Alzheimer's Blog:
Today on my ambulance I have been busy. Usually people think of ambulance people as doing 911 calls. Maybe a car accident or someone calling because a loved one is having a heart attach. But my favorite calls are for normal people with special needs.
One of my calls today was for an eighty year old female with dementia/ Alzheimer's. This woman lives in a nursing home, and some how fell out of bed. They knew she was up when it happened even though they were not in her room because they have an alarm on her bed to let them know when she gets up. She doesn't really walk, and just a few months ago had a hip fracture. They found her on the floor with a laceration to her head, bleeding. They are real good with their patients, and took her vitals, wrapped up her wound, lay ice pack on it, and gave her Tylenol for the pain. They called us and we showed up to help. This lovely elderly woman did not understand what was going on. She didn't want to get on our gurney, and fought me when I took her vitals. She mumbled a lot, and didn't make much sense. All I could do was love her even more.
Another one of my calls was for a fifty six year old male whose Foley was clogged. At the age of twenty four he had a diving accident which broke his neck and left him as a paraplegic. He can move his arms but doesn't have a lot of control over them. He was frightened when we got him. His big concern was that we were not going to put him in his bed and make sure everything was set up like he would want it before we leave. His care nurse was not around at the time. With help we sheet lifted him to our gurney, took vitals and off we went to his home. We made his bed, sheet lifted him into it, got his table over to him and made sure the phone and TV controls were in reach. He was very appreciative of our kindness to him. I wonder how other emt's treat him.
Sometimes I think my partner and I are hand picked for some of these jobs. These people need someone that is kind, compassionate, not in a hurry and ready to help where ever needed. These calls are the ones I love the best.
Be an angle, practice random acts of kindness.
Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/
Monday, April 11, 2011
Saturday, April 9, 2011
Alzheimer's Blog:
Importance of personal health!
Keep your mind active and sharp through various activities. Keep the mind healthy. Mental stimulation helps ward off memory loss. Watch a movie -- Watch a ball game -- Work on a cross word puzzle -- Join a chess
club or gardening group -- Volunteer in your community -- Work a part time job -- Have a hobby -- Eat a healthy diet -- Include physical activity during your day, at least 30 minutes to increase your blood flow to your brain. It is important to get respite care which is a temporary break from your daily care giving
responsibilities. If you choose to take care of your loved one at home it is important that you take care of yourself. Look around in your area for respite care. It can be in the form of an adult day care center so you can get a few hours of relief every week, or a nursing home so you can have a few days to rest. It is important to find a good support group. Support groups provide a forum to share feelings, concerns, and information as a way of supporting and encouraging each other. Look for support groups in your area on
the Alzheimer’s Association web-site. http://alz.org/apps/findus.asp
Remember life is an adventure and we need to take it, enjoy it, learn from it, and to take care of each other. That is what life is all about. Not what we can do for ourselves but what we can do for others.
Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/
Importance of personal health!
Keep your mind active and sharp through various activities. Keep the mind healthy. Mental stimulation helps ward off memory loss. Watch a movie -- Watch a ball game -- Work on a cross word puzzle -- Join a chess
club or gardening group -- Volunteer in your community -- Work a part time job -- Have a hobby -- Eat a healthy diet -- Include physical activity during your day, at least 30 minutes to increase your blood flow to your brain. It is important to get respite care which is a temporary break from your daily care giving
responsibilities. If you choose to take care of your loved one at home it is important that you take care of yourself. Look around in your area for respite care. It can be in the form of an adult day care center so you can get a few hours of relief every week, or a nursing home so you can have a few days to rest. It is important to find a good support group. Support groups provide a forum to share feelings, concerns, and information as a way of supporting and encouraging each other. Look for support groups in your area on
the Alzheimer’s Association web-site. http://alz.org/apps/findus.asp
Remember life is an adventure and we need to take it, enjoy it, learn from it, and to take care of each other. That is what life is all about. Not what we can do for ourselves but what we can do for others.
Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/
Friday, April 8, 2011
Alzheimer's Blog:
Things to know aboutAlzheimer’s
As I took care of my father-in-law I did a lot of research. So I hope to give you is some valuable research about this terrible disease. I truly hope this will help you understand this disease and help you with your decision on what you want to do.
Dementia (noun): Is defined as severe impairment or loss of intellectual capacity and personality integration, due to the loss of-or damage to neurons in the brain.
Alzheimer’s (noun): A progressive form of percentile dementia that is similar to senile dementia except that it usually starts in the 40’s or 50’s; First symptoms are impaired memory which is followed by impaired though and speech and finally complete helplessness.
Currently it is estimated that as many as 5. 2 million people in the U.S. have Alzheimer’s disease. This number is expected to grow over the next 50 years as the population ages and life span increases. Alzheimer’s disease affects three percent of the population between the age of 65 and 74. But estimates suggest that 19% of those older than 75 yrs and 47% of those older than 85 yrs have the disease.
Currently there is no cure for Alzheimer’s. Alzheimer’s disease it the most common form of dementia. Dementia is a term that is used to describe a group of brain disorders. These brain disorders cause memory loss and make it harder to carry out daily tasks. Alzheimer’s disease develops slowly over time. The symptoms begin to appear so gradually that it is often mistaken for normal aging. It is a progressive and degenerative disease, which means that it gets worse over time. When someone has Alzheimer’s disease nerve cells die in areas of the brain that are vital to memory and other mental abilities, and connections between nerve cells are disrupted. There are also lower levels of some of the chemicals in the brain that carry messages back and forth between nerve cells. This affects memory, judgment, and thinking, which in turn may hinder a person’s ability to handle day to day tasks.
Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pup., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/
Things to know aboutAlzheimer’s
As I took care of my father-in-law I did a lot of research. So I hope to give you is some valuable research about this terrible disease. I truly hope this will help you understand this disease and help you with your decision on what you want to do.
Dementia (noun): Is defined as severe impairment or loss of intellectual capacity and personality integration, due to the loss of-or damage to neurons in the brain.
Alzheimer’s (noun): A progressive form of percentile dementia that is similar to senile dementia except that it usually starts in the 40’s or 50’s; First symptoms are impaired memory which is followed by impaired though and speech and finally complete helplessness.
Currently it is estimated that as many as 5. 2 million people in the U.S. have Alzheimer’s disease. This number is expected to grow over the next 50 years as the population ages and life span increases. Alzheimer’s disease affects three percent of the population between the age of 65 and 74. But estimates suggest that 19% of those older than 75 yrs and 47% of those older than 85 yrs have the disease.
Currently there is no cure for Alzheimer’s. Alzheimer’s disease it the most common form of dementia. Dementia is a term that is used to describe a group of brain disorders. These brain disorders cause memory loss and make it harder to carry out daily tasks. Alzheimer’s disease develops slowly over time. The symptoms begin to appear so gradually that it is often mistaken for normal aging. It is a progressive and degenerative disease, which means that it gets worse over time. When someone has Alzheimer’s disease nerve cells die in areas of the brain that are vital to memory and other mental abilities, and connections between nerve cells are disrupted. There are also lower levels of some of the chemicals in the brain that carry messages back and forth between nerve cells. This affects memory, judgment, and thinking, which in turn may hinder a person’s ability to handle day to day tasks.
Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pup., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/
Thursday, April 7, 2011
ALZHEIMER'S BLOG:
Joe Fostino, U.S. Army Veteran, suffered from Alzheimer’s
Joseph A. Fostino was born on January 20, 1926 on the south side of Chicago. Except for his time in the Army, he lived there all his life. Like many youngsters who grew up during the Great Depression day, Joe only completed the tenth grade. Along with thousands of others like him, Joe became a soldier in the United States Army on 4 May 1944 shortly after his 18th birthday. He served in Europe and near the end of the
conflict, just as he was poised to invade Berlin, the Russian army arrived and his unit was recalled to France. From there he was sent to San Francisco where his unit, along with thousands of other soldiers, spent two
weeks of intensive training in preparation for a beach invasion of Japan. As he was traveling east by ship, the atomic bombs were dropped on Japan and World War II came to an end. Joe’s unit went on to the Philippines where he learned his civilian trade, truck driving. He fought with the Eagles 86th Infantry Division, Black Hawks. Joe left the armed services on April 16, 1946. On August 24, 1962, Private First Class
Joseph A. Fostino, of the United States Army, was awarded a Bronze Star Medal for meritorious achievement in ground combat against the enemy during WWII in the European African Middle Eastern Theater of Operations. Joe never mentioned this honor to most of his friends and co-workers.
Joe married “Jean” (Virginia) Gaeta on May 19, 1948 and they had three children, Jimmy (1953), Janet (1956), and Joann (1959). Tragedy struck early for Joe and Jean
when Janet was born severely handicapped. Janet was placed in a state institution at the age of twelve.
Joe’s wife, Jean, passed away in the summer of 1999. Friends and relatives alike feel that the death of his wife marked the beginning of Joe’s long battle with Alzheimer’s disease. Joe loved driving his big rig almost as much as he loved his family. He drove big rigs his entire working life, mostly for the Teamster’s Local 705.
He was a devoted husband, father and friend as well as a war hero. Joe will be sorely missed by all those
whose lives touched his over the years. He leaves behind three children, six grandchildren, and three great-grandchildren.
Alzheimer's doesn't care who it strikes. Every one has a story about his or her life before this terrible disease came along and took it from them. Share yours!
Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/
Joe Fostino, U.S. Army Veteran, suffered from Alzheimer’s
Joseph A. Fostino was born on January 20, 1926 on the south side of Chicago. Except for his time in the Army, he lived there all his life. Like many youngsters who grew up during the Great Depression day, Joe only completed the tenth grade. Along with thousands of others like him, Joe became a soldier in the United States Army on 4 May 1944 shortly after his 18th birthday. He served in Europe and near the end of the
conflict, just as he was poised to invade Berlin, the Russian army arrived and his unit was recalled to France. From there he was sent to San Francisco where his unit, along with thousands of other soldiers, spent two
weeks of intensive training in preparation for a beach invasion of Japan. As he was traveling east by ship, the atomic bombs were dropped on Japan and World War II came to an end. Joe’s unit went on to the Philippines where he learned his civilian trade, truck driving. He fought with the Eagles 86th Infantry Division, Black Hawks. Joe left the armed services on April 16, 1946. On August 24, 1962, Private First Class
Joseph A. Fostino, of the United States Army, was awarded a Bronze Star Medal for meritorious achievement in ground combat against the enemy during WWII in the European African Middle Eastern Theater of Operations. Joe never mentioned this honor to most of his friends and co-workers.
Joe married “Jean” (Virginia) Gaeta on May 19, 1948 and they had three children, Jimmy (1953), Janet (1956), and Joann (1959). Tragedy struck early for Joe and Jean
when Janet was born severely handicapped. Janet was placed in a state institution at the age of twelve.
Joe’s wife, Jean, passed away in the summer of 1999. Friends and relatives alike feel that the death of his wife marked the beginning of Joe’s long battle with Alzheimer’s disease. Joe loved driving his big rig almost as much as he loved his family. He drove big rigs his entire working life, mostly for the Teamster’s Local 705.
He was a devoted husband, father and friend as well as a war hero. Joe will be sorely missed by all those
whose lives touched his over the years. He leaves behind three children, six grandchildren, and three great-grandchildren.
Alzheimer's doesn't care who it strikes. Every one has a story about his or her life before this terrible disease came along and took it from them. Share yours!
Sincerely,
Marie Fostino
Alzheimer's A Caretakers Journal
Seaboard Press An Imprint of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/
Monday, April 4, 2011
Alzheimer's Blog:
CAREGIVERS ARTICLE From Alzheimer's Weekly this week:
Great results were attained by the U.S. Department of Veteran Affairs' pilot program called REACH (Resources for Enhancing Alzheimer’s Caregiver Health). Now, it will expand nationally to support caregivers of veterans with dementias such as Alzheimer’s.
WASHINGTON – The Department of Veterans (VA) is expanding support nationally to caregivers of Veterans with Alzheimer’s disease. A pilot program of the REACH VA (Resources for Enhancing Alzheimer’s Caregiver Health in VA) program showed great success in reducing stress on caregivers while improving care outcomes for the Veterans.
“The REACH VA model exemplifies the many different kinds of support VA offers to the caregivers of Veterans,” said Secretary of Veterans Affairs Eric K. Shinseki. “This program has been proven to provide the right resources, training and a renewed focus on personal health that can make a world of difference to those caregivers and their Veterans.”
“Caregivers step up every day to serve Veterans they love who sacrificed to defend our Nation,” Shinseki added. “To them, caregiving is a labor of love and devotion, but that alone does not ease the burden and personal stress placed on those who provide daily care for the disabled.”
REACH VA involved 127 caregivers connected to 24 VA medical centers. The median age for the caregiver was 72 and the majority of the participants were spouses.
Typical issues caregivers face when caring for Veterans with Alzheimer’s disease and dementia include memory problems, behavior problems and the need to provide basic attendance such as grooming assistance. Caregivers typically reported feeling overwhelmed, frustrated, cut off from family and friends, lonely, prone to bouts of crying and having worse physical health than the year before.
For six months, the REACH VA caregivers were provided 12 individual in-home and telephone counseling sessions; five telephone support group sessions; a caregiver quick guide with 48 behavioral and stress topics; education on safety and patient behavior management; and training for their individual health and well being.
Caregivers saw their burden reduced; drops in depressive symptoms and their related daily impacts; fewer frustrations, including those that have clinical potential for abuse; and decreases in dementia-related behaviors from the Veterans they cared for. Caregivers also reported they were able to spend fewer hours per day devoted to caregiving duties.
“Dementia caregiving is such an all encompassing task,” said Dr. Linda Nichols from the VA medical center in Memphis, Tenn., and co-author of a recent study on the program. “The intervention provided time for themselves, which caregivers never have enough of. REACH VA improved our caregivers’ knowledge to manage care, made them feel more confident and competent as they formed bonds with the VA staff supporting them, and decreased the inevitable feelings of isolation and loneliness that come from a selfless, but very sacrificial duty of care.”
VA will roll out REACH VA on a national basis through home-based primary care programs across the country. In addition, the program will be modified to assist caregivers of Veterans with other diagnoses like spinal cord injury and traumatic brain injury.
“Providing support to caregivers who sacrifice so much to allow Veterans to remain at home surrounded by loved ones is the right thing for VA to do,” said Dr. Robert Petzel, VA’s under secretary for health.
An article on the REACH VA program is being published in the Feb. 28 issue of the Archives of Internal Medicine. Nichols and Dr. Jennifer Martindale-Adams, also from VA’s Memphis facility, are the lead authors and based the VA pilot on the National Institute on Aging and the National Institute for Nursing Research funded REACH II study. REACH VA is the first national clinical implementation of a proven behavioral intervention for stressed and burdened dementia caregivers.
Sincerely,
Marie Fostno
Seaboard Press An Imprint Of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/
--------------------------------------------------------------------------------
CAREGIVERS ARTICLE From Alzheimer's Weekly this week:
Great results were attained by the U.S. Department of Veteran Affairs' pilot program called REACH (Resources for Enhancing Alzheimer’s Caregiver Health). Now, it will expand nationally to support caregivers of veterans with dementias such as Alzheimer’s.
WASHINGTON – The Department of Veterans (VA) is expanding support nationally to caregivers of Veterans with Alzheimer’s disease. A pilot program of the REACH VA (Resources for Enhancing Alzheimer’s Caregiver Health in VA) program showed great success in reducing stress on caregivers while improving care outcomes for the Veterans.
“The REACH VA model exemplifies the many different kinds of support VA offers to the caregivers of Veterans,” said Secretary of Veterans Affairs Eric K. Shinseki. “This program has been proven to provide the right resources, training and a renewed focus on personal health that can make a world of difference to those caregivers and their Veterans.”
“Caregivers step up every day to serve Veterans they love who sacrificed to defend our Nation,” Shinseki added. “To them, caregiving is a labor of love and devotion, but that alone does not ease the burden and personal stress placed on those who provide daily care for the disabled.”
REACH VA involved 127 caregivers connected to 24 VA medical centers. The median age for the caregiver was 72 and the majority of the participants were spouses.
Typical issues caregivers face when caring for Veterans with Alzheimer’s disease and dementia include memory problems, behavior problems and the need to provide basic attendance such as grooming assistance. Caregivers typically reported feeling overwhelmed, frustrated, cut off from family and friends, lonely, prone to bouts of crying and having worse physical health than the year before.
For six months, the REACH VA caregivers were provided 12 individual in-home and telephone counseling sessions; five telephone support group sessions; a caregiver quick guide with 48 behavioral and stress topics; education on safety and patient behavior management; and training for their individual health and well being.
Caregivers saw their burden reduced; drops in depressive symptoms and their related daily impacts; fewer frustrations, including those that have clinical potential for abuse; and decreases in dementia-related behaviors from the Veterans they cared for. Caregivers also reported they were able to spend fewer hours per day devoted to caregiving duties.
“Dementia caregiving is such an all encompassing task,” said Dr. Linda Nichols from the VA medical center in Memphis, Tenn., and co-author of a recent study on the program. “The intervention provided time for themselves, which caregivers never have enough of. REACH VA improved our caregivers’ knowledge to manage care, made them feel more confident and competent as they formed bonds with the VA staff supporting them, and decreased the inevitable feelings of isolation and loneliness that come from a selfless, but very sacrificial duty of care.”
VA will roll out REACH VA on a national basis through home-based primary care programs across the country. In addition, the program will be modified to assist caregivers of Veterans with other diagnoses like spinal cord injury and traumatic brain injury.
“Providing support to caregivers who sacrifice so much to allow Veterans to remain at home surrounded by loved ones is the right thing for VA to do,” said Dr. Robert Petzel, VA’s under secretary for health.
An article on the REACH VA program is being published in the Feb. 28 issue of the Archives of Internal Medicine. Nichols and Dr. Jennifer Martindale-Adams, also from VA’s Memphis facility, are the lead authors and based the VA pilot on the National Institute on Aging and the National Institute for Nursing Research funded REACH II study. REACH VA is the first national clinical implementation of a proven behavioral intervention for stressed and burdened dementia caregivers.
Sincerely,
Marie Fostno
Seaboard Press An Imprint Of James A Rock Pub., Co.
http://www.mariefostino.com/
http://www.mariefostino.blogspot.com/
--------------------------------------------------------------------------------
Sunday, April 3, 2011
Alzheimer's Blog:
Today I want to talk about Ethics.
I looked it up and here is the definition I found.
eth·ics /ˈɛθɪks/ Show Spelled [eth-iks] Show IPA –plural noun 1. ( used with a singular or plural verb ) a system of moral principles: the ethics of a culture. 2. the rules of conduct recognized in respect to a particular class of human actions or a particular group, culture, etc.: medical ethics; Christian ethics. 3. moral principles, as of an individual: His ethics forbade betrayal of a confidence. 4. ( usually used with a singular verb ) that branch of philosophy dealing with values relating to human conduct, with respect to the rightness and wrongness of certain actions and to the goodness and badness of the motives and ends of such actions.
Than I looked up Quality of Life:
Within the field of health care, quality of life is often regarded in terms of how it is negatively affected, on an individual level, a debilitating illness that is not life-threatening, life-threatening illness that is not terminal, terminal illness, the predictable, natural decline in the health of an elder, an unforeseen mental/physical decline of a loved one, chronic, end-stage disease processes. Researchers at the University of Toronto's Quality of Life Research Unit define quality of life as “The degree to which a person enjoys the important possibilities of his or her life” (UofT). Their Quality of Life Model is based on the categories “being”, “belonging”, and “becoming”, respectively who one is, how one is connected to one's environment, and whether one achieves one's personal goals, hopes, and aspirations.
I know you are wondering where this is coming from. I wrote on March 23 about one of my patients that I ran who had Alzheimer's, can not communicate and was having respiratory distress. I ran on her again early this morning. The nurse at the nursing home begged me not to bring her to the same hospital because she said that this patient came back three hours later and not stable. So she insisted that I go to a hospital fifteen minutes away. She said she had a DNR but there was no doctors signature on it so it was not valid. If you could understand my position you would realize how risky this was. I had an unstable patient, in respiratory distress, by my self. If this patient stops breathing and her heart stops, it will be very hard for me to work a code by myself.
My EMT and I were busy after we loaded her on my gurney and in my ambulance. We took vitals, placed ecg leads on her moist and cool body. Gave her a SVN albuteral treatment and solu-medro to help her with her breathing. It was hard but we even got in an IV.
We reached the hospital with the doctors angry with me for passing up other hospitals due to her respiratory distress. They finally got a hold of the family who said it was fine to intubate her but no compressions is she codes. I am so confused. Do these people know what they are doing to there mom. This patient is confused, scared, and has no idea what is going on. Yet her family is trying to keep her alive so they can visit her once in a while at the nursing home. What kind of quality of life is that for her?
Sorry I just had to vent. Think about this as you make your living wills for your loved ones with Alzheimer's.
Sincerely, Marie Fostino
Alzheimer's A Caretaker's Journal - Seaboard Press An Imprint James A Rock Pub., Co.
Friday, April 1, 2011
Alzheimer's Blog:
Assisted Oral Feeding and Tube Feeding
The Alzheimer’s Association has addressed the issue of end-of-life nutrition and hydration in several documents. The 1994 statement Guidelines for the Treatment of Patients with Advanced Dementia includes the following position: Severely and irreversibly demented patients need only care given to make them comfortable. If such a patient is unable to receive food and water by mouth, it is ethically permissible to choose to withhold nutrition and hydration artificially administered by vein or gastric tube. Spoon feeding should be continued if needed for comfort.
Ethical Issues In Alzheimer's Disease
http://www.alz.org/alzwa/documents/alzwa_Resource_EOL_FS_Oral_Feeding.pdf
Hope this helps. It is a hard decision on what to do toward the end stages of Alzheimer's. You are not alone. I have been there. If you need to discuss this please e-mail me.
Sincerely, Marie Fostino
Alzheimer's A Caretakers Journal - Seaboard Press An Imprint of James A Rock Pub., Co.
www.mariefostino.com www.mariefostino.blogspot.com
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