I love to promote those helping to spread awareness of the triumphs and challenges of family caregiving.
A new podcast, engAGING Conversations, launched this month. Sheryl Smith, RN, BSN, M.Ed Certified Health Coach, has created this podcast to cover a wide variety of caregiving topics. I recently had a conversation with Sheryl, in which we discuss my book, The Reluctant Caregiver. The episode is scheduled to air March 20.
On Google Play (requires login)
On iTunes (requires free iTunes software)
Smith has the experience of being a professional caregiver as a nurse and caring for her parents as they aged. Her insight is so valuable to family caregivers. Smith also hopes to carry forward the conversation about end-of-life planning, which is a topic near and dear to my heart.
The first three episodes are posted on Sheryl’s website, and you can subscribe to the podcast via your favorite provider.
Photo via Driving Miss Norma/Facebook
I’ve written before about how inspiring I found Miss Norma to be. At 90, after losing her husband and being diagnosed with stage IV uterine cancer in a short period of time, Norma decided to skip grueling cancer treatment and “hit the road.”
Norma joined her son, daughter-in-law, and dog and embarked on a year-long adventure of a lifetime. The journey was lovingly documented on the Driving Miss Norma Facebook page.
But all good things must come to an end. Norma Jean Bauerschmidt died Sept. 30, 2016. When asked how she wanted to be remembered, Norma said, “Wouldn’t it be nice if others could just spread joy in the world.”
Wouldn’t that be nice indeed.
Her bright, upbeat, and loving spirit will be missed, but I will forever be inspired by her choice to embrace quality of life and truly live the time she had left in this world. Norma in many ways reminded me of my own mother. I’ve included a couple of my favorite photos and posts of her below.
In memory of Norma, do something special for someone you love, or for a complete stranger. Spread the joy!
If you have Netflix, you may have seen an ad for the 24-minute film Extremis. I often ignore whatever Netflix is promoting, because often it just doesn’t match up with my interests. But this short film addresses an issue near and dear to my heart: end-of-life care wishes.
Extremis follows Dr. Jessica Zitter, a palliative care specialist at Highland Hospital in Oakland, California. She helps guide families through the toughest decision of all, when to transition from life-sustaining care that is often uncomfortable for the patient (breathing tubes, feeding tubes) and focus on comfort care, allowing a patient to die peacefully.
It is often the toughest decision a family will ever make.
Much like some people are more motivated to quit smoking after hearing the stories of lung cancer victims versus reading inspirational brochures, I hope that this film will serve as a sobering wake-up call about how important is to make end-of-life wishes. The consequences of ignoring such advice is outlined in painful detail in the film.
At the same time, when no orders are in place, each family reserves the right to decide what care their loved one will receive, even if it goes against the doctor’s advice. I may not have agreed with all of the family’s decisions in this film, but I could tell they came from the heart.
Anyone who has been through an emergency medical issue with a loved one will relate to this film. Suddenly you are faced with making major life-and-death decisions under the worst of circumstances. It is overwhelming and emotional. There is despair and hope and guilt and more than anything, a cloud of uncertainty hanging over everything. It’s a moment you never want to experience but also one that you never forget.
If you have a chance, check it out and let me know what you think.
There is much talk here in the U.S. as the new health care exchanges that the Obama administration has developed to lower health insurance costs open on October 1st. But I found an article this week that has some surprising results in another part of the health insurance world that impacts dementia patients.
Presbyterian Hospital, the last place I saw Dad alive.
A study conducted by NYU researchers found that dementia patients with managed care insurance were sent to the hospital less often to treat end-of-life health issues that would not improve their quality of life. Managed care organizations receive a lump sum payment for each patient, so they have an incentive to keep costs low by not encouraging unnecessary medical care. However, those with traditional Medicare which pays a fee for each service rendered were sent to the hospital more often. The difference in hospitalizations by insurance type was significant: only 4 percent for those with managed care vs. 16 percent for those with Medicare.
Managed care incentives to keep costs low can backfire on patients, sometimes limiting coverage of services that are not medically necessary but would improve quality of life. But in this instance, the focus on the financial aspect of healthcare actually benefits advanced stage dementia patients. My father was in and out of hospitals the last year of his life because his inpatient stays were completely covered by Medicare. But they did not improve his quality of life; in fact the sudden change of environment may have left him more mentally confused. The elderly are also at high risk for serious, even deadly hospital-acquired infections every time they spend time in an inpatient facility.
It’s one of those rare examples where shrewd and calculating financial decisions actually translates to compassionate action.