The other day I received an e-mail in honor of Mother’s Day that really spoke to me about the relationship between an aging mother and her daughter. It touches on many issues that our Homecare Advocate readers deal with as caregivers for an elderly person, and I wanted to share it with you.
Letter from a Mother to a Daughter:
“My dear girl, the day you see I’m getting old, I ask you to please be patient, but most of all, try to understand what I’m going through. If when we talk, I repeat the same thing a thousand times, don’t interrupt to say: “You said the same thing a minute ago”… Just listen, please. Try to remember the times when you were little and I would read the same story night after night until you would fall asleep. When I don’t want to take a bath, don’t be mad and don’t embarrass me. Remember when I had to run after you making excuses and trying to get you to take a shower when you were just a girl? When you see how ignorant I am when it comes to new technology, give me the time to learn and don’t look at me that way… remember, honey, I patiently taught you how to do many things like eating appropriately, getting dressed, combing your hair and dealing with life’s issues every day… the day you see I’m getting old, I ask you to please be patient, but most of all, try to understand what I’m going through. If I occasionally lose track of what we’re talking about, give me the time to remember, and if I can’t, don’t be nervous, impatient or arrogant. Just know in your heart that the most important thing for me is to be with you. And when my old, tired legs don’t let me move as quickly as before, give me your hand the same way that I offered mine to you when you first walked. When those days come, don’t feel sad… just be with me, and understand me while I get to the end of my life with love. I’ll cherish and thank you for the gift of time and joy we shared. With a big smile and the huge love I’ve always had for you, I just want to say, I love you… my darling daughter. “
If your mom is still here, be with her. Love her. Show her that you care. If your mom has already passed, look with fondness on the good times you shared, the lessons she taught, and all of the ways she helped you become the person you are.
We wish you all a very happy Mother’s Day.
::AWP::
PS. In the big world of social media and e-mail forwards, it’s hard to find the original source. To the best of my knowledge, it was originally submitted by Spring in the Air.
I’m back! I took a brief break from blogging to celebrate my sister getting married this past week; it’s good to be back in the blogosphere with our Homecare Advocate readers!
Those of us in the Tennessee Valley have a special appreciation for Earth Day as we are nestled at the base of the Smoky Mountains with access to lakes, rivers, and beautiful blooms. Some seniors fear that their instability or weakened endurance may prevent them from experiencing the great outdoors, so Homecare Advocate is bringing you senior-friendly nature spots you should definitely check out!
Here are ourTop 10 Senior-Friendly Nature Spots in and around Knoxvillethat you can enjoy this weekend, compliments of Mother Earth & her helpers who preserve its beauty.
10. Norris Lake
With over 700 miles of shoreline, Norris Lake is one of the cleanest lakes in North America and is run by the Tennessee Valley Authority. This massive reservoir was established in 1936 and crosses into 5 counties. Explore the lake via boat from one of the well-kept marinas or by visiting one of the 59 public access sites.
9. The Cove at Concord Park
Nestled in West Knox County, The Cove offers 500 acres of outdoor activities for the entire family. Stroll along the .35 mile paved walking trail or the 8 mile nature loop, then enjoy lunch in one of the picnic areas overlooking the water. A playground, volleyballcourt, marina, fishing area, and beach for swimming are available to the public, and River Sports Outfitters offers canoe & kayak rentals on location.
8. Seven Islands Wildlife Refuge
The Seven Islands Wildlife Refuge is a 360 acre wildlife refuge located along the French Broad River in Knoxville. Known for its birdlife, the Spring is a particularly eventful time of year during migration. The refuge has a one mile paved road, hiking trails, and a boat launch for kayaks and canoes.
7) Little River Road
Perfect for a day drive, the 18 mile Little River Road offers picturesque views of the mountains, wildflowers, the creek, and waterfalls from Townsend to the Sugarlands Visitor Center. Consider pulling over at one of the 7 marked stops, such as Metcalf Bottoms for a picnic, or “The Y” for a dip in the cool, calm waters of The Little River.
6) University of Tennessee Arboretum
A short drive from Knoxville, located in neighboring Oak Ridge, Tennessee is the 250 acre University of Tennessee Arboretum. Miles of walking trails enable you to enjoy the over 800 species of plants and trees grown at the Arboretum for educational purposes.
5) Dogwood Trails
Over 60 miles of dogwood trees and flora await you along the many Dogwood Trails in Knoxville. These paved trails are often in established neighborhoods and along beautiful roadways and are accessible via vehicle, foot, or bicycle. Visit the Dogwood TrailsWeb site for addresses of residential open gardens open from 10am-5pm daily and a listing of public gardens throughout Knox County.
4) University of Tennessee Gardens
Conveniently located off of Neyland Drive by the Tennessee River are the well-kept University of Tennessee Gardens. Over 1,400 species of plants grow here throughout the year, serving as an educational tool on pants appropriate for our climate and how to landscape accordingly. In addition to the beautiful flowers and plant life, the University also hosts events here open to the public throughout the year.
3) Knoxville Botanical Garden & Arboretum
This historic garden was originally established in the 1700s as Howell Nurseries and offers 44 acres of walking trails, gardens, unique stone walls, and more. The Knoxville Botanical Garden is maintained by the City of Knoxville and is open year-round for the public. My sister held her wedding here, and the blooms were absolutely stunning last week. One note of caution: the gardens are not fully handicapped-accessible, so please be mindful of the terrain and any possible obstacles.
2) Ijams Nature Center
For fun outdoor learning, visit Ijams Nature Center adjacent to downtown Knoxville. It’s 275 acres boasts beautiful trails, meadows, gardens, and a learning center open daily to the public. In addition to the self-led outdoor nature walks, Ijams teaches “conservation and responsible environmental stewardship” and offers bi-annual native plant sales to the public.
1) Cades Cove
Located inside the Great Smoky Mountains National Park, Cades Cove is a hotspot for visitors from all over the world. Explore its 6,800 acres via the 11 mile paved loop accessible by car, bicycle, and foot. Highlights of Cades Cove include is numerous historic buildings from the 1800s and wildlife spotting (including white-tailed deer and the occasional black bear).
May you find a way to enjoy this beautiful weekend; Happy Earth Day!
::AWP::
How is the most preventable, curable cancer also the second leading cause of death of all of the cancers in the US? It’s time we had a serious talk about Colorectal Cancer (aka “colon cancer”) and put an end to the needless deaths.
Nationwide, clinicians & advocacy groups are joining together this March to raise awareness of Colorectal Cancer Month and educate you about the importance of regular screening on this often symptomless killer. The Centers for Disease Control estimates that as many as 60% of the 50,000 annual deaths could be avoided through regular screening of those aged 50 plus. The Mayo Clinic continues, “80-90% of colorectal cancer patients are restored to normal health if their cancer is detected and treated in the earliest stages.” Those are pretty good odds–IF you do your part and have regular screenings to catch it before it’s too late.
Many of our Homecare Advocate readers are caregivers and often put the needs of others before their own. Their schedule is full, their personal time is limited, and they put off going to the doctor and doing routine maintenance for their health. Especially when it’s an embarrassing procedure like a colonoscopy. However, Colorectal Cancer is a deadly, but preventable cancer that will silently sneak up on you if you aren’t proactive. Don’t wait until you have symptoms–which may never occur until it’s too late. Invest in yourself the way you invest in others. Take care of yourself like you care for your loved ones. Don’t let your responsibilities become your excuse for not doing it. Make time. You deserve it, and you owe it to yourself. It can Save. Your. Life.
Here are some commonly asked questions:
1. What is Colorectal Cancer?
Colorectal Cancer is a type of cancer that typically begins as a polyp and develops into cancer in the large intestine (colon) or rectum. Through regular screening, polyps are often discovered before they become cancerous or while the cancer is still in Stage 0. In these instances, it can be removed during a colonoscopy. For more advanced stages (I-IV), surgery may be necessary. Over 140,000 people are diagnosed with Colorectal Cancer each year in the United States.
2. What are Common Symptoms?
Unfortunately, Colorectal Cancer often develops without symptoms, which is why regular screening is so important. However, of those who do experience symptoms, they include:
A change in bowel habits (lasting more than a few days)
Blood in stool or rectal bleeding
Cramping/stomach pain/gas pains
Feeling bloated/full in stomach
Weakness & Fatigue
Decreased appetite
Losing weight when trying not to
3. Am I at a Greater Risk?
Colorectal Cancer predominantly affects people 50 or older. However, people with a personal/family history of colorectal polyps, inflammatory bowel disease, Chron’s Disease, cancer (reproductive/breast/colorectal etc) should speak with their physician about an increased risk and possible need to do screening before age 50. Also, those who have a diet high in fat, don’t exercise, drink alcohol, and/or smoke increase their risk. To date, there has not been a correlation between Irritable Bowel Syndrome and Colorectal Cancer.
4. How Do I Reduce My Risk of Colorectal Cancer?
First and foremost, get regular screenings! Starting at age 50:
The stool tests are easily administered in the doctor office or the convenience of your own home and then sent off to a lab for evaluation. The flex sig is often done at your physician’s office where a short, thin, lit tube is partially inserted into your rectum & part of your colon. The colonoscoy, like the flex sig, uses a thin lit tube, but it checks the rectum and entire colon.
Moderate exercise, and a healthy diet low in red meat and fat while high in fiber are shown to help prevent Colorectal Cancer. Also, smoking increases the risk of cancer by up to 40%, so smokers should quit.
5. Any Advice for a Colonoscopy?
Focus on the Why. Many say that they put off getting a colonoscopy because it is awkward and embarrassing. But developing Colorectal Cancer is a far worse alternative! Katie Couric, whose husband died of colon cancer reminds people, “Don’t die of embarrassment!“ Get screened. 95% of tumors are discovered during colonoscopies, so it is vital that you go through with it. Check with your insurance company; many plans cover Colorectal Cancer screenings. Follow your physician’s orders for the prep exactly. It is especially important to thoroughly cleanse your colon via diet and medications so that your doctor can get a clear look at the lining of your colon. Dress comfortably, wearing loose-fitting pants (or perhaps a skirt/dress) and warm socks. Have someone drive you to your appointment, as you should not drive after being sedated. After your screening, call your sibling/neighbor/friend and urge them to as well. It wasn’t that bad, right? Be the accountability buddy that could help save a life.
Watch this video interview with Katie Couric, whose husband died of Colon Cancer in the late 1990s. Since his death, she has made it a priority to educate people about the importance of screenings and remove the stigma associated with screenings. You can also learn more about her advocacy work here.
At Homecare Advocate, our calendars are full of health awareness activities, such as this month’s American Heart Month. We use these events to bring a better understanding of these issues including disease prevention, disease management, and even advocacy. As result, common diseases like breast cancer and congestive heart failure are widely known, and support is available for those dealing with them. But what about other, lesser-known diseases? Where do these people go for help?
Rare Disease Day is celebrated worldwide this Leap Day as the world focuses on these 6,800-something rare diseases that all too often go unnoticed individually but affect nearly 1 in 10 Americans collectively.
The diseases these individuals deal with are uncommon, leaving many feeling isolated. Oftentimes these rare diseases are ‘severe & chronic, disabling, incurable, difficult to manage, and psychologically damaging as people struggle with the isolation, despair, and lack of hope’ according to Europe’s rare disease organization, Eurodis. However, they share some common traits and would all benefit from additional research & development, a compassionate friend, and optimism for the future.
Perhaps you’ve had some exposure to some of these diseases through the movies, such asThe Elephant Man (Proteus syndrome), Simon Birch (Morquio syndrome), or Amélie (osteogenesis imperfecta). Or perhaps you have a direct experience with the someone whose life is impacted by a rare disease.
When these diseases are personalized, a powerful thing happens. We develop a deep empathy and connection to those afflicted and are far more likely to help. It isn’t Patient #20934823; it’s Emma. And when it’s Emma (or George, Liam, Margaret…), we care.
Carter Cline is a sweet 18-month old who this week underwent a grueling 6-8 hour surgery in the latest effort to deal with his numerous health problems from OEIS Complex. According to his parents, “O.E.I.S Complex consist of an Omphalocele (some organs in a sack on the outside of the body), Exstrophy of the bladder (bladder on the outside of the body turned inside out), Imperforated anus and a Spinal defect.”
I first learned about Carter through a friend of the family. He told us about the incredible journey Carter and his parents are on and encouraged us to read about it in the family’s blog. Though this blog is written about the trials and triumphs of this little boy, it tells a larger story of family, hope, and perseverance that all of us can relate to, no matter our obstacles. Millions of Americans on their own courageous journey with a rare disease can relate to the doctor & hospital visits, the frustrating lack of information readily available, and the determination of loving parents who will never give up on their child.
One of the great things about Rare Disease Day is that it helps us see in collective mass what may be invisible individually.
In honor of Rare Disease Day and the millions of Americans like Carter who are impacted, let’s adopt the National Institute of Health‘s focus and commitment to:
And above all, remember the person behind the disease. We’re each different in our own way and face our own struggles. But we can positively impact one other’s lives, bring joy, and give hope. Don’t miss the opportunity to connect with others bring a little sunshine into their lives.
What is better in this world than having special people who lift us up, make us laugh, comfort us when we cry, and love us through it all? These are important people indeed, and Valentine’s Day is a great opportunity to take pause to celebrate them and what they mean to us.
This Valentine’s Day, we also encourage our Homecare Advocate readers to spread their love throughout their community. Reach out to a homebound senior in your church or neighborhood. Visit or call an elderly relative, and let them know you were thinking of them.
Local charities may also provide ways for you to connect with seniors. In our home city of Knoxville, a non-profit charity Random Acts of Flowers distributes donated floral arrangements to hospice and hospital patients. The flowers, which were originally used in weddings, funerals, and more, are recycled and repurposed to “spread joy and offer comfort through random, thoughtful, botanical deliveries.” What a great way to multiply love!
We *heart* all of our readers and wish you a very Happy Valentine’s Day. We’ve selected a few classic love-songs to leave you with today. What is your favorite love song?
Chet Baker “My Funny Valentine”
Dean Martin “You’re Nobody til Somebody Loves You”
Billie Holiday “Them There Eyes”
::AWP::
“Grow old along with me, the best is yet to be” –Robert Browning
Later this week, I’ll be traveling to Washington DC to speak with our elected representatives about homecare issues. Hundreds of homecare advocates from across the country will be flying in to attend a national legislative conference that focuses on ensuring that Medicare beneficiaries have access to quality home medical equipment (HME) and services.
As many of you know from our earlier posts on Homecare Advocate, a highly controversial new program is being rolled out nationwide that will detrimentally impact Medicare beneficiaries and destroy the home medical equipment provider community. Through this program, the government will select the narrow group of companies from which you can receive your medical equipment and care based of the cheapest bid prices–not the quality of care you need or the timeliness in which you need to receive your care.
Numerous credible, independent groups have reviewed this program and all find serious and consequential problems, yet the Centers for Medicare & Medicaid Services insist on moving forward. You can read some of the independent reviews here, here, and here. Last week the Wall Street Journal called the program “idiotic and designed for failure” in the latest of a growing number of media outlets covering this controversial program. A significant majority of Americans will be impacted by the next phase rollout, including all four major cities and surrounding counties in Tennessee.
Fortunately, a sustainable, alternative program has been proposed that achieves real market savings for Medicare and taxpayers while modernizing the payment rates for medical equipment to be consistent with true market prices. This program preserves patient choice and access to quality goods and services. Aptly titled the Market Pricing Program (MPP), this program has garnered support from leading economists throughout the country and is gaining momentum on The Hill as homecare advocates contact their legislators and urge a repeal of the current anti-competitive auction program in favor of MPP. For MPP to be implemented, we need a congressional legislative fix. This requires legislators to vote for it, which will likely occur if MPP can be attached to a larger bill being voted on this year. However, your representative needs to hear from you–the constituent–so that he/she knows that this is an important issue to you that demands his/her attention.
We need your help.
While not everyone can fly to Washington to speak out, you can make a difference from home. I urge you to contact your senators and Member of Congress and ask for a replacement of the Competitive Bidding Program with the Market Pricing Program.
You may also send an e-mail via this helpful Web site that allows you to copy and paste pre-crafted talking points into your e-mail that will be sent directly to your elected officials based upon your home address. You are welcome to customize it as you see fit.
We’ll keep you updated on our progress in Washington and will give you a full report next week. Feel free to leave a comment below with how you’re joining ranks of homecare advocates dedicated to making a difference.
What’s the Snowflake Ball, you ask? It’s an evening of dancing, live music, and tasty food for a good cause. This year marks the first Silent Auction with fabulous items such as a Wii, Robert Tino prints, original artwork by local artists, and more! The Senior Companion Program is run by the Knox County Office on Aging that pairs senior volunteers with senior clients in need of personal support services and companionship. Over 80 volunteers, called Senior Companions, are currently serving 200 individuals in our county, but more are needed. Through its annual fundraiser gala, the Snowflake Ball, funds are received to “train and place additional Senior Companions with those in need”, according to Elder News & Views.
After attending last year’s ball, I can speak from personal experience on how enjoyable it was. Here are some highlights from 2011:
Not only is this a fun event, but it supports a valuable program for Knox County seniors.
The Senior Companion Program is near and dear to my heart because senior advocate and long-time friend Deisha Finley is its director. She is a compassionate champion for seniors and has grown this program into one of Knoxville’s finest services for frail and homebound seniors. Last year, the Senior Companions spent over 70,000 hours helping these individuals remain in their homes instead of having to move into an institutional setting to get the care they need. I have had the opportunity to serve on its Advisory Council for over a year now, and I am touched by the stories that flood in from clients about the impact this program has on their lives.
For Mr. and Mrs. Jones* (name changed), the services provided by the Senior Companion Program has been a lifesaver. Mrs. Jones has progressive Multiple Sclerosis and requires round-the-clock care. When the Senior Companion comes over, it allows Mr. Jones to work, run errands, and have respite. Mr. Jones indicated that without the support of this valuable service, he wouldn’t be able to keep his wife at home.
If you would like more information on the services provided by the Senior Companion Program, please call 865-524-2786. For ticket information on this year’s Snowflake Ball on Saturday, January 21, you may order tickets via phone at 865-541-4500. Tickets are only $20 each, and you will have a great time while helping a worthy cause.
Promises, promises. It’s that time of year again where we stand in front of the mirror and tell ourselves that we’re going to do things better in the new year. Eat healthy. Exercise more. Quit bad habits. However, so many abandon their well-intended resolutions less than a month out and fall back into default mode. This year, let’s be different. Let’s make meaningful pledges to ourselves and stick with it.
How? The Washington Times recently published 6 key steps to keeping your resolution:
“Make your goals realistic and attainable.”
“Set both short-term and long-term goals.”
“Identify specific steps in your plan to achieve your goal.”
“State your intentions publicly, and enlist support.”
“Plan what you will do if you slip.”
“Celebrate your successes, and surround yourself with others who are on the road to success.”
This new year, Homecare Advocate encourages you make some resolutions of your own and to map out your road to success. We’ve compiled our own Top 5 Resolutions lists for seniors and for caregivers that we hope you’ll include in your own personal pledge for 2012.
In addition to the Top 5 below, we hope you will also make involvement in civic affairs a resolution of yours. If you’re reading Homecare Advocate, odds are your life is impacted by homecare and you have a great story to tell. Our elected representatives need to hear from us and to know the importance of homecare. Every person counts, and it is an individual responsibility we each bear. Embrace the freedoms granted to us by our founding fathers to participate in the political process and help shape our futures.
TOP 5 RESOLUTIONS for SENIORS
Exercise your body and your mind. Research shows numerous physical and psychological benefits; plus, this is great preventative care.
Eat nutritious meals. This is the fuel that gets your body through the day; make it count!
Fall-proof your home. Be proactive about your living situation and make it a safer place. Read our Fall Prevention Series for more ideas.
Get your affairs in order. Gather and organize important documents such as insurance, will, financial information, auto & home.
Increase your social activities and engagement with others. Visit a senior center or religious group; connect with others and make new friends.
TOP 5 RESOLUTIONS for CAREGIVERS
Make some YOU time. You’ll find that you’re a better caregiver when you’ve had a break!
Learn to say no. Over-committing wears you thin and can lessen the quality of the help you are providing.
Ask for help–and accept it. Get assistance with the caregiving responsibilities, be it from family or a professional company.
Take care of yourself physically and emotionally. Acknowledge and address your needs instead of solely focusing on the person you care for.
Get educated about your loved one’s illness, disability, or disease.
May you each have a beautiful beginning to the coming year. See you in 2012!
::AWP::
Special thanks to Laurie Edwards-Tate for Communities at WashingtonTimes.com for her contribution to editorial content.
“The journey of 1000 miles begins with a single step.” –Lao Tzu
We have exciting news about a new demonstration project the government is doing to evaluate the benefits of home-based care! The new Acting Administrator for the Centers for Medicare & Medicaid Services (CMS), Marilyn Tavenner, has a medical background where she has seen first-hand the benefits of homecare. She is spearheading a 3-year project, called Independence at Home, where CMS can explore how timely in-home primary care can “prevent such (emergency department) visits and inpatient hospitalizations by bringing clinical expertise and mobile technology into the home when clinical instability is first developing”.
As such, CMS is looking to “assess the effects of timely, in-home primary care on health costs, quality of care, and rates of preventable hospitalizations, hospital readmissions, and (emergency department) visits.” Up to 10,000 Medicare beneficiaries will be able to receive their primary care in-home through this demonstration project.
This project will focus on Medicare’s frailest and sickest beneficiaries who are at greatest risk of complications due to a lack of access to routine primary care. These Medicare patients, who represent about 5-8% of all Medicare beneficiaries, consume approximately 50% of all Medicare health costs. The demonstration project goal will be to provide them with “timely and appropriate care” to help address issues as soon as they begin developing, keeping them healthier and at home where they prefer to be. According to CMS, participating beneficiaries will benefit through increased access to care and improved patient satisfaction.
For a Medicare patient to qualify for Independence at Home Demonstration, he/she must have the following criteria:
Entitled to receive Part A and enrolled to receive Part B of Medicare benefits (not Part C or in PACE)
Have 2 or more chronic conditions (medical conditions that last more than one year, limit what one can do, and requires ongoing medical monitoring)
Have 2 or more functional impairments that require human assistance to perform activities of daily living (bathing, dressing, transferring, walking, toileting, or eating).
Have previously had a hospitalization or use of rehab or post-acute care 12 months prior to starting the program.
If your medical provider chooses to participate in Independence at Home, you will be notified by them prior to the implementation of the project. Voluntary beneficiary participation is automatic if you elect to have home services by a participating provider. What a great opportunity to benefit from an expanded homecare program and receive all of your needed medical services from the convenience and comfort of home. Should you need to be admitted to the hospital or visit the emergency room, your participating provider will contact you to check out how you’re doing and then within 48 hours of being discharged to establish a follow-up plan of care.
This program offers a payment incentive to participating medical providers if they successfully meet certain quality measures, have 200 or more eligible Medicare patients, and comply with eligibility requirements. For example, the practice must make in-home primary care visits and use electronic health records, remote monitoring, and mobile diagnostic technology. They will be available 24/7 to implement the individualized care plans for participating patients and will comply with all state and federal privacy laws. 50 entities will be selected for this program, and once enrolled, they will remain in the program for the duration of the 3-year demonstration project.
Study after study show the benefits of homecare, including faster healing times, reduced readmissions, and higher patient satisfaction. We’re optimistic about the Independence at Home Demonstration and the credibility it will bring to homecare as a viable alternative to our current methods for providing health care. Click here to learn more about the Independence at Home Demonstration and to read CMS’ press release.
In the words of Acting Administrator Marilyn Tavenner , “This program gives new life to the old practices of house calls, but with 21st Century technology and a team approach. In my days as a practicing nurse, I saw many patients whose health improved when they were happier with their living conditions. When a critically-ill patient can remain in familiar surroundings, the benefits are many: the person retains greater control over their daily lives, families and caregiver report greater satisfaction with the care, and unnecessary hospitalizations are avoided.”
The other day I received an e-mail in honor of Mother’s Day that really spoke to me about the relationship between an aging mother and her daughter. It touches on many issues that our Homecare Advocate readers deal with as caregivers for an elderly person, and I wanted to share it with you.
