Page 1

Healings in Motion was honored to work in conjunction with Health Plan of San Joaquin to present the Golden Gateway at Family Day in the Park. Thank you to all of our Caregivers, parents, grandparents, children and other remarkable people showing unyielding love, support and care for others.

3 56 S. Lincoln Street, Stockton, CA 95203 (877) 672-4480 FAX: 209-910-0451

Caregiver Appreciation By Mary A. Nicholson, Founder, Healings in Motion It is no coincidence that Family Caregivers Month occurs in the same month as Thanksgiving. It also is the time that we celebrate the heroic and selfless contributions of our veterans with Veterans Day. This is truly a time of gratitude and recognition of the services rendered by the caring people in our communities and to make sure that they are armed with the tools needed to fight against burn out, stress and prevent illness to themselves. Today, many Caregivers are “sandwiched� between caring for their immediate family, as well as an elderly parent, managing between work, taking care household needs at one household and perhaps more. Caregivers are often so absorbed into the good gestures that they are providing that they forget to care for themselves. Unfortunately, many of our veterans are living with the effects of PTSD (Post Traumatic Stress Disorder) and TBI (Traumatic Brain Injury). Their lives have changed greatly and so did the life of their loved ones serving as their Caregivers. For the last 8 years Healings in Motion has presented a special tribute to Caregivers. We celebrate Caregivers because we honor champions and warriors of hope to those living with a chronic illness, living with a disability or faced with mental and/or physical wound. Thank you for serving. As our baby boomers age, more Caregivers will be needed to care for them. As the need grows, Healings in Motion looks forward to bringing more Caregivers together for renewal, respite and rejuvenation.


The Caregivers Path By Amy White It was a cold late December afternoon when I first realized how far my son’s mental health had declined. A chain of events led us to the hospital and an extended wait in the comprehensive psychiatric emergency department. In a matter of months, my son had gone from a cheerful, happy-go-lucky teen to dark, dank and angry. Suddenly overnight I became a Caregiver. When my son was first hospitalized and even in the subsequent months and hospitalizations that came later, I did not necessarily look at myself as a Caregiver. But that is exactly what I was. I was making the majority of decisions about my son’s care, managing his treatment plans and working daily to ensure that all his needs were being met. I was also working a full time job, parenting another child and trying to hold my “normal” life together all at the same time. After a few months of this crisis, I realized that I needed additional support. Yet when I sought out groups or peers that could give me advice, lend a hand or listen to my fears and concerns, I found none. This became the consistent theme throughout the 18 months that my son was in crisis. What I found was the longer he was in crisis, the less support there seemed to be. When my son finally started to stabilize and was on the path to his own recovery, I made a decision to become a resource for other parents and Caregivers looking for support. I had learned so many lessons, tripped often into potholes and pitfalls I never saw coming and had recognized how important it was to have support during crisis times. I longed for connection with other Caregivers, even after I’d come through the challenging times. 8

Occupational Safety for Caregivers By Gloria Murphy, CEO, Diamond Care, Inc. The number one rule for Caregiving is to have as much control over your environment as possible. To achieve this control, you must (A) assess your work environment to identify and neutralize hazards, (B) assess the needs and the behavior of the person receiving care, and (C) generate and follow reasonable safety protocols. Failure to gain control over your environment could result in injuries to care receivers and care givers, which could also lead to the care givers missing work due to injury, or legal action against the care givers by the care receivers or their families. Health hazards in a caregiver’s environment include:  Blood-borne pathogens, which can be spread by inappropriate use of injection needles or other blood-related medical equipment.  Biological hazards such as soiled materials not being disposed of properly. The effects of these hazards can be exacerbated by a lack of access to protective clothing.  Hygienic hazards such as unsanitary homes or homes without safe drinking water.  Hazards from hostile pets or pets that have not been properly trained or have not had the appropriate vaccinations.  Hazards of temperature. Homes that lack adequate heating or air conditioning.  Hazards from latex sensitivities that can lead to rashes and opportunistic infections.


     

Ergonomic hazards in the work environment that encourage heavy lifting or extreme positions, which can result in musculoskeletal disorders or back injury. Hazards of violence from aggressive and unpredictable behavior on the part of care receivers. Hazards of hostility resulting from the relationship between the care giver and the care receiver or his or her family. Hazards from clutter or hording, including obstructed passageways. Hazards from a lack of appropriate handicap-related technology, such as hand rails or ramps. Hazards from weapons such as hidden guns or knives. Hazards involved in the operation of motor vehicles such as distractions from the care receiver.

The problems described above can be prevented by improving the work environment and by educating caregivers. Self-employed caregivers and small businesses may contact OSHA's free On-site Consultation services to help determine whether or not there are hazards at their worksites. To contact the free consultation services, go to OSHA's On-site Consultation webpage or call 1-800-321-OSHA (6742) and choose option 4 from the main menu. Workers may file a complaint to have OSHA inspect their workplace if they believe that their employer is not following OSHA standards or that there are serious hazards. Workers can file with OSHA by calling 1-800-321-OSHA (6742), online via eComplaint Form, or by printing the complaint form and mailing or faxing it to the local OSHA office. Complaints that are signed by a worker are more likely to result in an inspection. If you are self-employed you will have to resolve the problem with your client and in the case of continued noncompliance, you should cease all work. If you think your job is unsafe or if you have questions, contact OSHA at 1-800-32111

children living in grandparents’ homes and nearly 2 million children living in other relatives’ homes. These families are often called “grandfamilies.” More than 2.5 million grandparents are taking on the full responsibility for their grandchildren. Many grandparents and other relative caregivers and the children they are raising are often isolated. They lack information about the range of support services, resources, programs, benefits, laws and policies available to help them successfully fulfill their care giving role. In addition, to better serve children, families and older adults, educators and program practitioners need access to information. Resources: AARP Grandparent Information Center, 601 E. Street, NW Washington, DC 20049 │ (202) 434-2296│ The Grandfamilies State Law and Policy Resource Center serves as a national legal resource in support of grandfamilies within and outside the child welfare system. Grandfamilies of America 6525 Fish Hatchery Road, Thurmont, MD 21788 (301) 898-8023; (866) 203-8926, ext. 8103 Grandparent Advocacy Network of Northern California Contact: Sandy Weiss Phone: 530-756-0183 Email: Service Area: Northern California counties Description: Monthly informal lunches for grandparents Grandparent Project – Senior Legal Hotline of Legal Services of California Phone: 1-800-222-1753 (toll-free)│ Service Area: Statewide; some services Sacramento County only San Joaquin county-Human Services Agency, Aging and Community ServicesManuel Mendoza (See ad)

Caregivers to Veterans FREE Online Workshop Provides Information and Support 13

It’s called Building Better Caregivers and it is a free six-week online workshop for family caregivers of veterans. If you are taking care of a veteran, this workshop will help you learn a variety of skills like time management, healthy eating, exercise and dealing with difficult emotions. This program was developed by Stanford and has proven to reduce stress and depression while increasing your overall well-being. To register for the on-line 6-week program, go to National Resource Directory-Connecting Wounded Warriors, Service Members, Veterans, Their Families and Caregivers with Support Resources VA Caregiver Support American Foundation for Suicide Prevention (AFSP) (888)-333-2377 Anxiety Disorders Association of America (240) 485-1001 Freedom from Fear 308 Seaview Avenue Staten Island, NY 10305 (718) 351-1717

National Resource Directory│ Connecting wounded warriors, service members, veterans, their families and caregivers with those who support them.

Tributes│ FREE tributes celebrating the lives of a loved one and reach on-line support during your period of grieving.

VA Caregiver Support│(855) 260-3274│ Veterans Benefits Administration│


Ten (10) Tell-Tale Signs Your Aging Parent Can’t Live Alone By Carolyn Brent, MBA, Author of “The Caregiver's Companion: Caring for Your Loved One Medically, Financially and Emotionally While Caring for Yourself”

It’s a sad reality that, as we age, we become less independent than we once were – but for most blessed with longevity, it’s inevitable. With an estimated 13 million baby boomers throughout the U.S. caring for elderly parents, throngs of adult caregivers struggle with determining if their parent is fit to remain living alone. It’s a difficult, multi-faceted decision not to be made lightly as there is much at stake – both the physical and emotional well-being of the parent in question and for the extended family at large. To help ease the process of determining if an elderly parent should no longer live on their own, here are 10 tell-tale signs that can give you better peace of mind with making this allimportant decision: 1.

Mom or Dad has always been a great housekeeper, but the house just doesn’t look like it used to. You may remember a parent who was constantly on you about tidying your room or putting things away after you were done with them. The house was always spotless and everything was organized, clean and in its place. There was much pride in this fact. However, upon visiting with Mom or Dad today the home is decidedly cluttered and not nearly as clean as normal. Of course, this can mean a lot of things. Your parent may actually have an active social life and is more concerned with staying busy than tidying up. But, it could be a more ominous sign that your parent is having a difficult time keeping up with all the chores. She may feel overwhelmed or his physical 17

health is slowing him down. Ask your parent if help is needed with the clutter, but do it in a nonchalant way that could prompt a conversation indicating assistance is needed here. Keep a keen eye to discern if the clutter and filth is getting worse with each visit - it’s often a key sign. 2. The bills and other mail are piling up. While we all get busy – even those who are retired –basic tasks that were often dealt with quickly and easily when younger, but that are now falling by the wayside, is a sign that your older parent could be getting overwhelmed and not able to manage their daily affairs. This may also indicate some signs of forgetfulness and memory issues. Often, especially if a parent is alone without a spouse, they may not have someone to remind them to go through the mail and check to see if it’s time to pay certain bills. 3. The checking account balance is wrong and bills are going unpaid. If the mail, with bills included, is piling up, there is a good chance that the bills are not getting paid. You may also discover amongst mail issues that your parent’s checking account ledger balance is wrong or in arrears. These are also signs that your parent is having memory issues or difficulty with simple math cognition. It can also indicate a general apathy – a mindset that can be equally problematic for someone with the glut of responsibility required to effectively live alone. 4. Your parent is losing a lot of weight. A parent who may have lost their partner or who is generally depressed often loses interest in eating due to a reduced appetite. They may feel that it is not worth the hassle of shopping for and preparing meals if they are now living all alone. Accordingly, pay close attention to your parent’s weight. Also, check their refrigerator and pantry to see if there is 18

an appropriate supply of food and that what is there is fresh and edible. If the cupboard is bare and your parent’s frame is shrinking, living alone might become problematic. At the very least, you may want to think about bringing groceries by or looking into a service that offers prepared meal delivery. Otherwise, you may have to think about putting them somewhere that helps them eat regular, healthy meals. 5. They have forgotten the basics of hygiene. If you notice that your parent is wearing the same clothing day in and day out or that their hair or skin appears dirty on a fairly regular basis, they may have lost the motivation, ability and/or forethought to look after them self. Living alone, they may feel like they don’t have to dress up or clean up for anyone. Worse yet, they may have forgotten – or simply no longer cares - that such personal hygiene and cleanliness is an important part of daily living and maintaining one’s good health. 6. They appear in inappropriate clothing. While you may not share your mother or father’s sense of style, there is cause for concern if your parent dons summer clothing in the dead of winter or leaves the house in a nightgown and slippers for a trip to the store. This often happens when the elderly are suffering from confusion and lose the ability to have discretion in social situations. In this situation, wardrobe can be the least of the concerns as the problem manifests in other dangerous ways. 7. There are signs of forgetfulness in the home. Confusion can also show up in the kitchen and can prove to be deadly if not dealt with quickly. All too often there are stories of older people who accidentally burned their houses down because they left a pot on the stove for hours and fell asleep or have flooded the home 19

when they forgot to turn off the tap. Or, perhaps more subtly, the milk is in the pantry and the bread is in the refrigerator. These are all tell-tale signs that it may not be wise for your parent to be left home alone for extended periods of time. 8. Your parent regularly misses appointments and other important items. Forgetfulness, absentmindedness and memory issues may also show up when it comes to keeping certain appointments, recognizing key dates, or, even more importantly, maintaining medication dosages on schedule. This is a clear sign they need to live with someone who can help them stick to their schedules and stay on task. 9. They are just acting plain weird. This is always the sign that families dread the most. No one wants to turn into the “crazy cat lady” or the “man who mutters to himself.” But, unfortunately, between aging, mental degradation and the side effects from medication, you may note that your parent has lost their personalities and behavior has taken an odd turn for the worse. If you see signs of paranoia, fear, strange phone calls and conversations and nervousness, this should not be overlooked as it’s a blatant sign that living assistance is in order. 10. They exhibit signs of depression. There are a number of classic signs that can be connected with someone suffering depression. A loss of interest in caring for one’s self as well as a lack of participation in socialization and in once-loved hobbies can mean that your parent needs treatment or should reside in an environment where they can be around other people. Sometimes, depression comes from a sense of loneliness or the realization that they can no longer do things for themselves. Putting them 20

Fall Prevention Each year, millions of older people—those 65 and older—fall. In fact, one out of three older people falls each year, but less than half tell their doctor. Falling once doubles your chances of falling again.

Falls Are Serious and Costly

One out of five falls causes a serious injury such as broken bones or a head injury.1,2

Each year, 2.5 million older people are treated in emergency departments for fall injuries.3

Over 700,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture.3 22

Each year at least 250,000 older people are hospitalized for hip fractures.5

More than 95% of hip fractures are caused by falling,6 usually by falling sideways.7

Falls are the most common cause of traumatic brain injuries (TBI).8

Adjusted for inflation, the direct medical costs for fall injuries are $34 billion annually.9Hospital costs account for two-thirds of the total.

What Can Happen After a Fall? Many falls do not cause injuries. But one out of five falls does cause a serious injury such as a broken bone or a head injury.1,2 These injuries can make it hard for a person to get around, do everyday activities, or live on their own. 

Falls can cause broken bones, like wrist, arm, ankle, and hip fractures.

Falls can cause head injuries. These can be very serious, especially if the person is taking certain medicines (like blood thinners). An older person who falls and hits their head should see their doctor right away to make sure they don’t have a brain injury.

Many people who fall, even if they’re not injured, become afraid of falling. This fear may cause a person to cut down on their everyday activities. When a person is less active, they become weaker and this increases their chances of falling.9 23

What Conditions Make You More Likely to Fall? Research has identified many conditions that contribute to falling. These are called risk factors. Many risk factors can be changed or modified to help prevent falls. They include: 

Lower body weakness

Vitamin D deficiency (that is, not enough vitamin D in your system)

Difficulties with walking and balance

Use of medicines, such as tranquilizers, sedatives, or antidepressants. Even some over-the-counter medicines can affect balance and how steady you are on your feet.

Vision problems

Foot pain or poor footwear

Home hazards or dangers such as o

broken or uneven steps,


throw rugs or clutter that can be tripped over, and


no handrails along stairs or in the bathroom.

Most falls are caused by a combination of risk factors. The more risk factors a person has, the greater their chances of falling. Healthcare providers can help cut down a person’s risk by reducing the fall risk factors listed above. 


Treating fall injuries is very costly. In 2013, direct medical costs for falls—what patients and insurance companies pay—totaled $34 billion.1 Because the U.S. population is aging, both the number of falls and the costs to treat fall injuries are likely to rise. 

Each year, millions of people 65 and older are treated in emergency departments because of falls.2

Over 700,000 patients a year are hospitalized because of a fall injury, most often because of a broken hip or head injury.2

Fall injuries are among the 20 most expensive medical conditions.3

The average hospital cost for a fall injury is $35,000.1

The costs of treating fall injuries goes up with age.1

Medicare pays for about 78% of the costs of falls.1

Make your home safer About half of all falls happen at home. To make your home safer: Remove things you can trip over (like papers, books, clothes, and shoes) from stairs and places where you walk. Remove small throw rugs or use double-sided tape to keep the rugs from slipping. Keep items you use often in cabinets you can reach easily without using a step stool. Have grab bars put in next to and inside the tub and next to the toilet. Use non-slip mats in the bathtub and on shower floors.


Incidence and Prevalence of the Major Causes of Brain Impairment An Abstract - Federal Interagency Forum on Aging-Related Statistics

Overview Many of the diseases and disorders that affect the brain are progressive and their incidence and prevalence increase with age. Caring for those with adult-onset brain impairments frequently becomes a 24-hour, 7-day a week role. As the population ages, the need for care and for understanding the impact of these disorders on families becomes even more pressing. A recent report released by the Federal Interagency Forum on AgingRelated Statistics states that 35.8% of those 85 or older have moderate or severe memory impairment. Persons 85 years and older are the fastest growing segment of the population. By 2020, it is estimated that almost one million persons will be age 85+ in California alone – twice as many as there are today.2 The loss of cognitive and functional abilities affect the individual and his or her family in profound ways. Caring for adults with cognitive impairments is often very stressful and demanding. Caregivers cope with their loved ones' memory loss, behavioral and personality changes, chronic care needs and the high costs of care. Caregiving can span decades, can impact both the physical and mental health of the caregiver and can result in extreme economic hardship. The following tables estimate the incidence and prevalence of the major causes of brain impairment in adulthood in the United States in general and in California in particular. The estimates are conservative, excluding rare disorders for which reliable data are not available.


Table 1 shows an estimated 1.2 million people aged 18 years and older who are diagnosed annually with adult onset brain diseases/disorders in the United States (i.e., the incidence).

TABLE 1: Incidence of Adult Onset Brain Disorders

Diagnosed Yearly Stroke Alzheimer’s disease Epilepsy Traumatic Brain Injury Parkinson Brain Tumor Multiple Sclerosis Amyotrophic Lateral Sclerosis (ALS) HIV (AIDS Dementia) Huntington’s disease

600,000 250,000 135,000 80,000 54,927 33,000 10,400 5,000 1,196 NA

TOTAL ESTIMATED INCIDENCE 1,170,062 More than one million adults in the U.S. are diagnosed annually with a chronic brain disease or disorder. The need for both long-term care and support for family caregivers is dramatic. Many of these conditions, for example stroke and Alzheimer’s are associated with increasing age. Given the aging of the United States population, figures will increase proportionately in the coming decades.


Services Adaptive/Assistive Equipment Alert Medical Response 3012 S. Soderquist Road Turlock, CA 95380 (209) 262-4685 Assistive Technology│ Deaf and Disabled Telecommunications (DDTP) 1333 Broadway Street, Ste 500 Oakland, CA 94612 (510) 302-1100 (800) 806-1191 Durable Medical Equipment │ Lifeline- St. Joseph’s Medical Center 1800 N. California Street Stockton, CA 95204 (209) 467-6468 Shield Health Care (800) 765-8775 Advocacy Organizations that promote the health, dignity, rights and quality of life for seniors and those with disabilities. AARP (886)872-2277 Adversity to Advocacy (415)672-9050 American Civil Liberties Union


(212)549-2500 American Rights Coalition 800-823-6060 Consumer Complaints (800)782-1110 Disability Resource Agency for Independent Living - DRAIL The Disability Resources Agency for Independent Living (DRAIL) is dedicated to increasing the independence of individuals with disabilities through resources, advocacy and services. Modesto Office 920 12th Street Modesto, CA 95354 Stockton Office 501 W. Weber Avenue, Suite 200-A Stockton, CA 95203 National Alliance of Mental Illness (NAMI), California NAMI California is a grass roots organization of families and individuals whose lives have been affected by serious mental illness. NAMI educates and advocates for quality and respect, without discrimination and stigma to provide leadership in advocacy, legislation, policy development, more support for mental illness throughout California. 1851 Heritage Lane, Ste 150 Sacramento, CA 95815 (916) 567-0163 California Health Advocates 5380 Elvas Avenue, Suite 221 Sacramento, CA 95819 (916)231-5110 Disability Rights California (DRC) DRC is a non-profit organization which advances human and legal rights for persons with disabilities, providing legal assistance to protect those rights. Services and issues dealing with special education, Lanterman Act, benefits (i.e. Social Security, Medi-Cal, In-Home Supportive Services), housing rights, employment rights, access to services and more. 1831 K Street Sacramento, CA 95811-4114 916-504-5800

32 San Joaquin Pride Center 109 N. Sutter Street Stockton, CA 95202 (209) 466-SJPC (7572) Aphasia Aphasia Foundation Get the Aphasia Handbook (800) 922-4622 │ Aphasia Foundation│ Benefits Benefits Check Up│ Clinical Trials│ Medicaid │ Medicare│7500 Security Boulevard│Baltimore, MD 21244 (800) 633-4227 │

Office of Minority Health, California Regional Office Christina Perez, FNP, MN, RN,RMHC│ 90 7th Street│Suite 5-100│San Francisco, CA 94102 (415) 437-8124│

Patient Assistance for Prescription Drugs│ Senior Medi-Benefits│3195 Adeline Street│Berkeley, CA (510) 420-0550 (888) 789-4589│ Social Security (Disabilities)│(877) 803-6314

U. S. Government Benefits│


Brain Related Alzheimer's & Memory Center│ 6137 N. Thesta Avenue, Suite 101B │Fresno, CA 93710 (559) 227-4810 Alzheimer’s Association of Northern CA│ 1455 Response Road│Sacramento, CA│(916)930-9080 (800)272-3900 American Foundation for Suicide Prevention (AFSP)│ (212) 363-3500 Anxiety Disorders Association of America (240) 485-1001 Association for Behavioral and Cognitive Therapies (212) 647-1890 BeHaveNet A comprehensive resource guide for psychological illnesses.

Brain Aneurysm Foundation 269 Hanover Street Hanover, MA 02339 781-826-5556 . 888-272-4602 Brain and Behavior Research Foundation 60 Cutter Mill Road, Ste 404 Great Neck, NY 11021 (800) 829-8289 B.R.A.I.N. Brain Rehabilitation and Injury Network 5267 Warner Avenue Huntington Beach, CA 92649 (714) 318-6076


The Healing Brain Trust 459 Broadway, Suite 302 Everett, MA 02149 (877) 252-8480 Brain and Spinal Cord Injury Phone: 866-611-BASC

American Stroke Association 7272 Greenville Ave. Dallas, TX 75231 888-4-STROKE 888-478-7653 National Stroke Association 9707 E. Easter Lane, Suite B Centennial, CO 80112 800-STROKES 1-800-787-6537 Stroke Resources PO Box 77321 Modesto, CA 95357 (209) 521-1786 Brain Injury (866) 882-7246 Brain Injury Association of CA 888-662-4222 Brain Resource Center 263 W. End Ave. #1D New York, NY 10023 (212) 877-2130

35 Head Injury 206-621-8558 Post-Traumatic Stress Disorder (PTSD)│ (262) 567-6600 Traumatic Brain Injury of CA Two Commerce Square 2001 Market Street, Suite 2900 Philadelphia, PA 19103 Chronic Illness Center for Disease Control and Prevention (CDC) 1600 Clifton Rd. Atlanta, GA 30333, USA 800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 Elder Care There are a few things that you can do to insure a safer environment for elder seniors. As baby boomers age and take care of their parents, the industry for home conversions will also boom. Main Entrance  

Install a threshold ramp and chair railings to make it easier to leave and enter the home. Repair cracked sidewalks or uneven pavers that pose a tripping hazard.

Bathroom Safety    

Install grab-bars by the toilet and in your bathtub or shower. Add a no-slip rubber mat to the bottom of your bathtub or shower to prevent slipping. Add a shower chair or bench for enhanced stability and ease of bathing. Use a nightlight in the bathroom and hallway to illuminate the path from the bedroom to the bathroom at night.


Stair Safety     

Reinforce handrails. An adult should be able to securely wrap his or her hands around the entire handrail with ease. Add a second handrail on the opposite wall, if possible. Increase lighting on stairs. Use a two-way switch so the light can easily be turned on and off from both upstairs and downstairs. Remove rugs from the top and bottom of stairs. If possible, convert a downstairs room into a bedroom to reduce stair use.

Living Space Safety   

Remove throw rugs and runners or use double-sided tape and a non-slip backing to securely hold them in place. Secure extension cords against the baseboards and out of high-traffic areas. Reduce clutter. Remind children to keep toys and books off the floor.

Kitchen Safety   

If your elderly parent will be cooking or preparing meals, place pots and pans at waist level for easy access. If your elderly parent should not be cooking due to impairment, consider disconnecting the stove when you’re not home to prevent him or her from turning it on. Place a microwave on the counter (rather than over the stove) to reduce bending and stretching while preparing food.

Advantage Home Design 1671 Dickey Court Ripon, CA 95366 (209) 918-5910 Aging Parents. Com Dr. Mikol Davis & Carolyn Rosenblatt, RN, Attorney 930 Irwin Street, Suite 215 San Rafael, California, 94901 (866) 962-4464


Caregiver Support Central Valley Senior Services 178 West Adams Street Stockton, CA 95204 (209) 890-1300 Del Oro CRC Serving Alpine, Amador, Calaveras, Colusa, El Dorado, Nevada, Placer, Sacramento, San Joaquin, Sierra, Sutter, Yolo and Yuba Counties 8421 Auburn Blvd, Suite 120 Citrus Heights, CA 95610 (916)728-9333

Valley CRC Serving Fresno, Kern, Kings, Madera, Mariposa, Merced, Stanislaus, Tulare and Tuolumne Counties 3845 North Clark Street, Suite 201 Fresno, CA 93726 Eldercare at Home Elder Law Answers G. Archer Bakerink, A Professional Corporation 215 North San Joaquin P.O. Box 204 (95201) Stockton, CA 95202 (209) 598-7774 Family Caregivers Alliance (800)445-8106 Home Care: A Family Caregiver’s Guide


Rosalynn Carter Institute for Caregiving 800 GSW Drive Georgia Southwestern State University Americus, Georgia 31709-4379 (229) 928-1234 The National Alliance for Caregiving 4720 Montgomery Lane, 2nd Floor Bethesda, MD 20814 (301) 718-8444 California’s Advance Health Care Directive Dental Care University of the Pacific Dental Care Clinic A program providing comprehensive, quality dental care at reasonable prices. Dental Residents treat patients by integrating all phases of dentistry, with an emphasis on advanced comprehensive treatment. Denti-Cal and other insurance accepted. 757 Brookside Road Stockton, CA 95207 (209) 946-7404 Disabilities Arc-San Joaquin Stockton, CA 95202 (209) 955-1625 Fax: (209) 955-1627 Hanger 7551 Timberlake Way, Suite 110 Sacramento, CA 95823


RSC of San Joaquin, Inc. 2339 W. Hammer Lane, Suite C, PMB #233 Stockton, CA 95209-2368 209-403-8878 United Cerebral Palsy 333 W. Benjamin Holt Drive Stockton, CA 95207 (209) 956-6379

Food Artesian Natural Foods 145 Lincoln Center Stockton, CA 95207 (209)952-8787 Green’s Nutrition & Health Food Store 1906 Pacific Avenue Stockton, CA (209) 464-5738

Hospice Bristol Hospice 2140 Professional Drive, 210 Roseville, CA 95661 (916) 782-5511 Community Hospice 4368 Spyres Way Modesto, CA 95356 (209) 578-6300 Hospice of San Joaquin 3888 Pacific Avenue


In-Home Support Services (IHSS) IHSS is a state program administered by your county that provides homecare assistance to eligible aged, blind or disabled individuals. To be eligible for IHSS, you must be on Medi-Cal, be blind, disabled, or 65 years of age or older, and unable to live at home safely without help. IHSS-Merced 708 W. 20th Street Merced, CA 95340 (209)385-3105 IHSS-San Joaquin County PO Box 201056 Stockton, CA 95201 (209) 468-1104 Hospitals (See your phone book for total listing) Briggsmore Specialty Center 1409 E. Briggsmore Specialty Center Modesto, CA 95355 Central Valley Specialty Hospital -For patients who still need Acute Rehabilitation and Skilled Nursing Services. 730 17th Street Modesto, CA 95354 (209)248-7700 Dameron Hospital│STEMI Center Bariatric Surgery 525 West Acacia Street Stockton, CA 95203 (209)944-5550


Kaiser Permanente, Modesto Certified Stroke Center 4601 Dale Road Modesto, CA (209) 557-1000 St. Joseph’s Medical Center Certified Stroke Center STEMI Center MAKOplasty Surgery 1800 North California St Stockton, CA 95204 (209) 943-2000 San Joaquin County General Hospital Certified Stroke Center/ Trauma Center 500 West Hospital Road French Camp, CA 95231 (209) 468-6000 Sutter Gamma Knife Center 2800 L. Street Suite 630 Sacramento, CA 95816 (888)287-2270 Sutter Gould Foundation 600 Coffee Road Modesto, CA 95355 (209)835-1500 Sutter Tracy Community Hospital 1420 N. Tracy Blvd. Tracy, Ca 95376 (209)835-1500


Valley Choice Fertility Clinic 1409 E. Briggsmore Avenue (209)550-4720 Valley Heart Institute Part of Doctors Medical Center 4016 Dale Road Modesto, Ca 95356 (209) 577-5557

Housing Franco Center Apartments-Senior Community. Provides low-income, subsidized housing for senior citizens in the Stockton area. The complex offers studio apartments as well as one and two bedroom apartments. The community center is available to all seniors living in San Joaquin County 7 North San Joaquin Street, Suite 40 │Stockton, CA 95202 (209) 466-3577 (209) 460-502102 Email: │ Indian Health Indian Health Service CA Health Care Services Bay Area Indian Health Clinic

Journals A great place to connect with other Caregivers, including Caregiver Radio. Rehabilitation


California Department of Rehabilitation Vocational Services Clients must have documented disabilities. California Department of Rehabilitation assists Californians with disabilities to obtain and retain employment and maximize their ability to live independently in their communities. Eligible individuals are assisted in finding employment and/or independent living. Vocational training and counseling are also available. 1507 East March Lane, Suite A Stockton, CA 95210 (209) 473-5900 Fax: (209) 473-6511 Mental Illness Asian Americans for Community Involvement (408)975-2730

Behavioral Health Services, San Joaquin County 1212 N. California Street Stockton, CA 95202 (209) 468-8750 National Alliance of Mental Illness (703) 524-7600 (209)468-3755 Pain Management For Those in Pain (650) 968-2323

Respite and Day Care Respite offers a few hours of relief from your Caregiving duties. Respite affords the Caregiver time to refresh and include time for valuable self-care. Jene Wah, Inc.


Jene Wah, Inc. is a comprehensive community services agency that enables elderly citizens to live independently and enhance their quality of life. This multi-service agency also provides nutrition information for seniors, transportation to doctor visits, interpretation services and assistance with tax preparation. In addition, they offer congregate meal services, homemaker services, personal care and telephone assurance. The agency is open to new immigrants. They provide naturalization classes in English and Chinese, as well as ESL. 238 East Church Street Stockton, CA 95203 (209) 463-7654

Catholic Charities│ Provides personal care and homemaker services to low income seniors who are not eligible for In-Home Supportive Services (IHSS). In addition, Catholic Charities contracts to provide the following services: Caregiver Respite, Caregiver Chore, Home Modification, Telephone Reassurance and Caregiver Training. 1106 N. El Dorado Street Stockton, CA 95202 (209) 444-5951

El Concilio 1755 W. Hammer Lane, Suite #8 Stockton, CA Family Caregiver Alliance 785 Market Street, Suite 750 San Francisco, CA 94103 (415) 434-3388 (800) 445-8106 Family Caregiver Support Program-San Joaquin County 102 S. San Joaquin Street Stockton, CA 95201 (209) 468-3814


Lodi Memorial Hospital operates a State-licensed Adult Day Services Program at Hutchins Street Square for older and disabled adults who cannot fully care for themselves. The Adult Day Services Center helps fill the gap between senior centers and full time residential care. The Adult Day Program provides a safe, stimulating environment, and includes meals, supervised exercise, music therapy, computer memory skills programs, entertainment, and arts and crafts. Supportive services are available to assist caregivers. (209) 369-4443 Respite Care Locator United Cerebral Palsy of San Joaquin 333 W. Benjamin Holt Drive Stockton, CA 95207 (209) 956-0290 Seniors AARP│

Aging & Veterans Services 121 Downey Ave, Suite 102 Modesto, CA 95354 (800)510-2020 (209) 558-8698 Fall Prevention Center of Excellence

National Institute on Aging│

San Joaquin County Department of Aging│ Family Caregiver Support 102 South San Joaquin Street Stockton, CA 95201


U.S. Senate Special Committee on Aging│

Speech National Center for Voice and Speech 136 South Main Street, Suite 320 Salt Lake City, UT 84101-1623 (801)596-2012

Massage Therapy Choku-Rei Center 2028 West Orangeburg Avenue Modesto, CA 95350 (209) 450-6896 Music Therapy with Melody 9767 Deep Water Stockton, CA 95219 (209)482-4470

Travel/Transportation Access-Able Travel Source American Cancer Society The American Cancer Society presents the Road To Recovery Transportation Program. It provides transportation to and from treatment for people who have cancer who do not have a ride or are unable to drive themselves. (800) 227-2345 Environmental Travel Companions (415) 474-7662 www.etctrips


What is Holistic Medicine? Holistic medicine is the art and science of healing that addresses care of the whole person - body, mind, and spirit. The practice of holistic medicine integrates conventional and complementary therapies to promote optimal health, and prevent and treat disease by addressing contributing factors. Holistic healthcare practitioners strive to meet the patient with grace, kindness, acceptance, and spirit without condition, as love is life’s most powerful healer. In practice, this means that each person is seen as a unique individual, rather than an example of a particular disease. Disease is understood to be the result of physical, emotional, spiritual, social and environmental imbalance. Healing, therefore, takes place naturally when these aspects of life are brought into proper balance. The role of the practitioner is as guide, mentor and role model; the patient must do the work - changing lifestyle, beliefs and old habits in order to facilitate healing. All appropriate methods may be used, from medication to meditation. Holistic Terms Acupressure – A type of Asian healing art based on ancient Japanese and Chinese medicine. A practitioner puts pressure on specific points on the body with his or her fingers in order to relieve pain and discomfort, prevent tensionrelated ailments, and promote good health. Acupuncture – The Chinese practice of gently inserting fine needles into the body at specific points to cure disease, relieve pain and balance the energy systems in the body. Anthroposophic Medicine: A holistic and human-centered approach to medicine that uses all of the tools of conventional medicine, as well as aspects of spiritual science to assess each individual as a whole entity–physical body, life force, spirit and individual soul quality. The treatment process is based upon the uniqueness of the individual. All anthroposophic treatments are designed to stimulate the patient’s powers of self-healing, with emphasis on restoring the balance of bodily functions and strengthening the forces of individuality and autonomy in the organism. Applied Kinesiology – A method of testing muscles to find imbalances in the body. Rebalancing using massage of lymphatic areas, holding neurovascular points, running acupuncture meridians, holding acupuncture points, finding the proper nutritional support and addressing emotional aspects that are involved. Aromatherapy – The use of essential oils extracted from plants and herbs to treat conditions ranging from infections and skin disorders to immune


deficiencies and stress. Essential oils are widely used throughout Europe and a system of medical Aromatherapy is currently practiced in France. Ayurvedic Medicine – Practiced in India for the past five thousand years, Ayurvedic, meaning “science of life’ is a comprehensive system that combines natural therapies with a highly personalized approach to treatment of disease. Ayurvedic medicine places equal emphasis on body, mind and spirit, and strives to restore the innate harmony of the individual. Biofeedback — Quantum biofeedback is a computerized energetic device that detects and assesses imbalances in the body, then emits healthy, balancing frequencies back to the body. It works by reducing the stresses on a body at the electro-magnetic level caused by food, toxins, hormones, nutrient deficiencies, allergies, parasites, emotions, environment, genetics, and lifestyle. The system searches for stress patterns in the body and then administers appropriate therapies to help the body correct any imbalances found. Bodywork -The term bodywork refers to therapies such as massage, deep tissue manipulation, movement awareness, and energy balancing, which are employed to improve the structure and functions of the human body. Bodywork in all its forms helps to reduce pain, soothe injured muscles, stimulate blood and lymphatic circulation, and promote deep relaxation and enable the body to rally its own recuperative powers. Bowen Therapy – A series of gentle, simple non-invasive moves performed across muscle fibers and connective tissue, in a succession with waiting periods, incorporated into the session. The resting time allows the brain to assimilate, correlate and create a positive response to the area being treated. All body systems are accessed allowing muscle and nerve tissue to relax, toxins shed, circulation increased. Breath Work – The human breath has long been honored as a powerful pathway within the self to relieve pain, release blocked emotions, and deepen states of spirituality. Indian “prana,” Chinese “chi” and Japanese “ki” refer to the power of breath and its basic life force energy which enable all living things. When we restrict this life force we create disharmony and disease. Breath Work uses the full dynamics of our natural breathing path to open restricted patterns to access both the inner world and the higher self for personal healing and wellbeing. Practices such as Rebirthing, Hypnosis, Yoga, Chi Kung and Shamanic healing are all forms of this transformational tool. Brennan Healing Science (BHS) - BHS practitioners charge, clear and repair the human energy field which is the foundation of physical, emotional, and


spiritual health. It was developed by former NASA scientist, Barbara Brennan, author of Hands of Light and Light Emerging. Chi Nei Tsang (CNT) - A healing touch modality of Chinese Taoist origin. Soft touch and gentle massage on the abdomen stimulates the organs to work better and creates beneficial change in all the systems of the body: the digestive, lymphatic, cardiovascular, respiratory, nervous, endocrine, reproductive, urinary, muscular-skeletal, and the acupuncture meridian system that is the pathway for ‘chi’ or energy. A Chi Nei Tsang treatment releases deepseated tensions and restores vitality. The modality’s holistic approach integrates the physical, mental, spiritual and emotional aspects of our being. Cranial Sacral (CranioSacral)Therapy - A holistic, hands-on technique involving gentle manipulation of the bones of the skull, the underlying meningeal membranes, which surround the central nervous system to add an additional layer of protection beneath the bones of the skull and spine), and the nerve endings in the scalp. A practitioner is able to “listen” with their hands to what is called the cranial rhythmic impulse, which runs throughout our bodies. Colon Hydrotherapy – The absorption of nutrients is enhanced when the colon is cleansed. This safe and painless process involves infusing filtered and temperature regulated water into the large intestine to dislodge impacted material and dilute bacteria and toxic concentrations. Colon Hydrotherapy to improves muscle tone and facilitate peristalsis action. Doctor of Chiropractic (D.C.) – Through adjustments of the spine and joints, chiropractors can influence the body’s nervous system and natural defense mechanisms in order to alleviate pain and improve general health. Because of its effectiveness in treating back problems, headaches, and other injuries and traumas, chiropractic has become the second largest primary health care field in the world. Dreamwork – Dreams contain metaphorical, symbolic, and archetypal language and images. Many are multilevel, with messages relevant to various aspects of one’s being: physical health, emotional well-being, and soul level. Dreams may contain literal information about potential future paths. Dreamwork explores meanings of dreams and reveals how the different layers relate to one’s life. The dreamer is the authority on the meaning(s) of the dream; the dreamworker(s) offer insights using the “if this were my dream” format. Shamanistic dreamwork includes shamanic journeying on the dream images. EMDR (Eye Movement Desensitization & Reprocessing) – An advanced, rapid therapy approach for stress-related symptoms, traumatic memories, and to shift core beliefs. With bi-lateral stimulation of both sides of the brain, EMDR


allows the brain to reprocess the experience and go for a healthy resolution. The eye movements process the unconscious material like what is happening in REM or dream sleep and unlock the nervous system which allows re-integration of positive information and outcome. Your own brain with this technology does the healing and you are in control. Emotional Freedom Techniques (EFT) ~ Uses elements of Cognitive Therapy and Exposure Therapy, and combines them with Acupressure, in the form of fingertip tapping on 12 acupuncture points. Over 20 clinical trials published in peer-reviewed medical and psychology journals have demonstrated that EFT is effective for phobias, anxiety, depression, post-traumatic stress disorder, pain, and other problems. Eurythmy Therapy - Eurythmy Therapy is a movement therapy that harmonizes the whole human being by balancing the physical body with the life forces and soul forces, drawing upon the formative forces of the creative World Word, the planets and constellations, and the four elements. A key modality in Anthroposophical medicine, Eurythmy Therapy has been successfully practiced for more than 90 years, with application used for many indications from small children to senior citizens. These are non-aerobic exercises done in standing, wearing normal street clothes. Feldenkrais Method® ~ A unique body and brain improvement system designed by the physicist Dr. Moshe Feldenkrais to help those with physical problems & chronic pain, as well as to improve movement for athletes, musicians, actors, dancers. This method allows muscles to center bones, clarifies orientation in time and space, and activates new neural pathways. Feng Shui – The ancient Chinese art of intentionally arranging the spaces in which we live and work so that they are energetically balanced, so that they comfort and nurture and fully support and help us manifest what we need and want. Following the principles of feng shui, we place our furniture, introduce color and accessories, apply cures, and use our intention to create abundance, joy, and harmony in our lives. Guided Imagery – Guided Imagery uses the power of the mind to bring about healing. It is in the body-mind where we hold perceptions of the past, in the form of emotions and images. Our beliefs are different because our perceptions of the past are unique. Though imagery we can disengage beliefs that interfere with a healthy life. Healing Touch – an energy (biofield) therapy that encompasses a group of noninvasive techniques that utilize the hands to clear, energize, and balance the human and environmental energy fields. With some similarities to Reiki,


Healing Touch offers more techniques for physical, emotional and spiritual balancing. Herbal Body Wraps – An excellent detoxifying treatment. A fleece sheet is soaked in an infusion of blended herbs then wrapped around the body. The body is then kept very warm with the addition of additional heated blankets for 20 minutes letting the herbs draw out impurities. Herbalism – Western herbalism, like the much older system of traditional Chinese Medicine are forms of the healing arts that draw from the herbal traditions of Europe, the Americas and Asia. Both Western and Eastern forms of herbalism emphasize the study and use of naturally occurring substances in the treatment and prevention of illness. Holistic Counseling – A counseling approach which focuses on the whole person including feelings, thoughts and how they are connected to the body. Homeopathy – A natural pharmaceutical science that utilizes substances from the plant, mineral, and animal kingdoms and is based on the premise that these naturally occurring substances can cure disease symptoms similar to those they produce if taken in overdose. Each medicine is individually prescribed according to how it stimulates the immune and defense systems of the sick person. Sometimes it is called the “royal medicine.” Hypnotic techniques – can induce everything from a light to a heavy hypnotic state to help a client overcome psychological or physical problems. From helping people to overcome a craving for cigarettes to managing chronic pain from an illness or accident, trained hypnotherapists work with a wide variety of problems. Hypnotherapy – Hypnotic techniques can induce everything from a light to a heavy hypnotic state to help a client overcome psychological or physical problems, overcome a craving for cigarettes or overeating, managing chronic pain from an illness/accident, reducing or eliminating fears, and a wide variety of other issues to be overcome. Integrative Medicine- offers a personalized approach to care using evidencebased medicine that integrates contemporary biotechnical approaches with personalized holistic care. This approach goes beyond symptom treatment, serving the whole person to facilitate the body's innate healing response. Here are some of the Jin Shin Jyutsu – Brings balance to the body’s energies, which promotes optimal health and well-being, and facilitates our own profound healing capacity. It is a valuable complement to conventional healing methods, inducing relaxation and reducing the effects of stress.


Kundalini – Divine spiritual energy that lies coiled at the base of the spine. Once awakened, it travels upward through the chakra system, until it reaches the crown chakra. Once stabilized in the crown, the individual self merges into the supreme self, (enlightenment) and the cycle of reincarnation comes to an end. Lapa’au – a Hawaiian healing art practiced for thousands of years in Polynesia. During the healing session the practitioner becomes a bridge for healing, connecting the spirit of one or more Lapa’au Kahunas, the client, and the energies of the client’s Aumakua (personal guardian spirits). The client’s energy is balanced, distorted thought forms (that may result in illness) are removed, and energy links draining the client are disconnected. When the client is a healer, the work takes place under the guidance of a higher level of Aumakua on multiple planes at the same time. The healer’s energy level is optimized for their own unique characteristics and abilities. Lomilomi Massage – Hawaiian for “rub rub”, Lomilomi is a massage technique that’s been handed down from ancient Hawaiian healers. The stroke used are similar to the shiatsu technique of Japan but are gentler and shorter. Pressure wit the fingers at certain points is also part of the technique, but is it of shorter duration than most acupressure. Two identifying techniques of authentic Lomilomi are the emphasis on spirit-body connection and the use of the forearm and elbow as a massage tool. Manual Lymph Drainage Therapy – A hands-on technique designed to attain and sustain proper functioning of the human fluid system. The proper functioning of the lymphatic system is critical to our body’s ability to drain stagnant fluids, detoxify, regenerate tissues, filter out toxins and foreign substances, and maintain a healthy immune system. Medical Intuitive – Medical Intuition is a tool to give an accurate portrait of what is going on in a client’s body by paying close attention to gain accurate insight into the presenting symptoms of a client. The body offers much information to be shared such as the roots and influences of the present condition, what it wants and does not want and a physical, emotional/spiritual portrait of what is currently going on. Myofasical Release – Fascia is a tough connective tissue which spreads throughout the body in a three dimensional web from head to foot without interruption. Trauma, posture or inflammation can create a binding down of the fascia resulting in excessive pressure on nerves, muscles, blood vessels, osseous structures, and/or organs. The Myofascial Approach consists of the gentle application of sustained pressure into the fascial restrictions which relies on feedback received by the Therapist through the patient’s tissue. Myofascial


Release can help by addressing the cause of the problem to eliminate the symptoms and allow the body to make permanent changes resuming a healthy active life style. Naturopathic Medicine, Natauropathic Doctor, N.D. – Naturopathic medicine is a distinct and comprehensive system of primary health care practiced by a naturopathic doctor for the diagnosis, treatment, and prevention of human health conditions, injuries, and disease. Naturopathic doctors are statelicensed practitioners who perform physical exams, order lab testing, and prescribe a variety of natural treatments, including clinical nutrition, botanical medicine, homeopathy, physical medicine, exercise, and hormone replacement therapy. Naturopathy – a system of Natural Healing which, only through natural methods, assesses and cares for the health of the patient. Naturopathy is concerned with both a healthy lifestyle and the prevention of disease, and also with the use of natural therapeutics in the treating of human conditions such as: Pain, Injury, and any Physical, Chemical or Mental conditions. Naturopathy uses a philosophy of practice which bases its treatments of physiological functions and conditions, upon where the natural laws governing the human body have not been adhered to. Neurofeedback – a process that enables an individual to bring about an enduring improved state of function or being. Feedback is instantly and consistently given to the brain through audio and/or visual cues according to EEG (brainwave) measurement. Over time, the learning endures without continued use of an instrument. The first use of neurofeedback enabled people to be free of seizures without medication or surgery. Subsequent studies with humans with conditions including ADHD, Tics, Depression, Anxiety, Sleep Problems, Headaches, and other brain disregulations found that those conditions could also be remediated by brainwave feedback. NLP – Neuro-Linguistic Patterning is a useful model of beliefs and techniques that offer a way to use the mind and body to achieve excellence in learning, business, counseling, relationships, sports and other experiences of life. Numerology is a necessary component of astrology, though often not combined. It is the stand-alone science of numbers—in one’s birth blueprint, year cycles, dates, and names. By understanding how to read the map of your blueprint, you’ll have the self-empowerment to steer your life much more efficiently. Osteopathic medicine- A form of conventional medicine that, in part, emphasizes diseases arising in the musculoskeletal system with an underlying belief that all of the body’s systems work together, and disturbances


in one system may affect function elsewhere in the body, Some osteopathic physicians (sometimes known as DO or osteopath) practice osteopathic manipulation, a full body system of hands-on techniques to alleviate pain, restore function, and promote health & well-being. Raindrop Therapy – The application of therapeutic-grade essential oils using massage and vita flex techniques. Raindrop Therapy aids in the healing of physical and emotional injuries, strengthens the immune system, detoxifies the body, and helps to bring the body into physical and electrical alignment. Reconnective Healing® utilizes new frequencies to allow for the healing of the body, mind, and spirit. These energies, currently being researched by Dr. J. Schwartz at the University of Arizona, are highly palpable and continue working long after the healing session has ended. Initiated without specific intention they result in the healing your body truly needs, not necessarily what you requested or expected. After the initial one to three sessions, there is no need to return for additional work on that particular issue or illness. The Reconnection™ – Originally the meridian lines, sometimes called acupuncture lines, on our bodies were connected to the grid lines that encircle the earth. These grid lines were designed to continue outward and connect us to a vastly larger grid, tying us into the entire universe. Over time, we became disconnected from these lines. The Reconnection brings in “new” axiatonal lines that reconnect us to these grid lines. The unique vibratory levels and frequencies they bring in contribute to healing through the reconnection of DNA strands, and ultimately our personal evolution by providing the means to reconnect with our purpose. Reflexology – The application of pressure, stretch and movement to the feet and hands to effect corresponding parts of the body. Reflexologists view the feet, ears and hands as a mirror image of the body. By applying technique, a reflexologist can break up patterns of stress in other parts of the body. Stress is a barrier to the body’s return to a normal state of equilibrium. Reiki – A therapy based on Eastern concepts of energy flow and the seven energy centers in the human body. The purpose of treatment is to heal emotional, spiritual, and physical, pain through the transmission of universal life energy, called “ki” in Japanese. It is believed that “ki” flows throughout the universe, and that Reiki connects humans in a more direct way to this universal source. Reiki is used for the healing of animals as well as people. Rolfing® structural integration – Rolfing is a holistic, hands on, deep tissue modality that manipulates and changes the myofascial system throughout the


body. Through educated touch and movement education, a client’s posture and structure, their whole being is reorganizes within the field of gravity. Shamanism – A system of healing based on spiritual practices present in most indigenous cultures. The shaman acquires knowledge, wisdom and spiritual power from personal helping spirits encountered on journeys into other realities. They return with vital information about healing. Shamans are considered “walkers between the worlds” and retrievers of souls. Shiatsu -A Japanese form of physical therapy and therapeutic massage, based on traditional Chinese medicine. It combines massage, gentle physical manipulation, and pressure along channels or rivers of energy called meridians. Somatic experiencing (SE) - A therapeutic model designed for the treatment of trauma and associated symptoms, developed by Dr. Peter Levine. SE uses gentle self-awareness techniques to direct the energy of the nervous system in a way that corrects imbalances and restores it’s natural equilibrium. This results in reduced activation in the body and mind, bringing a greater sense of ease, balance and aliveness. SE is effective in the treatment of emotional, mental and physical symptoms of trauma including anxiety, depression, post-traumatic stress disorder, chronic pain and syndromes such as fibromyalgia. SE is used around the world to assist people recover from trauma, including accidents, disasters, and war. Sound Therapy / Vibrational Healing – A range of therapies in which sound is used to treat physical and mental conditions based on the theory that all of life vibrates, including people’s bodies. Treatment by sound waves is believed to restore that healthy balance to the body. The healing sound is transmitted to the affected area of the body and may be produced by any number of methods including voice, chanting bowls, drums, bell, tuning forks and/or music. Tai Chi - Tai Chi combines movement, meditation and breath regulation to enhance the flow of vital energy in the body, improve blood circulation, and enhance immune functions. Tai Chi is one of the most broadly applicable systems of self-care in the world. In China, it is estimated that 200 million people practice Tai Chi everyday. T’ai Chi Chih® - a set of movements completely focused on the development of an intrinsic energy called Chi consisting of 19 stand-alone movements and one pose. It is completely non-violent. Therapeutic Touch – A non-invasive, holistic approach to healing which stimulates the receiver’s own recuperative powers. It is a modern form of laying-on-of-hands and is based on principles of an energy exchange between


people. It is most useful to reduce or eliminate pain, promote healing, and elicit a relaxation response. ThetaHealing® - A powerful Energy Healing modality using Theta brainwaves and the creative power of the Universe to heal the physical body and to clear negative beliefs & fears held in the muscular tissue and organs. Other techniques facilitated by this process include seeing and speaking with your Guardian Angels, viewing inside the human body, remote viewing, healing and speaking with plants and animals, manifesting your Soul Mate, and more. Watsu - Aquatic bodywork involving stretching and Shiatsu which is applied while being floated in warm water. The water temperature (95† – 97† F) is ideal for experiencing a sensation of deep relaxation. Gentle stretching increases flexibility and strengthens muscles.

Yantra - A geometric image based in the tantric yoga tradition. One can use a it for meditation, inspiration, concentration, energy alignment, and transformation. A yantra creates an opening into sacred space. The vibrational qualities of the yantra will resonate with the vibrational aspects of one’s body, mind, and consciousness. Yoga – A general term for a range of body-mind practices used to access consciousness and encourage physical and mental well-being. Forms of “physical” Yoga include Hatha (Iyengar, Bikram, Ananda, Astanga Vinyasa/Power, Phoenix Rising, etc.) and Kundalini. Yoga Therapy - A one-on-one application of the philosophy and practices of yoga to directly and holistically facilitate healing. Techniques are chosen according to the individual client to resolve pain and blockages by supporting and nurturing the spine, nervous system, muscles, bones, joints, subtle channels, and the mind. While therapeutic approaches vary by yoga style, all promote noninvasive techniques that utilize yoga poses, breath, and wisdom for increasing prana (life force), tejas (energy) and ojas (resilience).


Glossary Many people caring for a loved one never even heard of the term, “Caregiver”. Not knowing that simple reference, blocks them from having a huge amount of information that could save time, alleviate stress and open the door for Caregivers to communicate. To support your loving and/or professional caregiving journey, here are some of the words used in health care that may help you navigate better. Acute Care Acute care is usually given in a hospital’s Emergency Department. Medical care for health problems that are new can quickly get worse, or result from a recent accident. Advance Directives Written instructions to health care professionals about the amount and type of medical care and treatment a person wants. Advance directives are used when people are too ill or injured or are unable for other reasons to state these wishes for themselves. There are two types of advance directives. One describes the type of care a person wants. The other names someone else (health care proxy or agent) to make medical choices, if needed. You can fill this form out on line by going to the Secretary of State website. Adult Day Care Social and recreational activities offered in a group setting. Adult day care does not offer health services that require a nurse. Adult Day Health Care Programs that provide social and recreational activities and health services to adults who are physically (body) or cognitively (mind) impaired. These take


place in supervised and structured settings.

Adult Protective Services (APS) State and local agencies that investigate reports of abuse or neglect. They also offer services to adults (18 years and older) who are physically, sexually, financially, or emotionally abused by someone involved in care. These abuses include neglect, exploitation, or abandonment. Alzheimer's, a form of Dementia Alzheimer's disease is a condition in which nerve cells in parts of the brain start to die. It is progressive, which means that mental and physical functions decline in stages. Ambulatory Care Medical care given in an outpatient setting (where the patient is not admitted to a facility). This is usually a doctor’s office or clinic, but may be a hospital. It includes diagnosis, observation, treatment, and rehabilitation.

Aphasia Aphasia is an acquired communication disorder that impairs a person's ability to process language, but does not affect intelligence. Aphasia impairs the ability to speak and understand others, and most people with aphasia experience difficulty reading and writing. Area Agency on Aging (AAA) Agency that gets state and federal funding to plan and coordinate services for people over age 60 within a local area. In some cities, towns and states, the AAA is also known as Department of Aging (DOA). Assisted Living or Assisted Living Facility (ALF)


A residence for people who do not want to, or cannot, live independently (on their own) but do not need nursing home care. ALFs offer different kinds of services, including social activities, supervision, and some health care services (but not as many as in a nursing home). ALFs are privately owned, prices vary.

Assistive Technology or Equipment Any device that helps you live independently or “assists” you to live functioning better. There are both high tech and low tech adaptive or assistive devices, including high tech devices include wheelchairs (powered and manual), electronic magnifiers, vehicle modifications, telephones with enhanced amplification (for those who are hard of hearing), special kitchen supplies, computer programs, and other types of technology. Attending Doctor Senior doctor at a teaching hospital. This doctor is often in charge of (responsible for) a patient’s care. The attending doctor supervises fellows (postgraduate doctors in a specialty), residents (house staff or doctors-intraining), and medical students. B Balance Disorder A balance disorder is a condition that makes you feel unsteady or dizzy, as if you are moving, spinning, or floating, even though you are standing still or lying down. Balance disorders can be caused by certain health conditions, medications, or a problem in the inner ear or the brain. Bed Hold Policy A term used in skilled nursing facilities to define the length of time the facility will hold a patient’s bed in case he or she has to leave the facility for care elsewhere, such as hospital, or for any other reason. There is a fee for holding a bed and each facility has its own policies and fees. If a patient has to leave the facility and did not secure a bed hold, there is no guarantee that he or she will be able to return to that facility for continuation of care and treatment.


Bed Sores Bed sores, also known as pressure ulcers, are the painful condition that occurs when constant pressure is applied to soft tissue. They are most often the result of a patient being bedridden and unable to change positions of their own volition. Besides being extremely painful, bed sores can lead to many dangerous complications for sufferers, including osteomyelitis (a bone infection), sepsis (whole-body inflammation), anemia, and gangrene. Beneficiary Listed as the recipient of an individual’s belongings after death. Usually the beneficiary is listed on an insurance policy. Blood Pressure Blood pressure rises with each heartbeat and falls when your heart relaxes between beats. While BP can change from minute to minute with changes in posture, exercise, stress or sleep, it should normally be less than 120/80 mm Hg (less than 120 systolic AND less than 80 diastolic) for an adult age 20 or over. About one in three (33.5%) U.S. adults have high blood pressure. Blood Type There are eight different common blood types, which are determined by the presence or absence of certain antigens – substances that can trigger an immune response if they are foreign to the body. There are four major blood groups determined by the presence or absence of two antigens – A and B – on the surface of red blood cells: Group A – has only the A antigen on red cells (and B antibody in the plasma) Group B – has only the B antigen on red cells (and A antibody in the plasma)Group AB – has both A and B antigens on red cells (but neither A nor B antibody in the plasma)Group O – has neither A nor B antigens on red cells (but both A and B antibody are in the plasma) O positive is the most common blood type. Not all ethnic groups have the same mix of these blood types. Hispanic people, for example, have a relatively high number of O’s, while Asian people have a relatively high number of B’s. Brain The amazing brain is an organ that serves at the center of the nervous system. It has the centralized control over all of the body’s organs.


Brain Attack Blockage to the brain; a stroke. Everyone is used to referring to blockage of the heart as a “heart attack. When that happens to the brain, it too is an attack. See Stroke. C Capacity In health care settings, “capacity” refers to a patient’s ability to understand and use medical information (such as treatment options, risks, and benefits) when making decision and choices about medical care. Capacity varies; a person may have the capacity to make some choices, but not others. A “health care proxy” can act as the patient’s decision maker if the patient loses capacity due to illness. Care or Case Manager Nurse, social worker, or other health care worker who plans and coordinates services for a patient’s care. This person usually works for an agency or facility. Caregiver “Caregiver” can mean family members, friends, and neighbors who provide ongoing help and assistance to people who are ill, frail, or disabled. Doctors, nurses, and social workers may use the term “caregiver” when talking about themselves. Caregiver Assessment This is a way to gather information to determine what level and kind of care a caregiver is able to provide. It assesses the caregiver’s own health and other responsibilities, resources and strengths (such as experience or special skills) as well as what he or she is willing and able to do. It also considers the caregiver’s own need for support and/or other services. Caregiver Coaches A professionally trained health or personal mentor to help Caregiver maintain a program for self-care, maintain goals and balance to prevent burn-out and minimize stress.


Caregiver Support Group A group of people who meet regularly to help each other by discussing feelings, common problems, ways of coping, available resources, and many other issues related to caregiving. Support groups may be for caregivers of patients who have certain diseases (such as Alzheimer’s, stroke and cancer. Some support groups meet in person while others are only online or by telephone. Care Plan A detailed written plan that includes needed tasks for patient care. It likely includes services provided by nurses, therapists, home health aides, and attendants. A good care plan should also list the tasks that family caregivers (who often do many of the tasks) do. A Caregiver Coach helps with the development and execution of a care plan. Certified Nursing Assistant (CNA) Person trained and certified to assist patients with non-clinical tasks such as eating, walking, and personal care (like taking a bath). This person may be called a “nursing assistant” in the hospital. Chronic Illness Physical or mental disability that lasts a long time or recurs (goes and comes back again). Treatment goals are to manage the illness and its symptoms, not cure them. Cognitive Brain Form a logical, plausible thought after considering the circumstances. Attention, Working Memory, Processing Speed, Long Term Memory, Visual Processing, Auditory Processing, Logic and Reasoning, Multi-Tasking and Decision Making Cognitive Impairment After a stroke, Traumatic Brain Injury or another illness, problems may occur that affect how clearly a person thinks, learns a new task, and remembers events and timelines or the speed at which it occurs. Community (Out-of-Hospital) DNR


An order (signed by a doctor) that says that the patient should not be resuscitated (given Cardiopulmonary Resuscitation, or CPR to restart a heartbeat) if he or she is at home when the heart stops beating. If emergency services are called, this order must be given to the medical team. Competence A legal term, usually used in a guardian hearing, means that a person is able to make decisions for themselves. To do that, he or she has to be an adult (18 years of age or older) and have capacity, which means the ability to understand and use information when making decisions. A judge is the only one who can declare a person “incompetent” (lacking the ability to make decisions). Chronic Illness According to the Centers for Disease Control and Prevention (CDC), 70 percent of all deaths in the United States are due to chronic diseases. Lack of physical activity, tobacco use, not consuming enough fruits and vegetables and drinking too much alcohol are common causes of chronic disease. According to the CDC, heart disease, cancer and stroke are the most common types of chronic diseases. With the exception of genetic risk factors, these chronic diseases can be prevented. Custodial Care Also called personal care. It is the kind of help or supervision people need with daily tasks such as getting dressed, eating, taking a shower or bath, going to the bathroom, and getting into a bed or chair. Custodial care may be given at home by family members or by home care aides or personal care attendants. This care is not paid for by insurance unless the patient also needs skilled care from a nurse or therapist. D Dementia A loss of brain function that disrupts or impairs a person’s memory, ability to think or speak clearly, and ability to perform everyday tasks. It can also affect a person’s personality, mood, social interaction (how he or she relates to others), and judgment. Discharge Planner


Nurse, social worker, or other health care worker who coordinates a patient’s transition (move) from one care setting to the next, such as from hospital to home. DNA Do Not Intubate (DNI) Order A DNI order instructs health care workers not to insert a breathing tube through the patient’s nose or mouth into the throat once breathing has stopped. A DNI order is part of an advance directive and is separate from a DNR order. Do Not Resuscitate (DNR) Order A DNR order instructs health care workers not to perform cardiopulmonary resuscitation (CPR) or other actions to restart a person’s heart or breathing once it has stopped. By law, a DNR order must be offered to patients and families. Signed DNRs must be part of the patient’s medical chart. A DNR order is part of an advance and is separate from a DNI order. Dual Eligible People who financially and medically qualify (meet the requirements) for both Medicare and Medicaid. Durable Medical Equipment (DME) Medical equipment that can be used more than once. It includes crutches, knee braces, wheelchairs, hospital beds, and prostheses. Durable Medical Power of Attorney A type of advance directive. It names a person to make health care choices for someone else if he or she becomes incompetent or cannot express wishes. Durable Power of Attorney A document which names a person who can make financial (money) decisions on behalf of someone else. This power of attorney remains in effect even when a person is disabled or incapacitated. Durable power of attorney covers financial (money) matters, not medical decisions.


E Elder Law Attorney A lawyer who specializes in the rights and issues of older adults and their health, finances, and well-being. F Family Caregiver Any family member, partner, friend, or neighbor who provides or manages the care of someone who is ill, disabled, or frail. There may be more than one family caregiver involved in a person’s care. Types of care include: Eldercare, Stroke Care, Cancer Care , Dementia (Alzheimer’s being the most common), Diabetes Care, Visible and Invisible Disabilities and Caregivers to Veterans Family Caregiver Support Program (FCSP) The family caregiver is the person(s) considered to be the primary source of support and routine assistance, and who may or may not be related by blood or marriage. This federal program, run by the U.S. Administration on Aging, offers support services to family caregivers who are: 60 years and older; adults of any age with dementia; Grandparents 55 years and older caring for grandchildren under age of 18 and adults with developmental disabilities aged 19 to 59. Services include counseling, information and referral, respite, and some funding for certain home modifications or emergency response systems. Each FCSP is under the direction of its local Area Agency on Agency (AAA) or Department of Aging (DOA).

Formal Caregivers This term usually refers to professionally trained caregivers. They usually work under the employment of for-profit Home Care Agencies that often gain contracts to provide respite service or scheduled care. Many formal Caregivers belong to SIEU, the largest national union speaking for formal Caregiver rights


Del Oro Caregiver Resource Center│ 8421 Auburn Blvd, Citrus Heights, CA 95610 │916- 728-9333 Serving San Joaquin, Sierra, Sutter, Yolo and Yuba Counties Valley Caregiver Resource Center │ 3845 North Clark Street, Suite 201│Fresno, CA 93726│559-224-9154 Serves Modesto G Geriatrician A medical doctor with special training in the diagnosis, treatment, and prevention of disabilities in older adults. Gerontologist A health care professional trained to work with older adults and their families. He or she may have an MS or PhD degree. Guardian There are times when individuals, such as children or the elderly, are forced to rely on other people for assistance in their daily lives because they lack the capacity to make decisions on their own. They require outside help in the form of surrogate decision makers, who have the legal authority to act on their client's behalf in all matters. Usually, these people are family members; however, if a family member is not available, or a third-party is requested for representation, a court-appointed guardian is assigned. Guardianship The process in which the guardian gets named by a judge. H Health Care Disparity Health disparities refer to differences between groups of people. These differences can affect how frequently a disease affects a group, how many people get sick, or how often the disease causes death. Many different populations are affected by disparities. These include


   

Racial and ethnic minorities Residents of rural areas Women, children, the elderly Persons with disabilities

HIPAA HIPAA, the American Health Insurance Portability and Accountability Act of 1996, is a set of rules to be followed by doctors, hospitals and other health care providers. HIPAA helps ensure that all medical records, medical billing, and patient accounts meet certain consistent standards with regard to documentation, handling and privacy. HIPAA requires that all patients be able access their own medical records, correct errors or omissions, and be informed how personal information is shared OR used. Other provisions involve notification of privacy procedures to the patient. HIPAA provisions that have led in many cases to extensive overhauling with regard to medical records and billing systems. Home-delivered Meals (Meals on Wheels) Meals brought to people who cannot prepare their own meals or are homebound (cannot leave their homes). Home Care, also referred to as Custodial Care Includes assistance with the activities of daily living such as light housekeeping, assistance with bathing and dressing, preparation of nutritious meals, help with walking and getting in / out of bed, medication reminders, conversation and companionship, and transportation to name a few. Home care services are generally not covered by insurances such as Medicare or HMO’s, however there are some private and long term care insurance policies that may cover services. Home Health Aide (HHA) A person trained to provide basic health care tasks for those who are elderly or disabled. Tasks include taking vital signs (such as heart rate and blood pressure) or helping with “dry dressing” for wounds. Tasks also include personal care, light housecleaning, cooking, grocery shopping, laundry, and transportation. Home Health Care


Home Health Care, also referred to as Skilled Nursing or Paraprofessional Care, covers a broad range of services including: Nursing Care, Physical Therapy, Occupational Therapy, Speech Therapy, Medical Social Work, and Respiratory Therapy. Skilled Nursing care is provided by a registered nurse (RN), nurse practitioner (NP), or a licensed practical nurse (LPN). Paraprofessional care is provided by home health aides, personal care assistants, physical therapy assistants, or certified occupational therapy assistants (COTA). Hospice A program of medical and social services for people diagnosed with terminal (end-stage) illnesses. Hospice services can be given at home, in a hospital, hospice residence, or nursing home. They are designed to help both the patient and his or her family. Hospice care stresses pain control and symptom management. It also offers emotional (feelings) and spiritual (faith) support. I Incontinence Loss of bladder (urine) or bowel movement control. Informed Consent Legal term meaning that a person with mental capacity has given permission for medical treatment. Consent comes after a full disclosure (talk) of treatment risks and options. Intern A doctor who has finished medical school and likely in the first year of special training. Interns are supervised by attending doctors and residents. Insurance The Patient Protection and Affordable Care Act (Affordable Care Act) is the federal law passed in 2010 that provides affordable health insurance to more Americans. The historic law has changed the way health insurance companies provide coverage, as well as the way consumers get coverage. Health insurance plans also must cover preventive care services, like mammograms and colonoscopies, for free. All plans being sold in the Covered


California marketplace, as well as those sold outside it, will be required to include these benefits. Fines for No Insurance Coverage. In January 2014, most adults will be required to have public — such as MediCal or Medicare — or private health insurance or pay a fine. The fine becomes more costly over a three-year period. In 2014, the fine will be 1 percent of yearly income or $95 per person, whichever is greater. For adults with children, the fine for lack of coverage for the child is $47.50. By 2016, the fine will be 2.5 percent of income or $695 for an individual, $2,085 for a family, whichever is greater. Covered California is managed by the California Health Budget Exchange. For more information go to J Joint Commission The Joint Commission is an independent, not-for-profit organization that accredits and certifies more than 20,000 health care organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards L

Legal Matters and End-of-Life Issues 

Legal Zoom│

Do –It-Yourself Will│

 

Learn the difference between a will and a living trust

Legal Guardianship│

Probate – How to Avoid It │

Power of Attorney│


LGBT LGBT are the initials for lesbian, gay, bisexual and transgender. The L refers to Lesbian, which means a woman who is attracted to other women. The G refers to Gay, which means a man who is attracted to other men. Bisexual is identified with the B, and transgendered with the T. A bisexual is someone who is attracted to both genders, and a transgendered person is someone who feels they are another gender. Living Will A type of Advance Directive that outlines a person’s treatment wishes if he or she is too ill or injured to make such choices. Laws about living wills vary from state to state. Licensed Practical Nurse (LPN) A health care worker who provides basic bedside care such as checking vital signs (temperature, blood pressure, and pulse). LPNs can also prepare and give injections and enemas, monitor catheters, apply wound dressings, treat bedsores, and give alcohol rubs or massages. LPNs report to registered nurses and doctors. Long-Term Care (LTC) A term used to describe the care needed by someone who must depend on others for help with daily needs. LTC is designed to help people with chronic health problems or dementia live as independently as possible. While many people think that long-term care happens only in a nursing home, in fact most long-term care is given by family caregivers in the patient’s home. Long-Term Care Insurance Private insurance designed to cover (pay for) long-term care expenses at home or in a facility other than a hospital. There are many long-term care insurance policies with a wide range of benefits (services they pay for). Lyme Disease An infection caused by a kind of germ carried by deer ticks (found in the northeastern and north-central United States) and western black-legged ticks (found mostly on the Pacific Coast). These ticks can spread the disease to animals and humans through tick bites. These ticks are typically about the size of a sesame seed.


M Managed Care Plans Health care system that includes financing (paying for) and delivering health care services. Many are Health Maintenance Organizations (HMOs) that offer a package of health care benefits to those insured. Meals on Wheels Association of America A national organization with a mission to support local programs and to end senior hunger and is operated through local agencies. Medicaid Health insurance program for people with low incomes. Medicaid is financed by both the federal and state government. States set their own rules about who can get Medicaid and what services it covers (pays for). Medicare A federal health insurance program for people aged 65 or older, or for those aged 64 or younger who have certain disabilities. You can learn more about Medicare terms by visiting the Department of Health & Human Services'. N Nurse Practitioner (NP) NP is a registered nurse with advanced training and experience. NPs can diagnose and manage most common, and many chronic, illnesses. They do so alone or along with the health care team. Today, NPs can prescribe medications and provide some services that used to be done only by doctors. Nursing Home or Skilled Nursing Facility (SNF) Facility that provides 24-hour care (all day and night) to patients who are chronically ill or disabled. Patients must be unable to care for themselves in other settings or need extensive (a lot of) medical care. O


Occupational Therapist (OT) Licensed health care professional who helps patients learn again how to do activities for daily living. OTs can also help plan ways to adapt (change) a person’s home so he or she can be as independent (do tasks alone) as possible. P Palliative Care Palliative care means keeping a patient as comfortable as possible during an illness. Palliative care may come into play at any point after a physician diagnoses a life-threatening condition. When patients find the side effects of treatment too much to bear and physicians have determined that the disease is incurable, palliative care may become the only focus of medical care. At this time, some patients opt for hospice services, during which health care workers give only palliative care. In the last months of life, hospice workers including physicians, nurses, clergy and social workers, concentrate on keeping the patient comfortable. Paratransit Special transportation for people with mobility (walking) problems. It may be a taxi or special van. Sometimes paratransit runs on a fixed schedule (as for shopping). Other times, people must call to for a reservation. Patient Assessment A way to gather patient information so as to assess functional needs (what tasks people need help with) and eligibility for services (what services they can get). Information may include health status, financial (money) status, mental status, and living situation. Patient Bill of Rights Listing of ways a health care facility will treat patients with dignity and respect. It includes how patients can fully participate (take part) in making health care choices. Personal Emergency Response System (PERS)


Electronic device that allows a person to call for emergency help at home. The device connects to the patient’s phone and is programmed to signal a response center when the "help" button is pressed. The patient may also wear a “help” button as a necklace or bracelet. This allows the person to move freely around his or her home. Lifeline is a company that provides this service. Physical Therapist (PT) Licensed professional trained to treat people with impaired motor function (such as problems walking). PTs use exercise, massage, and other ways to help improve a person’s function and strength. Power of Attorney (POA) Legal term that allows one person to act as someone else's attorney (lawyer) or agent. POA can be just for certain, specific responsibilities or it can be for more broad issues having to do with financial (money) affairs. Primary Care Provider (PCP) This term almost always refers to doctors, nurse practitioners, or physician assistants who provide preventive care (before people are sick). PCPs diagnose and treat common medical problems, assess how urgent these problems are, and may refer patients to other specialists if needed. PCPs practice in the community, not a hospital or other health care facility. Provider Often used to describe a person or agency that delivers health care or social services. Providers can be individuals (doctors, nurses, social workers, and others) or facilities (hospitals), or agencies (home care), or businesses that sell services or equipment. R Registered Nurse (RN) A person who has graduated from a formal nursing education program and is licensed to practice by the state board. RNs assess, plan, implement (carry out), and evaluate patient’s nursing care along with the rest of the health care team. Rehabilitation (“Rehab”)


Services to help people get back their mental (thinking and feeling) and physical (body) functions lost due to injury or illness. Rehabilitation may be given at the hospital or in a nursing home, special facility, or the patient’s home. Resident A person who lives in a long-term care setting (such as a nursing home). Resident Doctor A medical doctor who has finished medical school and internship and now is being trained in a specialty (such as surgery, internal medicine, or geriatrics). Respite Care Temporary (a few hours or up to a few days) care to offer relief for the family caregiver. Respite care may be given in the patient’s home or the patient may have a short stay somewhere else. It can be scheduled regularly (for example, two hours a week) or provided only when needed. Restorative Potential The level of function (ability to move or do activities of daily living) that a patient is likely to regain, based on the patient's condition and diagnoses. This is used by Medicare and other insurances to determine rehabilitative needs and the continued pay for treatment. Robotics More and more procedures are being done on an outpatient basis using robotic.. Hospitals use Robotics for surgical procedures or diagnostic studies that do not require an overnight stay. This medical device help hospitals eliminate lifethreatening drug and diluent exchange errors, improve drug potency, decrease other medical mistakes and sterility risks, reduce waste and controlled substances’ diversion and diminishes the gap between the rising patient volume/acuity and scarce nursing and pharmacy staff. S Senior Centers


Centers that provide services to senior citizens, aged 60 and over. They may offer social activities (like music or crafts), meals, health screenings (such as blood pressure checks), learning programs, and exercise classes. Skilled Care Nursing care given in a patient’s home or in a facility. It may include injections (shots), tube feeding, and changing sterile wound dressings. Most insurance plans require patients to need at least some skilled care before they can get other home care services. Speech Therapist Licensed health care professional who diagnoses and treats people with speech, language, or hearing problems. State Health Insurance Program (SHIP) State program that helps older adults with concerns about insurance, benefits, and claims. Stroke A stroke occurs when blood circulation to the brain fails. Brain cells can die from decreased blood flow and the resulting lack of oxygen. There are two categories of stroke: Ischemic, caused by a blockage of blood flow and Hemorrhagic, caused by bleeding. 800% of the strokes are Ischemic stroke, is the most frequent cause of stroke and is responsible for about 80 percent of strokes. Many of these stroke are preventable, while hemorrhagic strokes are more fatal. Stroke Disabilities Although stroke is a disease of the brain, it can affect the entire body. Some of the disabilities that can result from a stroke include paralysis, cognitive deficits, speech problems, emotional difficulties, daily living problems, and pain. Paralysis: A common disability that results from stroke is paralysis on one side of the body, called hemiplegia. A related disability that is not as debilitating as paralysis is one-sided weakness or hemiparesis. The paralysis or weakness may


affect only the face, an arm, or a leg or may affect one entire side of the body and face. A person who suffers a stroke in the left hemisphere of the brain will show right-sided paralysis or paresis. Conversely, a person with a stroke in the right hemisphere of the brain will show deficits on the left side of the body. A stroke patient may have problems with the simplest of daily activities, such as walking, dressing, eating, and using the bathroom. Motor deficits can result from damage to the motor cortex in the frontal lobes of the brain or from damage to the lower parts of the brain, such as the cerebellum, which controls balance and coordination. Some stroke patients also have trouble eating and swallowing, called dysphagia. Cognitive Deficits: Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory. If the cognitive problems are severe, the stroke patient may be said to have apraxia, agnosia, or "neglect." In the context of stroke, neglect means that a stroke patient has no knowledge of one side of his or her body, or one side of the visual field, and is unaware of the deficit. Language Deficits: Stroke survivors often have problems understanding or forming speech. A deficit in understanding speech is called aphasia. Trouble speaking or forming words is called dysarthria. Language problems usually result from damage to the left temporal and parietal lobes of the brain. Emotional Deficits: A stroke can lead to emotional problems. Stroke patients may have difficulty controlling their emotions or may express inappropriate emotions in certain situations. One common disability that occurs with many stroke patients is depression. Post-stroke depression may be more than a general sadness resulting from the stroke incident. It is a clinical behavioral problem that can hamper recovery and rehabilitation and may even lead to suicide. Post-stroke depression is treated with antidepressant medications and therapy. Pain: Stroke patients may experience pain, uncomfortable numbness, or strange sensations after a stroke due to many factors including damage to the sensory regions of the brain, stiff joints, or a disabled limb. There may be uncommon causes for pain as well.


Subacute Care Care or monitoring (watching) after a hospital stay. This can be in a less intensive setting (such as a rehabilitation service) or in a special unit in a hospital. Subacute care is usually short-term. Surrogate Decision Maker Person chosen by a patient to make choices if he or she cannot do so and advocate on the patients behalf. T Telemedicine Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status. Telemedicine includes a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology.

Transition A move from one care setting (hospital, nursing home, or home) to another. Care during transitions involves coordination and communication among patient, providers, and family caregivers. V Ventilator A machine that pushes air into the lungs through a breathing tube inserted into the patient’s throat. Also called a respirator or “vent.” Visiting Nurse A term often used for a nurse who visits patients in their homes. The job of a visiting nurse includes checking vital signs (such as heart rate and blood


2016 caregiver guide v1  
2016 caregiver guide v1