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November 2004
In this Edition:
Prepare for Life's Curveballs NOW: Don't wait for Next Year's Hurricane Season
Is it the Blues or Depression?
Holiday and Family Days
How can you protect your family's most important asset: good health?
Prepare for Life's Curveballs NOW: Don't wait for Next Year's Hurricane Season
By: Rona S. Bartelstone, LSCW, BCD, CMC, CEO
Didn't we just get through one of the worst hurricane seasons in history? Why am I bothering you
about this now? Good questions for you to ask.
One of the trends that we are seeing in the care management arena is that families are waiting
longer and longer to reach out for help. Some of this is perfectly understandable. Consumers
are better educated about eldercare issues, resources and potential solutions. Another reason
for waiting, especially in the last few years, is concerns about the economic situation.
Families are still recovering from the economic downturns and are trying to limit discretionary
spending.
However, taking proactive action, when it comes to caring for elders and those with chronic
illnesses may just enable families to save precious resources, contrary to popular belief.
Care management is actually a very positive value proposition, especially for long distance
family caregivers, but even for families that are close.
Care management often makes more efficient use of the scarce resources of time and money,
by eliminating some of the effort that families make in researching information, advocating
for quality care and coordinating services. By hiring a care manager, the family member is
empowered to spend time with a parent at their own discretion, and in the role of family member
rather than problem solver. This is a real stress reliever.
After this past September, when Florida was battered by one hurricane after another, we began
to get many calls from families who were frantic about the lack of services and follow up
emotional support for elders who went through the storms. Even those individuals, who did
not suffer dramatic physical damage, had lingering effects from the fear and uncertainty left
by the storms. Those who had damage to their homes, electrical outages and lack of potable
water suffered even more.
So, my best advice to families with elders, no matter where they live, is to get your plan
in place ahead of the crisis. Don't wait until you are at your wit's end to hire a care manager.
Keep your role as the child, spouse, sibling or other relation and let the care manager and other
professional advisors carry the tension of problem solving, emotional support and decisional
support. It will prevent emotionally and financially costly errors, and reduce the stress
of caregiving.
Hurricanes are a lot like life. We never know when they will strike, where they will come from,
or what their aftermath will look like. For those who have planned, and those who have a professional
support system, the crisis will be a little easier to endure.
Holiday visits present an ideal time to think about preparing for the future needs of our loved ones.
Is it the Blues or Depression?
By: Sandy Goldberg, RN Clinical Director of Nurses
The holidays bring to most of us feelings, of joy, togetherness, family and friends. However, some
seniors have lost many of their friends and their families are separated by geographical distance.
The senior is left with feelings of loss and abandonment. These feelings can lead to depression.
The question then arises, how do we know when our loved one has the "blues" or it is a clinical
depression?
Most of us have a day when we feel blue or "out of sorts." A sad mood is the normal response to
loss or disappointment. Depression, however does not simply last for a day or two but persists for
more than two or three weeks. Clinical depression also interferes with normal functioning and routine.
Depression which occurs after the loss of a loved one may be a normal part of the grief process and usually
does not interfere with normal functioning. Grief usually dissipates with time and needs evaluation only if
it persists longer than three months and impairs daily functioning, along with other symptoms of a
clinical depression.
Symptoms of clinical depression include:
- Difficulty falling asleep, staying asleep, or sleeping too much
- Reduced appetite and weight loss or increased appetite and weight gain
- Loss of interest in activities once enjoyed
- Feelings of anxiety, restlessness, or irritability that interfere with functioning
- Persistent physical symptoms that don't respond to treatment (headache, chronic pain,
digestive disturbances, dizziness). Somatic complaints
- Difficulty concentration, remembering, or making decisions
- Fatigue or loss of energy
- Feelings of guilt, hopelessness, or worthlessness
- Thoughts of death or suicide
- Crying spells, sadness, low mood, loneliness
An older person may not present as feeling sad or depressed and often deny that their mood is
depressed. Nevertheless, they may have a clinical depression if they have five of the symptoms
listed above. Many times the senior presents with agitation or severe anxiety and/ or numerous
somatic (physical) complaints.
Often the senior does not wish to see a psychiatrist and they are treated by their medical
doctor. There are many new medications which can now be prescribed by the family physician.
If the depression continues despite the medications it may be necessary to have the elder
evaluated by a mental health professional.
Holiday and Family Days
By: Clara Frieder, MSW, ACSW
Holidays may be sacred days, national celebrations, or local events having deep meaning only to a
small segment of people. Yet, they are times for renewing old ties, old friendships, old faiths,
seeing family despite the fact that our worlds have grown beyond our doorstep.
Associated with these special days are the presence of intergenerational gatherings of relatives
and friends, the chatter and laughter, the smell of foods specially prepared. The vibrant atmosphere
is enhanced by brightly decorated stores, and temptingly displayed merchandise which engender memories
we usually cherish all of our lives.
Getting together may have presented obstacles that families were both physically and emotionally bonded
to overcome because of the importance of maintaining and continuing their family and cultural heritage.
These times snatched from their busy lives were integral to their sense of themselves and identifying
their values, and what they wanted to inculcate into their children for the rest of their lives.
While this may hold true today, the older adult may not have the same opportunities to participate with
family as they once did. They are too often separated from the immediate presence of family and friends.
They sometimes also have lost the community supports that they once so zealously nurtured.
To them anticipation of holidays may not one of joy, but sadness and loss.
So it may be time to create new traditions that include our elders and facilitate role models for
the next generation. One client of our agency, lived in Florida far removed from her family. She
had been an excellent cook and everyone loved "Nana's" holiday feasts. Now she couldn't cook because
of blindness. To help her preserve her legacy for future generations, we helped her to record her
recipes and collect them with old family pictures. We put them in a book and sent them to her
granddaughters for the holidays.
In return, her granddaughters used Nana's recipes for their own celebrations and sent her tape
recordings of the family gathering and everyone enjoying her "old world" recipes. For the first
time in years, she felt included in a family holiday and her depression lifted. She decided to do
the same thing for the next round of holidays. A further, unexpected and happy outcome of this effort
was a new telephone relationship with one of her grandchildren who loved to hear her stories about the
"old days."
Another family who was concerned about grandma, being alone for the holidays decided to have a family
cruise celebration, rather than exclude grandma. Still another family that did not have grandparents
adopted a neighborhood elder who was alone, but who loved the company of their children and their dogs.
This was the neighbor who could always be counted on to bring in the mail and watch the house when they
went on vacation. This family was so appreciative of her protective presence that they made her their
honorary grandma.
When we pay attention, we realize that everyone has something to give, to teach or to share.
The joy of including people with a unique history, enriches us many fold and makes the effort seem
small in comparison. So reach out and enjoy the holidays!
How can you protect your family's most important asset: good health?
Learn about Pinnacle Care International, a member-based
organization that provides objective medical information and access
to top physicians across the U.S. and the world.
Hardly a day
passes without mention of "America's healthcare crisis." A recent
New York Times op-editorial quoted Dr. Barbara Starfield of the
Johns Hopkins School of Medicine and author of a prominent 2000
study examining the quality of healthcare in industrialized nations,
as saying "even the affluent are finding it more difficult to
obtain access to care." In the study, the United States ranked
12th out of 13 countries, and Dr. Starfield believes the situation
has only gotten worse.
Proactively managing the health needs of
a family is a significant responsibility. Many individuals and
families do not have an objective, trusted health advisor to provide
guidance and convenience - for themselves, aging parents or children
living far away. Facing pressure from managed care, physicians
today are packing more patients into their already tight schedules.
How can Americans be assured they are receiving quality care and
objective information about their health choices?
Featured in
The Washington Post and Bloomberg Wealth Manager as one of the
premiere sources for the best objective medical information and
advice available today, Pinnacle Care International provides personalized
and comprehensive health management for its Members and their
families. From staying fit and preventive health to managing a
chronic condition, Pinnacle Care International helps individuals
find and quickly access the best physicians, medical centers and
a variety of treatment options.
Each Pinnacle Care Member works
closely with a personal Pinnacle Advocate who offers time-saving
and objective resources to help families make informed healthcare
decisions - whether close to home or traveling abroad. When you
become a Pinnacle Care Member, your Pinnacle Advocate serves as
your trusted health advisor and is available 24/7 to:
Symptoms of clinical depression include:
- Gather your comprehensive medical records - very important when seeing new physicians or during an emergency
- Create a personalized action plan to address your health needs and wellness goals
- Research physicians and medical facilities in the U.S. and internationally
- Proactively help you to achieve wellness goals - losing weight, managing cholesterol, eating better, etc.
- Research different treatment options - such as surgery vs. alternative medicine; clinical trials, hormone therapies, etc.
- Arrange expedited access to chosen physicians - open doors to the best doctors who are often-times difficult to access
In our Member's words - "Pinnacle Care has helped us create an open dialogue about these family medical issues.
My parents, whether it be a generational thing or otherwise, tend to keep health problems secret, protecting the
rest of the family, leaving all of us with our suspicions and hunches, but unable to help. The process management
that the Pinnacle Advocates have had since they began working with my parents has inspired a great deal of confidence."
A membership includes primary member, spouse and unmarried children under age 23. If you are interested in learning
more about Pinnacle Care services, please contact Veronica F. Fleischer by calling 410 752 1712 x23. For web information,
go to: www.pinnaclecareinternational.com
Pinnacle Care International recommends these basic health tips to ensure access to quality care and proactively protect
your family's health and wellness:
- Get to the Best: If you are facing a serious health problem, schedule your consultation and treatment at a
major Center of Excellence, where the latest technologies are used and specialists perform the highest volumes
of procedures. U.S. News and World Report's annual America's Best Hospitals issue ranks top medical care in 17
specialties. Our Pinnacle Advocates assure that our Members are connected to the best care available by utilizing
our trustee and faculty-level access to the majority of the 14 hospitals on their Honor Roll, which singles out
hospitals that topped the rankings in six or more specialties.
- Use Your Medical Records to Identify Risk Factors: Review your family's medical records to identify hereditary
health issues so younger generations can be tested earlier. Our Pinnacle Advocates collect, carefully review, and
securely store each family member's medical records. In an emergency, records can be instantly transferred to the
treating hospital or physician, which prevents errors and could even be a lifesaving measure.
- Take an Advocate Along: Often, when being treated at a doctor's office or hospital, your nervousness and anxiety
prevent you from listening carefully to the physician's advice or from asking important follow-up questions. In
addition to providing objective information, our Pinnacle Advocates know the key questions to ask to help you
maximize your time with the physician and produce better outcomes.
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