Caring@Home: Is there a way to end the pain of families having ...

http://nursejackiehickey.blogspot.com/2011/03/is-there-way-to-end-pain-of-families.html?spref=bl: "As a family caregiver, how do you prepare for the expected inevitable? Many of us have bolted up out of our beds at 3 a.m. when the phone ri..."

Is there a way to end the pain of families having to decide life or death?

As a family caregiver, how do you prepare for the expected inevitable? Many of us have bolted up out of our beds at 3 a.m. when the phone rings. Or we’ve had that sick feeling in the pit of our stomach when no one answers the phone and they are expected to be at home. No one is prepared for the call saying something has happened to your mother – “there is no answer at your mom’s house.” So how do we prepare ourselves for what we know will eventually happen? Are there things we can do or put into place now, which will help us cope with the emotionally-taxing decisions about a parent’s life or death path?

As stated in the Toronto Star’s two part series (http://www.thestar.com/living/article/957080--gravely-ill-man-s-wishes-for-life-must-be-respected-panel-finds), “in many cases, we, the ill or dying, won’t be the ones making our own final call.” There is a very grey line when it comes to the legal and ethical issues around life-saving and end-of-life measures in Canada. These agonizing decisions generally are left in the hands of distraught family members. But recently, we have seen hospital administration stepping in and making suggestive solutions. Is there a way to end the unnecessary suffering of families of having to decide life or death? Who should be making these decisions? If we prepared in advance, could this situation be easier to manage?

In Ontario, it’s responsibility of the Ministry of Health and Long-Term Care (MOHLTC) to provide health care information to the general public. But this is a challenge when it comes to end-of-life. There are no clear provincial, federal or medical protocols – these situations can often end up in a stalemate. In some cases the wishes of family members conflict with the medical judgment of the hospital administration. The MOHLTC provides some direction (http://www.health.gov.on.ca/en/ministry/), but there’s no clear-cut statement that defines, as harsh as it may sound, “when to pull the plug.”

In my opinion, talking about and planning for death or sudden illness are a must. Regardless of your age, you should plan now. A simple drive to the corner store can change lives forever. Death is not something we obviously want to plan for, but we all know it’s inevitable – death and taxes, isn’t that what they say! So why not plan? Here are some tips to get you started:

• DON’T DO IT ALONE – Arrange a family conference; bring everyone together. Discuss your true wishes in the event of an unforeseen health event that leaves you incapacitated or dead.
• GET YOUR PAPERS IN ORDER – Complete a will; assign Power of Attorney (POA) for both health and finances (e.g., mortgage, banking, investments, insurance, pensions).
• CREATE A CHECKLIST – Include regular activities, what needs to be done around the house, important personal manners, bill payment).
• CONTACT INFORMATION – Record contact information for family members and friends, trusted advisers, attorneys, accountants and financial advisers.
• PRE-PLANNED FUNERAL – Many people are pre-planning and pre-paying their funeral arrangements to make things easier for family members.
• PERSONAL INFORMATION – Indicate where personal documents, financial statements, PIN numbers and passwords are located.

End-of-life decisions for yourself, a parent or loved one shouldn’t be made without prior direction. If crisis strikes, everyone should be on the same page and ready to handle the unimaginable. Planning ahead is the best solution. We know it’s easy to talk about life plans, but discussing illness or death is a different matter. Yet by planning for the unexpected, you can make a very difficult and emotional time less stressful and be by a loved one’s side when they need you most.

Caring@Home: Three steps to Healthy Street from Disease Street

http://nursejackiehickey.blogspot.com/2011/03/three-steps-to-healthy-street-from.html?spref=bl: "Once you develop or are diagnosed with a chronic disease, it will change your life forever. According to the World Health Organization..."

Three steps to Healthy Street from Disease Street

Once you develop or are diagnosed with a chronic disease, it will change your life forever.  According to the World Health Organization (WHO), chronic diseases are diseases of long duration and generally slow progression – or in plain terms, an illness that cannot be reversed on its own and requires ongoing treatment and monitoring.

According to Statistics Canada, thirty-seven percent of Canadians aged 40 to 59 have at least one chronic condition and 30 percent have two or more. Leading the pack are heart and circulatory problems, chronic pain and diabetes/obesity. But more fearsome is how chronic diseases affect our lifestyle, loved ones and, ultimately, our everyday lives.

Canadians with multiple chronic conditions have twice as many visits with a family doctor, one-and-a-half times as many consultations with specialists and other doctors, and are four times more likely to stay overnight in hospitals. Do we really have time for these added activities in our already busy schedules? Baby boomers are developing chronic diseases at a fast rate. Can prevention truly reverse, stop or delay the hands of time? If so, what are some key things we can do to prevent these conditions from taking over our healthy lives?

In my opinion, prevention is key – the key to good longevity and good health. Turning back time or stopping the aging process is futuristic but changing our lifestyle is something we can do on our own and start now.

The two biggest modifiable risk factors we can change are:
• Physical inactivity
• Unhealthy eating

By simply increasing our physical activity and eating according to the Canada Food Guide we can change our path from Disease Street to Healthy Street.

There are many health and wellness plans easily available to us. No matter where we go, we can find health clubs, weight loss groups, even online self-help – but you have to be the one driving the bus, you cannot just be a passenger. You need to create a customized plan specifically for you. Everyone is different and has their own, unique life schedule. So how do you fit in physical activity and eating right? I am certainly a prime example of procrastination to adopting a healthy lifestyle, but if I start small and incrementally build on it, it will work. Age, sex and family history can’t be the escape goat. The time is now, and we need to fit our busy schedules into our healthy lifestyle plan.

Start with some easy steps:
• Next time you hit the ten-minute snooze button don’t roll over and go back to sleep. Do 10 minutes of stretching from head to toe – 10 minutes, that’s reasonable!
• Change your meal menu to include brightly coloured foods. It will force you to eat more fruits and vegetables. Bread and carbs are pretty much white, absent of colour.
• Monitor what you do. If you write it down you can’t escape it – you will truly know what you are doing or not doing.

There are two websites I would like you to visit that can help you adopt a healthier lifestyle. One is the Canada Food Guide and the other is Canada’s Physical Activity Guide.

Let’s do this together! Since spring is in the air, it’s time to start something new. For the next two months, let’s incorporate the above three steps into our lifestyle plan and reconvene in May. And just think when it’s time to start your backbreaking gardening, you’re going to feel like a half-a-million bucks!

Caring@Home: Should health care jump on the social media bandwa...

http://nursejackiehickey.blogspot.com/2011/03/should-health-care-jump-on-social-media.html?spref=bl: "Last month in the UK a surgeon potentially saved the life of an old school friend by diagnosing his symptoms for appendicitis on Facebook. ..."

Should health care jump on the social media bandwagon?

Last month in the UK a surgeon potentially saved the life of an old school friend by diagnosing his symptoms for appendicitis on Facebook.

A family doctor Tweets a mom at home on a Friday afternoon about what time she can squeeze her daughter in for an appointment, in order to prescribe an antibiotic and save an unnecessary trip to Emergency.

A doctor sends an “all is OK” secure Blackberry message (BBM) directly to his patient, informing that her test results were negative, thereby ending her stomach-churning wait and avoiding an unnecessary doctor’s appointment just to hear the news.

We are increasingly hearing these types of social media health care success stories. So, is it time the health care system jumped on the social media bandwagon?

I recently jumped on the social media bandwagon with the goal of providing valuable health care information and advice through this blog. http://www.nursejackiehickey.blogspot.com/ is dedicated to helping family caregivers provide care, directing them to health care resources and offering health tips. I believe social media can make a difference in the way health care practitioners deliver care.

What if we were able to use social media applications to find a caregiver who could meet a client at home on a Friday evening so they wouldn’t have to wait until Monday morning for a hospital discharge?

What if you campaigned on Facebook for an organ donor or canvassed for donations to bring a child overseas for a lifesaving operation… oh, wait a minute, haven’t we already seen this happen?

What if health care professionals posted reliable, evidence-based health education videos on YouTube to be viewed in the comfort of a person’s home, 24/7?... oh, yes, we’re already doing this too.

There may be great potential for the use of social media to support client care in the 21st century.

In my opinion, social media have the potential to enable health care professionals to engage and communicate with patients about their health more effectively. Since social media’s role is to transport instant information, it could benefit health care by facilitating accurate health information and empowering patients to be proactive and take charge of their health. We need innovative health care services that are accessible, convenient and sustainable – and social media are the vehicle to drive these strategies.

Do you know the fastest growing demographic on Facebook is women over 55? – which is also a significant segment of family caregivers.

So, don’t wait. Get on the social media bandwagon today. Join the 600-plus million people on Facebook (http://www.facebook.com/). I’ll be your first friend (www.facebook.com/nursejackiehickey). I mentioned in my blog a few weeks ago that I set up my mom with her own Facebook page. Today she has nine friends, communicates with her granddaughter who is studying in New Zealand and checks in with her daughter each day just to make sure everything is all right.

Social media are convenient, accessible and sustainable. You betcha!

Caring@Home: Burnout and lack of support can lead to elder abus...

http://nursejackiehickey.blogspot.com/2011/03/burnout-and-lack-of-support-can-lead-to.html?spref=bl: "Recently, a news headline focused the public’s attention to the distressing case of a Toronto man being accused of keeping his elderly mothe..."

Burnout and lack of support can lead to elder abuse

Recently, a news headline focused the public’s attention to the distressing case of a Toronto man being accused of keeping his elderly mother in an unheated garage. The report had many groups calling for action – saying it's time for elder abuse to be given the same attention that child abuse and anti-violence groups have had. According to the Ontario Network for the Prevention of Elder Abuse (http://www.onpea.org/), elder abuse is defined as: “a single or repeated acts, or lack of appropriate action, occurring within a relationship where there is an expectation of trust, which causes harm or distress to an older person.” 

“Who are you and how did you get into my house?” “I am sorry it happened again and I couldn’t help it!” “Please don’t lock me in, I promise I won’t go anywhere.” These are outlandish but sometimes real statements made by older adults who have experienced abuse.

Elder abuse has many faces and can occur in different forms – often times the victims don’t even realize it’s happening to them. Why do incidences like this occur? What causes us to make a precarious decision that could ultimately have a life-altering outcome?

One of the causes of elder abuse can be a lack of support for family caregivers. In Canada, one in four family caregivers say they receive no help. The average family caregiver spends four years providing care and devotes 20 hours per week caring for a loved one. There is no vacation time, rescheduling or pay, for that matter – it’s an act of love that no one can fathom unless you have been a family caregiver yourself. 

The Canadian Institute for Health Information (CIHI) estimates the economic contribution of informal elder care at $25 billion a year. While 76 percent of caregivers feel rewarded, one in six experiences distress. Since family caregivers are the fastest growing non-profession in health care, it’s important to identify those who may be feeling overwhelmed, stressed or experiencing burnout. How do we recognize the signs of distress? How can we help prevent someone from innocently reaching the boiling point?

In my opinion, it’s vital that we help the millions of family caregivers across the country – the vast supportive arm of home and community care – and recognize the warnings signs of caregiver burnout:

• Ranting about insignificant things such as the mailman putting mail upside down in the mailbox.
• Becoming impatient and irritated by little things or snapping at family members.
• Changes in sleep patterns and problems falling asleep – or just look tired and run down. 
• Changes in eating habits, including not preparing meals, skipping meals or losing weight.
• Neglecting personal needs – which could be physical, emotional or social – and hearing family caregivers   say, “Don’t worry, I’m OK.”
• Seeing they are exhausted and overwhelmed, but not recognizing it. 

What can we do to help?

• Listen to what family caregivers are not saying – not many people take pride saying “I can’t cope.”
• Insist and don’t just offer to help them. For instance, prepare dinner and clean up afterward.
• Put tools into place that will help you, such as assistive equipment and devices or even home renovations. 
• Hire some extra help.

I personally witnessed how being a caregiver to my ailing father took a toll on my mother, and understand the anguish it can cause. There are many family caregivers just like you. However, a little extra help can make a big difference – don’t feel like you have to do it alone. We need to protect the generation that cared for and raised us, and ensure they don’t feel vulnerable – least of all someone we love. Always remember that if you ever feel like you’re close to that “boiling point,” pick up the phone and ask for help.

Caring@Home: Last week, the Toronto Star launched Begging for ...

Caring@Home:
Last week, the Toronto Star launched Begging for ...: "Last week, the Toronto Star launched Begging for Care, an investigative series looking at how the province is dividing up the $1.1 billion ..."