Thursday, November 23, 2017

Companion of 21 years

This week we had our cat, Junior, put down. 

It was very heart breaking to make the decision; it was time for him to crossover. Although we have been expecting this for some time when the time arrived, we were not ready. It was so sudden that our goodbyes had to be short. It has been an emotional roller coaster and our family has run the gamut of emotions. From heart break to guilt to anger and depression and then back through the list again. 

Junior was the kitten of our cat Mom. She gave birth to him 21 years ago. All our family life we have had cats in our home. These past 26 years we lived with five cats. All of them lived to be over 21. Each one we helped to crossover to the other side. One died 25 years ago and the other four died within the last two years. About every six months, we went through the emotional gamut again. Junior is the final cat to leave us and our home feels empty.

We decided not to take in any more companions. We are shattered. Our hearts are broken. Looking back, we cannot say that we regretted a single day having them underfoot with all their mischief.

 They unconditionally gave our family as much love, as we needed and then some.

However, we realize this is how life is to be. You share only a small piece of your life with someone and then it is gone. We carry on. This holds true to all relationships. Eventually our hearts will heal and our memories will be full of love.  

Take the time now to share your love with your companions and let them know it repeatedly. Life is too short.

Thursday, June 9, 2016

Don’t Be Afraid to Be a Difficult Patient | World of Psychology

Don’t Be Afraid to Be a Difficult Patient | World of Psychology: One of my favorite Seinfeld episodes is the one where Elaine snoops inside her medical chart and reads “patient is difficult.” The doctor takes a look at her rash and says, “Well, this doesn’t look serious,” and writes something in the chart. “What are you writing?” she asks. He sneers and walks out the door. Wanting a fresh start, she goes to see another doctor, and realizes her chart follows her there. The new doctor greets her warmly until he reads the comments. He glances at her arm and says impatiently, “This doesn’t look serious.” “But it really itches,” she complains. He writes something else down in the chart and walks out. So Kramer, disguised as Dr. van Nostrum, tries to steal the chart, telling the medical office that Elaine is dying. They don’t buy it and begin a chart on him. Personally, I think my chart must be atrocious by now. But oddly enough, I don’t care. I spent the first 42 years of my life trying to be the perfect, low-maintenance patient, placing all my trust in

Unpaid, stressed, and confused: patients are the health care system's free labor - Vox

Unpaid, stressed, and confused: patients are the health care system's free labor - Vox

Wednesday, March 18, 2015

Caregivers Sanity

Caregivers have a large impact on the health of the elderly they care for and the eventual outcome of the care. Caring for our loved ones can be overwhelming, as it becomes such an integral part of our focus. We feel exhausted and sometimes resentful when it begins to take over our lives. When caregivers stress over their loved one’s care, it puts pressure on their own health.
We forget to take time for ourselves to decompress. Maintaining your health and sanity is essential to moving forward. Slow down and partake in something rare as a caregiver… in the moment.
Take a break and spend a day just for you. Relax, take in a movie, or find a local coffee house to sit and sip your favorite cup of coffee or tea and read a magazine or your favorite book. Using other family members or friends, helps reduce stress. You cannot do this alone and you need to ask for help. Remember, it is important to connect with others via support groups, online conversations, newsletters, blogs, and family groups’ events. You are not alone.

If you know a caregiver, offering an outlet to caregivers to express themselves is productive for both the caregiver and the elder. They need liberation from the daily pressures. Having the support and understanding to help with the daily stress that come with this new role is important in keeping one’s sanity.

Monday, February 23, 2015

Colorado Advance Directives - Living Will Example

Colorado Advance Directives - Living Will Example


I________________________________, being of sound mind and at least eighteen years of age, (Name of Declarant)
direct that my life shall not be artificially prolonged under the circumstances set forth below and hereby declare that:

1. If at any time my attending physician and one other physician certify in writing that:

a. I have an injury, disease or illness which is not curable or reversible and which, in their judgment, is a terminal condition; and

b. For a period of _________ consecutive days or more, I have been unconscious, comatose or otherwise incompetent so as to be unable to make or communicate responsible decisions concerning my person; then I direct that, in accordance with Colorado law, life-sustaining procedures shall be withdrawn and withheld pursuant to the terms of this declaration; it being understood that life-sustaining procedures shall not include any medical procedure or intervention for nourishment considered necessary by the attending physician to proved comfort or alleviate pain. However, I may specifically direct, in accordance with Colorado law, that artificial nourishment be withdrawn or withheld pursuant to the terms of this declaration.

2. In the event that the only procedure I am being provided is artificial nourishment, I direct that one of the following actions be taken:

_______(initials of declarant) a. Artificial nourishment shall not be continued when it is the only procedure being provided; or

_______(initials of declarant) b. Artificial nourishment shall be continued for_____days when it is the only procedure being provided; or

_______(initials of declarant) c. Artificial nourishment shall be continued when it is the only procedure being provided.

3. I execute this declaration as my free and voluntary act this______day of this month __________, in this year of________.

The foregoing instrument was signed and declared by____________________to be his/her declaration, in the presence of us, who, in his/her presence, in the presence of each other, and at his/her request, have signed our names below as witnesses, and we declare that, at the time of the execution of this instrument, the declarant, according to our best knowledge and belief, was of sound mind and under no constraint or undue influence. We further declare that neither of us is : 1) a physician; 2) the declarant’s physician or an employee of his/her physician; 3)an employee or a patient of the health care facility in which the declarant is a patient; or 4) a beneficiary or creditor of the estate of the declarant.

Dated at_______________, Colorado, this______ day of ___________, in the year_______.

_______________________________________ ______________________________________
(Signature of Witness) (Signature of Witness)

Address:_______________________________ Address:________________________________
______________________________________ _______________________________________


STATE OF COLORADO, County of ___________________________
Subscribed and sworn to or affirmed before me by ____________________, the declarant, and _____________________ , and ______________________________, witnesses, as the voluntary act and deed of the declarant, this ______________ day of __________________, in the year ___________.

My commission expires: ___________________________________________
Notary Public

In Summary
• Federal law directs that any time you are admitted to any health care facility, or served by certain organizations that receive Medicare of Medicaid money, you must be told about Colorado’s laws concerning your right to make health care decisions.
• Upon admission, you must be given information about advance directives.
• Although you have the right to make an advance directive, you cannot be required to have or make an advance directive in order to be admitted to a health care facility or to receive treatment or care.
• Talk to your doctor about medical conditions which might make advance directives useful.
• Talk with your health care providers about your wishes and beliefs. Make sure that copies of your advance directives are included in your medical records. It is your responsibility to provide these copies to your health care providers.
• You must be given written information about your health care providers’ policies and procedures regarding your advance directives. Be sure to discuss whether your directive swill be honored. If you determine their policies are not consistent with your advance directives, you may wish to transfer to another facility or provider.
• If you do not want your family and closer friends to select a substitute decision maker (proxy) to make medical decisions for you, you should have an advance medical directive such as a medical durable power of attorney in which you name the person who will make decisions for you.
• You do not need to use a lawyer to complete your living will, medical durable power of attorney, or CPR Directive. If you have legal questions, however, you may wish to talk to a lawyer.
• If you have a living will, medical durable power of attorney, or CPR Directive, give a copy of it to your doctor, your family, your agent, if applicable, and to your health care facility. Talk with your doctor, family, and agent, if applicable, while you’re still in good health, so they will understand what you want.
• If you have completed a CPR Directive, be sure it is readily available at all times.
• Ordinarily, it is not advisable to have both a living will and a medical durable power of attorney, as long as your medical durable power of attorney contains any instructions you wish to give about your future medical treatment, including treatment when you are terminally ill.

Palliative and Hospice Care: the benefit of end of life care

Although I wrote this years ago, it still is significant today.
Effective end-of-life care includes both palliative and hospice care. The term palliative care is a broad concept, since it includes the management of the physical, psychological, social, spiritual, and existential needs of individuals with advanced disease without reference to a specified life expectancy of the patient. Palliative care is focused on treatment of conditions that are life limiting or refractory to disease-modifying treatment. The term hospice care usually refers to a special type of comprehensive palliative care provided during the last 6 months of life, and is often linked to the specific programs offered under the Medicare hospice benefit. Both palliative care and hospice emphasize the importance of addressing the needs of both these persons and their families (National Hospice Organization Standard and Accreditation Committee, 1997, Task Force on Palliative Care, 1998). This holistic approach to care required by hospice and palliative care, which recognizes the complex and multidimensional needs of patients and families, calls for an interdisciplinary team. Team members typically include nurses, physicians, and social workers, though others may be present, including psychologists, chaplains, pharmacists, dietitians, occupational or physical therapists, and volunteers. Conditions for which hospice and palliative care are appropriate include cancer, AIDS, congestive heart failure, chronic obstructive pulmonary disease, end-stage organ disease, and dementia and other progressive neurological diseases. The goal of hospice and palliative care is to achieve the best possible quality of life for patients and their families. This goal is achieved through relief of suffering, pain and symptom management, psychosocial support, optimization of functional capacity, and respect for autonomy and the appropriate role of family and legal surrogates. While palliative care does not require the exclusion of all aggressive or curative therapies, hospice patients typically must agree to fore go aggressive or curative treatments (though some interventions may be performed to maximize quality of life, such as blood transfusions to maintain energy level in leukemia patients). Specific goals of hospice include self-determined life closure, safe and comfortable dying, and effective grieving (National Hospice Organization Standard and Accreditation Committee, 1997).

Saturday, June 1, 2013

Question 3

What do you do to support your emotional and physical well being?

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Friday, May 10, 2013

Question Two

Do you know what resources are available to you and your family as a caregiver? Are you familiar with how and where to find the different resources needed? 

Tuesday, May 7, 2013

Caregivers Frustrations Question One

I will have a series of questions I am pondering for an upcoming article. I appreciate all feedback whether you have direct or indirect contact with caring for an elderly member of the family or someone you know. Please help me with this.

question one:

What was or is the most frustrating part of working with the healthcare system in providing care for your elderly person? 

Saturday, April 27, 2013

I say goodbye to a good friend and neighbor

Just recently I had an elderly friend pass away. As an outsider, I had the opportunity to witness the best of a family pulling together with their love to honor their dad, grandpa, uncle, and friend to everyone he knew. From the beginning this family had all their eggs in a row. How impressed I was with the willingness to work together and make sure there was always someone available to help with his needs. The meaning of caregiver and advocate was never more evident than with the actions of this family. My friend never had to worry for anything. The family took care of his medical appointments, hiring professional staff as needed, monitoring and keeping up with his health issues. They gave him reassurance, love and patience to make sure his final years were peaceful, filled with family and friends.  I commend this family for their untiring love. I say goodbye to a good friend.