Keep these families in your prayers!

In Mother’s Eyes (An Alzheimer’s Story) by Tom Tripp

When The Mind Says Goodbye

A Letter From Mom and Dad

Love Them While They’re With You

1. Create Expectations. Agree together that is important to regularly re-assess the situation. This will enable you, mom, and dad to work as team to determine what IS working and what might need a little fine-tuning and/or changed. This in-home assessment will include how the their home is being kept up, ensuring their medications are being taken as prescribed, and will provide an opportunity to observe their driving skills.

You may want to begin now to locate and interview other forms of transportation so that you will be prepared when the time comes to put away the car keys.

2. Use Technology. Establish ways that you can check on them throughout the day as well as at night. Discuss with mom and dad the pros and cons of using and/or not using a web/nanny cam. Also discuss the use of a monitoring system for falls as well as other emergenices. It might be necessary for you to draw a picture (so-to-speak) for your loved ones of the potential emergencies that could arise. You might be surprised to realize that mom and dad have not thought their situation through thoroughly.

A Link for 12 Handy Apps for Caregivers.

Also consider daily check-in calls or visits from neighbors or other people who will stop by to say hello. You might consider working with a Nurse Geriatric Care Manager to assist with the formation of a team, which will also ensure the team [and the plan] is operating smoothly in your absence.

3.  Make Food Prep Easier. In some areas you might find “Meals on Wheels” is available. There are also other agencies that make house calls. You can stop by frequently, or hire a Geriatric Care Manager to follow up in your absence, to see that they are eating, taking their meds, and are functioning well.

4. Create a Care Team. Make a list of “helpers” [nearby-neighbors, relatives, and family] to assist with check-ups and/or emergencies to ensure your plan runs smoothly. Don’t forget to incorporate siblings, mature neices/nephews, mature grandchildren,  church friends, volunteers, community outreach and elder care agencies into your Care Team. Finally, as you put your team together, determine which team members will be available to run errands. [Note: purchase a gift card for the team member to utilize for purchases and ask for the receipts, and the card, to be returned to a safe keeping place in the home.]

A Link for Additional Assistance.

Benefits of Geriatric Care Management.

How Healthcare Consultants Can Help.

It is our hope at Concierge Services/Nurses of Augusta to help caregivers and families find resources, as well as provide solutions to decrease the stressors of care-giving!

Sponsored by WJBF News Channel 6 and the Giving Your Best Partners – Georgia Bank & Trust, Solvay Advanced Polymers, and Walton Rehabilitation Hospital – the 2012 Shoeboxes for Seniors Campaign will run throughout the month of April.

Local residents are being asked to donate a variety of personal care and

household items needed by low-income seniors including:

• Toothpaste, toothbrush, and mouthwash
• Hand and bath soap (liquid or bar)
• Wash cloths and towels
• Facial and toilet tissue, paper towels, wet wipes
• First aid supplies
•  Hand lotion, deodorant, razors
• Shampoo and conditioner
• Dish and laundry detergent
•  Household cleaning supplies
• Aluminum foil, plastic wrap, sandwich and freezer bags
• Perfume and cologne
• Light bulbs and postage stamps
• Flashlight batteries and 9-volt batteries for smoke detectors
• Smoke detectors
• Nail clippers and emory boards

The shoeboxes will be packaged and decorated by students from a local after-school program and distributed by The Senior Citizens Council to low-income seniors in the Augusta area. Over 215 shoeboxes, in addition to a large number of items that would not fit into the shoeboxes, were distributed during last year’s campaign.

Donated items may be taken to any of the Giving Your Best Partner locations or to The Senior Citizens Council, 218 Oak Street North, Suite L, Martinez (near the intersection of Washington Road and Bobby Jones Expressway, behind Bojangles and Salsa’s Mexican Restaurant).

For more information, please call 706-868-0120.  If you would like to donate items, you may bring them to us  or call us for pick up.

Senior Citizens Council

We will also be accepting donations at the April 12, 2012 Augusta Care Network Meeting.

Thanks again!

Senior Citizens Council

May 1 – Don’t Miss the Annual Ribs, Bibs and Dibs Auction

What are Medical Errors?

Medical errors are health care mistakes that may injure you or affect your well-being. Errors can happen in a medical setting, such as the hospital or in your home. For example, you might be given the wrong drug, the wrong dosage, or the wrong type of blood, or have an operation on the wrong body part. Fortunately, most errors can be prevented, and you can help.

How can I help prevent medication errors?

Keep a list of all medications you use. Make sure you know what each one is for, how and when you take it, what to do if you miss a dose, and when to tell your primary care provider about side effects.

Write down all the medications you take,  prescriptions and over-the-counter medications, as well as herbal supplements. Discuss this list with your primary care physician at least once a year. Ensure you share with him or her any allergies you have, to foods and/or medications as well as environmental elements, and the adverse reactions you’ve experienced. Do not forget to mention adverse reactions to things like anesthesia or dyes utilized during certain medical procedures.  [Pertinent Example: if you are allergic to shell-fish, you will most likely be allergic to the dyes utilized in medical procedures.]

Take your medications as directed. If you have trouble swallowing a pill or capsule, ask your physician or pharmacist if the medication is supplied in liquid form. Be mindful that certain medications are coated or time released, and thus should not be split, chewed, crushed and/or mixed with food which could adversely effect the absorbency time of the medication. Also, note there are medications that should not be taken with certain foods or beverages and/or taken with or without food, of which your physician or pharmacist will advise you. This information is also provided in the attached information that is provided by your pharmacist with each medication.

Having all of your medications filled at the same pharmacy will enable the pharmacist to provide you with a safety net. By knowing all of the medications that you’re taking, the pharmacist will be able to provide you with detailed information related to medications that should not be taken together, should be taken with or without food, etc. This is especially important when you are seeing more than one physician.

At home, check your medicine cabinet every three to six months. Expired medications, including patches, should not be flushed down the toilet or thrown into the garbage. Contact a local pharmacy or health department for advice regarding the proper disposal of old medications. You might find that a local houssehold hazardous waste management program accepts old medications.

How can I prevent errors at the doctor’s office?

Be involved, don’t take a backseat, in your healthcare. Choosing a primary care provider that you feel comfortable talking with about your healthcare is essential. If you are uncomfortable asking questions, take a relative or friend with you to ask questions and to help you understand the answers. Making a list of questions or concerns prior to the appointment is helpful. Your list will provide cues related to the topics that you had thought about prior to the appointment, ensuring you touch on each topic of concern and/or each question.

If you had a test or procedure done, be sure to get the results. Don’t assume that everything is alright just because no one called. It is important to ask each physician, primary care and specialists, what their office procedure is to ensure you receive your test results.   During the appointment, ask for a copy of the test or procedure results to review at home, which will provide a quiet environment and  time to soak in the information that may have just been presented to you. Also, don’t forget to ask your physician the best way to get in contact with him or her should you have any questions or concerns after the appointment.

How can I prevent errors if I’m in the hospital?

Prior to your hospitalization, find a trusted friend or relative to be your advocate – someone who can make medical decisions for you if you can’t or receive an update after a surgical procedure. It is important that you put this advocacy relationship in writing, stating that the healthcare personnel have your permission to discuss your care with and accept medical decisions [if you are unable to make your own decisions] from this individual. Be sure that this document is signed and dated by both you and your advocate.

You will be asked at the hospital if you have an advance directive or durable power of attorney. If you do, take a copy of these documents for the hospital to keep on file. Also, remember to take your photo identification and insurance cards to be copied and kept on file at the hospital.

While hospitalized, be sure the healthcare provider checks your arm band before administering medication. It is also a good idea to look at the medication, checking for any pills that might not look like your normal medication regimen. If it doesn’t look like your usual medicine, ask the healthcare provider if it might be a generic [which is alright] or if it might be the wrong dose [strength]. If you are in doubt, ask the healthcare provider if the medication might be something new [or a new strength] recently ordered during your hospitalization.

Expect healthcare providers to introduce themselves when they come into the room and look for their hospital identification [name tag/badge]. If the healthcare provider is not wearing a badge or name tag, ask him or her to introduce themselves.

Also upon entering and the exiting room, be observant to see if the healthcare provider sanitizes their hands. Don’t be shy – ask each person, even visitors, to sanitize their hands each time he or she enters your room.

*Please note, this is in no way to be considered medical advice. It is intended only as useful tips to prevent potential medical errors.

Critical Questions Related To Current and New Medications:

What is the name of this medication—both the brand name and the generic name?

• There are many medications on the market that look alike and/or sound alike
• To ensure the correct medication is being taken
• Example: Ativan [lorazepam] and Xanax [alprazolam] and Klonopin [clonazepam]

Is a generic (low cost) version of this medication available?

• A generic version of a brand-name drug is not always available or recommended for everyone
• Discuss if a generic drug is right for you with your health care provider and/or pharmacist.

When should I expect the medication to begin to work? How will I know if it is working?

• Some medications take several weeks to build up in your system before becoming effective
• After 24-48 hours, if an antibiotic isn’t working [have seen little to no improvement in symptoms], the physician may consider the antibiotic ineffective, at which time a different antibiotic will most likely be prescribed

What are the possible side effects?

• For instance, a medication for high blood pressure, known as an ACE Inhibitor, can cause a “tickle” in the back of the throat, creating a chronic dry cough
• Inhalers can cause a husky or hoarse voice

Is this medication safe with reduced kidney or liver function?

• Ask this question if you have, or suspect that you have, one of these conditions
• If the kidneys or liver do not function optimally, medications can build up in the system
• It may be, the medication can be taken at a lower than normal dosage – discuss with the physician and/or pharmacist

Can the medication interfere with other medication I’m taking?

• For example, the physician may prescribe a pain medication that contains Tylenol – you would not want to take Tylenol over-the-counter simultaneously due to the harmful effects to the liver

Is there a recommended time that this medication should be taken?

• Example: Lipitor, a cholesterol lowering medication, works best if taken at bedtime [the same time each evening]

Which foods or drinks should I avoid? (including alcohol or caffeine)

• Grapefruit should be avoided if taking: Buspirone, Amiodarone, Sertraline, Fexofenadine, Carbamazepine, Nifedipine, Cyclosporins, Simvastatin, Lovastatin, Atorvastatin [is not a complete list]
• When taking Coumadin [warfarin], foods containing Vitamin K could reduce the effectiveness. Examples are: kale, spinach, parsley, Brussels sprouts, chard, mustard greens, collard greens
• When taking certain anti-depressants, known as a MAO Inhibitor [MAOI], foods with moderate to large amounts of tyramine should be avoided [including up to 2 weeks after the medication is discontinued]. Examples are: beer, aged cheeses, fermented soy beans, fermented cabbage, pickled herring, aged/smoked meats; white and red wine, yeast extracts
• Some Antibiotics, such as Tetracycline, shouldn’t be taken with Milk [Calcium can prevent absorption into the bloodstream; antibiotics are usually more effective taken with juices or water]
• Some medications must be taken with water only. [Medications such as Aspirin, Cold Tablets and Vitamins are best taken with water.]

Should I take this medication with food or on an empty stomach?

• Medications, such as Aspirin, can cause extreme irritation on an empty stomach
• Tetracycline, an Antibiotic that is affected by Calcium, could be taken one hour before consuming dairy products

Will this medication make me sleepy?

• Should I avoid driving or using heavy machinery?
• Should I take the medication at bedtime?

What should I do if I miss a dose?

• Never double up on a dose
• Follow your physician/pharmacist’s instructions
• This is a drug-specific question and varies with each client

How much water is needed when the instructions say “take with water”?

• This will vary with each patient
• Are fluid restrictions in place from your physician
• Some medications require 6-8 ounces of water

Can I crush a tablet or capsule into my food?

• Some medications, like time-released medications, have an enteric coating on the outside of the pill- Crushing the medication will disrupt the timing of the medication.

Can I split the pill into smaller doses?

• Some tablets are scored for the purpose of splitting
• Some medications have an enteric coating and should never be split

Can I get a refill? If so, when?

• Make sure that you have enough medicine and/or refills to last until the next visit
• Certain classes of medications, such as Narcotics [depending on the laws in your state], cannot be dispensed with refills, which would necessitate obtaining a Rx from the physician every 30 days

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

NOTE: [the form of the medication, such as a pill versus a liquid, is a strong factor in determining the absorption]

Uncoated Tablets

• Examples: Aspirin
• Absorbed slowly
• Stomach juices break them into small pieces before they can be absorbed
• Intended to be absorbed in the stomach

Coated Tablets

• Example: Motrin
• Absorbed very slowly into the system
• Intended to dissolve in the small intestine instead of the stomach [ where it could cause irritation]

Capsules

• Absorbed faster than tablets
• The medication is already broken into tiny particles
• The gelatin coating surrounding the particles dissolves quickly [allowing the medication to be absorbed rapidly]

**There are exceptions to all medications. All questions should be directed to your physician or pharmacist for specific administration instructions.

**This article is a guide, NOT medical advice, of important things to keep in mind related to medication that you will want to ensure you have a clear understanding of from your physician.

**The bullet points are examples provided to help understand the logic [reasoning] behind each question, and in NO way should be considered medical advice.

Finding the right care by the right provider, promoting quality care, continuity of care and cost containment is one of the many benefits of having a Patient Navigator. Working as your advocate, the Patient Navigator develops options to coordinate care, treatment and communication among all the providers of your healthcare team to ensure a smooth recovery.

While hospitalized, the Patient Navigator will work as your Personal Case Manager, over-seeing your care, to ensure all the bases are covered in the  care that is ordered and/or received. From day one, we begin working with the hospital staff to promote a smooth transition to home, coordinating integrative services for all your home care needs.

Advocating for patients’ rights and needs, Patient Navigators help cut the red tape, providing detailed insurance claims assistance. By tracking your medical paperwork and correcting errors, your Patient Navigator will ensure you receive full insurance benefits and coverage. Additionally, your Navigator will negotiate with an employer, healthcare provider or school to ensure you receive the care that is needed

Not only will your Personal Navigator be a coach and teacher, but over the course of time, he or she will also become a medical mentor and companion, sharing in the progress and set-backs along the way. While working to help you gain confidence in your personal advocacy skills, your Personal Navigator, your mentor,  will also enable you to speak the language of your disease.

The Navigator will also become your Research Partner, enabling you to focus on the most accurate, current and relevant information, ultimately eliminating the risk of information overload. The information provided during this process will ultimately enable you and the Patient Navigator to formulate an individualized plan of care.

With your individualized plan of care in place, your Navigator will help determine the
location of and access to appropriate services, and will begin mobilizing resources for your caregivers to support your treatment and recovery.

Concierge Services of Augusta and its team of Concierge Nurses are experts at solving problems , providing solutions to every day problems. CSOA is dedicated to working with patients and families to help navigate through the maze of  illness, aging and the healthcare system. We would be honored to become your Personal Navigator. Our Services are nationwide.  Call today for a Free Consultation. (706) 829-2032.