Winter Walking: Frightful or Delightful?
	by Caroline Gwaltney MSPT CWS December 15, 2011 Oh, the weather outside is frightful ... or is it? Our Copper Country winters can be gorgeous and treacherous at the same time. Many Yoopers enjoy getting out in the snow to walk and take in the beauty of this winter wonderland, while others cringe at the thought of being out in the "white stuff." Like it or not, we all have to brave the weather at some point, and it is important to keep safety a top priority to prevent falls and injury. Proper footwear is essential when walking on snow and ice. At a minimum, boots must have adequate tread to grip the snow much like the snow tires we put on our vehicles. My husband, an engineer, explained to me that there is much better traction between snow and snow, rather than rubber and snow. This is why a good snow tire or snow boot will collect snow in the tread. Smooth-soled shoes or boots with very little tread can cause you to lose your balance, even on a short walk from your car to the store. If you cannot afford new boots, consider buying ice cleats, such as "Yak Trax" to slip over your current boots or shoes. They are inexpensive and can make a world of difference. One thing to remember, be sure to remove the ice cleats before walking indoors. Also, it is important to remove snow from boots and shoes before walking indoors, especially in stores or businesses, to ensure you do not slip and fall. It seems the colder and nastier the weather, the faster people try to walk in parking lots. That is understandable, we want to get where it's warm as fast as possible but it is a recipe for disaster. We need to slow down in slippery parking lots so that we are in control of our bodies. When walking or moving slowly, we can effectively make adjustments to balance and posture to prevent falls, but when we rush, we cannot make the necessary corrections quickly enough, and a fall is more likely. It is vital to stay focused on your walking when outdoors in the winter. Often, falls can occur while people become distracted, such as when searching in a purse or pocket or talking on a cell phone. Dressing appropriately for the weather conditions will help to make our outdoor time more pleasant. Our winter weather can be so unpredictable. It may be sunny and calm in the morning, but snowing and blowing in the afternoon, so we must have the right layers to keep warm and comfortable all day. Several thin layers are typically better than one or two thick layers, not only for versatility, but also for comfort. It is convenient to take off a thin layer or two, leaving more layers to keep warm and comfortable. If you only have a thick, fluffy down jacket over a T-shirt, you will have to choose between being too hot or too cold. Either way, you will not be comfortable. You are best to choose a base layer made of material other than cotton, which gets wet and keeps that moisture close to your body. Silk or polypropylene are much better at wicking sweat away from your body to keep you warm and dry. The right gear makes all the difference. If you need to use a cane or crutches, please consider attaching an ice pick grip to the bottom. This will allow improved traction and help you to feel more confident on snowy or icy surfaces, and you can swing it out of the way when you are walking indoors. Always use a handrail when walking on steps to improve balance. If you should lose your footing on steps, you are much more likely to stay on your feet when you can use the handrail to help regain balance. There are many benefits to walking outdoors for exercise, even in the winter. Most of us spend less time outdoors in cold weather, but we need the exposure to sunlight to help improve our mood and prevent seasonal depression. Walking burns calories and improves energy, and this may be even more noticeable in the winter (especially after the holidays). Finally, and perhaps the biggest advantage of walking outdoors in the winter versus the summer, you can rest assured there will be no mosquitoes! Editor's note: Caroline Gwaltney, MSPT, CWS, is a physical therapist, certified wound specialist and rehab team leader with Aspirus Keweenaw Home Health & Hospice.
	November is Home Care and Hospice Month
	by Wanda Kolb, Division Administrator Aspirus Keweenaw Home Health and Hospice November 2, 2011 National Hospice and Palliative Care Month is November 2011. The theme for this year's event is "We Listen, We Care." Keweenaw Home Nursing brought Medicare skilled hospice care to this community 17 years ago. Prior to that, hospice was provided by groups of thoughtful volunteers who were interested in helping other people get through a most difficult time. We continue to be here for people to help get them through this time of life - we care, we listen. I once read the following quote: "We were given two ears but only one mouth, because listening is twice as hard as talking" - anonymous. I smile whenever I read this, because truly listening is much more difficult than speaking. To truly listen to someone is a gift, one that many hospice providers are skilled at. In our everyday life when conversation occurs, people are often not listening attentively. Active listening is a structured way of listening and responding to others, focusing attention on the speaker rather than being distracted, thinking of other things or what you will say next. Active listening involves listening without judgment and giving full attention to what the other person has to say. You will often hear us say in hospice that it is a privilege to be able to share listening moments with our patients. Consider taking a moment at noon Nov. 1 to listen to your community as bells are rung to bring attention to the hospice movement. We are inviting our local churches to ring bells and the staff of Aspirus Keweenaw Home Health & Hospice will be outside of our office ringing bells at noon time to bring attention to this worthy program. Even though hospice has been in our community for so many years, there are still people who do not understand what hospice is. We want people to know that hospice care focuses on living and on caring, not curing. Hospice care is provided wherever the patient calls home. This may include nursing homes, assisted living facilities or their home. Hospice provides end-of-life care and to all ages with any illness. Hospice care is covered by Medicare, Medicaid and most insurance plans providing quality, compassionate care for people facing a life-limiting illness. Hospice provides expert medical care, symptom management, emotional and spiritual support and for the family following the death of a loved one, bereavement care is provided as well. We care, we listen. Take time to listen at noon Nov. 1 to the bells for hospice. Listen and think about hospice care. We all live, we all die. Have you thought about how you want to spend your last weeks, days, months? Have you communicated this to your loved ones? Many people only consider hospice care in the final days of life but hospice is ideally suited to care for patients and family caregivers for the final months of life. While hospice cannot add days to your life, it can certainly add life to your days.
	Discussing end-of-life issues
	by Sarah Baratono, LMSW September 15, 2011 End of life issues, end of life decisions - two phrases that most of us choose not to bring into the conversation. Perhaps the reality of facing our own mortality or that of our parents or grandparents keeps us from wanting to talk about these necessary decisions that we all must make in our lives. We all hope to live a long healthy life and perhaps talking about end of life issues feels like a subject to avoid. In reality, this subject should not be avoided but rather looked at as an opportunity to share our thoughts and wishes with our loved ones no matter what our age is. Completing a Durable Power of Attorney for Healthcare form or a "Five Wishes" document is a good place to start talking about what our wishes would be at the end of our life. Making your wishes known ahead of time can be a gift your family and friends will appreciate when they have to communicate those decisions to health care professionals if you are unable to express them. According to AARP, "Planning now for your future health care is one of the most important acts you will ever do for yourself and your loved ones." The Community Coalition on Grief and Bereavement will be presenting a panel discussion entitled "Now and Then (Almost) Everything You Wanted to Know About End of Life Issues But Were Afraid to Ask" Oct. 5 at The Bluffs in Houghton. The panel will be composed of local professionals including Dr Sigurds Janners, Carol Olsen, MSW, Cindy Griffin, RN, Funeral Director Ron Antila, Pastor Amy Terhune and Attorney Roger Helman. Topics they will be discussing include end of life care issues, pain control, advanced directives, support for caregivers, home care, hospice and palliative care. Other topics include care for veterans, spiritual needs at the end of life, finding meaning in one's life, funerals, memorial services, cremation, wills and trusts, and financial power of attorney. The panel discussion will be moderated by Bonnie Johnson, RN. There will be time for questions at the end of the panel discussion. This free program will offer local residents an opportunity to plan and make the best decisions possible for themselves and their family. The Community Coalition on Grief and Bereavement is a nonprofit volunteer organization that provides grief education, support and referrals to grieving individuals in the Houghton, Keweenaw, Baraga and Ontonagon counties. Their website is grief-ccgb.org Please plan to join us at 6:30 p.m. Oct. 5 at The Bluffs for this educational opportunity. This event is open to the public and refreshments will be served. Editor's note: Sarah Baratono, LMSW, is a social worker and bereavement coordinator at Aspirus Keweenaw Home Health &?Hospice.
	A Different Kind of Independence Day
	by Wanda Kolb RN; Division Administrator June 23, 2011 Every elementary school child knows that Independence Day or the Fourth of July is a federal holiday commemorating the adoption of the Declaration of Independence on July 4, 1776, declaring independence from England. In my younger years I associated this day with parades, fireworks, picnics, community events and games. As a child, it was my second favorite day of the year, with only Christmas topping the list. How I looked forward to running the three-legged race at the Lake Linden Park, entering the bike parade or dancing polkas on the street in the evening. It was a time when relatives arrived from Detroit and Aunt Dorothy gave each of her nieces and nephews a crisp new one dollar bill to spend in any way we wanted. Can you imagine an entire dollar for just me? It was a magical time for a 9-year-old. Now, 50 years later with Independence Day just around the corner, my thoughts focus on a different type of independence, the type that is significant to me now. For those of us who work in Home Health Care each day that we are able to help keep a senior independent in their home is a reason to celebrate. Home Health Care has made a difference in our community. People who at one time would have been admitted to a long-term care facility can now remain relatively independent in their home with a little extra help. A recent AARP survey shows that 84 percent of all Americans want to stay at home as long as possible. A study by the California Department of Aging estimated that 30 percent of woman and 17 percent of men over the age of 75 need some form of assistance with personal care. In the age group 85 and older 49 percent need some form of personal care assistance. If you are in that age group or are helping to care for parents in that age group, it may be time to consider home health care. It is estimated that 65 million Americans are currently taking care of loved ones at home. This can be difficult and stressful situation for the caregivers. Especially for those of us who provided this care during our child rearing years when we were busy raising a family, working and then spent any free time dedicated to the care of a loved one. I have always been grateful to have been close to loved ones when they needed me but more than 9 million Americans live more than 100 miles from family members. The good news is that there is help. If persons qualify they may be eligible for financial assistance for home care through agencies like UPCAP, Department of Health and Human Services or the Veterans Administration. By dialing 211, you will be connected to an operator who can tell you about the services available in your community. Medicare and private insurances pay for skilled care if a skilled need is identified by your physician and you are homebound. If you do not meet the qualifications set by Medicare and you need help, private pay options are also available through private duty home health agencies. Help is available. It's what we do. Independence Day again approaches. I will be watching the fireworks and parade at Lake Linden as I have since I was a child. I'll be flipping pancakes at the Lion's Club breakfast with my husband and already have my picnic menu planned. But when the holiday is over I'll be back at work doing what Keweenaw Home Nursing and Hospice and Keweenaw Home Services (now owned by Aspirus) has done for over 22 years - helping people to celebrate their Independence Day. Wanda Kolb is the division administrator for Aspirus Keweenaw Home Health &?Hospice.
	Home telehealth: Benefits for Patients
	by Gladys Polzien, RN, MSN, CHPN May 12, 2011 Home Telehealth programs are being implemented across the nation as well as in the Copper Country as an intervention to support reduction of avoidable hospitalizations. Home Telehealth services include teletriage, phone monitoring and telemonitoring. Your physician plays an important role in successful telehealth through collaboration with local home care agencies to establish patient specific monitoring parameters. Teletriage service occurs when the patient or caregiver calls their home health agency with a question or problem. The home care agency registered nurse then triages, or sorts out, the patient's concern based on the information received to decide the best course of action. Teletriage may include symptom assessment, education or referral to physician or hospital. Phone monitoring is also used to decrease avoidable acute care hospitalizations and to improve patient self-care management. This service is done through scheduled phone calls by the home care agency registered nurse. Phone monitoring calls are provided in addition to home health visits. Telemonitoring is another innovative service for patients at risk for hospitalization, newly diagnosed with a chronic disease such as heart failure or those who would benefit from daily evaluation by a registered nurse. The goals of this program are to catch problems early before they turn into emergency situations, to decrease the need for hospital admissions, to help people manage their own health care at home and to provide peace of mind that a registered nurse is providing daily monitoring. Here's how telemonitoring works. Each day, the telemonitoring unit placed in patients' homes guides them through a simple, three-minute process with step-by-step instructions. People are able to record their weight, blood pressure, pulse, temperature and oxygen saturation. This data is then securely transmitted to the home care agency office where a nurse reviews the information and tracks it for significant change. Based upon parameters established by your physician in advance, the nurse responds with telephone interventions as prescribed. The interventions may include further assessment, teaching and/or communication with the patient's physician. For additional information about Home Telehealth services and availability, please contact Aspirus Keweenaw Home Health and Hospice at 337-5700. Gladys Polzien, RN, MSN, CHPN, works for Aspirus Keweenaw Home Health and Hospice.
	Do I Really Like My Job?
	by Melissa Anderson, CHPNA April 1, 2011 Many times I am asked the question, "do I like my job or do I get bored with my job"? The answer is simple for me. As a home health and hospice aide working for Aspirus Keweenaw Home Health and Hospice, I love the work that I do, and I never get bored with it. Every day brings something new and interesting. This may seem like a surprising statement since a recent article in the New York Post stated: "...45 percent of Americans are satisfied with their work." Some people may think that being an aide is all about giving baths, but there's so much more to it than that. Our clients look forward to seeing us, not just to provide care, but to visit with them and check on them as we may be the only person they see in a day. Yes, we do personal care and assist with activities of daily living, but we also form special bonds with our clients. That is the part of the job that I love the most. The first visit to a new client is always the most difficult, but by the end of the visit, you leave feeling like you've known this person for longer than an hour. We are fortunate to be able to spend considerable time with our clients, which puts them at ease so that they welcome us into their home. As a hospice aide, I care for clients with a terminal illness. In hospice, we are not only there for the client but also to support the family through these hard times. This aspect of the job is very important to me. Knowing that I am there when I am needed is very honoring. Of course, the aides do not do their work alone. In hospice, there is a whole team of professionals who work together to provide support, direction and the best care possible. It's an honor to hear a client tell me that I've done a good job, or they express happiness at seeing me. That's when I realize that my job is important, Iv'e done well, and I love my job even more. As I am doing my work I always try to provide caring and respectful work while acting professionally and our clients and families refer to us as "angels", when we are just doing the job that we were hired to do. Although I work in home health and hospice, both types of work are a bit different. In home health, we are in the home of the patient who requires skilled care following an illness or surgery. In hospice, we are in their home, which could be either a nursing home, hospice house, or their own home, providing comfort care to the client and their family. Having a home care and hospice in the area allows clients to stay at home and receive help so that they can stay there. Knowing that I am making it possible for them to stay at home is rewarding. So, to answer the question, "do I like my job"? Yes, I love my job. I love all the special bonds that I form with my clients and being there to hep them stay at home or in the case of hospice care, making their last days comfortable. Thank you to all of our clients and families for welcoming us into your home. I am proud to announce that three of the aides from Aspirus Keweenaw Home Health and Hospice have recently passed the hospice and palliative care exam. Congratulations to Melissa Anderson, Cherie Lasanen and Debbie Gagnon. Melissa Anderson is a home health and hospice aide for Aspirus Keweenaw Home Health and Hospice.
	April is Parkinson Disease Awareness Month
	by Sarah Baratono LMSW March, 2011 Parkinson's disease is a disorder of the brain that affects the transmission of messages to the muscles in a person's body. Characteristics include tremors, stiffness of the muscles and difficulty initiating movements. Parkinson's disease is a progressive disease which means it normally worsens over time. This disease most often occurs later in life, but can affect younger individuals as well. It usually, but not always, develops slowly. According to the Parkinson's Disease Foundation, they estimate there are nearly 1 million people in the United States living with Parkinson's disease and 4.1 million people worldwide. At this time, there is no cure for Parkinson's disease. However, with early diagnosis and an effective treatment plan, the symptoms of the disease can be controlled or lessened. Treatment can widely vary depending of the individual and may include medication therapy, rehabilitation therapy and lifestyle alterations. A person's physician would monitor any medications they had prescribed. Physical, occupational and speech therapists can assess the person's abilities and needs. They can provide exercises to help maintain the highest possible muscle tone, balance, flexibility and ability to communicate. Included in lifestyle alterations are exercises to maintain muscle tone and strength, good nutrition along with rest and stress reduction. Life with Parkinson's disease has effects not only on the persons who is diagnosed, but also on their family members and friends. Usually there is one person who takes on the role of the primary caregiver for the person who has Parkinson's disease. Like with any chronic illness, outside support is necessary for both the person with Parkinson's disease and their caregiver in order to better cope with the situation. Joining a support group may be helpful. In a support group you can ask questions, express concerns and compare your experiences. You may have discussions about new medications or treatments. Besides providing the opportunity for you to talk with others who are facing the same thing, a support group will also provide you with valuable information about Parkinson's disease. When dealing with a diagnosis of Parkinson's disease, you may need to actively seek out support from friends, family and other caregivers. Many in your life may recognize the challenges of a chronic disease and the role of caregiving and will be supportive of both of you. If people in your life do not offer to help, it may be that they just don't know what you might need. You may have to learn to ask for help. You need to learn to take care of yourself. If you are the caregiver you may be very much inclined to put the needs of your spouse or partner who has Parkinson's disease first. Try to set priorities, learn to relax and make time for yourself. Accept help from your family, friends and neighbors. By attending a support group, you can be a wonderful resource to others with Parkinson's disease. Perhaps you will have answers to questions others might be wondering about, or can share stories of how you are dealing with the disease. Aspirus Keweenaw Home Health and Hospice sponsors a Parkinson's disease support group on the second Monday of each month at 1 p.m. in their offices at 311 Sixth St in Calumet. This group is open to anyone who has Parkinson's disease or is caring of someone with the disease. The group meets from April through December. Guest speakers include physicians, physical therapists, occupational and speech therapists, gentle exercise and the occasional game of Wii to help with balance issues. Please join us at 1 p.m. April 12. Editor's note: Sarah Baratono, LMSW, is the family care/bereavement coordinator at Aspirus Keweenaw Home Health and Hospice.
	Dealing With Matters of the Heart
	by Colleen Rowe February 14, 2011 February is Heart Month. What does this really mean? I believe it means different things to different people. Barack Obama, president of the United States of America, believes it is so important that he proclaimed February 2011 as American Heart Month. Many of us think that this month is an opportunity to learn new or better ways about how to keep our hearts healthy. Some of us come from families with heart problems so we try to be proactive by practicing healthy lifestyles that includes exercising, eating heart healthy foods, maintaining a healthy weight, not smoking and limiting alcohol intake. The following numbers demonstrate the reasons why we should be concerned about and take good care of our hearts in February and every month of the year. In 2006, 631,636 people died of heart disease. Heart disease caused 26 percent of deaths - more than one in every four - in the United States. Heart disease is the leading cause of death for both men and women. Half of the deaths due to heart disease in 2006 were women. Every year, about 785,000 Americans have a first heart attack. Another 470,000 who have already had one or more heart attacks have another attack. In 2010, heart disease will cost the United States $316.4 billion. This total includes the cost of health care services, medications and lost productivity (for more information please visit CDC.gov/HeartDisease) Other people look at February as a chance to celebrate with the ones they love on Valentine's Day. Comedian Jim Gaffigan once said "Without Valentine's Day, February would be ... well, January." On the more serious side, Valentine's Day is a great opportunity to show how much you love all of the people you care about. But how do you mend a broken heart? When you lose a loved one, it's the memories that keep you going. Be thankful for the time you were given with this person. Think about all the times you laughed, cried, did silly things together. Get together with others and talk about all the memories you shared. Think about all the nice things you did for them; forgive yourself for anything you did that wasn't so nice. Sometimes we have time to ask for forgiveness and tell the person we love them. Sometimes we don't. Tell them anyway. My father died on his morning walk, my mother died after a short hospital stay and my good friend and co-worker died after a year and a half battle with cancer. It was much easier to feel at peace because I was able to let them know how much I loved them. We don't know how long someone will be with us. Take the time to thank them for things they've done and let them know you care for them while you have the chance. So keep your heart healthy by eating right and exercising. Celebrate Valentine's Day. Take time to let your loved ones know you care. All are matters of the heart. Editor's note: Colleen Rowe is an employee of Aspirus Keweenaw Home Health and Hospice.
	Medication Safety Prevents Mishaps
	by Cindy Mytty RN, BSN, CHPN January , 2011 Medication errors and adverse drug reactions account for numerous hospitalizations, injuries and deaths every year. The elderly are especially vulnerable to these issues because of an increase in the number of health problems encountered. This results in polypharmacy, or multiple medications being prescribed. The more medications a person is taking, the larger potential there is for drug interactions. Furthermore, the normal changes that occur with aging result in slowed absorption, metabolism and excretion of medications. The medications therefore, do not get broken down properly and stay in the body longer than they should, resulting in adverse reactions and side effects. In order to stay safe, take an active role in your health care. There are several simple tips that can help to prevent adverse effects from medications. Learn about every medication you are taking by reading medication labels and inserts. Know about possible side effects, adverse reactions and interactions with other medications, herbals and other supplements, foods, alcohol or even elements such as sunlight. Know the purpose, dose, frequency, best time to take medications and any special storage requirements. If you miss a dose, do not double up to try to "catch up." Instead, call your physician for counsel. Keep a list of your medications in your purse or wallet as well as in the home. Ask your physician or pharmacist if you have any questions. If you do experience side effects, keep track of them and inform your physician right away. Be certain to check each bottle when you receive a new prescription or when refilling medications. Read the label carefully and pay attention to caution stickers. If the pill looks different than usual, check with the pharmacist. It is also wise to use only one pharmacy as they will have a record of all of your medications and can alert you if any new medications could interact with others. Be sure to order refills prior to running out so that you do not have to miss any doses. Take each medication exactly as prescribed and never stop taking or reduce the dose without first checking with your physician. Last of all, keep your medications in original pill bottles. Keep all medical appointments and discuss medical conditions, test results, concerns and medications with your health care professionals. It is very important to keep scheduled appointments for blood draws as many medications need to be monitored closely. Have a "medicine check-up" at least once a year: bring all of your medications, including over-the-counter, vitamins, herbals, inhalers, eye drops, creams, etc. with you to your doctor's appointment for review. Many herbal supplements can interact with prescription medications so always discuss with your physician before taking. Have a friend or relative accompany you to appointments to write down information and ask questions. It is also a good idea to go through your medicine cabinet at least yearly. Get rid of all expired medications and those you are no longer taking. Do not flush pills or liquids down the sink or toilet. Instead, put them in a bag of kitty litter, coffee grounds or a similar substance, add water to dissolve, and dispose of in your regular trash. Keep all medications in a safe place, out of sight and reach of children and away from pets. Use reminders such as calendars, charts or pill boxes to help you to take medications properly. If you still have problems remembering, "talking med minders" are also available. Or you can ask a friend or relative for a "reminder phone call." Take responsibility for your own health by becoming an active member of your health care team. Become knowledgeable about your health issues and medications, keep asking questions and actively participate in health care decisions. Doing so will ensure that you will be as safe as possible. For further information, contact your physician or pharmacist or call Aspirus Keweenaw Home Nursing & Hospice at 337-5700. You can also access medication safety information online at cdc.gov/features/medicinesafety or at webmd.com. Editor's note: Cindy Mytty, RN, BSN, CHPN, is the home health and hospice nurse and oasis coordinator at Aspirus Keweenaw Home Nursing and Hospice.
	November: National Home Care and Hospice Month
	by Gladys Polzien RN, MSN, CHPN November, 2010 Each November, the National Association for Home Care & Hospice honors Home Health and Hospice employees who make a remarkable difference in the lives of patients and their families. In our community, we are proud to be part of a home care and hospice team that makes a difference in your life. If you have never used this health care benefit, you may ask yourself, what exactly does home care and hospice provide? We wanted to share the following information that may answer your questions about Home Health Care and Hospice services. What is Home Health? Home Health Care offers professional services such as skilled nursing, physical, occupational or speech therapy, medical social work, and home health aides, which have been prescribed by a physician and are performed in the home of a patient. What is Hospice? Hospice is an alternative program that focuses on the care of a person with a terminal illness. Hospice emphasizes the quality of life remaining by focusing on the person's special physical, emotional, social, and spiritual needs by a professionally trained hospice team. The Medicare Hospice Benefit covers related expenses including medications, supplies and equipment. Each year, we receive many notes or letters from families after they have had home care or hospice services thanking our staff for the care that was provided to them or to a family member. During this National Home Care and Hospice month, we thought it would be meaningful to share a recent letter that was sent to our local paper and to us from a family member that describes their experience with Hospice. To the editor: I imagine when some people hear the world hospice they might think of death. I did until my sister, Chrissie, became sick and we chose to keep her at home with us. At first, we thought we could do it ourselves, but we were offered hospice and realized we did need some help. No one cares to have strangers in their homes, but we decided we could at least try hospice. We had the help of a social worker, nurse and nurses' aides. We quickly became comfortable with everyone. I'm positive we got in their way sometimes trying to help Chrissie and there was never a complaint. It was comforting to have a medical team come to the home for reassurance and to teach us better ways to help Chrissie. Questions we had were answered professionally and with care, even when we weren't ready for the answers. We had formed a bond and could see how much they cared for Chrissie. When it was time to say goodbye, we were not alone. These special women helped us say goodbye and to let go. Hospice is still a part of our lives. The friendships made did not end. They have grief get togethers and lunches for people who have lost loved ones. We were not alone. Thank you to the hospice professionals, you are very special people. Melissa, thank you for being there with us until the end. It meant everything to us that you were there. We could not have done it without your guidance. The Family of Chrissie Gibson Zubiena Laurium If you have any questions or would like additional information about Home Care or Hospice Services, ask your health care provider or call Aspirus Keweenaw Home Health and Hospice at 337-5700. Editor's note: Gladys Polzien, RN, MSN, CPHN, is the director of operations at Aspirus Keweenaw Home Health and Hospice.
	Summer Safety in the Copper Country
	by Becky Swykert RN June 26, 2010 Looking forward to summer in the Copper Country makes our long winters bearable. Now that summer is here, these tips can help to assure that you and your loved ones have a safe and fun summer. We have some of the best beaches and swimming spots in the world right outside our doorstep. If you are taking young children swimming remember to have a responsible adult supervising at all times. It only takes a few seconds for a young child to drown. In cases where an adult was present when a child drowned they were distracted in some way, talking on the phone, reading, or chatting with others. Never leave a child alone near water, even if the water is only a few inches deep. Enroll your children in swimming lessons, even if you don't spend much time at the water. Studies show that children from non-swimming households are eight times more likely to be at risk of drowning. If you don't know how to swim, look into taking lessons with your child. Local swimming lessons are offered several times a year. Also, consider having your child wear a life preserver when swimming if they are not a strong swimmer. With access to water all around us, many people enjoy boating and fishing. If you and your family go out on a boat remember to get a copy of the Michigan Boating Laws and Responsibilities Handbook. You can download it for free on the State of Michigan website. It has a lot of important information in it, including requirements for personal flotation devices. You can also check with the local Coast Guard Auxiliary about getting a free safety check for your boat. Remember, it is against the law in Michigan to drive a boat while under the influence of alcohol or drugs. We've all read with horror the stories of children dying from hyperthermia after being left in a car. Often times the parents had no idea how quickly a child can overheat and die. One reason for this is that children's bodies don't regulate temperature as well as adult's and they can heat up three to five times faster. Another reason is that a car acts like a greenhouse and traps heat, so even on a relatively cool day the inside temperature of a car can quickly rise to a dangerous level. In fact, within 10 minutes the inside temperature of a car can reach 20 degrees hotter than the outside temperature, and after 30 minutes the inside temperature can reach 30 degrees hotter. Even if you leave the windows down slightly it can still become too warm. Pets can also succumb to the heat quickly, so to be on the safe side, never leave your pet in the car. If you are out in the summer it's inevitable that you'll be around mosquitoes, ticks, bees and other insects. A few ways to keep painful bites and stings to a minimum are to avoid using scented soaps, lotions, perfumes and hairspray as these will attract more pesky insects. Stay away from areas where insects gather, such as stagnant water or uncovered food. Watch out for bees if you're near blooming flowers. If you do get stung by a bee it's important to get the stinger out quickly. Many people advocate removal by scraping a credit card across the skin. Be cautious of squeezing the stinger as this could cause the release of more venom. If you are allergic to bee stings make sure your family and friends know this and speak to your doctor about carrying an epi-pen. Seek emergency treatment if you develop shortness of breath, hives, have multiple stings or have stings in the mouth, nose or throat. Many insect repellants which are commercially available contain the chemical DEET which is considered to be the best chemical defense against biting insects. If you prefer not to use DEET, there are alternatives available. The American Academy of Pediatrics has a lot of information about insect repellants and the current recommendations for children. The AAP does not recommend using a combination sunscreen and insect repellant as sunscreen should be reapplied every two hours but insect repellant shouldn’t be reapplied. There are numerous websites with information available regarding summer safety. Most importantly, remember to use common sense and be aware of your surroundings. Enjoy your summer, before we know it, it'll be winter again.
	AKHH&H Volunteer of the year, 2009
	Aspirus Keweenaw Home Health and Hospice VOLUNTEER of the Year 2009 Virginia(Ginny)Vairus has been chosen as the Aspirus Keweenaw Home Health and Hospice Volunteer of the Year for 2009 and was awarded at a Luncheon recently. Ginny has been part of the Hospice team since the Fall of 1993.She is a very caring and dedicated volunteer providing over 16 years of service for the agency with numerous hours of respite, administrative assistance, she has done life reviews, and provided beautiful organ music for several past hospice bereavement services. Ginny is very active in the community by volunteering at the Omega House, a local light house, a women's organization and very involved in her church.” Volunteer Ginny has provided excellent care with the terminally ill in our community through the years and we are so proud to honor her with this award from the Michigan Hospice Palliative Care Organization," says Volunteer Coordinator Karen Kezele.
	Roots and wings and moving off to school by Paula Huls RN, BSN
	September is back to school time; parents are busy getting their children prepared. The milestone years are clearly remembered: the first day of kindergarten, or the first day of high school. The biggest off-to-school passage we have experienced is sending our children off to college away from home. We have already experienced this with our oldest son, who will complete his degree this year. Our daughter, too, has chosen to attend a college nine hours away in the Lower Peninsula. The past two months were filled with many conversations regarding roommates, credit hours, majors, dorm room essentials and topics that parents worry about; health and safety. As this is our last child leaving the home, the topic of the empty nest has come up quite often. Whether your child is going off to college, or finally moving out to live on his own, regardless of how much you may have been anticipating this time, this normal life transition requires you to make some adjustments in your own life. Some of the tips from the website ehow.com that I found were helpful are: Realize that whether or not you have a career, taking care of your child was your primary job, which takes a majority of a parent's time. It is normal to feel some sadness as the definition of your job changes. Realize that you have raised your child well enough so that he or she is able to leave. As Jonas Salk said, "Good parents give their children both roots and wings." This sums up the responsibilities we have as parents: To provide a stable, nurturing environment for our children to grow, emotionally and physically, which will prepare them for the time when they will leave to live on their own. We hope that the roots become deep-seated and when they do move out, their path to live responsible lives will follow. Don't compare your feelings to those of other parents. Each person will experience this change differently. Eat healthy and exercise. You no longer need to stock the refrigerator for the kids. Support your child as he or she begins to manage their life. Be a mentor, not a manager. Let your children know you will always be there for them no matter what the problem is. I have begun texting recently; this, along with e-mail and instant messaging are wonderful ways to stay in touch and still allow each of you to have your space. The telephone calls will be quite frequent in the first year, but as I have learned, the longer your child is away from home, it is Mom who makes the calls to keep in touch. Find a new interest or hobby. Moving on in your life will help you adjust to your child moving on in his / her life. you will also continue to serve as a good role model for your child. This normal life transition is easier when you realize that your children are adjusting well to their new lives. I think the website feelgoodparenting.com, says it very well; "If the roots are strong enough, children will always come back home (hopefully not to stay), but they will share with their parents all of the new things in their own lives or maybe to get another dose of the love that helped them to be who they are. We, as parents, will then see that we never really lose our children, as long as they know there is something worth coming back to". Paula Huls, RN, BSN, is the clinical review coordinator at Aspirus Keweenaw Home Health and Hospice
	Volunteering - Touches Mind and Heart
	Volunteering Experience Touches Mind and Heart Keweenaw Home Nursing will be starting a new class for Hospice Volunteer training on April 9. May I recommend to all who have a need to relate to other human beings, or those interested in seeking a deeper significance of living other than being a consumer, to take the class. About a year ago I graduated the six week course given by Keweenaw Home Nursing, and I recommend it to all whom I meet. I was hesitant at first, not knowing what to expect. I had never been in a nursing home let alone with persons that were dying. Would I be able to help? Would I be able to say the right things? Maybe I would be unable to relate and feel comfortable. I could have easily talked myself out of volunteering and have left this entire thing to the professionals and medical staff. I persevered and found to my delight that I was accepted for whom I was and I really had only to bring with me a smile and an ear to listen as well as my own concern and compassion for those I visit. The education given was straight forward, and it teaches one how to treat each individual with great dignity. I found at the end of my own experience that the gift to me was not that I was giving of my time, but it was the gift I was giving to “myself”. The fragile human beings with whom I was dealing allowed me to experience the human condition in a new dimension. We often discount the elderly in our community. I have now experienced first-hand the wonderful opportunity to find that even as the body grows fragile, the personality, and depth of mind and heart are great gifts to those who take the time to see them. In sharing our common humanity, we really deepen ourselves as human persons. The elderly have much to give those who can take the time to visit and listen to their many stories. They are fragile in health, yes, and they are for the most part, bed ridden; they have difficulties that make us uncomfortable, this is all true, but they are also a rare and genuine source of marvelous memories, of living gathered over years of lives both productive and difficult. They can see outcomes for they have lived daily life to its humble end. They can be by their very selves, sources of great spirituality, and a fountain of sustaining wisdom. What you learn with the elderly and the dying is that they are “ourselves”. What we learn in serving them is our own humanity and the dignity of the human person. Many years ago, a Canadian by the name of Jean Vanier founded the International L’Arche Foundation. His foundation helps people who are mentally challenged and often physically impaired. Both normal and mentally and physically impaired people live in a community setting together. Vanier tells us that we need the other to understand the whole picture of our human dignity, that we are gifts to the other. I agree with his philosophy of giving. In caring for the elderly, I bring them my strength, my mobility and concern while they in turn give me their wisdom, their stories and most of all a special love that recognizes my efforts for themselves. What I have learned from this experience is that in giving we receive more than what we bring. In short, we are gifts to each other. As our modern world spins in its consumer orbit, I have found in serving the elderly and the dying a new depth to my own living. A clarification of my own life that allows me to see deeper what is important and what is mere distraction. My elderly allow me a new understanding of what it means to be human and the truism, that we are all connected to one and other. The true blessing of this work is that we learn to see the dignity of all human persons regardless of race, creed or color. In our contemporary society that finds pills and chemicals the cure for social problems and needs, and as the modern mind becomes more and more removed from the physical body and aging, I invite you to come closer and experience, to see the unity of mind and body in the aging. I invite you to the training given by Keweenaw Home Nursing and Hospice. It is a pathway that will not disappoint. It will challenge you, but never disappoint and it will enlighten and deepen your understanding of the human journey. Kathleen Carlton Johnson is a Hospice Volunteer for Keweenaw Home Nursing & Hospice. If you are interested in learning more about Hospice or volunteering call the office at (906) 337-5700.
	Owner's Manual For Your Body
	Patients As Partners in Managing Chronic Disease For a significant number of Americans, managing a chronic disease such as diabetes or heart, lung, or kidney disease has become a normal part of life, with many people having one or more chronic illnesses. However, our current healthcare system was designed to focus on acute illness and injury, not helping people manage long term conditions at home. Chronic disease changes a person’s life and dramatically transforms the role of patients in their own health care. For people to gain the knowledge and skills required to care for a chronic disease effectively, they need an extensive amount of education and support. The most effective care for chronic diseases demands that a person pay attention minute-by-minute and day-by-day to nutrition and hydration, physical activity, medication use, symptom management, and self-monitoring. How can someone become effective at managing a chronic illness? It’s a lot like having an owner’s manual for your car: •learning about the best fuel to keep your engine running smoothly (nutrition); •knowing how much water to put in the radiator to keep it circulating (hydration); •following the maker’s advice about best practices to stay efficient on the road (medication use and lifestyle behaviors); •paying attention to little subtle clues that something is going out of repair (symptom self-monitoring); •responding when the “check engine” light comes on (seeing medical help); •and making a list of things you noticed on the decline to tell your mechanic (patient daily diary). Patients and their caregivers (often family members) must learn how to deal with chronic symptoms and often with physical challenges. They may need to participate in complicated medication regimens, learn self-monitoring techniques, and make appropriate management decisions. Chronic disease may also require significant role and lifestyle changes and learning to cope with the ups and downs of the disease – physical and emotional. And on top of all that, patients and their caregivers must learn how to interact effectively with healthcare personnel, understanding their language and mysterious world of treatment options. Keweenaw Home Nursing and Hospice has designed self-care management information booklets for patients and families to acquire the self-confidence and skills to fully participate in management of their chronic disease. Patient Self-Care Management Programs on Diabetes, Heart Disease, Lung Disease, Hospice Care, and Kidney Disease are available for patients and families, to help them become the best owners of their bodies possible for them by learning the necessary skills and gaining self-confidence. Self-management education addresses use of medication, behavior change, pain control, coping with emotional reactions, learning to interpret changes in the disease and its consequences, and use of medical and community resources. Topics include: 1) techniques to deal with problems such as frustration, fatigue, pain and isolation, 2) appropriate exercise for maintaining and improving strength, flexibility, and endurance, 3) appropriate use of medications, 4) communicating effectively with family, friends, and health professionals, 5) nutrition and hydration, 6) how to evaluate new treatments, and 7) an emergency plan when symptoms suddenly worsen. When patients are given the tools, self-management education helps them to live the best possible quality of life with their chronic condition. People who learn about their disease and follow their self-care plan experience reduced symptoms, improved physical activity, and significantly less need for medical treatment and hospitalizations. Some benefits have lasted years beyond the time of diagnosis. The principal reason that patients and families experience benefit is growth in confidence in their ability to cope with their disease. If you want help learning to manage the challenge of a chronic disease, please call Keweenaw Home Nursing and Hospice at 337-5700 or visit us on-line at www.khn-hospice.com. Mary Hindelang, RN, PhD Education Coordinator at Keweenaw Home Nursing and Hospice
	Enhance Your Life By Becoming a Volunteer
	ENHANCE YOUR LIFE BY VOLUNTEERING! When you volunteer, you help make other people’s lives better. But did you know that becoming a volunteer can have positive effects on your life as well? Volunteer work is a known strategy to help deal with stress. And who doesn’t have stress these days? Donating your time and effort to someone else or a cause you believe in can elevate your spirits, helping you to better cope with stress. Your gift of time and talent is rewarded by the smiles on the faces or those individuals you help. Volunteers who get energized by the work they do are better able to put their problems in perspective. The old saying, “There’s always someone worse off than you,” is often found by volunteers to be true. Knowing the challenges that other people face can make your own troubles seem minor in comparison. Volunteering can help build meaningful relationships with people you might not ordinarily meet. Friendships can be created with staff members and other volunteers over the years. You are able to help people during the most difficult times of their lives. A recent research in the Journal of Health and Social Behavior reports that a volunteers’ work indeed enhances all six aspects of well-being: happiness, life satisfaction, self-esteem, sense of control over life, physical health, and depression. Older people who volunteer enjoy longer lives, higher functional ability, and lower rates of depression and heart disease. Part of the reason is the socialization that volunteering can provide and they are not alone or isolated. When a volunteer talks to a patient or family member they say something you can really relate to and it just makes your day. The best part about being a volunteer is knowing that you’re helping someone else get through tough times and telling them that they are not alone It can help make the person’s life better at the present moment. It can be challenging at times, but the reward is so great! Many volunteers express of a “helpers high” that they experience. This is described as a physical and emotional sensation of euphoria that lasts for days or weeks and spreads into other areas of the volunteer’s life. The more you volunteer and do things for others, the more benefits you receive. Among these benefits are: a more optimistic outlook on life, increased energy, better perceived health, a greater sense of relaxation and a stronger immune system. Helping others can bring about positive change in our community. Perhaps the best thing about volunteering is there is never a shortage of opportunities in your local community. There are agencies always in search of new volunteers. I urge you to consider what type of volunteer activities would make you feel a sense of accomplishment and seek out the organization that is the best fit for you. If you would like to learn more about Keweenaw Home Nursing and Hospice and the volunteer opportunities available, visit our website at www.keweenawhomenursing.com. or call the Volunteer Coordinator
	Caregiving During The Holidays
	Caregiving during the Holidays Providing care for a loved one can be difficult at anytime of the year, but the holiday season can add to an already heavy load of responsibilities and cause added stress in the life of a caregiver. The holiday season is typically a time to reflect on our past memories. This season that is intended as a celebration of joy and connection with family and loved ones, may often times be a reminder of the difficult changes in our lives. For those caring for an ill or disabled family member the time of reflection may make us more aware of the current situation we are facing. Perhaps you are caring for someone with Alzheimer’s disease and you remember the person prior to their memory loss and just how much life has changed for you and your loved one. This emotional pain of confronting these losses can add to your feelings of stress. You may be thinking “this may be mom’s last Christmas, so I want to make it extra special”. By putting these added demands on yourself you will make the holiday season more stressful. Instead give yourself permission to celebrate the holidays in a way that works best for you and your loved ones. Each holiday season is different and can be enjoyed it its own way. This may not be the year to make several different types of baked goods, but rather choose one or two that are special to your family. If all the usual decorations are not put up this year, it is okay. Give yourself a break and feel good about doing so. Set manageable expectations and limits for yourself. Be realistic about what you can and cannot do. Spend time with friends and other family members. Take time to laugh and have fun and not always focus on your role as the caregiver. This helps you to strike an emotional balance in your life. Learn to accept help. If family members or friends offer to share in your responsibilities of caregiving, allow them to do so. If the loved one you are caring for has dementia they may be better off staying at home with respite care rather than attending gatherings where there is too much stimulation. Grandchildren from out of town may enjoy spending time with grandma while you attend a Christmas concert. Remember the usual hints about caring for yourself including not abandoning healthful eating and drinking habits over the holidays. Exercise regularly, walking, swimming, or yoga can be great stress relievers. Remember not all giving in our community needs to be monetary. Your time is far more important to a friend, neighbor or family member who is providing care to a loved one. Offer to provide respite care so the caregiver can Christmas shop, go to lunch with a friend or attend a church service. You are not alone in your caregiving journey. Many others in our community are providing care also. If you are in need of support or you have support to share with others please join us for a monthly Caregivers Support meeting at Laurium Housing on the second Wednesday of each month at 2pm. For more information call KHN&H at 337-5700. Enjoy the holiday season and remember caregiving may be the most difficult job you have ever done, but there is none more rewarding than being able to care for someone who truly needs you. Sarah Baratono, LMSW, ACSW Keweenaw Home Nursing and Hospice
	Hospice is an Honor....says Volunteer
	Many people have asked me why I would choose to spend my time with people who are dying. First of all, Hospice, by its very nature, is not about death. It is about life and living that life to its fullest until death occurs, and accepting death as natural part of life. Hospice provides care in the home. This way a person who is dying may spend his or her last days surrounded by familiar things and loved ones. Hospice talks openly about the dying process with patients, families and caregivers, but also respects the wishes of those who do not want to talk about dying. Hospice also provides bereavement support after death to the family and to the caregiver(s). Each patient has a hospice team. This is an interdisciplinary team of trained professionals and volunteers to care for the physical, emotional, social, and spiritual needs of the dying. As a volunteer with Keweenaw Home Nursing and Hospice, I am trained to provide respite care, and to recognize needs in the home and relay these needs to other members of the hospice team. Volunteers do a variety of things, from washing dishes and other light chores to just spending time with the family. I like to sew, and one patient asked me to finish a baby quilt for a soon-to-be-born grandchild. Another patient didn’t want me to be in his room, but I had some wonderful conversations with his daughter. Each family is unique, Volunteers are there for the patient and the family. Some patients have wanted me to watch TV with them and discuss the program. The most memorable of those TV times was the O.J. Simpson trial and our arm-chair analysis of innocence or guilt. Hospice care was not available when my parents were in the last stages of life, and when hospice was introduced in this area, I decided to explore this wonderful program that supports families, assists in decision making, and provides help in the home for both patient and caregiver(s). In my fourteen years as a hospice volunteer, I have had the opportunity to meet many people. Each one has a story to tell - a unique view of life from his or her own perspective. During the past year I have had the privilege of recording a few of these life stories. If the patient so desires, I record this story on tape. In this way, the life story is told in the patient’s voice. I also provide a typed manuscript to the family. This experience of gathering pieces of a life story is a pleasant one, often filled with fond memories, laughter and sometimes tears. It is a treasure to families because of the memories it evokes. Hospice has another program called “Teddy Bear Care” where volunteers make bears out of a favorite article of clothing of hospice patients. The bears are then given to the family as a final gift and remembrance of their lives. To be allowed into a hospice home is an honor for me. To share the journey through the last months of life is a gift to me. I have seen remarkable courage and enduring love. I have watched families find strengths they never dreamed they had as they support their loved ones. In the end, grief comes for me too, but there is also the hope that I have served in some small way to make this transition a little more bearable. Needless to say, I get much more from being a hospice volunteer than I give, and it continues to be a rewarding experience. I would encourage anyone who wishes to know more about hospice work to call Keweenaw Home Nursing & Hospice. What are the qualifications for being a volunteer? They are: compassion, comfortable with the experience of death and spiritual needs, good communication skills, diplomacy, respect for confidentiality, tact, patience, a listening ear, a loyal tongue, personal discipline and understanding of the philosophy of Keweenaw Home Nursing & Hospice. Virginia Vairus, Hospice Volunteer Keweenaw Home Nursing & Hospice