The Wise Guide Spring 2018 - Northernmost Idaho by Jonnie Bradley

SPRING / SUMMER 2018

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

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Youth Transition Services Immunizations for Adults Kinetisense - The Future is Here!

What’s Behind That Smile? Birth Control on a LARC? #Listen2YourSelfie! A Focus on Family Harmony

Wise Guide | Spring / Summer 2018

Spring / Summer 2018 Features About the Cover................................................................... 5 Tinkle Tales!....................................................................... 6 What’s Behind That Smile?................................................ 8 Birth Control on a LARC?.................................................. 10 A Focus on Family Harmony........................................... 12 How Does Pain Affect Your Life?..................................... 16 Know Before You Go........................................................ 18

Persistence, Prevalence, and Patience.............................. 20

What’s Behind That Smile?

Don’t put off shopping for dental insurance

Suicide Prevention in Local Schools............................... 22 Listen to Your Selfie!........................................................ 24 Oral Healthcare Essentials............................................... 26 What is Elder Mediation?................................................ 28 What Are You Waiting For?.............................................. 30 What Is “Personal Safety?”............................................... 32 Osteoporosis and Vertebral Augmentation.................... 34 After a Stroke—Finding the Right Words........................ 36 Veterans Pages.............................................................38-42 Idaho County Veterans Outreach, Grangeville............... 43 Exploring Veterans’ Pathways to Justice.......................... 44 I Think I Have Alzheimer’s Disease................................. 46 Useful Links for Aging in Place....................................... 47

Birth Control on a LARC? Contraception can be carefree!

Alzheimer’s Association Support Groups....................... 48 Two Very Different Therapies to Consider...........................50 Speech Therapy at Home................................................. 52 LightForce Laser................................................................ 54 4 Reasons to Choose a Local, Independent Pharmacy.......57 Crossword and Sudoku.................................................... 58 Guardianship vs. Conservatorship.................................. 60 A Conversation Nobody Really Wants to Have.............. 62 Long Term Care Insurance............................................... 64 Alzheimer’s Disease—We Were Clueless!....................... 66 Support is Available for the Dementia Caregiver........... 68 Choosing to Live Every Moment..................................... 70 Run It By Tamara.............................................................. 78

A Focus on Family Harmony Will your children still be friends when you’re gone?

Descriptive Advertisers’ Directory........ 72 Wise Guide | www.TheWiseGuideOnline.com

The Wise Guide Spring / Summer 2018 Office: 208-263-5654 Email: info@thewiseguideonline.com www.TheWiseGuideOnline.com Jonnie Bradley Editor The Wise Guide

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.

Do you have a favorite pie that everyone requests for holidays? Make one and bring it to Life Care Center in Sandpoint on September 26th at 2:30 PM. Fabulous prizes for top three pies determined by a panel of official tasters/judges. Contact 208-265-9299 for details.

Wise Wise Guide Guide || Spring Spring // Summer Summer 2018 2018

About the Cover Cover Artwork:

“Waterski Gal” by Andy Sewell

About the Artist

Andy Sewell is a full-time painter living in Viola, Idaho centered in the rolling wheat fields of North Idaho known as “The Palouse.” He grew up in Ketchum, Idaho, studied at Boise State University, the University of Hawaii, and earned a Bachelor of Fine Art from the University of Idaho in graphic design and painting. He has his work in several galleries in the northwest, and travels in the summers doing many art-in-the-park venues. Andy has won several awards for his work, and been invited as a guest artist to several art shows. He has painted and sold his watercolor prints and originals for over 20 years, and enjoys painting his biggest works in oil. He loves to paint fishing scenes, wildlife, rural farm and country scenes, flowers and landscapes of the northwest, especially of his home state of Idaho. Andy strives to paint subjects that are impactive to the viewer in positive, personal, and meaningful ways; perhaps catching a glimpse of nature and freezing it in time to continuously bring delight and pleasure to the viewer. He wants

Forest Symphony

his paintings to cause his viewers to rekindle timeless memories of special places and things experienced in their own lives. Andy is a prolific artist with a wide variety of originals and prints available for purchase online at: finewatercolors.com.

Snowy Owl

If you have questions for Andy, please email him at info@finewatercolors.com.

Poppy Duo #2

Ford in Daisies Wise Wise Guide Guide || www.TheWiseGuideOnline.com www.TheWiseGuideOnline.com

Tinkle Tales!

by Dr. Karla J. Gowan PT, DPT, PCC, PRPC Newport Hospital and Health Services

re you suffering from urinary incontinence? A surprising number of people are. Do you know the “ potty dance” or the “gotta-go, gotta-go jig?” Do you cringe when you cough, sneeze, laugh or avoid stairs for fear of an unavoidable leak? If you’ve ever felt the embarrassment of urinary “leakage” or know someone who has, you’re not alone. Urinary incontinence is most commonly believed to be age related. But, the fact is, millions of women and men, of all ages, races, and geographic locations suffer from bowel and bladder issues. Have you spent hours searching for a cure, pondering the “Super Kegal Exerciser” or trying bulky pads, hydrogel adhesives, or the most recent pelvic floor exercises or app? If you have, then it’s likely that none of these “solutions” have provided the long lasting relief you’re searching for. In fact, some women have suffered with this affliction for so long they’ve resorted to surgery, and even that drastic measure has failed them!

Regardless of the causal factors, the good news is that effective treatments are available. Physical therapists perform treatments that do not require you to wear embarrassing and bulky diapers or pads or adhesives, and do not require dangerous and expensive surgeries. As we age, the muscles and tissue surrounding the urethra often become weak. These tissues may also become weak during pregnancy and postpartum, or during and after menopause, when estrogen production declines. The sphincter that closes the urethra can get lax or the bladder muscle itself may lose its elasticity. Both structures may gradually lose their ability to hold against abdominal pressure placed on them by activity.

Stress Urinary Incontinence (the most common type) can occur when an activity, such as coughing or sneezing, laughing, or even galloping a horse causes urine, from a few drops to a few ounces, to leak from the urethra. Stress Urinary Incontinence (the most common type) can occur when an activity, such as coughing or sneezing, laughing, or even galloping a horse causes urine, from a few drops to a few ounces, to leak from the urethra. For most women the urethra still does it’s job, most of the time, but even a few drops can disrupt your day, and keep you from feeling your best. Continuous or long-term exposure to urinary leakage can also place you at risk for urinary tract infections, yeast infections, or annoying skin rashes. There are different types of urinary incontinence, including stress, overflow, urgency, over active bladder, and functional leakage. Your physician, through urological testing, can determine your type. Most of you have heard of the term “Kegal.” Your Kegal muscles (pelvic floor muscles) are really just a hammock or sling of muscles at the bottom of your pelvis. This sling holds your organs in place, provides support for your core muscles. It is important in sexual function, and opens and closes those important sphincters that control bowel and bladder function. Kegal exercises are not a remedy for all incontinence related problems and can be harmful to certain physical conditions. Performing Kegals when one has pelvic pain may actually make your symptoms worse. Conversely, if performed correctly and for the right reasons, these exercises may significantly help to reduce leakage. But, see your doctor or Pelvic Health Specialist before undertaking any Kegal exercises. As a Doctor of Physical Therapy

and a Certified Pelvic Health Physical Therapist, I evaluate a variety of issues, including constipation, pelvic pain, hip pain, low back pain, tailbone pain, and many other, seemingly unrelated anomalies. During a pelvic health exam I focus on the body from the rib cage to the knees. A Pelvic Health Specialist may perform internal musculoskeletal exams and external exams to determine the cause of your weakness, pain, or dysfunction. A Pelvic Health Specialist will take an in-depth history, observe posture, test strength, look at your spinal and pelvic structure, and evaluate sensation. Just like other skeletal muscles, the pelvic floor can get bound up, spasm, or be too relaxed. The pelvic floor muscles need to be able to contract and relax, just like lifting a weight with your arm to strengthen then lengthen your bicep. My friend Julia agreed to share her “tinkle tale:” Julia is a 62-year-old active female. She loves going to Yoga and Zumba and is sexually active. While practicing Yoga, Julia was performing her “downward dog” position when she was startled by a “whoops moment.” She’d leaked urine for the first time since she was pregnant, forty years ago. Julia decided she would prepare for her next yoga session by wearing a protective pad. Much to Julia’s surprise, not only did she leak during her “downward dog,” but also during other poses. The light protective pad was inadequate. As Julia continued with her yoga she became more frustrated. As the problem worsened, she eventually quit Yoga and gym exercise altogether. Her primary care physician referred Julia to a Pelvic Health Physical Therapist who discovered that Julia had a small bladder prolapse that was interfering with her ability to contain the flow of urine when abdominal pressure was high, and that her pelvic floor muscles had become weak. After six weeks of focused physical therapy, appropriate exercises, learning about bladder irritants in the diet like citrus, spicy foods, artificial sweeteners, tomato based products, and learning some healthy bowel and bladder habits, Julia was able to return to her full fitness program. Julia’s intimacy with her husband has also blossomed and she is once again active! As we transition from cold and flu season to allergy

season, abdominal pressures from coughing and sneezing can become worse. But, treating pelvic floor dysfunction can be “Easy Pees’y.” You don’t have to live with “Aw Chew… Whoops” any longer. Be happy to know that nonsurgical help is available and can be fun! If you are having any type of incontinence, pelvic pain, or just plain not feeling well “down there” talk to your doctor or seek out a Pelvic Health Specialist to guide you back to feeling strong and confident. Don’t give up your exercise or activities and don’t shut yourself in due to fear of embarrassment. Take charge of your life and educate yourself about the helpful benefits and options available. ___________________________________________________________________

Dr. Karla J. Gowan earned her Doctorate (DPT) in Physical Therapy from the University of St. Augustine in Florida in 2003. Adding this extra curriculum afforded her a certification in Primary Care PT. Preceding her Doctorate, she received a Master’s Degree in Physical Therapy from Idaho State University in 1997 and a Bachelor’s Degree in Health Sciences from Boise State University in 1995. Her most recent accomplishment in 2013 is a certification in Pelvic Health from the Pelvic Rehabilitation Institute. Dr. Gowan has been a member of Newport Hospital and Health Services Rehabilitation Team since 2006.

Women’s Health Seminar Presented by Newport Hospital & Health Services

Saturday, October 20 Priest River Event Center Welcome & Continental Breakfast 9:30-10 AM Seminar Program 10 AM - 2 PM Luncheon served at 12 noon. FREE Event! Limited Seating. Adults Only. Call 509.447.7928 (ext. 4373) for FREE Pre-Registration. Pre-registration required by October 15. www.NewportHospitalAndHealth.org Wise Guide | www.TheWiseGuideOnline.com

What’s Behind That Smile?

by Carey Spears Spears Insurance

id you know that your dentist may be the first health care provider to notice a potential medical condition? Research shows that more than 90% of all diseases have oral symptoms! According to a survey commissioned by the Academy of General Dentistry, 63% of Baby Boomers (people born from 1946 to 1964) displaying an oral symptom, considered to be a key indicator of a more serious health condition, were unaware of the symptom’s link to the condition. By not seeing a dentist regularly, missing these valuable clues could negatively affect their overall health by delaying treatment for more serious health problems. “Because of their busy lifestyles, members of this age group may not take the time to seek regular dental treatment, especially if they aren’t in pain,” said Kevin Sheu, DDS, Director of Professional Services for Delta Dental. “Regular oral exams by your dentist can catch some diseases at their earliest stages, when they are most treatable.” Senior citizens sometimes need special dental care. As we age, our teeth and gums are more susceptible to decay, inflammation, and disease. Health problems, like osteoporosis, diabetes, heart disease, stroke, and respiratory disease can also affect dental health, and conversely, sometimes dental health exacerbates those conditions, according to the Columbia University College of Dental Medicine and the American Dental Association. Seeing a dentist regularly helps keep your mouth in top shape and allows your dentist to watch for developments that may point to other health issues. A dental exam can also detect poor nutrition and hygiene, improper jaw alignment and signs of developing oral problems. Contrary to common belief, tooth loss is primarily the result of preventable oral disease and not a result of the aging process. Gum disease is the major cause of tooth loss, and your dentist can help you keep your teeth right where they belong. Provide your dentist with a complete medical history and inform him or her of any recent health developments, even if they seem unrelated to your oral health. If you use over-thecounter or prescription medications, it’s important to let your dentist know. You should also mention any side effects you’ve experienced as these can negatively affect oral health and even lead to more serious conditions. Luckily, early detection can help reduce or alleviate many of these potential problems.

Wise Guide | Spring / Summer 2018

Often, people delay needed dental care because of the expense. Of all out-of-pocket health-care costs, 27% of expenses are related to dental services, according to the Robert Wood Johnson Foundation. Major medical health plans don’t usually include dental coverage. Dental coverage isn’t required for adults under the Affordable Care Act (ACA or “Obamacare”), and if you’re on Medicare, dental work is not covered unless medically necessary. How much does dental insurance cost? On average, Americans pay about $360 a year, or between $15 and $50 a month, for dental insurance. Costs will vary depending on where you live. Unlike medical insurance, which covers costs after you’ve reached your deductible, dental insurance coverage stops after you reach the annual limit. Most dental plans come with a maximum annual benefit or coverage limit which usually falls between $1,000 and $2,000. After you reach that limit, you pay any additional costs out of pocket. Only 2 to 4 percent of Americans will exhaust their maximum benefit annually, so you may not exceed your coverage limit. However, it’s more likely you will exceed your limit if you need a procedure like a root canal or a crown. Dental insurance can offer a safety net to offset some costs if you end up needing these types of procedures. For regular visits, cleaning and the occasional filling, dental insurance is worthwhile. Always carefully check the provisions of any insurance product you have or may consider purchasing. Be sure to read the fine print to make sure you understand what you’ll be responsible for paying out-of-pocket, what’s covered versus

what’s not, and what your deductible will be. You can save money by only buying what you need and stand-alone policies these days are very customizable to suit your needs and budget. Don’t put off shopping for a dental insurance plan. Most plans have a “waiting period” of up to a few months before coverage will officially kick in, so the sooner you purchase a policy, the sooner you can begin your path to oral and overall health. ___________________________________________________________________

Carey Spears, RHU is a licensed Life/Health insurance agent with over 20 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 208-610-8096 to learn the right steps in securing your Health Care options.

To learn more about dental insurance options, please call us for a no obligation appointment.

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Birth Control on a LARC? Contraception can be carefree! IUDs are safe for use between 3-10 years depending on which one you choose. The hormone-releasing IUDs have by Dr. Kristin Algoe, many health benefits including lighter Sandpoint Women’s and less painful periods, treatment of Health at endometriosis and prevention of uterine Bonner General cancer. IUDs work mainly by preventing Hospital sperm from fertilizing an egg. Many women have heard stories irth control is defined as any method from friends about complications with or practice that prevents pregnancy. the IUD. In truth, complications are very Deciding to start birth control and rare and usually happen around the time choosing the right birth control can be of insertion. If you wish to stop using an very big decisions for a woman. Birth IUD you can have it removed during an control is commonly understood to help office visit. prevent unintended pregnancy, but did The birth control implant is another you also know that it may help with long acting reversible contraceptive. It is heavy and/or painful periods and even a single flexible rod about the size of a help prevent certain types of cancers? matchstick that is inserted under the skin These days there are a lot of in your upper arm. This is also easily done options including long acting reversible in the office. The device cannot be seen contraceptives (LARCs). These LARCs but it can be felt. Once it is in place you have many wonderful benefits including do not have to do anything else to prevent their overall effectiveness, easy reversibility pregnancy, it is also highly effective. The and low or no hormone options. Even device releases progesterone hormone so, many women have some fears or for up to 3 years. The progesterone misconceptions regarding these methods. dose in this implant is higher and can I would like to teach you a little bit more stop ovulation. The most common side about what we know about long acting effect is irregular bleeding patterns. Most reversible contraceptives. The LARC methods include the IUDs (intrauterine devices) and the birth control implant. The IUD is a small T-shaped device that your healthcare provider inserts into your uterus during a pelvic exam. This is typically easily done in the office. Most women are good candidates for an IUD and it is a great option for young women and teenagers as well. You do not have to have had a child to use an IUD. Once it is in place you do not have to do anything else to prevent pregnancy, it is highly effective. There are hormone-releasing IUDs, which release a small amount of progesterone hormone and there are non-hormonal IUDs that contain copper.

Wise Guide | Spring / Summer 2018

women are great candidates to use the birth control implant as well. As providers of health care for women, we tend to be big proponents of these LARC methods for several reasons. First, the LARCs are so effective and easy for women to use. In the first year of typical use less than 1 out of 1000 women will become pregnant. This makes LARCs as effective as having a permanent procedure such as a tubal ligation or a vasectomy, but it is completely reversible! Most providers place these IUDs or implants very frequently and rarely encounter any issues. Second, we like to give our patients birth control options that contain very low doses of hormones or no hormones at all. And last, all of these options are safe with breastfeeding and can be inserted right after a pregnancy. These options do not prevent sexually transmitted infections, so safe sex practices with condoms and regular testing for STDs is very important. There are many benefits and the risks are quite low. Your healthcare provider can provide you with more information. If you are looking for a good web source for information, I always encourage my patients to visit ACOG.org (American Congress of Obstetricians and Gynecologists). In conclusion, I encourage you to consider a long acting reversible contraception if you are planning to use birth control. Visit us online at sandointwomenshealth.com Sandpoint Women’s Health is currently accepting new patients, please call 208-263-2173 today for an appointment. ____________________________________________

Kristin Algoe, MD is Board Certified by the American College of Obstetrics and Gynecology. Dr. Algoe graduated from State University of New York at Buffalo School of Medicine and completed her residency at Dartmouth-Hitchcock Medical Center. During her residency, Dr. Algoe received several awards including, the “Arnold P. Gold Award for Excellence and Humanism in Teaching,” the “Award for Excellence in Laparoscopic Surgery,” and the “Resident Researcher Award.” After completing four years of OB/GYN residency training, she joined Sandpoint Women’s Health in 2009.

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A Focus on Family Harmony: Will Your Children Still Be Friends When You’re Gone? What Are Some Of The Causes Of Family Conflict?

By: Jeffery Crandall, J.D., AEP, Certified Estate Planning Law Specialist Crandall Law Group

s experienced estate planning attorneys, we’ve seen countless family feuds erupt after the death of a parent. Many of those clients were convinced that this could never happen in their families. While clients expect us to advise them on the legal implications of their choices, we also counsel them on how to maximize the positive impact of their legacy and minimize the chance that resentment and conflict will cause a lasting family rift after they’re gone. Based on a recent study, we’ve learned that the top motivation for estate planning is to avoid chaos and conflict among heirs. Estate planning is more than the investment, management and disposition of assets upon disability or death. It includes the preservation of family values and traditions, not the least of which is family harmony.

Wise Guide | Spring / Summer 2018

Unexpected Greed: About $30 trillion in wealth will be transferred from one generation to the next over the next three decades. With this amount of money at stake, the inherent desire to “get their fair share” may spawn uncharacteristic selfishness in some children, resulting in fierce conflict with potentially devastating consequences. Depending upon family dynamics and history, equal distributions do not necessarily avoid the conflict, especially when family farms and businesses are involved or lifetime gifts and loans have made to some of the needy children. As we often explain to clients, “fair is not always equal and equal is not always fair.” Fiduciary Selection: The choice of “who does what” may impact family harmony more than “who gets what.” There are plenty of unexpressed expectations in almost every family that can come to a head when family members realize who has the power to settle the trust or manage a parent’s affairs during disability. Some people see the role as an honor; others as an unenviable chore. Some family members will assume that roles should be assigned based on age or birth order, rather than Continued on Page 14

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

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

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A Focus on Family Harmony Continued from Page 12

____________________________________ suitability. One of the most important reasons for seeking our professional assistance in designing your estate plan involves the choice of successor trustees, agents, and executors/personal representatives (“successor agents”), and the potential effects of those choices on family relationships. Naming your surviving spouse as your successor agent seems only natural; however, in some families, such as blended families, or in marriages where one spouse has had little involvement in family finances, naming them could ignite or exacerbate rifts in the family or cause overwhelming stress to the ill-equipped spouse who may be struggling already with inconsolable grief and loss. Naming the children in order of birth, without carefully evaluating their experience and temperament, sibling dynamics, and leadership styles, can also produce enormous conflict within the family. You should consider some of these important questions before selecting any family member to be your successor agent: How do they handle their own finances now? Are they good at follow through and attention to detail? Do the other children look up to them as a leader in the family? Are they tolerant of the life choices made by others in the family? What is their leadership style? Do they solicit input or issue autocratic mandates? Have any of the other children expressed frustration or concern about their ability to communicate with or relate to the other members of the family? The Forgotten Plans: Oftentimes, parents forget to plan for an item, or forget they told a child they could have it, or forget they already gave an item to a child. These situations may seem trivial, especially when the item has little monetary value, but we’ve seen intense, expensive family battles fought over “stuff” most of us would consider trivial or inconsequential. The In-Law Factor: Careful consideration should be given to the potential influence of sons/daughters in-law. Because the stakes can be high, they often find it difficult to resist involvement, and their influence can both ignite and fuel family conflict. Holding family meetings with your children to keep the lines of communication open, to educate them about the financial and legal aspects of your plan, to share your expectations, and to express your hopes for family harmony when you’re gone, may mitigate the potential impact in-laws can have on family conflict. Other Sources: These include family business or farm succession, and the importance of passing on control as well as ownership, especially when some children have been more active in the operations and added greater value than other children. Sources of conflict can also include ambiguities in the documents or the failure to provide basic information to the successor agent, such as insurance and account information, business interests, passcodes, safe locations and contents, keys, etc.

Wise Guide | Spring / Summer 2018

Solutions One of the most effective means of avoiding family conflict is to put everyone on the same team by selecting an independent fiduciary to serve as your successor agent. This avoids pitting family members against each other, and relieves them of the enormous burden placed on the successor agent. You’ve wisely hired a professional to document your plan; it makes sense to hire a professional to make sure your wishes get carried out. For a more detailed discussion on fiduciary selection, please revisit the article we published in the Wise Guide entitled “Choosing a Successor Trustee/Disability Agent (Spring/Summer 2017, thewiseguideonline.com/2017/06/7471). Additionally, consider holding family meetings to discuss how your plan implements measures to preserve family harmony. This prepares your children in advance for the orderly administration of your estate, educates them on the process, and thereby reduces anxiety, confusion and even paranoia that might fuel the fire of family conflict. Lastly, when we help you design your estate plan, we’ll discuss the potential benefits of no-contest clauses to preempt disputes, the consequences of complete disinheritance, and the role trust protectors can play to resolve disputes, efficiently oversee the actions of the successor agents and make necessary revisions to the plan to adapt to changing circumstances, law and practices.

Call to Action In many families, Mom and Dad are the glue keeping the family together in this busy, fast-paced, digitally dominated age we live in. Preserving family harmony and unity after we’re gone may be one of the most important legacies we can leave our children and grandchildren. If we don’t have an estate plan in place, it’s time to get that going. If we have an existing will or trust, let’s dust it off and evaluate our plan with a view towards reducing family conflict. At the Crandall Law Group, we offer complimentary consultations to review your existing estate plan, or if you don’t currently have a plan in place, to assist you in developing a plan that addresses family unity as well as all of the other important considerations necessary and relevant to you and your family. __________________________________________________________________

Jeff Crandall is a business and estate planning attorney with over 29 years of experience in business, tax, estate planning, elder law and business succession planning. He is licensed in Idaho, Washington and California and has been practicing in the Coeur d’Alene area for over 20 years. Jeff loves helping people solve problems and, whenever possible, helping them to avoid problems in the first place.

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How Does Pain Affect Your Life?

by Mindy Murray, Occupational Therapist Kauai Therapy & Wellness, Sandpoint (Ponderay) ID & Kauai, HI

hat are you unable to do? What do you want to do again, but pain holds you back? Is it taking your dog on a walk, sweeping the kitchen floor, sleeping through the night, or being able to simply hug your child? Ask yourself, “How much longer do I want to wait to find a solution that gets to the root of my problem?” Let me ask you: What are your fears that hold you back from seeking a solution? Is it that you don’t feel you have the time, the money, or the energy to invest in yourself?

Why Isn’t Pain Medication a Solution for Me?

Before you reach for another pain pill, listen up. Pain is an alert system telling your body that something is “wrong.” While it often happens in response to healing an injury and tissue damage, it can also persist even after the injury has healed. While pain medication can help for a short time, it is not by any means the long-term solution. As I mentioned, pain alerts your body that something is wrong. It is like a smoke alarm telling you that something is on fire. If injury is causing your fire alarm to go off, pain medication will suppress the signal and you will feel more comfortable while healing. However, if you use medication for a long time, you might injure yourself even worse by doing things you wouldn’t normally do because of your alert system being turned off by medication. Furthermore, in case of prolonged duration of pain, your nervous system sensitivity increases and pain circuits become more efficient and memorized, and the pain will become intensified. Your nervous system starts acting like a fire causing that alarm to go off. As long as your nervous system is “on fire” your pain will not get better with pain medication.

If Medication Is Not a Solution, What Can You Do? Let’s focus on three newest & most effective solutions to healing with no medications, surgery, or injections. 1) The Revolutionary 830 Cold Laser Cutting edge technologies such as cold laser therapy, electrical stimulation and electromagnetic pulse eliminate pain, speed up healing and depolarize painful nerves.

Wise Guide | Spring / Summer 2018

Furthermore, influencing pain modulators (stress, anxiety and sleep) gives successful pain relief with no pain medication. 2) MultiFunctional Movement Therapy This therapy stops pain, increases strength, confidence and agility through specialized movements proven to rapidly resolve these an other issues: • Back Pain, Neck, or Disc Problems • Shoulder or Knee Problems • Developmental or Coordination Issues • Chronic Pain • Foot/Ankle/Heel Pain Our Movement Based Treatment Program: • Mimics Movements from Yoga, Boxing, Martial Arts, and Plyometrics • Leverages the Body’s Synergies and Nervous System for Rapid Results • Is Provided by Trained & Certified Specialists All of these natural healing options including cutting edge technology, sleep hy-giene advice, lifestyle modification, nutrition advice, meditation exercises, and manual work are provided in one package at Kauai Therapy & Well-ness. Movement therapy, when supervised by a Certified Specialist, is proven safe even if you have had surgery, are pregnant, a child, have nerve conditions, and more. There are numerous advantages to movement therapy

that include: fast pain relief, rapid strength gains, increased athleticism, burns body-fat, normalizes nervous system, reduces stress, tones the body, removes belly-fat, increases endorphins, boosts self-confidence, and many other benefits. 3) Food as Medicine Stop Reaching for the Advil or Aspirin when you hurt, instead reach for certain food choices. There are many natural alternatives you can try before aspirin or anti-inflammatory medication. These foods will advance your health with powerful nutrients which will set the terrain to help prevent future pain and illness…and they taste incredible! Chronic pain can really deter you from doing even your routine activities. Anyone who suffers from any kind of chronic pain can surely tell you how difficult it is sometimes to get up from bed in the morning because their back or knee or neck has “pins” in it. Pain is a huge de-motivator and chronic pain has been linked to increased depression and cancer rates. Inflammatory cascades have many adverse effects causing soft tissues and even internal organs to swell, resulting in pain, discomfort and sometimes even hospitalization. Pain can be controlled in the long-term by dietary changes. Using prescribed pharmaceuticals or even over the counter pain pills will always result in some type of reoccurrence in patterns since they only address symptoms and not causes. A diet filled with foods that bombards your body with the right nutrients to sustain health and prevent pain has a lasting effect. Here is a list of 22 anti-inflammatory foods: 1. Ginger 2. Acai Juice 3. Coffee 4. Olive Oil 5. Sage 6. Raw Almonds 7. Walnuts 8. Greens 9. Grapes 10. Flax Seeds & Flax Oil 11. Turmeric

12. Salmon 13. Mackerel 14. Herring 15. Celery 16. Cherries 17. Blackberries 18. Raspberries 19. Blueberries 20. Strawberries 21. Cayenne Pepper 22. Honey

Let food be thy medicine and medicine be thy food. —Hippocrates We at Kauai Therapy and Wellness are innovative leaders in Physical Therapy and Revolutionary Techniques for pain relief in our area. Our revolutionary treatments are perfect for anyone suffering from sports injuries, arthritis, lower back pain, bursitis/tendonitis, carpal tunnel, plantar fasciitis, fibromyalgia, migraines or TMJ. Medical Insurance accepted. No Insurance? No problem! We have affordable solutions for you. For additional help with reducing your pain and inflammation please call us at 208-205-9559 to speak with a Licensed Therapist. __________________________________________________________________

Mindy Murray, OTR/L received a Bachelor’s degree in Occupational Therapy (OT) from Loma Linda University. She worked 18+ years in Kauai in a variety of occupational therapy/rehabilitative settings with pediatrics to geriatrics. Mindy also completed Hand Therapy internships at The Hand Therapy Clinic in Southern California, Whittier California Outpatient, & Rancho Los Amigos National Medical Center, Los Angeles CA. Mindy holds specialized training in dysphagia and swallow disorders. Mindy was born in Sandpoint and her passion was to return to her roots with a purpose to serve the community of Northern Idaho. “Part of my heart is right here in this tiny town & with these beautiful & kind people!”

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Know Before You Go

by Olivia Luther Morlen, Director of Community Relations Kaniksu Health Services

he emergency room (ER) is supposed to be just for emergencies, but studies show that it isn’t always used that way. While hospital ERs are indispensable to the acute health care system, many ER visits are not emergencies, or could be prevented with effective and timely outpatient care. Depending on the estimate, anywhere between 8 percent and 27 percent of care provided in ERs isn’t for medical emergencies, creating a very costly problem, and could have been provided in a different setting.

Emergency rooms are set up to focus on medical emergencies. They are not set up to focus on routine health care. Furthermore, using an emergency room for treatment of a condition that could be seen in a doctor’s office or urgent care center is an expensive choice. Emergency rooms are set up to focus on medical emergencies. They are not set up to focus on routine health care. Furthermore, using an emergency room for treatment of a condition that could be seen in a doctor’s office or urgent care center is an expensive choice. According to the New England Healthcare Institute, overuse of U.S. emergency rooms accounts for about $38 billion in wasteful spending each year. That’s because an emergency room visit for a non-urgent condition is two to five times greater than the cost of receiving care in a primary care setting for the same condition. For example, one study found treatment of an upper respiratory infection in the emergency department cost more than double than at a family practitioner’s office: $221 versus $106. Avoiding inappropriate emergency room use can be especially important during cold and flu season, when hospitals tend to be extra busy. Treatment of patients with non-urgent conditions can lead to delays in care for ER patients who are truly in need of urgent attention. ER visits often lead to extra, sometimes unnecessary, tests. Moreover, visiting an emergency room potentially exposes both patients and accompanying friends or family members to other infectious diseases.

Wise Guide | Spring / Summer 2018

For many, it can be challenging to figure out when to call your primary care provider, when to go to urgent care and when to visit the ER. Here are a few simple guidelines to help you navigate the system: • Call your primary care doctor first, even if it’s after-hours. Your doctor may provide access to a physician or nurse who can speak with you on the telephone to determine the most appropriate steps. • Check with your health plan. Some plans require you to call your primary care physician before you go to the ER unless your condition is life-threatening. Without preapproval, you may pay more for care. Some health plans also offer a telephone hot line to a nurse who can advise you on where to seek care. • Ask yourself if you can wait until the next day, when your physician is available. Some symptoms that might feel scary or serious turn out not to be so. Learning to understand those symptoms can not only help you to make an educated decision, but it could potentially save you a lot of money. For example, a fever in an adult rarely warrants a trip to an emergency room or urgent care facility, unless it is accompanied with severe diarrhea, a rash, or ongoing vomiting for 24 hours or more. Sprains and other minor muscle problems often don’t require medical attention either, and you should be able to make a regular appointment with a doctor or treat the problem at home. • Consider Urgent Care. Urgent care centers are springing up in many neighborhoods. Your primary care physician or hospital may even be part of a network with an urgent care center where your electronic medical records can be easily accessed for better, more personalized, care.

If you do have a condition that requires emergency care, call 911 or go to the nearest emergency room. And if you do visit the ER, it is important that you contact your primary care provider as soon as possible after receiving emergency services. Your primary care provider will update your records and assist you if additional care is needed. _________________________________________________________________

Olivia Luther Morlen has a strong mix of both for-profit and nonprofit management skills. She received her BA in Art History and Public Relations from SDSU and an MPhil in Art History from the University of Glasgow, Scotland. Originally from Southern California, Olivia has been living in Sandpoint since 2011. She works as both the Director of Community Relations for Kaniksu Health Services and Executive Director of the Bonner County History Museum and believes that a community centered organization is better positioned to remain relevant and vibrant.

The American College of Emergency Physicians offers a list of warning signs that indicate a medical emergency. • Difficulty breathing, shortness of breath • Chest or upper abdominal pain or pressure • Fainting, sudden dizziness, weakness • Changes in vision • Confusion or changes in mental status • Any sudden or severe pain • Uncontrolled bleeding • Severe or persistent vomiting or diarrhea • Coughing or vomiting blood • Suicidal feelings • Shortness of breath • Unusual abdominal pain

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Bonners Ferry· Ponderay · Priest River · Sandpoint Pediatrics · Sandpoint VA Wise Guide | www.TheWiseGuideOnline.com

Persistence, Prevalence, and Patience… The 3-Big “P’s” in Understanding and Treating Co-Occurring Disorders...

The Journey Continues… by Lynn Russell, LCSW, ACSW, CS Rathdrum Counseling Center, LLC

ne often wonders, and sometimes out loud, “Will I ever be free of this? Will I never stop feeling ‘urges’ and seeing ‘triggers’ all around me when facing the challenges, and demons of my addiction?” These questions arise almost like clock-work when working side-by-side with folks of all walks of life who enter into treatment services with Rathdrum Counseling Center, LLC. We have shared many stories through this Wise Guide, and I don’t use that term lightly. This ‘ailment’ we call “Addiction” is afflicted over and over with the “Big 3-P’s” – Persistence in its attempts to catch us off guard and bring us back into the abyss of the addictive patterns; Prevalence

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Wise Guide | Spring / Summer 2018

of the never-ending awareness of our addictive tendencies, and how they sneak up on us at the most inconvenient times, challenging us to a show-down, demanding our attention; and Patience, the art and virtue, according to my wise mother, of simply standing still long enough for it to pass. Her favorite phrase, “This too shall pass, Dear One.” Okay, Mom, I got it. Rathdrum Counseling Center, LLC continues to work hard, fight harder, and stand strong and tall along with you in your journey to wellness, balancing interfering psychiatric symptoms, and being substance free. We continue to use those “Big 3-P’s” as a strength with our Persistence in supporting you with interventions that are evidenced-based and proven to work as long as you want them to; our Prevalence in our commitment to never stop supporting you in the journey, regardless if you trip, fall, and are scared to stand back up and fight; and the Patience to continue to encourage you, challenge you, help you find your inner-strength in fighting and overcoming those barriers that keep you believing that you just many not win. Rathdrum Counseling Center, LLC’s commitment to you will never waver, never shut-down, never give up, and never walk away from you. The choice is yours, and the journey you can share. Rathdrum Counseling Center, LLC and Restored Horizons continue to provide quality Medication Assisted Treatment (M.A.T.) utilizing Suboxone as a viable part of

Free & Confidential • MEDICAL GRADE PREGNANCY TESTING • LIMITED ULTRASOUND IMAGING • MAN 2 MAN COACHING • LIFE SKILLS CLASSES • POST ABORTIVE HEALING CLASSES . . . AND MUCH MORE! Call or text today for your appointment

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your treatment regimen. We offer the same quality services as always, are in the same location as we have been, and have the same dedicated group of professionals who are eager and excited to work with you! We accept Idaho OPTUM Medicaid, BPA, and most private insurance. Please give us a call at 208-687-0538 for your confidential intake, or visit our website at www. rathdrumcounseling.com for more detailed information on our services. ___________________________________________

Lynn Russell, LCSW, ACSW, CS has been a practicing social worker in North Idaho for 26 years. She has worked tirelessly with her colleagues, community partners, and state systems, to build and sustain outpatient services that have far reach to those in rural areas of our state. Ms. Russell continues to have the same commitment to others as when Rathdrum Counseling Center, LLC was founded in 2007, “It’s about the folks who walk thru the door, and for us who invite them.” —L. Russell

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Proven results for recovery and wellness without residual withdrawal and detox. Rathdrum Counseling Center & Restored Horizons have joined forces, providing comprehensive mental health and addiction services under one roof! Utilizing the most effective methods, we assist you in learning new ways to approach life’s challenges, so you can build your own resilience tools and walk through life with confidence and resolve.

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Suicide Prevention in Local Schools by Marc Stewart Multimedia Specialist, Heritage Health

room full of experienced educators found themselves having uncomfortable conversations about suicide during a role-playing exercise. It wasn’t easy asking the question – or dealing with the answers. “Once the person said, ‘Yes, they were thinking about suicide,’ the enormity of the answer hits you,” said John Keating, who teaches social studies and economics at Lakeland High School in Rathdrum. “My first reaction was to think the student should really talk to someone and then I had this epiphany that I am that someone!” Keating is one of more than 700 Lakeland Joint School District employees who completed a suicide awareness training program called QPR: “Question, Persuade, Refer.” Idaho continues to have one of the highest suicide rates in the country. According to the Idaho Department of Health and Welfare, suicide is the second leading cause of death for Idahoans age 15-34 and males age 10-14 – that’s 46% higher than the national average. Heritage Health is trying to change those statistics. The QPR training instructor is Gina Prindle, and Ron Prindle who volunteers his time. Both are certified QPR trainers. “The training removes some of the myths about suicide. It’s a myth that if you ask someone if they’re feeling suicidal, you will inadvertently plant the thought about committing suicide,” said Gina Prindle, Director of Heritage Health’s School-Based Health Center. “It’s absolutely not true. Either they’re thinking about suicide or they’re not. The question has to be asked.”

It’s a myth that if you ask someone if they’re feeling suicidal, you will inadvertently plant the thought of committing suicide... ...It’s absolutely not true. Either they’re thinking about suicide or they’re not. The question has to be asked. “The goal of the training is to save lives,” said Lakeland Superintendent Becky Meyer. “Our district training stemmed from close to home events over the past few years where students, parents and former students have taken their own lives. I am so proud of the many community members willing to step up and help, and without their support, bringing awareness to suicide prevention would not be possible.” She further noted, “The importance of every staff member taking

Wise Guide | Spring / Summer 2018

part in the training is to enable the district to have a further reach because it is not only teachers that have daily interaction with students. Everyone from bus drivers to crossing guards, teachers to custodial staff are receiving the two-hour training.” Already educators are reporting the training has helped people get the help they need. Lakeland’s Director of Special Services Susan Morrison said a close friend was going through a very tough time. “As I was speaking to her, I knew I needed to ask ‘the question’ and because of the training, I knew exactly how to phrase it,” said Morrison. “When she said, ‘Yes, sometimes I think about ending my life,’ I was so glad I had the courage to ask. I was then able to convince her it was time to seek help. She had her first counseling session this week. I am so grateful for this training!” Spirit Lake Elementary School Principal Kristie Mitchell remarked that the training provides a useful tool and raises awareness about a difficult topic. “Today is a different world, and we are seeing more and more children and adults struggling with mental health issues,” said Mitchell. “Gina and Ron Prindle bring awareness to this very difficult yet extremely important subject in our lives.”

Peer Support Specialist Training Coeur d’Alene, September 17-21, 2018 www/idahopeersupport.com/training Questions? jess@idahopeersupport.com Peer support is provided by individuals who have personal lived experience with mental illness or mental illness with co-occurring substance use disorder. Certified peer support specialists offer their peers encouragement, hope, and understanding to support their recovery journey by sharing their own story of recovery. It’s a powerful form of support that’s based on the belief that recovery is possible for everyone. Peer support focuses on strengths, recovery goals, hope, and building trust. It eliminates the “you don’t know what it’s like” feeling that many people entering recovery may be experiencing. Certified peer support specialists (CPSSs) have experienced the recovery process firsthand and truly understand its challenges. Their inclusion in the behavioral health system promotes recovery for all! NAMI is holding a FREE Family-to-Family Educational Program for family and friends of individuals with brain disorders/mental illness. You will gain valuable information, insight, understanding and empowerment. May 20 - June 30, 2017 at the VFW Hall at Pine & Division, Sandpoint. Apply as soon as possible to ensure admission into the training, classes fill up quickly! Call 208-597-6573 to Register. Educators and support staff learn about suicide warning signs, including red flag behaviors, and how to deal with a person who might be contemplating killing themselves. “You have to establish a relationship with these students that builds trust and allows the student to share their thoughts and feelings,” said Gina Prindle. Heritage Health is North Idaho’s premier provider of integrated medical, dental, and behavioral health services. Heritage Health provided care to more than 29,000 individuals during 160,000 patient visits last year. A typical patient at the health center supports a family of four on less than $25,000 per year. Heritage dispensed close to $3.3 million of charitable discounts and services. Heritage Health has clinic locations in Coeur d’Alene, Post Falls, Rathdrum, St. Maries and Kellogg. Heritage Health provides health care from the heart.

Healthcare from the Heart

__________________________________________________________________

Marc Stewart, Multimedia Specialist with Heritage Health has worked in journalism, marketing, and communications for 20-plus years. He joined Heritage Health in February 2018 after working 2 ½ years at the Coeur d’Alene Press as their marketing writer. Previously he worked at STCU, Lewis-Clark State College, the Coeur d’Alene Press a couple of times as a reporter, and the Coeur d’Alene Tribe.

Accepting New Patients Call for more information today!

208.620.5250 myHeritageHealth.org

Wise Guide | www.TheWiseGuideOnline.com

Listen to Your Selfie!

by Jennifer L. Hammer Victim of Crime Advocate/Domestic Violence and Sexual Assault Advocate, Kalispel Tribe of Indians Panther Country Coalition Member

he Cusick Youth Coalition recently formed in the summer of 2017. This small group of passionate students hopes to be powerful change agents as they advocate for a safer and healthier community for everyone. The Cusick Youth Coalition is a resource for links to youth drug prevention, bullying, sexual assault and dating violence. In this day and age of marijuana legalization, it is important to educate the youth of Washington State of the risks associated with marijuana use. Washington State law states it is illegal for anyone under the age of 21 to possess or use marijuana unless medically authorized. Rates of youth marijuana use are on the rise in Washington State and in our neck of the woods. In 2016, 21% of Pend Oreille County 10th graders reported being current marijuana users compared to only 12% in 2014. The number of 10th grade users increased by 75% in just two years! Part of the reason can be attributed to the new legalization law for adults and the normalization of marijuana use in the media and in many communities. Another reason is linked to the students’ perception of harm. 22% of Pend Oreille County 10th graders believe that there is “No/Low risk from regular marijuana use.” Studies show when the youth’s perception of harm goes down, rates of use go up. One new prevention campaign the youth coalition is implementing aims to educate 12-17 year olds about the risks and consequences of marijuana use. The Listen2YourSelfie campaign taps into the popular activity of taking “selfies” to demonstrate the health risks posed by using marijuana while brains are still developing, as well as how using marijuana can derail personal goals and opportunities.

Wise Guide | Spring / Summer 2018

Guided by research conducted with a diverse group of youth across the state, the campaign features youth putting school, sports, extracurricular activities, friends, and families ahead of marijuana and empowers them to “Remember what’s important. Forget marijuana.” If getting good grades are important, then students might be interested in this information as well. Statewide, 10th graders who reported using marijuana were twice as likely to incur low grades compared to those who do not use. Low grades were defined as mostly C’s, D’s, and F’s. This group of students from the Cusick School District are diving into their school and community to offer education to their peers. The Cusick Youth Coalition wants to empower youth to make healthier choices. A message they want to share is: Sometimes it’s hard to remember what’s important in life when you’re faced with a hard choice. Ask yourself these questions to determine a good or bad decision:

• • • •

IS IT GOOD FOR ME? IS IT GOOD FOR MY FAMILY? IS IT GOOD FOR MY FRIENDS? WHAT ARE THE CONSEQUENCES?

#Listen2yourselfie! Teens: Go to Listen2yourselfie.org for more information on the risks and consequences associated with underage marijuana use. The Cusick Youth Coalition has been very active in their school and community since last summer. They met with the Cusick School Board, mailed out post cards to every resident in Cusick and Usk introducing themselves, their mission and informing the community of their Listen2yourselfie campaign. In addition they had a Valentine’s Day activity for all Cusick Junior/High school students and have decorated school bulletin boards with drug prevention messages. Their most recent project included volunteering for the “Longest Walk” (a call to End Substance Abuse and Domestic Violence) hosted by the Prevention Program with the Kalispel Tribe of Indians.

If you would like more information on the Cusick Youth Coalition, please contact Carrie McKinley at cmckinley@pendoreille.org or 509-447-6419. You may also contact them at the Cusick Youth Coalition Facebook page. The Cusick Youth Coalition is funded by Panther Country Coalition and Washington State Division of Social & Health Services.

Wise Guide | www.TheWiseGuideOnline.com

Oral Healthcare Essentials Six Quick Facts about Early Childhood Caries

by Marv Gottschall, DDS Camas Center Clinic

oth caries (tooth decay) and periodontal (gum) disease are classified as true diseases, caused by bacteria and transmissible to others. Dental caries, more commonly known as tooth decay, remains the most prevalent chronic disease in both children and adults, even though it is largely preventable. Although tooth decay has significantly decreased for most Americans over the past four decades, disparities remain among some population groups. In addition, this downward trend has recently reversed for young children and is on the rise. According to the American Academy of Pediatric Dentistry, children who are frequently exposed to sugary liquids, such as milk, breast milk, formula, fruit juice, and other sweet liquids, for long periods of time run a great risk of suffering from tooth decay known as Early Childhood Caries (ECC).

Wise Guide | Spring / Summer 2018

1. ECC is an infectious disease that can begin as early as the teeth begin to emerge (around six months of age), often progresses rapidly, and can cause great pain to the child. 2. ECC is defined as the presence of one or more decayed teeth, missing teeth (resulting from tooth decay), or filled tooth surfaces in any primary tooth in a child six years old or younger. 3. Tooth decay is the single most common chronic childhood disease—five times more common than asthma, four times more common than early childhood obesity, and 20 times more common than diabetes. 4. ECC is a multifactorial disease process initiated by bacteria. This simply means that after food enters the body, the bacteria can break down the carbohydrates, producing acids that cause mineral loss from teeth—a process that often results in cavities. 5. Typically, ECC that requires extensive dental repair (often in an operating room under general anesthesia) appears in children aged 22 months. 6. Left untreated, it can destroy the child’s teeth and have a strong, lasting effect on a child’s overall general health.

Tooth Decay

Six steps you can take to prevent cavities

Cavities, or tooth decay, is the destruction of tooth enamel, the hard, outer layer of teeth. It can be a problem for children, teens and adults. Plaque, a sticky film of bacteria, constantly forms on your teeth. When you eat or drink foods containing sugars, the bacteria in plaque produce acids that attack tooth enamel. The stickiness of the plaque keeps these acids in contact with your teeth, and over time the enamel can break down. This is when cavities can form. Cavities are more common among children, but changes that occur with aging make cavities an adult problem too. Recession of the gums away from the teeth, combined with an increased incidence of gum disease, can expose tooth roots to plaque. Tooth roots are covered with cementum, a softer tissue than enamel. They are susceptible to decay and are more sensitive to touch and to hot and cold. Itâ&#x20AC;&#x2122;s common for people over age 50 to have tooth-root decay. Decay around the edges, or a margin, of fillings is also common for older adults. Because many older adults lacked the benefits of fluoride and modern preventive dental care when they were growing up, they often have a number of dental fillings. Over the years, these fillings may weaken and tend to fracture and leak around the edges. Bacteria accumulate in these tiny crevices causing acid to build up which leads to decay.

1. Brushing twice a day with fluoride toothpaste. 2. Cleaning between your teeth daily with floss or interdental cleaner. 3. Eating nutritious and balanced meals and limit snacking. 4. Reading food and drink labels and looking for hidden sugars in your diet. 5. Checking with your dentist about the use of supplemental fluoride, which strengthens your teeth, and about use of dental sealants (a plastic protective coating) applied to the chewing surfaces of the back teeth (where decay often starts) to protect them from decay. 6. Visiting your dentist regularly for professional cleanings and oral examination. ____________________________________________________________________

Dr. Gottschall is a 1977 graduate of Loma Linda Dental School and has practiced dentistry for more years than he cares to admit. He has worked for the Kalispel Tribe of Indians at their Camas Center Clinic for nine years, is a golf addict and enjoys spending time with his three grandchildren. A romantic at heart, Dr. G has been married to his high school sweetheart for almost 48 years.

Wise Guide | www.TheWiseGuideOnline.com

What is Elder Mediation?

And, How Can It Help Our Family?

by Gary & Cathy O’Neal O’Neal Mediation Services

hat happens when seniors face major life transitions and their adult children are embroiled in painful and unrelenting conflict? Issues like residence decisions, distribution of caregiving responsibilities, safety and health concerns, wills and estates, the sale of the family home, and more can divide a family for years to come. When communication is difficult and critical decisions are put on hold, families may need the help of a skilled mediator to get them “unstuck” so they can move forward.

How Does Elder Mediation Help? Elder Mediation facilitates meaningful discussion with dignity, sensitivity and respectful communication to assist families as they plan for life’s changes. In fact, one might even call it a ‘family meeting’ with a bit of help. Some areas of conflict may be end of life topics, change of residence, healthcare, safety, and other intergenerational issues. A skilled elder mediator creates an atmosphere of safety and respect, listens deeply to each participant’s interests and concerns, brings clarity to the issues at hand, recognizes important thoughts to discuss, and assists in exploring options. The experienced mediators at O’Neal Elder Mediation are highly skilled conflict resolution experts and are neutral

Wise Guide | Spring / Summer 2018

facilitators who do not provide advice or “take sides” in these discussions, but rather identify points of agreement and help the parties discover mutually acceptable solutions. Bottom line, mediation is about making your own decisions, not having someone else make them for you. Our mediators have had specialized training in dealing with the aging population, their families and specific issues. The goals of mediation are twofold. First to allow families to create workable and mutually acceptable solutions to their difficult disputes; and second to develop communication strategies to enable them to successfully work together to make important decisions in the future.

The goals of mediation are twofold. First to allow families to create workable and mutually acceptable solutions to their difficult disputes; and second to develop communication strategies to enable them to successfully work together to make important decisions in the future. Essentially, Elder Mediation provides a forum for family decision-making. It is private, confidential and completely voluntary. Our mediators facilitate a purposeful and directed conversation in which family members are encouraged to express their interests and concerns. Meetings are informal and are held in locations which meet the family’s needs, including private homes, mediators’ offices and senior living facilities.

How Assets Will Be Handled and Who Will Be Involved Mediation isn’t simply an alternative to litigation, a “last resort” forum without the lawyers. Elder mediation is just as effective, and often more effective, at the beginning of the decision-making process, at a time when people are fact finding, struggling with options and discovering feelings about their parents, their siblings or other family members that well up and make clear thinking difficult. The process of mediation allows families to develop creative solutions to challenges in a way that the courts cannot. Courts rarely have the time or resources to explore options that would reflect the best interests of the senior while avoiding protracted family conflict. Mediation is efficient; once agreements are reached, documentation can be legally recognized without long drawn-out proceedings followed by potential appeals and more proceedings...all the while damaging the family, upsetting the senior, and draining finances.

Disputes Among Adult Siblings Perhaps the most difficult disputes of all are those in which family members, with or without the participation of the elder, must decide about the elder’s personal care and financial circumstances. These highly emotional issues often arise at a time of crisis when family members are least able to make rational decisions and can aggravate long dormant, unresolved or poorly resolved family disputes. Conflicts that may have simmered below the surface for years can boil up and make family conversations very difficult. Siblings, dealing with differences in their own geographic, economic and family situations, often find working together challenging and they may have spouses who hold strong views of their own. Thoughtful decision-making can seem all but impossible. Caregiver burnout and inheritance issues are common in families and require difficult conversations. Health, financial and caregiving concerns are serious and demand that all family members weigh in with their views. In mediation, siblings are often able to reach consensus and develop successful communication systems which allow them to successfully address future decisions as a family.

Don’t Wait! Early intervention is always best, before the family is in crisis. It allows family dynamics, including sibling rivalries, to be addressed at a time when everyone is calm, when thoughtful decision-making can occur. A trained third party neutral, a mediator, can simply convene a family meeting to create the space for everyone to be heard. This type of meeting can strengthen family ties and enable all family members to deal with the changing nature of their relationships and the realities of their situation, without the emotions a crisis brings to the forefront. When your family needs more than just yourselves, we are here to help. Contact us today at 208-660-3774 for your free 30-minute consultation. __________________________________________________________________

Gary and Cathy O’Neal are Certified Professional Mediators who are passionate about people and peacemaking. They have served for more than 30 years together in ministry and management. Each has a reputation for providing professional assistance to individuals in the are of dispute resolution and relationship development. To learn more about them, go to onealmediation.com/educationtraining-experience

What Is Elder Mediation? It’s a “family meeting” with assistance. An elder mediator protects the rights and opinions of all parties and the integrity of the process while facilitating family discussions on sensitive subjects. The main goal is to communicate effectively to overcome obstacles in reasoned decision-making, often restoring family unity.

For your free 30 minute consultation

208-660-3774

onealmediation.com

When a family needs more than just themselves. We are there to help you figure out what YOU need!

Shared Family Decision-Making with Dignity, Sensitivity and Respect

Wise Guide | www.TheWiseGuideOnline.com

What Are You Waiting For?

by Tina Mouser, Executive Director The Bridge at Sandpoint

re you a BABY BOOMER? Approximately 10,000 individuals per day are reaching the age of retirement and according to the U.S. Census, this number will increase as more baby boomers reach their golden years. This generation is known for their independence and as these individuals age, the need for services to this population is greatly increasing. While we all love our independence, what cost are you willing to pay to keep it? Many individuals believe they aren’t ready for Assisted Living so they wait until they have a traumatic incident that sends them to the hospital. Unfortunately, that incident may take them directly to a Skilled Nursing Home, permanently. The advantages for safety and overall health of Assisted Living far outweigh the chance of waiting until something happens that dictates where you can and can’t choose to live those golden years. What are you waiting for? In most Assisted Living Facilities (ALFs), you still have independence. You can drive, entertain your friends and family, eat in your own apartment, you’re even able to self-medicate if appropriate. What you gain is having a 24/7 care staff available in case of an emergency, having meals prepared, laundry washed for you, apartments cleaned, and transportation. Medication management, provided by your physician of choice, will be dispensed by highly qualified staff, overseen by a registered nurse, to provide you with the knowledge and security that the right medication is being given at the right time. Alternatively, if deemed safe and appropriate you have the choice of administering your own medication. These options allow you the safety and security that we all strive for when following a medication regimen. Twenty-four-hour care means care givers will provide for your needs while giving you optimal independence and freedom,

Wise Guide | Spring / Summer 2018

and timely intervention if the need arises. This level of care allows you to live independently, in you own apartment safely. A registered nurse is available 24 hours a day for consultation. There is in room communication to the 24-hour staff that allows you to alert them to your need for assistance; with this service a certain peace of mind exists. In an Assisted Living community, housekeeping services are provided to assure you the comfort of your own home without the associated difficulties with certain chores. Laundry services are an amenity that you may utilize as you and your family desire. Transportation to and from medical appointments is available for your convenience. Beyond making it safely to and from your physician, these transportation services provide a means to engage in activities outside the residence which allows continued independence out in the community. Different activities are scheduled within an ALF that allow you to interact with your neighbors who live within your new home. There is a dining area giving you the choice of coming to for meals where you will be able to socialize with your new friends, a private dining area to share meals with family and friends, or dining services where you can eat in the comfort of your own apartment. While considering all the advantages of an Assisted Living Facility remember these communities are designed with your independence in mind while maintaining that safety you so richly deserve. All these factors, your choice of physician, 24-hour care givers, licensed nursing oversight, housekeeping, laundry services, transportation, activities and meals should all be considered before a tragedy occurs. What are you waiting for? __________________________________________________________________

Tina Mouser has been providing healthcare services for over twenty years. She is currently the Executive Director of The Bridge at Sandpoint, a Century Park Facility. She has a Bachelor’s degree in Social Work from Lewis Clark State College. Tina is a Licensed Social Worker and Licensed Assisted Living Facility Administrator in the State of Idaho. Caring for the aged has been her focus for many years and she is an active community participant advocating for the dignity and respect for those served.

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What is “Personal Safety?’” by Deputy Chris Johnston Crime Prevention Unit Spokane County Sheriff’s Office

In Partnership with the Community. Dedicated to Your Safety.

Hi Everyone! I’d like to take this opportunity to speak to you about personal safety. Let’s start by answering the question, “what is personal safety?” Now, I’m sure if you looked in a dictionary, there are likely several definitions that could be used to describe what it means. First, I want to point out that personal safety is not self-defense. I think of self-defense as physical tactics that one might employ to defend themselves, if they were being attacked physically. An arm bar, a leg sweep, or strikes like punching and kicking. There is a proper way to employ these techniques, and, if properly used, they can be effective. That being said, let’s get back to my original question: What is personal safety? I have created a definition that I think

accurately answers this question. Personal safety is “the art of avoiding self-defense.” To clarify what that means, it’s really quite simple- if we do our best to make good decisions in our day-to-day lives, we can effectively reduce the chances of becoming the victim of an attack. Another strong belief that I have is that to be prepared does not make us paranoid; instead, it helps us confidently avoid the need. Upon donning my patrol uniform and gear, I gain 27 pounds. Each piece of my duty gear has a purpose, and allows me to be prepared for whatever situation that I might face. Let’s discuss some simple ways for you and your loved ones to be prepared, and don’t worry, I won’t ask you to carry 27 pounds of gear like I do…

• The MOST powerful set of personal safety tools humans

have is our senses. All too often, people choose to ignore that underlying, subconscious feeling that something is wrong. Don’t do that! If something feels amiss, it’s always best to err on the side of caution and trust your instincts.

• Walk with “purpose!” When moving about in your daily

life, pay attention to what is going on around you. Avoid distractions like talking on the phone or texting, updating your Facebook or Twitter feeds, and my personal favorite, stopping every 30 seconds to take a selfie. It’s best to have your head up, your eyes open, and your ears open, too (turn down that iPod).

• Don’t be afraid to react! For example, if you think you’re

being followed, abruptly change direction. Also, don’t be afraid to look directly at the person who is putting you in fear, as this accomplishes two things: First, it sends a message that you will not be an “easy” or “willing” victim. Second, it allows you to get a good description of the person, should something happen. The idea here is to move confidently, and make yourself a hard target.

• Use the buddy system whenever possible. We’ve been

hearing this throughout our entire lives, and that’s because it really is good advice. When I respond to any call that is potentially dangerous, I always request a backup, or “cover” officer. The reason why is simple: more eyes, more ears, and another set of hands should something go wrong. As an added bonus, it creates a deterrent in the mind of the attacker.

• Let people know where you’re going, and when you’re

expecting to return. I’ll use myself as an example once again; when dispatching myself on a service call, I always let the communications center know the call type, where I’m going, when I arrive, and when I leave. This gives other first responders the best chance of reaching me quickly should an emergent situation occur.

Wise Guide | Spring / Summer 2018

• Property is NEVER worth your safety! If someone demands

your wallet or purse, you’re faced with an immediate choice: comply or resist. As a general rule, compliance is best to ensure your personal safety. For example, if someone is armed with a weapon and demands your purse, GIVE IT TO THEM! In fact, throw it at them, and flee. There shouldn’t be anything in a purse that isn’t replaceable, however the person carrying that purse is irreplaceable. Assume that someone is armed and dangerous, even if you don’t see a weapon. People who commit these types of crimes are often desperate, and MUST be considered dangerous. To that end, you do have the legal right to use force to protect yourself and others if you feel threatened.

• Make some noise! Noise draws attention, and bad guys don’t

like attention. If you’re able to shout, do it. Another great way to make noise is with a personal alarm. They’re inexpensive, easy to carry, simple to deploy, and they are LOUD!

• Other tools. There are a myriad of other tools we can use to

defend ourselves, such as pepper spray, stun guns, TASERS, edged weapons, and even firearms. If we are considering using any of these, we are now in “self-defense” mode. These are all fine options, but make sure that you train and practice with whatever you select on a regular basis so you know that you’re capable of using it/ them under stress. Also, I advise you to take the time to learn the laws in your state as they relate to self-defense and the use of force. During my career, I have seen people get arrested and

receive criminal charges for using force in an unlawful manner (such as using a firearm to protect property).

• Do some drills, and practice for the “what if?” Have you

ever taken the time to ask yourself, “what would I do if this happened? How would I react? Am I prepared?” It’s worth mentioning one more time that this does not equal paranoia. Being prepared includes knowing as much information in advance as possible! These are just a few ideas that you can use to help yourself stay safe. On behalf of the Spokane County Sheriff’s Office and the Spokane Valley Police Department, I sincerely hope that you and your loved ones are enjoying the beautiful summer weather! As always… be safe!

____________________________________________________________________

Deputy Chris Johnston, Spokane County Sheriff’s Office. 11 years of experience in law enforcement, including response and investigations of burglary, assault, robbery, theft, homicide, traffic, drugs, sex crimes, and various domestic violence crimes. Currently assigned to the Crime Prevention Unit for the City of Spokane Valley, maintains certification as an emergency vehicle operations instructor, Crisis Intervention Team, and public instruction on topics such as personal safety, self-defense, workplace violence prevention, active shooter survival, crime prevention through environmental design, and verbal de-escalation techniques. Deputy Chris Johnston, Crime Prevention Unit SCSO/SVPD 389-2771

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Osteoporosis and Vertebral Augmentation

Vertebral Augmentation

This is a minimally invasive procedure that can alleviate a large portion of the pain caused by compression fractures. It can also stabilize the fracture as well. by Dr. Jessica Jameson Axis Spine Center

steoporosis is a disease that gradually weakens bones and increases the risk for fractures. Osteoporosis and osteopenia (low bone density) affects an estimated 54 million Americans, according to the National Osteoporosis Foundation. Left untreated, osteoporosis can progress silently and painlessly. Often times the first sign of these problems is fracture of a bone. Severe osteoporosis can cause fractures of the hip and wrist but can also cause compression fractures in the spine. This occurs when the spine bone, or vertebral body, collapses. This causes severe pain, deformity, and loss of height. It can also cause nerve compression. These fractures can be diagnosed with x-ray, CT scans, or MRIs. While osteoporosis is the most common cause, these fractures may also be caused by trauma or metastatic tumors. Some people have a higher chance of getting the disease because of: • Race: White and Asian women have the greatest risk. • Age: The chances are higher for women over 50 and go up with age. • Weight: Women under 127 pounds are at higher risk. • Smokers: People who smoke lose bone thickness faster than nonsmokers. • Gender: Women develop osteoporosis more often than men, although men do make up 20% of those with the condition. Compression fractures occur in more than 750,000 patients per year in the United States, are more frequent than hip fractures, and often result in prolonged disability. The symptoms of vertebral compression fractures may include any of the following, alone or in combination: • Sudden onset of back pain • An increase of pain intensity while standing or walking • A decrease in pain intensity while lying on the back • Limited spinal mobility • Eventual height loss • Eventual deformity and disability Until recently, doctors were limited in how they could treat osteoporosis-related spine fractures. Pain medications, bed rest, bracing or invasive spinal surgery were the only options available. This meant that patients had to endure a great deal of pain while they simply waited for their fracture to potentially heal. Today there are promising therapeutic treatments for compression fractures. These procedures are called vertebral augmentation.

Wise Guide | Spring / Summer 2018

How is Vertebral Augmentation Performed?

This is typically performed under local anesthesia sometimes with a small amount of sedation. Using image guidance x-rays, a small incision is made and a probe is placed into the vertebral space where the fracture is located. The bone is drilled and a cavity is created for cement to be placed in. Sometimes a balloon is used to create the space and expand the bone. The spaces created by the drill are then filled with PMMA which is an orthopedic cement that binds the fracture. The cement hardens quickly, providing strength and stability to the vertebra, restoring height, and relieving pain. After the procedure you are able to get back to your regular activities with minimal down time. Pain relief from this procedure occurs rapidly.

Benefits of Vertebral Augmentation

Limitations in the traditional treatments of vertebral compression fractures have led to the refinement of such procedures as vertebral augmentation. These procedures provide options for compression fractures and are designed to relieve pain, reduce and stabilize fractures, reduce spinal deformity, and stop the “downward spiral” of untreated osteoporosis. Additional benefits of these procedures include: • Short surgical time • Only sedation or local anesthesia required • No hospital stay • Patients can quickly return to the normal activities of daily living • No bracing required Complication rates for vertebral augmentation have been estimated at less than 2 percent for osteoporotic fractures. Screening for osteoporosis is very important. Bone density scans are typically covered by insurance and are important for detecting and monitoring osteoporosis. Be sure to ask your primary care physician about this important screening tool! ____________________________________________________________________

Dr. Jameson received her medical degree from Michigan State University and completed her internship at David Grant USAF Medical Center, Travis Air Force Base, California. After spending four years as a United States Air Force Flight Surgeon, Dr. Jameson completed her residency in Anesthesia at University of Iowa College of Medicine, Iowa City. She continued her education with a Harvard fellowship in Pain Medicine at Beth Israel Deaconess Medical Center, Boston, MA and became board certified in both anesthesiology and pain management by the American Board of Anesthesiology.

Services Offered Include: • Minimally Invasive Surgery

Jessica Jameson, MD Interventional Pain Physician

Molly Liter, ARNP Nurse Practitioner

Roland Kent, MD Spine Surgeon

Jeanean Rasmussen, PA-C Physician Assistant

• Motion Preservation • Revision Spine Care • Deformity Correction • Complex Spinal Trauma Care • Sacroiliac (SI) Joint Care • Spine Injections • Joint Injections • Botox for Migraines • Medical Weight Loss • Cancer Pain Treatment • Vertebral Augmentation • Platelet Rich Plasma • Stem Cell Therapy • Spinal Cord Stimulation

Jennifer Torok NP-C Nurse Practitioner

Axis Spine Center is the region’s ONLY comprehensive spine center. We are owned and operated by board-certified and fellowship trained spine physicians. We are committed to improving each patient’s quality of life by increasing daily functioning and empowering patients to achieve their goals.

1641 E. Polson Avenue Suite 101 Post Falls, ID 83854 (p) 208-457-4208 axisspinecenter.com

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After a Stroke – Finding the Right Words by Leticia Morales, Speech Pathologist Corpus Christi Rehabilitation Hospital

t’s common to struggle at times to find the right word during a conversation. But for an individual who has had a stroke, finding the right word may be much more difficult. Aphasia can be a side effect of a stroke, which can affect a person’s ability to communicate by impairing the ability to speak, read, listen or write. It doesn’t affect intelligence, however. When a person with aphasia has word-finding difficulty, it’s called anomia. Anomia is a common symptom of aphasia that makes it difficult to find the words or ideas that a person may wish to share. Anomia can be really frustrating for individuals because they know what they want to say, but they just can’t find the words. It can make a conversation difficult because sometimes the word will come and sometimes it won’t. There are various causes to word-finding problems in patients with aphasia, and they may present differently. For example, a person may not be clear on the meaning of a word so he or she may not be able to complete a task that requires knowing what the word means. Another person may not be able to identify a family member or name an item in a photo. Another may know a word and recognize it in print, but may not be able to pronounce the sounds to say it, or an individual may say a word that’s a little bit off from the right word (i.e. poon versus spoon). When these types of things happen in a conversation, the person who is speaking to the stroke survivor may want to jump in quickly to supply the word. But in reality, that can be more of a hindrance than a help. It would be more beneficial to help the person find the word they are looking for rather than supplying it.

Wise Guide | Spring / Summer 2018

To best communicate with someone under these circumstances, consider these following suggestions: • Be patient. Allow plenty of time for a response. Talk with the individual, not for him or her • Give the person time to respond and don’t rush him or her • Ask “yes” or “no” questions that can be answered simply and without a lot of explanation • Ask questions that can help zone in on what the individual wants to say. For example, if you were talking about flowers, ask “Is it in our yard?” • Use photographs or pictures to help provide cues • Write your cues – such as a letter or a drawing – on a piece of paper to share • Confirm and repeat back what the person has said. Use paraphrases or key words to be sure that you’re understanding properly • Use gestures as you ask questions The most important thing is to not “talk down” to an individual. Be respectful and provide emotional support showing that you recognize that the person knows what he or she wants to say. And remember that every word doesn’t have to be perfect, so downplay errors. Not all words need to be said perfectly to communicate. __________________________________________________________________

Leticia Morales is a speech pathologist at Corpus Christi Rehabilitation Hospital, a sister facility of Rehabilitation Hospital of the Northwest. These hospitals provide specialized rehabilitative care to patients recovering from disabilities caused by injuries, illnesses, or chronic medical conditions. For more information, visit RHN.ernesthealth.com, call 208-262-8700 or visit the hospital at 3372 E Jenalan Ave., Post Falls, ID.

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

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

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

MONTANA

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

Ryan Keeler, 406-755-3795 email: rkeeler@mt.gov

Boundary County John Tucker 208-267-8611 6635 Lincoln St., Bonners Ferry Thursdays 9:00 AM - 1:00 PM email: jtucker@bonnercountyid.gov

Bryan T. Zipp email: bzipp@mt.gov

Kootenai County Scott A. Thorsness, Director 208-446-1090/1092 120 E. Railroad Ave., Post Falls M-F 8:30 AM - 5:00 PM email: sthorsness@kcgov.us

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

‘If the wings are traveling faster than the fuselage it has to be a helicopter – and therefore, unsafe.’ –Fixed Wing Pilot

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

‘Never tell the Platoon Sergeant you have Nothing to do.’ –Unknown Infantry Recruit

READ THIS!

NORTH CENTRAL IDAHO Idaho State VSO

Bob Cooper 208-750-3690 821 21st Ave., Lewiston M-F 8:00 AM - 5:00 PM email: bob.cooper@veterans.idaho.gov

Idaho State VSO

Joseph Riener 208-750-3690 821 21st Ave., Lewiston M-F 8:00 AM - 4:30 PM email: joseph.riener@veterans.idaho.gov

Clearwater County

Fran Palasso 208-476-7378 330 Michigan Ave., Orofino M-TH 9:00 AM - 2:00 PM email: vsoclearwater@gmail.com

Idaho County

Camden Schacher 208-983-0239 320 W. Main Rm 29 M-F 8:30 AM -5:00 PM (appointments) Grangeville (Courthouse) email: cschacher@idahocounty.org

Latah County

June Beyer 208-883-7209 Latah County Annex 200 S. Almon St., Ste. 103 M-F 8:30 AM -12 noon, 1:00 - 4:30 PM email: jbeyer@latah.id.org

Veteran Service Officers (VSO’s) are trained, certified and accredited 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.

Nez Perce County

Please call the Idaho State VSO offices in Lewiston: 208-750-3690

Nez Perce Tribe Veteran Benefit Specialist

Mary S. Taylor 208-621-4738 271 B Street, Lapwai M-F 8:00 AM - 4:30 PM email: mtaylor@nezperce.org

Idaho Department of Labor - Veterans Reps. Moscow

Dave Darrow 208-882-7571 Ext. 3743 Veteran Services Representative 530 S. Asbury St., Ste 1, Moscow email: dave.darrow@labor.idaho.gov

Lewiston

Don Erickson Disabled Veterans Outreach Program (DVOP) Phone: (208) 799-5000 Ext. 3526 1158 Idaho St., Lewiston email: donald.erickson@labor.idaho.gov

Lewis County

Michelle A. Lyons 208-937-9248 510 Oak St. Room #1, Nezperce M-F 9:00 AM -12 noon, 1:00 - 5 PM Wednesdays & Fridays Drop-ins email: mlyons@lewiscountyid.org

‘Five second fuses last about three seconds.’ –Infantry Journal

NOTE: The Department of Motor Vehicles now offers a Veteran Designator on Idaho State Drivers Licenses. The veteran must provide proof of an Honorable discharge from the Armed Forces.

The NorthWest Service Dog Alliance (NWSDA) Bugles Across America

By law, every honorably discharged veteran has the right to a military honor guard at their memorial service. The honor guard must consist of at least 2 members of the military who fold and present the U.S. flag to the family and arrange for the sounding of taps, either live or recorded. Tom Day founded Bugles Across America in 2000. Provides musicians free of charge to sound taps at military funerals. Families can request a bugler at buglesacrossamerica.org and a notice is then sent to volunteers in the area. More than 4000 people of all ages, in all 50 states and several countries have registered as volunteer buglers. Despite the groups name, bugles aren’t the only instrument used to perform taps; trumpets, cornets and glugelhorns are also played.

VA Dental Insurance Program

Everyone enrolled in the VA Healthcare System is eligible for the VA Dental Insurance Program, and family members are eligible for enrollment if the veteran is rated 100% Permanent and Total and the family members are enrolled in ChampVA. More information can be found at www.va.gov/healthbenefits/VADIP/.

Youth Summer Camp!

YMCA Camp Reed has special scholarship funding 2018 for children, grades 1-9, from military families. June 24-29 - Fan Lake, North of Spokane. Current and active duty personnel from all service branches. Army, Navy, Marines, Air Force, Coast Guard, National Guard and reserve units whose members have been active with drills over the past year are encouraged to apply. Voted the Inlander’s Best Kids’ Camp since 2006. We wish to honor our military service families by offering these exclusive scholarships: it is our way of saying thank you for your service! Funds are available on a first come, first served basis. Don’t wait! Call now for more information 509-720-5630.

is a non-profit that helps educate, establish and maintain partnerships to share information about the rights and needs of Service Dog teams, Service Dogs and the abilities of those with disabilities. The NWSDA believes in CARES! Consult, Advocate, Reach, Educate, and Support. That is the best way to “Embark on Change One Dog at a Time!” NWSDA has launched a campaign, Unleashed, to bring awareness to the issues handlers and Service Dogs teams face each day. Come join us to share ideas. Service Dogs are welcome provided they are task trained to aid a disability and public access ready. Meetings are held the last Friday of each month from 4-5:30 PM. Locations may vary so please go to nwsdalliance.wixsite.com or facebook.com/groups/ 1840902172819572 for current information.

FREE COFFEE at G.I. Java Veterans Center, 1203 N. 4th, Coeur d’Alene Why Coffee? Coffee is part of our mission. It is universally recognized as a tool for socialization. Many of our wartraumatized vets isolate themselves and do not socialize. We provide free coffee to draw them to the Vet Center and hope, over time, that they will feel comfortable enough to interact with other veterans and if needed, join a peer support group. We also provide coffee to the public so that the community will come to the Vet Center and see the plight of many of our veterans, and donate to support our cause. Lastly, coffee is available as a convenience to those veterans attending the Vet Center and group meetings. vetcenter.org

EVENTS Veterans Stand Downs

Coeur d’Alene, ID - May 12th Kootenai County Fairgrounds, 8-1 Kalispell, MT - June 9th, Evergreen Fire Hall, 9-3 Wenatchee, WA - August 4th at the Armory on 5th St., 8-3 Helena, MT - August 18th, L&C County Fairgrounds, 10 AM Moses Lake, WA - September 29th Grant County Fairgrounds, 9-2 Libby, MT - October 6-7th in the Armory, 9-3 Kennewick, WA - November 9th City of Kennewick Event Center, 9-3

If you provide service to veterans, you’ll want to attend: Serving Those Who Served - 3rd Annual Veterans Resource Providers Conference -

August 1&2 from 8:00 AM - 5:00 PM - Wenatchee Convention Center, 121 N. Wenatchee Ave. Breakout cluster topics: suicide prevention, PTSD/TBI, Vocational Rehab., Service Animals, Homelessness, SOAR/TANF, Veterans Court, Healthcare, and MUCH more. Host hotel: Wenatchee Center Hotel - 509662-1234. For more info: MelissaR@dva.wa.gov

Salute to Service Resource Fair

River Park Square Mall, Spokane - May 19, 2018, 1:00 - 6:00 PM. Local Agencies, Community Partners and Businesses offering information and assistance toveterans, active duty, guard, reserve personnel, families, and caregivers. —Then stay for the Lilac Festival’s 80th Armed Forces Torchlight Parade & Cruzin’ the Falls Car Show!

3rd Annual Fallen Heroes Benefit Ride -

June 16, 2018 Registration at Curley’s at Hauser Junction 9:30 AM, Ride starts 11:00 AM. Early Registration $20 at https://2018fhride. eventbrite.com $25 at event

FREE BREAKFAST for veterans every Tuesday - 8:00 AM - Garden Plaza (off Mullan) in Post Falls.

Centennial Celebration American Legion - 100th Department of Idaho Convention July 12-15, 2018,

Hosted by American Legion Post 113Red Lion Down Town in Boise, ID for more information contact First Vice Commander, Steve North at snowth5401@gmail.com

86th Military Order of the Purple Heart & 85th MOPH Auxiliary National Convention - July 30-August 3,

2018, Red Lion Inn, Spokane, WA - for more info: mophnationalconvention.org

Peaceful Warriors - a FREE Ranch Retreat for Women Veterans

September 28 - October 1, 2018 Wolf Springs Ranch, St. Maries, ID Women veterans, active duty, reservist or retired connecting and working with horses, sharing meals, traditional crafts, massage, campfire circles, journaling, preparing and eating fresh farmstyle food, communing with nature and fellow women veterans. wwwlifeskillsranchprogram.org Deadline to sign up Sept. 1st

Time of Remembrance w/ Fallen Heroes Project -

September 28-30, 2018 - Red Lion Hotel at the Park, Spokane, WA Gather, remember, honor and celebrate the lives of the over 400 families from the WA/ID/OR region who have lost a loved one in the service since 9/11. Contact: wa.remembrance@gmail.com

Vietnam War Commemoration and Welcome Home Event

October 2, 2018, Spokane Vet Center, 13109 E. Mirabeau Pkwy., Spokane Valley, WA To recognize, thank and honor U.S. military Vietnam War Veterans. Family members are welcome. Event time: 1 PM to completion. U.S. Veterans who served from 11/1/1955 - 5/15/1975 eligible for lapel pin. Call 509-444-8387 to sign up for lapel pin.

EVENTS March for the Fallen

September 8th - 8:30 AM - Riverside State Park 7 Mile Trailhead. Ruck, Run, March, Walk. Register at MarchForTheFallen.com or email info@gruntwearclothing.com

Ironclad Art Competition

July 14th - 4:00 PM at The Big Noise Show event, Cruiserâ&#x20AC;&#x2122;s Bar and Grille on Seltice Way, Stateline/Post Falls. Create a piece of art with Metal or Wood and enter to win big prizes ($15,000 Scholarship to Oxarc Welding School, Tools of the Trades) Reception w/potential employers fun and opportunities. Info: Estelle Nelson 509994-6016, estelle@heroeventsupport.com

Dog Fest Walk nâ&#x20AC;&#x2122; Roll

Dog Fest North Idaho is celebrating the community of people and dogs that make it possible for Canine Companions to place assistance dogs with children, adults and veterans free of charge. These highly trained assistance dogs make a profound impact through the jobs they do, including opening doors, picking up dropped items, alerting to sounds and much more. Event will be held July 28, 2018 at Forrest M. Bird Charter Schools. Call Lilly Mitsui 208-304-4490 or Alyse Ruggles 509-939-4004 for information!

Idaho County Veterans Outreach and Community Center, Grangeville, Idaho

Veterans Serving Veterans

t the junction of US Highway 95 and Idaho Highway 13 lies the community of Grangeville, Idaho, county seat of Idaho County and commercial center for the Camas Prairie and Gateway to the Wilderness. As such, it is a haven for outdoorsmen and women, and has become a magnet for veterans and military retirees. Veterans are supported in the community by a VA clinic, a county service officer, a visiting state service officer and several veterans service organizations. What the community lacked was a physical location for veterans to meet and enjoy the camaraderie of fellow service members.

Idaho National Guard soldiers take a break for lunch at the Idaho County Veterans Center.

Enter the Idaho County Veterans Association, a collaboration between the American Legion, Veterans of Foreign Wars and other veterans service groups. Their first mission - find property suitable for both a veterans lodge and community center. A vacant storefront was located and through the skill and determination of a team of hard working volunteers - coupled with the generosity of local donors - the Idaho County Veterans Outreach and Community Center opened its doors in 2016. The Center serves heroes ranging from WWII, Korea, Vietnam and the Cold War to young veterans returning from service in Iraq, Afghanistan and the Global War on Terror. It also offers services to the community including a spacious hall for community events and a family oriented activity center with music and social activities. Because it’s open every day, the volunteer staff is able to reach out to all vets where and when they need assistance. They have made a difference in the lives of many who didn’t know where to turn, helping a Vietnam Vet get long overdue support and counseling, working with others to find assistance for severe PTSD, assisting young families in need to apply for emergency grants and reaching into their own pockets to help homeless vets find shelter or gas money to get to family or friends who had a place from them to stay.Many veterans come to the Center almost daily just for the camaraderie. “The Canteen Grill” opened in March 2016, as a means to bring in revenue to pay for the cost of operations. They

serve lunch on weekdays to the public and free breakfasts to veterans twice a month. In conjunction with a local church, they host special dinners, some free for Veterans, others open to the public. They host lunches and holiday meals for the local National Guard detachment. Through the generous donations of local citizens and organizations, the association has been able to host some amazing events like the Vietnam Veterans Welcome Home and Recognition Day last June. It was attended by veterans from around North Central Idaho, plus travelers from Texas, Pennsylvania and Washington State. Over 200 veterans and family members were treated to a wonderful meal of barbecue and the Welcome Home they so richly deserved. Most were deeply touched and there was much healing that day. The second annual Vietnam Veterans Welcome Home and Recognition Day is scheduled for June 16, 2018, starting at 2 pm at the Center. Donations to the Five generations of veterans (WWII, Iraqi Freedom, Desert Storm, association also helped Vietnam and Korea-era) put the sponsor an Operation Horses game on hold for a quick photo op. and Heroes (OHH) event in Grangeville. OHH is a nationwide program that brings together therapists specializing in equine assisted therapy and veterans to provide PTSD treatment using the power of horses. Food, beverages and support items were paid for through donations to the Veterans Association. On your next trip through Grangeville, you are invited to stop by the Idaho County Veterans Outreach and Community Center and Canteen Grill at 318 East Main, to check out the displays of military memorabilia and enjoy a tasty meal. The Center is open Monday - Friday from 9 am to 4 pm, later on Thursdays and Fridays and everybody is welcome. Contact phone number is 208-983-9387 and on Facebook @IDCOVetsCenter.

Vintage Grangeville fire engine announces the Vietnam Veterans Welcome Home and Recognition Day in June 2017.

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Exploring Veterans’ Pathways to Justice—Involvement

by Elizabeth Thompson Tollefsbol and Dr. Faith Lutze Washington State University

ver 20 million Americans were veterans of the armed services in 2015 (U.S. Department of Veterans Affairs, 2016). According to the 2015 data from the Bureau of Justice Statistics (BJS), veterans made up approximately 8% of the incarcerated population in the U.S. from 2011-2012. Most of those incarcerated veterans (77%) received military honorable discharges or discharged under honorable conditions, therefore becoming defendants in the criminal justice system was likely unanticipated for many of those men and women. Yet an estimated 43% of veterans in prison during that time had 4 or more prior arrests, and 22% of veterans had one prior arrest. Had these particular veterans received targeted interventions based on their unique circumstances after their first arrests, perhaps the subsequent arrests would not have occurred. Recently, a growing awareness of veterans’ circumstances and the risk factors that steer many into the justice system have brought a new research-based focus to justice-involved veterans. Much of the research indicates military service, in general, has a positive impact on service-members’ lives, perhaps providing more protective benefits than risk elements regarding criminal behavior (Bouffard, 2003; Brooke & Gau, 2018).

WSU researchers are seeking women and men veterans of the U.S. military to interview for this project. On the other hand, the data also indicates that veterans often face an uphill battle upon returning to civilian life, with numerous challenges reintegrating back into their families and communities. This frequently sets many veterans up for failure, nudging them toward behavior that can put them at odds with the law. These challenges may include substance addiction and abuse; homelessness; unemployment; injury, including traumatic brain injury (TBI), Post-Traumatic Stress Disorder (PTSD), and “moral injury,” which can be summed up as a violation of one’s personal code of right and wrong;

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and a host of other hardships (Brown et al., 2015; Brown et al., 2016). Research indicates the veterans’ path from military service to the justice system should be viewed as the result of various factors that influence individuals in varying degrees. Additionally, while many of the challenges facing women overlap with those of men, research suggests the two groups often face challenges more distinctive to their specific genders (Iverson et al., 2017; Scoglio et al., 2017). For instance, mental health and substance abuse issues are more common among justice-involved women than men. Women are also more likely to be the single parent of minor children, adding unique complications to their experiences with the justice system, including determining who will take care of their children while they are completing their sentences, maintaining close bonds with their children throughout their sentencing, and, for those who face incarceration, reintegrating back into families once they are released. Considering the distinctly different experiences women and men encounter from birth throughout their lives, it is no surprise that women and men often find themselves on different pathways to justice-involvement. How do the factors that lead to justice involvement for women compare to those of men? The number of women has dramatically increased in the criminal justice system and has created momentum for both policymakers and researchers to evaluate women in their own right. Researchers at Washington State University (WSU) are interested in exploring the role that military experience may have in subsequent justice-involvement. Additionally, the combined influence of gender and specific military experience is the focus of this project. By learning more about what led veterans to the justice system, the hope is to create more effective policies to assist veterans before they become involved in the justice system. Some questions being explored include: What factors connected to military service encourage people to enlist? Do they differ for women and men? Do those factors that push one toward volunteering for the military, in a sense, “follow” women and men and continue to exert influence over their lives for years and decades? What life experiences lead veterans to the justice system? Furthermore, does serving in the military strengthen or weaken the influence of specific life experiences after leaving the military? WSU researchers are seeking women and men veterans

of the U.S. military to interview for this project. Participants must live in Washington State, be veterans of the U.S. military, and either be current defendants in the justice system, or have previously been a defendant in the justice system (since leaving the military). This study has been approved by Washington State Universityâ&#x20AC;&#x2122;s Institutional Review Board; all information provided in interviews will be kept confidential; and the identities of participants will be kept anonymous. If you would like to learn more about participating in this study, please contact Elizabeth Thompson Tollefsbol or Dr. Faith Lutze at 509-335-2272 or via email at e_thompson@wsu.edu or lutze@wsu.edu. __________________________________________________________________

Elizabeth Thompson Tollefsbol is a PhD candidate in the Department of Criminal Justice and Criminology at Washington State University and an adjunct instructor of criminal justice and sociology. Her areas of interest include justice-involved veterans, gender responsivity and path-ways research, offender assessment, and policy effectiveness within the justice system. Faith E. Lutze, Ph.D., is a Professor and Graduate Director in the Department of Criminal Justice and Criminology at Washington State University. Her current research interests include community

corrections, homelessness and reentry, correctional industries and offender employment, incarcerated veterans with traumatic brain injury, drug courts, and gender and justice with an emphasis on masculinity. Dr. Lutze is the author of the book, The Professional Lives of Community Corrections Officers: The Invisible Side of Reentry (2014) and has published the results of her research in various journals including Criminal Justice and Behavior, Justice Quarterly, Crime & Delinquency, Criminology and Public Policy, Journal of Offender Rehabilitation, and the Journal of Criminal Justice. She teaches courses on gender and justice, violence toward women, and corrections. She is active in the community supporting violence prevention programs, promoting equality, and serving her rural community as an emergency medical technician.

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I Think I Have Alzheimer’s Disease: How do I Get Evaluated?

by P.J. Christo, MS, RN Outreach Coordinator Alzheimer’s Association Coeur d’Alene

lzheimer’s disease typically begins in the part of the brain that affects learning; therefore, the most common early symptom is difficulty remembering newly-learned information. Although, having trouble with your memory does not mean you have Alzheimer’s or another type of dementia. Many health issues can cause problems with memory and thinking, including treatable conditions like depression, drug interactions, thyroid problems, excess use of alcohol or certain vitamin deficiencies. Some of these may be reversible, so if you are experiencing memory loss, it’s important to get checked by your doctor. Here are some things to keep in mind as you go through this process: The first step in following up on symptoms is finding a doctor with whom you feel comfortable. Many people first contact their regular primary care physician about their concerns regarding memory loss. Primary care doctors often oversee the diagnostic process, but they may also refer you to a specialist. If you prefer to see someone with advanced training in dementia, ask to be referred to a health care provider who specializes in the diagnosis and treatment of memory loss. If you need assistance finding a doctor with experience evaluating memory problems, our local Alzheimer’s Association chapter can help.

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Specialists include: • Neurologists, who specialize in diseases of the brain and nervous system • Psychiatrists, who specialize in disorders that affect mood or the way the mind works • Neuro-psychologists with special training in testing memory and other mental functions Your health care provider will do a thorough review of your medical history. Your physician will want to know about any current and past illnesses, any medications you are taking, and your family medical history. We recommend bringing a list of symptoms, when they began, and how frequently they occur. It is also a good idea to take all medications to the visit, both over-the-counter and prescription. Most importantly, have a family member present to help you provide accurate input

while answering the doctor’s questions honestly and to the best of your ability. There is no single test that shows a person has Alzheimer’s. While physicians can almost always determine if a person has dementia, there are many causes and types of memory loss, making it difficult to make an exact diagnosis. Instead, a careful medical examination and testing will often be used to rule out other causes of dementia-like symptoms. Mental status/cognitive testing is often the starting point in the evaluation of memory. These tests will measure your ability to solve simple problems and other thinking skills. • The Alzheimer’s Association suggests the use of three validated patient assessment tools: the General Practitioner Assessment of Cognition (GPCOG), the Memory Impairment Screen (MIS) and the Mini-CogTM. • Some health care providers and specialists may use more involved cognitive screening tests such as the Montreal Cognitive Assessment (MoCA) or The Saint Louis University Mental Status Examination (SLUMS). During a neurological exam, the physician will closely evaluate you for problems that may signal brain disorders other than Alzheimer’s. The physician may test reflexes, coordination, muscle tone/strength, eye movement, speech, and sensation. The neurological exam may also include a noninvasive brain imaging study, such as an MRI. These types of tests are primarily used to rule out other conditions that may

cause symptoms similar to Alzheimer’s but require different treatment or are reversible. Early testing and diagnosis is of utmost importance. Being in denial or delaying evaluation for any reason is not to your advantage. The most important thing to note is that getting an evaluation early is key to treatment of any physical disorder, including memory loss. Do not delay — you may have a condition that’s treatable and reversible! If you have any questions or concerns, please do not hesitate to contact the Alzheimer’s Association’s free 24/7 helpline any time, day or night: 1-800-272-3900. You may also contact the local Chapter in Coeur d’Alene for assistance at: 208-666-2996. ____________________________________________________________________

A Chicago native, PJ Christo received a BA Education and BS Nursing from Southern Illinois University, and a MS in Physiology from the University of Arizona. PJ worked many years as an RN in hospitals, a Charge Nurse in Neurology at Letterman Army Medical Center, and ICU at the VA San Francisco. In 1997 she became employed by the Alzheimer’s Association and coordinates support groups, answers the helpline, presents educational programs, does care consultations and assists with fundraising for Alzheimer’s disease - a national epidemic and defining disease of the Baby Boomers. Her duties encompass the greater Spokane region, all of northern Idaho from Lewiston/Clarkston Valley to Montana and to the Canadian border and the Palouse. The satisfaction of helping families in her community is what keeps her uplifted, determined, and encouraged.

Useful Links for Aging in Place More and more seniors are homeowners these days. It’s wonderful that older generations are able to stay in their homes, and there are considerations they should keep in mind when doing so. Below are some online resources, courtesy of ElderImpact.org, that may help people make informed decisions about aging in place.

• Guide to Room-by-Room Repairs for Easy Accessibility for Disabled Loved Ones www.homeadvisor.com/r/home-accessibility-room-to-room-guide • Technology, Gadgets For Seniors Aging in Place www.aarp.org/home-family/personal-technology/info-2014/is-this-the-end-of-the-nursing-home • The Boomer’s Ultimate Guide to Adding Value to Your Home www.improvenet.com/a/the-boomers-ultimate-guide-to-adding-value-to-your-home

• Modifying Outdoor Spaces for Senior Safety

www.seniorhomes.com/w/modifying-outdoor-spaces-for-senior-safety

• 5 Fall Prevention Ideas for Bathroom Showers

www.angieslist.com/articles/5-fall-prevention-ideas-bathroom-showers • 26 Home Security Tips for Seniors billfish-security.squarespace.com/26-home-security-tips-for-seniors • Getting a Pet Can Improve Aging in Place www.aginginplace.org/seniors-and-pets • The Senior’s Guide to Moving in with a Roommate www.redfin.com/blog/seniors-guide-moving-in-with-roommate Wise Guide | www.TheWiseGuideOnline.com

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

NORTHWEST MONTANA

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

Immanuel Lutheran Church, Kalispell Buffalo Hill Terrace, 40 Claremont Street 3rd Monday @ 3:00 PM Call 406-849-6207 for information

Trinity Baptist Church “Fireside Room” 711 Fairview Dr., Moscow 2nd Thursday @ 1:00 - 2:30 PM Facilitators: Tammie Poe 208-874-2667 & Dr. Ira Srivastava 208-297-0189 Sandpoint Senior Center, Sandpoint 820 Main Street 1st & 3rd Thursdays @ 1:00 - 2:00 PM Facilitators: Jan Griffitts 208-290-1973 & Liz Price 208-263-7889 (Free respite care at DayBreak Center next door with advanced reservation - 208-265-8127) St. George’s Parish Hall 2004 N. Lucas St., Post Falls 1st Wednesdays @ 2-2:30 PM Facilitators: Rosemary McDougall, RN 208-699-6060 & Cheryl Thompson 208-699-7548 Orofino & Cottonwood Areas: Sister Barbara will help form a group in Cottonwood or Orofino - call her at: 208-962-3251

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

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Presbyterian Church of Polson 301 4th Ave. East 2nd Wednesday @ 1:30 PM Facilitator: Arlene 406-849-6207

TELEPHONE 24/7 HELPLINE: 800-272-3900

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

POWERFUL TOOLS FOR CAREGIVERS CLASSES Classes provide a practical approach to dealing with caregiver stress, prioritization, challenging family communication and planning. In the six weekly classes, caregivers develop a wealth of self-care tools to: reduce personal stress; change negative self-talk; communicate their needs to family members and healthcare or service providers; communicate more effectively in challenging situations; recognize the messages in their emotions, deal with difficult feelings; and make tough caregiving decisions. Class participants also received a copy the The Caregiver Helpbook, developed specifically for the class. Classes are offered in Coeur d’Alene & Regionally. If you are interested, please call 208-666-2996 for the schedule.

MEMORY CAFÉ Living with memory issues…You are not alone! This is a new offering by volunteers and the Alzheimer’s Association. People with the memory loss are welcome to come and feel comfortable in a casual gathering to provide socialization, interaction and fellowship. Socialization creates confidence and a sense of belonging and well-being. Open to ALL stages of the disease. If the person can physically go out and drink coffee, then they are welcome, but of course, they should be accompanied by their family member/ friend. It is designed to provide a lovely afternoon in the company of others with whom they can identify. This is not a support group, it is purely an opportunity for those with dementia and their caregiver to enjoy companionship. Longboard Coffee Company 5417 Government Way, Coeur d’Alene 2nd & 4th Mondays at 1:00 PM Kokanee Coffee Company 509 N. 5th Avenue, Sandpoint 2nd & 4th Tuesdays from 2:00 - 3:30 PM

EASTERN WASHINGTON: SPOKANE NORTH Church of the Nazarene 9004 N. Country Homes Blvd. Last Thursdays of each month @ 6:30 - 8:00 PM Facilitators: Gene Engelbrecht 509-842-6034, Dawn Keig, PhD 509-808-4076 Spokane Valley United Methodist Church “Fireplace Room” 115 N. Raymond Rd. 1st & 3rd Tuesdays from 1:00 - 2:30 PM Facilitator: Carley Olland 509-981-3161 Whitworth Presbyterian Church 312 N. Hawthorne Road 2nd Mondays @ 1:00 - 2:30 PM Facilitator: Christine Ambrose, RN 509-456-0456 x8313

SPOKANE SOUTH First Presbyterian Church 318 S. Cedar Street 3rd Tuesdays @1:30 - 3:00 PM Facilitator: Beth Priest 509-590-3965

SPOKANE VALLEY Good Samaritan Village 17121 E. 8th Avnue 1st & 3rd Tuesdays @ 1:00 - 2:30 PM Facilitators: Kathleen Burzynski 509-924-6161, Patricia Garcia 509-789-4377

EARLY STAGE SUPPORT GROUP

Meets monthly at the Spokane Alzheimer’s Association office in the afternoons. This group is for people with dementia and their care partners. This is a closed group and there is a screening process for admission. For more information, please call the chapter office at 509-4560456 x8314

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Two Very Different Therapies to Consider

by Jan Rudeen, Lifestyle Massage Therapy

Myofascial Release Therapy The “fascia” is a system throughout the body, very densely woven, covering and interpenetrating every muscle, bone, nerve, artery and vein, as well as, all of our internal organs including the heart, lungs, brain and spinal cord. The most interesting aspect of the fascial system is that it is not just a system of separate coverings. It is actually one continuous structure that exists from head to toe without interruption. The entire body is connected to every other part by the fascia, like the yarn in a sweater. Fascia plays an important role in the support and function of our bodies since it surrounds and attaches to all structures. In the normal healthy state, the fascia is relaxed and wavy in configuration. It has the ability to stretch and move without restriction. When one experiences physical trauma, emotional trauma, scarring, or inflammation, however, the fascia loses its pliability. It becomes tight, restricted, and a source of tension to the rest of the body. Trauma, such as a fall, car accident, whiplash, surgery or just habitual poor posture and repetitive stress injuries has cumulative effects on the body. The changes trauma causes in the fascial system influences comfort and function of our body. Fascial restrictions affect our flexibility and can exert excessive pressure causing all kinds of symptoms producing pain, headaches or restriction of motion and affect our ability to withstand stress and perform daily activities.

The use of prescription drugs only temporarily reduces pain and does nothing about the “straight-jacket” of pressure that is causing the pain. Traditional physical, occupational and massage therapy treats the symptoms caused by the pressure of the “straightjacket” of the Myofascial system, but does nothing about the causes and perpetuates the symptoms. This is why so many patients only have temporary results and don’t progress past a certain level with traditional therapy. Only Myofascial Release treats the entire Myofascial complex eliminating the pressure of the restricted Myofascial system (the straightjacket). It treats the causes, not just the symptoms. Consider Myofascial Release Therapy when medicine, surgery or traditional therapy or massage are not producing the results you desire. Myofascial Release will safely and gently release the entire Myofascial complex for lasting and comprehensive results and genuine healing. Myofascial Release treatments will help with the following: • • • • • • •

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Back Pain & Sciatica Scoliosis Headaches & Migraines Neck Pain & Whiplash Pelvic Pain Sports Injuries Chronic Pain

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Janice Rudeen, Licensed Massage Therapist, holds degrees in Speech Pathology and Masters of Education in Curriculum and Instruction from University of Washington. Jan later completed a Massage Technology Degree in Northern Idaho, focusing on anatomy, physiology, nutrition, hydro-therapy and ethics. She works closely with her clients addressing neck, back, spine, shoulder, arm, foot and a variety of other medical issues, serving ages from 1 - 100 throughout the region with offices in Bonners Ferry and Sandpoint. janrudeen.massagetherapy.com

Private Insurance, Sliding Fee Scale and Private Pay

Idaho & Montana Medicaid, BPA Funding, Veteran’s Services,

MENTAL HEALTH & ADDICTIONS TREATMENT, TRAUMA SPECIALIST, CHILDREN, ADOLESCENTS, ADULTS, COUPLES AND FAMILIES 6807 Cody Street • Bonners Ferry 208-267-0900 • rawlingscommunitycounseling.com

Pelvic Floor Dysfunction Neurological Dysfunction Fibromyalgia Chronic Fatigue Syndrome Painful Scars & Adhesions Carpal Tunnel Jaw Pain (TMJ)

Wise Guide | Spring / Summer 2018

Raindrop Technique “RAINDROP technique is a powerful, non-invasive tool for assisting the body in correcting defects in the curvature of the spine. During the years that it has been practiced, it has resolved numerous cases of scoliosis and kyphosis and eliminated the need for back surgery for thousands of people. Raindrop Technique originated in the 1980s from the research of Dr. Gary Young working with a Lakota medicine man named Wallace Black Elk. It integrates Vitaflex technique with the power of essential oils in bringing the body into structural and electrical alignment.” (From the Essential Oils Desk Reference) Raindrop Technique uses a sequence of essential oils that are immune enhancing, support the body’s natural defenses, as well as the circulatory, respiratory, endocrine, digestive, nervous, and other body systems. These oils, which are high in antioxidants, are also mood elevating and antiseptic, creating an unfavorable environment for harmful viruses and bacteria that can hibernate in the body. Essential oils are known to boost stamina and energy, help you relax, help manage stress and promote overall health, vitality, and longevity. The principal single oils used include: • Thyme (Thymus vulgaris) • Oregano (Origanum compactum) • Wintergreen (Gaultheria procumbens) • Cypress (Cupressus sempervirens)

• Peppermint (Mentha piperita) • Basil (Ocimum basilicum) • Marjoram (Origanum majorana)

The oils are dispensed in little drops from a height of about six inches above the back, which is where Raindrop Technique gets its name. They are then massaged along the spine and back muscles. They are also applied to the feet. The whole process takes about an hour and a half and may continue to work in the body for up to one week following a Raindrop session, with possible realignment and bodily adjustment taking place during this time.

10% off your first 3 sessions! Techniques are tailored to the clients’ needs Call today to schedule your appointment:

208-290-7281

Jan Rudeen

Licensed Massage Therapist janrudeen.massagetherapy.com

A good massage therapist is your therapist for life! Wise Guide | www.TheWiseGuideOnline.com

Speech Therapy at Home

by Amy Bartoo, Account Executive North Idaho Home Health

ome Health is a wonderful solution for many people who have suffered an illness or injury and upon returning home from a stay at the hospital or skilled nursing facility, are experiencing difficulties. Help can be provided in their home by nursing, physical therapy, occupational therapy, social work and speech therapy to address a variety of needs including: balance, strength, wound care, caregiver/patient education, and monitoring of their illness or unstable medical conditions. Speech therapy is one area of home health that is often overlooked and underutilized. Skilled speech therapy can be provided for difficulties with communication, cognition and swallowing. When speech intervention is necessary it means that one of the most essential human functions is compromised. What could be more important than restoring

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a means of communication, and the ability to think and eat? SpeechLanguage Pathologists are trained professionals with the ability to improve or restore function in these areas. All Speech-Language Pathologists must have a Masterâ&#x20AC;&#x2122;s degree and state licensure and most hold clinical certification (CCC) from the American SpeechLanguage Hearing Association (ASHA). Speech Therapy can help people suffering from a variety of symptoms including: â&#x20AC;˘ Eating Difficulties: chewing food, initiating the swallow,

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Voice: struggling with volume, breath support for speech, resonance. Deficiencies in one or more of these areas may negatively impact the following tasks that are crucial to everyday living: schedule management, finances/bill paying, eating your favorite foods, talking on the phone, following a recipe for cooking, finding a new location/following directions, managing medications, making a grocery list, getting back into the workplace, ordering at your favorite restaurant and holding conversations with friends and family. Gaining the support of a Speech Therapist allows you or your loved one to target goals in specific areas of need so that you can get back to doing the everyday essentials of living as well as many activities you enjoy. If you believe that you may benefit from support in one or more of these areas, contact your physician about a referral to speech therapy. There’s no need to struggle with these things when help is available.

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coughing or choking after swallowing. Cognitive Difficulties: impaired memory, decreased attention, planning and problem solving. Language: word-finding difficulties, comprehension, reading and writing.

Amy Bartoo is a Coeur d’Alene native. In 1991, she became the Executive Director of Idaho Drug Free Youth and worked as a Prevention Specialist, being recognized as the 2010 recipient of the Governor’s Volunteer of the Year award for inspiring teens to resist drugs and alcohol. Upon retirement from IDFY in 2011, Amy joined the team at North Idaho Home Health as a marketing Account Executive. She and her husband Gary have a 21-year-old son, Trey, four gorgeous grandchildren and a two year old Great Dane, Digby.

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LightForce Laser— Photobiostimulation Relieves Pain & Promotes Healing American Physical Therapy Association, the World Health Organization and the International Organization for the Study of Pain.

What’s Different? by Daniel Moore, D.C. Moore Chiropractic

“I traveled to Boise seeking Class IV Laser therapy because it was recommended to me by a neurologist after medication and treatment failed to address nerve injury and a terrible radiating pain in my left leg. It worked so well, I wanted to share it with my patients.” –Dr. Daniel L. Moore, D.C.

ince we began providing the LightForce Class IV Laser, we have had great success helping patients alleviate pain and accelerate recovery from a wide variety of acute and chronic issues such as arthritis, tendonitis, neuropathy and plantar fasciitis. Knee, hip, neck and back pain have also been shown to respond extremely well to treatment.

Skeptical? Let’s learn about it… Shortly after the laser was invented in 1960, Endre Mester noticed that applying laser light to the backs of shaven mice caused their hair to grow back more quickly than in mice not exposed to laser. He also observed that skin incisions appeared to heal faster when treated with laser. These findings initiated research to understand the effects of light on living cells and the mechanisms involved. Since then, there have been hundreds of scientific studies to develop dosage and demonstrate the effect of laser therapy. LightForce Lasers are state of the art, FDA approved, adhere to strict ISO standards for safety and are highly sought-after and endorsed by professional organizations such as the

Wise Guide | Spring / Summer 2018

Class IV laser therapy is a non-invasive, highly effective form of treatment providing a deeper depth of tissue than lower wattage Class I, II or III lasers. It is simply faster than modalities like ultrasound, and is a safe and effective alternative to drugs and surgery.

Photobiomodulation The Class IV laser helps your body uses its own natural healing power by generating a photochemical response in damaged or dysfunctional tissue through a process called photobiomodulation, healing on a cellular level by enabling cells to more rapidly produce energy (ATP). Treatments last between 5 and 20 minutes depending on the condition being treated. The majority of conditions require 6 to 12 treatments over 2 to 3 weeks period of time.

Endorsed by Professional Athletes Many professional sports teams including the Los Angeles Dodgers, The Seattle Seahawks, and the LSU Tigers football team, use the LightForce Laser. Lesley Paterson, a three time world triathlon champion and Dale Richardson, a professional golfer are users of the Class IV Laser. This cutting edge, professional grade treatment is available to the public now and I am pleased to provide it in a small town setting where our lifestyles and day-to-day activities demand so much from our bodies.

Hear What Our Patients are Saying… “Laser therapy has been a natural tool in reducing the pain and inflammation from my Osteo and Rheumatoid Arthritis. It helped

“Deep tissue laser therapy has been very effective at alleviating the pain and swelling from a broken ankle. I’m getting back on my feet much faster than expected.” –Cynthia D. “In 2017 an orthopedic surgeon said that the MRI of my right shoulder showed that the joint was bone on bone, with extreme arthritis and a bone spur. He recommended that the joint be replaced. I initially tried steroid shots and several sessions with physical therapy with limited relief until last August when I tried the laser. Now,I have increased mobility.For people experiencing similar symptoms,I would recommend trying the laser first before going under the knife.” –John N.

The LightForce Class IV Laser was developed by leading laser scientists and engineers and we are proud to offer it in North Idaho. I have treated hundreds of patients with such great results that I have many health care practitioners stop in to see what deep laser can do for their patients. We encourage those who have tried other forms of treatment without success to try the technology. Contact our office at 208-267-2506 to schedule your complimentary first treatment and start on your road to a pain-free life today. __________________________________________________________________________

me transition off medications, providing a productive tool to manage my pain and inflammation more effectively. I recommend it to everyone!” –Kathy W. “I have been a patient of Dr. Daniel Moore for 4 years. My back condition is from hard work, abuse and car accidents. I started using Dr. Moore’s treatment with the laser last month. I am amazed how quickly it has relieved my pain and the degree of relief that I am enjoying today. I highly recommend this treatment to anyone who is suffering from back pain.” Mike M.

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

“I have acute arthritis in both feet and was referred to Dr. Moore to try laser treatment. I was taking injections in both ankles until they stopped working and could barely walk without severe pain. After the first laser treatment, the pain level dropped by 50%. I now have no pain during the night and at least 80% reduced pain during the day while working and doing daily activities. I usually do a follow up treatment once a week which seems to be working well for me.” –Pete W. “Since Starting Laser treatment, I have more range of motion in my neck. I also suffer from plantar fasciitis and the laser treatment has helped with inflammation and my pain level. I highly recommend this treatment. Dr. Moore has given me a new outlook on being active and staying working.” –Sharon C.

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Short-term therapy services to help you get back to what you love.

get back to living Senior CARE FACILITY

460 N. Garden Plaza Ct. Post Falls, ID 83854

LifeCareCenterofPostFalls.com

208.762 .1122

Skilled nursing

500 W. Aqua Ave. Coeur d'Alene, ID 83815

LifeCareCenterofCoeurDAlene.com

Life Care Centers of North Idaho are proud to be voted Best Senior Care Facility & Best Skilled Nursing again!

Wise Guide | Spring / Summer 2018

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4 Reasons to Choose a Local, Independent Pharmacy

hen it comes to choosing a pharmacy, consumers have a lot of options these days—and the market is saturated with national chains. But selective consumers who want an outstanding customer experience are looking to their independent neighborhood pharmacies for prescriptions and over-the-counter medical needs. But, what can a local pharmacy offer that a national chain doesn’t

Excellent Customer Service

Your medication is an essential part of your overall health care. National chains can be a revolving door of employees, but at a local pharmacy, you may be served by the owner or long-time employees. This allows you to build a relationship with your pharmacist, who will get to know your medical history and medication needs.

Expanded Services

Unhampered by the decisions of a corporate office, a local pharmacy can offer a wider array of services that are tailored to the needs of the community. Some examples of these services are: • Compounding: Most independents offer compounding, or custom-mixing, services to tailor medication for individual patients. For example, they can make a medication without a certain dye for a patient with an allergy, or create a liquid version of a drug for a patient who has trouble swallowing pills. • Medication adherence packaging: Other benefits of pharmacists who work independently include flexible drug packaging options. Novel drug packaging options are often a staple of the small independent pharmacist. Using such options makes medication easier to take; which helps patients adhere to their prescriptions and results in improved health outcomes.

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Immunizations and Vaccinations: Are your immunizations up to date? Do you need to be protected against Shingles? Your independent pharmacy can help answer these questions and provide the services you need. Home delivery: Your neighborhood pharmacy may offer this personal service that takes the hassle from driving to the store and waiting in long lines.

3 4

Shorter Wait Times

Have you ever arrived at the pharmacy only to find your prescription was not ready? Probably not, if you use a locally owned pharmacy. Chain pharmacies can be understaffed, which results in longer wait times for you.

Opportunity to Support a Locally Owned Business

Opportunity to Support a Locally Owned Business When you shop at your local pharmacy, you’re supporting an individual or family who is invested in your community because they live there, too. If you want more of your consumer dollars to stay in your town, rather than going to shareholders or corporate executives, a local pharmacy is your best choice. The Medicine Man Pharmacy is an independent pharmacy that was established back in 1978. They have grown to 10 locations across North Idaho and strive to improve your health, along with the health in their communities. At Medicine Man, you will find more than a place to fill your prescriptions; you will receive personalized care and answers to your questions, along with exceptional customer service. They appreciate your business and the opportunity to show you why a community pharmacy is different and better.

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Crossword Cowboys Across

Down

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Wise Guide | Spring / Summer 2018

49 Tabloid twosomes 52 1965 Ursula Andress film 53 Astronautâ&#x20AC;&#x2122;s insignia 55 ___-de-France 58 Tiny criticism 60 Big ___, Calif. 61 Jacuzzi 62 Hall-of-Famer Mel

1 Carve in stone 5 Eagerly excited 9 Trophy 12 Cowboysâ&#x20AC;&#x2122; ___ out 14 Kind of blocker 15 Cream additive 17 Aquarium fish 18 Potting need 19 Wise to 20 Japanese wrestling 22 Places for a cowboyâ&#x20AC;&#x2122;s rides 24 Chip in chips 27 Elbowâ&#x20AC;&#x2122;s site 29 Bouquets 30 Wranglerâ&#x20AC;&#x2122;s wear 33 Tryouts 34 Downsâ&#x20AC;&#x2122; opposite 35 Bridle part 38 â&#x20AC;&#x153;___ when?â&#x20AC;? 39 Aardvarkâ&#x20AC;&#x2122;s tidbit 40 Pear-shaped instruments 42 Inquire 43 Gallery display 44 Pour out 45 Cowgirl of old 47 Proclamation 50 Cousin of an ostrich 51 Memory unit 52 Cowboy hat 54 Vivacity 56 Bigger than big 57 Prefix with second 59 Dogie catcher 63 Dutch export 64 Horned goddess 65 Explode 66 Slalom curve 67 Feedbag feed 68 â&#x20AC;&#x153;Phooey!â&#x20AC;?

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 78.

Turning 65 and have questions about Medicare?

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nna and her husband Joe live in beautiful North Idaho. Like many of us, their personal values run deeply. This commitment to family includes caring for those they love, like Annaâ&#x20AC;&#x2122;s adult brother, Ron, who has mental disability. Confusion arose after reading online about different ways to legally be able to make both medical and financial decisions for Ron. The options they saw available were: Guardianship - A legal relationship established by the court in which a person is given legal authority over another person when he or she is unable to make safe and sound decisions regarding his or her person, or property. Conservatorship - A guardian or a protector is appointed by a judge to manage the financial affairs and/or daily life of someone due to physical or mental limitations, or old age. To put this another way, a guardianship grants physical control over the ward (person in need of guardianship). This gives the guardian control over things like where the ward lives, what they eat, what they do. A conservatorship gives the conservator control over the finances of the ward. When seeking a guardianship and/or conservatorship, the court will try to allow the person to maintain as much independence as possible while protecting the ward. For example, if the ward can make daily living decisions, such as proper hygiene and diet, but cannot adequately handle their finances, then the court will appoint just a conservator, but not a guardian.

Wise Guide | Spring / Summer 2018

by Tom Bushnell Attorney at Law Bushnell Law

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The People Involved Lawyers For care to be effective the paperwork must be done nhsuguardianship B .A samohand T a conservatorship are correctly. Bothlalelegal normally facilitated with One lawyer .A.P ,w aL attaleast yentwo rottattorneys. A noitautis euqinu represents the tproposed guardian or conservator. In the eertS ianetooK 0346 sâ&#x20AC;&#x2122;moT .uoy rof above fact pattern this would be Anna. One lawyer represents D I , y r r e F s r e n n o B .mrRon. fi wal reg the proposed ward, in this case Annaâ&#x20AC;&#x2122;s disabled brother 1239a-legal 762-conservatorship/guardianship 802 The costs for acquiring .yadirF d runs from $4,000 - $7,000.

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For care to be effective the paperwork must be done correctly. Both a legal guardianship and a conservataorship are normally facilitated with at least two attorneys. One lawyer represents the proposed guardian or conservator.

Court Appointed Visitor The court must appoint a “visitor of the court.” The court visitor may be a person with a post-baccalaureate degree, including, but not limited to, a Masters in Social Work (MSW), Masters of Science in Nursing (MSN), Juris Doctorate (JD), and at least two years of relevant experience; or at least two (2) years of relevant experience in the range of guardianship or conservatorship type of cases. The court may determine whether the proposed visitor’s experience is sufficient. (See Idaho Court Administrative Rule 54.4). The visitor visits with the proposed ward and then files a report with the court, the specific details required in the visitor’s report are listed in Idaho Code 15-5-303. After the visitor-ofthe-court visits with Anna and Ron (and possibly others) they write a document called a Visitor’s Report. This describes the situation and recommends (or does not recommend) Anna as the proper person to legally care for Ron.

Court Appointed Medical Professionals The court will normally appoint a physician and a mental health professional, or other person qualified to evaluate the alleged impairment of Ron.

After Being Appointed Guardian/ Conservator Each year after being appointed, the guardian MUST* file an Annual Status Report with the court. This report deals with the living arrangements and other non-financial aspects of the ward.

If Anna is appointed as a conservator, then each year she (the conservator) MUST* file an Inventory of the ward’s assets within ninety (90) days of appointment and then also a Conservator’s Accounting annually with the court. This accounting covers all the financial assets and liabilities of the ward. (Here is a link to a sample Annual Status Report as well as a Conservator’s Accounting: https://courtselfhelp.idaho.gov/ guardianship-conservatorship) In the past, many guardians/conservators failed to file the required annual reports. This resulted in some abuses. The Idaho Supreme Court subsequently stepped in and now has a department down in Boise that reviews all guardianships and conservatorships. If Anna would fail to report in a timely manner, or if there are any issues that cause a concern for the person reviewing the report, then Anna’s local county magistrate court will be notified. The judge will call for a hearing where Anna will have to explain to the judge’s satisfaction the issue that was raised. Most of the time these can be cured with a letter of explanation to the judge without a hearing. In the next article, I will discuss a Power of Attorney Upon Disability which, in many cases can be used for an aging parent and is much less expensive. ___________________________________________________________________

Tom Bushnell is an attorney who lives in Bonners Ferry, Idaho with his wife and family. Tom’s life experience working as a logger, landscape contractor and director of a national organization gives him a rich and knowledgeable experience base for practicing law. Specializing in estate planning, insurance claims and contract law, his warm welcome and reasonable pricing will put you at ease.

B U S H N E L L L AW Wills / Estates Adoption / Guardianship Property Law Personal Injury Contract Law Free half hour consultation Tom takes the time to get to know you, to understand your unique situation and provide the most cost-effective and practical solutions for you. Tom’s specialty is solving problems without the expense of a larger law firm.

Free seminars start at 6:30 pm every 3rd Friday. Call to reserve a seat!

Thomas A. Bushnell Attorney at Law, P.A. 6430 Kootenai Street Bonners Ferry, ID 208-267-9321 boundarycountylaw.com

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A Conversation Nobody Really Wants to Have…

What is long-term care?

by Jan Noyes Associate Ombudsman Area Agency on Aging

o one ever says, “Oh, boy, I can hardly wait until I can move into a long-term care facility.” It’s a pretty safe bet that living in long-term care is probably not on your bucket list. Nor would anyone say, “Gee, Mom, don’t you think moving into assisted living would be fun?” or “Dad, I’m going to find a stranger to come into your home and help you take baths.” We all want to stay as independent as possible for as long as we can, but we may need help when safety and health are at risk. For some, long-term care is a welcome safety net but, needless to say, the move to a long-term care facility is not an easy subject to broach with a loved one. Before you do, it’s important to understand the options.

Wise Guide | Spring / Summer 2018

Long-term care includes in-home care, certified family homes, and assisted-living and skilled-nursing facilities. Each provides a variety of designated services to people who can no longer live independently and need assistance with daily living activities. The facilities give continuous assistance, social services, and medical care to people with chronic health problems and general vulnerability. • In-home care is provided by a service company or individuals hired for a designated number of hours a week to give assistance with bathing, dressing, managing medications, or other needed services. • Certified family homes (CFH), overseen by Health and Welfare, provide a family-style living environment for adults who need some assistance with the activities of daily living. Usually there are one or two adult residents in a CFH. • Assisted-living facilities (ALF) are residential facility for people with chronic conditions or disabilities. The facilities provide a group living environment and typically offer help with bathing, dressing, eating, medication management, and some medical assistance. • Skilled-nursing facilities (SNF) are residential nursing homes that provide 24/7 supervised nursing care or rehab services.

• Facility transportation for shopping, banking, etc. • Community involvement • Available activities • Laundry services • Anything else you can think of Have a look around. • Is staff friendly and interacting respectfully with residents? • Housekeeping: Is the facility neat, clean and comfortably furnished? • What do the individual rooms look like? • Are the grounds and building well cared for? • Talk to residents. Are they happy with the food, staff, services?

Staying at home Most of us would rather stay in our own homes, make our own decisions, and take care of our ourselves. But sometimes we need help. In-home care by an agency or individual may provide enough help to keep a person living safely at home. Family caregiving can be rewarding and stressful. Respite care at a facility for the loved one provides an opportunity for socialization and individual time for the caregiver. In-home care is an additional respite option for family. The Area Agency on Aging is a source of information about available services.

When is a long-term care facility needed? A move to a facility is usually precipitated by failing health, dementia, or general vulnerability. Families often feel guilty even thinking of putting their loved one in long-term care. Promises have been made and now must be broken, but no one knew how difficult caregiving would be. No one knew the time, attention, energy and unlimited patience needed to keep their loved one safe and cared for. There may come a time when the care needed is more than can be given by family members or even an agency. It’s then that a move to long-term care is the best solution. Long-term care facilities give continuous care night and day by trained staff.

How do you choose a facility? Advertisements are meant to grab your interest and may not be nearly as interesting when you show up at the location. Your local Area Agency on Aging and the Ombudsman can provide a list of facilities. Facility visits are a must. Make a list of questions to ask and things to look for. Talk to management. Ask about services and any other important features. • Levels of care and costs • Charges for personalized services • Medical services and medication management

When do you begin planning for long-term care? When you start thinking about it is the time to start planning. It’s never too soon to plan, even if the plan changes over time. Visit or call your local ombudsman (a great source of current information), visit facilities, and make a folder of information. Gathering information and planning is essential, and best done before the situation becomes critical.

Grappling with reality Even when families make every effort to care for their ailing loved ones, conditions change. Placing a loved one in a facility is difficult and is often accompanied by guilt, hurt and anger, even when it’s the best decision. If the situation becomes critical and you must make all the decisions, do your homework. Visit several facilities, gather information, include your loved one as much as possible, and continue to offer positive, loving support as your loved one makes the transition to long-term care. __________________________________________________________________

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

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Long Term Care Insurance - A Simplified Overview

by Linda Davis Director of Building Relationships The Lodge Assisted Living

ooking forward in life requires planning and insight. One step in that planning is to examine financial preparedness for care requirements that might be forthcoming. Long-term Care Insurance just might be a remarkable tool to cover the costs of home care, assisted living, adult daycare, respite care, hospice care and more. “As we get older, we may need a little more help. Sometimes we reach the point when we’re unable to care for ourselves—because of an illness, injury, gradual frailty, or a sever cognitive impairment such as Alzheimer’s disease. We may need help with daily activities, or more specialized care. That’s where long-term care insurance comes in—you could

receive thousands of dollars in benefits to help pay for the care you may need in the future. Doesn’t that sound better than tapping into your retirement savings to pay for your care?” (Long-term Care Insurance Policy Guide, State Farm Mutual Automobile Insurance, 06-2016, p.1)

Here are some insights to encourage you to consider the possibilities of such coverage. A complete retirement plan includes coverage for life’s unknowns, including the possibility of needing care for an extended amount of time. A key statistic that you may have already seen is that 7 out of 10 individuals age 65 or older will need some type of long-term care assistance in their lifetime. (U.S. Department of Health and Human Services, National Clearinghouse for Long-Term Care Information, www.longtermcare.gov/the-basics (accessed April 2015). Since estimated costs can exceed $90,000 annually (John Hancock 2016 Cost-of-Care Survey), choosing to retain the risk of an extended care event can have a devastating impact on your retirement goals. It is important to understand the differences in the options available to you. There are three broad types of insurance protection that address the cost of extended care. They are categorized based on your primary need—do you only need coverage for care, or would some amount of benefit available at death also be important? • Stand-alone long-term care (LTC) policies provide the most flexibility, but only offer coverage for an LTC event. • Asset Based LTC policies provide primarily LTC coverage but also include a death benefit. A death benefit, LTC benefit, or both will be paid regardless of the situation faced by the client. • Life insurance policies now include riders that allow all or a portion of the death benefit to be used during lifetime for extended care—the primary purpose however is to provide death benefit coverage.

Wise Guide | Spring / Summer 2018

Experts suggest that decisions regarding Long-term Care Insurance should be made while the consumer is in their fifties. Medical information and health history are significant in helping insurance providers make informed policy-approval decisions. Height and weight calculations are used to determine body mass index (BMI), which is also used in reviewing eligibility. Additionally, the complexity of individual medical histories is considered by the insurance underwriters. These insights are just the beginning of the process of preparation. At The Lodge Assisted Living Homes, we highly recommend that you seek professional guidance in taking steps to plan for the future. Also, we welcome Long-term Care Insurance coverage for our residents and celebrate the relief that it provides. Each type comes with unique features and benefits that allows for the customization of a plan to best address your needs. For example, some policies include a return of premium (ROP) feature that many clients may desire so they have access to their premiums. Others may have a different definition for benefit payouts that make placing the policy in trust more acceptable (reimbursement vs. indemnity). …By understanding the choices available, you can begin to build a plan to address the catastrophic impact an extended care event could have on your retirement.” (Wells Fargo Advisors, 1016-04192, p. 1)

Experts suggest that decisions regarding Longterm Care Insurance should be made while the consumer is in their fifties. Medical information and health history are significant in helping insurance providers make informed policyapproval decisions. Long-term Care Insurance is both comforting and efficient in covering costs incurred during long-term care. Costs in today’s market range from $3,000 to $9,000 per month in many cases.

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

208-457-3403 www.LodgeLiving.net

If you know someone who would like to join our circle of caregivers in one of our homes, please contact Linda at 208-755-3637 or linda@lodgeliving.net. We even have gorgeous onsite studio apartments which include meals and all utilities as a part of our employment package. We are delighted to schedule around school commitments for our employees who are reaching ever upward. Call us!!

Locally owned and operated

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

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Alzheimer’s Disease—We Were Clueless! by Anne Haynes, CNA Program Coordinator, Daybreak Center

e didn’t have a clue how long, nor what the toll would be, by the time we reached the end of the road that began when the neurologist told me he had tested everything he could, and was fairly sure that Mom had Alzheimer’s disease. Dad had asked that I not tell her if Alzheimer’s was the diagnosis, so I tried to make light of it and told her it was only a possibility. Mistake Number 1— We clammed up, gritted our teeth, and determined to just get through the days. We didn’t make a plan—that was Mistake Number 2. Back in the 1970’s when we started that walk down that road, there wasn’t much in the way of research, education, support or even statistics about dementia. And few realized the toll these diseases could take on family caregivers. Mistake Number 3 — Dad thought he needed to deal with it all himself. He gave up recreation and time with friends, and grandkids. His days were stressful. He struggled with depression and felt guilt and anxiety when he did leave Mom’s side. Always financially prudent, he rarely spent the money he had available to hire caregivers until later in the game when he was wearing out. His world shrunk to the house and the car rides he took Mom on for something to do. Mom’s world shrunk right along with his. She was the social one who loved doing things, talking to others, laughing with friends, but we didn’t know how to give her the socializing that she could still enjoy and needed. Her children didn’t live in the area and she was often afraid of “that gentle man” who was always there telling her what to do.

The caregiver who tries to do it all sets themselves up for isolation, stress, depression, health problems, and for their loved one, creates isolation, sadness, anxiety and often a rapid progression of the disease through lack of stimulation. The family caregiver and the person cared for both need a break from each other. Often in the mind of someone with dementia the caregiver spouse becomes the one to resist, and the caregiver child is still their child, not their peer or their friend. A huge difference can be made if others are allowed to give the caregiver needed respite time and the person cared for a social outlet of their own. Willing family members and hired caregivers can provide beneficial help. Even better would be an option that wasn’t available to my parents: a socially active adult daytime care center where the person with dementia can be engaged in games, art, music, dance, conversation or outdoor activities, modified to meet their abilities. An Adult Day Care Center can take part of the burden off the family by providing a safe, fun space for a few hours or all day, and where they can interact with peers who become friends. The costs are usually surprisingly reasonable and there is often financial help as well. Mom would have loved being somewhere like this for part of the days and Dad would have had some worry free hours to either take a nap at home or do errands or see friends and replenish his energy and vitality. Don’t make the mistakes we made! Open the discussion, make a plan, do the research and get help by pulling together

Bring Your Loved One to Us! First Visit (up to 3 hours) FREE!

ALZHEIMER’S & DEMENTIA CARE FOR THE DAY OR JUST A FEW HOURS... EXPERT CARE IN A SAFE AND POSITIVE ENVIRONMENT 8:30 am to 5:30 pm Monday through Thursday $10/hour (Financial Help Available)

208-265-8127

www.SandpointAreaSeniors.org/daybreak-center

Wise Guide | Spring / Summer 2018

820 Main Street, Sandpoint

as a team with specific responsibilities. Find out who and what is available in your area. Guilt, depression and lack of finances often get in the way of meeting the needs of both the family caregiver and the person with dementia. Meet these head on and through good planning, creativity, research, and discussion these caregiving years can often be joyful.

__________________________________________________________________

Anne Haynes is the Program Coordinator for DayBreak Center, an adult daytime care center and a program of Sandpoint Area Seniors, Inc. She has worked as a Certified Nursing Assistant (CNA) for over 20 years in care facilities, home health and hospice, and in private homes. Anne especially enjoys working with people with dementia. Call Anne at 208-265-8127 for more information about DayBreak Center.

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Support is Available for the Dementia Caregiver

by Sarah Miller Speech Language Pathologist Valley Vista Care

ore than 50 million individuals worldwide are currently affected with dementia requiring varying levels of care. The process of caring for an individual with dementia can be an exhausting endeavor. The inability for your loved one to complete basic self care, wandering, negative behaviors, poor nutrition, and falls can create a tremendous burden for caregivers in the home. Caregivers frequently find themselves struggling to balance care giving responsibilities while also maintaining a home, family and career. While caregiver burnout is different for everyone, individuals commonly experience denial, anger, worry, grief, exhaustion, failing health, guilt and chronic stress. Many times family members say, “They made me promise I would always care for them and never put them in a nursing home.” While these promises are made out of love, it may be a promise that can’t always be kept. It is important to remember that if your loved one trusted you enough to ask you to make these promises, then they trust you to make the right decision regarding their care. Caregivers have options for obtaining assistance and reducing caregiver burnout.

In-home Dementia Care The goal for many families is to keep their loved one home for as long as possible. Many states and companies are looking at how to better serve people with dementia while assisting them in maintaining their independence as long as possible. We are seeing increased senior transportation

systems, specialized outpatient services, grocery and pharmacy delivery, and in-home recreation and rehab services. As caregivers struggle to keep their loved one home, developing ways to keep loved ones and caregivers safe is of utmost importance. Valley Vista Care Center offers a Certified Dementia Care Practitioner to consult on environmental modifications, routine establishment, strategies to improve communication, and activities to maximize independence. This is an outpatient therapy service where individuals participate in both standardized assessment and observation. It is critical to have a very detailed initial assessment to ensure that recommendations are tailored to each person’s abilities, preferences, past pursuits, culture, religion, work history, function and cognition. Frequently, caregivers are encouraged to get involved in a support group. While it may feel like just another task added to your list, there is no substitute for the personal experiences that are shared by families going through the same struggles.

Fully Secured Dementia Care Units When is the right time to move a person with dementia? Frequently this question is directly correlated with “How is the caregiver?” and “Are your loved one’s needs being safely met in the home?” Caregivers frequently hide their struggles due to guilt and fear of failing on their promise to never put their loved one in a nursing home. However, as a caregiver you must give up the guilt, recognize your own limitations and be honest with what you believe is the best decision for your loved ones care. Expect it to be difficult. Transitions are always hard and it may take time to adjust. When considering long term care facilities, it is important to ensure they are memory care specific. Make sure you tour the facility, ask questions regarding their dementia specific programs and express any concerns you may have. Secured Dementia care facilities can be difficult to find

Providing continuity of care along life’s journey . . . we are with you every step of the way. • Short Term Rehab, Long Term Care, Hospice Care • Physical,Occupational, Speech, Restorative & Aquatic Therapies • Home Health & Outpatient Therapies • Behavior/Dementia/TBI Care for Difficult to Place Residents • Secure Behavior Units Valley Vista Has Received the L. Jean Schoonover Excellence in Care Award Consecutively Since 2013. CMS 5 Star Rating.

220 S. Division, Sandpoint, ID 83864 Most insurances accepted.

Wise Guide | Spring / Summer 2018

208-265-4514

and available openings limited. One local facility here in Sandpoint is Valley Vista Care Center. Valley Vista offers gender specific secured, specialized, units for any level of behavior and memory care. Their goal is to provide residents with dementia and other memory impairments an environment that maintains the highest quality of life and personal independence. They offer Telehealth psychiatric coverage by Dr. Abhilash Desai, a much-respected member of the psychiatric medical community. The facility has a full time behavior nurse and specially trained staff skilled in memory deficits. Valley Vista’s goal is to provide a comfortable, quiet, and secure environment while respecting the uniqueness and dignity of each resident.

& Dementia Care Trainer (CADDCT) & Certified Dementia Practitioner (CDP) through the National Council of Certified Dementia Practitioners. She currently works as part of the therapy and behavioral care team at Valley Vista Care in Sandpoint, Idaho. Sarah will be holding future trainings for medical professionals and community members on Alzheimer’s Disease and Dementia Care.

What is the Next Step? As a caregiver, remember your mental and physical health matters. Your loved one is counting on you to be at your best. There are community resources available to support you in your role as a caregiver both in the home and when it is time to transition your loved one. Ask for help. Write down ten ways others can offer you assistance. People want to help, they just don’t know how. Join a support group. Knowing you are not alone on this journey is priceless. Be prepared and start looking into long term care options. As your loved one advances in their dementia, you may or may not be able to continue meeting their needs. Know your options so that when the time comes, you can make a smooth transition without the stress of uncertainty. If you are interested in more information on available services please contact Sheila Balison or Sarah Miller at 208-265-4514. ___________________________________________________________________

Sarah Miller graduated from Eastern Washington University with her Masters of Science. She has advanced her clinical skills as Speech Language Pathologist working in both acute rehabilitation and long term care settings. Sarah is a Certified Alzheimer’s Disease

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Choosing to Live Every Moment

by Mike Haycraft, Executive Director Auburn Crest Hospice

any who deliver hospice care believe as Mother Teresa did when she said, “Do small things with great love.” Small things might look like; painting cheerful colors on frail finger nails, singing a favorite hymn together, turning burgers on the barbecue, turning pages in a cherished scrapbook, balancing the patient as they step into their walker, helping to navigate through funeral home plans or safely moving from the sofa to the bedroom.

Our team of dedicated caregivers tries to help the hospice recipients “live every moment.” We live by that phrase. Many believe that “seeing death as the end of life is like seeing the horizon as the end of the ocean.” One family member reminisced, “The hospice team’s attentiveness freed me to love with abandon and to be loved when I felt abandoned.” Another recalled, “The imprint of my hospice nurse’s touch on my shoulder and my hand remained tender yet strong as my loved one’s touch grew lighter and weaker.” Another hospice worker reflected, “The hospice path is just one among many paths along life’s journey. And, even if I walk the trail more than once with a different hand to hold, a new seedling may crest the soft soil, a new set of robin’s footprints may be noticed; the sunbeam may penetrate the fluttering leaves uniquely this time. And, oh the indescribable feeling of seeing my patient, my friend, discover these special details, makes me again know that I get to walk someone very special home. That alone makes this journey just as treasured as all the rest.” The following is a short story about a patient we all were blessed to care for and how he chose to live some of his final moments. Smokey Moses had spent a significant part of his engineering career as an avionics specialist involved with the precision design and calibration of systems for the SR 71 stealth Blackbird and the Air Force’s F16 fighter jet. Though articulate and highly esteemed for his creativity and technical prowess on these top secret challenges (and dozens of others), Smokey had not had the opportunity to fly from the cockpit position of an aircraft he helped design. Finally at age 93, though on hospice care with Auburn Crest, he was able to live out this seemingly “impossible” dream.

Wise Guide | Spring / Summer 2018

With his nurse Mary Jean and physical therapists, Mike Dusbabek and Gary Rossberg, Smokey was able to climb into the cockpit simulator of a 21st century digitally advanced avionics cockpit. He buckled in, and with a certified flight instructor by his side, “flew” the aircraft for nearly 20 minutes! Smokey’s wife, Leora of 60+ years, 2 of his daughters Charlene and Kathleen, son in law Rick and 2 great granddaughters Hannah and Chloe, proudly experienced his joy nearby. This memorable morning was capped off by a lunchtime celebration at an aircraft themed restaurant serving right in front of Spokane’s Felts Field airport. Smokey, family, friends, and Auburn Crest’s team truly chose to LIVE every moment of this 93 year old’s special adventure! As you can see, choosing to live every moment is a value that we hold dear to our hearts. Coming alongside our patients and their families to live every moment is something we strive for every day. Living every moment looks different for every individual, and is never the same. At times, it can be as simple as allowing themselves to appreciate the sunshine that day or having a member of their care team make them their favorite flavor of ice cream. Other times, it is allowing Auburn Crest to help cross off an item on a bucket list. As we have encouraged our patients to live every moment, we have seen and shared some amazing experiences. One of our nurses went parasailing on lake Coeur d’Alene with one of our patients. Seeing the smiles and listening to her tell her story of that experience was unforgettable. Choosing to live every moment puts an emphasis on quality. While individuals don’t know how much time they have left; if the focus is on living and on finding value in each moment, they can then hopefully go on without regret. So, how will you choose to live every moment?

began volunteering at an assisted living community while he was in High School. One of his primary goals is to ensure that every person Auburn Crest Hospice has the pleasure of working with has a sense of value and purpose for the time that they have left.

“CdA Eagle Soaring” By cover artist Andy Sewell. See page 5.

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

____________________________________________

Mike Haycraft, LMSW, joined Auburn Crest Hospice in November of 2012. He has spent the past 5 years working with those who are faced with grief and loss. Mike has had a passion for working with seniors since he

“Thank you for the privilege of serving for 10 years!”

208-665-8111

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

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Directory Listings Agencies & Free Referral Services Alzheimer’s Association Inland NW Chapter N. Idaho Office.....................................................208-666-2996 24-Hour Help line................................................800-272-3900 alz.org * P.J.Christo, RN; email: pj.christo@alz.org We connect families to needed programs, products and services, provide Dementia Information, Local Support Groups, State and Federal Advocacy, educational programs, workshops and lectures for caregivers, families and the general public. Area Agency on Aging of North Idaho................. 208-667-3179 Toll Free................................................................800-786-5536 2120 Lakewood Dr., Ste. B, CdA • aaani.org AAANI is a grant funded agency providing services for seniors including information on in-home and community services, senior center meals, home delivered meals, homemaker, respite for family caregivers, legal assistance, adult protection, long term care ombudsman, long term care options counseling, hospital to home care transition, and volunteer opportunities. Compassionate Care Referral Service..................208-660-9982 compassionatecarereferral.com I can refer you to the best fit for your Assisted Living, Senior, and Disabled Care Services. Through mutual discussion and needs assessment, I will create for you a customized short list of possible solutions. Panther Country Coalition................................... 509-447-6419 panthercountrycoalition.com • starttalkingnow.org The Coalition is a collaborative effort between Pend Oreille County, The Cusick School District, Kalispel Tribe and WA State Division of Social & Health Services, implementing the “Start Talking Now” campaign in and near the communities of Cusick, Usk, Kalispel and Newport to help parents realize they are the most powerful influence in helping their children stay drug and alcohol free. Retirement Publishing.......................................... 800-584-9916 retirementpublishing.com Keeping Idaho seniors informed of their options with our FREE publications: Idaho Elder Directory, North Idaho Retirement, Assisted Living in Idaho, Alzheimer’s Resource Directory. Call toll free during regular business hours for your FREE copy or visit our web site. Chiropractic and Massage Therapy Camas Center Clinic.............................................. 509-447-7111 1821 W. LeClerc Rd. #1, Cusick, WA kalispeltribe.com/camas-center-clinic The Camas Center Clinic offers comprehensive healthcare including: medical, dental, chiropractic, physical therapy and massage therapy. The clinic is open to the general public and accepts most major commercial and public insurance carriers. Ride Monday-Thursday round-trip from Newport to Clinic. Suggested donation $1.Call 800-776-9026 for more info.

Wise Guide | Spring / Summer 2018

Lifestyle Massage Therapy.................................... 208-290-7281 200 Main St., Ste 211, Sandpoint 6843 Main St., Bonners Ferry JanRudeen.MassageTherapy.com An experienced and skilled therapist can relate to your specific needs and becomes your therapist for life. Various techniques are used to address trauma from a fall, car accident, surgery; posture, stress-related pain, TMJ, headache, sleep disorders. I provide care for ages 1 to 100. Let me help you. Moore Chiropractic 6843 Main St., Bonners Ferry...............................208-267-2506 315 E. Missoula Ave, Ste. 4, Troy, MT ..................406-295-5252 danmooredc.com Providing gentle, effective, quality care that’s affordable for everyone. Dr. Daniel Moore has over 25 years experience utilizing the latest techniques and chiropractic physiotherapy technologies ensuring the fastest recovery time possible. Come see why over 4,000 patients have trusted Dr. Moore with their health! Counseling Heritage Health Mental Health............................208-769-4222 2025 W. Park Pl., Ste B, Coeur d’Alene Family Support Services....................................... 208-620-5210 2201 Ironwood Pl., Ste.100, Coeur d’Alene myheritagehealth.org We offer and provide excellent, affordable mental health services to individuals and families with unique situations and needs. A collaborative integrated care model with Family Support Services ,helps clients discover and strive to reach their full potential through care coordination with medical providers. Kaniksu Health Services........................................208-263-7101 Behavioral Health 6615 Comanche St., Bonners Ferry 30410 Hwy 200, Ponderay 6509 Hwy 2, Ste. 101, Priest River 420 N. 2nd Ave., Ste. 100, Sandpoint kaniksuhealthservices.org Kaniksu Health Services is a nonprofit community health center which plays a vital role in Idaho’s safety net by providing medical, dental, behavioral health and VA services to the residents of Bonner & Boundary Counties. Life Choices Pregnancy Center............................. 208-263-7621 502 N. 2nd Ave., Sandpoint • lifechoicespc.org Offering free & confidential pregnancy testing, ultrasound imaging, options education and parenting/life skills for women and men facing unplanned pregnancy, assistance for women struggling with past abortion or miscarriage, and guidance for young ladies who are wrestling with sexual integrity.

Pend Oreille County Counseling Services .......... 509-447-5651 After Hours Crisis Services: 866-847-8540 105 S. Garden Ave., Newport, WA pendoreilleco.org/your-government/counseling-services Outreach Offices: Cutter Theater in Metalline Falls & Selkirk School District. Providing quality integrated behavioral healthcare (mental health and chemical dependency), and supportive services for adults, adolescents, children and families of Pend Oreille County. We promote the values of consumer driven recovery, resiliency and self-determination, working collaboratively to provide outpatient, crisis, prevention and psycho education services. Rathdrum Counseling Center, LLC......................208-687-0538 14954 Coeur d’Alene St., Rathdrumrathdrumcounseling. com Rathdrum Counseling Center is a full outpatient substance use disorder and mental health treatment clinic. We focus on client strengths, needs, abilities, and strive to encourage least restrictive interventions that are culturally sensitive, cost effective and within your own community. Rawlings Community Counseling.......................208-267-0900 6807 Cody St., Bonners Ferry rawlingscommunitycounseling.com Mental health counseling for children, adolescents, adults, couples and families. Offering addiction treatment, case management, and EMDR Therapy for trauma treatment. We accept most insurance, Medicaid and a sliding fee scale is available. Dental

Tom Davies, D.D.S., PLLC.................................... 208-263-8514 103 W. Superior, Sandpoint daviesfamilydds@gmail.com We provide dental services to the entire family. We offer are: Mini Denture Implants, Fillings, Bridges, Root Canals, Veneers, Whitening, Extractions, Dentures/partials, Suction Cup Relines, Dental Cleanings, Laser Assisted Periodontal Therapy, Nightguards/Mouthguards, Sealants. Call today for an appointment. See our ad for specials! Hearing Audiology Research Associates 700 Ironwood Dr., Ste. 220, Cd’A 208-765-4961 123 S. 3rd Ave., Ste. 9, Sandpoint........................208-255-4389 hearingtricities.com Serving North Idaho for over 20 years. We help you hear better! Hearing evaluations for adults and children. We sell the most advanced digital hearing aids available and each hearing aid comes with 3 to 5 years free batteries. Hearing Center of Deer Park................................509 276-8859 708 S. Main St., Deer Park, WA • eargeek.com The HEARING CENTER is committed to providing outstanding customer service and superior products. We offer complete audiometric hearing evaluations, consultations, full service repair & custom hearing protection. We specialize in Workman’s Comp and WA Labor & Industry claims. Hospice

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

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

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

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

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

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

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Directory Listings Hospitals, Medical Care & Pain Management Axis Spine Center..................................................208-457-4208 1641 E. Polston Ave., Ste 101, Post Falls axisspinecenter.com The region’s ONLY comprehensive spine center, owned and operated by board-certified and fellowship trained spine physicians. Dr. Kent and Dr. Jameson are committed to improving each patient’s quality of life by increasing daily functioning and empowering their patients to achieve their goals. Bonner General Health........................................ 208-263-1441 520 N. 3rd Ave., Sandpoint Bonner General Immediate Care......................... 208-265-3751 400 Schweitzer Plaza Rd., Ponderay • bonnergeneral.org Your community hospital providing quality, compassionate care in a comfortable, healing environment. We provide a full range of healthcare services, including home health, hospice, physical, occupational and speech therapy, radiology, laboratory, surgery, and emergency services. Camas Center Clinic.............................................. 509-447-7111 1821 W. LeClerc Rd. #1, Cusick, WA kalispeltribe.com/camas-center-clinic The Camas Center Clinic offers comprehensive healthcare including: medical, dental, chiropractic, physical therapy and massage therapy. The clinic is open to the general public and accepts most major commercial and public insurance carriers. Ride Monday-Thursday round-trip from Newport to Clinic. Suggested Donation $1. Call 800-776-9026 for more info. Heritage Health Medical Centers 1090 N. Park Pl.,Coeur d’Alene............................208-292-0292 925 E. Poston Ave., Post Falls............................... 208-618-0787 14775 N. Kimo Ct., Ste.B, Rathdrum...................208-687-5627 Mountain Health Care, 740 McKinley, Kellogg...208-783-1267 myheritagehealth.org Our Primary Care Providers (PCPs) have a broad set of skills and are able to diagnose and treat most conditions and ailments: Chronic Disease Management, Diagnostic Services, Express Care/walk-ins, Minor Outpatient Surgery, Routine Medical Care, Women’s Health, Wellness Care—at affordable prices. Kaniksu Health Services........................................208-263-7101 Medical, Pediatrics 6615 Comanche St., Bonners Ferry 30410 Hwy 200, Ponderay 6509 Hwy 2, Ste. 101, Priest River 420 N. 2nd Ave., Ste. 100, Sandpoint VA Clinic...............................................................208-263-0450 420 N. 2nd Ave., Ste. 200, Sandpoint kaniksuhealthservices.org Kaniksu Health Services is a nonprofit community health center which plays a vital role in Idaho’s safety net by providing medical, dental, behavioral health and VA services to the residents of Bonner & Boundary Counties.

Wise Guide | Spring / Summer 2018

Kauai Therapy & Wellness 208-205-9559 30544 Hwy 200 Ponderay, ID • kit-therapy.com Comprehensive Pain Relief without surgery or invasive procedures. Rehabilitative services Swallowing, TBI, Joints, Balance, various injuries and age-related issues. We also specialize in Pediatric developmental disabilities; genetic, neurological & injury related. Please visit our website to learn about those. Kootenai Urgent Care Coeur d’Alene........................................................ 208-667-9110 700 Ironwood Drive, Ste 170E Hayden, 566 W. Prairie Avenue............................. 208-772-9110 Post Falls................................................................ 208-777-9110 1300 E. Mullan Ave., Ste 600 kootenaiurgentcare.com Kootenai Urgent Care of Coeur d’Alene, Post Falls and Hayden specializes in cost effective medical care for minor accidents, injuries or illnesses, including: sprains, minor fractures, sports injuries, infections, burns, and illnesses. Save your spot in line at kootenaiurgentcare.com. Newport Hospital & Health Services................... 509-447-2441 714 W. Pine St., Newport, WA • phd1.org We provide 24-hour care when you need it! Two primary care clinics offer same day/walk-in appointments. Other services: Emergency; General Surgery; Obstetrics; Anesthesia; Diagnostic Imaging; Laboratory; Physical, Speech, & Occupational Therapy; Acute Care; Swing Bed; Long Term Care; Assisted Living. North Idaho Advanced Care Hospital .................208-262-2800 600 N. Cecil, Post Falls • niach.ernesthealth.com We hold a Joint Commission “Gold Seal of Approval” and 5th in the nation rating for care of diseases associated with respiratory failure (COPD, pneumonia, cystic fibrosis, etc.). Our 40-bed facility provides long-term acute care and critical care services for patients recovering from serious illnesses or injuries. Pain Management of North Idaho.......................208-765-4807 1686 W. Riverstone Dr., Coeur d’Alene • cdapain.com Pain Management of North Idaho is Coeur d’Alene’s only comprehensive Pain Management Center where patients have access to two fellowship-trained interventional pain physicians and a multidisciplinary team. Rehabilitation Hospital of the Northwest 3372 E. Jenalan Ave., Post Falls............................208-262-8700 rhn.ernesthealth.com We provide intensive physical rehabilitation services to patients recovering from strokes, brain, spinal cord and orthopedic injuries and other impairments as a result of injuries or illness. Also treated are cerebral palsy, ALS (Lou Gehrig’s Disease) multiple sclerosis & Parkinson’s disease.

Rose Terrace Country Homes............................... 208-623-6154 5672 W. Rhode Island, Spirit Lake Rose Terrace Cottages...........................................208-665-0580 632 N. 21st St., Coeur d’Alene • roseterrace.org Our quaint, home-style facilities offer a compassionate, caring environment with well trained staff 24/7. Nurses available 7 days a week, wonderful meals and fun activities. Private and semi-private rooms. Medicaid accepted. In-Home Personal Care

Independent & Assisted Living, Memory Care, Adult Day Care Boundary Community Restorium........................208-267-2453 6619 Kaniksu St., Bonners Ferry • boundarycountyid.us Our facility accommodates 52 residents with 24-hour care, home-cooked meals, help with shopping, medications, and bathing, rides to appointments. All inclusive rates. Medicaid accepted. We offer an array of activities for our residents and adult daycare is available. DayBreak Center................................................... 208-265-8127 820 Main Street, Sandpoint sandpointareaseniors.org/daybreak-center DayBreak provides quality daytime care for individuals with memory impairments allowing caregivers a much needed break. In addition to offering a safe, responsive, and homey environment for your loved ones, the professionals at DayBreak provide activities that stimulate memory, health and socialization. The Bridge Assisted Living...................................208-263-1524 1123 N. Division Ave., Sandpoint • CenturyPA.com Adjusting to the transition of a new home is made easier with the intimate and compassionate environment at The Bridge. Assisted care is developed on an individualized basis. It’s the right place for home! The Lodge Assisted Living....................................208-457-3403 52 N. Cedar St., Post Falls 58 N. Cedar St., Post Falls 3989 N. Player Dr., Coeur d’Alene • lodgeliving.net We provide the most dignified environment for aging members of our community. Our highly trained staff and loving environment is perfect for you or your loved one with additional care needs. Our communities are custom built and locally owned offering comfort, security, convenience to our family of residents. River Mountain Village Assisted Living...............509-447-2903 608 W. Second Ave., Newport, WA • phd1.org A beautiful 42 unit studio & one-bedroom apartment community for an active, independent lifestyle. En-joy the cozy fireplace, a stroll along a lovely landscaped walking path, and a variety of daily activities to meet the individual needs of our residents.

Addus Health Care................................................208-667-2309 850 W. Ironwood Dr., Ste. 101, Coeur d’Alene • addus.com Since 1979 we have been providing quality in-home care; companionship, light housekeeping, meal preparation; transportation to appointments, bathing assistance, medication reminders. Our cost-effective services are designed to improve health and well-being and make your choice easier to remain independent at home. Advanced Care Northwest, LLC ...........................208-263-3225 Serving All of North Idaho advancedcarenorthwest.com Promoting safe and independent living, we are committed to providing compassionate and enjoyable personal care services to Seniors, Children, and Individuals with intellectual and developmental disABILITIES. Accepting BlueCross/TrueBlue, Medicaid/Medicare, Veteran, and most Private Insurance carriers. Call today for a FREE in-home consultation!

August

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

Customize your own plan today!

Let the Sun Shine!

Medicaid Accepted

www.AugustHH.com

208-664-0858

Serving North Idaho since 1994

August Home Health, Inc ....................................208-664-0858 Toll free............................................................. 1-800-664-0838 2005 Ironwood Pkwy #227, Coeur d’Alene • augusthh.com New clients call Lynn our Supervising Nurse to schedule a visit! A Medicaid and Veteran approved Agency we hire and screen local caregivers (even family members) to provide assistance for Seniors struggling with tasks or the disabled of any age. If you are selecting an Agency to provide care, or know someone who needs help give us a ring. There is no obligation. We simply love what we do!

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Directory Listings

Boundary Personal Care

Rehabilitation Hospital of the Northwest...........208-262-8700 3372 E. Jenalan Ave., Post Falls, ID • rhn.ernesthelath.com We provide intensive physical rehabilitation services to patients recovering from strokes, brain, spinal cord and orthopedic injuries and other impairments as a result of injuries or illness. Also treated are cerebral palsy, ALS (Lou Gehrig’s Disease) multiple sclerosis & Parkinson’s disease.

(a division of August Home Health)

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

Customize your own plan today!

Let the Sun Shine!

Medicaid Accepted

www.AugustHH.com

208-267-5070

Serving North Idaho since 1994

Boundary Personal Care....................................... 208-267-5070 6821 Main Street, Bonners Ferry Dawn Pownall is all about her hometown. A Medicaid and Veteran approved Agency we hire and screen local caregivers (even family members) to provide assistance for Seniors struggling with tasks or the disabled of any age. If you are selecting an Agency to provide care, or know someone who needs help give us a ring. There is no obligation. We simply love what we do! In-Home, In-Patient & Out-Patient – Skilled Nursing & Rehabilitation Bonner General Health Home Health Services .. 208-265-1007 520 N. 3rd Ave., Sandpoint • bonnergeneral.org Providing skilled, intermittent care in the home. Services include skilled nursing care; physical, occupational and speechlanguage therapies; medical social services and certified home health aid services. Covered by Medicare, Medicaid and most private insurance. Life Care Centers of North Idaho • LCCA.com 500 W. Aqua Ave., Coeur d’Alene.......................... 208-762-1122 460 N. Garden Plaza Ct., Post Falls..................... 208-777-0318 1125 N. Division St., Sandpoint...........................208-265-9299 Our in-house physician, rehabilitation and nursing teams focus on inpatient and outpatient rehabilitation with 24-hour skilled nursing care to create individualized care plans, taking each resident’s and patient’s needs and goals into account. We focus on physical, occupational and speech therapy and provide advanced treatment options. Stop by for a tour today.” Newport Hospital Long Term Care & Skilled Nursing.................................................509-447-2464 714 W. Pine St., Newport, WA • phd1.org Our Long Term Care offers both long and short term skilled nursing and restorative care. We provide skilled nursing 24 hours a day, coordinating care with local physicians. North Idaho Home Health...................................208-667-7494 850 W. Kathleen, Coeur d’Alene • amy.bartoo@LHCgroup.com We provide skilled nursing, physical therapy, occupational therapy, speech therapy and medical social work. Proud to serve Kootenai County since 1979. Jayco Certified. 4.5 Star rating.

Wise Guide | Spring / Summer 2018

Valley Vista Care 208-265-4514 220 S. Division, Sandpoint • valleyvista.org Offering in-patient and out-patient & in-home skilled nursing. We provide Physical, Occupational, Speech, Restorative & Aquatic Therapies for Short Term Rehab, Long Term Care & Hospice Care. Specialized care for Behavior/Dementia,TBI and Difficult to Place Residents. Secure Behavior Units. Insurance Humana MarketPoint .......................................... 208-215-5817 Christopher “Chris” Murphy, Sales Associate 1300 N. Washington St., STE 3500, Spokane cmurphy16@humana.com Humana is a leading health and well-being company focused on making it easy for people to achieve their best health with clinical excellence through coordinated care. The company’s strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people Humana serves across the country. Spears Insurance, Inc............................................ 208-610-8096 102 S. Euclid Ave., Ste. 103, Sandpoint 1121 Mullan Ave., Ste. 208, Coeur d’Alene cspears4insurance.com There are many types of benefit plans. Which one is right for you? Let’s first understand the basics of Medicare in plain simple language, and then discuss other factors to finding the right coverage for you. Call me today to schedule your appointment. Serving ALL of NORTH IDAHO! Legal Bushnell Law, Thomas A. Bushnell, Attorney at Law, P.A. 6430 Kootenai St., Bonners Ferry........................ 208-267-9321 boundarycountylaw.com Tom is an attorney downtown Bonners Ferry, providing estate planning, probate, real estate, business, adoption and guardianships. Tom is honest and professional. Providing personalized service, let him find a cost-effective, practical solution for your unique situation. Free half hour appointment. Crandall Law Group.............................................. 208-772-7111 8596 Wayne Dr., Ste. B, Hayden • crandalllawgroup.com The Crandall Law Group is a boutique law firm offering highly specialized, top quality legal services to clients in the Inland Northwest region in the areas of estate planning, business, elder law, probates, guardianships, tax and business succession planning. We offer free initial consultations during which we will review your estate, discuss your needs, and explain your planning options.

Coyle & Wytychak Elder Law................................208-765-3595 314 E. Garden Ave., Coeur d’Alene • cwelp.com Since 1987, Coyle & Wytychak Elder Law, PLLC has provided the senior and disabled population of North Idaho and their families with individualized service to help them through difficult issues related to Estate Planning, Probates, Trusts, Guardianship, and planning for Long Term Care and Public Benefits. Estate & Long Term Care (ELTC) Law Group 7177 Main St., STE E, Bonners Ferry, ID..............208-263-3585 418 W. 3rd St., Newport, WA................................509-447-3242 102 S. Euclid Ave., Sandpoint, ID.........................208-263-3585 ELTCLawGroup.com Elder Estate Planning including Trusts, Wills, Long Term Care Calculations, Health Care Powers of Attorney, Living Wills, Advance Directives, Asset Preservation, Medicaid Planning, Probate and Trust Administration. Serving Idaho and Washington. Pharmacies, Medical Equipment,& Supplies Medicine Man Pharmacy Bonners Ferry 6452 Main St. (in Super-1)........... 208-267-4021 Sandpoint 624 Larch St. (in Super-1)..................208-597-7466 Rathdrum 15837 Westwood Dr. (in Super-1)...... 208-687-5717 Hayden 8093 N. Cornerstone Drive.....................208-762-9355 Hayden 240 W. Hayden Ave (in Super-1).............208-772-3311 Coeur d’Alene 305 W. Kathleen (in Super-1).......208-765-2268 Coeur d’Alene 1114 Ironwood Drive....................208-666-2502 Post Falls 802 E. Medical Court...........................208-773-3566 Post Falls 805 E. Polston Ave. (in Super-1)..........208-777-7732 medmanpharmacy.com At Medicine Man Pharmacy we work to improve your health and the health of our community. You’ll find more than a place to fill your prescriptions: You’ll receive personalized care, answers to your questions and exceptional customer service. Visit our website to find a Medicine Man near you,

Hospice of North Idaho Thrift Stores • honi.org 1823 N. 4th St, Coeur d’Alene.............................. 208-667-5128 503 E. Seltice Way #5, Post Falls..........................208-773-5076 Shop our huge selection of high quality, gently used items from furniture, books, electronics, craft sup-plies, kitchenware, linens, clothing, shoes, accessories, and much more. All proceeds go to Hospice of North Idaho, the community’s non-profit hospice. Transportation Kaltran - Kalispel Tribal Transit 509-447-7247 72 Camas Flat Rd., Cusick, WA facebook.com/KalispelTribalTransit Routes to Kalispel Reservation, Newport, Ione, Cusick & Spokane. Wheelchair accessible buses run Monday-Thursday 7am-5pm. Call Thursday for appointments on Friday, Saturday or Monday. Suggested donation $1, Medicaid Card - free. Veterinary & Animal Care Bonners Ferry Veterinary Clinic...........................208-267-7502 Emergency Phone................................................. 208-444-1024 6657 Main St., Bonners Ferry Let us help you care for your favorite four-legged friends! Our clinic provides complete veterinary services for healthy pets and for sick or injured animals, including horses and livestock. We provide an on-call emergency service in addition to our regular hours.

Complete Veterinary Services for Small & Large Animals Roland H. Hall, DVM 24-HOUR EMERGENCY Chad A. Burt, DVM 208-444-1024

Jill Lang, DVM

8:30 - 5:00 M-F 8:30 - 1:00 Sat.

Recreation & Shopping NorthWest Recumbent Cycles.............................. 208-818-5491 Gary@NWrecumbentcycles.com We specialize in getting anyone riding cycles, especially those with special needs. We build custom bikes and trikes for those with almost any disability. Come on out to Post Falls and play on many models of the most stable and comfortable bikes and trikes in the world. Call for appointments.

208-267-7502

6657 MAIN BONNERS FERRY

Bonners Ferry Veterinary Clinic 5% DI

Your North Idaho Recumbent Dealer

M COUNT Wiseention ! Guid e

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

208-818-5491 Wise Guide | www.TheWiseGuideOnline.com

Run It By Tamara

In recent months, I have received several calls from adult children who are moving their parent(s) to Idaho to be closer for care reasons. With all the logistic inquiries, several common themes have surfaced that may prove helpful to readers.

To place someone in Assisted Living in Idaho, a doctor must be involved and must have seen the Senior within 6 months of admission. This is to identify care needs for ADLâ&#x20AC;&#x2122;s (Activities of Daily Living) and to have a Care Plan for the facility to follow for care and medications. Independent Senior Living Communities do NOT require a doctorâ&#x20AC;&#x2122;s care plan or visit since the senior is still considered able to do self-care.

by Tamara Jacobson, Compassionate Care Referral Services, Inc.

Know your parentsâ&#x20AC;&#x2122; monthly income and liquid assets. This is crucial in finding a place that is affordable for the long term. Each Assisted Living, from smaller Certified Family Homes to larger Continuing Care Retirement Communities, have their own criteria for means of payment and duration. For example, several have adopted requirements of two years private pay before converting to state-managed Medicaid benefits for long term care.

From a social worker, â&#x20AC;&#x153;My uncle lives a very isolated life out on the family ranch. There have been some falls and we are concerned. We are looking for ideas. Can you help?â&#x20AC;?

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

While the saying goes, â&#x20AC;&#x153;You can lead a horse to water, but you cannot make them drink!â&#x20AC;? If your uncle is still the decision maker, you can only try talking with him about benefits he may not be aware of, and hasnâ&#x20AC;&#x2122;t considered, such as: â&#x20AC;˘ Getting a medical alert pendant or wrist band, one which also detects falls in case the button is not pushed. â&#x20AC;˘ Enlisting one of the volunteer programs or churches to visit him once a week. â&#x20AC;˘ Moving into an independent community, just for winter months, that provide transportation and meals to residents. Several do not require leases. â&#x20AC;˘ Having a non-medical In-Home Care company come on a set schedule to do some of the most often needed household chores, shopping or cooking. â&#x20AC;˘ Finding an activity or interest of your uncleâ&#x20AC;&#x2122;s and encourage him to meet with groups that share it. Or better yet, go with him to one or two and help him get acquainted. ___________________________________ Tamara Jacobson, 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 client.

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Wise Guide | Spring / Summer 2018

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