rights of the protected person by restricting the guardian and conservator’s authority to only the “least restrictive means.” Idaho Code states, [i]t is desirable to make available the least restrictive form of guardianship to assist persons who are only partially incapable of caring for their own needs. Recognizing that every individual has unique needs and differing abilities, the public

welfare should be promoted by establishing a guardianship that permits meeting the essential requirements for their physical health and safety, in protecting their rights, in managing their financial resources, and in developing or regaining their abilities to the maximum extent possible; and that accomplishes these objectives through providing, in each case, the form of guardianship that least interferes with the legal capacity of a person to act on his own behalf. I hope this article has corrected some misconceptions that exist regarding the guardianship and conservatorship process. As the statutes allude, each case is different. If you are weighing this process for your family, consult an Elder Law attorney to go over your options and decide what route is best for you. ___________________________________________________________________

Katherine (Kate) Monroe Coyle is a Certified Elder Law Attorney (CELA) at Coyle & Wytychak Elder Law. She has been practicing Elder Law in North Idaho since 2008 and a graduate of the University of Montana and Gonzaga University School of Law. Kate is one of 5 CELA certifications in the State of Idaho. She is active on the Kootenai Health Ethics Advisory Committee, serves as counsel for the Kootenai County Board of Community Guardians, and is a member of the local CareNet chapter, and the National Academy of Elder Law Attorneys. Kate is an active educational speaker for the Alzheimer’s Association and is on the Coeur d’ Alene Estate Planning Council.

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Medicare – Important Notes and Changes for 2020

by Noreen Brisson SHIBA Volunteer Services Coordinator

Fall is here, which means Medicare Annual Enrollment is in full swing and the new benefit year is around the corner, so here are some important notes and changes for 2020.

any plans are changing their premiums and coverage, and new plans are being offered In Idaho in 2020. The best way to know you have the best Prescription Drug Plan (PDP) or Medicare Advantage Plan (MA/MAPD) is for you is to complete a review of your coverage before December 7.

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Medicare Advantage plans will be available in Shoshone County (in addition to Kootenai, Boundary, Bonner, Latah, and Nez Perce). Medicare Advantage plans are managed care with networks of providers. They are required to provide coverage that is as good, or better than Medicare and offer a maximum out-of-pocket limit for Medicare expenses. They might also include extra benefits, such as allowances for over-the-counter medications and basic dental and vision services. Medicare Advantage (MA) plans both with and without prescription drug coverage are available in Idaho in 2020. Medicare Advantage plans without drug coverage CANNOT be combined with Part D drug plans. If you do not have prescription drug coverage through another source - such as the VA – you must buy a Medicare Advantage plan WITH Prescription Drug (MAPD) to have coverage for drugs purchased through pharmacies. Medigap Plans F & C are not going away, but will not be available to everyone, either. Plan F and Plan C Medigap plans will not be sold to those newly eligible for Medicare in 2020. A high-deductible Plan G will be available beginning January 1.

The 2020 national base rate for calculating Part D penalties is $32.74/month. People without creditable prescription drug coverage who do not sign up for a Medicare drug plan when first eligible for coverage may have to pay a late enrollment penalty if they enroll later. The penalty is calculated by multiplying 1% of the base premium (.3274) by the number of uncovered months, then rounding to the nearest ten cents. The penalty amount is added to monthly drug plan premiums and re-calculated each year based on the new base beneficiary premium amount, so it may go up or down each year. The Coverage Gap (AKA the Donut Hole) is (sort of) closing in 2020 – Covered brand-name and generic drugs are discounted 75%, so beneficiaries pay 25% of the retail price. Beginning in 2020, beneficiaries only pay 25% of the price until they reach the out-of-pocket spending limit ($6,350 for 2020), and enter the catastrophic coverage benefit period. Starting January 1, 2020, claims must be submitted using the new Medicare Beneficiary Identifier (MBI). New Medicare cards were mailed to all Medicare beneficiaries in 2018. After January 1, claims filed using a Social Security Number will be rejected. To avoid problems, be sure your medical care providers have your new Medicare “number” before the start of the new year. Medicare.gov website and Medicare Plan Finder updated - If you like to manage your Medicare online, but haven’t been on the Medicare.gov website in the past few months, you will notice some big changes. • The Medicare Plan Finder has been updated and redesigned to be more user friendly. • Medicare.gov now has a “What’s Covered” mobile app and search box on the website. • eMedicare and MyMedicare accounts have expanded online self-service. Medicare beneficiaries are now able to print their own replacement Medicare cards and make online premium payments.

What hasn’t changed – Idaho SHIBA offers free, unbiased Medicare information, workshops, presentations and resources, and has Medicare counselors available throughout Idaho. For more information, call 800-2474422 or visit http://doi.idaho.gov/shiba _____________________________________________________ Noreen Brisson is a Volunteer Services Coordinator with the Senior Health Insurance Benefits Advisors (SHIBA) program in Coeur d’Alene. She has been a member of the Department of Insurance and SHIBA staff for over 7 years and loves winter, her granddog, and helping fellow Idahoans learn about Medicare.

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Long-Term Care and Medicaid, Myths vs. Facts Medicaid Myths by John Todd, Medicaid Planner ElderCare Financial, LLC

aying for long-term care can take one of several forms:

• Medicare - covers only a portion of long-term care costs up to 100 days; 20 days are provided at no cost and the remaining 80 are at a significant co-pay for the insured. • Long-term disability insurance - covers your lost income, but doesn’t pay for any LTC needs. Oftentimes, when your job ends, so does your coverage. • Health Insurance - does not cover long-term care expenses. Medigap policies are health insurance and also do not cover LTC expenses. • Self-Insure - assets used to pay for long-term care can deplete future income for your spouse as well as drain the inheritance you planned to leave for your loved ones. • Long-Term Care Coverage - There are various insurance products that may help cover the cost of your long-term care, while offering you the flexibility, choice and control over how you receive that care. The original Long-Term Care policies were quite expensive and were “use-it-or-lose-it” policies. The major insurance companies are now providing new features on life insurance policies that can help with long-term care. If you have not explored this in the last six-months, this might be a good time to do some planning with your insurance agent. • Family members - even the most responsible, are not always prepared physically, emotionally or financially to care for their loved one. 53% of Americans caring for a loved one lost income due to the demands of providing that care.4 • Medicaid - covers long-term care expenses for individuals. When Long-Term Care become medically necessary, Medicaid may be an option. Medicaid is usually considered a last resort for the most financially needy. However, with long-term care coverage, there are several federal provisions that must be allowed in every state. One of the main protections allows one spouse to be approved for Medicaid and protects some of the income and assets so as not to impoverish the well spouse that is continuing to live in the community.

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Myth #1 - Medicaid is only for “broke people.” Reality - Medicaid does have income and property guidelines. However, most, especially couples, are NOT too rich for Medicaid when one spouse needs long-term care. Myth #2 - You have to “spend-down” all your assets to qualify for Medicaid. Reality - Not exactly. Federal Law gives couples special treatment to reposition assets. Myth #3 - There is a five-year look-back that won’t allow for any movement of money. Reality - Yes, there is a five-year look-back/ review for any assets that were given away or sold for less that full value. There are some exceptions to this rule involving gifts for disabled children (of any age) and children that have been providing care for their parents. Also, federal law allows for re-positioning of assets between couples, and limited gifting might make sense in some cases. Myth #4 - Medicaid will take my house. Reality - Medicaid is not coming to kick you out of your house. The Medicaid Estate Recovery provision DOES allow Medicaid to put a lien against your home, upon the passing of the couple, to help recover what they have spent on your behalf. During your life-time, you get to live in your home, just like you always have. Note: Because Medicaid has rules for every situation, including both state and federal laws, a couple with over $25,000 may do well to consult with an Elder Law Attorney or Medicaid Planner to fully utilize these provisions.

qualify for Medicaid for George? Unfortunately, the answer varies and is based on the state in which they live. With the help of a qualified Medicaid Planner, federal provisions would allow them to keep virtually all of their assets. George could qualify for Medicaid to help cover the Memory Care costs while not robbing Debra and Caylee of their future plans.

With the help of a qualified Medicaid Planner federal provisions would allow them to keep virtually all of their assets.

Next Steps There are a few things that all of us can do to help prepare for possible long-term care needs. Legal-Work: Everyone needs to get some basic legal work done. This would include a Last Will for the disposition of your assets, a Living Will to express your wishes concerning

medical care when you are unable to express your wishes, Health Care/Mental Health Power of Attorney, and Financial Power of Attorney, allowing someone else to handle your financial affairs when you are no longer able. LTC Pre-planning: If you are over the age of 40, don’t wait until a crisis to set yourself up for success. Explore LTC options with your insurance agent. You can save yourself time, money and a ton of stress. Long-Term Care Crisis Planning: If your loved-one is already needing long-term care, it is likely he can qualify for Medicaid. If you’ve been told you probably don’t qualify for Medicaid because of your finances, contact a Medicaid Planner who can review whether federal provisions have been correctly applied. ____________________________________________________ John Todd is a Medicaid Planner working as an independent agent with The Krause Agency, which provides Medicaid Planning in all 50 states. John is an independent insurance agent, licensed to sell Medicaid compliant financial products in Idaho, Washington and several other states. He previously worked for five years in the Idaho Medicaid office, reviewing Long-Term Care Medicaid applications.execution of clinical trials.

Example Debra is 51 years old, healthy and working. George is 64 and needs Memory Care Assisted Living. His condition is noncurable and is worsening. George and Debra have a 13-year old daughter, Caylee. Based on George’s physical health and age, it is possible that George could need care for another 20 years. Current cost for George in the Memory Care Assisted Living is about $6,000/month. Thankfully, they have their home paid for, free and clear. They also have bank accounts and investments of about $270,000. Of course, they need to be able to manage expenses in the community for Debra and Caylee. Eventually, there will be college costs, home repairs, maintenance and replacement of vehicles, etc. How much should Debra get to keep? How much should the couple have to “spend-down” before they

Caring for someone with Alzheimer’s or dementia?

You're not alone. We're here to help.

24/7 Helpline

1.800.272.3900 alzwa.org Wise Guide | www.TheWiseGuideOnline.com

Alzheimer’s & Dementia:

Early Detection & Diagnosis is Key

by Joel Loiacono, Regional Director, E. WA & N. ID Alzheimer’s Association

tudies have shown that fewer than half of people living with dementia have actually received a diagnosis. The fact that these diseases are going unrecognized and undiagnosed is a significant issue. Why? Because early detection and diagnosis offers many benefits to the person living with the disease and their loved ones. It also allows the person to play an active role in planning for their future and making the most of life. Here are a few key benefits of early detection and diagnosis: • Accurate diagnosis – Seeking an early diagnosis can help determine if someone’s cognitive changes are truly due to Alzheimer’s or dementia. The person may have another, possibly treatable, condition that’s affecting their memory or cognition. • Medical benefits – Early diagnosis allows individuals to adopt lifestyle changes that may help preserve their existing cognitive function for as long as possible. Such interventions include controlling blood pressure, smoking cessation and exercise. While current medications do not prevent, stop or reverse Alzheimer’s, they can help lessen the symptoms, such as memory loss and confusion, for a limited time. An early Alzheimer’s diagnosis provides you with a better chance of benefiting from treatment. • Participation in clinical trials – Early diagnosis allows individuals to enroll in clinical trials that advance research and may also provide other benefits such as: expert medical care at leading healthcare facilities (often free of cost) and access to potential treatments before they’re widely available to the public. Participating in clinical trials also allows people to play a more active role in their healthcare and help future generations by contributing to Alzheimer’s research. • Emotional and social benefits – Early diagnosis provides individuals with the best opportunity to spend time doing meaningful activities and interacting with

Wise Guide | Winter/Spring 2020

the most important people in their lives. It also gives individuals living with the disease and their loved ones time to take advantage of educational opportunities, connect with others in a similar situation and build a community network of support that will sustain them throughout the dementia journey. • Planning for the future – Early diagnosis allows individuals more time to plan for the future while they are still able to make their own legal, financial and endof-life decisions. It allows families to address potential safety issues, such as driving and wandering before a crisis occurs. Making these plans can give individuals peace of mind, while reducing the burden on family members and preventing disagreements about future care decisions. Close family members are typically the first to notice memory issues or cognitive problems, but they are often hesitant to say something – even when they know something is wrong. The Alzheimer’s Association encourages families to trust their instincts and address cognitive concerns early and proactively before a “crisis situation” arises. If you notice changes in friends, family or others close to you and are concerned for their health — particularly when it involves changes in memory, thinking or behavior — it can be difficult to know what say or do. The “ABC” steps below can help: A. Assess Changes – What changes in memory, thinking or behavior do you see? Has anyone else noticed changes? Learn the warning signs of Alzheimer’s and keep track of what you’re noticing. B. Begin a Conversation – Plan ahead and decide on the best approach for discussing your concerns. Where and when should you have the conversation? Who should be involved? When it’s time to talk, try starting with something simple, such as: “How have you been feeling lately? You haven’t seemed like yourself.” C. Contact a Doctor and the Alzheimer’s Association for help – If you or a loved one are experiencing any of the warning signs of Alzheimer’s or dementia, it’s important to see a doctor as soon as possible. You may also call the Alzheimer’s Association at any time, day or night, for information or guidance at 1-800-272-3900. __________________________________________________________________

Joel Loiacono has been with the Alzheimer’s Association for nearly 20 years and currently serves as the Regional Director for Eastern Washington and Northern Idaho. He holds a Master’s in Public Administration and a certificate in health care administration from Eastern Washington University.

Alzheimer’s Association Support Groups Why struggle alone? Attendees share their knowledge and experience of what works and what doesn’t in caring for themselves and loved ones. Groups are facilitated by professionals and are confidential. Come — learn — and get solutions. TELEPHONE

24/7 HELPLINE: 800-272-3900

ONLINE ALZConnected.org An online social networking community for people with Alzheimer’s, their caregivers and others affected by the disease. ALZ.org for more valuable resources! IDAHO PANHANDLE

• Kootenai Health Medical Center, Coeur d’Alene Main Building - Main Floor Classrooms 3rd Saturday @ 1:30 - 3:30 PM Facilitators: Arlene Sleigh 208-772-2542, Connie Clark, CSA 208-660-2030 • St. George’s Parish Hall 2004 N. Lucas St., Post Falls 1st Wednesdays @ 2-2:30 PM Facilitators: Rosemary McDougall, RN 208-699-6060 & Ene Gaines 208-970-8471 • Sandpoint Senior Center, Sandpoint 820 Main Street 1st & 3rd Thursdays @ 1:00 - 2:00 PM Facilitators: Jan Griffitts 208-290-1973 & Liz Price 208-263-7889 (Free respite care at DayBreak Center next door with advanced reservation - 208-265-8127)

MEMORY CAFÉ

Who: Persons diagnosed with Alzheimer’s or related Dementia and care partners. What: A casual and FREE gathering to provide socialization, interaction and fellowship, creating a sense of belonging, well-being and confidence. • Kroc Center Café 1765 W. Golf Course Rd., Coeur d’Alene 2nd & 4th Mondays at 1:00 PM • Connie’s Café 323 Cedar Street, Sandpoint 2nd Wednesdays 10:00 AM • Skyway Café at Felts Field 6105 E. Rutter Ave., Spokane 1st & 3rd Mondays from 10:00 -11:30 AM

EASTERN WA: SPOKANE NORTH

• Church of the Nazarene 9004 N. Country Homes Blvd. Last Thursdays of each month @ 6:30 - 8:00 PM Facilitators: Gene Engelbrecht 509-842-6034, Dawn Keig, PhD 509-808-4076 • Whitworth Presbyterian Church 312 N. Hawthorne Road 2nd Mondays @ 1:00 - 2:30 PM Facilitators: Christine Ambrose, RN & Paul Dionne 509-290-1816

DEER PARK

• St. Mary’s Presentation Catholic Church 602 E. 6th St., Deer park 2nd Wednesdays @ 1:00 - 2:30 PM Facilitator: Paul J. Dionne 509-290-1816

SPOKANE SOUTH

• First Presbyterian Church 318 S. Cedar Street 3rd Tuesdays @1:30 - 3:00 PM Facilitators: Beth Priest 509-590-3965 & Norma Juarez 509-389-5458

SPOKANE VALLEY

• Spokane Valley Senior Center Center Place, Room 235 2426 N. Discovery 2nd Thursdays from 1:00-2:30 PM Facilitator: Erika Grant 509-904-82

NORTHWEST MONTANA

• Immanuel Lutheran Church, Kalispell Buffalo Hill Terrace, 40 Claremont Street 3rd Monday @ 3:00 PM Call 406-849-6207 for information • Presbyterian Church of Polson 301 4th Ave. East 2nd Wednesday @ 1:30 PM Facilitator: Arlene 406-849-6207

EARLY STAGE SOCIAL ENGAGEMENT for people with dementia & their family. Please contact Coeur d’Alene branch office to register 208-666-2996

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Crossword The Catâ&#x20AC;&#x2122;s Meow Across

Down 1 2 3

Blows over Deal maker Brooklynâ&#x20AC;&#x2122;s ___ Island

4 Sense of self 5 Spotted cat 6 True inner self 7 Hoity-toity sorts 8 Large wine casks 9 German river 10 Tropical American wildcat 11 â&#x20AC;&#x153;Rule Britanniaâ&#x20AC;? composer 12 Bargain 13 Vittles 18 Kind of plan 22 â&#x20AC;&#x153;Buenos ___â&#x20AC;? 25 Be a snitch 26 Legal matter 27 Jezebelâ&#x20AC;&#x2122;s idol 28 ___ slaw 29 Jewish month 30 Sawbucks 31 Canvas cover 32 Inkling 33 Thug

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34 Carnival 35 Unlock, in verse 38 Kind of school 39 Battleship letters 41 Units of resistance 42 Imperial decree 44 Some cross-breed cats 45 Stable worker 47 Burgundy grape 48 Perspective 49 Playing marble 50 Travelerâ&#x20AC;&#x2122;s stop 51 Outmoded 52 Art ___ 53 Essenâ&#x20AC;&#x2122;s river 54 Mystery writer Ambler 55 Cougar 58 Moose ___, Saskatchewan 59 Trophy Copyright ÂŠ2019 PuzzleJunction.com

1 Kind of lift or card 5 Hindu social division 10 Green gem 14 Spellbound 15 Per ___ (yearly) 16 Atlas stat 17 They take â&#x20AC;&#x153;prideâ&#x20AC;? in each other 19 Pesky insect 20 Chemical suffix 21 Branches 22 Some showdowns 23 Itâ&#x20AC;&#x2122;s often sloppy 24 Wood sorrels 25 Spanish aunt 26 Milne marsupial 27 Civet of Asia 31 Striped wildcat 34 Farm young 36 Flowery verse 37 Ruckuses 38 Kind of cross 39 ___ Bator, Mongolia 40 Old Olds 41 Bay window 42 Consumers 43 Large spotted feline of tropical America 45 Gives the green light 46 Rascal 47 â&#x20AC;&#x153;Que ___?â&#x20AC;? (Sp.) 49 Basic unit of electric current 52 Grounds 55 Pub orders 56 Manila bean 57 Continental coin 58 Leopards and the like 60 Goateeâ&#x20AC;&#x2122;s locale 61 Detergent plant 62 Western Indians 63 Tolkien creatures 64 No-cal drink 65 Brazilian soccer legend

Sudoku

Home of the Famous Orange Roll Wedding Cakes â&#x20AC;˘ Dimensional Cakes Birthday and Special Event Cakes Specialty Cupcakes and Cookies Cheesecakes and Pies

How to Play Sudoku To solve the Sudoku puzzle, each row, column and box must contain the numbers 1 to 9. Crossword and Sodoku answers on page 85

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Care & Services 4 24-Hour Skilled Nursing Our amazing team 4 Long-Term Care of physicians, therapists, 4 Short-Term Rehab dieticians nurses and OPENING OCT. 1st â&#x20AC;&#x201C; other caregivers NEW SECURED focus on providing MEMORY CARE UNIT exceptional www.coeurdalenehealth.com clinical care. 1-208-664-8128 Wise Guide | www.TheWiseGuideOnline.com

Directory Listings Agencies & Free Referral Services Alzheimer’s Association N. Idaho Office............................................................... 208-666-2996 24-Hour Help line.......................................................... 800-272-3900 alz.org * P.J.Christo, RN; email: pj.christo@alz.org We connect families to needed programs, products and services, provide Dementia Information, Local Support Groups, State and Federal Advocacy, educational programs, workshops and lectures for caregivers, families and the general public. Area Agency on Aging of North Idaho............................208-667-3179 Toll Free.......................................................................... 800-786-5536 2120 Lakewood Dr., Ste. B, CdA • aaani.org AAANI is a grant funded agency providing services for seniors including information on in-home and community services, senior center meals, home delivered meals, homemaker, respite for family caregivers, legal assistance, adult protection, long term care ombudsman, long term care options counseling, hospital to home care transition, and volunteer opportunities. Compassionate Care Referral Service............................ 208-660-9982 compassionatecarereferral.com I can refer you to the best fit for your Assisted Living, Senior, and Disabled Care Services. Through mutual discussion and needs assessment, I will create for you a customized short list of possible solutions. Northwest Parkinson’s Foundation................................509-443-3361 1420 E. Sprague Ave., Ste. 103, Spokane • nwpf.org We help people with Parkinson’s and their loved ones experience improvement in physical symptoms, reduction in anxiety and a clear path forward on the journey with Parkinson’s.We bridge that gap between diagnosis and cure, with the best evidence-based programming available at no or low cost. Pend Oreille County Prevention Services ......................509-447-6419 GetTheFactsRx.com • www.StopOverdose.org www.TakeBackYourMeds.org Pend Oreille County has three Community Prevention and Wellness Initiative (CPWI) Coalitions working to create healthier communities for youth and families. We are sponsored by the Health Care Authority and implement evidenced-based programs and community educational events. We’ve created Action Plans based on local data and community collaboration. We are here to create positive change, promote healthy lifestyles, and reduce youth substance use rates in schools and communities. Our coalitions are the Newport Youth Task Force, Cusick’s Panther Country Coalition, and the Selkirk Wellness Coalition. Sandpoint Community Resource Center........................208-920-1840 231 N. Third Ave, Ste. 101 Sandpoint SandpointCommunityResource.com We are here to help you find needed social services in Bonner and Boundary Counties. We have a library of over 400 state and local resources and can assist you in person, via email or online to easily access available services. Senior Medicare Patrol........................................... 208-667-3179 x232 Toll Free..................................................................800-786-5536 x232 2120 Lakewood Dr., Ste. B, CdA • aaani.org We work to prevent Medicare Fraud. Volunteers like you are trained and provide community outreach to educate and inform consumers on how to prevent, detect and report Medicare fraud and abuse. Want to help? Come join us!

SHIBA (Senior Health Insurance Benefits Advisors) ........................................................................................ 800-247-4422 2005 Ironwood Pkwy, Ste. 143, Coeur d’Alene • doi.idaho.gov/shiba SHIBA is a division of the Dept. of Insurance. SHIBA counselors offer free education and assistance about Medicare benefits, plan choices and billing. SHIBA counseling is done by phone, email or at community partners locations throughout Idaho.

Chiropractic & Massage Therapy Camas Center Clinic......................................................... 509-447-7111 1821 W. LeClerc Rd. #1, Cusick, WA kalispeltribe.com/camas-center-clinic The Camas Center Clinic offers comprehensive healthcare including: medical, dental, chiropractic, physical therapy and massage therapy. The clinic is open to the general public and accepts most major commercial and public insurance carriers. Ride Monday-Thursday round-trip from Newport to Clinic. Suggested donation $1. Call 800776-9026 for more info. Moore Chiropractic 6843 Main St., Bonners Ferry..........................................208-267-2506 danmooredc.com Providing gentle, effective, quality care that’s affordable for everyone. Dr. Daniel Moore has over 25 years experience utilizing the latest techniques and chiropractic physiotherapy technologies ensuring the fastest recovery time possible. Come see why over 4,000 patients have trusted Dr. Moore with their health!

Counseling & Support Bonner General Behavioral Health.................................208-265-1090 Pinegrove Bldg., 606 N. Third Ave., Ste. 102 Sandpoint bonnergeneral.org/behavioral-health Bonner General Behavioral Health offers outpatient mental health services from our licensed psychologist, Dr. Joe Wassif, and psychiatric services for adults, provided by our board-certified psychiatrist Dr. Terry Johnson. Colonial Clinic................................................................509-327-9831 910 N. Washington, Suite 210, Spokane WA • ColonialClinic.com Intensive Outpatient Substance(s) misuse treatment for family & addict/alcoholic. 34 years in Spokane. Evaluations/Assessments for inpatient and outpatient, Addiction Counseling, Family Therapy, Mental Health Counseling, Dual diagnosis treatment. Family Support Groups, Educational Seminars, Relapse Prevention Therapy, Women’s Group. Free consultation! Call for costs. Most insurances accepted! Community Cancer Services........................................ 208-255-2301 1205 Highway 2, STE 101-B, Sandpoint communitycancerservices.com Serving anyone in Bonner and Boundary counties who have been diagnosed with cancer. CCS provides financial and emotional support to patients, families and caregivers affected by cancer. Heritage Health Mental Health....................................208-769-4222 2025 W. Park Pl., Ste B, Coeur d’Alene Family Support Services................................................208-620-5210 2201 Ironwood Pl., Ste.100, Coeur d’Alene • myheritagehealth.org We offer and provide excellent, affordable mental health services to individuals and families with unique situations and needs. A collaborative integrated care model with Family Support Services ,helps clients discover and strive to reach their full potential through care coordination with medical providers.

The Human Connection.............................................. 208-265-5412 2023 Sandpoint West Drive, Sandpoint • sandpointhc.com Confidential, Professional, Quality Support. Making a Huge Difference in the lives of Couples, Families and Individuals since 1991 in Sandpoint, Idaho. Call “Our Team of Genuinely Caring Counselors” to see if we would be a good fit for you.

Heritage Health Dental Care........................................ 208-620-5250 1090 W. Park Pl., Coeur d’Alene • myheritagehealth.org Our patients benefit from our skilled, caring staff, advanced technology, and modern dental treatments. Whether you are bringing your family in for a regular check up or are in need of restorative dental care, you can trust us to keep your smile looking its best!

Kaniksu Health Services................................................ 208-263-7101 Behavioral Health • 6615 Comanche St., Bonners Ferry 30410 Hwy 200, Ponderay 6509 Hwy 2, Ste. 101, Priest River 420 N. 2nd Ave., Ste. 100, Sandpoint kaniksuhealthservices.org Kaniksu Health Services is a nonprofit community health center which plays a vital role in Idaho’s safety net by providing medical, dental, behavioral health and VA services to the residents of Bonner & Boundary Counties.

Kaniksu Health Services................................................ 208-263-7101 6615 Comanche St., Bonners Ferry 30410 Hwy 200, Ponderay • kaniksuhealthservices.org Kaniksu Health Services is a nonprofit community health center which plays a vital role in Idaho’s safety net by providing medical, dental, behavioral health and VA services to the residents of Bonner & Boundary Counties.

Pend Oreille County Counseling Services .....................509-447-5651 After Hours Crisis Services...........................................866-847-8540 105 S. Garden Ave., Newport, WA pendoreilleco.org/your-government/counseling-services Outreach Offices: Cutter Theater in Metalline Falls & Selkirk School District. Providing quality integrated behavioral healthcare (mental health and chemical dependency), and supportive services for adults, adolescents, children and families of Pend Oreille County. We promote the values of consumer driven recovery, resiliency and selfdetermination, working collaboratively to provide outpatient, crisis, prevention and psycho education services. “The Struggle Became My Strength” www.amazon.com/Struggle-Became-My-Strength-Recovery/ dp/1093760079 An amazing personal story of the struggle with opioid and alcohol addiction. It is written to help readers understand what their loved ones are experiencing, and to help those struggling with addiction to know that they are NOT alone, that there is hope, and there is help once you decide to seek it.

Dental Camas Center Dental Clinic......................................... 509-447-7111 1821 W. LeClerc Rd. #1, Cusick, WA kalispeltribe.com/camas-center-clinic The Camas Center Dental Clinic offers comprehensive dental healthcare for all ages. The clinic is open to the general public and accepts most major commercial and public insurance carriers. Ride Monday-Thursday round-trip from Newport to Clinic. Suggested Donation $1. Call 800-776-9026 for more information.

“I may be disabled, but I can try to do anything” Multiple Sclerosis Advocate Meeting Monthly Call or email for more details: beth@mswobbles.com

208-818-2150 76

Wise Guide | Winter/Spring 2020

Financial Planning, Insurance & Legal Crandall Law Group......................................................... 208-772-7111 8596 Wayne Dr., Ste. B, Hayden • crandalllawgroup.com The Crandall Law Group is a boutique law firm offering highly specialized, top quality legal services to clients in the Inland Northwest region in the areas of estate planning, business, elder law, probates, guardianships, tax and business succession planning. We offer free initial consultations during which we will review your estate, discuss your needs, and explain your planning options. Coyle & Wytychak Elder Law.......................................... 208-765-3595 314 E. Garden Ave., Coeur d’Alene • cwelp.com Since 1987, Coyle & Wytychak Elder Law, PLLC has provided the senior and disabled population of North Idaho and their families with individualized service to help them through difficult issues related to Estate Planning, Probates, Trusts, Guardianship, and planning for Long Term Care and Public Benefits. Edward Jones...................................................................208-255-2613 Ken Wood, Financial Advisor • ken.wood@edwardjones.com 477100 Hwy 95, Ste.B, Sandpoint At Edward Jones, we focus on serving the financial needs of individual investors of all ages and financial means. We have built our business by treating our clients as we would want to be treated, a simple idea that still makes sense in today’s complex marketplace. ElderCare Financial LLC................................................. 208-553-8634 ElderCareFinancial@gmail.com At ElderCare Financial we offer specialized financial planning for Long-Term Care. We provide FREE initial consultations and develop a personalized plan. Our Medicaid Planning helps families preserve assets while one spouse qualifies for Long-Term Care. Spears Insurance, Inc.......................................................208-265-2026 300 Bonner Mall Way, Ste. 48, Ponderay 1121 Mullan Ave., Ste. 208, Coeur d’Alene cspears4insurance.com There are many types of benefit plans. Which one is right for you? Let’s first understand the basics of Medicare in plain simple language, and then discuss other factors to finding the right coverage for you. Call me today to schedule your appointment. Serving ALL of NORTH IDAHO!

Fun Stuff – Exercise, Training, Recreation, Food, Shopping Friends of the Scotchman Peaks Wilderness..................208-290-1281 P.O. Box 2061, Sandpoint, ID 83864 • scotchmanpeaks.org The FSPW mission statement is: To protect the Scotchman Peaks for future generations through Wilderness designation, ongoing stewardship and education.

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Directory Listings Hearing

5% DI

Your North Idaho Recumbent Dealer

M COUNT Wiseention ! Guid e

Home of the comfortable, affordable, reliable and fun way to bicycle! Gary Dagastine Call or email for appointment gary@nwrecumbentcycles.com

208-818-5491

Audiology Research Associates 700 Ironwood Dr., Ste. 220, Cd’A .........................................208-765-4961 123 S. 3rd Ave., Ste. 9, Sandpoint ........................................ 208-255-4389 hearingtricities.com Serving North Idaho for over 20 years. We help you hear better! Hearing evaluations for adults and children. We sell the most advanced digital hearing aids available and each hearing aid comes with 3 to 5 years free batteries.

Hospice

Hospice of North Idaho Thrift Stores • honi.org 1823 N. 4th St, Coeur d’Alene.........................................208-667-5128 503 E. Seltice Way #5, Post Falls.....................................208-773-5076 Shop our huge selection of high quality, gently used items from furniture, books, electronics, craft sup-plies, kitchenware, linens, clothing, shoes, accessories, and much more. All proceeds go to Hospice of North Idaho, the community’s non-profit hospice.

Auburn Crest Hospice 1221 W. Ironwood Dr., Coeur d’Alene ..........................................208-665-8111 6371 Kootenai St., Bonners Ferry....................................208-267-0579 auburncrest.com We admit quickly upon doctor’s orders, equipment delivered within 4 hours. We listen to our patients, loved ones and caregivers to develop a care plan with the wishes of the patient first, allowing patients to live out their lives with trust, dignity, comfort and compassion.

Kalispel Park 370 Qlispe River Wy, Cusick, WA • kalispelcasino.com Nestled along the Pend Oreille River at the foot of the Selkirk Mountains, Kalispel Casino & Market, opening this fall, located just north of Cusick, Washington, on Highway 20 (part of the International Selkirk Loop). RV Resort opening next spring/summer. Offering locals and travelers a destination to enjoy Kalispel Hospitality at the heart of nature.

Bonner General Health Community Hospice................ 208-265-1179 A service of Bonner General Health 520 N. 3rd. Ave., Sandpoint • bonnergeneral.org Caring for terminally ill patients and their families in Bonner and Boundary counties. Services include pain management, specialized nursing care, bathing and personal care, chaplaincy, supportive counseling, medical supplies and equipment. Covered by Medicare, Medicaid and most private insurance.

NorthWest Recumbent Cycles......................................... 208-818-5491 Gary@NWrecumbentcycles.com We specialize in getting anyone riding cycles, especially those with special needs. We build custom bikes and trikes for those with almost any disability. Come on out to Post Falls and play on many models of the most stable and comfortable bikes and trikes in the world. Call for appointments. Pastry and More.............................................................. 208-667-3808 411 W. Haycraft Ave., Coeur d’Alene • PastryAndMore.com A full service scratch bakery with unlimited imagination. Bring us your ideas and we’ll create something delicious for you. We have all been brought together by a love of baking, a commitment to quality, and a desire to bake the world a happier and sweeter place.

• Comfort THE • Security PERFECT • Convenience CHOICE FOR THE HIGHEST Call us STANDARD today: IN ASSISTED LIVING

208-457-3403 www.LodgeLiving.net

Hospice of North Idaho................................................. 208-772-7994 2290 W. Prairie Ave., Coeur d’Alene • honi.org We provide end-of-life care to anyone in our community regardless of their ability to pay. We are a non-profit hospice serving the seriously ill and those touched by loss since 1981.

Hospitals, Medical Care & Pain Management Axis Spine Center.............................................................208-457-4208 1641 E. Polston Ave., Ste 101, Post Falls • axisspinecenter.com The region’s ONLY comprehensive spine center, owned and operated by board-certified and fellowship trained spine physicians. Dr. Kent and Dr. Jameson are committed to improving each patient’s quality of life by increasing daily functioning and empowering their patients to achieve their goals.

Locally owned and operated

Bonner General Health...................................................208-263-1441 520 N. 3rd Ave., Sandpoint Bonner General Immediate Care................................... 208-263-0649 400 Schweitzer Plaza Rd., Ponderay • bonnergeneral.org Your community hospital providing quality, compassionate care in a comfortable, healing environment. We provide a full range of healthcare services, including home health, hospice, physical, occupational and speech therapy, radiology, laboratory, surgery, and emergency services. Camas Center Clinic......................................................... 509-447-7111 1821 W. LeClerc Rd. #1, Cusick, WA kalispeltribe.com/camas-center-clinic The Camas Center Clinic offers comprehensive healthcare including: medical, dental, chiropractic, physical therapy and massage therapy. The clinic is open to the general public and accepts most major commercial and public insurance carriers. Ride Monday-Thursday round-trip from Newport to Clinic. Suggested Donation $1. Call 800-776-9026 for more info. Heritage Health Medical Centers 1090 N. Park Pl.,Coeur d’Alene.................................... 208-292-0292 925 E. Poston Ave., Post Falls....................................... 208-618-0787 14775 N. Kimo Ct., Ste.B, Rathdrum...........................208-687-5627 Mountain Health Care, 740 McKinley, Kellogg...........208-783-1267 myheritagehealth.org Our Primary Care Providers (PCPs) have a broad set of skills and are able to diagnose and treat most conditions and ailments: Chronic Disease Management, Diagnostic Services, Express Care/walk-ins, Minor Outpatient Surgery, Routine Medical Care, Women’s Health, Wellness Care—at affordable prices. Kaniksu Health Services................................................ 208-263-7101 Medical, Pediatrics 6615 Comanche St., Bonners Ferry • 30410 Hwy. 200, Ponderay 6509 Hwy. 2, Ste. 101, Priest River 420 N. 2nd Ave., Ste. 100, Sandpoint VA Clinic....................................................................... 208-263-0450 420 N. 2nd Ave., Ste. 200, Sandpoint • kaniksuhealthservices.org Kaniksu Health Services is a nonprofit community health center which plays a vital role in Idaho’s safety net by providing medical, dental, behavioral health and VA services to the residents of Bonner & Boundary Counties. Newport Hospital & Health Services........................... 509-447-2441 714 W. Pine St., Newport, WA • phd1.org We provide 24-hour care when you need it! Two primary care clinics offer same day/walk-in appointments. Other services: Emergency; General Surgery; Obstetrics; Anesthesia; Diagnostic Imaging; Laboratory; Physical, Speech, & Occupational Therapy; Acute Care; Swing Bed; Long Term Care; Assisted Living.

North Idaho Advanced Care Hospital .........................208-262-2800 600 N. Cecil, Post Falls • niach.ernesthealth.com We hold a Joint Commission “Gold Seal of Approval” and 5th in the nation rating for care of diseases associated with respiratory failure (COPD, pneumonia, cystic fibrosis, etc.). Our 40-bed facility provides long-term acute care and critical care services for patients recovering from serious illnesses or injuries. Pain Management of North Idaho..................................208-765-4807 1686 W. Riverstone Dr., Coeur d’Alene • cdapain.com Pain Management of North Idaho is Coeur d’Alene’s only comprehensive Pain Management Center where patients have access to two fellowship-trained interventional pain physicians and a multidisciplinary team. Rehabilitation Hospital of the Northwest 3372 E. Jenalan Ave., Post Falls.......................................208-262-8700 rhn.ernesthealth.com We provide intensive physical rehabilitation services to patients recovering from strokes, brain, spinal cord and orthopedic injuries and other impairments as a result of injuries or illness. Also treated are cerebral palsy, ALS (Lou Gehrig’s Disease) multiple sclerosis & Parkinson’s disease.

Independent & Assisted Living, Memory Care, Adult Day Care Boundary Community Restorium.............................. 208-267-2453 6619 Kaniksu St., Bonners Ferry • boundarycountyid.us Our facility accommodates 52 residents with 24-hour care, homecooked meals, help with shopping, medications, and bathing, rides to appointments. All inclusive rates. Medicaid accepted. We offer an array of activities for our residents and adult daycare is available. The Bridge Assisted Living............................................. 208-263-1524 1123 N. Division Ave., Sandpoint • CenturyPA.com Adjusting to the transition of a new home is made easier with the intimate and compassionate environment at The Bridge. Assisted care is developed on an individualized basis. It’s the right place for home! Coeur d’Alene Health & Rehabilitation of Cascadia......208-664-8128 2514 N. 7th St., Coeur d’Alene • coeurdalenehealth.com We provide personalized 24-hour skilled nursing care and a newly opened and Secured Memory Care unit in addition to our short term rehabilitation services.

Advanced Care Northwest LLC In-Home Care at its Finest - Available 24/7

All clients & caregivers supervised by a Registered Nurse (RN) Special focus on matching personnel with each client to bring compassion, comfort and enjoyment to your in-home care experience. Familiar with use of assistive devices.

Four Convenient Communities: Welcome to a place • The Lodge at Riverside Harbor 1 & 2 —52 & 58 N. Cedar Street, Post Falls, ID you’ll truly love to call home. • The Lodge at Fairway Forest 1 & 2 —3989 & 3991 N. Player Dr., Coeur d’Alene, ID

Wise Guide | Winter/Spring 2020

Serving all ages in Bonner, Boundary & Kootenai counties

Call for a Free In-home Consultation 208-263-3225 www.advancedcarenorthwest.com

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Directory Listings

August

Coeur d’Alene Health & Rehabilitation of Cascadia.... 208-664-8128 2514 N. 7th St., Coeur d’Alene • coeurdalenehealth.com Our patient-centered rehabilitation is offered seven days a week for both short and long-term stays in surroundings that are intimate and comfortable with private and semi-private rooms. We provide personalized 24-hour skilled nursing care and a secured memory care unit as well.

Home Health • Bath Aide • Meal Prep • Housekeeping • Transportation • Med Reminders

Customize your own plan today!

Let the Sun Shine!

Medicaid Accepted

www.AugustHH.com

208-664-0858

Serving North Idaho since 1994

Boundary Personal Care

In-Home Personal Care

(a division of August Home Health)

• Bath Aide • Meal Prep • Housekeeping • Transportation • Med Reminders

Customize your own plan today!

208-267-5070 Medicaid Accepted

Let the Sun Shine! Serving North Idaho since 1994

www.AugustHH.com

The Lodge Assisted Living...............................................208-457-3403 52 N. Cedar St., Post Falls, 58 N. Cedar St., Post Falls 3989 N. Player Dr., Coeur d’Alene • lodgeliving.net We provide the most dignified environment for aging members of our community. Our highly trained staff and loving environment is perfect for you or your loved one with additional care needs. Our communities are custom built and locally owned offering comfort, security, convenience to our family of residents. The Renaissance Assisted Living, A Radiant Senior Living Community ........................... 208-2664-6116 2772 W. Avanté Loop, Coeur d’Alene assistedlivingcda.com The Renaissance is a one-of-a-kind assisted living community offering excellent resident to care staff ratios 24/7 for personal care and specialized memory care services, in Coeur d’Alene. Our gorgeous French-chateau atmosphere is simply a complement to our dedication to quality-of-life. River Mountain Village Assisted Living..........................509-447-2903 608 W. Second Ave., Newport, WA • phd1.org A beautiful 42 unit studio & one-bedroom apartment community for an active, independent lifestyle. En-joy the cozy fireplace, a stroll along a lovely landscaped walking path, and a variety of daily activities to meet the individual needs of our residents. Rose Terrace Country Homes..........................................208-623-6154 5672 W. Rhode Island, Spirit Lake Rose Terrace Cottages......................................................208-665-0580 632 N. 21st St., Coeur d’Alene • roseterrace.org Our quaint, home-style facilities offer a compassionate, caring environment with well trained staff 24/7. Nurses available 7 days a week, wonderful meals and fun activities. Private and semi-private rooms. Medicaid accepted.

Wise Guide | Winter/Spring 2020

AAging Better In-Home Care Offices in CDA/Post Falls, Sandpoint, Kellogg & Spokane TOLL FREE: Idaho......................................................... 866-464-2344 TOLL FREE: Washington................................................844-814-8080 aagingbetter.com One of the Inland Northwest’s largest and most trusted providers of quality, affordable in-home healthcare services for seniors, veterans and the disabled of all ages. Locally owned and operated, serving all of North Idaho and Spokane Metro Area counties of Spokane, Stevens, Pend Oreille and Ferry! Advanced Care Northwest, LLC ..................................... 208-263-3225 Serving All of North Idaho • advancedcarenorthwest.com Promoting safe and independent living, we are committed to providing compassionate and enjoyable personal care services to Seniors, Children, and Individuals with intellectual and developmental disABILITIES. Accepting BlueCross/TrueBlue, Medicaid/Medicare, Veteran, and most Private Insurance carriers. Call today for a FREE in-home consultation! August Home Health, Inc .............................................. 208-664-0858 Toll free........................................................................... 800-664-0838 2005 Ironwood Pkwy #227, Coeur d’Alene • augusthh.com New clients call Lynn our Supervising Nurse to schedule a visit! A Medicaid and Veteran approved Agency we hire and screen local caregivers (even family members) to provide assistance for Seniors struggling with tasks or the disabled of any age. If you are selecting an Agency to provide care, or know someone who needs help give us a ring. There is no obligation. We simply love what we do! Boundary Personal Care..................................................208-267-5070 6821 Main Street, Bonners Ferry Lisa Medeiros is all about her hometown. A Medicaid and Veteran approved Agency we hire and screen local caregivers (even family members) to provide assistance for Seniors struggling with tasks or the disabled of any age. If you are selecting an Agency to provide care, or know someone who needs help give us a ring. There is no obligation. We simply love what we do!

In-Home, In-Patient & Out-Patient Skilled Nursing & Rehabilitation Bonner General Health Home Health Services........... 208-265-1007 520 N. 3rd Ave., Sandpoint • bonnergeneral.org Providing skilled, intermittent care in the home. Services include skilled nursing care; physical, occupational and speech-language therapies; medical social services and certified home health aid services. Covered by Medicare, Medicaid and most private insurance.

Life Care Centers of North Idaho • LCCA.com 500 W. Aqua Ave., Coeur d’Alene................................. 208-762-1122 460 N. Garden Plaza Ct., Post Falls............................. 208-777-0318 1125 N. Division St., Sandpoint..................................208-265-9299 Our in-house physician, rehabilitation and nursing teams focus on inpatient and outpatient rehabilitation with 24-hour skilled nursing care to create individualized care plans, taking each resident’s and patient’s needs and goals into account. We focus on physical, occupational and speech therapy and provide advanced treatment options. Stop by for a tour today.” Newport Hospital Long Term Care & Skilled Nursing......................................................... 509-447-2464 714 W. Pine St., Newport, WA • phd1.org Our Long Term Care offers both long and short term skilled nursing and restorative care. We provide skilled nursing 24 hours a day, coordinating care with local physicians. North Idaho Home Health...........................................208-667-7494 850 W. Kathleen, Coeur d’Alene • amy.bartoo@LHCgroup.com We provide skilled nursing, physical therapy, occupational therapy, speech therapy and medical social work. Proud to serve Kootenai County since 1979. Jayco Certified. 4.5 Star rating. Rehabilitation Hospital of the Northwest................... 208-262-8700 3372 E. Jenalan Ave., Post Falls ID • rhn.ernesthealth.com We provide intensive physical rehabilitation services to patients recovering from strokes, brain, spinal cord and orthopedic injuries and other impairments as a result of injuries or illness. Also treated are cerebral palsy, ALS (Lou Gehrig’s Disease) multiple sclerosis & Parkinson’s disease.

Wheelchairs & More..................................................... 509-489-6879 Western Medical Specialties......................................... 509-326-7615 216/220 W. Indiana, Spokane WesternMedicalSpecialties.com A HUGE inventory of canes, walkers, scooters to electric wheelchairs and everything in between for your mobility needs - in store NOW - and we rent and repair too! We also carry medical, cleaning and incontinence supplies, and can ship directly to you as well.

Transportation Kaltran - Kalispel Tribal Transit .................................. 509-447-7247 72 Camas Flat Rd., Cusick, WA • facebook.com/KalispelTribalTransit Routes to Kalispel Reservation, Newport, Ione, Cusick & Spokane. Wheelchair accessible buses run Monday-Thursday 7am-5pm. Call Thursday for appointments on Friday, Saturday or Monday. Suggested donation $1, Medicaid Card - free.

Veterinary & Animal Care Bonners Ferry Veterinary Clinic................................... 208-267-7502 6657 Main St., Bonners Ferry • 24-Hour Emergency Available Let us help you care for your favorite four-legged friends! Our clinic provides complete veterinary services for healthy pets and for sick or injured animals, including horses and livestock. We provide an on-call emergency service in addition to our regular hours.

Bonners Ferry Veterinary Clinic

Complete Veterinary Services for Small & Large Animals

208-267-7502

24-HOUR EMERGENCY

Valley Vista Care........................................................... 208-265-4514 220 S. Division, Sandpoint • valleyvista.org Offering in-patient and out-patient & in-home skilled nursing. We provide Physical, Occupational, Speech, Restorative & Aquatic Therapies for Short Term Rehab, Long Term Care & Hospice Care. Specialized care for Behavior/Dementia,TBI and Difficult to Place Residents. Secure Behavior Units. Welcome Home Healthcare......................................... 208-263-7007 120 E. Lake St., Ste.319, Sandpoint WelcomeHomeHealthcare.com We are a family-owned, home health care provider serving Bonner, Boundary & Kootenai counties. We hand-pick our team of caregivers who share and embrace our core values of honesty and integrity. Providing Skilled Nursing, Physical/Occupational/Speech Therapies, Social Work, Home Assistance, Massage Therapy & Pastoral Care.

Medical Equipment, Products & Supplies North Spokane Hemp Co. 509-919-3759 9323 N. Division St., Spokane Open: Mon-Sun 10-8 • NorthSpokaneCBD.com We offer free shipping to ID, MT, and WA. Full-spectrum CBD oil. Zero THC CBD oil. Hemp cigarettes. Balms, salves, and ointments. Capsules and pills. Terpene infusions. Pet CBD. Locally sourced hemp. Menstrual relief capsules. And More!

8:30-5:00 Mon-Fri 8:30-1:00 Sat In-Office & Farm Calls

Roland H. Hall, DVM Chad A. Burt, DVM Jill Lang, DVM

Beth Walker, DVM Zach Damby, DVM

6657 MAIN STREET • BONNERS FERRY BonnersFerryVeterinaryQP2019.indd 1

7/16/19 6:42 AM

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Community Cancer Services…

Providing Emotional & Financial Support by Cindy Marx, Executive Director

Cindy Marx has been connected to the organization since the beginning; she knew Heather Gibson and attended the early fundraisers. Cindy is a two time breast cancer survivor and having been through chemotherapy and radiation, she is able to connect with clients in a way many of their medical team cannot. The Butterfly is Cindy, summer of 2008.

his article must begin with a huge “THANK YOU!” to Carey Spears of Spears Insurance Inc. for sponsoring our Wise Guide ad this year. This type of support from local individuals and businesses is integral to the work Community Cancer Services is able to do. Founded in 2002 by Heather Gibson and Cynthia Dalsing, Community Cancer Services (CCS) has been providing support to residents of Bonner and Boundary counties ever since. Our services have grown and changed as the needs of our clients have changed and our budget has grown to accommodate more clients and higher costs for everything. Our funding comes from two fundraisers held each year, The Mad Hatter Tea in April and A Night to Remember in November. We also receive donations large and small from community members, organizations and local businesses as well as grant requests from local and regional sources. All of our funds stay in our community, directly supporting

Wise Guide | Winter/Spring 2020

community members dealing with a cancer diagnosis. We keep administrative costs as low as possible while maintaining a non-clinical, cozy office where people can interact directly with our small staff for the support they need. All it takes to receive assistance from us is a verifiable cancer diagnosis and a completed application. Our services support the whole family and caregivers as we realize that a cancer diagnosis does not only affect an individual but extends to their network of family, friends, coworkers and beyond. Therefore our counseling services are available to patients, caregivers and family members who are supporting each other on this journey. Many times someone will schedule “just one” counseling session to check in and realize there is actually a lot to talk about. It feels good to talk about it and we offer a calm, safe place with a professional counselor to talk with once or as long and often as needed. Some people come to us reluctant to ask for help having always been the person to take care of others. Many come to us overwhelmed with the information they have received, treatment plan in hand and no idea how they are going to afford gas to get to Coeur d’Alene, Post Falls or Spokane daily for 6-8 weeks of treatment. They are traveling 650 miles a week from Bonner County, and 910 miles a week from Boundary County, and that’s after they get from their homes to Sandpoint or Bonners Ferry. We do all of this with a small board and smaller staff. We are looking for a few committed folks to join our board and a small army to help on committees for our fundraisers. We would greatly appreciate the help!

Please contact us at 208-255-2301 to learn more.

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Run It By Tamara by Tamara Jacobson, Compassionate Care Referral Services

From a daughter who is navigating her motherâ&#x20AC;&#x2122;s failing health.â&#x20AC;&#x153;Lately, when I have had to take my mom to the ER, we never know if she will be sent home although we feel her care is becoming more than we can handle. What are our alternatives?â&#x20AC;?

Depending on her clinical condition, the hospital may decide to either admit your mother, observe her for a night or two, or send her back home. Sometimes it is an insurancerelated criteria. If you find yourself overwhelmed with her care, I suggest the following: â&#x20AC;˘ Speak up! Especially if you feel it is unsafe to take her home. â&#x20AC;˘ Most hospitals have a patient advocate you can consult. â&#x20AC;˘ If more than 30-40 hours of inhome care assistance is needed, Assisted Living can be a less expensive option to consider. â&#x20AC;˘ A respite stay at an Assisted Living (paid with a daily rate) for 2 or more weeks may show improvement. â&#x20AC;˘ Hospice or Palliative Care can be partnered with any Assisted Living Facility to provide that extra medical attention. â&#x20AC;˘ Doctor-ordered Physical Therapy (under the Home Health umbrella) can also be brought to your mother. â&#x20AC;˘ Calling Area Agency on Aging in Coeur dâ&#x20AC;&#x2122;Alene can provide an Ombudsman who can be your voice if needed.

Since some of your family live out of state and you are the only one caregiving, start with small steps to help everyone cope with this disease, including your wife. Depending on her interests, keep taking her out to enjoy life within her parameters of comfort. There are local casual coffee groups for those with Alzheimerâ&#x20AC;&#x2122;s accompanied by a friend or caregiver. They meet just to chat and be social, and not feel out of place. Seek counseling if there is paranoia or fear issues that have changed your relationship and you are not sure how to respond. There are local daycare options that charge an affordable hourly rate that specialize in dementia care. These serve a dual purpose; giving you a break and providing a safe, interactive environment during the day. The empathy and wisdom of other spouses in your situation, found through a local support group, seems to be the strongest bond I have observed for

From a husband with a wife diagnosed with Alzheimerâ&#x20AC;&#x2122;s, â&#x20AC;&#x153; When is it time to seek help outside the family?â&#x20AC;?

Wise Guide | Winter/Spring 2020

adjusting to your new life. Seek one out! Hire an assistant so your wife feels okay and adjusts to having someone other than you to help her. I would be happy to give you contact information for any of these needs. If you would like to submit a question and â&#x20AC;&#x2DC;Run It By Tamaraâ&#x20AC;&#x2122; regarding senior day-to-day care issues, please email to: CCRS@netscape.com or call 208-660-9982. There is something so encouraging and comforting just sharing our concerns with one another. I look forward to hearing from you! â&#x20AC;&#x201D;Tamara Jacobson ___________________________________ Tamara Jacobson, a Senior Care Consultant and founder of Compassionate Care Referral Services, Inc., www. CompassionateCareReferral.com Tamara formed the company as a way to connect area seniors and services in a personal but professional manner. Straight forward comparisons are discussed to fit the individuality of her clients.

Your Only Locally Owned Referral Service

A personal approach to evaluating senior care choices to fit your needs and budget. NO FEES. NO PRESSURE.

Tamara Jacobson Senior Care Consultant

(208) 660-9982

www.CompassionateCareReferral.com

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Critical Hospice Care Meets Growing Demand

by Denna Grangaard, Director of Communication Hospice of North Idaho

daho’s only hospice inpatient unit is stretching into its expanded footprint and meeting local demand. Hospice of North Idaho recently completed the Schneidmiller House expansion project. The communityowned Hospice added 7 rooms to the unit to accommodate pressing needs for end of life care in North Idaho. The Schneidmiller House offers 24-hour medical support to patients requiring specialized care at the end of life. Hospice built the original 14-room unit in 2011 on Prairie Avenue in Coeur d’Alene, Idaho. This development added to the organization’s repertoire of hospice care in the home and in skilled care facilities. The 7-room expansion aims to meet current and future demand on healthcare resources. The 65-and-older

population is booming. An astounding 30.8% of population growth in Kootenai County in the next decade will occur in age 65 and over, according to Idaho Department of Labor. Before expansion, Hospice’s inpatient unit was already in high demand, experiencing 85% capacity in its twelve rooms. In the future, with current population growth, timely access to the in-patient unit for end-oflife care would have been much more difficult. Kootenai Health gifted a sizable contribution of $150,000 to Hospice of North Idaho for the expansion. A $20,000 portion of that gift will help support the Wine Taste annual fundraiser for three years, with Kootenai Health as Presenting Sponsor. “Kootenai Health and Hospice of

Nurses Week 2019

Wise Guide | Winter/Spring 2020

North Idaho have a long history of working together. We are both nonprofit organizations with a common goal of ensuring people in northern Idaho can receive the care they need, close to home,” said Kim Anderson, spokesperson for Kootenai Health. Kim Ransier, Hospice of North Idaho, Executive Director, gave appreciation saying, “With this donation, Hospice of North Idaho and Kootenai Health are ensuring that our community receives the best care, at the right time, in the right place.” The expansion ensures that individuals and families receive a seamless continuation of care in our community. “We understand the need these new rooms will fill for families in our community, and we are proud to be able to support Hospice of North Idaho in this way,” adds Kim Anderson. With nearly 40-years’ experience, Hospice of North Idaho holds national Hospice Honors designation as well as local Best Hospice in North Idaho. This care is backed by the Joint Commission; the nation’s most prestigious accrediting organization. Hospice of North Idaho provides expert hospice care in Kootenai, Shoshone and Benewah counties regardless of a person’s financial circumstances. The organization also offers advanced care planning, grief support for all ages, volunteer opportunities and two thrift stores in North Idaho. _____________________________________________________ Hospice of North Idaho welcomed Denna Grangaard as Director of Communication in 2016. Denna worked 10-years for the State of Idaho with 7 years focused on public involvement and communication and is an Alumni of the University of Idaho. Honored to work alongside the experienced and heart-centered staff at Hospice of North Idaho, her approach is to create awareness, education, and compassion through various media channels to benefit the community.

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