We’re told all the time that we need to prepare advance directives. We should tell our families how we want to be treated in death—or near death.
But by the same token, our families need to return the favor. And yet, how do you ask your parents, “When you die …?” or, “If you’re on a machine …?”
Dale Carter, founder of Transition Aging Parents, offers some tips on how to start the conversation at the Home Instead Senior Care blog. “We have to learn to assist, not insist,” she says. Touché. She also recommends making a special visit for the talk and “using the phrase, ‘What if?’”
“What if your arthritis gets worse and you need help in your home” or “What if one day you need full-time care?” If your parent doesn’t want to talk about it at that time, know that you’ve planted a seed.
We also have an article on the topic, which includes advice on how to deal with resistant parents. After all these tips, if you’re ready to give it a go, you might as well bring some advance directive forms with you, eh? The National Hospice and Palliative Care Organization offers free downloads by state.
After wading through the daunting task of deciding what type of care your parent needs, you’ve finally decided on nursing home.
And then come the options … lots more options.
“As in any industry, there are good and bad nursing homes,” says Carol Odell of the Better Business Bureau of Southern Colorado. You just have to do your homework. When choosing a nursing home, she writes in her blog:
Begin by checking with your county ombudsman who works with the Area Agency on Aging, your BBB and the State Medical Board before investing any time in visiting nursing homes.
If you feel you are getting close to making a decision, have lunch with the residents and take your loved one with you if he/she is able. Visit with the residents to see how they like the facility. What are the people like? Would there be some people your loved one would enjoy interacting with? Is this the right type of senior housing? There are many levels of assistance that are offered.
She offers more tips here. We also have a plethora of information about nursing homes, including a search engine and a list of the best nursing homes in the country.
Have you had experience with nursing homes? What advice would you give?
Using a hospital bed in your home? Watch out for the bed rails, warns The New Old Age, a blog from The New York Times. Bucking common sense, they can actually be dangerous. A patient can get trapped between the bars, or between the rails and the mattress, and suffocate.
Think they’ll at least prevent falls? Well, yes, but there’s a catch:
“Rails decrease your risk of falling by 10 to 15 percent, but they increase the risk of injury by about 20 percent because they change the geometry of the fall,” [geriatrician and bioethicist Steven Miles of the University of Minnesota] explained in an interview. Confused or demented patients who try to climb over the rails, instead of falling from a lower level and landing on their knees or legs, are apt to fall farther and strike their heads.
Despite the dangers, accidents may be uncommon. The article says the FDA found 480 deaths, 138 injuries and 185 close calls over 24 years. But “Dr. Miles believes those statistics represent only a small fraction of the total accidents, which often go unreported.”
The FDA offers tips for hospital bed safety, including for home use. In fact, nursing homes usually don’t use bed rails these days, says Dr. Miles. (When evaluating a facility, make sure no more than one or two beds in ten have rails up, he suggests.) From the FDA:
“Not all patients are at risk for entrapment, and not all hospital beds pose an entrapment risk,” says [Joan Ferlo Todd, RN, a senior nurse-consultant at the FDA Center for Devices and Radiological Health]. “But health care facilities, as well as patient caregivers, are urged to take a careful look at hospital beds. They need to determine if there are large openings that present an entrapment risk, and to take steps to minimize this risk.”
Does your parent have a defibrillator? If hospice becomes necessary, you may need to point that out to doctors. The fact is, they just may not ask, reports HealthDay.
In a recent survey, only 10 percent of hospices “said it was their policy to discuss deactivating the devices,” says HealthDay. From the article:
A defibrillator delivers a shock to restore a normal heartbeat in people with rhythm abnormalities. “The purpose is to save a patient’s life,” said study author Dr. Nathan Goldstein …. “But there is no sense getting a shock when it is not going to fix their underlying condition.”-Some hospice patients have compared the shock given by a defibrillator to being kicked or punched in the chest, Goldstein said.
(Updated March 5, 12:16 pm)
For the time being, it appears that money from the Citizens’ Election Program won’t be used to re-open the statewide respite care program to new applicants after all.
The Joint Committee on Human Services voted to remove section 2 of HB 5111 Tuesday before passing it, which would have transferred $2.3 million from the CEP to DSS for the respite care program. This program affects residents with Alzheimer’s disease, dementia-related illnesses and their caregivers.
The vote was not unanimous – 15 voted in favor, 3 opposed, and one legislator was absent.
Rep. Toni Walker (D-New Haven) says the issue is not so much about the Alzheimer’s respite care program but about how to fund the budget as a whole. The bill has been referred to the Appropriations Committee, who will decide whether to fund the program. Walker, who is also a member of the Appropriations Committee, says no firm date has been set to vote on the budget.
“It’s not really appropriate for us to find out where the funding comes from,” Walker says, referring to the Committee on Human Services. “I wanted the issue to be very clear that we were supporting the Alzheimer’s program. I didn’t want any hidden agendas. When we got the bill, there were a lot of people in support of the Citizens’ Election Program and the Alzheimer’s respite program but didn’t want them in the same policy.”
Beth Rotman, Director of the Citizens’ Election Program, was pleased with the outcome.
“The Commission appreciates the serious financial circumstances facing Connecticut now, and we understand that legislators need to look everywhere for funding,” Rotman says. “However, fully funding the state’s public financing program represents an investment in the future of Connecticut and a commitment to returning democracy to the people.”
The Appropriations Committee is divided into 13 subcommittees, so HB 5111 ’s next stop is to the Human Services subcommittee, which Sen. Edith Prague (D-Columbia) chairs. The subcommittees will go through legislation and submit a report to the committee chair. Once the chair gets all the reports back, a date will be set, and the vote will take place.
In addition to the respite care program, there are several other bills Appropriations will consider from legislators, Walker says.
“Once we come up with a budget, that’s where we’ll figure out where everything will be funded,” Walker says.
Bill Directing DSS to Re-Open Statewide Respite Care Program to New Patients Clears Hurdle
The Select Committee on Aging has unanimously passed a bill regarding the DSS Statewide Respite Care Program. Under this bill, the Committee has requested a transfer of $2.3 million from the Citizens Election Fund to DSS so that the respite care program could be re-opened to new enrollees. This would impact caretakers of individuals with Alzheimer’s disease. How your legislators voted
The Select Committee on Aging held a public hearing on Feb. 16th, where this bill was raised. This bill was referred to the joint Committee for Human Services on Feb. 22. Brie Johnston, the clerk for the committee, says, “I have the bill in my possession and it could be acted on as early as March 4th.”
The bill says, “Such respite care services may include, but need not be limited to (1) homemaker services; (2) adult day care; (3) temporary care in a licensed medical facility; (4) home-health care; (5) companion services; or (6) personal care assistant services.”
Sen. Edith Prague (D-Columbia), a member of the committee, said she has had difficulty garnering support for this bill because of negative feedback. She says she is pressing on because the issue is really important to her.
“The respite program has been closed to new members since last spring,” Prague says. “There are 300 people on the waiting list. Caretakers struggle to take care of family members with Alzheimer’s. When the caretakers don’t get respite, they get sick.”
“We absolutely must fund this program,” Prague continued. “Spending money on this program is more important than giving politicians money for their campaigns. I support the campaign fund but not at this time when we can’t support anything else.”
Laurie Julian, public policy director for the Connecticut chapter of the Alzheimer’s Association, was pleased with the result.
“The Alzheimer’s respite care program makes sense,” says Julian. “It is good for the patient, for families and makes business sense. It saves millions in Medicaid nursing home delays, and preserves jobs in the healthcare industry while protecting the patient and caregiver’s health. “
Mag Morelli, the President of Connecticut Association of Not-for-Profit Providers for the Aging (CANPFA) is hopeful the bill will be part of the budget, although she added, “It’s been hard to get anything this session.”
“I don’t know if people realize how much care is given by informal caregivers,” Morelli says. “This respite care program is a small piece that the state can provide to allow caregivers to care for Alzheimer’s patients. It saves the state something like a billion dollars keeping people out of nursing homes.”
In a sufficiency report written in December 2009, the State Elections Enforcement Commission, whose Public Financing Unit oversees the Citizens Election Program, wrote: “Currently, the Commission finds that the CEF has sufficient resources for certain plausible scenarios for the 2010 election cycle. Without any additional cuts, the CEF should have at least $38 million for the 2010 election cycle. Therefore, the Commission has not identified an insufficiency at this time. However, the CEF is at a critical point—any further reductions would risk the State’s ability to fund campaigns for statewide and General Assembly candidates in 2010…To date, $38.5 million has been swept from the Program to mitigate the State’s budget deficit.”
Beth Rotman, the Director of the Citizens’ Election Program, says the December report does not take into account Gov. Rell’s deficit reduction plan, which calls for an additional $12 million in cuts to the fund.
“Of course, the Commission is not in a position to judge the relative merit of different programs that I’m sure are worthy of funding,” Rotman says. “Public financing has been called “change that makes change possible.” We believe this program makes it possible for legislators to make the right decisions and we understand they make difficult ones every day.”
Rotman says the Citizens Election Program helps legislators make decisions free of special interests’ influence and says it costs the state more money when legislators make decisions for the wrong reasons.
The state’s Department of Social Services declined to take a position on the bill.
“The bill will go to another committee or committees, and the department may offer comment or testimony at that time,” spokesman David Dearborn says. “Our agency does not have cognizance over the citizens’ election fund.”
DSS has encouraged people interested in enrolling to seek guidance regarding their options, including the Connecticut Homecare Program for Elders while they wait to see if the respite program will be opened to new enrollees again.
When asked how many people in the respite program DSS referred to CTHPE from May 2009 to present, Dearborn says, “The number of individuals on the Connecticut Statewide Respite Care Program referred to the Connecticut Home Care Program for Elders during this period was approximately 350 statewide.” Here is the brochure for that program.
Previously, OurParents.com wrote a two part story on how the Statewide Respite Care program had been closed to new enrollees as of May 11, 2009. We’ll keep you posted.
Story: DSS Statewide Respite Care Program Affected by Connecticut Budget Deficit
Story: Local Resident Hopes to Help Others Understand, Cope with Alzheimer’s
The Charles A. Dean nursing home in Greenville, Maine has been managed so well it has been on our Honor Roll List as one of the best nursing homes in the nation for over a year, but that has been overshadowed by financial woes.
The lateest state and federal reimbursements, proposed state cuts in MaineCare — as Medicaid is called in Maine — and an operating loss are threatening to cripple the 24-bed nursing home and adjacent hospital, which are part of Eastern Maine Healthcare Systems.
“These state cuts can significantly paralyze us,” Geno Murray, president and chief executive officer of the nursing home and hospital, said this week. C.A. Dean, the region’s largest employer, has 172 employees and pumps about $10 million into the local economy, he said.
Click here to read the rest of the article on the bangor daily news.
Tips For Managing Your Sibling Relationships Over Parent Care And Avoiding The Sibling Rumble
If you are your parent’s primary helper…As our parents age, it becomes harder and harder to feel secure that they are safe and healthy in their home. This becomes even more difficult if we do not live nearby and are unable to “pop in” to make sure they are okay. We are left to rely on their self-report of their situation.
- Ask your parent to sign a consent to release information from ALL of their health care providers so that you can gather collateral information about their functioning. Get a list of the names and phone numbers of these individuals.
- Encourage your parent to complete a power of attorney at all of their financial institutions so you can monitor their management of money. Make sure to tell them that you do not plan on taking over; you just want to oversee to ensure they are not being taken advantage of by another and if they have questions, you can assist them.
- Encourage your parent to draft a Mandate/Living Will/Durable Power of Attorney for Health Care so you have the legal authority to make decisions and manage their finances if they become unable to do so.
- Ask your parent to list all of their utility providers, their mortgage carrier, car insurance, etc. and account numbers and to give these facilities authorization to share information with you so if they are confused about their accounts, you can assist them. (See our website for a complete list).
- Arrange for automatic bill pay where applicable.
- Ask your parents for the location of all important documents (power of attorney, birth certificate, deeds, etc.).
- Obtain SaferAging, LifeLine, Medic Alert, or another type of safety system so that your parent can access help if he/she falls or has another emergency.
- Obtain a list of individuals nearby who could stop by your parents’ home if you have an immediate concern (neighbor, friend, relative, etc.)
- Obtain a complete and updated list of all medications, prescribed and over-the-counter.
- During a visit to your parents, conduct a home safety assessment and make all necessary modifications to the home. (See our website for a complete list of areas to observe).
- Prepare a list of private and community agencies that are available to make visits to your parents for future or immediate reference.
- If your parent is at a facility, get the names, phone numbers, and emails of at least two professional staff members (nurse, social worker, etc.) and make contact with them periodically to foster an on-going relationship.
- If you can afford it, arrange for a monthly visit from a social worker or nurse to monitor your parents’ safety and report back to you. The money spent will be worth the peace of mind and may prevent major crises.
- Begin a journal of all of the above information, as well as on-going updates about your impressions of their functioning, including specific examples (i.e., my mom called me again to ask about her phone bill; I noticed she has lost weight since our last visit, etc.).
- Monitor the following when you visit: Physical appearance and hygiene, medication administration habits, ambulation risks and falls, home cleanliness and organization, food acquisition and preparation, driving, memory loss, ability to express thoughts, social interaction or isolation, judgment, decision-making, etc.)
This press release is presented for information purposes only, as a service for our readers, and should not be viewed as an endorsement. Please consult with your doctor before using.
CALMAR PAIN RELIEF’S FIRST TREATMENT CENTER SITE OF LAUNCH
North Providence, RI – (January 13, 2010) – Competitive Technologies,
Inc. (NYSE Amex: CTT) announced that its Calmare® Therapy Treatment
medical device has been commercially launched at Rhode Island-based
Calmar Pain Relief, LLC’s first Pain Therapy Center in North
Providence, RI. CTT and Calmar demonstrated and reviewed the benefits
of this innovative, non-invasive pain management therapy at a press
briefing here, today.
“Calmare Therapy Treatment is a non-invasive medical device for
treating high intensity oncologic and neuropathic pain, including pain
resistant to morphine, without the adverse and harmful side effects
linked to narcotic painkillers,” said John B. Nano, CTT’s Chairman,
President and CEO. “We are thrilled to showcase this success story to
the media and to a Korean delegation that included company leaders
from GEOMC Co, Ltd., our device manufacturer, as well as
representatives from an institutional investment group. Everyone is
impressed with Calmar’s state-of-the-art facilities in North
Providence where, with four of our Calmare Therapy Treatment devices,
as many as 30 patients can be treated each day.”
“As a physician, I appreciate the opportunity to participate in the
continuing evolution of pain relief therapy,” said Dr. Stephen
D’Amato, Calmar Pain Relief’s Medical Director, ”and be able to
relieve the suffering of patients, particularly within the context of
my medical oath ‘Primum Non Nocere’ (first do no harm). Calmare is a
non-addictive therapy, in sharp contrast to the host of pain killers
on the market today.” A 1976 graduate of the University of Padua, in
Italy, Dr D’Amato used his fluency in Italian when he met with Calmare
inventor Prof. Giuseppe Marineo, in Rome last year to learn the
advanced applications of the pain therapy medical device. Dr. D’Amato
is the premier U.S. medical expert in the use of CTT’s Calmare Therapy
Treatment.
“We are quite pleased to be here due to the importance of the US
market for our overall commercial success,” said Seung Bum Oh, GEOMC’s
Executive Vice President. ”We are impressed with this business model
and are fully committed to ensuring that our manufacturing capacity
supports the growing worldwide order pattern.”
“Calmar Pain Relief is excited about our first clinic here in
Providence, which has been successfully treating patients suffering
from severe pain since November of 2009,” said Robert Smith, Calmar
Pain Relief Managing Member. “Our business plan calls for the opening
of similar pain treatment clinics featuring CTT’s Calmare Therapy
Treatment devices in ten additional U.S. cities in the next 24
months.”
”The Calmare Therapy Treatment is a prime example of CTT’s strategy
to connect clinical science to patient care with proven efficacy and
safety as validated by our US FDA acceptance and European Union CE
Certification,” Mr. Nano said. “We currently have distribution
agreements in place covering 45 countries around the world, accounting
for nearly 55% of the world’s population.”
Developed in Italy by CTT’s client, Professor Giuseppe Marineo, this
non-invasive medical device was brought to CTT through the efforts of
the Zangani Investor Community™ and with the cooperation of Mr.
Guiseppe Belcastro, Legal Counsel for Professor Marineo. The device,
with a biophysical rather than a biochemical approach, uses a
multi-processor able to simultaneously treat multiple pain areas by
applying surface electrodes to the skin. For more information on the
device, visit www.CalmareTT.com.
About Calmar Pain Relief, LLC
Calmar Pain Relief, LLC, the privately held company based in North
Providence, RI, was established to provide medical equipment, office
leasing, and other business services to medical doctors looking to
offer this non-invasive pain therapy to patients in a clinical
setting. For more information about Calmar Pain Relief, please visit
www.calmarpainrelief.com.
About GEOMC Co Ltd.
GEOMC Co. Ltd. of Seoul, Korea, has current manufacturing facilities
capable of commercially producing 200 pain therapy medical devices per
month and the partners have agreed to expand production capacity to an
increased production level of 600 units per month to match increased
order demand. GEOMC has invested over $3 million for the design,
tooling and manufacturing facilities for the Calmare medical device.
About Professor Guiseppe Marineo
Professor Guiseppe Marineo is a researcher and bioengineer, who
advanced theories to reformulate the concept of disease and the
corresponding treatment from a biophysical rather than a biochemical
point of view. He is the founder of Delta R&D, a bioengineering
research center. Visit Delta R&D’s website: www.deltard.com/eng.
About Competitive Technologies, Inc.
Competitive Technologies, established in 1968, provides distribution,
patent and technology transfer, sales and licensing services focused
on the needs of its customers and matching those requirements with
commercially viable product or technology solutions. CTT is a global
leader in identifying, developing and commercializing innovative
products and technologies in life, electronic, nano, and physical
sciences developed by universities, companies and inventors. CTT
maximizes the value of intellectual assets for the benefit of its
customers, clients and shareholders. Visit CTT’s website:
www.competitivetech.net.
Statements made about our future expectations are forward-looking
statements and subject to risks and uncertainties as described in our
most recent Annual Report on Form 10-K for the year ended July 31,
2009, filed with the SEC on October 27, 2009, and other filings with
the SEC, and are subject to change at any time. Our actual results
could differ materially from these forward-looking statements. We
undertake no obligation to update publicly any forward-looking
statement.
Calmare® Therapy Treatment Product Q & A
What is Calmare® Therapy Treatment?
Calmare® therapy treatment is a 510(k) FDA-cleared, non-invasive pain therapy device for the management of chronic and acute pain. It is used to treat debilitating pain, especially when narcotic painkillers, such as Morphine, are ineffective.
Calmare® has been successful in treating pain associated with:
- Oncology (cancer), including pancreatic, breast, bladder, lung, prostate, colon, rectal, kidney, ovarian, cervical, liver, uterine, etc.
- Neuropathy (nerve/nervous system), including sciatic and lumbar pain, phantom limb syndrome, failed back surgery syndrome, etc.
Is it Effective?
The Calmare® therapy treatment has helped thousands of patients reduce and manage their pain while many patients report becoming pain-free after completing the treatment protocol. It is safe and free from side effects and addiction associated with other treatment options. Regardless of pain intensity, during each treatment, a patient’s pain can be completely removed for immediate relief.
How does it work?
Patients are comfortably connected to the Calmare® therapy treatment via small surface
electrodes (similar to those used in EKG and other medical procedures) that are placed on the patient’s skin near the area where the patient is experiencing pain. Thus it treats pain through a biophysical rather than with drugs. When the device is turned on, it reads the body’s existing pain signals and sends a very low current of electrical stimulation through the nerve fiber, which carries a “no pain” signal to the brain to essentially override the previous pain signal. After a series of treatments with our Calmare® therapy device the patient’s pain is steadily decreased to allow the patient to participate in more daily activities and enjoy a better quality of life.
How is it Different from Other Pain Management Therapies?
Calmare® therapy treatment has been shown to be effective in treating pain associated with nerves such as neuropathic and oncologic pain unlike other pain management devices such as a traditional TENS device which works primarily with skeletal-muscular pain, including arthritis. Unlike narcotic drugs (morphine, etc), the Calmare® therapy treatment is a non-addictive treatment that avoids the harmful, potentially fatal, adverse side effects and addictive properties linked to addictive, sometimes toxic, painkillers.
What is the Treatment Protocol?
Patients receive a prescription from their doctor to receive treatments as an outpatient
procedure. Each treatment steadily diminishes the pain intensity of the patient. During
treatment a patient is treated at a level that removes pain and doesn’t cause discomfort.
−
- For patients with neuropathic pain: 10-12 daily treatments of 30-45 minutes are scheduled during which a patient is connected to the device.
- For Patients with oncologic pain: 10-12 treatments are scheduled based to patient’s pain control needs.
Where is it in use?
Calmare® is currently in use in the United States at major pain management and cancer
research hospitals including:
- University of Miami Pain Management Center
- Virginia Commonwealth University’s Massey Cancer Center
- University of Wisconsin-Madison’s Paul Carbone Cancer Center
It is also available in Rhode Island at the Calmar Pain Relief Center provided by Dr. Stephen D’Amato. More information available at: http://calmarpainrelieftherapy.com
It has been in use internationally at major pain clinics and hospitals including:
- La Sapienza University of Rome
- Pain Management Center at Tor-Vergata University Medical Center, in Rome
- Fondazione Parco Biomedico San Raffaele, in Rome (www.scienceparkrome.eu)
- Istituto Nazionale dei Tumori, in Milan
More Questions?
Contact:
Tara Maroney
RF|Binder Partners
212-994-7551
