Alzheimer's, Dementia, Emergency Preparedness, Health & Wellness, Senior Services

Emergency Room Environment for Alzheimer’s Patients – Denver Hospital Takes the Lead

I would not call the emergency room featured in the article below “paradise”, but I would say it is a vast improvement over others in terms of amenities and should be considered for all emergency rooms, not only for those receiving persons with Alzheimer’s and dementia.

There are large clocks to read the time, big white boards written with exactly what tests and treatments you are receiving and how long they will last, softer lighting, no disruptive noises from monitors, curtains with soothing scenes to look at such as waterfalls.

The report claims the floors are designed with falls in mind but the bathroom floor looks like tile. No to tile! Use linoleum (rubber) or other material which can cushion falls and is quiet!!

Wondering if I missed seeing guard rails on the bed.

The senior TV correspondent in the video in the link falls short of being articulate, but the TV station footage captured at the hospital is worth viewing.

Congratulations to Denver’s Lutheran Medical Center for taking this first step. May the world follow your lead.

Note: The article in the link below was found on an excellent free weekly newsletter (via a Denver TV station). Alzheimer’s Weekly.

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Aging, Hospice, Mexico, Palliative Care, Senior Services

2nd International Palliative Care Congress in Guadalajara, Mexico – Oct 2015

Juntos Contra el Dolor, AC (United Against Pain) a palliative care non-profit in Guadalajara, Mexico produced its 2nd International Palliative Care Congress (II Congreso Internacional de Cuidados Paliativos) at Expo Guadalajara October 29, 30, and 31, 2015. Physicians, psychologists, social workers, tanologists, nurses, and hospice volunteers participated in a study of the theme, Health Crisis: A Threat or an Opportunity for Growth?

Juntos Contra el Dolor Palliative Care Congress, Oct 2015, Mexico
Juntos Contra el Dolor 2nd International Palliative Care Congress, Guadalajara, Mexico   October 2015

Dr. Marcos Gomez Sancho, pioneer and thought leader in palliative care from Spain’s Canary Islands, was the main speaker. He spoke of the History of Death in Different Cultures, the Agony of Death vs. Dying in Peace, and, Advice for Family Caregivers in Terminal Situations. In addition to his own conclusions, he chose quotes from poetry, music, psychiatrists, and authors, as well as art work, to illustrate his main points:

the family must allow the ill person to make their departure

the experience of the person who is dying can help those who are witnessing their passing

the worst deaths are for those attached to machines (extreme personal pain, extreme financial costs)

the care team must be inter-disciplinary for best positive outcomes (attending to psycho-social, economic, physical, and spiritual needs of patients and families)

Dr. Marcos Gomez Sancho of the Canary Islands, Spain
Dr. Marcos Gomez Sancho of the Canary Islands, Spain, thought leader in palliative care signing one of his books

Dr. Gomez played a tape of Greek singer Demis Roussos’ Morir al Lado de Mi Amor (To Die Beside My Love), which reiterates a common last wish. He also quoted Austrian neurologist Sigmund Freud, “If you want life, prepare for death.”

Here below are You Tube links to Demis Roussos’ music in Spanish and French. (The Congress heard audio only, it did not view photos):

https://www.youtube.com/watch?v=193oMUtQzGE with Spanish sub-titles

https://www.youtube.com/watch?v=S5pu-FheBAo woman admirer’s production with no sub-titles

https://www.youtube.com/watch?v=QTBQm5RWUcw  in French

Other compelling lectures included anesthesiologist Dr. Beatriz Angelica Flores Garcia’s controversial topic Morfina vs. Marihuana. She outlined how morphine and marijuana can be used for pain relief. No one on the panel of professionals, nor anyone from the audience, could agree about use of either or both, and/or effects.

Psychologist Ortencia Gutierrez Alvarez focused her talk about crisis in the family as it relates to decisions. Conclusion? Allow free will of the patient. Psychologist Fabiola Montoya Martin del Campo who has worked with youth with cancer for over 20 years shared stories of the bravery and wisdom of children facing crisis. Dr. Cristina Orendain, a well-known naturopath with a number of health food stores in Guadalajara, spoke about tryptophan for pain relief and as a mood enhancer in our food and in supplement form.

Juntos Contra El Dolor founder Dr. Silvia Susana Lua Nava, an expert in palliative care and a nun, was the guiding light behind the conference together with Sister Martina Zumaya Tamayo, a nurse nun with a specialty in bio-ethics. They offer an integrated model for Mexico including best possible professional care with support for both patient and family. They welcome persons of diverse socio-economic background, religion, age, and race at their hospital for care, counseling, or to arrange in-home services.

 

Hda. Madre Silvia Susana Lua Nava, MD
Hda. Madre Silvia Susana Lua Nava, MD

Dr. Lua offered her own account about suffering and pain as an opportunity for spiritual growth. In 2015 she experienced three invasive surgeries, one to correct a surgery gone wrong. From age 19 to 2015 she endured five other surgeries. The presentation of how she learned to confront and overcome pain and the unknown was both amusing and inspiring. Dr. Lua is also the author of a book about palliative care which shares her insights, El Enfermo: Terreno Sagrado (The Ill: Sacred Ground).

Dr. Manuel Centeno from OPD Hospital Civil Guadalajara (the new civic hospital Dr. Juan I. Menchaca) addressed the most frequent problems treating patients with cancer of the colon. Nurse Elisa Gutierrez Andrade spoke of placement and complications involved with surgically implanted PEG’s (percutaneous endoscopic gastronomy), stomach feeding tubes. In both instances, explicit photos were shown and the lessons about care were clear and convincing.

Maria de Jesus Gonzalez Romo spoke of home nursing care and a not unusual circumstance – attending to men who have two families – two “wives” and two sets of children all meeting at the man’s death bed. Gonzalez spoke of what the patient suffers physically, psychologically, and spiritually – and how survivors deal with the patient’s pain and their own. Lots of drama – anger, forgiveness, fighting – but also a lot of love.

Attendees earned 20 continuing education credits and a diploma from the Colegio Nacional de Cuidados Paliativos de Jalisco, www.comecupal.com.mx

A note about palliative care in Mexico:

The Ministry of Public Health instituted a law in 2009 that all citizens should have access to palliative care (pain relief and comfort for chronic diseases and at end-of-life). In October 2014 the Human Rights Watch conducted a study which showed the availability of palliative care is uneven and limited throughout the country. There are also politics associated with obtaining opiods. See article at http://www.ehospice.com/ArticleView/tabid/10686/ArticleId/13355/language/en-GB/Default.aspx

A note about Juntos:

As with most non-profits, Juntos Contra El Dolor relies on donors – pharmaceutical companies, the Catholic church (which provides the housing), volunteers, and others. Throughout the year Juntos hosts weekly educational activities in an effort to support its professionals and its expenses. Dr. Nava and two other nuns are unpaid. Funds for cleaning supplies, diapers, kitchen items, linens, gasoline for in-home visits, nursing staff, nursing supplies, and upgraded office equipment are always in need. Juntos is registered as an international non-profit and all donations are tax deductible by deposit to the Juntos Contra El Dolor account at ScotiaBank CTA 01002517167. More information is available at tel. (52)(33) 3617-2417, http://www.JuntosContraElDolor.com, or at juntoscontraeldolor@gmail.com.

The web site for Dr. Marcos Gomez Sancho is http://www.mgomezsancho.com

 

Aging, Ecuador, Ecuador Senior Living, Health & Wellness, Senior Services

Cuenca, Ecuador Inaugurates New City Senior Center

Mayor Marcelo Cabrera, his wife, city dignitaries, employees, and approximately 150 seniors were present Sunday morning, April 19, as Cabrera proudly inaugurated one of Cuenca’s special projects, the “first free public senior center” also known at El Hogar del Abuelos (Home of the Grandparents).  Eight other city senior centers are in the planning stages.

See Cuenca High Life article at link below

http://cuencahighlife.com/cuenca-mayor-cabrera-inaugurates-new-city-senior-center/

Cuenca Ecuador's new city senior center in the El Vergel neighborhood
Cuenca Ecuador’s new city senior center in the El Vergel neighborhood
Aging, Alzheimer's, Assisted Living, End-of-Life Care, Health & Wellness, Hospice, Long-Term Care, Palliative Care, Senior Services

Institute of Medicine End-of-Life Care Conference March 20

I am super excited to attend this on-line conference (a webinar), open to the public, on Dying in America – what we can do for better communication with patients and their families, what education and development opportunities can be created and implemented, and most of all how we can create a future where palliative and hospice care is serene, comfortable, painless (should the patient wish this), supportive, and honoring free will. See link below for details.

IOM looks deep into end-of-life care.

Assisted Living, Health & Wellness, Mexico Senior Living, Retirement, Senior Living, Senior Services

Mexico’s AMAR Hosts Senior Living Convention w/ North American Investors & Retirees

AMAR, the Mexican Association of Retirement Communities (Asociacion Mexicana de Asistencia en el Retiro), is hosting AMAR’s International Convention 2014 at Rosarita Beach Hotel, Rosarita Beach, Baja California, October 23-25, for North American and Mexican senior housing industry professionals and the public. Rosarito Beach is 20 miles south of San Diego, CA in Mexico.

The event focus, part of a continuing dialogue, is how to attract a portion of North American Baby Boomers over the coming years to senior-friendly, affordable destinations in Mexico with ideal weather,  health services, infrastructure, and proximity to the U.S. It is anticipated that of 100 million boomers in Canada and the U.S., 4 million will consider living in Mexico. According to Internet statistics, there are currently 1,400,000 to 1,600,000 U.S. citizens living in Mexico, not all retirees.

Experienced Canadian and U.S. senior living developers, operators, and executives will meet to discuss collaboration possibilities with Mexican developers and investors.

Among the 22 scheduled speakers are Americans Martin Lakatos, VP and developer for California based Front Porch Development Company; Patricia Will, CEO of Belmont Village Senior Living (23 Assisted Living properties across the U.S. and one in development in Mexico City); and Matthew J. Downs of the Center for Medicare Portability. Javier Govi, Founder & CEO of AMAR; Ignacio Bernal of FONATUR (a Mexican government entity which plans and develops top tourist destinations); and Rodrigo Contreras Mejia of PROMEXICO (a Mexican government trust for international trade and investment) will be among the speakers from Mexico.

Subjects will include elements for successful operation of CCRC’s, active senior living, and Alzheimer’s and dementia care with holistic/wellness-based concepts, eco-friendly LEED-certified construction, universal design, and health information technology. Topics will also include the state of MOM and POP projects, aging in place communities where services come to you, and Medicare in Mexico. (Medicare is not yet accessible outside the U.S. unless under rare circumstances. American seniors can purchase Medigap emergency plans C, D, F, G, M, or N with a $250 deductible).

Lic. Javier Govi, Founder & CEO AMAR
Lic. Javier Govi, Founder & CEO AMAR

When asked about the current state of senior living and its future in Mexico, AMAR’s Javier Govi stated, “We currently cater to the mom and pop market, the parents of baby boomers. We are simultaneously transitioning to meet the needs of boomers who have begun to retire. We have spent years studying this market, looking at the history, and visualizing the future. The important components for boomers will be wellness, fitness, and a holistic approach.”

An adjunct part of the event is the 50+ Expo and Workshops for Healthy Living where the public can learn about senior living options in Mexico.

AMAR Friends Foundation, which helps retirees find independent or assisted living in Mexico, is sponsoring the 50+ Expo. Seminars are designed “to answer questions from banking to moving belongings, and what is involved in obtaining a residential visa,” added Govi. The expo also includes product displays and music. The foundation will soon be providing social service projects for poor elderly Mexicans through its North American volunteers. See http://www.amarfriends.org.

AMAR, founded in 2007, is the first national Mexican non-profit organization committed to educate and collaborate with Mexican government regulatory agencies and business executives in Mexico and North America on the potential of the senior housing industry in Mexico.

For more information on the event go to http://www.amar.org.mx, write info@amar.org.mx, or call San Diego, CA number (619)564-4007.

Alzheimer's, Assisted Living, Health & Wellness, Senior Services

Interior Design for Alzheimer’s/Memory Care Communities – A Successful British Experiment

For almost two decades, especially since I served as night time administrator and marketing director at an Alzheimer’s campus in southern California, I’ve been focused on universal design – how to create a safe, practical, healthful, and inviting environment not only for those requiring memory care, but for anyone, even those of us fortunate enough to be well.

What could be better than an immaculate, welcoming, protective atmosphere where ever you live?

Yesterday I viewed a video about interior redesign of a dementia wing at Elmhurst, an assisted living village in England. I like much of what was chosen. I might not have chosen laminate flooring even if it looks great and is easy to clean, I don’t find it eco-friendly.  I may have choosen linoleum, cork, or wood instead as there is no off gassing. These green products might be safer for falls.  But I imagine there may have been budget considerations. Other than that, a fine redesign job. Based on a visual site visit, even from afar, I would consider recommending this community focused on wellness.

Note the energy of light features, especially the use of skylights and large windows, and the secure garden area.  Also note the reason red prompts were chosen for the bathroom, and cerulean blue gray for the dining room plates. There is valuable information in the video at the link below.

http://www.alzheimersweekly.com/2014/09/redesigning-home-for-dementia-care.html

   please don’t be shocked by the red, there is an excellent reason for the choice

 

Emergency Preparedness, Health & Wellness, Long-Term Care, Senior Services

CMS (Medicare and Medicaid Services) Proposes Stepped-Up Emergency Preparedness

In light of devastating and continuing natural disaster challenges throughout North America, the Centers for Medicare and Medicaid Services proposes increased emergency preparedness standards for long-term care facilities.  May this plan be implemented soon!!  Below is an article with more details by  for McKnight’s

January 03, 2014

CMS proposes more rigorous emergency preparedness rules for long-term care facilities

CMS proposes more rigorous emergency preparedness rules for long-term care facilities
CMS proposes more rigorous emergency preparedness rules for long-term care facilities

Long-term care facilities would have to meet more comprehensive emergency preparedness guidelines, under a newly proposed rule from the Centers for Medicare & Medicaid Services.

Events such as the Sept. 11 attacks, Hurricane Katrina and recent devastating floods around the nation have shown that current emergency preparedness requirements for Medicare and Medicaid providers are inadequate, according to the 120-page proposed rule. Therefore, CMS has drafted more robust requirements for providers and suppliers.

Long-term care facilities would be subject to similar requirements proposed for hospitals. These are based on the principle of “all-hazards planning,” the rule states. This means planning should not involve developing highly specific plans for every conceivable threat, but should focus on creating the capacity to handle a spectrum of emergencies. The government has identified 15 scenarios for healthcare providers to use in assessing their risks, including natural disasters, cyber attacks and biological attacks.

Based in part on a risk assessment, hospitals should develop specific policies and procedures, the rule states. These include such items as tracking the location of staff and patients, and ensuring that medical records are “secure and available” in an emergency.

Long-term care facilities would be responsible for meeting all the hospital requirements, with some specific adjustments and additions, according to the rule. LTC facilities would specifically be directed to account for missing residents during a disaster, would have to determine what emergency planning information should be shared with residents and families, and should evaluate the need for chargers or electrical outlets for items such as motorized wheelchairs.

Click here to access the complete document, issued Dec. 27. Comments are being accepted through Feb. 25.