The Wise Guide Fall 2017 Winter 2018 - N.Central Idaho & S.E. Washington by Jonnie Bradley

FALL 2017 / WINTER 2018

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Healthy Feet are Happy Feet! From Hope to a Cure Laser Therapy Works! Medicare & Your 100 Days

Wise Guide | Fall 2017 / Winter 2018

N. Central Idaho & S.E. Washington â&#x20AC;˘ Fall 2017 / Winter 2018

Features About the Cover........................................................... 5 Healthy Feet Are Happy Feet....................................... 6 Medicare and Your 100 Days....................................... 8 Understanding Long-Term Acute Care......................... 12 Is It Time for Home Care?......................................... 14 Finding Disability-Friendly Businesses..................... 16 Importance of Therapy and an Interdisciplinary Team in Skilled Nursing........... 18 Diabetes and Your Feet.............................................. 20 Free Community Meals............................................. 21 Crossword/Sudoku.................................................... 22 Making the Best of Your Healthcare Appointment...... 24 Getting the Conversation Started.............................. 26 Deep Tissue Laser Therapy Works!............................ 28 The Right Care, at the Right Time............................. 30 Veterans Pages..................................................... 32--36 Senior Meal Sites........................................................ 38 Need a Ramp for Accessibility?................................. 39 From Hope to a Cure................................................. 44 Alzheimerâ&#x20AC;&#x2122;s Association Support Groups................. 46

6 Healthy Feet are Happy Feet

Feet are more than something to put shoes on

Directory

28 Laser Therapy Works!

Let the body heal without prescription drugs

Agencies, Free Referral Services & Volunteer Opportunities................................... 40 Entertainment & Recreation...................................... 40 Gifts & Shopping........................................................ 40 Hearing & Vision........................................................ 40 Hospice....................................................................... 41 Hospitals & Medical Care.......................................... 41 Independent Living, Assisted Living, Memory Care & Respite Care................................ 41 In-Home Health & Personal Care............................. 41 Long-Term, Skilled Nursing & Restorative/Rehabilitative Care............................. 41 Legal............................................................................ 42 Pharmacies, Medical Equipment, Safety & Supplies.................................................. 42

From Hope to a Cure

Research is the beacon of hope Wise Guide | www.TheWiseGuideOnline.com

The Wise Guide Fall 2017 / Winter 2018 Office: 208-263-5654 Email: info@thewiseguideonline.com www.TheWiseGuideOnline.com

Your Social Security Card will no longer have your social security number on it! The Centers for Medicare & Medicaid Services (CMS) is readying a fraud prevention initiative that removes Social Security numbers from Medicare cards to help combat identity theft, and safeguard taxpayer dollars. The new cards will use a unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI), to replace the Social Security-based Health Insurance Claim Number (HICN) currently used on the Medicare card.

Jonnie Bradley Editor The Wise Guide

Patty Jo Carter Marketing Director The Wise Guide

CMS will begin mailing new cards in April 2018 and will meet the congressional deadline for replacing all Medicare cards by April 2019.

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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. It is meant to serve as an information resource guide and not as a substitute for professional assistance. The Wise Guide, LLC is not responsible for the contents of any websites referenced within this directory, nor does it endorse any specific products or services referenced. No part of this directory 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.

About the Cover Cover Artwork:

“Lil’ Cowpoke” by Carol Hayes

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

Later, she continued taking classes from a local artist and was encouraged to start selling her art. In 1989, Carol started an airbrush business called Personal Selections by Haz where she continued to explore art by creating works on fabric. She was hired to airbrush a 120-foot-long mural for a new bank in a town in Washington, and from that job Carol and her new partner started Swan Design,

Facing the Storm Together

Elk Listening Carol grew up in the wilderness of Alaska and Idaho spending her time observing nature. While raising her two boys, she took a few art classes at the College of Southern Idaho.

Quiet Confidence

began teaching oils and airbrushing privately and in-classroom instruction. She loves to teach and has painted many different subjects, but her favorite is to bring animals to life in their natural habitat. Carol and her husband, two dogs, mules, and chickens reside in a small

a mural business. They did several banks, homes, a 15’ x 60’ long mural “The Hot Springs” at Vale Oregon. After moving to Montana in 1993, Carol completed 8 more murals and

town tucked in the valley between the beautiful Bitterroot and Cabinet mountains. Her work is displayed in a few galleries, shows and gift shops in Montana and Idaho. Carol has many originals, limited edition prints of florals, wildlife, landscapes, still life, fantasy, and historical subjects. You can view more of her work and purchase originals and giclee prints through her Facebook page: Carol Hayes Fine Art. You can also phone Carol at 406-847-2449 or email: hazyacres@blackfoot.net

Whitetail Buck

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Healthy Feet Are Happy Feet by Dr. Karl Johnson, Tri-State Podiatry

eet are a fascinating area of the human body but they are also one of the most underappreciated. Luckily, more people are recognizing that making foot health a priority is well worth the effort in the long run. While feet are amazingly durable, even under the harsh demands of daily life, foot problems may develop if feet are pushed over their limits. One of the most common foot problems is heel pain. Heel pain is a result of excessively tight calves which may be due to genetics, or, research today has shown that sitting in a chair is also a contributing factor. The most common cause of heel pain is plantar fasciitis, an inflammation of the thick band of tissue that connects the heel bone to the toes. The most common symptom of plantar fasciitis is a sharp pain in the heel during the first steps in the morning.

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To alleviate heel pain, the following steps are recommended:

• For acute heel pain, treat it with ice, massage, and supportive footwear. • For chronic heel pain, stretching the tight heel cord (the back of the lower leg) and strengthening the foot are excellent treatment options. To stretch your heel cord, keep your knee straight and bend forward at the ankle. • Always stretch after walking for a few minutes to warmup the muscles. There should never be pain or discomfort while stretching.

forefoot flexibility is the principle trait that is inherited. Bunions have two main components: a bump on the side of the great toe joint and turning of the great toe to the lesser toes. This joint is painful to move and also suffers from painful rubbing against the shoe.

To relieve bunion pain, the following should be considered:

Heel pain may also be a result of wearing the wrong shoes. There are a few key characteristics to consider when choosing the right pair of shoes if you experience heel pain:

• Fit: Shoes should be long, wide, and have a roomy toe box. Check to see if the shoe allows your toes to move up and down with ease and look for shoe brands that offer multiple widths indicated by letters in the alphabet (i.e. C, D or E). • Rigidity: A shoe’s rigidity means the shoe does not bend or flex easily in any direction. To test this, try bending the shoe in half and twisting the shoe like a rag. It should resist a mild effort in bending. Consider transitioning back to less support over several months to strengthen the foot. • Comfort: Shoes should feel good immediately and should not require a break-in period. Be sure to walk in a pair of shoes for at least five minutes before purchasing. Another common foot problem is bunions. Unlike heel pain, bunions are more closely related to inherited traits rather than lifestyle habits such as wearing tight shoes. The degree of

• Keep the toe aligned straight with a bunion splint to relieve pain from the joint. • Wear shoes with extra width and soft material to relieve bump pain. • If a bunion does not respond well to conservative treatment, it may require surgery to realign the toe and eliminate the bump. Be sure the motion of the foot is addressed in some way or the bunion is likely to return even after surgery. Motion can be reduced by supportive footwear or opting for surgical procedures that are designed to reduce excessive foot and ankle motion. As you can see, feet are more than just something to put shoes on and forget about. By following these basic principles of foot care it will help keep feet healthy, strong, and pain free for years to come. Happy walking! ___________________________________________

Karl Johnson, DPM graduated from Brigham Young University with a BS in Biology and went on to graduate from the College of Podiatric Medicine and Surgery at Des Moines University. After a three year podiatric surgical residency, he gained extensive experience in advanced foot and ankle reconstruction and became certified in reconstructive rearfoot/ankle surgery in 2016. Dr. Johnson is currently accepting new patients at Tri-State Podiatry.

back to doing what

you love

SERVING THE PULLMAN COMMUNITY! Avalon Care Center - Pullman oﬀers more than just 24-hour nursing care, we cater to both the physical and emotional health of our residents and patients. Our teams work together to create personalized treatment plans to help patients through their care journey. We strive to provide industry-leading outcomes through coordination of all aspects of your care. • ON-SITE PHYSICIAN & NURSE PRACTITIONER • PHYSICAL, OCCUPATIONAL, & SPEECH THERAPY • 24-HOUR NURSING SERVICES • COORDINATION OF CARE & DISCHARGE PLANNING

1310 NW Deane Pullman, WA 99163 Phone: 509-332-1566

avalonhealthcare.com

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Medicare and Your 100 Days

by Tiffany Goin, Executive Director, Life Care of Lewiston

hen patients are admitted to a skilled nursing facility (SNF) they are often under the assumption that traditional Medicare will automatically pay for 100 days of care. While Medicare beneficiaries do have up to 100 days of skilled nursing benefits, there are criteria that must be met in order to utilize this benefit.

Who is eligible for Medicare? •

•

Anyone with Medicare Part A with days remaining in their benefit period. A patient must have a minimum stay of at least 3 consecutive midnights in a hospital. This does not count an observation period. An inpatient stay begins on the day you are admitted to a hospital. The patient requires daily skilled care given by skilled nursing or therapy staff.

Continued on Page 10

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Five-Star Quality Care Full-Time On-Site Physician | Therapy Offered 7 Days a Week Skilled Nursing and Long-Term Care | Memory Care Unit Certified Wound Care Services Call today to schedule a tour.

208.798.8500

LifeCareCenterOfLewiston.com 325 Warner Dr. | Lewiston, ID Wise accredited Guide | Joint Commission

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Medicare and Your 100 Days Continued from Page 8

____________________________________

Skilled nursing and/or skilled rehabilitation services are those services, furnished pursuant to physician orders, that: •

•

Require the skills of qualified technical or professional health personnel such as registered nurses, licensed practical (vocational) nurses, physical therapists, occupational therapists, and speech-language pathologists or audiologists; and Must be provided directly by or under the general supervision of these skilled nursing or skilled rehabilitation personnel to assure the safety of the patient and to achieve the medically desired result.

Medicare covered services in a SNF include, but are not limited to: • • • • • • • •

Room rate Meals Skilled nursing care Physical, occupational, and speech-language services (if needed to meet your health goals) Social services Medications Medical supplies and equipment used in the facility Dietary services

Your costs associated with a Medicare skilled nursing stay: • •

•

Days 1 – 20: $0 for each benefit period Days 21 – 100: For calendar year 2017, the co-pay is $164.50 per day. Many people have a supplemental insurance plan that will cover some, if not all, of the co-pay. Days 100+: You are typically responsible for all costs.

What if your Medicare coverage stops or you are discharged from the facility prior to using all 100 days? This depends on how long your break in SNF care lasts. Less than 30 days: You don’t need a new 3-day inpatient hospital stay to qualify for coverage, but you do need to meet all other coverage requirements. Your current benefit period would continue where it left off when you were discharged from the facility. The maximum coverage is still 100 days. At least 30 but less than 60 days: Medicare won’t cover additional SNF care unless you have a new 3-day qualifying inpatient hospital stay, and you meet all other coverage requirements. The reason for the new hospital stay does not

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have to be the same as the previous stay. Since the break in your SNF stay was less than 60 days your current benefit period would continue. At least 60 days: Medicare won’t cover additional SNF care unless you have a new 3-day qualifying hospital stay, and all other coverage requirements are met. Since your break in skilled care lasted for at least 60 days in a row, this would end your current benefit period. This means that the maximum coverage available would be up to 100 days of SNF benefits in your new benefit period. Medicare uses a period of time called a benefit period to keep track of how many days of SNF benefits you use, and how many are still available. A benefit period begins on the day you start getting inpatient hospital or SNF care. You can get up to 100 days of SNF coverage in a benefit period. Once you use those 100 days, your current benefit period must end before you can renew your SNF benefits.

There’s no limit to the number of benefit periods you can have. However, once a benefit period ends, you must have another 3-day qualifying hospital stay and meet the Medicare requirements before you can get up to another 100 days of SNF benefits. Clear as mud? If you have more questions about Medicare, you have several resources available to you. You can go online to medicare.gov or contact the the Senior Health Insurance Benefits Advisors (SHIBA) at 800-247-4422, or go online to SHIBA at shiba.idaho.gov As a skilled nursing facility (SNF) we deal with Medicare on a daily basis and can easily and promptly answer your questions. Just give us a call at 208-798-8500. We are here to help! ___________________________________________________________________

Tiffany Goin is a licensed nursing home administrator with over 13 years experience in long term care. She is currently the Executive Director at Life Care Center of Lewiston. Tiffany resides in Clarkston, WA with her husband, Darrin, and daughter, Macie.

Tools for Life Fair 2018 Held in Moscow! March 5-6, 2018 Join us at the 13th Annual Tools for Life: Secondary Transition and Technology Fair. The Tools for Life Fair travels around the state between Northern Idaho, Boise, and Idaho Falls to make the Fair more accessible to students and families across Idaho. In 2018, the Tools for Life Fair will be in Northern Idaho at the Best Western Plus University Inn Hotel in Moscow, ID. Tools for Life Fairs are for students with disabilities and anyone who offers support as they transition from high school to college or work. The event includes presentations about secondary transition and assistive technology. Idaho Educators, Post Secondary Educators, therapists, counselors, service providers, job developers, and other rehabilitation specialists, and especially secondary students with disabilities and their families are encouraged to attend. An Exhibitor Hall will be open both days to allow higher education institutions, state agencies, and vendors the opportunity to promote their organizations, present resources, and demonstrate their newest products.

Registration is free for K12 educators/staff. Registration is $10 per student. Hotel rooms, food stipends, and transportation are available for students who wish to attend! The conference fills up quickly so please register early! Registration Opens October 15th, 2017 at: http://idahoat.org/services/tools-life For more information: 800-432-8324

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Understanding Long-Term Acute Care

by Heidi Frazier, Director of Marketing & Business Development Northern Idaho Advanced Care Hospital

ong-term acute care. The term may sound a bit confusing at first, but it’s important to know what it is before you need it, according to Una Alderman, Chief Executive Officer of Northern Idaho Advanced Care Hospital. “Most people who need inpatient healthcare services for serious injuries or illnesses are admitted to an ‘acute care’ hospital for a relatively short amount of time,” Alderman says. “But when someone is recovering from a medically complex condition, he or she may be referred to a long-term acute care hospital (LTACH) for continued care beyond the original hospital stay. This type of hospital is also certified as an acute care hospital, but specializes in long-term and critical care services.” When patients are referred to a long-term acute care hospital like Northern Idaho Advanced Care Hospital, they usually have one or more serious conditions that require critical care services. These conditions can include respiratory failure, cardiovascular disease, trauma, infectious diseases, complex wound healing, and more. “At a long-term acute hospital, medical services are tailored to the complex needs of each patient, and a personalized plan of care is created by an interdisciplinary team for each individual,” says Dr. Kevin Strait, Medical Director of Northern Idaho Advanced Care Hospital. “The medical team can provide services such as 24-hour nursing care, ventilator weaning, respiratory care, pain management, wound care, and physical, occupational and speech therapies, among other medical services. Being provided with this comprehensive, specialized care can be significant to a patient’s recovery process.”

Confirming this is a study published in Medical Care, a journal of the Medical Care Section of the American Public Health Association. The study shows that in most cases, medically complex and critically ill patients have better results at a long-term acute care hospital compared with similar patients in other settings. In particular, the research found lower death rates among most non-ventilator patients with multiple organ failure, and those who had spent three or more days in an acute-care hospital’s intensive care unit (ICU) prior to going to a long-term acute care hospital. “I think the study reflects that long-term acute care hospitals are well equipped to handle medically complex conditions,” Dr. Strait says. “Through use of specialized equipment and training of staff, those of us in long-term acute care settings can offer a patient continued high-quality long-term or critical care needed so he or she can eventually be discharged either to home, a skilled nursing facility, or to an inpatient rehabilitation hospital to meet further medical needs.” Dr. Strait suggests when looking for long-term acute care for you or a loved one, to be sure to discuss options with your physician or healthcare provider. “Do research on facilities in your area and ask for recommendations,” he says. “I always suggest touring the hospital as well. This is a good way to get a sense of the care provided. It gives you the opportunity to observe the attitude of the staff, type of equipment, and the cleanliness of the facility. It’ll also give you a chance to ask any questions you have.” Other items that can be reviewed with the staff include: • healthcare specialists who will be involved in your care, • therapy programs offered, • nurse-to-patient ratio, • comfortableness with private rooms and baths, • nursing station locations, • certifications and credentials of the staff, • hospital accreditations and recognitions, • patients’ results, • level of involvement of family with patient care, • and general information such as visitation hours or overnight policy.

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

600 North Cecil • Post Falls, Idaho 83854 • 208.262.2800

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NIACH.ERNESTHEALTH.COM

In addition to choosing an appropriate facility, Strait also suggests that family members educate themselves on what to expect when a love one is in critical care. “For a critical care patient, the road to recovery may be a long and overwhelming experience for not only him or her, but for family members as well,” he says. “So knowing what to expect can provide some ease of mind and help everyone deal with the situation better.” Dr. Strait shares the following to help prepare for when a loved one is in critical care: 1. Remember that you have an experienced team on your side. The hospital staff that’s caring for your loved one is highly skilled and prepared to treat the sickest – and most medically complex – patients. From the physicians and nurses to the respiratory therapists and dietitians – they all are specially trained to care for your loved one. 2. The tubes and equipment in a critical care unit can be intimidating. But, they all have a role and purpose in providing your loved one with the intensive healthcare that he or she needs. The healthcare team will be able to explain the role of any equipment to help you better understand what it happening. 3. Information overload can – and most likely will – occur. Everything will be new to you from the equipment and noises to the procedures and health professionals. Take a deep breath. Once you get your bearings, think of how you can best keep track of information. Write in a notebook. Keep notes on your phone. Jot down items like key information, questions you want to ask, purpose of treatments, and names of hospital personnel. 4. Expect peaks and valleys. Critical care can be a bumpy ride. Some days will be better than others. As much as possible, try to be patient and keep perspective. 5. Talk to your loved one. Communicating with your loved one is important for not only him or her, but for your entire family. Often patients can hear while in critical care. Speak calmly and clearly, and make short, positive statements. Hold your loved one’s hand or touch him or her gently if a member of the healthcare team says it’s OK. 6. Take care of yourself. It may be a long road to recovery, so be sure to take time for you. Sleep, eat, and shower. Don’t be afraid to leave the room for a bit. The healthcare team will be there 24/7 to provide care. ___________________________________________________________

Northern Idaho Advanced Care Hospital is a 40-bed, freestanding facility providing long-term acute care and critical care services for patients recovering from serious illnesses, illnesses or chronic medical conditions. It is the first hospital in Idaho to earn The Joint Commission’s national certification in Respiratory Failure. For more information, call 208-262-2800 and visit NIACH.ernesthealth.com.

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Is It Time for Home Care?

by Cindy Barnett, Director Addus HomeCare, Coeur d’Alene

very family must face the question at some point: What’s the best way to care for our elderly relatives? There are many factors to consider, of course, such as your loved one’s health needs, available financial resources, and where the various family members live. There are many options for care as well, including nursing homes, assistedliving facilities, and adult family homes. When possible, however, many families are considering in-home care. According to AARP, 82 percent of people say that they would prefer to stay in their homes as long as possible. This comes as no surprise. Home is obviously the most familiar and comfortable place to be, especially when a person isn’t feeling their best. And being in one’s home offers more

freedom, independence and dignity than a community living situation allows. Studies by the National Association for Home Care & Hospice have confirmed that in many cases home care is a cost-effective service that reinforces and supplements care provided by family and friends, while also allowing people to take an active role in their own care, which promotes healing and faster recovery.

Ten Questions To Help Decide

So, how do you know when it’s time for home care for your loved one? Here are 10 questions that could help you decide.

1. Has there been a recent emotional or medical crisis? 2. Are pills left over or being used too quickly? 3. Does your loved one require assistance walking? 4. Is he or she becoming more forgetful? 5. Are there signs of burnt pans on the stove or scorch marks on pot holders, dish towels, etc.? 6. Is his or her hearing or vision affecting their ability to function? 7. Is he or she unable to run errands or travel to appointments alone? 8. Is routine house cleaning being ignored? 9. Have social activities become less frequent or stopped altogether? 10. Have there been recent falls? 14

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can help prevent problems that could affect their ability to stay in their home. Addus HomeCare is focused on one goal: keeping our clients healthy and independent at home. We are here to help residents throughout all of Northern Idaho. Call us at the Lewiston Branch: 208-746-8881 and the Coeur d’Alene Branch: 208-667-2309. ____________________________________________________________

Cindy Barnett is the Director of Addus Homecare in Coeur d’Alene; providing quality In-Home Care to those in need. Cindy has a degree in Psychology and a minor in health promotions from Weber State University. Over the last 30 years she has worked with a range of age groups; many who suffer with depression. Her passion is to help others live a better quality of life.

If the answer to any of these is “yes”, it may be time to consider in-home care.

Addus Has All the Home Care Services You Need

Agencies such as Addus HomeCare provide in-home support, including personal care and other assistance with “Activities of Daily Living.” These typically include: • Personal Care (bathing, dressing and grooming) • Meal Planning and Preparation • Household Chores (light housekeeping and laundry) • Medication Reminders • Transportation (appointments, shopping and errands) In addition to providing companionship and support, professional home care aides will also advocate for your loved one by observing and reporting Changes in Condition – anything that is noticeably different in their behavior, appearance or living situation, from one visit to the next. This

Two locations serving all of Northern Idaho Lewiston Branch

Coeur d’Alene Branch

Latah, Clearwater, Nez Perce & Lewis Counties

Kootenai, Shoshone, Benewah, Bonner & Boundary Counties

208.746.8881

208.667.2309

www.addus.com

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Find Disability-Friendly Businesses on the “BluePath”

by Vicki Leeper, Marketing Specialist, Disability Action Center NW

ost restaurant reviews don’t include comments on accessibility, leaving potential customers with different disabilities to guess whether they can get in and around a restaurant, read the menu, and hear conversation while enjoying the food. The same is true for other retail establishments, hotels, and businesses, especially when one is traveling or in unfamiliar territory. At the same time, business owners may incorrectly assume their building is completely accessible, when relatively minor changes might vastly improve the ease with which any customer could access their services. A new resource is available now to bring business owners and customers with disabilities together.

A Resource for Customers with Disabilities This resource is BluePath, a completely free non-profit website that details the accessibility features of some local businesses throughout the Palouse and surrounding areas. The goal of BluePath is to provide information about the types of

BluePath is also designed to provide technical assistance to businesses to help them get on the BluePath and become aware and proactive about access and customer service for people with mobility and sensory challenges. “Even though businesses have been required since 1990 to be accessible,” Director of DAC NW explains, “there are a lot of ways that we can inform business about things they don’t realize they don’t know.”

access before arriving at the business. BluePath informs people so they “know before they go” that they will find a reliable, usable “Blue” Path! Starting with parking, it reviews an accessible route to the business, doorways and interiors, restrooms, and it also

Wise Guide | Fall 2017 / Winter 2018

covers visually impaired and deaf accommodations. And more than restaurants, it’s all kinds of businesses, from law offices to public and government buildings and programs. Each accessible business is provided with a decal the business can display in the window. When you see it, you know the business is willing to provide you with a welcoming, user-friendly experience. BluePath also allows customers, called PathFinders, to rate accessible features and to write reviews about their experience. They can list any business they find accessible so others can find them too! Business owners then have the opportunity to claim their listing, respond to comments, allowing discussion and education surrounding access.

A Resource for Businesses 25% of the population have a disability or a close friend or family member with a disability. And more than 80% of people with disabilities have “walked away” from a business that didn’t accommodate their needs. BluePath is designed to

help businesses market to this consumer group with twice the spending power as the teen market! BluePath is also designed to provide technical assistance to businesses to help them get on the BluePath and become aware and proactive about access and customer service for people with mobility and sensory challenges. “Even though businesses have been required since 1990 to be accessible,” Director of DAC NW explains, “there are a lot of ways that we can inform business about things they don’t realize they don’t know.” For the first year volunteers combed the area and reviewed and loaded accessible businesses on the site. Otherwise, a business can go to the BluePath website and do the selfassessment checklist from their phone or other hand held device. The checklist helps identify any issues or barriers. In Woodinville, WA, Nathan Wetmore, General Manager of Redhook Brewery, took action on several BluePath recommendations. He painted an extra accessible parking space closer to the entrance, got a quote for automatic doors, and bought asphalt to smooth out the bottom of the curb ramp leading to the entrance. In Eugene, OR, BluePath assessed several St. Vincent de Paul locations and made a number of recommendations. As a result, Charlie Harvey, Associate Executive Director, widened aisles at his stores, lowered mirrors to allow people using wheelchairs to see better, and changed door handles from knobs to levers.

Help Build the BluePath BluePath is growing in the Pacific Northwest. With a national network of ADA Information Centers, BluePath has the potential support to become a nationwide resource. BluePath needs YOU to help build the directory! You can register as a PathFinder at www.blue-path.org and add an accessible business that you love. BluePath makes it easier to get around and get business done! ___________________________________________________________________

Vicki Leeper was hired by the Board of Directors at Disability Action Center NW several years ago. The Marketing Specialist for all three offices, she uses her experience to get the word out about DAC and all they do. She finds making information about disabilities accessible to our consumers and the community through outreach, the website and social media very rewarding. An expert in planning and marketing events, Vicki helps promote the independent living philosophy of DAC and related local organizations throughout Idaho.

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Importance of Therapy and an Interdisciplinary Team in Skilled Nursing

Dustin Blewett, AIT Director of Admissions EmpRes – Royal Plaza Health and Rehabilitation

killed nursing facilities provide both sub-acute rehabilitation and long-term rehabilitation for their residents. Residents may stay for their recovery period or an extended length of time. Therapists that work in a skilled nursing facility can provide treatment for, or assistance with, many illnesses and conditions affecting daily life. Nursing facilities have evolved over the years to serve an aging population that has become increasingly more clinically complex and requires intensive rehabilitation. Recent studies show that over half of all Medicare beneficiaries are now requiring additional skilled care following a hospitalization. Individualized treatment plans devised by therapy professionals are an important part of this care. Therapy services enable patients to regain speech and motor function, as well as master key daily activities, such as bathing and dressing.

Wise Guide | Fall 2017 / Winter 2018

Therapy services share a common goal of helping residents achieve and maintain their highest practical level of function. In this way, therapy plays an important role in meeting the Omnibus Budget Reform Act, or OBRA, of 1987 requirements. These guidelines establish a minimum standard of care including an expectation that nursing facility resident’s ability to perform activities of daily living and functional mobility would be improved or maintained, absent of medical challenges. Therapy services in conjunction with skilled nursing care establish expert clinical programs tailored to enable better outcomes and improvement. These programs invest clinical resources to meet the needs of residents. This includes residents recuperating from joint surgery, strokes, cardiac illness, or other conditions requiring an interdisciplinary nursing and rehabilitation regimen. Such regimens include physical, occupational, and/or speech therapy to restore physical and mental functions necessary for independent living. With the application of specialized clinical programs to meet the unique needs of each resident, therapy services are driving very specific and measurable improvements that are important to recognize in the discussion of the role of skilled nursing facilities within the post-acute continuum of care. Combining cutting edge technology with proven therapeutic programs improves outcomes, decreases length of stay, and provides each resident the opportunity to reach their highest level of function and discharge home whenever possible. People tend to think that a rehabilitation program is all about a grueling regimen of therapeutic exercise. That is the cliché – lots of movie montages have shown it that way. But, that is rarely how it happens. Each skilled nursing facility is equipped with a therapy department that typically utilizes a strong physical therapy program, which focuses on the identification, prevention, and rehabilitation of individuals with physical impairment and pain. Following an evaluation, the physical therapist develops an individualized treatment program for you that will address lower extremity and trunk strength, range of motion, balance, coordination, functional movement, ambulation, endurance, and pain reduction. In addition to physical therapy, you may be working with a member of the occupational therapy team. Occupational therapy programs address activities of daily living skills, including eating, dressing, hygiene, and home management tasks. They also provide treatment interventions for upper extremity function, cognition, perception, and community reintegration. Depending on your condition, you may need speech therapy services provided by a licensed and skilled speech language pathologist. Speech therapy provides a continuum of services, including assessment, education, and treatment of patients with communication, cognitive, and swallowing

We are a full-service community. Our first priority is to make you feel at home!

The mission of Royal Plaza Retirement and Rehabilitation Center is to assist each resident in reaching his or her desired potential.That’s our.....

We also offer • Independent Living Cottages • Assisted Living to fit your needs • Respite and Hospice Care

Commitment to Caring

5-star rated quality & comprehensive care to meet your needs: • Extensive Rehabilitation • 24-Hour Skilled Nursing • Long & Short Term Care • Restorative Nursing • Physical, Occupational and Speech Therapies

Call or stop for a free lunch and tour. Ask about our rent and veterans’ specials!

2780 Juniper Drive, Lewiston, Idaho Health & Rehab: 208-746-2855 • Retirement: 208-746-2800 RoyalPlazaHealthAndRehab.com • RoyalPlazaRetirement.com

problems. Treatment programs are directed towards improving communication skills in the areas of comprehension and expression. Patients admitted to a skilled nursing facility who are receiving nutrition partially or exclusively from an artificial feeding source via a tube are evaluated for their potential to return to solid foods as appropriate. Throughout your stay in a skilled nursing facility, your progress will be monitored by an interdisciplinary team, which consists of doctors, nurses, therapists, and dietitians. This team ensures that you are making progress towards your goals, and, if necessary, can reevaluate those goals with you. You will have care conferences that include members from the nursing department, social services, and the therapy department to give updates on the progress that you have made. This is also a great time for you, or your family, to ask questions or voice concerns that you have pertaining to your stay. These care conferences typically occur at the beginning of your stay, at approximately half way through your stay, and just prior to discharging. It takes a team to care for people. Teamwork across all disciplines and staffing units, including clinical, nursing, environmental services, and dietary work together for the benefit of the resident. Great facilities prohibit the “it’s not my job” attitude creating a positive and supportive work and healing environment. Since a skilled nursing facility is a home for its residents, it is important that the facility feels warm and friendly. It is important that a facility provides support to meet productivity expectations. Most facilities help therapists be as efficient as possible, just by their layout. Transporting residents between their rooms and the gym hinders the

process. One solution is having sub-acute resident’s live in a designated rehabilitation wing, which provides therapists with easy access to meet residents and get them to the gym. Nursing staff can also help therapists improve efficiency by ensuring a timely delivery of the medications that are necessary for the rehabilitative process to take place. Rehabilitation after illness or injury is a slow step-by-step process that aims to help you recover. Rehabilitation might help you get moving again, regain your strength, relearn skills, or find new ways of doing things. The aim of rehabilitation is to help you lead as good a life as possible. That may be the same life you had before you got sick or injured, or it may be different. You can speak to your doctor about what you would like rehabilitation to do for you. With your doctor, and a therapy team, you will set therapy goals. Then, you and your team will work out how to achieve those goals. You will play a very important part in your rehabilitation. You will need to be patient – it takes time – but, rehabilitation can help ___________________________________________________________________

Dustin Blewett is the Director of Admissions and an AIT student for Royal Plaza Health and Rehabilitation. Dustin has been a long time Clarkston resident, born and raised here in the valley. With two decades of healthcare experience, he boasts a vast set of skills, including long term care and aging, long term care pharmacy, hospital pharmacy, and health policy administration. Dustin earned his Bachelors of Science from Washington State University and is working on completing his masters in Health Policy Administration from Western Governors University, as well as his masters in Physician Assistant Studies from Yale School of Medicine.

Wise Guide | www.TheWiseGuideOnline.com

Diabetes and Your Feet

by Dr. Karl Johnson, Tri-State Podiatry

aking care of your feet and inspecting them on a regular basis is important to maintain healthy feet for everyone. If you also have diabetes, these health routines become all the more important. Diabetes affects foot health for a number of reasons. The most important changes a person with diabetes experiences is reduction in blood circulation, sensation, and immune system response. There are some essential things to do to maintain healthy, strong feet for those living with diabetes.

Check your feet and legs every day. A thorough inspection of your feet and legs should be completed on a daily basis. Check for any unusual swelling, areas of increased temperature, or discoloration. If there are any breaks in the skin, pay particular attention to the areas between the toes and on the bottom surface of the toes and heels. Wear socks with shoes at all times. Socks reduce friction and provide protection from moisture by absorbing sweat. The material of the sock should be made of cotton, wool, or a synthetic blend. The ideal color is white as it makes any bleeding, blistering, excess dirt, or other saturation more visible. If there is any bleeding or blistering this may be an indication to see your provider as soon as possible. Basic foot maintenance is a difficult subject for people with varying levels of diabetes. While there are some things you should do, there are also things to avoid in diabetic foot care. Do not go barefoot. Try to avoid being barefoot even while at home, and especially while outside. Objects such as a needle or toothpick could cause a serious injury and lead to infection. Do not self-treat foot problems. Avoid self-treating corns, calluses, toenails, or other foot problems when you have diabetes. This is commonly referred to as â&#x20AC;&#x153;bathroom surgeryâ&#x20AC;?. Despite what is available in-stores, never used chemical agents or medicated pads, such as corn removers, as these are too acidic and can cause serious injury. If you must treat thick areas of skin, make sure it is done without any harsh chemicals or sharp objects. Using urea cream 40%, available over-the-counter, is a good way to breakdown areas of thick skin. Using a pumice stone or other mildly abrasive products is also reasonable. Many foot problems that lead to hospital admission could be avoided by following these basic foot care tips. Remember to inspect your feet and legs daily, wear socks and appropriate footwear, and never self-treat. If you have diabetes, visit a foot care specialist regularly to help avoid complications of infection and possible loss of tissue or limb. The goal for diabetic foot care is to keep you walking and performing all of the activities you enjoy with two full limbs and all ten toes for your entire life! ___________________________________________________________________

Wise Guide | Fall 2017 / Winter 2018

Free Community Meals Family Owned & Operated Since 1896

The Salvation Army

1220 21st Street, Lewiston 5:00-6:00 pm Every Monday, Tuesday, Wednesday & Friday

•••••••••• First Christian Church

840 10th Street, Clarkston (10th and Diagonal) 5:00 pm Every Thursday

Full Service Pharmacies Hallmark Gold Crown, Fine Gifts, Fashions & Accessories

•••••••••• Church of Christ

Served at The ROC, 1803 6th Avenue North, North Lewiston 6:00-7:00 pm Every Thursday

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(Lower Level Southway) Complete Line Medical Uniforms, Nursing Shoes and Accessories. Many Name Brands to Choose From

•••••••••• Grace Evangelical Lutheran Church 3434 6th Street, Lewiston Orchards 5:00-6:00 pm st rd th 1 , 3 & 5 Saturday’s of the month

•••••••••• Episcopal Church of the Nativity 721 8th Street, Lewiston 4:00-5:30 pm nd th 2 & 4 Saturday’s of the month

•••••••••• Orchards Church of the Nazarene

208-743-7766

347 Thain Road, Lewiston 11:00 am-1:00 pm th 4 Saturday of the month

•••••••••• Unity Church of Clearwater Valley

Served at The ROC, 1803 6th Avenue North, North Lewiston 3:00-4:30 pm Every Sunday

(Lower Level Southway) Home Medical Supplies, Rentals & Sales, Scooters, Power Lift Chairs, Mastectomy Products and More

Updated July 2017

Wise Guide | www.TheWiseGuideOnline.com

Crossword Cowboys Across

Down

1 Superlative suffix 2 Definite article 3 Bunkhouse bunk 4 How a cowboy travels 5 Soak up 6 Prefix with political 7 Ear-related 8 They can be found in saloons 9 Arab capital 10 Of an arm bone

11 Swimming venues 13 Greek cross 16 Printerâ&#x20AC;&#x2122;s widths 21 Giant great Willie 23 Map rtes. 24 Makes a scene? 25 Water wheel 26 Special delivery? 28 Canadian cowboy, maybe 31 Bullring cheer 32 Choose 35 Cowboyâ&#x20AC;&#x2122;s rig 36 Europeâ&#x20AC;&#x2122;s â&#x20AC;&#x153;bootâ&#x20AC;? 37 Doctrine 39 Prince Valiantâ&#x20AC;&#x2122;s son 40 Pastoral place 41 Eye affliction 43 San ___, Texas (Alamo site) 44 Sullen 45 Coolers, briefly 46 Raise a design 47 Opus 48 CĂŠzanne contemporary

Wise Guide | Fall 2017 / Winter 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 27.

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Making the Best of Your Healthcare Appointment

By Michael Meza, M.D., Director, Heritage Health, Post Acute Care

daho is ranked 49th in the country for access to healthcare providers per capita. Frequently time is limited when you are at your appointment with your healthcare provider. Therefore it makes sense to make the best of your appointment. Be prepared, focus on specific issues, listen carefully and learn as much as possible. If it’s your first visit with a new provider, bring a written copy of your health history. This will expedite the intake process. This document should include a list of any previous physicians and providers you have seen in the past or currently. Please provide contact information such as phone and fax numbers if at all possible. This will allow your care team to quickly access any pertinent medical information during or after your visit. This document should also include a list of your Medical History, such as high blood pressure, diabetes, lung disease, etc. It will also be helpful to list any previous Surgeries, no matter how long ago they occurred. Then list any Allergies to medications and associated reactions such as nausea or itching. Most importantly create an up-dated list of any and all of your Medications including prescription, over-thecounter and herbal. It’s important to write down the name of

If it’s your first visit to a new provider, bring a written copy of your health history. This will expedite the intake process....this will allow your care team to quickly access any pertinent medical information during or after your visit each medication, units such as milligrams and how often you are taking them (i.e., once a day, twice a day, as needed). It is also very helpful to bring in all your medication bottles with you to each visit. This is the most accurate way to make sure your medication list is as up to date as possible. This is called Medication Reconciliation and is one of the most important steps in providing safe care to all patients. Next, list any blood relative Family Medical History, which may be helpful. This can include parents, siblings and

Wise Guide | Fall 2017 / Winter 2018

children and consider any cancers, early heart disease, strokes, psychiatric illness, etc. Next is your Social History. List any smoking or alcohol history and be honest. This can be very helpful in the care planning process. Then list marital status, emergency contacts, people who live in the home with you and any resources you currently have available to you, such as Home Health, In-Home care, church friends and neighbors who can truly help you in case of need. Consider tracking your immunizations and vaccines such as Pneumonia shot, flu vaccine and tetanus. Also helpful would be a list of any screening studies such as mammograms and colonoscopies. Include dates when these were last done, if possible. Keep this document updated as changes can occur with each visit to your healthcare providers. Perhaps a family member can create this document for you and save it to your or their computer for easy access and updates. This would make it easier to print two copies for each visit, one for you and one for your provider. It would be especially useful to have a copy for any Urgent Care or Emergency Room visits. Some patients keep a folder in their home for rapid access, which can be handed to Emergency Medical Technicians for ambulance transfers to the hospital.

Whether a new or established provider appointment, consider making a short list of specific issues you want to address days before you head to the clinic. If necessary, write down a bit of history pertaining to those issues, such as type of symptoms, duration of symptoms, any changes in character, which may be related to activity, foods or medications. Be as concise and clear as possible, as this will help your provider make the best decision in your care. Don’t be surprised if your provider limits the number of issues to be addressed at each visit. Prioritize your concerns and do not bring in a “laundry list” which will be overwhelming to your healthcare team. During the appointment, listen carefully and take notes. Better yet, if at all possible, have a family member join you during the interview process. They can take notes for you, then step out of the room during the exam process if necessary. When exiting the appointment, ask for a copy of your visit summary. This should be provided for all appointments

and should include a list of your current medications as noted by your provider. Look for any discrepancies and clarify as soon as possible. This summary should also have a list of recommendations, instructions and perhaps references to learn more about your health and disease process. Lastly, make sure you understand when and where your next appointment will be and if there are any laboratory or radiology studies that needs to be completed prior to the next visit. Unfortunately, you have limited time with your healthcare providers. Be prepared and make the best of the time you have with them. But don’t worry. If you forget something or need to give more information, please call the office or better yet, use your electronic Patient Portal to communicate with your Patient Centered Healthcare Team. Ask your clinic if this is available and if not, ask when it will be. This will require a user name and password. You may consider granting access to family members to help you navigate this relatively new communication tool. In a fast paced healthcare world, use the help any chance you get! “Best wishes and good health!” —Dr. Michael Meza ___________________________________________________________________

Dr. Meza graduated medical school from the University of Texas Southwestern in Dallas, Texas in 1993, followed by Family Practice residency at John Peter Smith Hospital in Forth Worth. After graduation he moved to Orofino, Idaho and enjoyed 16 years practicing full spectrum family medicine, providing care in the clinic, hospital, emergency department and Skilled Nursing Facility. He also provided obstetrical care, including cesarean sections, and performed colonoscopies and EGDs for his patients. He and his wife Casey moved to Coeur d’Alene in January 2012 and began focusing on care for the elderly. He enjoys seeing residents of “the greatest generation” in the Post Acute Care facilities, Skilled Nursing facilities, and Assisted Living facilities where they live, and building a health care team to support their needs. He works collaboratively with Kootenai Health through the Community Partners group to in-sure a smooth transition of care for patients discharged from the hospital to these types of facilities.

hen someone you care about needs caring for.

To learn more, call (208) 882-6560.

All faiths or beliefs are welcome.

Wise Guide | www.TheWiseGuideOnline.com

Getting the Conversation Started

by Hope Brackett, Executive Director Brookdale Lewiston

alking to your loved one about the possibility of moving into an assisted living community may seem like an impossible task. It is common to feel uncomfortable when suggesting to someone that they may need assistance while performing daily tasks or activities. Unfortunately, even though it may be an uncomfortable topic, getting assisted living help is probably not a conclusion that your loved one will reach on their own. Here are a few tips to help you approach the conversation in a way thatâ&#x20AC;&#x2122;s both beneficial to you and your loved one: Start the conversation early: You do not want your loved one to feel as if you are forcing them to move tomorrow. Begin talking about the possibility of moving into an assisted living community while it is still off in the distance. This will help them feel like it is less of an ambush, as well as give them some time to come to terms with the idea.

Wise Guide | Fall 2017 / Winter 2018

Do research: Having the information and facts about a few local assisted living facilities can help you explain what your loved one will gain if they move. You can list the positives, as well as the negatives, of each facility. By simply relaying the facts, you can help dispel a few of the negative connotations that your loved one might associate with assisted living. Keep it private: Your initial conversation should be held in a comfortable, private setting. If you would like another family member or two present, this is okay. However, try to minimize the number of people. You do not want your loved one to feel embarrassed or threatened in any way. By keeping the initial conversation private, they may feel more open to hearing about a possible assisted living move. Focus on the positives: When your loved one hears the phrase â&#x20AC;&#x153;assisted living community,â&#x20AC;? there is a good chance that it conjures up all sorts of negative imagery. This is why it is important to focus on the positive aspects that this change in lifestyle will bring. Talk about the services, the social opportunities, and the security. Explain to them how the move will impact their life in a positive way. If you or your loved one want to know more details about assisted living, Brookdale Lewiston can help. Bring them for a tour so they can see for themselves what a

modern, comfortable and active community is like. This will help dispel negative ideas about assisted living and give them a chance to see how staff interacts with residents and ask questions. Brookdale Lewiston is an exceptional assisted living community serving seniors and their families from Lewiston and surrounding towns in northwestern Idaho and eastern Washington state. We are located on ten acres with a view of Lewiston Hill, the Lewis-Clark Valley, and nearby orchards. The community offers several amenities such as a beauty/ barber shop, fireside living room, walking paths, and more. At Brookdale Lewiston, our assisted living services provide the senior in your life the freedom and comfort of living independently, plus peace of mind from having help close at hand. Your loved one spent decades taking care of others. Now, itâ&#x20AC;&#x2122;s their turn to be pampered. For more information on assisted living at Brookdale Lewiston, you may visit our website, brookdale.com and please call 208-746-8676 or come visit us at 2975 Juniper Drive, Lewiston. ___________________________________________________________________

His generation put a man on the moon. You know he has ideas worth hearing. At Brookdale, weâ&#x20AC;&#x2122;re looking for interesting seniors â&#x20AC;&#x201D; people whoâ&#x20AC;&#x2122;ve lived life to the fullest and are hungry for more. Call us, and find out how weâ&#x20AC;&#x2122;re Bringing New Life to Senior LivingTM. For more information, call us...208-746-8676

Hope Brackett is the Executive Director at Brookdale Senior Living in Lewiston Idaho. She has twenty-eight years of management experience in the Healthcare field. She began in healthcare managing a very large multi-physician clinic, and the most recent fourteen years have been in management of Senior Living. Hope received her education from Walla Walla Community College and Lewis Clark State College.

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Wise Guide | www.TheWiseGuideOnline.com

Deep Tissue Laser Therapy Works!

by Dr. Daniel L. Moore, Moore Chiropractic

ince running an article on the use of LightForce Laser, Photobiostimulation in the previous edition of The Wise Guide: LightForce Laser, Photobiostimulation Relieves Pain & Enables Healing, I have had many new patients come to me with a variety of needs. I wanted to share their experiences with readers, and encourage you to read the previous article to understand how photobiostimulation works, and consider this form of treatment for your own acute or chronic condition. The article is also posted on my website danmooredc.com or you may obtain a printed copy from my office. Whether you are seeking faster healing, or relief from chronic pain, this non-invasive form of therapy can help you. It helped me when nothing else worked for a nerve injury causing excruciating pain in my leg. It is because of my own experiences that I have brought this treatment option to my patients.

Story at-a-glance Infrared laser therapy treatment helps reduce pain, reduce inflammation, and enhance tissue healing, both in hard and soft tissues, including muscles, ligaments, or even bones. It increases oxygenation of tissues and allows injured or damaged cells to absorb photos of light, which speeds healing. Class 4 laser therapy can be effectively combined with a number of other treatment modalities.

Wise Guide | Fall 2017 / Winter 2018

Laser therapy can be helpful for acute injuries, such as strains, sprains, and shoulder injuries; repetitive-use injuries, such as carpal tunnel syndrome; traumatic injuries, and chronic issues such as frozen shoulder and arthritis. One of the greatest benefits I’ve found is that Class IV laser therapy allows the body to heal without the use of prescription drugs. These patients whose testimonials follow, were treated using photobistimulation via the LightForce Class IV Laser. A typical treatment session can take anywhere from 5 to 20 minutes, dependent upon your injury or condition. The majority of conditions require 6 to 12 treatments over a twoto four-week period of time.

Here are just a few examples: “I’m suffering from plantar fasciitis and the laser treatment helped with inflammation and my pain level. It has given me a new outlook for staying active and working in a whole new light!“ —Sharon C. Plantar fasciitis is a common cause of heel pain. It involves inflammation of a thick band of tissue that runs across the bottom of the foot connecting the heel bone to the toes (plantar fascia). It seems that there is little agreement as to who may develop it, nor the best treatment, however there is one thing that does help and that is laser therapy, but not just any laser therapy. The deep tissue laser reaches into the location of the pain and works there. “Deep tissue laser therapy has been very effective at alleviating the pain and swelling from a broken ankle. I’m getting back on my feel much faster than expected.” —Cynthia D. It takes at least 6 weeks for a broken ankle to heal, sometimes longer, depending upon the severity and location of the breakage. Class IV laser therapy allows my patients to return to the activities they love while maintaining their healthy lifestyle. Recovery from injuries is much faster, often avoiding surgery altogether.

“I sustained a deep cut on my finger while on a construction job and had a laser treatment right away. After the treatment, I had almost no pain, and my finger healed phenomenally fast.” —Forest D. Laser therapy generates a photochemical response in damaged tissue by a process called photobiomodulation. This process stimulates healing on a cellular level by enabling cells to more rapidly produce energy (ATP). “I came into the office bent over with a painful limp and walked out like a normal human being. Dr.Moore actually hears me, knows what is causing my pain and takes time to fix it.” —Judy M. Deep tissue laser therapy is a non-invasive use of laser energy that promotes healing of damaged or dysfunctional tissue. This form of therapy helps your body use its own natural healing power by activating a positive cellular response, increasing microcirculation to reduce inflammation. For those suffering from chronic, nagging pain, inflammation and lack of mobility, Class IV laser therapy offers fast, healing relief. “I am diabetic and haven’t had any feeling in my feet for years, although my legs feel like they are on fire sometimes. With just the first treatment, I felt tingling in my lower legs and feet, and walking isn’t as painful.” —Charles B. In general, diabetic neuropathy is thought to be the result of chronic nerve damage caused by high blood sugars. Similar to how an electric wire is surrounded by insulation, our nerves are surrounded by a covering of cells called Schwann cells. Water is drawn into these cells causing nerve swelling and damage resulting in pain. Unless the process is stopped and reversed, both the Schwann cells and the nerves they surround will die. The application of photobiostimulation that the Class IV laser delivers to these cells prevents or reverses the biochemical processes that cause this damage.

My own personal experience: “I traveled to Boise seeking Class IV laser therapy. 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 that I wanted to share it with my patients.”—Dr. Daniel Moore, D.C. The LightForce Class IV Laser was developed by leading laser scientists and engineers and we are proud to offer one of the very few Class IV LightForce Lasers in North Idaho. I have treated hundreds of patients with such great results that I have many health care practitioners stop in to see what deep laser therapy can do for their patients. We encourage those who have tried other forms of treatment without success to try the technology We have already seen many of our patients benefit from this treatment with as few as two treatments. We are so confident that this exciting new treatment can help you that your first treatment is on us. Contact our office at (208) 2672506 to schedule your complimentary first treatment and start your road to a pain-free life today. Visit danmooredc.com to see a short video on how the Class IV Laser works. __________________________________________________________________

Daniel L. Moore D.C. has been in private practice for more than 30 years. His career began in Los Angeles, California in 1984. While working with Olympic athletes under Dr. John Thie, he mastered cutting-edge techniques like kinetic taping and Kinesiology. A past board member of Boundary Community Hospital and Vice President of Boundary Community Ambulance, Dr. Moore currently works with several athletic teams at Bonners Ferry High School and is often seen on the sidelines during football, baseball and track events. 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.

Wise Guide | www.TheWiseGuideOnline.com

The Right Care, at the Right Time

by Darryl Heisey, Idaho State Veterans Service Officer

f you want to learn something about VA benefits, what you read in this article may change your life or the life of someone you know. Are you a Marine? Did you serve at Camp Lejeune? Do you have one of the following conditions: Kidney Cancer? Liver Cancer? Non-Hodgkin’s Lymphoma? Adult Leukemia? Multiple Myeloma? Parkinson’s Disease? Aplastic Anemia and other myelodysplastic syndromes? Bladder cancer? These conditions are considered presumptive for 30 days of total service at Camp Lejeune, North Carolina or MCAS New River North Carolina. Veterans who served from August 1, 1953 to December 31, 1987 are considered to have been exposed to contaminated water at Camp Lejeune or MCAS New River. The new presumptive conditions where written into law on March 14, 2017. IF one of your loved ones passed away from one of the eight conditions, the surviving dependent family members may be eligible for Veteran Affairs Benefits. If you have or had one of these conditions listed and you meet the criteria of 30 days cumulative time at Camp Lejeune or MCAS New River, you need to contact your nearest Veteran Service Officer for more details and help with filing service connected disability claims. In August 2017 President Trump signed the VA Choice and Quality Employment Act of 2017. The VA has been authorized $2.1 billion for the Veterans Choice Program (VCP). What changes? This will allow VA Medical Facilities to maximize referral to local VCP participants in the community where veterans reside. Keep in mind that eligibility for Choice Program has not changed. Choice First may be referred if requested care is not offered at the local Veteran Administration Medical Center (VAMC) or, if the VAMC can’t see the veteran for specific care, and is over 30 days from a preferred date, or 40 miles driving distance from the closest VA health care facility; these facilities include Community Outpatient Clinics (CBOCs). The veterans Choice Program WILL NOT pay for emergency visits. The Choice Program requires approval from the VA Health clinic/hospital after all attempts to receive needed care cannot be met; once that has been established the veteran can call the Choice Line at (866) 606-8198. The North Idaho and Eastern Washington Choice number is (509) 484-7969. Choice falls under Triwest the website for Triwest is www.triwest.com. To reach the VA Care in the Community or Choice Program Troubleshooters call (509) 434-7969. IF you have a VCP billing issue call 877-881-7618.

Wise Guide | Fall 2017 / Winter 2018

Services NOT covered under the Choice Program: Nursing home care; hospice; long term acute hospital; homemaker and home health aide services; chronic dialysis treatments; dental care; pediatric services; durable medical equipment including eyeglasses and hearing aids; orthotics and prosthetics; non-urgent/non-emergent medications; compensation and pension examinations and EMERGENCY ROOM care. Co-pays: Under the Choice Program veterans are required to make a co-pay in the same manner they would for care or treatment from the VA health clinics/hospitals. IF the veteran has approval for the Choice Program, be sure that the local provider submits bills to the following address: WPS-VAPC3 PO Box 7926 Madison, WI 53707-7926. Your local County and State Veteran Service Officers are able to assist you and steer you in the right direction when you have questions about VCP. Keep in mind you must be enrolled in VA medical care in order to qualify for this program. Call your local VA clinic or your County or State Service officer and they can help you with your enrollment process into the VA healthcare program. Please contact Darryl Heisey at 208-446-1096 if you would like to learn more about your earned VA benefits. __________________________________________________________________

Darryl Heisey is the State Veterans Service Officer, Idaho Division of Veteran Services, Post Falls. Darryl served in the U.S. Army as 56M40H Chaplain Assistant Supervisor from 1982-2002. Army Duty Assignments: Fort Polk, LA, 588th Engineer Battalion, 5th Infantry Division (Mechanized); Fort Richardson, AK, 1st Brigade, 6th Infantry Division (LIGHT); Fort Carson, CO, 4th Infantry Division, Mechanized; Fort Monmouth, NJ, United States Army Chaplain Center and School; Fort Jackson, SC & Schofield Barracks, HI, 25th Infantry Division (LIGHT); Fort Huachuca, AZ, United States Signal Command. Darryl holds a B.S. degree in Human Resource Management from Madison University. A past board member of Boundary Community Hospital and Vice President of Boundary Community Ambulance, Dr. Moore currently works with several athletic teams at Bonners Ferry High School and is often seen on the sidelines during football, baseball and track events. 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.

Keep hearing the sounds you love!

HEARING AID SOURCE Spence Killian, Hearing Aid Specialist

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30 day trial program. Reasonable pricing and hearing aids of most types and styles. 3-year warranties and 3-year free batteries with purchase of new digital hearing aids. Appointments on Tuesdays - Call to schedule today!

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Alice in Wonderland theme this year at the FREE Snow Bash Camp in Cascade, Idaho. Statewide Transportation Provided (see below)

The Idaho National Guard offers this FREE winter camp for military connected youth, ages 10-18 yrs. Held for 3 days from January 12-15, 2018. There is a “fee” of $35 to hold a spot, fully refunded upon arrival. All included food, lodging & activities (snow sledding/tubing, arts & crafts, resiliency, dance). It’s a great winter fun camp! Call 208-282-4387 OR 208-272-8397 for registration forms and information. Seeking Youth 10-18 yrs., Adult Chaperones & Teen Counselors Transportation is provided from: Gowen Field, Idaho Falls Armory, Lewiston Armory, Pocatello Armory, Post Falls Armory, Twin Falls Armory.

Wise Guide | www.TheWiseGuideOnline.com

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These Veterans Service Officers are here for you:

“Our commitment to caring extends to all our veterans and their families.”

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

Wise Guide | Fall 2017 / Winter 2018

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

Tyler Anderson 208-265-0193 Ext. 4079 613 Ridley Village Road, Ste. C, Sandpoint email: tyler.anderson@labor.idaho.gov

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Veteran Service Officers (VSOâ&#x20AC;&#x2122;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.

â&#x20AC;&#x153;If you are a Veteran....Thank you! If you are not a Veteran...Thank one!

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

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.

Clearwater County

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

Moscow

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

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 220 E. 5th St., Moscow M-F 8:30 AM -12 noon, 1:00 - 4:30 PM email: jbeyer@latah.id.org

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

Lewiston

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

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.

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We Salute Our Veterans . . . RESOURCES

If you are a veteran or partner of a veteran, these organizations are here to help with free assistance. Call any of them and they can connect you with the services you are seeking.

“Let us never forget their sacrifices.”

Need to talk to someone NOW?

Combat Call Center/Crisis Line - 1-877-927-8987 Veterans Crisis Line: 1-800-273-8255 Press 1 Confidential Online Chat: VeteransCrisisLine.net

VA Outreach Centers

Spokane Vet Center 509-444-8387 Kalispell Vet Center 406-257-7308 or 877-927-8387 Missoula Vet Center 406-721-4918 Walla Walla Vet Center - 509-526-8387 Spokane Mobile Vet Center - they come to your area! Call your local VFW for schedule.

CBOC’s and Rural Health Clinics Colville Rural Health Clinic 509-684-3701 1200 E. Columbia, Colville, WA Coeur d’Alene CBOC 208-665-1700 915 W. Emma Ave., Coeur d’Alene Grangeville Outpatient Clinic 208-983-4671 711 EW. North Street., Grangeville Kalispell CBOC 406-758-2700 Three Mile Professional Bldg. 31 Three Mile Dr., Ste. 102, Kalispell, MT Lewiston CBOC 208-746-7784 1630 23rd Ave., Bldg. 2, Lewiston Libby Veterans Clinic 406-293-8711 211 E. 2nd Street, Libby, MT Missoula CBOC 406-493-3700 2687 Palmer St., Ste. C, Missoula, MT Sandpoint Veterans’ Clinic 208-263-0450 420 N. 2nd Ave., Ste. 200, Sandpoint

Wise Guide | Fall 2017 / Winter 2018

Online Resources va.gov/homeless Each VA medical center has a homeless coordinator and programs that help veterans establish or maintain safe, stable housing. Call VA’s National Call Center for Homeless Veterans 1-877-424-3838, 24/7. oefoif.va.gov Toll-free line and website that provide information about health care, dental care, education and other benefits for OEF/OIF/OND veterans. 1-877-222-8387 ptsd.va.gov VA’s center of excellence for research and education on the prevention, understanding and treatment of PTSD. 1-802-296-6300 caregiver.va.gov Provides support for caregivers of veterans and information about services that may be available to them. 1-855260-3274

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“For their valiant courage in defending the cause of freedom, we honor our Veterans.”

VA MEDICAL CENTERS & TRANSPORTATION Walla Walla VA Medical Center 888-687-8863 77 Wainwright Dr., Walla Walla, WA DAV Van Schedule: Thursdays: 6:00AM departs State Veterans Home 821 21st Ave., Lewiston Picks up: Clarkston, Pomeroy, Dayton,Waitsburg & Dixie, WA APPOINTMENTS FOR RIDES MUST BE MADE 72 HRS. IN ADVANCE Call DAV Transportation Office Walla Walla VA Med. Ctr.: 888-687-8863 x22529 Spokane VA Medical Center 800-325-7940 4815 N. Assembly St., Spokane, WA DAV Van Schedules: Wednesdays & Fridays: 6:00 AM departs State Veterans Home, 821 21st Ave., Lewiston Wednesdays - Picks up: Genesee, Moscow, Viola, Potlatch, Tensed, Plummer & Worley Fridays - Picks up: Uniontown, Colton, Pullman, Colfax, Steptoe, Rosalia & Spangle, WA Noxon & Libby DAV Van Schedules: Mondays, Wednesdays and Fridays - (Noxon Van) Picks up: Noxon, Bull River Junction, Clark Fork, Hope, Sandpoint, LaClede, Priest River, Newport, Diamond Lake, Chattaroy, Spokane VA. Tuesdays and Thursdays - (Libby Van) Picks up: Libby, Bonners Ferry, Sandpoint, LaClede, Priest River, Newport, Diamond Lake, Chattaroy, Spokane VA. APPOINTMENTS FOR RIDES MUST BE MADE 72 HRS. IN ADVANCE. Call DAV Transportation Office at the Spokane VA Med. Ctr. 800-325-7940

Veterans Transportation Services - for FREE transportation to VA Medical Centers, Outpatient Clinics (CBOC’s) & authorized VA appointments 509-434-7527

VAMC Mobile Health Clinic

Days & Locations: Moscow - Fairgrounds - Last Monday Pullman - WSU Alumni Center - Last Tuesday Osburn - VFW Post - Last Wednesday & Thursday To be seen by the mobile health clinic, a veteran must call the Mann-Grandstaff (Spokane) VAMC and ask for an appointment. 1-800-325-7940 or 1-509-434-7000 The VAMC tries to schedule all of these appointments for the last week of each month.

The VAMC Bus

GOVERNOR’S VETERANS AFFAIRS ADVISORY COMMITTEE TOWN HALL MEETING

Washington Veterans are invited to attend a Governor’s Veterans Affairs Advisory Committee Town Hall Meeting. Meet area leaders and providers to learn about local veterans services and benefits, and hear about veterans issues being debated in the Washington State Legislature. Information will be available on transition, employment, education, housing, benefits (compensation, pension & military funeral honors) counseling, financial assistance and support services. A free Continental breakfast is provided. Held November 16, 2017 from 9:00 AM - 12:00 PM at the Lincoln Center, 1316 N. Lincoln St., Spokane

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America’s Wars

Department of Veterans Affairs American Revolution (1775-1783)

217,000 4,435 6,188

War of 1812 (1812-1815) Total U.S. Servicemembers Battle Deaths Non-mortal Woundings

286,730 2,260 4,505

Indian Wars (approx. 1817-1898) Total U.S. Servicemembers (VA estimate) Battle Deaths (VA estimate)

106,000 1,000

Mexican War (1846-1848) Total U.S. Servicemembers Battle Deaths Other Deaths (In Theater) Non-mortal Woundings

78,718 1,733 11,550 4,152

Civil War (1861-1865) 2,213,363 140,414 224,097 281,881 1,050,000 74,524 59,297 Unknown

Spanish-American War (1898-1902) Total U.S. Servicemembers (Worldwide) Battle Deaths Other Deaths in Service (Non-Theater) Non-mortal Woundings

306,760 385 2,061 1,662

World War I (1917-1918) Total U.S. Servicemembers (Worldwide) Battle Deaths Other Deaths in Service (Non-Theater) Non-mortal Woundings

World War II (1941 –1945)

Total U.S. Servicemembers (Worldwide) Battle Deaths Other Deaths in Service (Non-Theater) Non-mortal Woundings Living Veterans 5

4,734,991 53,402 63,114 204,002 16,112,566 291,557 113,842 670,846 1,711,000

______________________________________

NOTES: 1. Exact number is unknown. Posted figure is the median of estimated range from 184,000 – 250,000. 2. Exact number is unknown. Posted figure is median of estimated range from 600,000 – 1,500,000. 3. Death figures are based on incomplete returns. 4. Does not include 26,000 to 31,000 who died in Union prisons. 5. Estimate based upon new population projection methodology.

May 2017

Korean War (1950-1953)

Total U.S. Servicemembers1 Battle Deaths Non-mortal Woundings

Total U.S. Servicemembers (Union) Battle Deaths (Union) Other Deaths (In Theater) (Union) Non-mortal Woundings (Union) Total Servicemembers (Conf.) 2 Battle Deaths (Confederate) 3 Other Deaths (In Theater) (Confederate) 3, 4 Non-mortal Woundings (Confederate)

Office of Public Affairs Washington, DC 20420 (202) 461-7600

Wise Guide | Fall 2017 / Winter 2018

Total U.S. Servicemembers (Worldwide) Total Serving (In Theater) Battle Deaths Other Deaths (In Theater) Other Deaths in Service (Non-Theater) Non-mortal Woundings Living Veterans

5,720,000 1,789,000 33,739 2,835 17,672 103,284 2,275,000

Vietnam War (1964-1975)

Total U.S. Servicemembers (Worldwide) 6 Deployed to Southeast Asia 7 Battle Deaths 8 Other Deaths (In Theater) 8 Other Deaths in Service (Non-Theater) 8 Non-mortal Woundings 9 Living Veterans 5, 10

8,744,000 3,403,000 47,434 10,786 32,000 153,303 7,391,000

Desert Shield/Desert Storm (1990-1991) Total U.S. Servicemembers (Worldwide) Deployed to Gulf Battle Deaths Other Deaths (In Theater) Other Deaths in Service (Non-Theater) Non-mortal Woundings Living Veterans 5, 10

2,322,000 694,550 148 235 1,565 467 2,244,583

America’s Wars Total (1775 -1991) U.S. Military Service during Wartime Battle Deaths Other Deaths (In Theater) Other Deaths in Service (Non-Theater) Non-mortal Woundings Living War Veterans11 Living Veterans (Periods of War & Peace)

41,892,128 651,031 308,800 230,254 1,430,290 16,962,000 23,234,000

Global War on Terror (Oct 2001 - ) The Global War on Terror (GWOT), including Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), are ongoing conflicts. For the most current GWOT statistics visit the following Department of Defense Website: https://www.dmdc.osd.mil/dcas/pages/casualties.xhtml

________________________________________________________ 6. Covers the period 8/5/64 - 1/27/73 (date of cease fire) 7. Department of Defense estimate 8. Covers period 11/1/55 – 5/15/75 9. Excludes 150,341 not requiring hospital care 10. Defense Manpower Data Center (DMDC) estimate, as of 4/09, does not include those still on active duty and may include veterans who served in Iraq and Afghanistan. 11. Total will be more than sum of conflicts due to no “end date” established for Persian Gulf War. Source: Department of Defense (DOD), except living veterans, which are VA estimates as of Sep 2010.

Claims 101

by Bryan Hult, Bonner County Veterans Service Officer

ecently a veteran said, “Claims should be simple!” Sometimes they are. Other times a claim to the Veterans Administration (VA) is not only difficult, but is often intimidating! I enjoy helping veterans make disability claims to the VA. As a Veterans Service Officer (VSO), I’m an “advocate of veterans to the VA.” I believe the VA “intends” to make the process simple, but that is not always the case. Fortunately there is hope! Every claim for disability compensation is based on three things: a current chronic condition, a situation or event during a veteran’s military service and a link between the service and the current condition. The first factor is a current chronic condition. Let’s say you have a condition, such as Diabetes Mellitus type II, or Peripheral Neuropathy of the lower extremities (numbness in the feet or sometimes tingling). The best way to ensure verification of the condition is to have your doctor make a written diagnosis. While the condition is very real to the veteran, the VA works off objective evidence, not subjective claims. Hence, you need a written diagnosis from an expert in the medical field, such as an Endocrinologist, or Neurologist, in the above examples. So, the first requirement is a current condition that is chronic (persistent) rather than acute (sudden or short duration). The second factor required for every claim is that there must be a situation or event during military service that “triggered” or aggravated a health condition. Exposure to Agent Orange, acoustical trauma (noise exposure) from combat as an infantryman, or Traumatic Brain Injury (TBI) from an Improvised Explosive Device (IED) are all examples of situations that “trigger” chronic conditions either immediately or manifested later in life. These triggers can be verified by orders or noted on the DD 214, Military Occupation Specialty (MOS) and deployment on the battlefield, or written in service medical records (SMRs) substantiating treatment for a concussion, in the above examples. There must be situation that occurred while on active duty. The third factor is a link between the two above items. The link can be established in a number of ways. For example, Diabetes Mellitus type II (DM2) is “presumed” to have come from exposure to Agent Orange. DM2 is one of over twenty presumptive conditions related to Agent Orange. The link for noise exposure is confirmed by a good write up in the claim,

the military occupational specialty and military conditions that cause acoustical trauma. The link for TBI is the note in military records that records the IED (or otherwise) event and the accurate diagnosis of the brain concussion by a qualified medical person. Without a good link, the claim will be denied. This link is just as important, if not more, than the other two factors. Let me explain. I provide a six page handout on the “Nexus Letter.” The word “nexus” can mean many things in different contexts. In this context it means the “link” between the military trigger and the current chronic condition. The handout explains how there must be irrefutable evidence for a disability claim. A nexus letter must be brief, written by a medical expert (e.g. oncologist for cancer related conditions) and the doctor must have reviewed all available and pertinent service medical records. The doctor does not have to use absolutes or that the “trigger” caused the current condition. He/She must, however, record his/her opinion of whether the condition is “more likely than not” (probability greater than 50%) or “at least as likely as not” (probability of 50%). This is a broad brush summary of the three essential ingredients for making a claim and the possible need for a Nexus Letter. There are many exceptions to a simple claim that can make the process frustrating, but there is hope. Give me a call and I’ll be happy to walk through the details of your claim. __________________________________________________________________

Bryan Hult is the Bonner County Veterans Services Officer. He enlisted in the infantry, graduated from Officer Candidate School and Jump School from Fort Benning, Georgia and Flight School from Fort Rucker, Alabama. He then flew helicopters at Fort Hood, Texas. His military education included the Army War College in Carlisle, PA. After seminary, he served at every level of the Army chaplaincy in the Indiana National Guard and retired in 2010 as the Assistant Chief of Chaplains.

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Senior Meal Sites Seniors are offered a nutritious hot meal at these locations for minimal donation. Those â&#x20AC;&#x153;younger folksâ&#x20AC;? are welcome too and only asked to pay a very reasonable cost to join them. Cottonwood Community Church 510 Gilmore Cottonwood, ID 83522 208-962-7762 Meals served at noon on Tuesday.

Orofino Senior Center 930 Michigan Ave. Orofino, ID 83544 208-476-4328 Meals served at noon on Tuesday and Friday.

Grangeville Senior Center 108 N. State Street Grangeville, ID 83530 208-983-2033 Meals served at noon on Monday and Friday.

Potlatch Senior Citizens IOOF/Rebekah Hall on Pine St. Potlatch, ID 83855 208-875-1071 Meals served at noon on Tuesday and Friday.

Kamiah Senior Center 125 N Maple St. Kamiah, ID 83536 208-935-0244 Meals served at noon on Monday, Wednesday and Friday.

Riggins Odd Fellows Building 121 S Lodge St. Riggins, ID 83549 208-628-4147 Meals served at noon on Tuesday.

Kendrick Senior Citizens Center 104 S Sixth Kendrick, ID 83537 208-289-5031 Meals served at noon on Wednesday and Friday. Lewiston Community Center 1424 Main St. Lewiston, ID 83501 208-743-6983 Meals served at noon on Monday, Tuesday and Wednesday. Orchards United Methodist Church 1213 Burrell Ave. Lewiston, ID 83501 208-743-9201 Meals served at noon on Monday, Tuesday and Wednesday. Moscow Senior/Community Center 412 3rd St. Moscow, ID 83843 208-882-1562 Meals served at noon on Tuesday and Thursday. Nezperce Senior Citizens 501 Cedar St. Nezperce, ID 83543 208-937-2465 Meals served at noon on Monday and Thursday.

Wise Guide | Fall 2017 / Winter 2018

Weippe Hilltop Sr. Citizens Center 115 1st Street West Weippe, ID 83553 208-435-4553 Meals served at noon on Monday and Thursday. Winchester Senior Citizens Center 413 Nezperce St. Winchester, ID 83555 208-924-6581 Meals served at noon on Wednesday.

Need a Ramp for Accessibility?

he Disability Action Center (DAC NW) in Moscow & Post Falls can help! A variety of access ramps have been purchased and are available throughout northern Idaho at no cost to the recipients. For some of these recipients, it means everything to be able to stay in their own home. Other ramps have been used to make public events accessible. For the Lloyd Home Dedication held on April 30th in Moscow, a ramp was set up so everyone could have access to see the home. “It worked wonderfully!” said a Palouse Habitat for Humanity Representative, “We had several individuals attend who had limited mobility, another who was in a wheelchair, and a family with children in strollers -- and they all made good use of the ramp.” Another ramp was installed at a home in Clarkston, Washington. The resident there is a chair user but steps to the front door prevented him from living there. Volunteers delivered and set up a new ramp that he will be able to use indefinitely. In September 2016, Disability Action Center NW received a $17,500.00 grant from the Christopher & Dana Reeve Foundation for providing access to ramps. This grant provided funds to purchase a variety of modular aluminum ramp systems that are designed to address different needs. These are deployed to community members on a short- or long-term loan basis, with volunteer labor from community service organizations. The grant also paid for transportation costs and for a new trailer to move the ramps to different locations. “We ran into road blocks with our volunteers finding the use of a large enough pickup to move the ramps when needed,” said program manager Mellowdee Brooks of DAC NW. “Now it’s as easy as loading the sections on the low deck of the trailer, hooking up and off they go.” The Christopher & Dana Reeve foundation have been supporting this program since September 2016. Some of these ramps are still waiting for a new assignment. People who need a ramp and can’t afford it can contact the Disability Action Center at 208-883-0523 to find out more. To learn about DAC, visit our website at dacnw.org

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Directory Listings Agencies, Free Referral Services & Volunteer Opportunities AARP Idaho.................................................................... 208-855-4004 3080 E. Gentry Way, Ste. 100, Meridian, ID facebook.com/AARPIdaho AARP Idaho is a nonprofit, nonpartisan organization, with a membership of more than 175,000 in Idaho that serves as a voice and an advocate to protect consumers and improve the lives of Idahoans age 50 and over. Aging and Disability Resource Center/ N. Central Idaho Area Agency on Aging........................ 208-746-3351 124 New 6th St., Lewiston, ID cap4action.org/PSAgencyOnAging Providing information and assistance for people of all ages, incomes and disabilities enabling them to plan for present and future longterm care needs. Assisting older Americans and their families in making informed decisions and choices about life. Aging & Long Term Care................................................ 509-758-2355 744 5th, Clarkston, WA Providing Family Caregiver Support Services and Senior Information & Assistance. Our Assistance and Case Management services and information are free to the public. Alzheimerâ&#x20AC;&#x2122;s Association, Washington State Chapter Serving Washington & North Idaho.....................208-666-2996x8314 alz.org/inlandnorthwest P.J.Christo, RN; email: pj.christo@alz.org 24-Hour Help line.......................................................... 800-272-3900 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. Board of Community Guardian.................................... 208-750-2080 Nez Perce County, Lewiston, ID We are a last resort for anyone (often with dementia or debilitation) without family or friends to care for them. If you know of anyone like this, or would care to serve as a guardian or conservator, please call Stephanie at 208-750-2080.

Disability Action Center NW 330 5th St., Lewiston, ID............................................... 208-746-9033 505 N. Main St., Moscow, ID......................................... 208-883-0523 dacnw.org DAC NW is the local Center for Independent Living which offers a variety of services from peer-to-peer independent living support, medical equipment exchange, help with self-advocacy, and access to assistive technology. 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, Alzheimerâ&#x20AC;&#x2122;s Resource Directory. Call toll free during regular business hours for your FREE copy or visit our Web site.

Entertainment & Recreation 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, ID and play on many models of the most stable and comfortable bikes and trikes in the world. Call for appointments.

Gifts & Shopping Owl Pharmacies/Hallmark Gold Crown Stores 720 16th Ave., Lewiston, ID........................................... 208-743-5528 1275 Highland, Clarkston, WA...................................... 509-758-5533 owlpharmacies.com We carry Hallmark Gold Crown Cards and Keepsake Ornaments at both locations. Offering a wide array of hard to find Fine Gifts and Fashion Accessories. Stop in today and see what we have to offer.

Hearing & Vision Hearing Aid Source........................................................ 509-751-9440 721 6th St., Clarkston, WA 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. Each new digital hearing aid comes with a 30-day trial program, 3 year warranties and 3 years free batteries. Appointments on Tuesdays - call to schedule today!

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 40

Wise Guide | Fall 2017 / Winter 2018

Idaho Commission for the Blind & Visually Impaired............ 208-799-5009 1118 F St., Lewiston, ID gworthington@icbvi.idaho.gov ICBVI is a state agency that provides free independent living training and offers adaptive aids, such as magnifiers and talking devices, to help individuals who are struggling with vision loss to be more independent in their homes and the community.

Lilac Blind....................................................................... 509-328-9116 1212 N. Howard St., Spokane, WA lilacblind.org Lilac Services for the Blind provides individualized training in alternative techniques and strategies, adaptive aids and optical devices, and continuing support to help individuals maintain independence and safety at home and in their communities. Serving Eastern and North Central Washington.

Good Samaritan, Moscow Village................................. 208-882-6560 640 N. Eisenhower, Moscow, ID • good-sam.com/moscow A continuum of care community that provides post-acute rehabilitative and long-term skilled nursing care including a memory care unit. Also offers assisted living apartments and independent living apartments & duplexes, all located on 22 beautifully landscaped acres in northern Idaho, nestled between Moscow Mountain and the rolling hills of the Palouse.

Hospice

Guardian Angel Homes ................................................ 208-743-6500 2421 Vineyard Ave., Lewiston, ID guardianangelhomes.com Providing Independent & Assisted Living, Alzheimer’s & Dementia special care and Respite Services. Assistance with all aspects of daily living and a full-time nurse on duty. Pets are welcome. Family, dignity, independence, and choice are not simply words; they are a way of life.

Friends of Hospice......................................................... 509-332-4414 Gladish Community Center 115 NW State St., Ste. 117, Pullman, WA friendsofhospice.net Offering a wide range of services to ease suffering at the end of life. Willow Center Lewiston/Clarkston ........................................................208-791-7192 Moscow/Pullman........................................................... 208-669-0730 willow-center.org Making a profound difference in the lives of grieving children by helping assist them with hope and healing. Offering a unique program of peer support to assist children, teens & families after the death of someone close.

Hospitals & Medical Care North Idaho Advanced Care Hospital........................... 208-262-2800 600 N. Cecil, Post Falls, ID 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. Tri-State Memorial Hospital & Medical Campus .......... 509-758-5511 1221 Highland Ave., Clarkston, WA • tristatehospital.org Tri-State Memorial Hospital & Medical Campus is committed to caring for you with the latest in medical technology and techniques, yet true healing takes place when expert medical care is combined with a smile, a caring touch, a kind word.

Independent Living, Assisted Living, Memory Care & Respite Care Brookdale....................................................................... 208-746-8676 2975 Juniper Dr., Lewiston, ID • brookdale.com Offering seniors the independence of a private home plus the type of supportive aid they need with daily tasks. Residents live as members of a family of friends in resort-style comfort with personalized care. Good Samaritan, Fairview Village Estates..................... 208-882-6560 403 Samaritan Lane, Moscow • good-sam.com/moscow Independent Living, part of the Good Samaritan Society Moscow, offers modern one & two bedroom apartments and duplexes for independent seniors. You can be part of the Good Samaritan network and transition to our Moscow Village Campus as needs change.

Royal Plaza Retirement & Rehabilitation Center.......... 208-746-2800 2870 Juniper Dr., Lewiston royalplazaretirement.com royalplazahealthandrehab.com Our mission at Royal Plaza Retirement and Rehabilitation Center is to assist each resident in reaching his or her desired potential. That’s our: Commitment to Caring. Wedgewood Terrace Assisted Living & Memory Care......................................................... 208-743-4545 2114 Vineyard Ave., Lewiston tmielke@provident.org We provide social, spiritual, health and nutritional needs in a positive supportive, loving environment tailored to the needs of each individual. Offering assisted living apartments, secure dementia and Alzheimer’s special care, as well as adult daycare and respite/ temporary care.

In-Home Health & Personal Care Addus Health Care......................................................... 208-746-8881 1037-A 21st St., Lewiston 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 costeffective services are designed to improve health and well-being and make your choice easier to remain independent at home.

Long-Term, Skilled Nursing & Restorative/ Rehabilitative Care Avalon Care Center ....................................................... 509-332-1566 1310 NW Deane St., Pullman, WA avalonhealthcare.com We are a premier provider for post acute care and rehabilitation services with 24-hour nursing, wound care, therapy services, family support services, comprehensive restorative programming, and discharge planning. Our individual approach to care puts residents and their choices first.

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Directory Listings Good Samaritan, Moscow Village................................. 208-882-6560 640 N. Eisenhower, Moscow, ID good-sam.com/moscow A continuum of care community that provides post-acute rehabilitative and long-term skilled nursing care including a memory care unit. Also offers assisted living apartments and independent living apartments & duplexes, all located on 22 beautifully landscaped acres in northern Idaho, nestled between Moscow Mountain and the rolling hills of the Palouse. Life Care Center of Lewiston......................................... 208-798-8500 325 Warner Dr., Lewiston, ID LCCA.com Life Care Centers of North Idaho specialize in long term care, special needs and dementia care, post-operative and acute illness restorative nursing and therapy, 24/7 admissions. Full-time on-site physician. Respite stay is also available. Semi-private and private rooms. Schedule your tour today! Rehabilitation Hospital of the Northwest .................... 208-262-8700 3372 E. Jenalan Ave., Post Falls, ID rhn.ernesthealth.com We provide intensive physical rehabilitation services to patients recovering from strokes, brain, spinal cord and orthopedic injuries and other impairments as a result of injuries or illness. Also treated are cerebral palsy, ALS (Lou Gehrig’s Disease) multiple sclerosis & Parkinson’s disease.

Pharmacies, Medical Equipment, Safety & Supplies Owl Pharmacies: Owl Southway & Owl Uniforms.................................... 208-743-5528 720 16th Ave., Lewiston, ID theowlpharmacies.com Full Service Pharmacy, over-the-counter medications, and Hallmark Gold Crown cards and keepsake ornaments, fine gifts & fashion accessories. Our lower level offers medical uniforms, scrubs, nursing shoes, accessories with brands such as Dickies, Cherokee, Koi, Dansko and much more. Owl Tri-State.................................................................. 509-758-5533 1275 Highland, Clarkston, WA theowlpharmacies.com Full Service and Compounding Pharmacy. We are also a Hallmark Gold Crown store with cards and keepsake ornaments to a wide array of hard to find fine gifts and fashion accessories. Stop in today and see what we have to offer! Owl Home Medical........................................................ 208-743-7766 720 16th Ave., Lewiston, ID theowlpharmacies.com Carrying a full line of home medical products. Rentals &/or sales of scooters, power chairs, walkers, lift chairs, etc. We also carry Amoena post-mastectomy produ

Legal Idaho Legal Aid Services ............................................... 208-743-1556 633 Main St., Ste 103, Lewiston, ID Idaho Legal Aid has attorneys available to assist you at NO COST if you qualify. Call us to determine if you are eligible and schedule an appointment with an attorney in person, or by phone.

Choose a Nationally Recognized Hospital – It Matters! Rehabilitation Hospital of the Northwest is ranked in the U.S. in the Top 10% for patient care. And, we’ve earned The Joint Commission’s Gold Seal of Approval.

3372 East Jenalan Ave • Post Falls ID 83854 • 208.262.8700

Wise Guide | Fall 2017 / Winter 2018

RHN.ERNESTHEALTH.COM

effective communication effective communication strategies strategies for dementia caregivers

an education program by the alzheimer’s association Communication is more than just talking and listening – it’s also about sending and receiving messages through attitude, tone of voice, facial expressions and body language. As people with Alzheimer’s disease and other dementias progress in their journey and the ability to use words is lost, families need new ways to connect. Join us to explore how communication takes place when someone has Alzheimer’s, learn to decode the verbal and behavioral messages delivered by someone with dementia, and identify strategies to help you connect and communicate at each stage of the disease.

Thursday, Nov. 16, 2017 1 to 3 p.m.

Friday, Nov. 17, 2017 10 a.m. to 12 noon

Area Agency on Aging Community Action Partnership Conference Room 124 New 6th St., Lewiston, ID 83501

Gritman Medical Center Conference Room 700 S. Main St. Moscow, ID 83843

DSHS-approved Continuing Education Hours (CEs) are available upon request. There is a $20 processing fee for 2 CEs. For free in-home respite during either presentation, call Stephanie Bodden at 208.743.5580

This program is presented without charge by the Alzheimer’s Association and is open to the public. No reservations necessary. For more information, call 208.666.2996.

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From Hope to a Cure Provided by the Alzheimer’s Association

hen people are asked “What gives you hope in the face of Alzheimer’s?” their answer is always the same: “A cure, of course!” For caregivers, people living with memory loss and those who have lost loved ones to dementia, research is the beacon of hope they can all reach to even when current advancements won’t change their fate. This is not to say that services and support to people living with dementia now aren’t just as important. The growing need for support is paramount to our mission at the Alzheimer’s Association and those caring for and living with dementia. However, what people affected by Alzheimer’s and dementia really want to see is the end of this disease. Research is complicated, and the science is just the beginning. Research depends on a collaborative, international community of scientists, researchers, and clinicians supported by significant private and governmental funding. We can see the culmination of these things at the Alzheimer’s Association International Conference (AAIC), the world’s largest forum for the dementia research community. International investigators, clinicians and care providers

gather to share the latest study results, theories and discoveries that bring the world closer to breakthroughs in dementia science. Research shared at AAIC comes from years of trials, countless grant applications and diverse volunteer participants to pursue promising discoveries. Despite its complexities, research is the ultimate solution we can all reach to and it’s the solution to Alzheimer’s and dementia that we can all propel forward. By supporting local researchers, scientists and institutions as volunteers in research trials our community can come together to find a cure. Over 30 individuals leading research in our community will be at AAIC lending a voice from home to crucial advancements. Research done at the University of Washington and Washington State University depend on local residents living with dementia and healthy individuals alike to participate in studies and advance the international communities’ understanding of the disease. Research volunteers are

Brian advances research so that someday his daughter (above) can benefit from a cure.

Wise Guide | Fall 2017 / Winter 2018

As a healthy control subject, Ann visits the University of Washington Alzheimer’s Disease Research Center once a year for tests including basic check-ups and memory tests. empowered by the experience. Brian Whitney of Manson, Washington, has attended AAIC as a volunteer and participant in the DIAN-TU, Dominantly Inherited Alzheimer’s Network Trial. Brian qualifies for the DIAN-TU study because he carries a rare deterministic gene mutation that will someday

“What we could never give her was our sorrow and rage about Alzheimer’s” said Ann, “so what could we do with those emotions? One answer I found: volunteer for research.” Research helps people like Ann be a part of the most significant solution we can find to the pain dementia causes people; a cure.

develop into Alzheimer’s disease. For Brian and his family, this research means hope, “It’s the first time that they’ve ever looked at a drug and tried treatment on people before they showed symptoms of Alzheimer’s. That’s exciting to me. To me that’s a reason to hope,” said Brian. Seattle writer Ann Hedreen advances research as a healthy research participant. Unlike Brain, Ann isn’t currently showing

signs or symptoms of dementia but still shares Brian’s hope for a cure. When Ann’s mother was diagnosed with younger onset Alzheimer’s she and her siblings were able to spend time with their mother, give her the joy of grandchildren and provide simple pleasures for her throughout the disease. But there was still a frustration with how little they could do to help treat her disease. “What we could never give her was our sorrow and rage about Alzheimer’s” said Ann, “so what could we do with those emotions? One answer I found: volunteer for research.” Research helps people like Ann be a part of the most significant solution we can find to the pain dementia causes people; a cure. Because people like Ann, Brian and others like them support research, the research community in Washington and Northern Idaho is strong, and growing. But it needs more help and support to continue to advance toward treatments. Today, at least 50,000 volunteers with and without Alzheimer’s disease are urgently needed to participate in more than 130 trials actively enrolling participants. You can join them. Don’t just hope for a cure. Help us find one. Learn more about research trials in your area through the Alzheimer’s Association TrialMatch program today: alz.org/trialmatch and call 800-272-3900.

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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

TELEPHONE

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 208-769-9560

ONLINE

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) 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 x8314

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

Wise Guide | Fall 2017 / Winter 2018

24/7 HELPLINE: 800-272-3900

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 x8314 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 Whitworth Presbyterian Church 312 N. Hawthorne Road 2nd Mondays @ 1:00 - 2:30 PM Facilitator: Christine Ambrose, RN 509-456-0456 x8313 Providence Adult Day Health 6018 N. Astor St. (not affiliated with Alzheimer’s Assn.) 1:00 - 2:30 PM 2nd Mondays - Designed for All Caregivers 3rd Mondays - Male Caregivers Only 4th Mondays - Female Caregivers Only Facilitators: Oscar Haunt, MSW & Hannah Teachman Adult daycare available at no charge if pre-arranged 509-590-3965

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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