Omaha Business Hall of Fame

Committed to Quality Care
In an effort to monitor and improve the experience of all of the Home Instead Senior Care network’s clients, the network has commissioned J.D. Power and Associates, a globally-recognized independent market research firm, to conduct periodic surveys of all of its valued clients.

J.D. Power and Associates conduct surveys with clients (or their designated family members) to monitor our progress as we continuously strive to better serve you – and any future clients you might refer to Home Instead Senior Care.  These telephone surveys are conducted twice per year: once in January, and again in July.

The telephone surveys are brief (about 4 minutes) and may be completed during the weekdays, weeknights, or weekends – whichever is most convenient.  And if you would like to provide more detailed feedback, provide the telephone interviewer with your e-mail or mailing address and you will have the opportunity to complete a comprehensive survey via the mail or e-mail – at your convenience.

we encourage you to participate again – this helps us understand whether we’re still on track!

We truly appreciate your candid and honest feedback.  Please understand that these surveys are exclusively for research purposes only.  No one will try to sell you anything as a result of your participation in this research.

If you would like any additional information regarding J.D. Power and Assoc., please visit their website at jdpower.com.

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Happy Birthday to the King!

If you think about rock and roll then the first person that
comes to mind is Elvis Presley. We know him as the “King”
– his voice, looks, and moves have captivated us all.  
January 8 is Elvis Presley’s birthday.  Here are some
interesting facts that you may not have known about this
legend.

1. Elvis had an identical twin brother, who was stillborn.
2. Elvis received a guitar for his eleventh birthday; he was
    disappointed; he was hoping for a bike.
3. In the eighth grade, Elvis received a “C” in music.
4. Elvis was six feet tall.
5. The Cleveland Browns was Elvis’ favorite football team.
6. Elvis’ natural hair color was blond (in his early years) and light/dirty brown;
    he dyed it black.
7. Elvis was awarded two medals while serving in the Army, one for marksmanship,
    the other for sharp shooting.
8. Elvis held a black belt in karate.
9. Elvis wore a cross, a Star of David, and other religious symbols around his neck,
    explaining “I don’t want to miss out on heaven due to a technicality.”
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The Elvis Sandwich
Ingredients
• 2 tablespoons butter, softened
• 8 slices white bread
• 1/2 cup smooth peanut butter
• 1 large, ripe banana, sliced
• 1/4 cup honey
• 12 slices bacon, sautéed until crispy
• 
Directions
Spread the butter on 1 side of each slice of bread. On the other side of half of the slices spread peanut butter. Place banana slices on top of peanut butter. Drizzle honey over bananas. Place 3 bacon slices on top of the banana, then place the remaining buttered bread slices on top, butter-side-out.

Place sandwiches on a preheated grill pan or griddle. Flip them over when they become golden brown and crispy. When the sandwiches are browned on both sides, remove to plates. Slice in half and serve immediately, ENJOY!!!! 

Seasonal Affective Disorder or Sad…

Seasonal affective disorder (also called SAD) is a type of depression that occurs at the same time every year. If you’re like most people with seasonal affective disorder, your symptoms start in the fall and may continue into the winter months, sapping your energy and making you feel moody.

Treatment for seasonal affective disorder includes light therapy (phototherapy), psychotherapy and medications. Don’t brush off that yearly feeling as simply a case of the “winter blues” or a seasonal funk that you have to tough out on your own. Take steps to keep your mood and motivation steady throughout the year. Symptoms may start out mild and become more severe as the season progresses.

Winter-onset seasonal affective disorder symptoms include: Depression, Hopelessness, Anxiety, Loss of energy, Heavy, “leaden” feeling in the arms or legs, Social withdrawal, Oversleeping, Loss of interest in activities you once enjoyed, Appetite changes- especially a craving for foods high in carbohydrates, Weight gain, and Difficulty concentrating.

 If your seasonal depression symptoms are severe, you may need medications, light therapy or other treatments to manage seasonal

affective disorder. However, there are some measures you can take on your own that may help. Try the following:

 Make your environment sunnier and brighter. Open blinds, trim tree branches that block sunlight or add skylights to your home. Sit closer to bright windows while at home or in the office. 

Get outside. Take a long walk, eat lunch at a nearby park, or simply sit on a bench and soak up the sun. Even on cold or cloudy days, outdoor light can help — especially if you spend some time outside within two hours of getting up in the morning.

 Exercise regularly. Physical exercise helps relieve stress and anxiety, both of which can increase seasonal affective disorder symptoms. Being more fit can make you feel better about yourself, too, which can lift your mood.

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ScienceDaily (July 29, 2011) — Hospice services substantially improved the provision of care and support for nursing home patients dying of dementia and their families, according to an analysis of survey responses from hundreds of bereaved family members. The research comes as hospice funding has received particular scrutiny in the debate over Medicare spending.

“People whose loved ones received hospice care reported an improved quality of care, and had a perception that the quality of dying was improved as well,” said Dr. Joan Teno, a BrownUniversitygerontologist and the lead author of the study published online in the Journal of the American Geriatrics Society. “This is one of just a few studies out there that has examined dying with dementia where the predominant site of care is a nursing home and can report the benefits of hospice services. As just one example, for nursing home patients not in hospice, one in five family members reported an unmet need for shortness of breath while that was only 6.1 percent for people in hospice.”

Hospice care was a great comfort to Bartley Block, ofProvidence, when he lost his wife, Janet, to dementia in October 2010. He and Janet received service from Home and Hospice Care of Rhode Island on and off for about a year as her condition wavered, and then ultimately declined. Block said that even after his wife began struggling to eat, she still would get up and walk. Hospice workers would help the couple take walks at the nearby Tockwotton Nursing Home and patiently feed her food that they’d puree.

“It meant a great deal to her and to me,” Block said. “It not only was able to calm her, but it was calming to me. There were spiritual sessions for me. They did so much for her to make her life easier.”

That kind of experience is reflected in the responses of hundreds of families in the survey. In all, Teno’s team asked 538 family members of nursing home patients who died of dementia to reflect on the care and support they experienced and observed at their loved one’s end of life. Of that group, 260 received hospice care and 278 did not. Among the report’s key findings:

Family members of hospice recipients were 51 percent less likely to report unmet needs and concerns with quality of care. They were 49 percent less likely to report an unmet need for management of pain. They were 50 percent less likely to have wanted more emotional support before their loved one’s death. They rated the peacefulness of dying and the quality of dying more positively than families whose loved ones did not receive hospice care.

The survey also found that people who felt their loved one received hospice care “too late” had stronger concerns about care and support in almost every one of the survey’s many measures. They felt worse off than people who had no hospice care at all.

“These are people who get slammed around the healthcare system in the last days of life,” Teno said. “These are people with transitions who go from an acute care hospital to a nursing home in the last 24 hours. They are reacting to a set of circumstances that shouldn’t have occurred.”

Dementia is a particularly important area to study, Teno said, because the untreatable condition has only recently gained recognition as being terminal illness. The unpredictability of its progress, however, has led to a large number of dementia patients staying in hospice for longer than people with other conditions. That has made dementia a focus for scrutiny in discussions of cost.

But the study provides new evidence that hospice provides a meaningful benefit to nursing home patients with dementia and their families, such as the Blocks, Teno said. Policymakers should therefore factor in that evidence as they discuss the future of Medicare funding.

“It is a terminal illness,” Teno said. “As we do payment reform we should preserve access and quality of care for those persons dying of dementia.”

In addition to Teno, other authors of the paper are Pedro Gozalo, Ian Lee, and Sylvia Kuo of Brown, Carol Spence of the National Hospice and Palliative Care Organization, Stephen Connor of the Worldwide Palliative Care Alliance, and David Casarett of the University of Pennsylvania.

The National Institute of Aging funded the research.

Depression is not a normal part of aging, but when older adults do have depression, it may be overlooked, according to the National Institute of Mental Health. Seniors may show different, less obvious symptoms and may be less inclined to experience or acknowledge feelings of sadness or grief. The winter months can be especially challenging because some seniors experience seasonal affective disorder (SAD), a depressive illness triggered when there is less natural sunlight.

The Geriatric Mental Health Foundation says that an elderly person who may be depressed should see a medical professional. Talk to a client’s family or doctor if you suspect a senior is depressed.

For others, keep the winter blues at bay by using these ideas to inspire ways you can cater to each client’s interests with your personal spin:  

• Eat something new – Tackle a new recipe or re-invent a traditional one. Invite family and friends once a week for dinner and take turns preparing meals. Host a potluck dinner or an evening with international cuisine.
• Exercise the mind – Try a jigsaw puzzle or solve riddles. Discuss our question of the week
• Indulge – Enjoy a healthy dessert or sip a hot drink.
• Go for a walk – Invite family members and friends for an evening stroll. During bad weather, complete laps inside a local mall or community center.

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TurkeyNoodle Soup

• 5 quarts water
• 1 cup celery, chopped
• 1/2 cup celery leaves, chopped
• 1 cup onion, chopped
• 7 chicken bouillon cubes
• 1 tablespoon salt
• 1/4 teaspoon black pepper, ground
• 1 bay leaf
• 1/2 cup fresh parsley, chopped
• 1 cup fresh peas or 1 cup frozen peas
• 1 cup carrot, sliced
• 1 cup cut green beans, fresh or frozen
• 4 cups fine egg noodles (8 Oz)
• 1/4 cup butter or 1/4 cup margarine
• 1/4 cup flour
• turkey carcass, from a 15-20 pound turkey

Directions:

In an eight quart kettle or Dutch oven place turkey bones, water — down through to and including the bay leaf.  Heat to boiling; reduce heat, cover and simmer for 1 hour.  Remove the bones to a platter and let cool.

Add the parsley through to green beans.  Heat to boiling; reduce heat and simmer for 10 minutes.  Meanwhile, scrape meat from carcass and return meat to soup pot. Add liquid if required.  Heat to boiling; add noodles and cook uncovered for 10 minutes.

Melt butter in a small frying pan; stir in flour.  Cook over low heat, stirring constantly, until the flour browns.  Stir into boiling soup.  When the soup returns to a boil; reduce heat and simmer for 5 minutes.  Serve hot.

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Holiday Card Project

Pressed Flowers/Leaves –

Pick fresh flowers or leaves from a walk. Remove any wilted petals and leaves. Try not to let flower parts overlap. Leaves should lay flat. Choose a heavy book and line the inside pages with 2 or 3 sheets of paper to protect the book. (Using paper towels might turn the whole thing to mush). Carefully lay the flowers/leaves on the paper, and cover with another 2 sheets. After closing the book I stack another couple of books on top. Or you can also place the book in your microwave and “cook” it for 30 seconds. You’ll have to repeat it a few times, checking to see if the flowers/leaves are almost dried. Then I let the book sit for at least another two weeks before opening.

Use the dried flowers and leaves to make holiday greetings for family and loved ones. Take a moment to arrange the flowers on your card, taking note of how and where you want to position them.  The pressed flowers can be mounted directly on the card itself, or you may want to adhere a background of fabric, or handmade paper to the card stock first before gluing the flowers down.  Hold the pressed flower, apply a very small amount of glue to the back of the flower, position it on the card, and gently press down.  Do the same with the stems and leaves.  Once you’ve finished adhering your pressed flowers/foliage, it’s a good idea to place the card under a heavy book for a few minutes.  The firm pressure will ensure that your pressed flowers will dry flat.

Hope you enjoy our holiday kick off of fun things to enjoy this  time of year!

Fight the flu

“A flu shot is your best protection against catching the flu,” says Randy Bergen, MD, pediatric infectious disease specialist at Kaiser Permanente. The flu virus changes often. The protection given by the flu vaccine only lasts for about a year, so you need to get a flu shot every year, preferably in the fall.

The Centers for Disease Control and Prevention recommends that children 6 months and older, and every adult, get vaccinated against the flu. Children and adults who have a chronic health condition or weakened immune system, adults 65 or older, or smokers who are between 19 and 64 should also get a pneumonia vaccine. When you come in for your flu shot, ask if you need a pneumonia vaccine.

Flu shots are safe and won’t give you the flu .

What to do if you get the flu

1.Don’t ask for antibiotics, which won’t help because the flu is caused by a virus.
2.Stay home to help avoid spreading the flu to others.
3.Wash your hands often and avoid touching your face.
4.Use home remedies or over-the-counter medications, but don’t give any cough or cold products to children 6 years old or younger.
Protect yourself and family

The flu is more serious than the common cold, so do everything you can to prevent it. A flu shot (or nasal spray) is your best defense. The vaccine is safe, won’t make you sick, and generally has few side effects.

The flu virus changes often, and the protection from the vaccine only lasts for about a year. That’s why you should get a flu shot every year, preferably in the fall.

Who should get a flu shot?
The CDC recommends everyone 6 months and older get a flu vaccination every year.

The flu shot helps prevent you from getting the flu and from spreading it to others. Even healthy people can develop serious complications or even die from the flu — so protect yourself and your loved ones by getting vaccinated.

Vaccination is especially important for:

*people 50 years and older
*children 6 months through 4 years old
*women who are or will be pregnant during flu season
*people with chronic medical conditions or weakened immune systems
*people who live in nursing homes and other long-term care centers
*health care workers
*people who live with or care for anyone at high risk for flu-related complications
*Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes.

Why kids should get a flu shot
Children can spread the flu easily to adults and other children. Getting vaccinated also helps protect infants (who cannot receive a flu shot), pregnant women, the elderly, and people with chronic conditions.

Make sure your children get all recommended vaccinations on time. Check your child’s immunization record.

Flu shots will be available beginning in early fall 2011.  They are available from your health care provider or at local CVS drug stores & local Safeway stores! Do you have a primary care physician to help you if & when you do get the flu? Dr. Thomas Yatteau is a wonderful physician here  in Sonoma County who offers Concierge medicine.

 Dont forget  or delay- Get your flu shot today!

November is National Family Caregivers Month

Every day, more than 65 million family caregivers in the United States fulfill a vital role on the care team. November is National Family Caregivers Month, a great time to honor the family caregivers who devote their lives to caring for senior loved ones.

Family caregivers need support, which is why the Home Instead Senior Care^® network launched Caring for Your Parents: Education for the Family Caregiver^SM. This family caregiver support series addresses senior resistance to care and features a variety of topics such as choosing an in-home care provider, the signs of aging, long distance caregiving and communicating with aging parents. Materials and videos are available at www.caregiverstress.com.  Tell a family Caregiver about this valuable resource.

ScienceDaily (Jan. 10, 2011) — A large proportion of Medicare expenditures for nursing home residents with advanced dementia, a terminal illness, is spent on aggressive treatments that may be avoidable and of limited clinical benefit, according to a new study by the Institute for Aging Research, an affiliate of Harvard Medical School, published in the online version of the Archives of Internal Medicine on Jan. 10, 2011.

The study examined Medicare expenditures for 323 nursing home residents with advanced dementia in 22 facilities in the Greater Boston area as part of the Choices, Attitudes, and Strategies for Care of Advanced Dementia, or CASCADE, study. According to the findings, the largest proportion of Medicare expenditures was for hospitalizations (30.2%) and hospice (45.6%). Medicare expenditures rose by 65 percent in each of the last four quarters before death, primarily due to an increase in both acute care and hospice services. Acute care costs were lower among residents who had either a Do Not Hospitalize (DNH) order, lived on a special care dementia unit, or did not have a feeding tube.

“Our study demonstrates that a large proportion of Medicare expenditures in advanced dementia are attributable to acute and sub-acute services that may be avoidable and may not improve clinical outcomes,” says senior author Susan L. Mitchell, M.D., M.P.H., a senior scientist at the Institute for Aging Research.

An additional 10 percent of Medicare expenditures were for care in a rehabilitation facility after hospitalization. Dr. Mitchell calls the benefits of skilled nursing or rehabilitative care for these patients “questionable,” given that most of them are totally physically functionally and cognitively impaired.

Strategies that promote high-quality palliative care may shift expenditures away from aggressive treatments for dementia patients at the end of life and more toward a comfort care approach, say the researchers.

“The strong association between the lack of a DNH order and higher acute care expenditures supports the notion that advance care planning may be a key step toward preventing aggressive end-of-life care,” says Dr. Mitchell, an associate professor of medicine atHarvardMedicalSchool. Among cancer patients, advance planning lowers costs in the last week of life, and lower costs are associated with a higher quality of dying experience.

Both hospice and palliative care focus on quality of life or “comfort care,” including the active management of pain and other symptoms, as well as the psychological, social and spiritual issues often experienced at the end of life. Unlike hospice, however, palliative care services do not depend on life expectancy and may be used in conjunction with curative treatments.

Estimates peg 2010 total health-care expenditures for dementia at $172 billion, which will continue to rise as the number of people experiencing the end stages of this disease increases. Currently, more than 5 million Americans suffer from dementia, a number that is expected to increase to almost 13 million in the next 40 years. Total Medicare and Medicaid payments (nursing home care is generally paid for by Medicaid after individuals have exhausted their savings) for patients with dementia are roughly three times higher than they are for those without dementia.

Dr. Mitchell’s team looked at Medicare health services used by the nursing home residents over 18 months, culling data from hospital admissions, emergency department visits, primary care provider visits, and hospice enrollment. Roughly one-third of all Medicare costs for dementia were for hospitalizations, which Dr. Mitchell says are burdensome for many of these patients because, among other reasons, they involve a physical transfer and dementia patients often become even more confused and agitated in an unfamiliar environment. Previous studies by Dr. Mitchell and others have shown that most hospitalizations for patients with end-stage dementia are for conditions such as pneumonia that could be treated as effectively and at less cost in a nursing home setting.

Hospice payments accounted for close to half of all Medicare expenditures even though only 22 percent of the nursing home residents received hospice care. Hospice has been shown to benefit residents dying with dementia, but it is greatly underutilized with this population.

Dementia is a group of symptoms severe enough to interfere with daily functioning, including memory loss, difficulty communicating, personality changes, and an inability to reason. Alzheimer’s disease is the most common form of dementia.

A 2009 study by Dr. Mitchell in the New England Journal of Medicine was the first to rigorously describe the clinical course of advanced dementia and to label the disease a terminal illness similar to other incurable diseases, such as cancer.

Happy Veteran’s day to all those who have served & who are currently serving!  And to the families who lent us your sons & daughters, your husbands & wives, your fathers & mothers! Today we honor them all & Thank them for their sacrifice and courage!

Veteran’s Day Parade & BR Cohn Flyover
If you like Aircrafts, Parades, and an Airshow, you’ll love the Petaluma Veteran’s Day Parade. It’s held in beautiful downtown Petaluma. Vintage war birds and sleek air racers fly-in to take part in what has been called the “largest Veterans Day Parade north of the Golden Gate.” The Petaluma Veterans Day Parade features war planes that fly in formation over Historic Downtown Petaluma. The Parade winds its way north from the starting point at Walnut Park at “D” Street & finishes back at Walnut Park.

Every year on November 11th Petaluma hosts the largest Veterans Day Parade. Watch the parade, then take the short drive to B.R. Cohn Winery. We are honoring our Veteran’s during this weekend with complimentary wine tasting for all Veteran’s with ID. Plane Flyover at 2:30pm at B.R. Cohn!
Join us outside our tasting room around 2:30pm on Nov 11th, for a special fly over by a select group of WWII planes!

 
B.R. Cohn Winery
15000 Sonoma Hwy, Glen Ellen
(800) 330-4064

A Salute to our Nation’s Veterans
Friday, November 11th from 10amo-1pm.
Join us on November 11th for a celebration worthy of America’s finest. It’s the perfect time to thank & honor all those who have protected our nation by serving in the armed forces, and to show our appreciation for their dedicated service. The program will include a complimentary lunch & a special presentation on the Veterans Aid & Attendance Benefit by Mel Aguilar, VA pension specialist with Design Benefits Financial. If you are a veteran who served during wartime, or the surviving spouse of a veteran, this is one presentation you cannot afford to miss. Make plans now to attend.
Lodge at Paulin Creek
2375 Range Avenue, Santa Rosa.
(707) 575-3722

Petaluma Veterans Day Parade
Date: Friday November 11, 2011
Time: 1pm
Cost: FREE