The Wise Guide 2021/2022 edition

2021/2022 ISSUE

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

Why Do Genetic Testing?

Go Wild in the Wild!

Kalispel RV Resort in Cusick, WA

Start Talking Now!

Preventing Youth Substance Use

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FREE

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CONTENTS Run It By Tamara...................................................... 4 Why Do Genetic Testing?......................................... 6

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Hope for Mental Health.......................................... 8 Improving Breastfeeding Outcomes Through Family Support....................................... 12 Start Talking Now.................................................. 14 Go Wild in the Wild in Cusick, WA!.................... 18 Gum Disease and Heart Disease: The Common Thread............................................ 22 Family Crisis Network: From Grass Roots to a Valuable Community Asset.......................... 28 Amputation, a Life-Changing Event..................... 34

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What is Huntington’s Disease?............................. 36 Alzheimer’s Association Support Groups..................................................... 42 Real Life “Golden Girls”....................................... 44

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Social Isolation and Loneliness: The Silent Pandemic............................................. 48 Crossword.............................................................. 56 Making the Most of Medicare............................... 58

& Much More!

28 The Wise Guide 2021/2022 (208) 255-5950 info@thewiseguideonline.com www.TheWiseGuideOnline.com Copyright ©2021/2022, All Rights Reserved.

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.

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Run It By Tamara

2020 brought changes to Senior Care, for how long, we don’t know yet. During the pandemic, specific protocols were directed by the health district, however facilities varied somewhat on routine and criteria in areas not strictly mandated. Following are concerns of family during these uncertain times.

by Tamara Jacobson, Compassionate Care Referral Service

Q

Q A

From a daughter with a mother in the hospital — “My mom broke her hip and now cannot go home. What are her options and will she be isolated from family?”

If your mom is not able to bear weight and help with transitions to stand and transfer to chairs or the restroom, skilled nursing with rehabilitation is a good choice for recovery.

Some Assisted Living Facilities offer quite a high level of care but that is dependent upon adequate staff and the facility’s ability to meet the care needs. Home Health (Physical and Occupational Therapy) can come to an assisted living facility to provide those services.

Regarding family isolation, both Skilled Nursing and Assisted Living facilities, have required a two week quarantine for new patients. However, with in-house testing and fewer cases of COVID, I am happy to report more facilities are allowing family visits, with precautions such as masks and hand washing, because loved ones are absolutely essential in the healing process.

There is something so encouraging and comforting just sharing our concerns with one another. I look forward to hearing from you!

— Tamara Jacobson If you would like to submit a question and ‘Run IT By Tamara’ regarding senior care issues, please email: CCRS@netscape.com or call 208-660-9982

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 4 Wise Guide | 2021/2022 Edition

From a family wanting to move their father to the area from out of state — “My dad is very lonely and isolated now from all his friends and we want him closer.

We aren’t sure if an independent apartment or assisted living would be right for him?”

A

I have helped moved several seniors to Idaho with these considerations. If he is able to dress and shower by himself and only needs help with transportation and meals, then Independent Senior Living Communities do fit the bill for affordability and are a simple move. When more care is warranted, an Idaho doctor must be involved if he is to move into Assisted Living. A care plan would be developed, and also timing is the key to finding vacancies. Let’s plan ahead!

Q

From an upset family regarding their mother suffering from mid-stage dementia residing in Assisted Living during a lock down period in the pandemic — “We cannot call Mom and there doesn’t seem to be enough staff to facilitate a phone call. We do not know what is happening with her care and we know she must be confused, wondering why we aren’t there. What can we do?”

A

The isolation with those seniors suffering from dementia is a devastating outcome of this past year. Staffing shortages were at an all time high, but does not excuse neglect or disregard of family concerns. In general, I find that a smaller setting with more eyes on the senior tends to be a better environment, especially when dementia adds to the confusion. In addition to phone calls, a stuffed animal that reminds them of a past pet, or a digital frame that can receive family pictures automatically over Wifi, are great ways to remind them of your presence and love.

Tamara Jacobson, is a Senior Care Consultant and founder of Compassionate Care Referral Services, Inc., 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.

2021/202 2

On The Cover

AN IN SIG

About the Artist

HTFU

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T Kurtz T Kurtz is a pastel artist working on a suede surface. It is a very forgiving surface that embraces her medium and pastel just clings to it. Suede is a wonderful surface that you can add layer upon layer of pigment. This creates rich colors with great depth. T is mostly self-taught in her medium but has had generous input along the way from other talented giants in her field.

“Artists are generous, I have had pastelists gather at an art show and pass around their sticks of pigment. One of my favorites artists, Judy Fairley; brought me over a brand new box of Terry Ludwig pastels to play with. She took it back; I so wanted to keep it; but she did share it.”

T has been a working member of the art market for over 40 years as support for

Country Road

Sunset Splash

Why D o Geneti c Testin g?

Go Wil d in Kalispel RV Reso the Wild! rt in Cus ick, WA Start Ta lking N Preventin ow! g Youth Substa nce Use

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COVER ART: “Love is Respect” her mother, Gabe Gabel, and T started painting about 6 years ago. In her travels, she has been able to experience painting demonstrations by Terry Lee, Robert Krogel, Judy Fairley, Everett Russell, Bev Plumb and countless others.

“Art is subjective but ultimately it is the free interaction that tells you when something is successful. An honest reaction to your work will teach you more about where you need to strengthen your technique than any educator.”

T Kurtz currently lives in Sagle Idaho with her husband, two aloof cats, and one faithful dog.

T Kurtz offers classes locally in her studio for small groups or one on one. Her work is displayed locally in Sandpoint, ID at Misty Mountain Furniture Gallery on 5th Street and at The

4/30/21

6:09 PM

Schweitzer Mountain Gallery at the resort village. Please contact her at supert-rex@hotmail.com or at 208-255-8813 for class information or about her works of art.

You can also see her work at: TKurtz.com.

Ivory Lady

Dancers Birds on BathSun Fresco www.TheWiseGuideOnline.com | Wise Guide 5

Why Do Genetic Testing?

by Jill Ciccarello, CEO & Research Program Director, Inland Northwest Research

W

hat is a gene? A gene is the most basic unit of biological material that codes for heredity, or the passing of coding material given from parents to their children. The sequence of genes is commonly called Deoxyribonucleic acid or DNA. Every living thing has DNA. Each person has a set of unique DNA, which contain instructions for how a human being develops, functions, grows and reproduces.

Jill Ciccarello is a native of the northwest currently residing in Spokane. She has been working in biomedical research for the past 19 years. Jill has experience with federally and privately funded research programs. Before coming to Inland Northwest Research, she spent 4 years as a Subject Matter Expert and Science Officer for the US Medical Research and Materials Command, working primarily in Neurological Research, including Parkinson’s, TBI, PTSD and Alzheimer’s.

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Your DNA is what makes you who you are.

Variation in DNA makes you unique, but variation can also affect health. About 1 in 6 people carry a genetic variation that may increase their risk of developing a disease. Many people have a family history of disease, and it is one of the most common reasons people seek genetic testing. Genetic testing can provide essential health information to help identify an individual’s risk of disease, or the risk to other family members.

Knowing risk can empower people to work with their doctor to prevent, detect or treat disease early.

Another reason an individual might seek genetic testing is because their family history of disease is unknown.

Studies have suggested that, 80% of those who have passed a genetic illness on to their children, had no family history or symptoms of that disease.

These individuals are called carriers; they carry the genes for disease, but do not necessarily suffer from the disease themselves.

Common genetic tests include screening for neurological disorders such as Alzheimer’s or Parkinson’s Disease, autoimmune disease, cancer, pediatric conditions, heart disease, mental illness, or other rare genetic disorders. It is important to note, that just because an individual may have a genetic marker for a particular disease, does not mean they will develop that disease. Genetic markers increase the risk for disease, but do not determine disease development, alone.

doctor and health insurance provider, before seeking genetic testing. To learn more about the ACA, please go to www.healthcare.gov.

Ways to get genetic testing: These days, there are many ways to obtain genetic testing. Broad genetic testing is often done by popular companies such as, 23andMe, AncestryDNA, My Heritage DNA, Living DNA etc. For more disease specific genetic testing, there are several companies that offer testing, often available through your doctor’s office, i.e., Invitae, MyDNA, Verge Genomics, Precision Oncology etc. In addition to individual testing (above), there are many clinical trials that offer genetic testing. Locally, Inland Northwest Research, in Spokane, WA, offers genetic test for many neurological disorders, including Parkinson’s Disease (PD). Nationally, Michael J Fox Foundation trial finder (https://www. michaeljfox.org/trial-finder) lists many clinical trials for movement disorders, such as PD. Talk with your doctor to determine what type of genetic testing might be best for you.

Other Considerations: Another factor to discuss with your loved ones and medical care provider, before seeking genetic testing, is how the outcome of your genetic results may affect your family’s and your mental and emotional well-being. Talk with your doctor about setting up a meeting with a genetic counselor, psychologist, and/ or other mental healthcare professional, before to seeking genetic testing. Please note, that many genetic counselors are now available online, via Telehealth.

Inland Northwest Research are leaders in national and global research, focused on neurological disorders. We offer high impact clinical trial opportunities in Parkinson’s Disease, Huntington’s Disease, Multiple Sclerosis, Essential Tremor and dementia.

We take great pride in helping those with neurological disorders navigate through clinical trial participation, and explore options that are the best fit for their needs. We are proud to partner with Invitae, to offer our community affordable genetic testing services.

Genetic testing can be performed as part of a clinical trial registry or electively. Call us at 509-960-2818 and visit inwresearch.com for more information.

Genetic testing may also provide individuals with a medical diagnosis for unexplained symptoms, discover better treatment options for known diseases, and may reduce or eliminate the need for more invasive testing, as many genetic tests can be done with just saliva.

Things to consider: Per Health and Human Services (hhs.gov), under the current Affordable Care Act (ACA—known as Obama Care), insurance companies can no longer deny an individual (adult or child) healthcare coverage or charge more for an insurance plan because of a pre-existing condition.

This rule does not apply to health insurance policies “grandfathered” or purchased before 23 March 2010. Please review your health insurance with your www.TheWiseGuideOnline.com | Wise Guide 7

Hope for

Mental Health

by Beth McQuinn, ND, Camas Health Clinic

Y

ou’re tired, stressed, confused, angry or sad… such seem the signs of these times. The world is a volatile place and there appears to be much to despair over (financial stability, keeping a job, finishing school, and/or food resources), and I want to talk to you about how a change of perspective can turn your experience from one of fear or sadness, to one of hope.

“Change” is the only constant in our lives. If we cannot adapt to change, our minds and bodies struggle to be healthy. My medical training taught me that we are made up of a mind, body and soul and if we don’t attend to all three, there can never be full health. We need to constantly battle stress and negativity in our mind in order for our bodies to be healthy.

Our bodies are intelligent and maintain a stable environment even in the harshest of conditions. Our system initiates a survival mechanism we affectionately label your “fight or flight” response. It’s our failsafe when it comes to being mentally or physically overwhelmed, but it comes with consequences. Chronic stress (aka, fight or flight response) can cause a miscommunication between the immune system and the hormonal system creating chronic conditions such as chronic fatigue, metabolic disorders (e.g., diabetes, obesity), depression, and immune disorders.2 The effect of chronic stress on the GI tract can be far reaching from radical shifts in gut bacteria to reduction in absorption of nutrients, all of which influence mood and the brain.2 Other effects of long term stress include reduced sex drive, reduced fertility, stomach pain, or heart irregularities.

So, how do we “battle” in our minds what appears to be so real? There’s a practice called meditation that has proven to help those with depression and anxiety, equal to medications, if practiced regularly. The definition of meditate is “to train, calm, or empty the mind” or “to engage in contemplation or reflection.”

How often can you honestly say you simply stop and empty your mind? Or is your mind going 90 mph from the moment you wake to the moment your head hits the pillow? Consider this: it’s much easier to maintain control of a car going 30 mph than the one going 90 mph. If you need better control of your mind, it’s time to slow it down a bit and allow space for chaos to come under control. Some practical tips are to buy a small notebook and practice jotting down things you’re grateful for throughout the day. There are many “gratitude journals” for purchase on Amazon and many of the popular “self help” books or authors recommend this practice to get your mind off the negative circumstance, and instead, saturated in all the positives you have going for you! Also, create a consistent time in your busy schedule EACH DAY to stop and clear your mind or at least organize your thoughts. A great resource is “The Miracle Morning” by Hal Elrod which walks you through a morning routine to get your mind and body ready for the day.

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A silver lining in the clouds of mental illness is the strength of your community. Mental health is a personal achievement, but family and community health play a large role. So, how is mental health defined? Mental health is “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.”3 Human beings are social animals and require social interaction to thrive. Get involved in your community and tap into community resources, or better yet, volunteer in your community yourself! Getting the focus off how bad your personal situation is, and helping others rise to their potential, can be a successful climb out of mental negativity or illness.

If you find that you’re not the representation of good mental health and recognize the need for someone outside the home to help you back on the path to mental health, there are accessible and inexpensive resources available:

Health Apps:

• What’s Up: “an amazing free app that uses Cognitive Behavioral Therapy and Acceptance Commitment Therapy methods to help you cope with Depression, Anxiety, stress and more.”2 • Quit That! “a free app that helps users beat their habits or addictions… whether drinking alcohol, smoking, or taking drugs.”2 • Recovery Record: “a great free app for anyone recovering from an eating disorder and wanting to develop a more positive body image.”2

Hotline Resources • Camas Path Behavioral Health Advice Line: 866-270-8603 • Chemical Dependency Clinic (Melissa Hurt-Moran): 509671-4128 or 509-671-6221 • National Suicide Prevention Hotline: 1-800-273-8255 with trained counselors • National Gambling helpline: 1-800-522-4700 • National Domestic Violence Hotline: 1−800−799−7233 Sources: 1 https://www.psychologytoday.com/us/blog/balanced/201907/meditation-and-mentalhealth 2 https://www.apa.org/topics/stress/body 3 Healthypeople.gov/2020/topic-objectives/topic/mental-health-and-mental-disorders 4 Top 25 Mental Health Apps: An Effective Alternative for When You Can’t Afford Therapy? Jessica Truschel 5 https://www.reuters.com/investigates/special-report/health-coronavirus-usa-cost/?fbcl id=IwAR2rkXY4UPjUvb2aa6P43oEkge7vc3OXd0KdAcKmDBfXazdlXfdE_rHXwq4

Dr. Beth McQuinn is a Naturopathic Physician at Camas Center Clinic in Cusick, WA. In her leisure time, she enjoys nature in the form of hiking, running, equestrian and family activities with her community friends and family. In 2018 she and her husband purchased Bear Paw Camp, thus they move from Western WA to Newport. Beth has an adventurous husband and three busy kids who love life right alongside her.

DR. MCQUINN, NATUROPATH Now Accepting New Patients

HOURS

Monday - Wednesday 8am - 5pm Thursday 9am - 5pm CAMASCENTERCLINIC.ORG

1821 N LeClerc RD, Ste #1 Cusick, WA 99119 The Camas Center Clinic is open to the public and accepts most public and commercial insurances.

• General family practice • Herbal / natural prescriptions • Acute care (colds, pain, non-emergency) • Chronic disease care • Wellness exams • Hormone imbalances (men and women) • Weight management • Nutrition counseling • Exercise counseling

APPOINTMENTS: 509.447.7111 www.TheWiseGuideOnline.com | Wise Guide 9

H Burning and Gritty and Sandy, Oh My!

by Dr. Brayden Petersen, Eye Clinic of Sandpoint

10 Wise Guide | 2021/2022 Edition

ave you ever wondered why your vision fluctuates during the day? Or, why your eyes sometimes burn, feel sandy or gritty? The answers to these questions stem from one condition that is more common than you may think. The condition I am referring to is known as “Dry Eye.” Some studies point to a prevalence of 50%!

If the visual system is working correctly, all the light rays that enter the eye are bent to focus in one spot on the back of the eye. If all the light rays are focusing in the same spot then we see a clear, single image. If the visual system is broken, the light rays will enter the eye and each light ray will have a different focusing point, thus creating a nonuniform image. This would be perceived as a blurry or distorted image.

Anatomy of the Front of the Eye

Aqueous Deficient Dry Eye

To better understand how dry eye changes your vision we need to first understand the anatomy involved. The clear structure on the front surface of the eye is known as the cornea. On the front surface of the cornea is the tear film. The tear film has many functions but one of the more important features is how it bends light. It is often assumed that the cornea or lens has the strongest refractive power (ability to bend light); however, this is only partly true. The tear film also contributes a large portion in the bending of light.

With the tear film contributing so much to our visual clarity, it is important to understand the tear film anatomy. The tear film consists of three layers. The bottom layer is known as the mucous layer and its primary role is to adhere to the cornea.

The middle layer is known as the aqueous layer and is comprised mostly of water to keep the eye lubricated. And the very top layer is an oil layer produced by glands in our lids. The purpose of the oil layer is to prevent evaporation of the tear film.

The second type of dry eye is known as aqueous deficient dry eye. This is when the lacrimal gland does not produce enough aqueous layer (the middle layer).

Causes of this type of dry eye include Sjogren’s disease, contact lens use, LASIK/ PRK, surgeries, previous infections, or other systemic conditions. This type of dry eye can also cause transient vision for the same reason stated above. Treatments also include topical drops, medications, and management of underlying conditions if applicable.

In realty most dry eye symptoms felt by a patient stem from both types. Treating one would surely help the other. But there

is a catch. As our world becomes more digital we are seeing even more strain on the visual system. It has been measured that when we look at screens or read we blink 60% less than we would normally.

This alone accounts for the increase in prevalence we are seeing. One could only assume that this trend will continue unless we begin now to protect our visual system.

So, next time you sit down to read or do computer work, are you noticing some blur? If so, you now understand why. If you or anyone you know is suffering from these types of symptoms, we encourage you to give us a call at 208-263-8501. If you would like to learn more please visit our website at www.eyeclinicofsandpoint.com.

Dr. Brayden Petersen earned his Doctorate of Optometry from Pacific University College of Optometry. He gained advanced training at the Forest Grove Pediatric Clinic, Salt Lake City Veterans Hospital and Eye Institute of Utah. During this time, he specialized in the treatment of ocular disease, contact lenses and comanagement of ocular surgeries. Dr. Brayden enjoys talking with his patients about their eyes. He believes in not only discussing the treatment plan but also wants his patient to understand “why” the condition occurs and provides the most comprehensive exam possible with the most up to date technology available.

Evaporative Dry Eye The most common form of dry eye is known as evaporative dry eye. This type of dry eye is when the oil glands in our lids fail to produce enough oil to stabilize the cornea and tear film. If we no longer have oil to prevent the evaporation of our tears, we begin to lose both the top and middle layers simultaneously. When we no longer have those layers we begin to have dry eye symptoms. Not only will the eye begin to feel gritty, sandy, heavy or on fire, but it also causes visual fluctuations.

From our anatomy paragraph we learned that the tear film bends light.

When light rays entering the eye hit the areas of dryness, the light rays will bend differently than light rays that hit a lubricated area. If we have two light rays bending in different locations its perceived as a blurry image. And that is the answer to our question. The instability of the tear film causes these visual fluctuations.

But there is good news! There are many treatments to help with these symptoms.

They include artificial tear programs, dry eye therapies and devices, or topical medications. www.TheWiseGuideOnline.com | Wise Guide 11

Improving Breastfeeding Outcomes Through Family Support

by Heather Hamilton-Post

“W

IC was all I knew for help, but I didn’t qualify. I pushed through nursing, but I had mastitis six times. Looking back, I was definitely doing something wrong,” says Kala Hernandez, a breastfeeding mother in Idaho. “More knowledge of resources and easy access could have made life much easier.”

Hernandez isn’t the first to experience hiccups in the breastfeeding relationship. For many women, breastfeeding support offers a crucial piece of puzzle that keeps breastfeeding relationships going. In her case, support could have prevented repeated illness, complications, and frustrations. But Hernandez wasn’t doing anything wrong–she was simply doing it alone.

In Idaho, the CDC reports that 94.6 percent of infants are ever breastfed. By six months, this number drops to 63.4 percent, and by a year, 38.3 percent. The data tells us that parents understand the importance of breastfeeding early on, but as infants age, these numbers decrease. Many of these dyads represent instances of combination feeding, in which an infant is receiving breastmilk and formula in combination.

Often, this isn’t the plan, but a necessity born of inadequate support given to the breastfeeding parent or lack of access to resources.

Whether parents access support within a hospital, at a private practice, via a support group, or even in a virtual space, it is an essential part of building a breastfeeding relationship with the positive outcomes parents desire.

Plan to Attend!

Idaho Breastfeeding Summit - Nourishing Partnerships to Benefit Idaho Families June 24-25, 2021, JUMP (Jack’s Urban Meeting Place) - 1000 W. Myrtle Street, Boise

Two full days of IBC & National Speakers, Continuing Education for Nurses, IBCLC’s & Registered Dietitians and offering breastfeeding education to breastfeeding advocates. For more information and registration go to our website: Idahobreastfeeding.org 12 Wise Guide | 2021/2022 Edition

The right kind of support For many parents, breastfeeding is always part of the plan.

But, in an effort to keep them committed early on, nobody mentions or plans for potential complications. For Hernandez, breastfeeding was ‘much harder than I expected’, which she now attributes to likely tongue and lip ties that remained undiagnosed because she wasn’t interacting with individuals specifically trained in breastfeeding and working toward the goals of breastfeeding families.

Getting breastfeeding families access to the right kind of support matters. Specific breastfeeding support helps troubleshoot, brainstorm, and establish great habits at every phase of the breastfeeding relationship.

Types of breastfeeding support professionals Because breastfeeding support is so varied, it is important to understand some of the types of support available. Generally, they fall into six categories: breastfeeding medicine specialists (doctors with additional training in lactation), International Board Certified Lactation Consultants (IBCLS), certified breastfeeding specialists and lactation counselors (CLCs), doulas and childbirth educators with lactation training, peer counselors, and lactation educators (CLEs) who train others.

Where to look for breastfeeding support Many factors can contribute to determining the kind of support that will help sustain a breastfeeding relationship.

Location, access to technology, comfort in group situations, and stage of breastfeeding or specific obstacles to breastfeeding all help determine the best option for helping families. In addition to books by professionals, here are some of the myriad of services available to families: Hospitals and Birth Centers Often, places that help facilitate the birth of babies offer some form of lactation support. Many have certified lactation consultants onsite, or can recommend an outside professional to families. This resource is especially helpful as breastfeeding begins, but many facilities also extend care for a few months.

Hospitals and birth centers typically offer prenatal breastfeeding support, assist with breastfeeding after delivery, and can offer follow up in your home or at a clinic. They are often also able to bill insurance for lactation services.

Support Groups At any stage, breastfeeding support groups like La Leche League and Breastfeeding USA can help build community and offer advice through peer support. These frequently happen in online spaces too.

Private Practice Lactation Support These licensed professionals are an excellent resource for families experiencing difficulty breastfeeding. Like professionals in a hospital setting, private practice consultants are trained in breastfeeding issues across the spectrum and can help connect families as needed.

Complimentary Services A variety of professionals support breastfeeding through things like chiropractic care, craniosacral therapy, and even massage. Often, lactation professionals have relationships with related businesses who also help maintain breastfeeding relationships.

Additional Resources The Idaho Breastfeeding Coalition is a nonprofit 501(c)3 who strives to establish breastfeeding as a biological norm for a healthier Idaho by working in five focus areas (legislative, breastfeeding research, coalition support for breastfeeding as a norm, community outreach and education, and support of national initiatives). In support of breastfeeding families, we have developed a robust bank of resources, listed by Idaho Health Department District, on www.idahobreastfeeding.org/ community-resources. Please let us know if there’s something we can do to support you.

Heather Hamilton-Post is a passionate advocate for breastfeeding after embarking upon very different breastfeeding relationships with each of her children. She holds a degree in Agricultural Communications from University of Idaho and an MFA in Creative Nonfiction from University of Arizona. A lifelong Idahoan, she now works as a writer and editor in Caldwell.

www.TheWiseGuideOnline.com | Wise Guide 13

Start

Talking Now

Preventing Youth Substance Use - You are the #1 Influence!

by Donna M. Kelly, CPWI Coalition Coordinator Panther Country Coalition & Cusick Youth Coalition

T

he key reason kids give for not using alcohol, marijuana, or other drugs is that they do not want to disappoint their parents (Monitoring the Future survey). Parents can truly make a difference by talking to their teens about the risks of underage use. It is not uncommon for teens to act like they are not listening to you but in fact they are! Even though they may walk around with headphones on 24/7 do not assume they are listening to music at high volumes and not overhear you or that what you say is not being taken to heart, because many times it is. Kids are listening and paying attention. They also want to be happy, make you proud and live long healthy lives. One way to help them is by talking early (by 6th grade) and often about the consequences and risks of underage substance use.

What are the risks of underage use of alcohol, marijuana, and other drugs?

Early use of alcohol, marijuana, and other drugs puts teens at greater risk for addiction and other health problems such as failing in school, and limited career choices by arrests and lack of education. These substances can impair areas of the brain that control motor coordination, impulse control, memory, learning and judgment. Because the teen brain is still developing, it is more vulnerable than an adult’s brain to the effects of alcohol, marijuana, and other drugs according to the National Institute on Drug Abuse (NIDA).

The Centers for Disease Control and Prevention (CDC) reports underage substance use is associated with the top three causes of teen deaths: accidents (including traffic fatalities and drowning), homicide, and suicide. Over eighteen-hundred college students deaths each year are related to underage drinking according to the National Institute on Alcohol Abuse and Alcoholism.

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Teens who drink and use other drugs are more likely to engage in risky behaviors like sex. Such behavior can result in pregnancy, AIDS, and other sexually transmitted diseases (CDC).

Kids who drink before age 15 are 4 times more likely to develop alcohol problems as adults (Center for Behavioral Health Statistics and Quality 2015).

How can I prevent my child from using alcohol or marijuana?

Parents and caregivers have the greatest influence on a child’s decision about alcohol and other drugs. Research consistently shows that kids who learn a lot about the risks of alcohol and other drugs at home are 50% less likely to use, yet many parents find it difficult to talk about this.

In fact, in Pend Oreille County over half of the parents (54%) have talked to their 10th graders about not using alcohol and marijuana according to the WA state 2018 Healthy Youth Survey.

Local youth substance use is increasing as noted in the 2018 Pend Oreille County Healthy Youth Survey that reports 25% of 10th graders reported using marijuana in the past 30 days where as in 2016 it was only 20%. Alcohol trends are similar. In October of 2016, 26% of Pend Oreille County 10th graders report current use of alcohol and that is up from 18% in 2014. Parents are needed now as much as ever to help their teens make healthier choices.

Tips for parents • Create healthy substance free a rites of passage to adulthood • Set clear rules against using alcohol, marijuana, and other drugs • Help your children deal with peer pressure and stress • Be a good role model - show kids you don’t need a drink to relax or celebrate

• Talk with them early and often about the ways alcohol and marijuana can harm them, ask questions and be a good listener • Stay involved in their lives • Know who their friends are, and where they are going

Create close bonds with your children Children are less likely to drink, use marijuana or other drugs when their parents are involved in their lives and when they feel close to their parents. Family conflict and lack of bonding increase the risk of drinking and marijuana use.

To increase family bonding: • Give kids at least 15 minutes of one-on-one time every day • Do fun things together • Give positive feedback about the healthy choices your child makes • Eat as a family five times per week

Set clear boundaries for your children Set clear standards early and talk about the rules often.

To set boundaries: • Help your child practice ways to say no to drugs • Use fair and consistent discipline any time your standards are broken • Help your kids have positive relationships with peers

Monitor your child’s interactions Always know what your kids are doing. Help them plan safe and fun activities.

To monitor your child, ask these five questions when she or he spends time with friends:

• Where are you going?

• What will you be doing?

• Who will be with you?

• When will you be home?

• Will there be alcohol, marijuana or other drugs?

An excellent multi-lingual online resource for parent-child communication is StartTalkingNow.org, sponsored by the Washington Healthy Youth Coalition.

The Panther Country Coalition is a local resource in Cusick, WA with a mission to prevent and reduce youth substance use. We offer evidenced-based parenting programs, Sport Prevention and Wellness, a health promotion program that highlights the positive image benefits of an active lifestyle to reduce the use of alcohol, tobacco and drug use by high school students, free parenting workshops, and leadership opportunities for students involved in our youth coalition. The Panther Country Coalition is funded by the Washington State Health Care Authority. Please contact us today for more information at 509-447-6416, email dkelly@pendoreille.org or visit StartTalkingNow.org Donna Kelly, CPC, is a Certified Peer Counselor with over 7 years of substance abuse prevention experience working with local and community coalitions. She is a Certified Parent Workshop Facilitator. Donna is currently employed by Pend Oreille County Counseling Services as the Community Coordinator for the Panther Country Coalition.

www.TheWiseGuideOnline.com | Wise Guide 15

She Had

Nowhere to Turn

by Roberta Romero, Development Manager, Peer Spokane

I

... She learned firsthand how difficult it is to find support for people who are struggling with addiction or mental health and most likely both.

16 Wise Guide | 2021/2022 Edition

t may have been 34 years ago, but Georgia Butler can clearly remember when she had nowhere to turn. A Spokane native, she found herself in Texas, a single mom struggling with mental health and substance use challenges.

With help, she got sober and returned to her roots in Spokane.

At that time in 1991, she learned firsthand how difficult it is to find support for people who are struggling with addiction or mental health and most likely both, “I was sober, but I couldn’t find a rental, quality child care, it was a daily struggle,” says Butler.

Butler focused on her sobriety and education. While working odd jobs, she got her degree in applied psychology and women’s studies. Armed with both book knowledge and lived experience, she was ready to get to work.

She learned how vital a genuine connection is for people suffering from behavioral health issues, beginning her career working with women and their children, then moving into treatment counseling. “Sharing my own story resonated with people, and I learned that shared lived experience is what makes a huge difference in success,” says Butler.

After building an acclaimed reputation as a recovered sober leader, opening nonprofits, and reducing mental health and addiction stigma, Butler wanted to do even more. “I knew that the Spokane Valley needed support with a deep commitment to community and to helping others,” says Butler. So at the age of 64, she helped officially open Peer Spokane.

Peer Spokane is a program of Peer Washington, a nonprofit founded in 1984, which is peer-led, peer-run, and dedicated to providing emotional support and development services to adults with mental health, addiction, and/or HIV/AIDS. “I’m so proud to be the Director of Peer Spokane. With a well-established successful program, we are already making a difference in the Spokane Valley. It’s the peer-to-peer, shared lived experience that bridges the gap,” says Butler.

of what you want or can do, there is no judgment, and every employee and volunteer has lived experience with mental health or addiction or both.”

One of the most significant barriers to getting help is also eliminated by Peer Spokane; all of its services are FREE. “There are people seeking support who have never asked for help for addiction, trauma, or mental health before; we are here to be that first safe place to start on the road to recovery,” says Butler.

And the need could not be higher. According to the Washington State Department of Health COVID Report, the pandemic has caused a surge in behavioral health symptoms across the state.

Butler adds, “Rural areas in our area are particularly vulnerable and less likely to have access to high-quality care.”

Peer Spokane can help fill that need. Led by trained employees who identify as peers, they help people navigate everything from treatment access to employment to housing.

Peer support groups are offered as well as an open door and open heart. Butler says, “We offer a space even if you are unsure

Peer Spokane celebrated its first anniversary in September 2020, a year like no other, with COVID closures, but that did not stop Butler and her team. They continued to work online and have now returned to seeing members in the office while following CDC safety guidelines. Butler is grateful to see people again; she says, “The best part of my job is standing in the lobby when someone walks in for the first time, and I can say, ‘How can I help you?’”

If you need help or would like to learn more about Peer Spokane, go to our website peerspokane.org.

Roberta was born and raised in Albuquerque, New Mexico. She moved to Seattle in 1992 for a reporting job at KING 5 (NBC) news.

She spent the next two decades covering major news events in Washington state. While working as a full-time reporter and raising three kids with her partner, her alcoholism was activated. She was lucky enough to find treatment and is now in long-term recovery.

Roberta is passionate about helping disenfranchised people and others to get help and is especially focused on meeting people where they are. She believes deeply in the peer-to-peer model and has seen its benefits work on many levels. She has a unique skill set to help tell stories and get messages across to a wide audience. She enjoys spending time with her son, twin daughters, and husband. (but secretly, her favorite is her dog, Abby.) www.TheWiseGuideOnline.com | Wise Guide 17

Go

d l i W d l i W

in the

by Donna Molvik, Marketing Manager, Kalispel Tribe of Indians

Kalispel RV Resort is your basecamp for adventure

18 Wise Guide | 2021/2022 Edition

!

A W , k c i s u C in

A

fter a year of being cooped-up and stressed-out by the global pandemic, getting outdoors and away from it all never sounded better. A little bit of adventure is good for the soul, and that’s just what you’ll find in the Pend Oreille River Valley, in Cusick, Washington.

We welcome you to this lush, glacier-carved valley along the International Selkirk Loop that stretches from Lake Pend Oreille in North Idaho, through the Selkirk Mountains in Northeast Washington, and up to southern British Columbia.

Outdoor adventure-seekers will find more than a million acres to explore in the surrounding Colville National Forest and Selkirk Mountains. Hikers, lace-up your boots and grab a backpack to trek trails at nearby Bead Lake, Indian Creek, and Chewelah Mountain, where you’ll discover camas-covered meadows, mountainside huckleberry bushes, and groves of cedar, fir, and hemlock.

Birdwatchers can tick their checklist and chase the 273 species that live in or visit the Pend Oreille Valley. A favorite are the tundra swans that rest at Calispell Lake each spring along their migratory journey to the Arctic. And speaking of wildlife, this region is a hunter’s paradise with waterfowl and big game like deer, elk, moose, and bear.

Fishing is always in season here, and anglers can cast lines for days in the Pend Oreille River and in dozens of nearby lakes. If matching the hatch and quietly casting is more your speed, head over to Browns Lake, which is exclusively reserved for fly fishing.

And when winter conditions are just right, the lakes freeze over and ice-fishing extends the sport all year long.

Whether you canoe, kayak, or standup paddleboard, the Pend Oreille River Water Trail offers historical and environmental points of interest to explore. This designated water trail flows North 70 miles from nearby Oldtown, Idaho, to Boundary Dam that’s just a mile south of the British Columbia border in Canada.

Off-road enthusiasts can discover miles of OHV trails. Dirt bikers can ride single tracks at nearby Batey-Bould park and Little Pend Oreille Trail System. ATV riders can motor up the mountains for vista views in every direction by setting out from Middle Fork Calispell OHV, Kings Lake Route, and the Bead Lake Loop. And mountain bikers can hit the downhill runs on Chewelah Mountain.

The Pend Oreille Valley and Selkirk Mountains are also popular winter recreation destinations for snowmobiling, skiing, and snowboarding. Groomed trails for cross-country skiing, snowshoeing, and fat tire bikes are also easily accessible at the nearby Geophysical Sno-Park.

When you hear the call of the wild, indulge your wanderlust in the Pend Oreille Valley and enjoy plenty of amenities while staying at Kalispel RV Resort in Cusick, WA. No RV? No problem.

We have cottages furnished with the comforts of home that will keep you cozy during any season. Once you’ve had your fill of the great outdoors, you can head indoors for gaming entertainment and dining at Kalispel Casino located just steps away. And for those times when Mother Nature doesn’t cooperate and you don’t want to be stuck inside a cramped RV, take a quick drive over to the Camas Center and pick up a day pass for the family.

Kids will love swimming in the heated indoor pools with spray toys and slides, and there’s a 32-foot rock climbing wall, fullcourt gym, and indoor fitness center that will keep your blood pumping.

The Pend Oreille Valley and Selkirk Mountains are those rare gems of wild, open spaces where you can really get away from it all. With Kalispel RV Resort as your basecamp, you’ll be in the center of adventure. Come stay with us! *Due to possible COVID restrictions please call ahead to inquire about availability of amenities: Camas Center 509.447.7122 and Kalispel RV Resort 509.447.7144.

Donna Molvik is a strategic marketing and business operations professional with a passion for entrepreneurship, outdoor recreation, and tourism. In her time off you’ll find her hiking, kayaking, and camping with her dog Finn.

www.TheWiseGuideOnline.com | Wise Guide 19

The Promises We Make

T

hink of all the promises you’ve made in your life. Did you keep them all? Some promises are much easier to keep than others. We make promises in the moment, and when we get to that proverbial bridge “we’ll cross when we get there,” things may be very different when we arrive at that bridge than what we expected, or hoped.

Hope is what keeps us going forward, living our lives as if our dreams will be fulfilled, and sometimes life brings us more joys than we could ever have imagined. Life also brings sadness, perhaps it is the price we pay for happiness. As we age, those around us are aging too, and “things” happen that were not in the plan. It’s different with pets, we expect to outlive them, although sometimes it’s our children or grandchildren who end up caring for our pet when we don’t outlive them. And, we have the choice to determine when we feel their quality of life is so poor, we are only keeping them alive because we don’t want to lose them.

In the case of our human loved ones, what happens when their quality of life shifts in directions we didn’t expect? Are you really capable of managing their care? Did you ever promise not to “put them somewhere” when they became old? If you already promised that, and find yourself in the position of breaking that promise, and making the heart wrenching decision to face the fact that you simply cannot care for them any longer, you feel horrible guilt. The only way to assuage that guilt is to recognize that YOU cannot care for them and that they need the kind of care that will be MUCH BETTER for them. After all, isn’t it their care that is truly important? Not to mention the fact that you will be able to be the daughter, son, grand child, loving family member and/or friend rather than their overwrought caregiver.

If you haven’t made any promises, either directly to someone, or even to yourself, the very best thing you can do is check out the communities

Are you turning 65 or new to Medicare?

I can help you get Medicare ready.

Y0040_GHHHXDDEN21_C 20 Wise Guide | 2021/2022 Edition

available to you — just in case, and BEFORE you’re in crisis mode. The range of type, style and amenities of the various communities will surprise you. There are Independent Living communities where there are close neighbors you see as often as you wish, become acquainted with, and sometimes form strong bonds. There are Assisted Living communities where staff is on duty 24/7 to assist with activities of daily living; dressing, bathing, with transportation to appointments, fun on-site and off-site activities. There are Skilled Nursing Facilities in which medical care is provided. They are not the rest homes of yesteryear! They usually have both long term residents who need some degree of medical supervision, and short term residents who are there for the therapies needed for recovery from more serious illness, injury or even elective surgery.

The most intense care communities are often referred to as Memory Care. “Lock down” is a very negative term associated with them, but it simply means the residents are NOT free to wander off, as is the case with some dementia patients. Sometimes, in the early stages of dementia, Assisted Living communities will care for them, as long as they do not develop more serious behaviors or health needs for which their staff is not capable or qualified to provide. That doesn’t mean that the residents in Memory Care are drugged and kept in bed. That brings the old “sanitorium” of black and white movies to mind. The residents are usually free to be active and participate in whatever level of social and mental activity they can.

One last thing to put your mind at ease about ALL communities; they are rigorously and regularly monitored by a whole gamut of federal, state and county agencies. All of which are there to protect the residents and ensure quality standards of care are met.

Now, ask yourself, “Are you qualified, or capable of providing 24/7 quality care for your loved one? Would you keep your promises at all cost, regardless of the outcome?” We make promises because we love someone and want to do right by them. But what if life brings far more than you bargained for? Let yourself off the hook and do what is right for them and forgive yourself.

Call a licensed Humana sales agent.

Christopher “Chris” Murphy 208-215-5817 (TTY: 711) Monday – Friday, 8 a.m. – 5 p.m.

where the deer and the benjamins play.

Nestled in the mountains, perfectly situated near the river, there's a place where you can relax, recharge and refuel. Play the latest slots in the casino, enjoy some Northwest comfort food or sip on a drink in the neighborly restaurant and lounge. Stay for days at Kalispel RV Resort featuring hookups and cozy cottages. Or just fill up on grab-n-go food and drinks, groceries, camping and fishing supplies, and Chevron fuel at Kalispel Market. Whatever you do, there's no wrong way to experience the beautiful Pend Oreille River Valley. ex

W he re se re ni ty m ee ts Am en it ie s.

Kalispel Tribe Reservation on the Pend Oreille River at the foot of the Selkirks

420 Qlispe River Way, Cusick, WA 1-833-881-7492 | kalispelcasino.com

www.TheWiseGuideOnline.com | Wise Guide 21

Gum Disease and Heart Disease: The Common Thread

by Brett Matteson, DDS, FACP, DABP, Lakeview Dental Clinic

How plaque on your teeth may be connected to plaque in your arteries

F

or decades, researchers have probed the link between gum disease and cardiovascular health. Gum disease begins when the sticky, bacteria-laden film dentists refer to as plaque builds up around teeth. A completely different type of plaque — made of fat, cholesterol, calcium, and other substances found in blood — can build up inside arteries. Known as atherosclerosis, this fatty plaque is the hallmark of coronary artery disease.

People with gum disease (also known as periodontal disease) have two to three times the risk of having a heart attack, stroke, or other serious cardiovascular event. But there may not be a direct connection. Many people with heart disease have healthy gums, and not everyone with gum disease develops heart problems.

Shared risk factors, such as smoking or an unhealthy diet, may explain the association. Still, there’s a growing suspicion that gum disease may be an independent risk factor for heart disease.

Periodontal disease increases the body’s burden of inflammation. Acute inflammation — which involves an outpouring of immune cells that attack irritants and microbial invaders — fosters healing over the short term. But long-term (chronic) inflammation is a key contributor to many health problems, especially atherosclerosis.

To date, there’s no proof that treating gum disease will prevent cardiovascular disease or its complications. But the connection is compelling enough that dentists (and many doctors) say it’s yet another reason to be vigilant about preventing gum disease in the first place.

Daily tooth brushing and flossing can prevent and even reverse an early stage of gum disease, known as gingivitis. If your dentist says you have gingivitis, ask for a brushing and flossing demonstration to make sure you’re doing both correctly. I did not know this as a dentist until I was in dental school and had many classes on Hygiene. Many people don’t spend enough time or care when brushing (the recommended duration is two minutes). Flossing sweeps away the sticky film between teeth that leads to plaque buildup. Twice-yearly cleanings by a dentist or hygienist are also advisable.

Left untreated, gingivitis can turn into periodontal disease (see “Signs of gum disease”). The gums become loose around the root of the tooth, creating a gum pocket that gradually deepens. Eventually, the infection and inflammation can cause the tooth to loosen and possibly fall out.

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Signs of gum disease Any of these signs can be a clue that you have periodontal disease: • swollen, red, or tender gums • gums that bleed easily • pus between the teeth and gums • bad breath • buildup of hard brown deposits along the gum line • loose teeth or teeth that are moving apart • changes in the way dental appliances fit

Periodontal Disease in Men PROSTATE HEALTH

Prostate-specific antigen (PSA) is an enzyme created in the prostate that is normally secreted in very small amounts.

However, when the prostate becomes inflamed, infected, or affected by cancer, PSA levels rise. Research has shown that men with indicators of periodontal disease such as red, swollen or tender gums as well as prostatitis (inflammation of the prostate) have higher levels of PSA than men with only one of the conditions. This means that prostate health may be associated with periodontal health, and vice versa.

HEART DISEASE Research indicates that periodontal disease and cardiovascular disease are associated; having periodontal disease may actually increase your risk of cardiovascular disease. Both diseases are chronic inflammatory conditions, and researchers believe that inflammation is the connection between gum disease and heart disease. Since men are already more likely to develop heart disease than women, maintaining periodontal health is another way to reduce this risk.

IMPOTENCE Men with periodontal disease, especially those younger than 30 or older than 70, are at increased risk of developing impotence, according to research. Researchers believe that inflammation may be the link between the two conditions; prolonged chronic inflammation (the same type of inflammation that is associated with periodontal disease) can damage blood vessels leading to impotence.

CANCER Research has found that men with a history of gum disease are 14 percent more likely to develop cancer than men with

healthy gums. Specifically, men with periodontal disease may be 49 percent more likely than women to develop kidney cancer, 54 percent more likely to develop pancreatic cancer, and 30 percent more likely to develop blood cancers.

Periodontal Disease in Women PUBERTY During puberty, an increased level of sex hormones, such as progesterone and possibly estrogen, causes increased blood circulation to the gums. This may cause an increase in the gum’s sensitivity and lead to a greater reaction to any irritation, including food particles and plaque. During this time, the gums may become swollen, turn red and feel tender.

MENSTRUATION Occasionally, some women experience menstruation gingivitis. Women with this condition may experience bleeding gums, bright red and swollen gums and sores on the inside of the cheek. Menstruation gingivitis typically occurs right before a woman’s period and clears up once her period has started.

PREGNANCY Some studies have suggested the possibility of an additional risk factor – periodontal disease. Pregnant women who have periodontal disease may be more likely to have a baby that is born too early and too small. However, more research is needed to confirm how periodontal disease may affect pregnancy outcomes.

All infections are cause for concern among pregnant women because they pose a risk to the health of the baby. The Academy recommends that women considering pregnancy have a periodontal evaluation.

MENOPAUSE AND POSTMENOPAUSE Women who are menopausal or post-menopausal may experience changes in their mouths. They may notice discomfort in the mouth, including dry mouth, pain and burning sensations in the gum tissue and altered taste, especially salty, peppery or sour.

In addition, menopausal gingivostomatitis affects a small percentage of women. Gums that look dry or shiny, bleed easily and range from abnormally pale to deep red mark this condition. Most women find that estrogen supplements help to relieve these symptoms.

A board-certified prosthodontist can help with all of your dental needs while ensuring optimal outcomes. To learn more about the scope of our services, go to our website: LakeviewDentalClinic.com.

Resources American Academy of Periodontology. Gum Disease and Women. www.perio.org 3/3/21 American Academy of Periodontology. Gum disease and Men. www.perio.org 2/3/21 Harvard Heart Letter. Gum Disease and heart disease. www.health.Harvard.edu/ heart-health

After graduating from dental school, Dr. Brett Matteson was accepted into the United States Army’s “Advanced Education in Prosthodontics” program. It was Dr. Matteson’s honor to treat our soldiers around the world, and it is now his privilege to treat the community of Coeur d’Alene and surrounding areas, including Post Falls and Hayden Lake. Dr. Matteson is an active member with the Idaho State Dental Society, and is the Vice President of the Idaho Panhandle Dental Society. www.TheWiseGuideOnline.com | Wise Guide 23

O

ver this past year, CASA has been creative in our grant writing and have had the opportunity to work on some “out of the box” ideas with donors on different service needs for our CASA children.

The CASA Learning Lab was established through a living trust from a married couple on their 35th wedding anniversary. They both have a passion for education, so wanted to make an impact on children through tutoring. We now have an endowment over the next 10 years to provide tutoring services for school aged children.

The development of our Project Permanency grew out of a need to provide basic household essentials for reunified families.

Furniture to help instill family activities and normalcy, such as a kitchen table or refrigerator. Beds for every child to feel like they are worthy of their own space and have something to call their own. We are thankful that we have the resources and the revenue to be able to provide these extended services to our CASA children. We are excited to be able to support local stores, such as Sandpoint Furniture when purchasing these essentials for our deserving families.

CASA helps children overcome the trauma they have experienced and to provide hope for a better future. Whether reunification with the biological family or adoption into a new 24 Wise Guide | 2021/2022 Edition

family, that is CASA’s goal for a child, CASA serves the whole family. Through Project Permanency, CASA works to support family connections, aid in the process of releasing shame and helps to build stable relationships within the nuclear family.

In addition to recommending services to the Court, CASA can provide basic needs and supplies as well as, critically needed items that help develop a healthy and stable home environment.

The benefits of a stable home extends far past furniture CASA has many tools and resources to help families build trust, relationships and connections and ease the transition into new homes, both emotionally and financially. CASA builds the foundation for permanency success. Through a formal application process, CASA tracks families and purchases. Funds received and expended are recorded on the monthly financial Statement of Activity. CASA strives to build capability within these families and homes, not dependency. Our goal is to encourage the betterment of parents’ lives and the children they care for.

All children CASA serves are eligible to receive basic needs and supplies: toiletries, diapers and baby supplies, clothing, books, comfort toys, blankets, snow and beachwear, and gift cards for clothing, gas, and food. CASA provides additional tangible goods

CASA Has Two New Programs!

CASA Learning Lab & Project Permanency

by Kristin Ludwig, Director of Development, North Idaho CASA

Kristin Ludwig, Director of Development, and CASA team member has over 20-years experience in event planning, advertising and marketing.

After moving to Coeur d’Alene in 2005, she became involved in local volunteer organizations and political campaigns, advocating for the good of the community. She has worked with the Coeur d’Alene Backpack Program since it’s inception and was lead planner on Wine, Women & Shoes for Idaho Youth Ranch.

Setting our families up for loving success When a CASA works towards reunifying a family, the family has been under the Child Protective System purview for at least several months or even years. The family is well known and understood by the CASA advocate, the Court, the social worker, and service providers. The family has demonstrated compliance with the terms of their case plan and completed the court-ordered tasks in order to be reunified with their children. These tasks may include providing safe housing, being employed, attending parenting classes, participating in counseling, and performing drug and alcohol testing. At this stage of a child protection case, the IDHW, CASA, and the District Courts are working together to reunify the family and coordinate services. In most cases, the difference between the path to successful permanency, or financial and emotional turmoil, can be as simple as having a drivable car or a working refrigerator.

The National CASA/GAL (Guardians ad Litem) Association (founded in 1977) and North Idaho CASA (founded in 1993) have proven records of positive outcomes. CASA is mandated and accountable to both the Idaho Supreme Court and National CASA. The program has a successful history of raising funds from the generous contributions of state and federal agencies, foundations, individuals, and businesses in our community. If you would like to become a donor to Project Permanency, please visit our website: www.northidahocasa.org to learn more.

to families demonstrating resiliency and courage to repair their lives and provide stable homes for their children. CASA provides beds, dressers, mattresses, car seats, swing sets, and bicycles.

Examples of additional items provided during 2020 include a washer, dryer, and deep freezer for a single father of eight children (three of which are foster children); snow tires on a family’s only vehicle; car repair, and a refrigerator for a single mom; new carpet and window treatments for a trailer home; and a deck for a tiny house giving the kids more room to play.

Adoptive parents are also eligible to apply for the Project Permanency program. As with reunification with biological families, adopting a child into a family is a new beginning. This process deserves all the same encouragement and support to help the family build a healthy and permanent home.

In addition to breaking the cycle of abuse, we strive to provide hope, encouragement, and pride for families trapped in generational poverty. Poverty can make people feel they are deficient. Poverty impacts motivation, expectations, learning, relationships, and communication. We empower individuals to thrive rather than survive. Envision the pride instilled in providing a bed for a child who usually sleeps on the floor or new clothes to a child who has only worn hand-me-downs. Partnering with these biological and adoptive families helps set parents up for success. www.TheWiseGuideOnline.com | Wise Guide 25

Bonner General Ophthalmology

Getting to Know Dr. Torres

Career Veteran, Medical Professional, and why he chose Bonner General Health for his next adventure.

by Kristin Carlson, Marketing Specialist, Bonner General Health

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phthalmology was a service line missing from Bonner & Boundary County since the retirement of Dr. Charles George, in 2017. Bonner General Health recognized the need and planned to add this specialty service to its umbrella of clinics. The robust recruitment efforts paid off when Dr. Mark Torres from Tacoma, Washington, moved to Sandpoint and joined our team. The clinic was slated to open in February 2020 but was halted by the COVID pandemic. Dr. Torres and his team hit the ground running as soon as the clinic opened in May and has proven to be a vital and essential service to our community.

I sat down with Dr. Torres to allow the community to get to know him and see just why Bonner General Ophthalmology is a success.

1. What is your favorite thing about living in Sandpoint/ Bonner County?

I grew up in a town very similar to Sandpoint - a small town in the Rocky Mountains. Sandpoint and Bonner County remind me of all the things I cherished from that upbringing. Friendly people saying “hello” when they pass you on the sidewalk and are always interested in pausing for a brief “catch-up” chat.

Folks who are resilient, responsible, and independent in all aspects of life, yet never hesitate to reach out and assist a neighbor in need. People with a bond to the outdoors and all the beauty and adventure that entails. They wake up every day, look outside their windows at a mountain paradise, and head out to live life as it was meant to be lived.

2. You have traveled and lived in many places throughout your career. What is a unique place you have lived in, and what did you like about it?

Germany was my favorite military duty location, really for the same reasons as Sandpoint and Bonner County. I lived in a small German town, where the people were very hospitable and practical. Even though I was a foreigner, they were always courteous and friendly and always willing 26 Wise Guide | 2021/2022 Edition

to help out an “outsider” who may not be wise to their unique customs, traditions, and routines. On this personal level, they were not much different than other folks around the world.

3. What motivated you to join the military? Is your military career what led you to a path in the medical field?

There are few reasons behind my military background. My father was a career Air Force person, and I very much respected and admired him. He never pushed me toward military service, only highlighted the opportunities that military experience can sometimes bring. Of course, nothing is guaranteed; you still have to put in the work. Also, the military offered a financial pathway and means to fund college and medical school, a common reason many individuals consider military service. Regarding my medical career, I was interested in scientific pursuits at a very young age. Along the way, those interests remained solid and unchanged, and a career in the medical field became the best fit for my goals and aspirations.

4. How did your military experience affect your life and career today?

I came away from my military service with many life lessons and tools that you can acquire from military experience; self-discipline, self-confidence, and selfreliance in everyday tasks and pursuits.

Also, respect for all individuals from widely diverse backgrounds and widely different life and career paths and interests. The functioning as part of a wellorganized and successful team and the teamwork necessary to make it happen.

The ability to move on in life when your

“run is done,” with an outlook that other unique and wonderful life experiences are on the horizon. Just like my experience with Sandpoint, Bonner County, and Bonner General!

5. What are some of the honors you are most proud of in your career?

I’m honored to have had the privilege to serve in the US military. Working side-byside, for so long and so successfully, with so many talented and passionate individuals from diverse backgrounds and exciting places, is something I’m exceptionally proud of. I’m honored to have had the opportunities and experiences along the way and shared those with others. I’m honored to be an American. We’re not perfect, but our country is grounded in solid principles and ideals, and many places in the world are not so fortunate.

I’m honored to have visited other places globally and have interacted with people of different cultures and traditions. At the individual level, their goals, dreams, and priorities are not much different than ours — freedom, family, opportunity. I’m honored to have been able to serve in a medical profession that ultimately benefits others. Lastly, I’m honored to have the chance to continue that medical profession at Bonner General Health!

Dr. Torres specializes in corneal and refractive surgery, diagnosis and treatment of conditions, injuries, and diseases related to the eye.

Bonner General Ophthalmology is the only ophthalmology clinic in Sandpoint and the surrounding area. The clinic is located at 423 N. Third Avenue in Sandpoint. (208) 265-1011, bonnergeneral.org.

Kristin Carlson holds a Bachelor’s Degree in Public and Interpersonal Communication from North Carolina State University. She joined the Bonner General Health team in March 2020. Before BGH, Kristin worked as the Communications and Tourism Specialist for the Greater Sandpoint Chamber of Commerce and has experience in Project Management, Recruiting, and Administrative Roles. Her goal is to ensure individuals living in or visiting our community are aware of the exceptional care, providers, and services available at BGH.

www.TheWiseGuideOnline.com | Wise Guide 27

Family Crisis Network

From Grass Roots to a Valuable Community Asset

by Sarah Kramer, Program Manager, and Cody Francis, Assistant Director

M

ost people who encounter Family Crisis Network for the first-time state, “I never knew you existed!” and we reply, “Most don’t… unless they find themselves needing our services.” Domestic Violence and Sexual Assault are not usually a part of everyone’s daily vocabulary but unfortunately it is a part of several family’s silent struggles. FCN has been serving many of these families in this community since 1982. As a grass roots advocacy agency in a time when people wanted to help abused woman and children but did not have the legislation, support, or resources, volunteers answered a domestic violence hotline in the basement of the United Church of Christ while a few community members opened their homes to provide a safe haven for families fleeing from abuse. Since the beginning, the agency has moved locations several times but has been in its current location since 1990. As the years passed, advocates and lobbyist made great strides in providing laws and resources for Domestic Violence and Sexual Assault victims and the Violence Against Women Act (VAWA) was finally passed in 1994. The agency began to grow as resources became available to support a proper working staff and more resources became available in the community.

Flash forward to 2021 and Family Crisis Network has become a multiple service agency providing advocacy, case management, shelter, crisis intervention, trauma therapy, and financial resources for victims of domestic violence, victims of sexual assault, victims of all other crimes, and the homeless. FCN also provides food, personal care items, winter clothing, tents,

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sleeping bags, shuttle passes to Spokane, prescription vouchers and emergency financial assistance to persons in need. FCN provides a confidential environment with trained advocates who are there to listen and support while empowering survivors to make their own educated choices. In response to the COVID-19 pandemic, FCN was recently given funding to maintain units to be used for isolation and quarantine for the duration of the pandemic. We work closely with the medical community and emergency management team to help fill this need.

In July of 2019 FCN expanded by opening a Child Advocacy Center (CAC) for Pend Oreille County. Before this was available, child victims of sexual assault, abuse and neglect in Pend Oreille County had to wait for an appointment in Spokane to be interviewed and at times that could take weeks. This was not only inconvenient and stressful, but the process jeopardized the prosecution in their effort to hold the abuser accountable.

Today, at the CAC, a child is interviewed in a timely manner by a trained, experienced forensic interviewer in a child friendly environment. The family can access resources from the CAC and receive support from the Care Coordinator. Resources include medical advocacy, legal advocacy, and professional therapy. Children are interviewed in a soundproof room with audio visual equipment, while law enforcement and related legal professionals observe in a nearby watch room. The team, then can follow up with any needs and concerns and provide a cohesive process throughout the case and beyond. We hope that having this process available in our community will encourage

families, agencies, and community members to feel more comfortable in reporting abuse of children.

Family Crisis Network agency has come from a place of scarcity and grass roots efforts to a place where valuable community change can be pursued. At Family Crisis Network, above and beyond the level of crisis, we wish to help people understand the dynamics behind abuse and shift the cultural norms surrounding violence to families. We do this by providing outreach and education to the community in the form of events, trainings, and media outreach. One such event is the annual Child Abuse Awareness Walk. This year’s walk, themed Choose Kindness, was held virtually from April 22-24th. The walk is to bring community together, not to point fingers, but to raise awareness for Child Abuse Awareness Month by promoting happy, healthy, and safe families. If you missed this year’s virtual walk, we plan to walk in person approximately the same time next year. Please join us!

As an agency we provide services but as a community member you can also contribute. Here are four ways you can support victims of abuse and the homeless: 1.

Seek to understand, not judge: Arm yourself with knowledge about the dynamics of abuse and the effects of trauma so you can provide empathy and support instead of advice.

2. Guide to resources: Have a list of resources available for people you may encounter that may need some help.

3. See something, say something: Report abusive behavior.

Your voice can count when others are forced to remain silent.

4. Call us: Give our agency a call and find out what needs you may be able to help fill.

The quote by Dr. Sukhraj Dhillon that states “Maybe I can’t stop the downpour, but I will always join you for a walk in the rain,” provides an accurate description of how Family Crisis Network provides services. An advocate may not be able to change the trauma that has been done to another, but they can stand by their side and walk through the journey with them by providing a shoulder to lean on and a voice when they feel like they have none. If you need someone to walk that journey with you or you would like to find out how to support the cause, please contact our agency at 509-447-2274.

Surgical experience you trust.

Personal care you deserve.

For general, orthopedic, and gynecological surgeries... close to HOME!

Newport Hospital & Health Services Family Crisis Network: Jackie Kiehn, Director - Sarah Kramer, Program Manager - Cody Francis, Assistant Director

714 W. Pine St., Newport WA (509) 447-2441 NewportHospitalAndHealth.org www.TheWiseGuideOnline.com | Wise Guide 29

How Do I Choose?

They All Seem Alike!

by Carey Spears, RHU, Spears Insurance, Inc.

I

t isn’t just procrastination when it comes to not being prepared for Medicare. Life has been busy, even during the pandemic. Sometimes just trying to get information or a call back during this time has been more frustrating than a year ago. It seems so much harder to simply pick up the phone and call someone!

It is with mixed feelings that I admit that I am only a short 6 months away from eligibility for Medicare. With all my preaching on being prepared…I have fallen short. I’ve been told that people will take more time planning their vacation than for Medicare and retirement. We drag our feet for things we don’t want to outright acknowledge; turning 65 and Medicare!

You are, for the most part, on your own when choosing health care coverage.

Should you stay on an employer plan?

When, where and how do you enroll in the Basic Medicare Benefit? The Human Resources (HR) department of your employer can discuss your group benefits, but they do not have the information

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about what to do when turning 65, or if you decide to retire early. The Medicare world is complicated; the alphabet soup of enrollment periods…ICEP, IEP, AEP, SEP, OEP…which one applies to you? At one point, they all can!

Destination Medicare may take everyone to the same location, but the choices and route getting there may be very different.

Just like using a travel agency to plan your trip, or a Financial Planner to set up your retirement plan, working with a Health Insurance Professional is like having your own, personal HR department when it comes to getting started and evaluating your coverage needs.

Our services don’t stop once you are enrolled in a plan. We are here to review your coverage every year because not only will your needs change, but the plans themselves change too — especially Prescription Coverage. Maybe the premium doesn’t change much but prescription drugs could change in tier level or be removed altogether. Evaluating Part D benefits can’t be done based solely on the cheapest premium.

We can help you every year to evaluate the best options for you, based on prescriptions, how often they are filled, which pharmacy you use. Part D is just one segment of coverage to review. We will review your options between Medicare Supplements and Medicare Advantage Plans based on your needs. Factors to be considered are choice of doctors, lifestyle and travel, ongoing health issues, options for more preventive care, fitness center benefits, extra benefits not included in basic Medicare coverage like vision, hearing and dental. These things should not be overlooked.

Have You Noticed?

Television commercials for Medicare Benefits and Options have been running 90 miles per hour for months now, even after the close of the Annual Enrollment Period on Dec 7th, 2020! And to what purpose? Are they really legitimate? I’ve been asked that question a thousand times at least! My answer to you is, as the saying goes, “It’s 5 o’clock somewhere!” The information is legitimate, for some people, somewhere!

Most of those products advertised are Medicare Advantage plans which combine your Medicare Part A and B, and most times the prescription Part D, into one single plan, managed by the insurance company. You are still required to have Medicare Part A, pay your Medicare Part B premium, and to live in the area the plans are offered in order to enroll in these plans.

Medicare Advantage plans often add extra benefits that Medicare does not cover such as routine vision, hearing and sometimes dental. These types of plans are legitimate and are available here in our counties.

The problem with those commercials is they entice you with zero premiums, no copays to doctors and hospitals, and some even say they will give back a portion of your Part B premium. I will caution you, it is not as it seems!

Those types of plans are not necessarily available here, they may be somewhere, but not here! Some plans are available only if you meet income guidelines. Please know that “One Call” does not stop there. You have now opened a Pandora’s Box. That “one call” is to a call center that now has the ability to call you back. If you do talk to a call center agent, remember — they DO NOT work for Medicare! Those call centers

Destination Medicare may take everyone to the same location, but the choices and route getting there may be very different. most likely are not located in our local area, or even our country, and only represent the insurance plans offered by National companies. Will they do a full evaluation of your needs by reviewing the network to make sure your doctors are part of the network? Do they compare prescription cost overall to see that you are getting the best savings? Is our local hospital included in the network? You might be surprised. How do you know if the local Idaho companies can give you better coverage in benefits and doctors? Is the customer service here in Idaho? ‘Yes’ for our local Idaho companies,

‘No’ for the national companies.

I’m just saying, as wonderful as it is to call a celebrity like Joe, you may be getting more than you bargain for with all the extra calls hitting your phone! I advocate for the local insurance agent right here!

Using an agent doesn’t make your premium cost more — it may actually save you money in the long run because you have benefits that you need and use.

We have local resources at our fingertips to assist you in almost any situation.

Whether you are turning 65, leaving employment to go to Medicare or even just retiring early. We advocate for you. We can help you review qualifications on limited income. The conversation with your local insurance professional is truly Free, No risk, No obligation. So, save yourself the headache, don’t call Joe! Stop in, have a cup of coffee and tell us what’s on your mind about your health insurance coverage.

Carey Spears, RHU, is a licensed Life/Health insurance agent with over 26 years experience with Senior products such as Medicare Supplements, Part D Prescription plans and Medicare Advantage Plans. With offices in Sandpoint and Coeur d’Alene, she offers ‘no obligation’ consultations for individuals as well as providing group presentations on the Beginners Guide into Medicare! If you are considering a retirement date or turning 65 in the next year, call Carey at 208-265-2026 to learn the right steps in securing your Health Care options.

www.TheWiseGuideOnline.com | Wise Guide 31

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 VSOs

MONTANA Montana State VSOs

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

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 208-255-8882 6635 Lincoln St., Bonners Ferry Wed & Thur 8:00 AM - 1:00 PM email: veterans@boundarycountyid.org

Kootenai County Thomas Freeman 208-446-1090 120 E. Railroad Ave., Post Falls M-F 8:30 AM - 5:00 PM email: tfreeman@kcgov.us

Shoshone County Mac Gibler 208-752-1264 700 Bank St., Suite 120, Wallace M-F 8:00 AM - 4:00 PM email: mgibler@co.shoshone.id.us

Carolyn Collins Ryan Keeler Bryan T. Zipp National Guard Armory 406-755-3795 2989 Hwy. 93 North, Kalispell Appts. M & F, walk-ins welcome Wed., Tues. is outreach, Thurs. closed.

WASHINGTON Washington State VSO Spokane County Regional Veterans Service Center 509-477-3690 1117 N. Evergreen, STE 2, Spokane M-F 8-4

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

Veterans Events & Services Need ANYTHING from the VA? Call 800-698-2411 regardless of what questions or services you are calling for (benefit or medical) there is now a NEW Single Access Point to all VA contact centers.

The 2021 National Defense Authorization Act (NDAA) has been approved, which included the addition of three new conditions to be added to the approved herbicide exposure conditions associated with Vietnam service, service on ship within 12 nautical miles of the Vietnam coastline, service on the Korean DMZ from 1968-1971, served along the perimeters of an airbase in Thailand during the Vietnam War or served on a flight/ground crew for C-123 Aircraft until 1986. The three new conditions are Bladder Cancer, Hypothyroidism, and Parkinsonism/Parkinson-like symptoms. The VA still has to release the rules of how and when they will adjudicate claims (to include survivor benefits) similar to how the Blue Water Agent Orange claims were handled. If a veteran previously filed for one of these conditions and was denied, do not do anything else until the rules have been released. At that time, we can file a VA Form 21-0995 (Supplemental Claim) for those previously denied issues. If a veteran has never filed for those conditions, you should file an Intent to File to protect the earliest possible date of claim. Please note Hypertension (high blood pressure) was not included as an herbicide presumptive condition on the NDAA. Contact your VSO for more details and help filing!

www.ShopMyExchange.com ALL honorably discharged veterans are now permitted to use the Online Military Exchange to purchase items with no taxes charged and free shipping. Log into www.shopmyexchange.com for more information

ADDITIONAL EMPLOYMENT, EDUCATION, & SOCIAL RESOURCES

Vietnam War Commemorative Books The State of Idaho had Vietnam War Commemorative Books created to distribute to all Vietnam veterans within the State of Idaho. If you have not received one, please contact one of our State Service Officer locations and we will assist in providing the book to you.

MISSION 43 from the J.A. & Kathryn Albertson Family Foundation www.mission43.org WYAKIN WARRIOR FOUNDATION HIRE HEROES USA

www.wyakin.org

www.hireheroesusa.org/idaho H2H HERO 2 HIRED TEAM RUBICON

www.h2h.jobs

www.teamrubiconusa.org TEAM RWB www.teamrwb.org

EMPLOYER SUPPORT OF THE GUARD AND RESERVE www.esgr.mil www.TheWiseGuideOnline.com | Wise Guide 33

Amputation,

a Life-Changing Event

by Heidi Frazier, Director of Marketing and Business Development, Rehabilitation Hospital of the Northwest

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wo legs, two arms, ten fingers and ten toes are physical attributes that many people take for granted. Unfortunately, more than 2 million Americans live with limb loss or due to amputation, and more than 28 million are at risk of amputation surgery.

Fortunately, there are many organizations to support and empower Amputees to help them achieve their greatest potential.

Factors that lead to an increased risk of an amputation include: • Diabetes or High blood sugar levels • Smoking • Nerve damage in the feet (peripheral neuropathy) • Calluses or corns • Foot deformities • Poor blood circulation tot he extremities (peripheral artery disease) • A history of foot ulcers • A past amputation • Vision impairment • Kidney disease People with amputations have special physical, mental, and social conditions during their lifetime. There are many things that can be done to prepare mentally and physically for an elective amputation surgery, so doing research ahead of time can help patients choose a team that has experience with amputations. Getting your surgical and rehabilitation team in place prior to surgery can help improve confidence and outcomes.

Your team may include a primary care provider, surgeon, rehabilitation and therapy team, and your prosthetist.

Research has shown that the first several months of rehabilitation are crucial to a patient’s long-term success as an amputee. Depending on the individual’s goals, a comprehensive inpatient and outpatient therapy schedule is the best way to achieve activity levels in a matter of months. Recovering from an amputation is most often done in an inpatient setting like an acute inpatient rehabilitation hospital. Inpatient rehabilitation hospitals use a comprehensive approach to ensure all needs of the individual are being met while they participate in intense therapy and caregiver or family training to prepare to discharge home. Inpatient rehabilitation will provide education on residual limb care, preparing for a prosthesis, wound management, and pain control techniques as well as safety techniques for returning home and when in the community.

An amputation is a life-changing event and requires a new approach to life in a whole new way. Choose therapists that are experienced in helping adapt to new norms and working to overcome the challenges that arise after an amputation. Providing emotional support and access to favorite activities or support groups through programs like the Amputation Coalition or the US Department fo Veterans Affairs should be considered part of a robust limb loss program. Your amputation team can provide the education and support to help live a healthy, productive life.

Rehabilitation Hospital of the Northwest is a 30-bed, free-standing rehabilitation hospital providing the highest level of inpatient rehabilitative services available.

Patients are our priority. We are passionate about patient care and consider it a privilege to be able to provide services to patients and their family members throughout Idaho and surrounding states. Our efforts have earned us national recognition as a healthcare leader. The hospital is the first hospital in Idaho to earn certification by The Joint Commission. For more information, call 208-262-8700 and visit RHN.ernesthealth.com.

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www.TheWiseGuideOnline.com | Wise Guide 35

What is Huntington’s Disease?

by Melissa Bixby, MS, CCRC, Project Manager, Movement Disorders, Inland Northwest Research

H

untington’s Disease (HD) is a genetic disorder that causes a mutation or expansion in the Huntington’s gene, located on chromosome 4. This abnormal mutation in the Huntington’s gene causes the nerve cells in the brain to breakdown over time. HD affects a person’s movement (ability to walk, speak, control movement), cognitive ability (reason, memory, concentration) and emotions (aggression, mood, reaction). HD is an inherited disease, which means the gene for this disease is passed from parent to child. Every child of a parent with HD has a 50/50 (fifty percent) chance of inheriting the HD gene. Every person who inherits the expanded HD gene will eventually develop the disease. Symptoms usually appear between the ages of 30 to 50 and worsen over a 10 to 25year period. Today, there are approximately 30,000 symptomatic Americans and more than 200,000 at-risk of inheriting the disease. It is estimated that 3 to 7 out of every 100,000 people have HD.

Why is it important for research?

The HD gene was identified in 1993, and currently, there is no therapy which can halt, slow, or reverse the progression of HD. However, much of the current HD research is focused on understanding HD and how to modify or stop the progression of disease. Doctors and scientist are using gene-editing drugs to stop the formation of the harmful HD proteins in the brain. Unfortunately, because this disease is rare, there is not as much funding for research. Although there were recently several setbacks in latephase HD clinical trials, all trials (even failed ones) provide important knowledge, that scientists can learn from and build upon. Currently there are several new Phase I trials including, Branaplam, a repurposed spinal muscular atrophy drug, from

Parkinson’s Support Groups In-person support groups have been suspended during the pandemic. Contact the individuals below to learn if they are meeting virtually, and what their plans are for resuming in-person groups.

COEUR D’ALENE

SANDPOINT

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

East Bonner County Library meeting room, 1407 Cedar St., 2nd Mondays at 2 - 3:30 pm.

Contact: A.C. Woolnough 208-304-5756 Email: acwooly@gmail.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.

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!

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SPOKANE

Women Affected by PD Support Group Riverview Retirement, Dining Room 1801 E Upriver Drive, 1st Thursdays at 1 - 2:30 pm A 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

Check www.NWPF.org for details Follow us on Facebook! @NW Parkinson’s Foundation

Novartis, that has shown to reduce the levels of mutant huntingtin protein in preclinical models. Companies like Triplet Therapeutics, who specialize in triplicate repeat disorders, are conducting a data collection trial, to help develop their upcoming antisense oligonucleotide (ASO), and small interfering RNA drug trials. These research trials are designed to prevent or delay disease onset and stop or slow disease progression. This is great news for families affected by this devastating disease. Access to resources, education, and research are the cornerstones to successful identification, treatment, and prevention of neurodegenerative diseases. To learn more about these trials please go to the Huntington’s Disease Society of America (HDSA) website at, https://hdsa.org/ hd-research/hd-trial-finder/.

What options are there?

If you have a family history of Huntington’s Disease or know someone who does, it is important to identify what resources are available to support you or your loved ones. Genetic testing for HD can be a difficult and personal choice. Many people do not see benefit in knowing their genetic status, and others find value in understanding their genetic information and risk of disease. Knowing and understanding your genetic risk can you help navigate future medical and personal decisions but can also carry emotional concerns. Talk with your doctor or genetic counselor about moving forward with genetic testing. Typically, genetic testing is not recommended for children under the age of 18, as they may not fully understand what a positive genetic result would entail for their future.

The exception would be to confirm a diagnosis of a juvenile onset of HD, should a child display early symptoms of HD. There is a large social support network for HD families through programs like the Huntington’s Disease Society of America who can provide access to social workers, genetic counselors, family planning, advocacy events and volunteer opportunities. The journey of how to navigate Huntington’s Disease is an intensely personal one and there is no right answer in how to complete it. Raising awareness and advocacy on a political and community level is what will help move us all forward in finding a cure.

Inland Northwest Research are leaders in national and global research, focused on neurological disorders. We offer high impact clinical trial opportunities in Parkinson’s Disease, Huntington’s Disease, Multiple Sclerosis, Essential Tremor and dementia. We take great pride in helping those with neurological disorders navigate through clinical trial participation, and explore options that are the best fit for their needs. We are proud to partner with Invitae, to offer our community affordable genetic testing services. Genetic testing can be performed as part of a clinical trial registry or electively. Call us at 509-960-2818 and visit inwresearch.com for more information.

Melissa Bixby is the Project Manager for Movement Disorders at Inland Northwest Research. She is a Certified Clinical Research Coordinator (CCRC) and clinical lab scientist with over 15 years of experience in the medical field. She holds a degree in biochemistry from Towson University and a graduate degree in biomedical science from Johns Hopkins University.

She runs many of the large Phase 1 and Phase 2 interventional trials and is a credentialed coordinator with both the Parkinson and Huntington Study Groups where she is involved with other collaborative academic trials with sites around the world.

www.TheWiseGuideOnline.com | Wise Guide 37

Interventional Pain Management Individualized Treatment for Acute and Chronic Pain

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

A

cute and chronic pain continue to be common medical problems despite advancements in pain management therapies. Chronic pain is typically more difficult to treat than acute pain requiring more frequent and diverse treatment. If chronic pain can be prevented before it’s occurrence or effectively treated once it has occurred there is dramatically reduced patient suffering, improved quality of life and reduced healthcare costs.

The most effective treatment of pain (both acute and chronic) requires applying the most precise and comprehensive therapies at our disposal while minimizing risks and side effects. The decision making for which therapies to apply for a specific pain presentation are not algorithmic and vary greatly depending on the source, severity, duration and secondary suffering.

Interventional pain management continues to be one of the mainstays of therapy for the treatment of both acute and chronic pain. Interventional pain management is best described as using a specific procedure, or intervention, to diagnose and/or treat a specific type of pain. We have a number of different interventions at our disposal. A combination of the patient’s history, physical examination and imaging helps us identify the source of the pain which will determine which type of treatment and intervention we will employ.

Some of the benefits of interventional pain management include reduced office visits, reduced patient suffering and reduced opioid requirements. Using a specific intervention targets the pain at the source compared to medication treatment which can affect the entire body. Most of the medications we use to treat pain are limited to a few different classes of 38 Wise Guide | 2021/2022 Edition

medications; anti-inflammatories, muscle relaxants, and neuropathic medications. Side effects are common with pain management medications. Combining interventional therapy with medication treatment can reduce the dosage and frequency of medications minimizing unwanted side effects. For example, patients who suffer from arthritic joint pain commonly have to take anti-inflammatories such as ibuprofen or naproxen regularly for pain relief. Frequent use or high dose exposure to anti-inflammatories can result in damage to the stomach and kidneys. Patients with heart disease or on anticoagulants typically have to restrict or minimize anti-inflammatory usage.

Employing interventional options such as a nerve block or injection to the painful arthritic joint can reduce or eliminate the need for medications. Newer treatments for arthritic joint pain include nerve blocks, radiofrequency ablation, and peripheral nerve stimulation. We continue to use steroid injections when effective as well as viscosupplementation.

Interventional pain management can commonly produce more rapid pain relief than other types of therapy. One of the most effective ways of treating chronic pain is stopping the formation of chronic pain before it starts. Interventional therapy can sometimes provide potent pain relief in hours to days. The sooner acute pain can effectively be treated, the less likely it is going to turn into a chronic problem. For example, one of the most common pain sources we see in our practice is acute low back pain that radiates down the leg(s). This is commonly secondary to a disc herniation compressing the spinal nerves as they exit the spine. This type of pain is quite common and it routinely goes away on its own. But when the pain is severe

and quality of life is impacted, the more important it is to treat that pain effectively and quickly. Using interventional therapy we can apply medication directly to the location of the disc herniation to reduce pain and inflammation. This therapy can produce significant pain relief within days. The pain relief results in improved quality of life, improved patient function and reduced disability which can ultimately prevent the formation of chronic pain or a surgical procedure.

There are interventional treatments for both acute and chronic pain. Specific interventional therapies are used to target different sources of pain including common sources like joint and spine pain. However, more complex pain like headaches, pelvic pain and neuropathy can sometimes be effectively managed with interventional therapy. Not all interventional therapy contains steroids or medications. New treatments such as peripheral nerve stimulation and spinal cord stimulation are non-medication, minimally invasive, interventional options that can provide long term pain relief. Radiofrequency ablation can be applied to certain locations to treat head pain, neck pain, back pain and certain joint pain.

Most of the interventional pain management therapies are minimally invasive and are performed in the office or as a same day outpatient procedure. Image guidance utilizing x-ray (fluoroscopy) and ultrasound are commonly employed improving safety and effectiveness. The side effects and complication rates are typically very low and the specific risks, benefits and alternatives would be discussed for the specific intervention being considered.

Interventional pain management is also commonly performed by a board certified pain medicine physician.

These providers have completed medical school and residency training and then complete a separate fellowship specific for pain management. Common board certified pain specialists are anesthesiologists and physical medicine and rehabilitation doctors. One of the primary benefits of seeing a board certified specialist for pain management is the comprehensiveness of care. We can help diagnose and treat the pain problem from the onset and are not limited to only providing a single aspect of pain care. Because every patient’s pain is unique, the decision making for what diagnostic tools and treatments to utilize should depend on an individualized workup including patient history, examination, and review of appropriate diagnostic studies such as MRI. Effectively tailoring an individualized treatment plan from all of the available pain therapies including conservative therapy, medication management, interventional therapy will improve the efficiency and effectiveness of the patients pain management care. If you suffer from acute or chronic pain consider discussing your pain with the pain management specialists 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. Dr. Thome takes great pride in his medical understanding, exceptional clinical skills and ability to compassionately connect with patients to provide extraordinary care.

www.TheWiseGuideOnline.com | Wise Guide 39

Finding Hope in Alzheimer’s Research

by Carrie McBride, Director of Marketing & Communications Alzheimer’s Association, Washington State Chapter

C

urrently, more than 6 million people in the U.S. are living with Alzheimer’s disease — a number that’s expected to nearly triple by 2050. Prior to the pandemic, Alzheimer’s was the sixth leading cause of death in the country, and the only disease in the top 10 with no way to prevent, cure or even slow its progression.

While the impact of Alzheimer’s continues to grow, researchers across the globe are advancing basic knowledge about the disease, exploring ways to reduce risk and developing potential treatments.

The National Alzheimer’s Plan, first released in 2012, established an ambitious goal of developing preventions and effective treatments for the disease by 2025. The Alzheimer’s Association is leading the way as the world’s largest nonprofit funder of Alzheimer’s and dementia research. Currently, the Association is investing over $208 million in 590 research projects across the globe.

Federal funding for Alzheimer’s and dementia research is also critical in addressing the Alzheimer’s crisis. Again, the Alzheimer’s Association is playing a vital role as the largest Alzheimer’s advocacy organization in the world. With the help of grassroots advocates across the country, funding for Alzheimer’s and dementia research at the National Institutes of Health (NIH) has increased sevenfold since 2011. Today, funding for Alzheimer’s and dementia research at the NIH is at $3.1 billion annually — and we are calling on Congress to increase funding by an additional $289 million in 2022.

As a result of this unprecedented funding, scientists have been able to work at a more rapid pace and have made many strides in recent years. The latest advancements in Alzheimer’s research give us many reasons to be hopeful.

A blood test for Alzheimer’s is closer than ever.

It wasn’t that long ago that the only way to diagnose Alzheimer’s was through an autopsy. We’ve made some progress — Alzheimer’s can now be diagnosed through a PET scan, but it’s very costly and isn’t covered by Medicare, Medicaid or any kind of health insurance.

There is a global effort in the Alzheimer’s field to identify and develop accurate, less expensive diagnostic tools for Alzheimer’s and other dementias. Blood tests have emerged in the last few years as a potential solution. In fact, new research released at the Alzheimer’s Association International Conference last year identified a blood marker that shows both Amyloid plaques and Tau tangles — the two hallmark features of Alzheimer’s disease.

Why is finding a blood test so important? Blood tests would be a game changer for Alzheimer’s research. Scientists would be able to identify clinical participants more quickly and they would have an easy way to measure the efficacy of the drugs they’re testing. This would ultimately speed up the development of a drug to slow or stop the progression of the disease.

The drug pipeline for Alzheimer’s is heating up.

In late 2019, Biogen released promising data about its drug, aducanumab. In Phase 3 clinical trials, the company found a significant reduction of cognitive and functional decline in people with mild dementia and mild cognitive impairment (MCI) due to Alzheimer’s. The drug is currently being reviewed by the FDA, and if approved, it would be the first available treatment to potentially change the progression of Alzheimer’s disease.

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

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40 Wise Guide | 2021/2022 Edition

The latest advancements in Alzheimer’s research give us many reasons to be hopeful.

In March, Eli Lilly & Co. reported detailed results of their Phase 2 clinical trial for their drug, donanemab. People taking the experimental drug did not maintain or improve their cognitive abilities; they continued to decline, but at a measurably slower rate. While these results are encouraging, longer and larger trials are needed to determine the safety and efficacy of the drug.

We’re learning more about prevention and risk reduction.

There is growing evidence that suggests choices we make throughout our lifespan may impact our risk of developing dementia. A 2020 report by the Lancet Commission identified 12 modifiable risk factors for dementia: less education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, low social contact, alcohol consumption, traumatic brain injury and air pollution.

They estimate that 40% of dementia cases worldwide could theoretically be prevented or delayed through these modifiable risk factors.

The US POINTER study, a two-year clinical trial led in part by the Alzheimer’s Association, is evaluating whether lifestyle changes can protect cognitive function in people at risk of developing dementia. The trial involves 2,000 volunteers,

age 60-79, who will follow either a self-guided or structured program encouraging increased physical exercise, a healthier diet, cognitive and social stimulation, and self-management of heart and vascular health. Final results of the trial are expected in 2023. If the interventions prove effective, an evidence-based program for prevention could be developed and implemented in communities across the country.

Today, we have more momentum in Alzheimer’s and dementia research than ever before. With the advances being made in prevention, early diagnosis and drug therapies, we know that hope is on the horizon. Every day, we’re moving one step closer to our vision of a world without Alzheimer’s and all other dementia.

Carrie McBride is the Director of Marketing and Communications for the Alzheimer’s Association in North Idaho. She has a degree in Communications from University of Washington and 15+ years of experience working for health-related causes.

She is also a member of the Dementia Action Collaborative, helping to implement the Alzheimer’s State Plan in Washington State. www.TheWiseGuideOnline.com | Wise Guide 41

Alzheimer’s Association Support Groups WHY STRUGGLE ALONE?

Participants 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.

Connect — learn — and get solutions.

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

EASTERN WA: SPOKANE NORTH • Whitworth Presbyterian Church 312 N. Hawthorne Road 2nd Mondays @ 1:00 - 2:30 PM Facilitator: 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

Additional Alzheimer’s/Dementia Support Groups IDAHO PANHANDLE

NORTHWEST MONTANA

• Columbia Bank Building, Sandpoint Tango Café Meeting Room, 414 Church St. 1st & 3rd Thursday @ 1:00 - 2:30 PM Facilitator: Jan Griffitts 208-290-1973

• 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

Caring for someone with Alzheimer’s or dementia?

You're not alone.

We're here to help.

42 Wise Guide | 2021/2022 Edition

24/7 Helpline

1.800.272.3900 alzwa.org

Emergency “Firewood Rescue” – a 501 (c) 3 non-profit volunteer organization – is providing 1 load of firewood per year to Bonner and Boundary County residents who are in desperate need of firewood until other sources can be found. Fast acting….help is on the way!

Contact: FirewoodRescue2020@gmail.com or (208) 265-9613

“Reflections” By this issue’s Cover Artist: T Kurtz

www.TheWiseGuideOnline.com | Wise Guide 43

Real Life

“ Golden Girls”

Co-Housing, and the Future of Senior Living

by Rebecca Eyman, Partner, Coyle & Eyman Elder Law

I

deally our “golden years” are filled with peace and contentment. Unfortunately, many seniors struggle with current housing options available to them. After losing a spouse, a widow or widower can find themselves living alone for the first time ever. While many would prefer to “age in place,” meaning remain at home rather than moving to an assisted living facility, living alone can lead to depression, anxiety, and isolation. It can also be more difficult for an older person to afford household expenses, physically navigate a house, and keep up with maintenance and household chores.

By the 2030’s, for the first time ever, there will be more people in the population who are over the age of 65 than under the age of 18. Our current homes are not particularly well-designed for aging, argues Rodney Harrell, the Director of Livable Communities at the AARP Policy Institute. Suburban neighborhoods lack transportation options for non-drivers.

Flights of stairs present physical challenges, and people on fixed budgets living alone can face financial strain.

44 Wise Guide | 2021/2022 Edition

For this reason, an increasing number of seniors are exploring alternative housing arrangements to address these issues.

Some have opted to live with roommates, creating a trend of real-life “Golden Girls,” and some organizations are stepping up to help. Wendi Burkhardt is the co-founder and CEO of Silvernest, an organization that pairs Baby Boomers, empty nesters, and other aging adults with compatible long-term housemates. Burkhardt was inspired to start her own business after her own newly-widowed mother struggled to adjust to sololiving. Silvernest helps seniors with a variety of housing tools, including finding roommates, conducting background checks, and setting up auto-payments for rent.

Ann Glass, a gerontologist and professor at the University of North Carolina Wilmington, categorizes senior housing options as “shared housing” and “co-housing,” which she notes are frequently mixed up. Shared housing is when you rent a room in someone else’s house, or rent out your own spare room. This can be a great option for empty nesters looking for

extra income and help with household chores.

Co-housing, on the other hand, refers to a community or neighborhood of seniors each with their own home but sharing a common space. It’s frequent in these situations for the community to come together several times a week for shared meals or events. Co-housing arrangements are a far cry from assisted living because people living in co-housing are typically completely independent. Glass has found that having the support of co-housing neighbors substantially improves quality of life, and allows seniors to comfortably age in place.

Particularly health-minded individuals have begun living in communal housing situations known as “wellness communities,” which are alternatives to independent or assisted living for seniors. These communities are comprised of residents living in close proximity who share common goals and interests in proactively pursuing wellness.

Diana Lind, an urban policy specialist and the author of Brave New Home: Our Future in Smarter, Simpler, Happier Housing, has advocated for major changes in U.S. housing in order to address ongoing social, economic, and environmental problems. Lind suggests moving away from a majority of singlefamily homes and incorporating more co-housing, accessory dwellings and tiny homes, multi-generational housing, and wellness communities.

According to Lind, there is a misconception that suburban houses with white picket fences is the way that people in the U.S. have always lived. In actuality, for the majority of the country’s history, more communal styles of living were more common, and ultimately more affordable and flexible. This included boarding houses, apartment hotels and tenements, and single

Let our team help plan for your future.

Our highly specialized legal professionals are dedicated to helping you navigate some of life’s most challenging decisions, including:

room occupancy buildings. It was only in the last several decades that single-family home ownership in the suburbs began to grow in popularity.

While some people may think that the experiences of the passed year would discourage seniors from living communally, actually the opposite may be true. The experience of isolation and loneliness by seniors during the COVID-19 pandemic may actually drive seniors toward co-housing options. Seniors living alone have not been able to see family members or participate in the community. Facilities have been on lock-downs with repeated rounds of quarantine and isolation of seniors.While keeping seniors safe and healthy is paramount, the anxiety and depression that has resulted from the isolation also endangers health. Many who resisted the idea of communal living may be willing to take another look after the experiences of the passed year.

Consideration of senior housing options and long-term care planning is an essential part of a comprehensive estate plan. The attorneys at Coyle & Eyman Elder law can help you get started. Call our office at (208) 765-3595 or visit cwelp.com to learn more!

• Probates and Trust Estate Administration • Guardianships and Conservatorship • Other related Tax, Real Estate, and Financial issues facing seniors

Rebecca Eyman is an Elder Law attorney and partner at Coyle & Eyman Elder Law in Coeur d’Alene, Idaho. Rebecca was born and raised in the San Francisco Bay Area, and graduated from the University of San Francisco School of Law in 2012.

As an Elder Law attorney, her practice includes estate planning, guardianships/conservatorships, probate/trust administration, and Medicaid/longterm care planning.

Katherine M. Coyle is the region’s only certified elder law attorney—certified by the National Elder Law Foundation.

Rebecca Eyman and the rest of the team have the expertise and experience to guide you and your family each step of the way.

• Wills & Trusts • Estate Planning • Powers of Attorney Estate Planning · Elder Law (208) 765-3595 · cwelp.com

www.TheWiseGuideOnline.com | Wise Guide 45

How to Balance Work with Caring for an Elderly Parent

by FirstLight Home Care of Spokane and Coeur d’Alene

COVID-19 has turned our lives upside down. It has changed how and where we work and go to school. It has impacted household dynamics with a growing number of families managing multi-generational homes. And, it has made our elderly loved ones more dependent on us as stricter stay-at-home orders are placed on the most vulnerable.

This article is provided

by Brad Leggat and Matt Zastrow, owners of FirstLight Home Care of Spokane and Coeur d’Alene.

For more information, visit www.coeurdalene.

FirstLightHomeCare.com or call (208)758-8090.

46 Wise Guide | 2021/2022 Edition

The pandemic is stirring up a variety of emotions. As demands increase, we are all feeling overwhelmed, stressed and worried that another shutdown will happen and further disrupt our lives. For many, the unknown has interrupted the balance between work, family, school and the care of our elderly parents.

To help manage the stress that often comes with caregiving in general, we have gathered some tips and advice to help family caregivers balance work with caring for an elderly parent.

Stick to a routine. Try to separate work from your caregiving duties. Make caregiving-related calls and schedule doctor appointments during your personal time rather than during work hours. Wait until you get home from work to do more of the time-consuming tasks that involve your loved one.

Establish boundaries. Whether you are working in an office or working from home, make sure your parent knows you are in fact working, and that they should respect the schedule you have in place. Set aside certain times for short breaks during the day when you can check in with them.

Understand your benefits. Your company may have policies on caregiving, flexible work options, and family leave.

You may also have access to an employee assistance program, which can be a valuable resource.

Talk with your supervisor in advance. Let them know about your caregiving situation. Make sure they understand that unforeseen things may come up that could impact how and when you work. Emphasize that you have an important responsibility to your elderly parent but that you are committed to your job as well.

Have a back-up plan at work and at home. Arrange for a co-worker to step in if you need to leave work unexpectedly to care for your loved one. Think ahead at home as well. As a family caregiver, you should have a plan for alternative care and prepare others for what they need to know should you be exposed or become ill with COVID-19.

Take care of yourself. Your well-being is important. Eat healthy, balanced meals, maintain a regular sleep routine, exercise, allow yourself time each week to take care of personal errands, or simply take time to relax.

Put safety measures in place. Have everyone in your household follow CDC-recommended protocols for personal hygiene and other guidelines, especially if the person in your care lives with you. If your aging parent falls ill with the flu or with COVID-19, that could be dangerous. If you get sick, you cannot go to work or be an effective caregiver.

Caring for an aging parent is not easy, and it can put a strain on your personal life and your career. Preparation and planning, knowing what resources are available to you and finding balance are all essential.

FirstLight Home Care is a leading provider of non-medical home care, helping individuals achieve the quality of life they deserve. Our professional caregivers provide care at private residences, independent and assisted living communities, and other healthcare facility settings. FirstLight Home Care was the 2020 winner of “Best Home Care Agency” by the CdA Press and Business Journal of North Idaho.

www.TheWiseGuideOnline.com | Wise Guide 47

Social Isolation and Loneliness:

The Silent Pandemic

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

T

he COVID pandemic has made isolation and loneliness familiar words and, to some, a familiar experience. Social isolation and loneliness are often closely related, but there is a difference.

Social isolation is defined as infrequent social contact with others.

Loneliness is a feeling of being isolated regardless of social contact.

They often go hand-in-hand.

Some people handle social isolation and loneliness better than others, and while it may be a temporary uncomfortable inconvenience to some, it can be a serious emotional and stressful problem for others.

Dangers of chronic isolation

Limited access to normal daily activities and social interactions with others can affect mental health and weaken physical health, particularly for those who already struggle to maintain well-being.

Immediate effects of social isolation related to the pandemic have been noted as mental health concerns, substance abuse, and domestic violence. More than two million Americans purchased guns during the month of March, 2020, raising concerns for increased risk of suicide.

Together we can help you find solutions to issues facing aging adults!

208-667-3179 * 800-786-5536 * www.aaani.org 402 W. Canfield Ave, Ste 1, Coeur d’Alene, ID 83815

• • • • • • • •

A ‘Hub’ for available resources in the community Senior Center meals and information Home Delivered Meal information Support and referrals for suspected Elder Abuse Long-Term Care Elder Advocate Help with navigating Advance Directives Connection to Alzheimer & Dementia resources Medicare Fraud education

• • • • •

Funding & support to give you a break when caring for a loved one Caregiver educational programs Fit & Fall information Referrals for Housing, Legal, Transportation & much more Help with Wheelchair ramps, Grab-bar installation & other minor home repairs

PROUDLY SERVING BENEWAH, BONNER, BOUNDARY, KOOTENAI, & SHOSHONE COUNTIES

48 Wise Guide | 2021/2022 Edition

Dangers of chronic loneliness

Chronic loneliness results from constant feelings of being alone and separated from others for a long period of time. Loneliness has been found to raise levels of stress, impede sleep, promote anxiety and depression, and as a result, harm the body. Research shows that chronic loneliness can have a significant impact on overall health, including brain health.

Dangers of chronic stress

Stress during an infectious disease outbreak can cause a mix of emotions and reactions.

• Fear and worry about personal health and the health of loved ones • Change in sleep and eating habits • Difficulty sleeping or concentrating • Worsening health problems • Worsening mental health conditions • An increase in the use of alcohol, tobacco, and other drugs

Who is affected?

Everyone’s daily life has been altered in varying degrees by the pandemic. Anyone can be affected by the stress of isolation and loneliness. Even the apparent social butterfly can be lonely, but some groups are particularly at risk.

A study by the Centers for Disease Control and Prevention (CDC) found that many adults aged 50 and older are socially isolated in ways that are a risk to their health. Social isolation and loneliness are difficult to measure exactly, but there are definite risks such as premature death, an increase in the risk of dementia, and a high risk of serious disease and suicide.

Older adults, people of color, those with low incomes, and those in congregate homes and prisons, have been overwhelming victims of COVID-19. These populations are high risk for poor health outcomes, social isolation, loneliness, and stress.

Long-term care facilities have the responsibility of monitoring both the emotional and physical health of residents. They have followed the mandates for social distancing and limited visitation, but while those restrictions are necessary safeguards against contracting and spreading the virus, those very restrictions can lead to deep feelings of isolation. Keeping residents engaged and families connected can be challenging.

Staying healthy

The National Institute of Health (NIH) lists 5 things the general public can do to stay mentally healthy during the pandemic. Staying mentally healthy is important to physical health.

1. Avoid the use of alcohol.

2. Stay active and exercise.

3. Meditate, do yoga or breathing exercises.

4. Reach out to others online, connect by phone, and chat outdoors, keeping distance.

5. Talk to a doctor.

Being active and out in the sunshine can help elevate endorphins and serotonin. Those “brain hormones” are mood boosters. Keeping a relatively normal schedule—eating regular meals, going to bed and getting up at the same time, and walking the dog help to maintain a sense of normalcy.

Staying connected is part of being human and high-quality social relationships can help us live longer and healthier. Sharing feelings and experience with someone trustworthy helps to bond us to others.

When the stress of isolation or loneliness gets critical, it may be time to talk to a health care provider.

The future

The CDC reports that the changes in our social behavior as a result of this pandemic are far-reaching, and we do not yet know what the long-term public health effects will be. If the existing rates of social isolation and loneliness remain elevated or increase, these changes could likely lead to a greater public health burden in the longer term.

As individuals, we will experience varying degrees of isolation, loneliness, and stress, but if we act responsibly, take care of ourselves, and reach out to those we love, it will only be temporary. We are all in this together.

Jan Noyes holds a degree in education and has used her teaching skills in public schools, adult education, workshops and seminars for church, civic groups, and corporations. Jan has been an ombudsman with the Area Agency on Aging for 15 years, recruiting and training new ombudsmen, visiting facilities and advocating for their resident rights, quality of care and quality of life. www.TheWiseGuideOnline.com | Wise Guide 49

Dementia Behaviors:

Expert Tips for Understanding and Coping

by Linda Davis, Director of Building Relationships, The Lodge Assisted Living

M

erritt Whitley writes the following: Anger, confusion, and sadness are a few symptoms a person with dementia may experience regularly.

Even though you know your loved one’s dementia behaviors are symptoms of a disease and not intentional, dealing with them is often emotionally and physically challenging. Learn more about typical dementia behaviors and expert tips for managing them.

Common Dementia Behaviors: A person with Alzheimer’s or another type of dementia may become irritable and even belligerent without being provoked. They may go in and out of confusion and disorientation or attempt to manipulate those around them. Here are examples of common dementia behaviors and phrases you may hear: Aggression: This behavior includes being mean, lashing out, or using combative statements such as “I don’t want to take a shower!” or “I don’t want to eat that!” Sometimes this type of anger may escalate to physical violence.

Confusion: This could mean saying phrases like:

• “I want to go home!”

• “This isn’t my house.”

• “When are we leaving?”

• “Why are we here?”

Paranoia and frequent mood swings also often result from a person with dementia feeling confused.

Poor judgment: This can include unfounded accusations such as “You stole my vacuum cleaner!” Struggling to balance a checkbook or calculate a tip at a restaurant can also be the result of dementia. Other examples include hoarding, stockpiling, and repeating statements and tasks.

Manipulation: This usually involves inventing truths to get what they want. A person with dementia may say things like “You told me I could drive to the store,” or use bargaining methods such as “If you let me drive to the store, I will take my medicine.”

Managing dementia behaviors may be difficult, but it’s not impossible. Your words and actions have the power to quickly de-escalate intense situations.

Follow some expert do’s and don’ts for calmly and effectively dealing with these four common types of dementia behaviors: 50 Wise Guide | 2021/2022 Edition

Aggression: “A lot of times, aggression is coming from pure fear,” says Tresa Mariotto, a social services supervisor in Bellingham, Washington, and certified trainer in dementia and mental health. “People with dementia are more apt to hit, kick, or bite in response to feeling helpless or afraid.”

Do: The key to responding with care to aggression caused by dementia is to try to identify the cause. What is the person feeling to make them behave aggressively?

• Are they in pain?

• Is their mind just wandering?

• Have they been triggered by something?...

Don’t: “The worst thing you can do is engage in an argument or force the issue that’s creating the aggression,” Napoletan says.

“Don’t try to forcibly restrain the person unless there is absolutely no choice.”

How to manage repeated questions and confusion: Do: When your aging loved one is confused about where they are or what’s happening, try these tips from the American Psychological Association:

• Communicate with simple explanations

• Use photos and other tangible items to help explain situations

• Remain calm and supportive, and don’t take their confusion personally

• Use tools such as alarms, calendars, and to-do lists to help them remember tasks Don’t: Lengthy explanations don’t work. “You have to figure out what’s going to make the person feel the safest,” says Mariotto.

“Even if that ends up being a therapeutic lie…”

How to help with poor judgment: The deterioration of brain cells caused by Alzheimer’s disease leads to poor judgment and errors in thinking. Some of these symptoms are obvious and apparent such as hoarding household items, accusing a family member of stealing, or forgetting how to do routine tasks. These tasks can include balancing a checkbook or paying bills on time…

Do: A caregiver can often minimize frustration and embarrass­ ment for dementia patients by:

• Listening and offering subtle help

• Working together to fix a problem

• Simplifying a task or routine by breaking it down into smaller steps…

Don’t: Blatantly questioning the person’s ability to take care of the situation at hand or arguing with them isn’t helpful. You may risk alienating them…

How to deal with attempts at manipulation: Your loved one may have lost the ability to distinguish between truth and falsehoods, and they may no longer have a sense of morality around lying. These symptoms can be especially difficult for a caregiver to handle as it may feel like a complete change in personality. In fact, a person with dementia may not realize they’re lying…

Do:

• Separate the behavior from the person, and do not hold it against them

• Set limits when possible, communicate expectations clearly, and work together to find a resolution when you’re able to

• Remain aware of your own personal responses. Do you feel angry, hurt, or frustrated? If so, do you act on these emotions around your aging family member? Acting on these emotions can bring more distress to an already stressful situation

WE NOW

• Comfort • Security • Convenience

Don’t:

•B ring up events to prove or disprove statements

•U se accusatory language such as “you’re lying” or “you’re being manipulative”

•E ngage in heated arguments Dealing with dementia behaviors can quickly wear out a caregiver or family member. If you care for a person with dementia and are feeling resentment, anxiety, or depression, don’t hesitate to seek help. A caregiver support group, counselor, friend, or family member can offer support and advice…

The staff at The Lodge Assisted Living at Riverside Harbor Secure Facility in Post Falls is gifted with loving and caring for your loved when the time is right for them, and for their family. Contact Linda Davis, 208-755-3637 for a tour when that time comes along

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• The Lodge at Fairway Forest 1 & 2 —3989 & 3991 N. Player Dr., Coeur d’Alene, ID www.TheWiseGuideOnline.com | Wise Guide 51

If You’re Caring For A Loved One,

52 Wise Guide | 2021/2022 Edition

Who’s Caring For You?

T

en years ago the ratio of working age adults to older adults in Idaho was 6 to 1. With the growth of Idaho’s aging population, this ratio was projected to reach 3 to 1 by 2020.1 This means there are now fewer professional caregivers available for a rapidly increasing number of Idaho seniors. The COVID-19 pandemic also stretched the professional care system beyond its limits, making it even more difficult for aging citizens to access daily living support, in-home or in residential/live-in facility care. These factors have driven a significant increase in the number of Idahoans (and nationwide) who have made the decision to take on the full-time care of their loved-ones in their homes. While this decision has a number of advantages, one of the most significant being the opportunity for the person in need of care to remain in the comforts of their home, it also comes with significant challenges.

It is estimated that 1 in 4 Idahoans is now an unpaid, in-home caregiver. Parents, children, spouses, neighbors and friends are caring for their loved-ones and providing 171 million hours of unpaid labor annually.2 While the decision to take on this commitment is made out of love and respect, it is not without consequences. If you are one of the many family caregivers in Idaho, chances are you’ve put your own health and well-being on the back burner. If you’re not taking care of yourself, and don’t have the support you need, you will likely find yourself on the receiving end of care.

Whether you are caring for a loved one who has a disability such as Alzheimer’s, Dementia, or who is frail or ill, it can be complicated and overwhelming. Family caregivers report experiencing feelings of isolation, frustration, resentment, anxiety about the future, loneliness and extreme fatigue. But you are not alone, and there is support! Have you ever heard the word “respite?” Respite is defined as a short period of rest or relief. Did you know that respite programs exist throughout Idaho (and nationwide) that can cover some, or all of the costs, of hiring a provider to fill in for you while you take a break?

Even more exciting, there are new respite programs that don’t require you to hire a professional care-provider or agency! You can hire a friend, family member or whomever you trust to fill in while you take the breaks you need to rest, re-energize, and care for yourself!

How can you as a family caregiver use your respite time? Its entirely up to you! Go fishing, visit a friend, take an extra long bubble bath, plan a date night with your spouse, follow through on a long, overdue medical appointment of your own, work in the garden, or walk the dog. Respite time is designed to allow you, the caregiver, to take the time you need, in whatever manner you choose that will allow you to maintain your own health and well-being as you continue on your caregiving journey.

Taking time for yourself has also proven critical to maintaining

by Pamela Pearson, Senior Services Coordinator Area Agency of Aging, North Idaho (AAANI)

the stability and well-being within the caregiver/care recipient relationship by helping to alleviate those feelings of isolation, frustration, fatigue and anxiety so often reported.

The Area Agency on Aging of North Idaho is just one of the organizations in Idaho that offers Respite Programs to eligible caregivers. Applying is easy and we are passionate about supporting Idaho’s family caregivers!

Call us today at 208-667-3179 and find out how we can help!

Idaho Commission on Aging 2018 Annual Report AARP, 2017

1 2

Pam Pearson has been in public service for over 17 years, managing a variety of programs designed to support and empower Idahoans. Pam was also a live-in caregiver to her mom for almost ten years.

She experienced first-hand, the challenges senior citizens face as they try to navigate through a vast and often confusing “care system”, which fueled her desire to advocate on behalf of Idaho seniors for easier access to the supports they need.

www.TheWiseGuideOnline.com | Wise Guide 53

Rural Dementia Caregiver Project

54 Wise Guide | 2021/2022 Edition

Are you caring for someone with memory loss who lives in a rural area?

If so, the University of California, San Francisco (UCSF) invites you to take part in a FREE 6-week online workshop and study for caregivers.

“Being a part of the ‘caregivers [workshop]’ has given me an assurance that I am not alone with caring for my husband. It was good that I could join in on this discussion at any time day or night and that I did not have to drive anywhere.

It is also easier to open up by being anonymous.

Thank you to all for their guidance, support, and great suggestions.” — Workshop Participant “One of the most useful aspects of this workshop are the comments, suggestions and support from fellow participants. Many offered insights I hadn’t even considered.”

— Workshop Participant

Are you a stressed caregiver? Do you want to learn new caregiving skills?

Are you a caregiver living in a rural area? Do you want to learn from other caregivers? This free workshop and study may help. There is no cost to you for participating.

In the workshop you will…

• Log on whenever you want (day or night).

• To get the most out of the workshop log on 2 or more times per week, for 10 to 30 minutes each time • There is no Zoom/video that is required to participate

You will learn new skills to…

• Help you reduce your stress • Manage difficult behaviors of your friend or family member • Take better care of yourself • Plan for the future

You will get…

• Ideas and support from other caregivers and trained staff • Information on community resources • A free workbook to keep

What do I need to do to join the study and get a workshop?

If you join the study you will…

• Complete an online eligibility survey to determine if you are eligible.

• Complete a study consent and first study survey that will officially enroll into the study. It will take about 20-40 minutes.

• Be assigned to a workshop. A computer program will determine whether you start the workshop right away or have to wait.

• Complete 3 more study surveys. These will take place 6 weeks, 6 months and 12 months from the time you join the study, and will take about 20-30 minutes each.

• All caregivers will receive up to $80 in cash for completing the 4 study surveys ($20 per completed survey).

Have more questions? Call toll free at 1-833-634-0603 Monday through Friday, 9:00 A.m. to 4:00 P.M. PST email: caregiverproject@ucsf.edu website: https://caregiverproject.ucsf.edu

www.TheWiseGuideOnline.com | Wise Guide 55

Crossword Specialty Dogs Across

56 Wise Guide | 2021/2022 Edition

Down 1 Egyptian fertility goddess 2 Litter member 3 ___ of Capri 4 Military dog 5 Single or double 6 Passover feast 7 Paranoiac’s worry 8 Vatican vestment 9 Female ruff 10 Stadium walkways 11 Cockamamie 12 Article of faith 13 Old lab heaters 19 Woodworking tools 21 Therapy or water dog 24 It’s found in banks 25 Spill the beans 26 Guide dog 27 Ancient Greek sophist 28 Floor model 29 Conceited

30 Frontiersman Daniel 33 Loafer, e.g.

34 Tennis units 35 Down ___ (Maine) 38 Rackets 39 Game retriever spaniel 41 Monteverdi offering 43 Notable period 46 Sin city 47 Related maternally 48 Eagle’s claw 49 Clocked 50 Some wedding guests 52 Genesis son 54 River to the Rhine 55 Greek portico 56 Coop group 58 Hanoi holiday 59 Chapel vow 60 Triumphant cry

Copyright ©2021/2022 PuzzleJunction.com

1 With 46 Across, gun dogs 6 Trade punches 10 Bar mitzvah, e.g.

14 Kind of bar 15 Model Macpherson 16 Work without ___ (be daring) 17 Arm of the sea 18 A guard dog 20 Big first for a baby 21 Permit 22 Sleeping disorder 23 Icy coating 25 Scenting dogs for small game 27 Modifier 30 Radar screen image 31 Safari member 32 Paddles 33 Compass dir.

36 In the center of 37 Pueblo brick 39 Where the Mets once played 40 Prince, to a king 41 Valhalla chief 42 Terminals 44 Corn bread 45 Collar 46 See 1 Across 50 Jai follower 51 Pleasant way to walk 52 Pool tool 53 “The Turtle” poet 57 Hunting or carriage dog 60 Banded stone 61 Oklahoma native 62 Blue-pencil 63 Long-necked bird 64 Darn, as socks 65 Scads 66 Bailiwicks

Sudoku

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 59

www.TheWiseGuideOnline.com | Wise Guide 57

Making the Most of Medicare

by Noreen Brisson, Volunteer Services Coordinator Senior Health Insurance Benefits Advisors (SHIBA)

Discharge and Advanced Care/ End of Life Planning

W

e are living in a world that bombards us with information – some helpful, much of it aimed at selling something, and too much trying to fool us into allowing criminals to access our money and benefits. This can make it hard to know where to look, and trust resources to make decisions, especially when we are feeling vulnerable due to illness or situation. Fortunately, Medicare offers a number of services and tools to help to ensure we can make the most of our healthcare and have a voice in the decisions made – two of these services are Discharge planning and end-of-life Advance Care planning.

Discharge Planning Effective Discharge planning is one of the easiest ways to support your recovery. Knowing what to ask and what to expect – especially when the hospitalization is for a planned procedure – can help the process.

Things to do to prepare for discharge from a hospital or other in-patient facility: 1. Make sure you and your caregiver are part of the discussion regarding discharge and what is expected to support recovery once home.

2. H ave a written list of questions you need answered to feel confident and prepared for discharge. Questions might include, but not be limited to (a) Where will you be getting care next – at home, in a facility as an in-patient, or an out-patient – and who will be providing the care? (b) Will you need to find providers or arrange for medical equipment?

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3. Share any concerns related to your situation. Your input is important – it is the only way others can know potential barriers and limitations that may affect your ability to remain safe and recover effectively.

4. Try to gain as sound of an understanding as possible of what to expect and what is expected of you. This can be hard when not feeling well, having the person who will help you later (i.e. spouse, adult child or friend, or case manager) present can help.

5. Find more questions you may want to consider asking in the Medicare Publication “Your Discharge Planning Checklist” available on Medicare.gov, Your hospital or care facility may also have this document available.

If you feel services are being stopped or you are being discharged too soon, you have a right to file a fast appeal.

Within 2 days of your admission and prior to your discharge, you should get a notice called “An Important Message from Medicare about Your Rights.” This notice is sometimes called the Important Message from Medicare or the IM. It explains your rights and includes instructions for submitting a fast appeal. If you don’t get this notice, ask your provider for it. With a fast appeal, an independent reviewer will decide if your covered services should continue.

You can contact your Beneficiary and Family Centered Care-Quality Improvement Organization (BFCC-QIO) for help with filing an appeal. You may be able to stay in the hospital (coinsurance and deductible may apply) while the BFCC-QIO reviews your case. The hospital can’t force you to leave before the BFCC-QIO reaches a decision.

Advance Care Planning

Medicare also covers Advance Care Planning with your doctor to make end of life decisions.

This is planning for the care you would get if you become unable to speak for yourself.

You can talk about an advance directive with your health care professional, and they can help you fill out the forms, if you prefer. An advance directive is an important legal document that records your wishes about medical treatment at a future time, if you’re not able to make decisions about your care.

If you have original Medicare you pay nothing for this planning if it’s part of your yearly Medicare “Wellness” visit. If it’s provided as part of your medical treatment, the Part B deductible and coinsurance apply.

Consider carefully who you want to speak for you and what directions you want to give. You shouldn’t feel forced to go against your values and preferences, and you have the right to carry out your plans without discrimination based on your age or disability. You can update your advance directive at any time.

Most of the information in the article is compiled from Medicare.gov and Medicare publications. If you have questions about Medicare benefits, Idaho SHIBA staff, partners and volunteers offer free, unbiased information, resources and assistance with plan comparisons and resolving complaints. If you would like help, or are interested in becoming a SHIBA volunteer, please call the SHIBA Medicare Helpline at 800-247-4422.

For more information, please call the SHIBA Medicare Helpline at 800-247-4422 or visit 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 9 years and loves winter and helping fellow Idahoans learn about Medicare.

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Call SHIBA Senior Health Insurance Benefits Advisors (SHIBA) A service of the Idaho Department of Insurance • Understand your Medicare preventive & wellness benefits • Extra Help & Part D assistance • Individual counseling

This project was supported, in part by grant number 2002IDMISH, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201

1-800-247-4422 SHIBA.idaho.gov www.TheWiseGuideOnline.com | Wise Guide 59

Simple Cooking for Better Health

by Lenna Kamps, Registered Dietician, Life Care Center Coeur d’Alene & Post Falls

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s we age and circumstances change, it can be very difficult to know how to care for ourselves. Many people are finding themselves alone when they have not been for many years. For a variety of reasons, loss of a spouse, medical ailments, lack of energy, etc., we begin to find it challenging to even make food. Fortunately, there are a few things you can do to eat healthy meals without spending hours in the kitchen.

Healthy meals do not need to be complicated. Oftentimes, simpler meals are more healthy. The first concept I’d like to introduce is called “speed scratch.”

This is where you use a convenience food as a base for your meal, such as boxed

mac and cheese, and add healthier foods to it, such as fresh, frozen, or canned vegetables. You can also add canned tuna or chicken to make a quick, stovetop casserole. The other benefit to the speed scratch method is that fewer perishable ingredients go into it, which is helpful when you are shopping for one person.

Keep in mind that canned foods will have more sodium so if your doctor has suggested a cardiac diet, it would be better to add in fresh or frozen items.

Another way to make cooking easier is by batch cooking. Plan to have leftovers and either freeze them or eat them within the next few days. I prefer to not eat anything after 4 days in the fridge but some things are fine up to one week.

Cook extra pasta for use in a salad or with a different sauce or cook more than one chicken breast to use for your next meal.

In addition to batch cooking, you can also batch prep. For example, if you are using a bell pepper in a recipe, don’t cut what you need for that recipe, cut the whole thing and store it in the fridge. By cooking and prepping more than what you immediately need, you can save yourself time and energy later and it doesn’t take much more effort in the moment.

The last thing I would suggest is meal sharing. If you have a friend or neighbor who also has difficulty planning meals, you can coordinate and trade meals throughout the week. You can utilize the batch cooking method, make extra for

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ts: Ingredien k beans 1 can blac s anzo bean 1 can garb ey beans te) allo 1 can kidn ore to tas pico de g m f d o d s (a p u g c dressin 1½-2 otle ranch ip h c f o s p 1-2 cu ic powder 1 tbs garl in a together er to taste p ts p n e ie p d k c re g Bla ning bine all in g or seaso ans. Com in s e s b re e s d n ri add more Drain and l. You can w o b g in large mix . as needed

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the friend and trade your extras for theirs.

This way, you aren’t doing any extra work and you get more variety. Include several people to add greater variety. You can also use this concept by assigning a day of the week for each person to cook, this gives each person some time off from cooking.

Lenna Kamps is a graduate of the University of Idaho’s Coordinated Program in dietetics. She is the registered dietitian for Life Care Center Coeur d’Alene as well as Life Care Center Post Falls. Lenna loves what she does and has a deep appreciation for the people she works with as well as the residents she serves.

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Agencies & Free Referral Services Alzheimer’s Association................ Pg 40, 42

Advertisers’ Directory

Area Agency on Aging of North Idaho................................... Pg 48, 53 Compassionate Care Referral Service..................................... Pg 4 Idaho Breastfeeding Coalition........... Pg 13

Humana............................................... Pg 20 Spears Insurance, Inc.......................... Pg 31

Inland Northwest Research............ Pg 7, 37 Newport Hospital & Health Services.................................... Pg 29 North Idaho Advanced Care Hospital ................................ Pg 35, 64 Pain Management of North Idaho..... Pg 39 UCSF Dementia Caregiver Project...... Pg 54

In-Home Personal Care

North Idaho CASA............................... Pg 25

Recreation

Panther Country Coalition.................. Pg 15

Kalispel Park & Casino........................ Pg 21

SHIBA (Senior Health Insurance Benefits Advisors)............................... Pg 59

Dental, Hearing & Vision

FirstLight Home Care.......................... Pg 47

Audiology Research Associates......... Pg 57

In-Home, In-Patient & Out-Patient Skilled Nursing & Rehabilitation

Assisted Living & Memory Care Boundary County Community Restorium........................ Pg 62 The Lodge Assisted Living.................. Pg 51

Counseling & Support Bonner General Behavioral Health.... Pg 27

Camas Center Dental Clinic.................. Pg 9 Eye Clinic of Sandpoint........................ Pg 11 Lakeview Dental................................. Pg 23

Holistic Health Camas Center Clinic.............................. Pg 9

Family Crisis Network......................... Pg 28

Hospice

Peer Spokane.................................. Pgs 2, 16

Bonner General Health Community Hospice............................ Pg 27

Pend Oreille County Counseling Services ........................... Pg 57

Financial Planning, Insurance & Legal Coyle & Eyman Elder Law................... Pg 45

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Hospitals, Medical Care, Pain Management & Research Bonner General Health....................... Pg 27 Camas Center Clinic.............................. Pg 9

Advanced Care Northwest, LLC ........ Pg 40 August Home Health ......................... Pg 57

Bonner General Health Home Health Services......................... Pg 27 Life Care Center of Coeur d’Alene & Post Falls.................................... Pg 60, 63 North Idaho Home Health.................. Pg 43 Rehabilitation Hospital of the Northwest.......................... Pg 35, 64

Veterans Veterans Resources/ Service Offices...................................... Pgs 32-33

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Choose a Nationally Recognized Hospital – It Matters!

When choosing healthcare, quality matters.

Our two hospitals are nationally recognized for their patient care, meaning that we bring the highest level of care available in the nation right to our own community.

We offer two distinct specialties:

Rehabilitative Care

Long-Term Acute Care

Rehabilitation Hospital of the Northwest is ranked in the U.S. in the Top 10% for patient care. And we’ve earned The Joint Commission’s Gold Seal of Approval.

Northern Idaho Advanced Care hospital is the first hospital in Idaho to earn The Joint Commission’s Gold Seal of Approval for Respiratory Failure. We also are among 700 nationwide – or 15% – recognized for our respiratory care services.

We treat patients recovering from: • Strokes • Brain injuries • Spinal cord injuries • Orthopedic injuries • And more….

We treat patients recovering from serious illnesses or injuries, such as: • Trauma • Acute respiratory failure • Wound healing • Infectious diseases • Cardiovascular disease

Where you receive care matters.

RHN.ERNESTHEALTH.COM

NIACH.ERNESTHEALTH.COM

3372 East Jenalan Ave • Post Falls ID 83854 • 208.262.8700

600 North Cecil • Post Falls, Idaho 83854 • 208.262.2800

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