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2020 ISSUE


The Family

Not Defined By Genes

Changing Behaviors... Changing Lives

Chronic Pain

You Don’t Have to Live With It!


bag a jackpot.

or a burger.

Getting out and exploring the beautiful Pend Oreille Valley is an unforgettable experience. And so is playing the latest slots, enjoying some Northwest comfort food and relaxing in a neighborly lounge! Do it all at Kalispel Casino where you can dine in Wetlands restaurant, have a cold one at The Slough, and play your favorite games. You can even stay for days at the adjoining RV resort featuring hookups, tent sites and cottages. Or just ďŹ ll up on fresh food, fountain drinks and Chevron fuel at Kalispel Market. Make your RV resort reservations today at kalispelrvresort.com

W he re se re ni ty m ee ts Am en it ie s.

Kalispel Tribe Reservation on the Pend Oreille River at the foot of the Selkirks

2 Wise Guide | 2020 Edition

420 Qlispe River Way, Cusick, WA 1-833-881-7492 | kalispelcasino.com


CONTENTS Run It By Tamara



Changing Behaviors... Changing Lives 6


Family is not defined by our genes... 10 Chronic Pain – You Don’t Have to Live With It! Therapy and Parkinson’s Shining Light on the Eye



Protecting Youth from Multiple Health Risks



36 Activate Your Body’s Natural Healing Power 40 The Perfect Medicine 50 Sandpoint’s Premier Health Care Facility

12 26


Citizen Soldier for Life — Find A Track to Follow! 62 Parkinson’s Support Groups


Alzheimer’s Association Support Groups 71 Crossword


& Much More!



The Wise Guide 2020 (208) 255-5950 info@thewiseguideonline.com www.TheWiseGuideOnline.com Copyright ©2020/2021, All Rights Reserved. Although every precaution has been taken in the publication of this guide, the publisher and authors assume no responsibility for errors or omissions. This guide is not intended to be legal or medical advice or to endorse any product or service. The Wise Guide, LLC is not responsible for the contents of any websites referenced within this guide. No part of this guide may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by an information storage and retrieval system without the express written permission of the publisher, The Wise Guide, LLC.

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Run It By Tamara

In the ever-changing aftermath of the pandemic, my focus is to be in sync with local senior care businesses and their individual protocols adopted to keep our North Idaho Seniors safe. Call me for updates and new incentives they are offering!

by Tamara Jacobson, Compassionate Care Referral Service


From a daughter — “My father is in Assisted Living and looks like he cannot fulfill the 3 years needed for private pay before converting to Medicaid this particular facility requires, are there other alternatives?”


From a 63-year-old woman — “I had an unexpected turn with my MS and cannot live alone anymore, are there any places for a younger, social senior to live?” Although it takes more investi­ gating to find a place that fits your care needs and yet promote your social interaction, I am able to assist in explaining the options in our area. Sometimes, certain Independent Living Communities will be an option that offer amenities such as meals and transportation. Additional in home care for occasional needs may be a way to stay independent a while longer if that is what is desired.

There is something so encouraging and comforting just sharing our concerns with one another. I look forward to hearing from you! — Tamara Jacobson If you would like to submit a question and ‘Run IT By Tamara’ regarding senior care issues, please email: CCRS@netscape.com or call 208-660-9982

Your Only Locally Owned Referral Service

A personal approach to evaluating senior care choices to fit your needs and budget. NO FEES. NO PRESSURE.

Tamara Jacobson Senior Care Consultant

(208) 660-9982

www.CompassionateCareReferral.com 4 Wise Guide | 2020 Edition


Over the past several years, many facilities have either dropped Medicaid as payment for Assisted Living, or have determined the years of private pay required before conversion to Medicaid, allowing them to still offer this method of payment for Long Term Care. This being said, with some searching, usually there are a few choices with good timing. It is becoming crucial to discuss assets with your family and seek professional planning, for example with an Elder Care Lawyer, to create an individualized outline to fulfill projected costs.


From a son — “We moved to Coeur d’Alene and brought my mother whose dementia is worsening. We cannot handle the nighttime wandering and agitation. Where do I begin looking to find a place where she can be cared for?”


The first step would be to find a local doctor, not only for your mother’s sake but also for a correct diagnosis and possible medication to help. The local Alzheimer’s Association is also a wonderful resource from educational presentations to support groups. I can help you find Assisted Living Facilities that are equipped to handle these behaviors although if she is aggressive to other residents, it is more complicated because of state regulations. Tamara Jacobson, is a Senior Care Consultant and founder of Compassionate Care Referral Services, Inc., CompassionateCareReferral.com. Tamara formed the company as a way to connect area seniors and services in a personal but professional manner. Straight forward comparisons are discussed to fit the individuality of her clients.

2020 IS SU


On The Cover


About the Artist







Shirley Hitchcock Offill Shirley Hitchcock Offill is a professional artist and muralist, working for forty years in her profession. She holds art degrees in Graphic Design and Illustration. Growing up in Missoula, she attended the University of Montana for two years, studying Fine Art, Interior Design and Native American Studies. She transferred to Spokane Falls Community College to finalize her art education. For the past eighteen years, she has been the artist and owner of Specialty Walls. As a specialty contractor she drew a great deal of inspiration from HGTV. Shirley created beautiful custom faux finishes for residential clients as well as custom murals and Trompe l’œils.

The Fa

Not Defi mily ned By G enes


ing Changin g Lives

Behav iors...

Chronic Pain

You Don ’t


Have to Live

With It!


.indd 1

COVER ART: “Granddaughter”


9:32 PM

Winter Moose Self Reflection

War Horse

Buffalo Chief

Shirley is a Native American from the Flathead tribe, and naturally loves to paint her people. Her painting of her granddaughter graces the cover of this Wise Guide issue! However, she also enjoys The Lion and The Lamb painting all subject matter. Shirley has traveled to Ireland, Wales, Israel, Jordan, Mexico and Hawaii inspiring murals, paintings, photographs and even hand dyed silk scarves. Her work will be on display at Art on the Green in Coeur d’Alene this August. You can find more of Shirley’s work on fineartamerica.com. There you can purchase her work printed on canvas, pillows, cell phone covers and greeting cards! Call Shirley at 208-699-0061 or email her at divinedesigns2@yahoo.com. Birds on Bath Fresco

Lion of Judah

www.TheWiseGuideOnline.com | Wise Guide 5

Changing Behaviors...


ost everyone will acknowledge that they have been affected in some way by addiction. Whether someone struggles with addiction themselves, or has a family member or friend who is struggling, addiction is widespread in our society. These people are in dire need of help. Addiction steals life, hope, dreams, compassion, and happiness from addicts and their families. When someone has reached the point that they know what they are doing and the way they are living cannot continue, it is time for change. We all have the capability of choosing to change our behaviors when life knocks us down. It is a matter of deliberately making changes that will move us forward; finding a way to progress with purpose, rather than simply letting life knock us around into whoever we will become next. Having the willingness to change is one of the bravest choices we can make in life. Allowing ourselves to be open to new ideas from others who

have overcome adversity, and applying those suggestions to our lives, are steps in the right direction. Change is difficult and it can be scary. This discomfort is a necessary component for growth to make change. Choosing to ask for help to find recovery from drugs and alcohol disrupts our comfort zones. It allows us to confront our self-doubts and fears and begin to navigate the uncertainties of what lies ahead. More importantly, it helps us gain new tools to change our behaviors. It is the bravest choice one can make to escape their addiction and learn a new way for a healthier lifestyle. Spokane Falls Recovery Center is a place where the employees believe in the miracle of recovery and where we have come together as a family to share our experience, strength and hope. Who we are is evident in how we lead and how we show compassion to others. We listen with the same passion with which we want

Tracy Dantzler, BA, SUDP Brandon Sturm, Corrie Sturm and Tracy Dantzler have joined arms to create a unique recovery center for Spokane, embodying care and compassion for people’s circumstances, their histories, and their individual needs. They know the Spokane community, and each one of us are intimately familiar with the journey of recovery. Brandon, Corrie and Tracy live the message that they share with the people who come to Spokane Falls Recovery Center: sobriety is possible, and recovery is life-changing. Together, they share over 40 years of combined service in substance abuse along with the passion to help people overcome their addictions and find hope again.

Administrator Tracy has worked in the field of addiction for 23 years, in both private and public settings. She delivers sincere compassion for those who struggle with addiction and believes in their ability to transform their lives. It is her passion for helping others and being an integral part of the change process while working with colleagues and individuals that sets her apart from the rest. Tracy leads Spokane Falls Recovery Center with impeccable ethics and standards of excellence. She is committed to providing the best care possible to the individuals served, while ensuring compliance with the American Society of Addiction Medicine (ASAM) criteria and Washington state administrative codes.

Brandon Sturm, DC

Corrie Sturm, NAC

Executive Director

Director of Administrative Operations

Brandon has found victory in a life of long-term recovery, which began in 2007 after struggling with drug addiction and alcoholism. His purpose today is to bring the pieces together for others in treatment, with the flexibility that makes it possible to experience the true miracle of recovery, and to provide a genuine place of healing at Spokane Falls Recovery Center. Brandon has worked in executive leadership for substance use treatment facilities since 2012. In his leadership of Spokane Falls Recovery Center, he emphasizes community connections and creating an environment that is as healthy for employees as it is for the people who receive care here.

Corrie began her journey in recovery in 2007 and accredits her joy and life successes to sobriety. The forefront of her life’s purpose today is positively impacting people in need and witnessing others overcome addiction. As Director of Administrative Operations, Corrie oversees human resources, facilities, and employee management. These entities are the operational pieces that build a safe and effective treatment environment and offer a healthy place for employees to work. Corrie is committed to adding the little things that let people know that they are seen as a person with dignity; with compassion and understanding for the choices they have made and the choices they will make, to find a better life that is free of addiction.

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Changing Lives.

to be heard. We teach addicts and alcoholics how to stop using drugs and drinking alcohol. The culture at Spokane Falls Recovery Center is one where people feel safe and are seen, heard and respected. We help change lives from the inside out, allowing people to become the best versions of themselves. The Spokane Falls Recovery Center family embraces individuals and their loved ones with open arms. We understand the struggle, the fight, the hard work and the open and honest introspection that is needed to overcome the relentless disease of addiction. Our family welcomes your family with open arms and guides you and/or your loved one with compassion, love and integrity. We believe in the miracles that come to pass while in recovery and are honored to be part of the process of seeing families restored. Together, we can rise again and overcome addiction while changing behaviors and changing lives.

There are genuine feelings of joy and gratitude when a person entrusts you with being part of their recovery process. Witnessing a person go from hopeless to hopeful again, with a lifestyle free from substance abuse is a joy like no other. At Spokane Falls Recovery Center, we understand how difficult it can be to ask for help and we are honored to be part of the process. If you, or someone you know is struggling with addiction and in need of help, we are here for you. Spokane Falls Recovery Center provides evidence-based treatment modalities recognized by The American Society of Addiction Medicine (ASAM®), as well as involvement with 12-Step programs. We work in partnership with each person to create an individualized plan of recovery that works to restore one’s physical, mental, and spiritual health.

Services Include PHP, IOP, OP and DUI/SUD Assessment Services • Individual Therapy • Individual Assessments • Group Therapy • Yoga & Meditation • Massage Therapy • Nutritional & Dietary Therapy • Adventure Therapy

www.TheWiseGuideOnline.com | Wise Guide 7

Guiding Good Choices Through Family Bonding and Clear Expectations By Donna M. Kelly, Certified Guiding Good Choices Facilitator


have such a sense of fulfillment when I see parents and caregivers have the courage to reach out, explore and learn new skills. They may not realize it but they are deciding to help their families achieve a new level of success and reach their goals. I have been facilitating “Guiding Good Choices,” an evidenced based program for parents since 2014. Many parents and caregivers may think, I don’t need a program, I need help! That is why “Guiding Good Choices” is such a powerful program. It is developed locally by David Hawkins and Richard Catalano from the University of Washington and it is based on the “Social Development Strategy.” This strategy organizes the research on protective factors—the factors that can buffer young people from risks and promote positive youth development. The goal is to prevent adolescent problem behaviors including alcohol, drug use, delinquency, teen pregnancy, dropping out of school and violence. In “Guiding Good Choices” workshops we practice how to use the new skills we’ve learned with real life sample scenarios. Our families learn to use these new tools, while having fun in a supportive and nonjudgmental environment. I’ve taken the concepts taught in “Guiding Good Choices” and provided something for us to consider while we have an opportunity to develop a closer relationship with our children and strengthen family bonds during this time of Covid-19. Let’s consider for a moment, what do we desire the most for our children? To be healthy? Well educated? Financially secure? Caring? Compassionate? Defining what we want for our children’s future will determine how we parent them today. Families have been in very close quarters over the past couple of months. While it may have been a major adjustment it also may have been an opportunity for us to see a side of our children we have not seen before. We should always be mindful of our children’s behavior and look for opportunities to give specific feedback and praise for a job well done, but what about those behaviors that make parenting challenging? Refusing to do what is requested, wanting to spend an inappropriate amount of time “binge watching” television programs or playing video games. What do we do when bedtimes become wartimes and chores are not completed on time or to satisfaction? While every family has their own selfgovernance, it is wise to step back and see if 8 Wise Guide | 2020 Edition

our family guidelines or rules are producing the behavior we desire in order to help our children reach healthy goals in their lives. I would like to suggest some tools that might be helpful in effectively addressing challenging behaviors. First, be sure you give age and ability appropriate tasks and instructions. Write down your expectations and desired frequency. For example: Clean the bathroom sink every Monday, Wednesday and Friday after you eat breakfast. Video games may be played after dinner, and only if all your assigned chores and homework are completed. If age appropriate, have older children choose a time to prepare a simple, nutritious meal for the family. Secondly, ensure that we have shown them how to do the task or chore that we are requesting. Make it fun and engaging, while emphasizing how important this chore and their role is to the family. Provide the necessary equipment and caution them on any chemicals that may be needed, and how to use and store them properly, keeping them out of the reach of younger siblings or household pets. It is also important to give children your expectations on how to treat family items like games, toys, and craft materials. Show children how to put them away and store them safely after each use. Explain to them the importance of needing all the game or puzzle pieces picked up and stored safely. Items left out can get lost, stepped on, or broken like their favorite DVD. Remind them that it can also be dangerous with toddlers or young children in the home to leave toys out. Third, monitor to see that the task or chore is completed to expectations. If so, heap on the praise and give them a good consequence. For example, if they clean the bathroom sink three times in a row, they may have a special game time with Mom or Dad, or have some extra free time, maybe even a special healthy treat just for them! However, if the chore or task is not done to expectations, some re-direction may be needed. Be sure to always commend and praise their efforts. Remember, if this is

new territory for your child it may be necessary to demonstrate the task a couple of times before they are proficient. Fourth, if the goals are still not met, we must provide some negative consequences. First, try to figure out why your child is not meeting the expectation. If the child is showing some rebelliousness, or resistance, we as parents should provide some direction in the form of consequences. Here it is crucial to spend time alone to be sure we are not approaching the situation from purely an emotional state. Extreme consequences or hurtful words can be spoken and damage family bonds. One of my favorite sessions of “Guiding Good Choices” is session number 4, “Managing Conflict: How to control and Express Your Anger Constructively.” This session alone is worth the entire 5-week investment. Once you are sure you can address the behavior calmly, ask yourself what is the goal of this consequence? Express your concern to your child using feeling statements. Avoid generalities and focus on the specific task that produced the feeling. Ask how they think you could work with them to solve this problem. Now it is time to agree on a negative consequence if the chore is not done on time or up to standards. Write it down if necessary and be sure to follow through with the consequence in a timely manner. Failure to do so can undermine your effectiveness and again, weaken family bonds. Consistency is the key! Once your child knows you mean what you say, they will be less likely to disregard the family rules and you have reinforced your family’s clear standards. I recently heard a quote from Joel Ecklund, a local Pastor in Oldtown, Idaho, “The habits our children form during these times, they will carry with them for the rest of their lives.” Let’s well equip our children! For families who live in Pend Oreille County we offer Guiding Good Choices year-round and would love for you to participate, free of charge through one of our three Community Prevention and Wellness Initiative Coalitions. We have a coalition in Newport, Cusick, and Ione/Metalline/ Metalline Falls, WA. Due to current social distancing guidelines we are happy to offer the workshop remotely so you may participate in the privacy and comfort of your own home via the “Zoom” online meeting platform. Our program is fully funded through grants from The Washington State Health Care Authority.

If you would like more information on Guiding Good Choices, or to register for one of our workshops, please contact the facilitator, Donna at 509-447-6416. Donna M. Kelly is the mother of three remarkable children. She is dedicated to family wellbeing and healthy communities. Donna is the Community Prevention Wellness Initiative Coordinator for the Cusick School District. She has worked with Prevention for over 6 years in Pend Oreille County and is a Certified Facilitator for “Guiding Good Choices” an interactive parenting workshop.

www.TheWiseGuideOnline.com | Wise Guide 9

by Kristin Ludwig, Director of Development, North Idaho CASA

Family is not defined by our genes, it is built and maintained through love.

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en years ago, a baby was born. The biological mom abandoned him at birth, so his dad was his only family. At 18 months of age, the baby was living in a home with his dad and stepmom. The amount of historical abuse the baby endured is unknown, but what is known is one night, dad got drunk and smacked the baby so hard, he left a handprint on the side of his face. Only out of fear of getting blamed herself, the stepmom took the baby to the pediatrician. Authorities were notified and after further investigation, the baby was placed in foster care. A CASA Advocate was assigned to the baby’s case who made sure he was placed in a safe, secure and loving home. As he grew, he learned what empathy and compassion felt like and for a year of his young life, he was able to develop like a typical toddler. Dad worked his court-ordered child protection case plan and through counseling and attending domestic violence classes, earned his parental rights back and was reunified with his son, who was now a toddler. Over the course of the next three years, the little boy was abused, tortured, starved and deprived of necessities by both

his dad and stepmom. At age six, one incident resulted in him having a very serious injury. Stepmom reluctantly took the boy to the pediatrician, claiming he had eaten the foam out of his pillow because he was autistic. The little boy’s belly was so distended, and his vital signs were so low, he was air-lifted to a children’s hospital. The doctor’s initial evaluation was the little boy was near death. He had a ruptured organ, was extremely malnourished, and had bruises and cuts in different stages of healing all over his body. Police arrested both the stepmom and dad. Through a lengthy jury trial, a judge found both parents guilty of child abuse and their parental rights were terminated. They both received 10-20 years in jail. The judge noted that this was the worst case of child abuse he had ever seen.

abuse can be stopped with the help of your continuous support of the CASA program. Statistically, children with Advocates have better outcomes and are more likely to succeed. CASA Kids: The Innocence of a Self Portrait. When children are asked to look in the mirror and draw what they see, the world they live in is about to be set free. Self-expression is an important part of therapy and essential in beginning the healing process of childhood trauma. To find out more about the CASA Self Portrait campaign, please visit our website: NorthIdahoCASA.org

With a strong support system and the unconditional love of his new family, this child victim has a chance at a happy and healthy life.

Kristin Ludwig, Director of Development, and CASA team member has over 20-years experience in event planning, advertising and marketing. After moving to Coeur d’Alene in 2005, she became involved in local volunteer organizations and political campaigns, advocating for the good of the community. She has worked with the Coeur d’Alene Backpack Program since its inception and was lead planner on Wine, Women & Shoes for Idaho Youth Ranch.

The little boy recovered in the hospital and was released to foster care. He was assigned the same CASA he had three years earlier. She fought for what permanent home would be best for him and worked with the school to help him catch-up on his social interaction and education. The boy had never been enrolled at pre-school or had any healthy interactions with children his age. After two months, he was placed in his final foster home, a single mom with a loving heart. At age seven, the boy was adopted by his foster mom who committed to make his life the best possible. Now, age 10, the boy has a strong, natural athletic ability and is an excellent swimmer and loves playing water polo. He is always smiling and enjoys hanging out with his friends. He does not have a diagnosis of autism. He still exhibits behavioral problems relating to the trauma he experienced and occasionally struggles in social situations. But with a strong support system and the unconditional love of his new family, this child victim has a chance at a happy and healthy life. North Idaho CASA serves over 500 child victims every year throughout the five northern counties. Last year, 141 of these children were reunified with a parent, 29 were adopted and over 330 are still in foster care. The cycle of www.TheWiseGuideOnline.com | Wise Guide 11

Chronic Pain You Don’t Have to Live With It!

by Amanda Thome, PT, DPT & Owner, Cornerstone Physical Therapy

In the medical field, depending upon the disease or injury, “acute” pain refers to pain experienced initially and typically lasting less than 6 months. “Chronic” pain is of longer duration, often after healing has occurred.


o you know that your body has amazing ways of healing itself? After an injury, it goes through a cascade of events to help the tissues heal. But what happens when pain outlasts the healing? That’s when pain can become chronic. If you have experienced chronic pain, chances are you’ve seen a healthcare professional for this condition. Along your journey, you may or may not have seen a Physical or Occupational Therapist, or even a Chiropractor, to help give you relief. As a Physical Therapist with a clinic staffed by licensed providers who have taken special interest and training to help treat patients in chronic pain, we often find that the past therapy provider tried to “fix you” through interventions more appropriate for someone dealing with acute pain. Chronic pain and acute pain are NOT the same, and require different therapies to address each appropriately for a positive outcome. Chronic pain requires a team of skilled providers to do a thorough examination of your body; however, it also requires a thorough history intake and open dialogue about your current symptoms. Symptoms may include your mood, sleep habits, sensitivities to movements, sounds and/or light, sensitivities to weather changes, stress level, changes in your ability to remember things, and intolerances to activities like sitting, standing or walking. Pain can become long lasting and chronic because the central nervous system has become sensitized. Once this sensitization happens, it no longer takes the same amount of movement or lack of movement, degree in temperature or weather changes, or level of

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stress to trigger pain symptoms to increase. Research shows that when someone with chronic pain is dealing with a sensitized nervous system, we need to incorporate a holistic approach that includes education, movement, relaxation techniques and more. It is important that you understand why you feel the way you do, because studies have shown that once you understand the how and the why of pain, your pain levels will decrease. A skilled therapy team will teach you to become an expert in understanding your pain and take you through techniques to calm the nervous system. This may include guided breathing, meditation, and yoga therapy, just to name a few. Movement and exercise are often a trigger for many people in chronic pain, which is where a team of therapists with the knowledge of how to pace your exercise is crucial. Additionally, use of supportive interventions, such as warm water pool therapy, can be vital. While many of our chronic pain patients do amazingly well in our warm water pool, let’s face it, the pool isn’t for everyone. So how do we help you move and exercise, thereby calming your nervous system and not increasing your pain? The answer is the AlterG, our NASA designed antigravity treadmill system, which fills with air from your waist down and allows us to take away up to 80% of your body weight in 1% increments. This can allow you to walk, and possibly even run again, without the same degree of pain. For those of you who have circulatory or inflammatory conditions contributing to your pain, we recommend use of either our targeted infrared light therapy, or time in our medical grade, full spectrum infrared light sauna. Just as each and every person’s pain experience is different, so is the appropriate treatment for your pain. Our therapists have many years of experience and additional training to help you through your chronic pain. We also have wonderful relationships with pain management physicians in the region and can help you with that portion of managing your pain through open communication between them and our team of providers. If you or someone you know suffers from chronic pain, you are encouraged to talk to your healthcare provider about seeing an outpatient therapy clinic with a focus on treating you and your pain conditions. If you would like to learn more about the warm water pool, AlterG, infrared sauna or about our Physical Therapists, Occupational Therapists or Chiropractor, please visit our website at: www.sandpointphysicaltherapy.com

Amanda Thome PT, DPT graduated magna cum laude with her Doctorate in Physical Therapy from Columbia University in 2010. Amanda received her bachelors in science degree from Ursinus College in Collegeville, PA in 2007. During her time at Ursinus College she was a NCAA track and field athlete. Amanda uses skills she gained working for nationally top-ranked rehabilitation facilities and has a strong background in manual therapy and the treatment of acute and chronic pain conditions including neuropathy pain, post surgical rehabilitation, balance and vestibular disorders as well as those with neurological conditions. Amanda is one of only a few ImPACT Concussion trained physical therapists in Idaho. Amanda and her highly skilled team also offer treatment for Pelvic Floor Disorders (PFD); Functional Capacity Evaluations for those returning to work, and/or beginning a physically demanding job; balance or dizziness disorders; and utilize the only FootMaxx Computerized Gait Analysis System to create custom orthotic devices. Please visit our website: www.sandpointphysicaltherapy.com to learn more about our full range of services and call 208-265-0610 for a free phone consultation.


208.265.0610 1301 N DIVISION, SANDPOINT, ID www.TheWiseGuideOnline.com | Wise Guide 13

Neurotherapy and Neurostimulation Advancements in Psychological Counseling by Caleb Orr, Licensed Professional Counselor The Human Connection

Difficulty Sleeping, Anxiety, Depression, Headaches, PTSD, ADHD, Addictions? Neurotherapy may be able to help! Psychological counseling has long been a valuable tool to support people as they navigate challenging situations and create positive changes in their lives. Counseling, with or without supplemental medication, has yielded extraordinary results for many people. As the field of psychology has advanced over the years, professionals are becoming more adept at directly addressing needs expressed by clients without the use of psychotropic medications. Many people hope to avoid using medications as they are often accompanied by unpleasant side effects. One of the newer, and less well known advancements in the field of psychology is Neurotherapy. Neurotherapy is a powerful and highly effective tool that can improve a client’s emotional, mental and physical well being. The benefits are often so great as to allow clients to reduce, or even eliminate, the use of adjunct psychotropic medications. Neurotherapy’s effectiveness is based on the concept of Neuroplasticity; the brain’s ability to change continuously throughout an individual’s life. Historically, many professionals believed that brain growth and development occurs only in childhood, and that once the “wiring” is formed, it is then established and unchangeable for the remainder of an individual’s life. This perspective had dire consequences for the approach to healing for people with TBI’s (Traumatic Brain Injuries), PTSD (both of which have been all too common in our Veterans), and people struggling with ADD or ADHD. Research clearly shows that life-long neuroplasticity occurs at multiple levels, moving from individual neurons to synapses (the connections between individual brain cells), to entire neural networks functioning in a dynamic and synergistic fashion. Stimulation to the brain, whether electrical, chemical, behavioral, cognitive, emotional, social or environmental inevitably facilitates change, whether it be in a positive or a negative direction. Neurotherapy is a powerful tool that allows professionals to affect brain function. When used in conjunction with psychological counseling, such a tool can be used to enrich early childhood development, facilitate learning and memory throughout the lifespan, enhance our ability to regulate emotional states, and speed recovery from emotional and physical trauma, including direct injury to the brain. 14 Wise Guide | 2020 Edition

Neurotherapy began in the late 1950’s with Joe Kamiya’s work on Neurofeedback. Neurofeedback is a form of Biofeedback that uses real-time displays of electrical signals naturally produced by the brain, called brain waves. Current neurofeedback technology uses visual and auditory feedback to paint a picture of real-time electrical activity within the client’s brain. Once observed, the client and professional develop a strategy and work together to modify the client’s brainwaves to address their therapeutic goals. Neurostimulation is another Neurotherapy tool that improves brain functioning by using very small amounts of electrical energy to produce specific electrical frequencies needed to accomplish the desired level of activity in specific areas of the brain. You can think of Neurofeedback and Neurostimulation as like going to the gym. This is a workout for the brain. With repetition, the brain can develop new habits and patterns to replace old and undesirable patterns.

Who can benefit from Neurotherapy and Neurostimulation? Neurotherapy has been used for many years to enhance performance by a variety of individuals, including Olympic athletes, business leaders, professional musicians, public speakers, as well as many “ordinary” people looking to improve their daily lives. Many people struggling with a mental health issue may also benefit from Neurotherapy. Research shows neurofeedback may be useful for a range of brain-related conditions including: Difficulty Sleeping, Depression, Anxiety, PTSD, ADD and ADHD, Headaches, Autism, and Addiction.

Calming the Nervous System Anxiety and Depression are pervasive in our world today. Many people struggle with levels of stress that prevent them from achieving and maintaining a mentally and physically relaxed state. Our Nervous Systems function as though they are in a heightened state of threat, feeling under attack which, over time, can lead us to a state of exhaustion, hopelessness or despair. That “state of threat” can be seen by observing the electrical activity in our brains. Our brains are trying to figure out, “Should I fight, or flee, or, if there is no chance for any escape, maybe I should just freeze?” Neurotherapy is a direct method for bringing relief to overlystressed brains. As your brain moves into a state of greater calm, your brain gradually learns how to “hold that state” until it becomes the “new normal.” Many people find that neurotherapy treatments begin to show positive results in one to five sessions. If this promising therapy sounds interesting to you please reach out to a counselor, research more online, or call The Human Connection at 208-265-5412 for more details.

With a masters degree in counseling from Boise State University, Caleb is further certified in Mindfulness Based Cognitive Therapy and is the Director of the Neurofeedback Program at The Human Connection in Sandpoint, Idaho where he is a member of “A Team of Genuinely Caring Counselors.” A North Idaho native, Caleb loves helping his community become THE BEST IT CAN BE.

www.TheWiseGuideOnline.com | Wise Guide 15

Therapy and Parkinson’s What is Parkinson’s Disease? Parkinson’s disease (PD) is a neurodegenerative brain disorder, with symptoms that take years to develop and slowly progress over time. Nearly one million people in the US are living with Parkinson’s disease. The cause is unknown and although there is presently no cure, there are treatment options such as medication and surgery to manage its symptoms. Parkinson’s involves the malfunction and death of vital nerve cells in the brain, called neurons. Parkinson’s primarily affects neurons in an area of the brain called the basal ganglia, and more particularly in a center called the substantia nigra. These neurons produce a neurotransmitter called dopamine, a chemical that allows messages to transmit through parts of the brain that control movement and coordination. As PD progresses, the amount of dopamine produced in the brain decreases, leaving a person unable to control movement normally. Exercise is an important part of healthy living for everyone. For people with Parkinson’s, exercise is more than healthy: it is a vital component to maintaining balance, mobility and the ability to perform activities of daily living. Experts recommend that people with Parkinson’s exercise with intensity for as long as possible as often as possible. There are many approaches to exercise that have been researched and while no single approach has been shown to be better over the long term than another, there are generally accepted principles of rehabilitation that successful programs have in common.

5 Principles of Rehabilitation: Physical, Occupational and Speech Therapy Across all rehabilitation disciplines, there are basic assumptions that apply to rehabilitative treatment of Parkinson’s disease regardless of the task or function being focused on. 1. Normal movement is possible in Parkinson’s disease; what is required is appropriate activation. The skilled therapist is able to determine the most effective methods to activate normal movement. 2. Complex movements need to be broken down into smaller components. This is to take advantage of increased movement ability that often happens at the beginning of a movement task. 3. Each component of a task needs to be performed at a conscious level, meaning you are actively thinking about the movement you are performing. Conscious attention appears to bypass the basal ganglia and restore movement towards normal.

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4.  External cues may be used to start and maintain movement and cognitive processes. Visual (seeing), auditory (hearing) or proprioceptive (feeling) cues may be used. Cues help generate appropriate movement size and appear to help maintain attention on a task. 5.  Multi-tasking with movement and thinking tasks should be avoided. This is because the more automatic task is not completed properly and only the task demanding more attention is satisfactorily completed. Because Parkinson’s disease affects the neural pathways of the brain, treatment approaches should also adhere to the following principles of Neuroplasticity.

10 Principles of Neuroplasticity Contrary to what has historically been believed, the human brain has the ability to change or “re-wire” (neuroplasticity) across the life-span, and those changes can be for the better or the worse. Whenever a new skill is acquired as a result of repeated practice, there are associated physical changes within the brain. Likewise, repeated negative behavior or “bad habits” will also lead to physical changes within the brain. Parkinson’s disease leads to a major “re-wiring” of how the brain works. Our goal in inpatient rehabilitation is to reinforce intact neural pathways that allow you to bypass the impaired pathways that are caused by Parkinson’s disease. Our goal in rehabilitation should always be to harness or tap into the brain’s ability to change. There are 10 principles of Neuroplasticity that should be considered in order to get maximum benefit from rehabilitation. • Use it or lose it • Use it and improve it • Specificity matters • Repetition matters • Intensity matters • Time matters • Salience matters • Age matters • Transference • Interference


Early Symptoms of Parkinson’s Disease Parkinson’s disease is a chronic and progressive movement disorder. Some symptoms of the disease are easy to see, while others are hard to detect. Early signs of Parkinson’s disease can include: • Tremor or shaking of a body part

• Voice becomes softer or lower

• Handwriting becomes smaller

• Serious look on your face even when you’re not in a bad mood

• Loss of smell • Trouble sleeping • Trouble moving or walking • Constipation

• Dizziness or fainting • Stooping or hunching over • Trouble swallowing

No one symptom necessarily means that you have the disease, as it may be caused by another condition. However, if you are experiencing symptoms, don’t hesitate to visit your physician. To learn more about how Rehabilitation Hospital of the Northwest helps patients with Parkinson’s disease, call 208.262.8700.


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Vitamin D

and Multiple Sclerosis …correcting a risk factor does not result in a treatment

by Dr. Steven Pugh, Inland Northwest Research Selkirk Neurology

How do we increase our levels of vitamin D?

ccording to the National Multiple Sclerosis Society (NMSS) up to 800,000 people have multiple sclerosis (MS) in the United States. MS is widely accepted as an autoimmune disease of the central nervous system (when the brain and spinal cord are attacked by one’s own immune system) and remains the most common cause of permanent neurological disability (decreased function of the brain and spinal cord), in young patients. The damage caused to the brain and spinal cord from the active cycles of MS will happen over a lifetime and patients are disabled in different ways. Every MS patient has a unique pattern of neurological symptoms and problems, although many patients have similar patterns, such as difficulty walking, double vision or vision loss, chronic pain, fatigue, and bladder problems. Many risk factors from our environment have been associated with the risk of developing MS. One of the most discussed and studied risk factor has been the relationship between vitamin D and multiple sclerosis. There are many rolls that have been linked to vitamin D and the function of a healthy immune system. Thus, it seems logical that vitamin D, especially in vitamin D deficient patients, might serve as treatment to slow the progression of this devastating neurological disease.

The body naturally produces cholecalciferol (vitamin D3), in the lower layers of the skin through exposure to sunlight. This means that the body (skin) must be exposed to sunlight in order to convert vitamin D (non-usable) into the usable (active) form, vitamin D3. Only a few food sources have naturally occurring high levels of dietary vitamin D3, such as the flesh of certain fish or egg yolks. Take for instance the diets of certain Scandinavian countries, which vary significantly between people living on the coastlines vs those that live further inland. The coastline residents have diets higher in fish and other seafood, and the inland residents have diets higher in red meat and other sources of protein. There is clearly a difference in the risk of MS between the inlanders and the coastline residents, with the inlanders at higher risk of having MS (fortunately this risk is small). Additionally, there is a well-documented increased risk of MS in geographic locations further from the equator, thought to be tied to less sunlight exposure, and therefore lower blood levels of vitamin D, since less sunlight equates to lower levels of vitamin D3 being produced. Birth month is even factor, with people born in May 20% more likely to develop MS than people born in November. One interesting theory to explain this “birth month risk” is the naturally lower occurring levels of vitamin D in the mother during the gestation period that includes months that are naturally darker, however this theory would be very difficult to prove.


Vitamin D as a Risk Factor for MS What causes MS to develop is complex and is probably caused by a combination of environmental and genetic risk factors. Low levels of Vitamin D in the blood is a risk factor for developing MS. This fact brings up the question of how much vitamin D should an MS patient be taking. Several welldesigned observational studies have clearly shown an increased risk of developing MS with low levels of vitamin D in the blood and, independently, low dietary intake of vitamin D. 18 Wise Guide | 2020 Edition

Vitamin D as a Treatment for MS In the United States some foods are enriched with vitamin D3, such as milk, breakfast cereals and other plant derivative milk substitutes, but is this enough? Successful treatment in MS by any medication or dietary supplement includes the following attributes:

• lowering the relapse rate • decreased inflammation on brain and spinal cord MRIs • and most important, a reduction in the accumulation of neurological disability These measures are compared over time, in a group of MS patients, and are direct and indirect measures of MS disease severity. There are many smaller studies that report conflicting data, for supplemental vitamin D as a treatment for MS. Some smaller studies showing benefit, and other studies showing no change in disease severity and activity. These inconsistent results led to the need of large well-designed and controlled trials of vitamin D as an add-on therapy for controlling the severity of MS disease activity. To date, the data from three large, well-designed trials have been published. The MS world was disappointed with the largely negative results from all three studies, as different vitamin D dosing plans did not appear to significantly change these three measures of disease activity. Yet, there were some positive trends towards more stable MRIs and less relapses in the vitamin D treated groups. To date, there is no consistent, replicated, clinical trial data to support that vitamin D is an effective treatment for MS, although there was very little data to support that the higher doses of vitamin D had any serious harmful side effects.

Too Much Vitamin D? Some patients have been observed in the clinic taking ultrahigh doses of vitamin D in an effort to cure or treat MS. There is much online literature of personal accounts (patients and physicians alike), supporting a variety of unproven online protocols (treatment plans) promoting vitamin D supplements, as part of a treatment plan. Some patients take a daily dose as high as 80,000 to 100,000 IUs. It should be noted that these patients are at risk of vitamin D toxicity, and there is a range of medical side effects from this, including neurological complications (such as confusion, depression, and seizures), gastrointestinal effects (nausea, vomiting, abdominal pain, anorexia), and even cardiac complications (abnormal heart rhythms, low heart rate, hypertension), to name a few. Based on a review of wideranging data, vitamin D levels at or below a level of 120-130 ng/ml seem to provide the potential therapeutic (beneficial) effects from vitamin D supplementation. Based on the data, the daily vitamin D doses ranged from 10,000 to 40,000 IU, but not

more than that. Blood levels higher than 150 ng/ml are thought to be toxic and potentially harmful.

What to do? If you are an MS patient and concerned about your vitamin D levels, the first step is taking a blood test to determine your level. If your vitamin D levels are low, consider a daily vitamin D3 supplement. Please note, that many patients, even those without MS, have low vitamin D levels, especially for patients living in geographical locations with low sunlight (long winters). Patients are also able to safely take vitamin D supplement without a blood test confirmation, as many health plans do not to cover vitamin D testing, even with MS patients. In clinic, doctors routinely recommend vitamin D replacement with 10,000 IU daily of vitamin D3, which is widely available and relatively low-cost. Excessive sunlight exposure should not be utilized to increase vitamin D levels because of the risk of skin cancer. Lastly, vitamin D3 supplementation should never take the place of an FDA approved medication that has been shown to prevent the progression of MS, commonly known as disease modifying therapies. Please consult your doctor before starting or stopping any new medication or dietary supplement. Steven Pugh, MD, completed a BS in Neurosciences from Texas Christian University in 1991 and Medical Degree from University of Missouri – Columbia in 1996, completing an internship in medicine, and residency in neurology in 2002 from the University of Washington School of Medical, Seattle. Dr. Pugh diagnoses and treats all neurological disorders. He is Board Certified by the American Board of Psychiatry and Neurology and is sub-specialized in the diagnosis and treatment of multiple sclerosis. He has extensive experience in hospital-based neurology, diagnostic adult neurology, EMG and electrodiagnostics, botulinum therapy, and intrathecal baclofen therapy. Dr. Pugh is also extensively involved with the MS Society in an advisory role. He is a Clinical Instructor with the University of Washington Department of Neurology and is involved with the education of both medical students and residents, and is the co-founder of Selkirk Neurology in Spokane, WA.

www.TheWiseGuideOnline.com | Wise Guide 19

Staying Mentally Healthy During Crisis by Kristin Carlson, External Marketing Specialist, Bonner General Health


t’s a trying time in America, and worldwide. We are in shut-down mode, trying to “flatten the curve,” and prevent the COVID-19 novel coronavirus from spreading further. Here is some insightful advice from our Bonner General Health Psychologist, Dr. Joe Wassif, PhD, on keeping you and your family mentally healthy during the COVID-19 crisis. Regardless of your situation, we are all in circumstances which could cause heightened stress. Working parents who are now trying to juggle a full-time job and being an at home teacher for their children. There are numerous individuals in our community who have been laid off due to business closures, resulting in loss of income. Adults worried about elderly parents. How you react to these situations is how we can keep our stress to a minimum and your mind healthy. “Let’s be mindful of the fearbased environment being created. Yes, it is absolutely a frightening time and needs to be taken seriously, but try to give yourself and others a break from the topic when appropriate. Don’t let the virus monopolize every conversation you have,” advices Dr. Wassif. He also stresses to make sure the information you are sharing about the virus is accurate. Reporting “hear say” only escalates fear. While the term “Social Distancing” is being used to communicate the need to distance ourselves and avoid the spread of the virus, Dr. Wassif prefers the term “Physical Distancing.” “Physical isolation coupled with social isolation is a key pathway to depression,” he says. Don’t disconnect: • Communicate with your people – check up on family, friends, and neighbors through phone calls, Facetime, letters, and emails. • Open your windows and let the fresh air in.

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• Go for a walk outside or at least maintain some physical activity. • Continue healthy eating habits. All the things you were doing before the virus to keep yourself healthy still apply TODAY. “We need to try even harder to overcome the symptoms of anxiety and depression to keep ourselves healthy, thinking rationally, and making good choices,” says Dr. Wassif.

Dr. Joe Wassif, PhD

Another trigger for stress can come from the disruption of routine. When we don’t have our usual habits or means of entertainment, what do we do? Dr. Wassif says this is not always a bad thing, it just requires more creative solutions. Not only are we trying to take care of one another, we want to make sure there are resources for everyone, especially our healthcare professionals. In this specific situation with COVID-19, the majority of us will be

just fine. Even if we get the virus we will recover easily with minor complications. The reason we are following guidelines and acting as a collective community is to keep the at-risk population healthy and safe and allow the hospitals to be able to provide good care, and not just to virus patients but to all patients. It triggers a change in our values. “The hope is when you have to improvise from your regular routines, healthier solutions come out of it,” says Dr. Wassif, “We are all in this together.” Things to think about: • Try not to panic: Focusing on the “What If” creates fear, rash decision making, and the hoarding mentality. The reality is there is plenty to go around. • Don’t discount each other: If your neighbor is trying to make a positive statement and your response is negative, you are discounting their statement, a sign you are overwhelmed by fear. Try listening instead. • Stay positive and check in on the people in your life near and far. • The most stressful jobs right now are front-line medical staff and GROCERY STORE CLERKS. Be kind to these people. • Use developmentally appropriate language when talking about the virus to and around your children. Be mindful of words and discussions our younger minds may not be ready to hear. Are they in ear shot? Treat this like any other sensitive subject. Be able to talk about it and not treat it like a secret.

Kristin Carlson holds a Bachelor’s Degree in Public and Interpersonal Communication from North Carolina State University. Kristin most recently worked as the Communications and Tourism Specialist for the Greater Sandpoint Chamber of Commerce and has experience in Project Management, Recruiting, and Administrative roles. Kristin has also been a Medical Aesthetician for the past 10 years. Her goal is to ensure every individual living in or visiting our community is aware of the exceptional care available at BGH.

www.TheWiseGuideOnline.com | Wise Guide 21

Are Your Ears Ringing? by Kevin W. Hague, M.A., CCC-A Certified Audiologist Hearing Healthcare Associates


innitus is an abnormal perception of a sound not caused by external noise, and typically heard only by the patient. It may be a ringing, buzzing, cricket-like, ocean, or other type of sound in the ear or head. It may be intermittent, constant or fluctuating, mild or severe and varying in nature from a low roaring sensation to a high-pitched sound. While it may be associated with hearing loss, it will not cause you to go deaf, and statistically, tinnitus decreases or is hardly perceptible over time in 50 percent of patients. Tinnitus may occur with hearing loss, vertigo, or pressure symptoms in the ear or it may occur alone. This condition is a neurological symptom and not a disease, just as pain in the arm or leg is a symptom and not a disease. Because the function of the auditory (hearing) nerve is to carry sound, when it is irritated from any cause, it produces head noise. Tinnitus may originate from various lesions at different locations in the auditory system. A lesion may be located on the auditory nerve or cochlea and does not reach the brainstem, or it may begin at the brainstem and involve other portions of the central nervous system. The auditory system involves highly complicated inner ear structures, many nerve pathways, and a great amount of nuclei that form a complex neural network. Pinpointing the cause of tinnitus to a certain structure can be difficult. There are many other causes related to the ear which would result in tinnitus:

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• Abnormal neural activity in the auditory nerve fibers, which may occur if there is a partial breakdown of the myelin covering of individual fibers. A defect in the hair cell would trigger the discharge of connected nerve fibers. • Chronic cochlear disorders – There are two different kinds of afferent fibers in the auditory nerve: inner hair cell fibers with large diameters and outer hair cells fibers with small diameters. Loss of signals from the cochlea between the two sets of fibers or other abnormal changes of the cochlear fluids may result in tinnitus. • Medications – If you have tinnitus and are on medication, you should discuss the symptoms with your physician. • Ear wax (Cerumen) in the ear canal. • Fixation of the stapes bone in the middle ear (Otosclerosis). • Meniere’s disease – a complex syndrome involving hearing loss and vertigo. • Sudden trauma from a direct blow to the ear or head. • Damage to the inner ear such as exposure to excessively loud sounds. • Tumors on the hearing nerve or other problems in the brainstem or central nervous system. • Other vascular abnormalities that can occur in the skull or base of the skull. Generally, most patients will not need any medical treatment for their tinnitus. For patients who are greatly bothered by tinnitus, they may use masking techniques and other treatments, such as: • Listening to a fan or radio. This generally is more advantageous if one is attempting to go to sleep. • A tinnitus masker – a small electronic instrument built into a hearing aid case. It generates a noise which prevents the wearer from hearing his own head noise. The masker is based on the principle that most individuals with tinnitus can better tolerate outside noise than they can their own inner head noise. • Biofeedback training is effective in reducing tinnitus in some patients. It consists of exercises the patient learns in order to control various parts of the body and relax the muscles. When a patient is able to accomplish this type of relaxation, tinnitus generally subsides. Most patients have expressed that the biofeedback offers them better coping skills. • Avoidance – This includes making every attempt to avoid anxiety, as anxiety increases tinnitus. A person with tinnitus should avoid losing sleep and becoming fatigued, because, generally, patients who are tired seem to notice their tinnitus more. Also, the use of nerve stimulants is to be avoided, as excessive amounts of coffee and smoking contribute to the head noise. • Medications – There are some medications utilized to suppress tinnitus. Some patients benefit with these drugs, and others do not. Each patient has an individual response to medication, and what works for one patient will not always work for others. Some of these medications have been proven, however, to decrease the intensity of the tinnitus and make it much less noticeable to the patient. There is, however, no drug anywhere which will eliminate tinnitus completely and forever. If you are experiencing severe, disabling tinnitus, have a complete cochleovestibular evaluation done to attempt to establish the site of lesion and to rule out any significant pathology which may require further treatment.

Room for One More?

by Family Resource and Training Center


ne of the most rewarding things about being a foster parent is creating lifelong connections with children as well as their parents. We were over the moon when we received our first placement and just as excited when our most recent “bonus kiddo” moved in. Over the years we have learned many things, including how to love and let go. Do these children come into our home with challenging behaviors? Yes. Do we spend lots of time at child welfare offices, court houses, and doctor’s appointments? Yup. Can it be difficult fitting in one more child’s schedule into our already busy lives? You bet. However, do you know what else we get to do? We get to provide stability and support to a child who may have never experienced such things. We are allowed the opportunity to model healthy relationships and boundaries to birth parents who may need all the help they can get. We are a source of hope and healing to broken and traumatized children. While taking classes to obtain our license we heard it all. “I would get too attached.” “I could never treat them like my own.” “Their behaviors are too difficult to manage.” It is stigmas such as these that keep many from becoming a foster parent. Look at what happens when you change the perspective: “I can be the first positive relationship this child experiences.” “I may be the

only adult who allows this teenager space to experience life as a teenager.” “I can allow this child a safe place to experience and learn from his emotions.” A few years, and a few placements later, here are a few things we have discovered. We found immense joy in meeting these kiddos and their parents, cheering for them along their journey, and celebrating when a child returns home. We love to reminisce about each of the firsts and lasts we’ve had with all of our children. We laugh over the many batches of burnt cookies we’ve baked with our bonus kiddos. Currently, in Washington and Idaho, there are more foster children than there are foster homes. Due to lack of resources, siblings are separated and children are moved away from their community. Sometimes, if a placement cannot be found, a child will spend the night in a hotel with social workers working through the night to find them a safe place to lay their heads. We wanted to help but we were not sure how. After long discussions and lots of thinking and praying we decided to become foster parents. Our first step was to attend an info meeting. During the info meeting we had many of our questions answered by seasoned foster parents and a social worker. They explained to us what the licensing process looks like and encouraged us to call them whenever we had any questions. Then, we filled out an application and attend training classes. Finally, we completed our home study and became licensed foster parents. These steps seemed daunting to us, but we had a team of supporters rallied around us the whole time. We were never on this journey alone. I hear you now. “I live in a one bedroom apartment. There’s no room for a foster child.” “I’m too busy with my own children to take on one more child.” I get it. There are lots of other ways for you to help! You can support your local foster parents and child welfare workers. You can become a respite provider to give much needed relief to our tired foster parents—we could use a break too from time to time! Volunteer with your local agencies that support the foster care community. This is tough, but necessary work. We, just like you, are regular people—not super heroes. You can do this. The Family Resource and Training Center (FRTC) was founded in 1993 with a commitment to support the foster care community. Since the FRTC’s opening, their scope of practice has broadened to include the Washington State Department of Children, Youth, and Family. The FRTC now works to recruit, train, and support foster parents throughout the states of Washington and Idaho.

www.TheWiseGuideOnline.com | Wise Guide 23

Chronic Pain is Unique to the Individual by Dr. Clinton M. Thome, Pain Management of North Idaho


hronic pain is an extremely complex medical condition. The complexity stems from each person’s unique pain history and how pain signals are processed. Pain is an incredibly unique experience for each person. Living with chronic pain affects multiple components of the body and mind. When pain limits a person’s ability to think, move, sleep, perform their hobbies and the ability to take care of themselves or family, their entire life is impacted. This has a negative impact on one’s mental health which affects their families, careers, and that individual’s quality of life. When other coexisting health issues are factored in such as COPD, diabetes, rheumatoid arthritis and many others, the situation becomes even more complicated. Many chronic diseases lead to a proinflammatory state, decreased oxygenation, poor sleep, decreased function which increases the risk of the formation of chronic pain and decreases the likelihood of response to treatment. This is a very brief explanation of why chronic pain is such a complex disease state and subsequently difficult to treat. Simply relying on a pill, an injection or surgery is unlikely to truly help unless the entire umbrella of suffering is also addressed.

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If you suffer from any type of chronic pain condition you should try and optimize the health problems that are able to be optimized. See your primary care provider regularly and take medications and treatment recommendations as prescribed. Taking non-narcotic medications and trying conservative therapies such as physical & occupational therapy, massage therapy, chiropractic, acupuncture, heat/ice, exercise/stretching are usually the first steps in managing and preventing chronic pain. When these

Unless the intervention is directed towards the true source of pain the therapy is unlikely to work. measures fail there is an extensive list of interventional options available. If these non-operative measures fail surgery may be necessary. While these measures are being employed you should make sure your sleep and mood are being addressed. Anxiety, depression and poor sleep are commonly associated with chronic pain and all three of these diseases are intimately related to one another. Treating one without the other is unlikely to yield

long term success. The longer one suffers from untreated chronic pain the more likely they are going to start suffering from anxiety/depression/poor sleep and vice versa. A multi-disciplinary approach is often necessary to treat chronic pain in its entirety. Sometimes this simply includes your primary care provider and a pain specialist. But often times, incorporation of a mental health provider or a sleep medicine specialist can help enhance care. Interventional therapy can be an extremely important aspect of pain care and is a very precise, non-surgical, approach to attacking pain. Interventional therapy has the greatest chance of success when the other coexisting factors explained above are optimized. In cases where anxiety or sleeplessness are created from a specific pain complaint, interventional pain management can be the bridge to optimizing those conditions. Many patients don’t realize that interventional therapy, including injection therapy, is typically very precise for a specific type of pain. For example low back pain has an assortment of different pain generators. Low back pain can be caused from arthritis, spinal stenosis, disc pain, hip arthritis, sacroiliac joint pain, intra-abdominal pain, muscle pain, nerve pain, referred from some other

pain source entirely, or number of other possible sources. Unless the intervention is directed towards the true source of pain the therapy is unlikely to work. Having co-existing disease(s) properly addressed, exponentially helps to limit possible sources of pain and improve the chances that treatment is successful. A board certified pain specialist can perform a proper history and physical exam, customize and enhance your pain medication regimen, and order and review X-rays and advanced imaging (CT and MRI) to help accurately diagnose your pain and use precise interventional therapy to directly target the pain source. There are an assortment of interventional tools including; epidural steroid injections which can help treat pain stemming from disc herniations or spinal stenosis. Nerve blocks to help diagnose and treat spine or extremity pain. Radiofrequency ablation of the small nerves that send pain signals from arthritic and degenerative joints in the spine can be targeted to treat spine pain. Image guided joint injections to place steroid, hyaluronic acid, platelet rich plasma into the affected joint. Spinal cord stimulation can be an option for

many patients who suffer from severe neuropathic pain and there are new applications for the therapy that have changed the lives of many patients who have suffered from chronic pain. Peripheral nerve stimulation is a newer therapy now being used to treat an assortment of pain conditions including knee and shoulder pain as well as a variety of neuropathic pain conditions. One of the major benefits of spinal cord stimulation and peripheral nerve stimulation is that the therapy can be trialed first. The trial will help confirm that the procedure will produce desired results. People who suffer from painful fractures of the spine can have a vertebral augmentation performed to stabilize and treat the painful fracture. There are many other interventional options that

your pain specialist can review with you and help identify which options are best suited for your pain condition. If you or someone you know suffers from chronic pain, please reach out to the providers at Pain Management of North Idaho. We are a pain specialist team that wants to work with you and your healthcare team to identify and treat your entire chronic pain condition. We will work with you individually to help you identify your specific pain source and discuss a treatment plan that is tailored for your needs. We offer state of the art interventional options, our own ambulatory surgery center and have a strong working relationship with many providers in the surrounding area to ensure that your chronic pain and the associated ailments are properly treated.

Dr. Thome, a fellowship trained pain management physician, completed his anesthesiology residency and fellowship at the University of Texas Health Science Center, San Antonio and was chief resident during his final year of residency training. He had the opportunity to train under some of the most highly regarded individuals in the field of pain medicine. Dr. Thome takes great pride in his medical understanding, exceptional clinical skills and ability to compassionately connect with patients to provide extraordinary care.

www.TheWiseGuideOnline.com | Wise Guide 25

Shining Light on the Eye by Dr. Brayden Petersen, Eye Clinic of Sandpoint


uring an exam there are many questions I routinely encounter. However, it is natural to hear some more than others. Below you will find two of the most asked questions I receive as your local eye care provider. To better answer these questions we first need to understand one specific anatomy structure of the eye. Inside our eye we have a large clear structure known as the ocular lens. It hides right behind the color part of our eye known as the iris. This lens is comprised of different collagens fibers and cells. With time, these fibers and cells undergo multiple changes that ultimately result in the answer to our questions.

Why do I struggle seeing at night? I find it helps to use analogies when discussing this answer with patients. The analogy I like to use is the headlights of your vehicle, for our purpose a car. As a car sits outside for many years the headlights become opaque and foggy due to the UV exposure changing the plastic. If you have

ever kept a car long enough there comes a point when that opaqueness or fogginess interferes with the lights ability to penetrate the plastic. You then go out and try to scrub and clean the plastic in hopes of making it more clear so the light can pass through the plastic easier. Much like the headlights on a car, the lens inside our eye becomes opaque and foggy with time. In the eye this change in clarity is known as a cataract. When the lens becomes opaque enough it begins to block and scatter the light that enters the eye. When less light is getting to the back of the eye and when light is scattering within the eye, symptoms begin. Two of the more noticeable symptoms include glare and starbursts especially during low light conditions or headlights from oncoming cars. These symptoms are what lead to a struggle seeing at night. So the answer to question one is one of the most common eye conditions in the world, cataracts.

Why I am having a hard time seeing up close? This answer is also found from the lens in

our eye. As we add candles to our birthday cake (specifically around 40-45 of them) we begin to loose the ability to see up close. Luckily the explanation for this is simple. The lens is surrounded by a muscle, when this muscle contracts it changes the shape of the lens allowing us to focus at a specific distance. The closer an object is, the more this muscle has to contract, which in turn makes the lens flex more. The lens undergoes a hardening process as we age that doesn’t allow it to flex as much. This is known as “presbyopia” or the inability to focus up close. This condition happens to everyone as we do not have anything that prevents it yet. Luckily there have been some lenses designed to help with this, known as a bifocal lens or progressive lens. These lenses take the new near prescription and combine it with a distance prescription so we can see at multiple distances. The progressive lens has taken out the lines found in the bifocals and added an intermediate distance. In summary, as we get wiser our lens within our eye begins to change in two ways: clarity and flexibility. Both of these are a natural process. Luckily the two conditions spoken about are easily diagnosed and treatment is readily available for both. Dr. Brayden enjoys talking with his patients about their eyes. He believes in not only discussing the treatment plan but also wants his patient to understand “why” the condition occurs. He also takes pride in giving the most comprehensive exam possible with the most up to date technology available. If you are suffering from either of these or just feel like your vision isn’t quite right, give us a call at 208-263-8501 and let us answer your questions. Dr. Brayden Petersen earned his Doctorate of Optometry from Pacific University College of Optometry. He gained advanced training at the Forest Grove Pediatric Clinic, Salt Lake City Veterans Hospital and Eye Institute of Utah. During this time, he specialized in the treatment of ocular disease, contact lenses and co-management of ocular surgeries.

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Defend Yourself Against Viruses! by Brooke Heather, Naturopath, Heather Holistics


he foundation to sustainable health is always about balance, whether it be gut flora being in check or maintaining emotional balance. Be true to yourself, listen to your body’s cues for rest and take your well-being seriously. This does not mean you need to have fear. Taking matters seriously is not having fear but rather, being proactive. It is not the pathogen (virus, bacteria or parasite), it is the terrain. In my upcoming book, I talk about the bioterrain and how to gain and maintain balance. When it comes to bolstering the immune system, the first line of defense is our mucous membranes and the skin (obviously as a protective layer). Beyond that it is the gastrointestinal system that is responsible for killing pathogens we ingest. Making sure we have adequate hydrochloric acid, or stomach acid, and pancreatic function is where it begins. On down the line in the intestines, the gut Microbiome determines the vast majority of our state of health. Before I outline the most effective protocol in healing or improving the gut, over-riding harmful pathogens and improving immunity, I will point out that the mucous membranes comprise of epithelial tissue. Mucous membranes immediately remind us of the sinuses, but they also include the mouth, trachea and lungs and technically, epithelial tissue lines the gastrointestinal (GI) system all the way down the line to the bladder and urethra. When you improve the epithelial tissue, you improve the immune system. I am sure you are wondering how to most effectively improve the immune system in such a way that repairs the GI.

supervision by a qualified professional. Call me to get set up to order from the pro line Standard Process and MediHerb. A German study found licorice to be the most effective for inhibiting viruses. These above three products are a good start for a healthy immune system. If you are looking specifically for more immune support, Congaplex is my whole-food go to supplement. Enveloped viruses, such as the Coronavirus, or COVID-19, have a protective protein coating that contains spiked glycoproteins on its surface that dock themselves onto lung cells. Hospitals in China (FOCUS magazine (Germany) Feb 29 2020, issue 10 page 7) found that by using enzymes against Coronavirus the protein coat dissolves which then disables the virus. Therefore, a specific enzyme formulation taken therapeutically literally dissolves the Coronavirus - that is what enzymes do (dissolve proteins)! Enzyme therapy has been used medicinally in Germany for injuries, inflammation and the elimination of pathogens and cancer since the early 1990s. I implore everyone, especially the sick or susceptible to utilize affordable Telecare for holistic advice. This is a fast, efficient, personalized telephone-based healthcare option. Programs can be customized to fit everyone’s needs and budget.

Visit my VirtualHealthcarePortal.com for low cost, highly effective, quality care on demand. Choose phone, Skype, email or text support — and visit my website: NaturopathicClinic.info or call 208-231-7149. Let’s get you on the path to health!

The Protocol - Guard yourself against the Coronavirus: Spore probiotics, also referred to as seed probiotics, work differently from your typical probiotic supplements of which 90% may be killed by the stomach acid. Spore probiotics heal the gut in 30 days. An important aspect of digestion is to have enough stomach acid (hydrochloric acid). This acidity is what kills pathogens. Supplementation with every meal is recommended especially when traveling or eating out. There are a lot of enzyme supplements out there and I can help you pick the most effective one based on your needs. A combination herbal product, which I have found effective in eradicating viruses, containing, licorice and St. John’s Wort however, both herbs are not for everyone for various reasons. Herbal medicine is potent and effective but is to be used under Naturopath Brooke Heather has operated her private practice for over 12 years. Heather Holistics Naturopathic Clinic has two locations, in Sandpoint and Spokane. Metabolic regulation is the key in one’s ability to manage stress and live healthfully. Brooke uses neurofeedback and biofeedback to therapeutically help create this metabolic regulation. Many of her tools for healing Brooke expands upon within her book on both physical health and psychospiritual-socio-emotional wellbeing. www.TheWiseGuideOnline.com | Wise Guide 27

Protecting Youth from Multiple Health Risks by Carrie McKinley, Program Manager, Pend Oreille County Counseling Services, Community Prevention and Wellness Initiative


esearch indicates that most U.S. youth experience multiple co-existing health risks and problems, like physical inactivity, unhealthy eating, lack of sleep, uncontrolled stress and substance use. To address these concerns a national program has been developed (SPORT PPW) that provides a whole-body experience where youth focus on improvements in their lives instead of drugs or other substances…a light bulb goes on when they connect their future self with the lifestyle they want to obtain of being happy and healthy.

What is SPORT PPW? SPORT Prevention Plus Wellness (PPW) is a single-session evidence-based program that prevents substance use and promotes physical activity, sports, healthy eating, sleep and stress control among youth. The program is specifically designed to address these risks in a single program and setting, to cost-effectively improve the “whole health” of youth. Youth are screened to determine their current health habits, provides feedback and positive image messages, and helps them set multiple health behavior goals. SPORT PPW cues naturally motivating peer and desired future images of youth engaged in wellness behaviors and links substance use as harming personal goals to achieve positive behaviors and identity. Youth learn to set and monitor goals to avoid substance use and increase protective wellness behaviors and improve self-regulation skills. SPORT PPW comes with optional parent materials and web-resources to extend and enhance program outcomes. This program is offered ONLINE and FREE of charge to all 12–17 year olds in Pend Oreille County (internet required). Please contact us today to sign up!

SPORT PPW prevents/reduces: • Alcohol use • Cigarette smoking • Marijuana use • Substance abuse problems

SPORT PPW promotes: • Sports & physical activities • Healthy eating • Getting adequate sleep • Controlling stress • Setting multiple health goals • Positive self-identity

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Programs & Training

 PORT PPW Programs in high school, middle school and elementary S school versions include a manual with scripts to provide an individual or group lesson, digital downloads with slides and reproducible materials, optional parent materials and web-resources, and built-in pre-post program surveys.  nline and Onsite Training Workshops allow professionals and O youth leaders to quickly learn how to implement the program.  ther PPW Programs include InShape PPW (young adults), SPORT 2 O PPW (6- lessons), Vaping PPW and Marijuana PPW. SPORT Prevention Plus Wellness (PPW) Pend Oreille County Counseling Services, Community Prevention and Wellness Initiative, Carrie McKinley, Program Manager, cmckinley@pendoreille.org 509-447-6419. Sponsored by the Washington State Health Care Authority.

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Inflammation? Class IV Laser to the Rescue! by Dr. Daniel Moore, Moore Chiropractic


he body’s response to tissue damage, whether it be from bacteria, trauma, toxins or other is to rush blood, in particular white cells, to an injury. Without this “acute inflammatory response,” the damaged tissues cannot heal. Problems develop when an injury doesn’t heal properly leading to chronic inflammation, which in turn can lead to some very serious life threatening diseases. Research suggests chronic inflammation may be implicated in diabetes, Alzheimer’s, rheumatoid arthritis, atherosclerosis, and muscle loss that occurs with aging to name a few. Therefore, inflammation needs to be managed, not just ignored. Damage to nerves outside the brain and spinal cord are termed “peripheral neuropathy.” These can occur from nutritional deficiencies, chemical exposure, pressure on the nerves, injuries and medications such as those used in chemotherapy or to treat AIDS, and even diabetes-related as a result of chronic nerve damage from blood sugar imbalance.

I was taking Ibuprofen 3-4 times a day for my chronic back issue. I came and tried the laser therapy. By the next day, I was feeling 90% better. L. Hernandez

Nerve cells that are damaged, may leak chemicals into the body, as well as drawing fluids into those damaged cells, causing swelling and pain. While many therapies may be used to address some specific conditions, Class IV Deep Tissue Laser penetrates deep into the tissues and actually reduces inflammation at the cellular level accelerating the healing process for many suffering from nerve damage, resulting in both acute and chronic pain. Long-term damage to the joints can cause fibrous tissue to form around joints, and bones may fuse together, causing deformity and loss of mobility. Through the photochemical reactions produced by laser therapy, arthritis symptoms often improve. In one example, patients with rheumatoid arthritis who were treated with laser therapy had a 70% reduction in pain compared to the placebo group. There was also a significant improvement in morning stiffness and hand flexibility.

I had surgery and a skin graft on my hand. After laser therapy, blood is going through my thumb and fingers, I was able to move my hand! Laser is a warm, comforting no pain treatment and it works! R. Moeller

How Does it Work? The Class IV laser is a non-invasive use of laser energy that generates a photochemical response in damaged tissue, which stimulates healing on a cellular level. This form of therapy helps your body use its own natural healing power by activating a positive cellular response, increasing microcirculation 30 Wise Guide | 2020 Edition

Tip of Laser – Cell Penetration

to reduce inflammation. Laser therapy can alleviate pain and accelerate recovery from a wide variety of acute and chronic issues such as arthritis, tendonitis, neuropathy and plantar fasciitis. Knee, hip, neck and back pain have also been shown to respond extremely well to treatment with laser therapy. Class IV lasers provide a deeper depth of tissue penetration unachievable with lower wattage lasers and are unrivaled by Class I, II, and III lasers. This is due to their ability to treat both superficial and deep tissue conditions. The LightForce Class IV Laser was developed by leading laser scientists and engineers and we are proud to offer one of the very few Class IV LightForce Lasers in North Idaho. People often ask, “Does it hurt?” No! All you will feel is a soothing warming sensation. And, they sometimes assume that a chiropractic adjustment is part of the treatment - and that is not the case in many instances. When warranted and desired, an adjustment may be offered, depending entirely on the symptoms. Many times, the laser treatment is all that is needed.

Prior to coming to Dr. Moore, my doctor recommended surgery for my herniated L4 and L3,L5 discs that were bulging.The pain was so bad,I didn’t care if I lived or died. After the first laser treatment, the pain decreased and I am back to my normal routine. L. Fox Class IV laser therapy allows my patients to return to the activities they love while maintaining their healthy lifestyle. Recovery from injuries is much faster, often avoiding surgery altogether, not to mention the time associated with post-op healing. One of the greatest benefits I’ve found is that Class IV laser therapy allows the body to heal without the use of prescription drugs. We have already seen many of our patients benefit from this treatment with as few as two treatments. We are so confident that this exciting new treatment can help you that your first treatment is free. Contact our office at (208) 267-2506 to schedule your complimentary first treatment and start your road to a pain-free life today. Visit danmooredc.com to see a short video on how the Class IV Laser works. Daniel L. Moore D.C. has been in private practice for more than 30 years. His career began in Los Angeles, California in 1984. While working with Olympic athletes under Dr. John Thie, he mastered cuttingedge techniques like kinetic taping and Kinesiology. Dr. Moore’s advanced rehabilitation and athletic training has served Bonners Ferry and surrounding communities in North Idaho and Western Montana for over 20 years. He has continually led his field in the application of ground-breaking technologies including the LightForce Class IV Laser used in the treatment of nerve-related pain. www.TheWiseGuideOnline.com | Wise Guide 31


The Missing Link to an Effective Behavioral Health Outcome by Joshua A. Wallace, Executive Director, Peer Spokane


eeling isolated and degraded in an environment where you don’t feel it’s safe to talk about what’s going on with you? Honest sharing in a non-judgmental setting will help you move past what is holding you back in life. Peers, those who have been down the path you’re on, truly understand what you are experiencing. They provide a community of understanding that can be enormously helpful in healing and navigating a future. Peer support services reduce the utilization of costly professional behavioral health (which represents mental health and/or addiction) services because peer support prevents isolation, builds a community based on shared experience, addresses the gaps left by professional services, reduces the incidence of relapse, and encourages people to focus on progress and healing. Traditional counseling services apply advanced learning as a therapeutic tool for healing. From this perspective, it is not necessary or relevant in the application of professional behavioral health services to have had similar experiences in order to apply learned knowledge as a means of service. In the clinical setting, behavioral health conditions are treated as a onesided struggle on the part of the client, which creates barriers to progress in healing by isolating the individual’s ability to evaluate their success with others like them. The only issue at hand is the client’s issue. It is the focus of the

conversation visit after visit leaving the only option for assessing progress as the client’s individual achievement from one visit to the next. This singular focus on progress eliminates the opportunity for clients to hear what has worked for others in their situation. This limits the client’s ability to see how their progress looks in comparison with others like them and leaves no opportunity for reinforcement of their personal accomplishments. Formal group settings, led by a professional behavioral health provider, often reveal social stigmas and can be very limiting to clients who need a community of support. Behavioral health diagnoses accompany an inherent negative impli­ cation. Judgment, whether real or perceived, does not lend itself to a feeling of safety when sharing about significant life struggles. The need to relive through explanation and justification why those emotions exist serves to focus repeatedly on the cause or diagnosis leaving the client to feel misunderstood and alone. Peer support fills the gaps in support of daily living that traditional professional behavioral health services do not address. For those who are transitioning from an inpatient care community to outpatient care can be a daunting task. The upheaval in daily routine, location, and dependence on services often leads to a breakdown in the client’s coping abilities. This transition typically involves relocating to a new home, a change of behavioral health providers, reliance on self-care, and the stresses of rejoining society

in general. Peer support providers begin work with these clients during the inpatient stay and remain a constant during the transitional phase to living in the general community. The involvement of a peer supporter through these many aspects of change and their effect on the client would be cost prohibitive and outside the scope of service for a professional behavioral health provider. A peer supporter can begin that process with the client before inpatient discharge and, through shared experience and daily encouragement, remain a support to the client throughout the transition until housing, support, routine and outpatient services could become a regular and comfortable part of the client’s routine. The more successful the process of transition is for the client, the less likely they will require an additional inpatient stay and serves to advance the progress of the client’s rehabilitation. The relationship of support between the client and the peer supporter is mutually beneficial, establishing a strong opportunity for perpetuating this type of peer support by transitioning clients to the role of peer supporter. After transitioning into the role of peer supporter, the client can reexamine their own success and receive validation through those they work to support. Essentially, the relationship between the client and the peer supporter become mutually beneficial in terms of continued progress and healing. The potential for transition of roles from clients to peer supporters perpetuates the ongoing role of support and personal healing and empowers individuals to utilize their experience or diagnosis to benefit others who are dealing with the same issues. No matter where you find yourself in your struggle to regain your confidence in recovery, we at Peer Spokane are here for you. Please reach out! We’ve been there and know how hard it can be to want help, and then to take that step to seek it. And, if you think you’d like to help others by becoming a peer supporter, we welcome you.

For more information on services or how to get involved, check us out at: Peer Spokane 425 W 1st Ave., Spokane, WA 99201 509-867-3778 / julie@peerspokane.org / Peerspokane.org Joshua Wallace identifies as a person thriving in long-term recovery from mental health and addiction challenges. He is a cofounder of the Washington Recovery Alliance and Washington Peer Advancement Coalition and currently serves as the co-chair of the Washington Behavioral Health Advisory Council. In his spare time, Joshua provides peer services consulting internationally on program development, evaluation, and training. 32 Wise Guide | 2020 Edition

www.TheWiseGuideOnline.com | Wise Guide 33

Medicare A Can Be Like a Jungle

by Carey Spears, RHU, Spears Insurance, Inc.

year ago or more I said the year 2020 would be a year of change. I knew of the anticipated changes to Medicare but like everyone else, I didn’t expect a worldwide pandemic to close almost every non-essential business down and make us question our health and uncertain about our future. Like most, I have been self-isolating, doing the usual time off things like spring cleaning, reorganizing the house, and sitting here with a cup of coffee deciding what to do next. Faced with so many people not able to work because we have to slow a virus from spreading, we have come to realize we have taken much in life for granted. The ability to come and go when we choose, the freedom to buy the necessities…like toilet paper! And most of all, everyone has had to seriously evaluate their health and hope that the insurance they have will cover them in a worse case scenario. It’s made me ask, “How prepared will I be when I really do want to retire? Is my insurance adequate in times like these?” Hypothetically, if you were unexpectedly plunked down in the jungle, at 65 year of age, handed a machete and told to find a path through the tangle, wouldn’t you feel overwhelmed? That is how many of us view Medicare and all the options associated with it. We ask, “How do I choose where to start and which way to go after I’m deep in the jungle with little to guide me?” When you are facing an unexpected health issue, you need to have coverage you can count on. It’s as simple as that! I’m a Health Insurance broker, I represent many insurance companies so that you have several options to fit your needs. I can help you consider them in finding your way through the jungle. Options vary when you retire, depending on your age of course. If we assume age 65, you are eligible for Medicare, but you aren’t necessarily eligible for full Social Security benefits. When you are

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eligible for Medicare, you are no longer eligible for the Advanced Premium Tax Credit (APTC). There’s a little planning you will need to do. If you are not going to draw social security benefits yet, then you need to apply for your Medicare online, by phone or in person 3 to 4 months prior to your 65th birthday. Easiest online! If you applied for social security benefits early, such as age 62, Medicare will send you your Medicare Card and statement explaining the cost that you will pay. Sorry, but the myth that Medicare is free, is False! You have worked most of your lifetime to be entitled to Medicare Part A (in-patient hospital coverage). Medicare Part B has a premium, currently for 2020 of $144.60 (unless you have higher incomes above single $87k/married $174K then you will be assessed IRMAA). These 2 Parts A & B are referred to as Original Medicare. Each part has its own deductibles:

Part A hospital inpatient deductible and coinsurance

You pay: • $1,408 deductible for each benefit period • Days 1-60: $0 coinsurance for each benefit period • Days 61-90: $352 coinsurance per day of each benefit period • Days 91 and beyond: $704 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime) • Beyond lifetime reserve days: all costs

Part B deductible and coinsurance

$198. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment (dme)

You will notice that something is missing... Medicare was not designed with the protection of Out of Pocket maximums. With that in mind, there are products that work with your Medicare in the form of Medigap plans, or as they are also referred to, Medicare Supplements (second payer to Medicare). And then also Medicare Advantage Plans. Each has its pro’s and con’s and should be evaluated based on your own sense of risk, health and lifestyle. Other things to consider in your health care benefit package will be Prescription coverage or Part D. And perhaps dental, vision, and hearing. Medicare does not cover these benefits if billed as routine care. I’ve only scratched the surface. There are many things to be aware of in the Medicare World. Trying to weed through the details can seem like fighting your way through a jungle! Luckily, I’ve been navigating this jungle for years. Consider me to be like a free guide through the tangle. It costs you nothing to seek my help and the price you pay for any coverage is the same, but online you don’t get a personal guide who can save you from the unexpected struggles you face now and in the future. I am here to help!

Carey Spears, RHU is a licensed Life/Health insurance agent with over 25 years experience with Senior products such as Medicare Supplements, Part D Prescription plans and Medicare Advantage Plans. With offices in Sandpoint and Coeur d’Alene, she offers ‘no obligation’ consultations for individuals as well as providing group presentations on the Beginners Guide into Medicare! If you are considering a retirement date or turning 65 in the next year, call Carey at 208-265-2026 to learn the right steps in securing your Health Care options.

www.TheWiseGuideOnline.com | Wise Guide 35

Sandpoint’s Health Care Facility


pillar of the community, Life Care Center of Sandpoint is a skilled nursing and rehabilitation center in Sandpoint, Idaho, that offers a healing environment for seniors needing a variety of services, and is well-known for catering to its residents as if they’re family. Along with 24-hour skilled care, the facility provides physical, occupational and speech therapies on an inpatient and outpatient basis. Many residents choose Life Care Center of Sandpoint for their rehabilitation after orthopedic surgery, including knee or hip replacement. A team of in-house therapist and associates from other disciplines meet with each patient to develop an individualized care plan, and associates encourage family involvement and provide education for the patient and his or her family throughout the therapy process. In addition, the in-house physician, Dr. Scott Burgstahler, works with the interdisciplinary staff to provide patients with personal response to medical changes or emergencies in a timely manner. The facility also boasts several private rooms and a therapy gym with the latest rehab equipment and interventions. One of these is Kinesio Taping, which physical therapists often use to provide support and flexibility for the healing of joints. Another piece of therapy equipment used for rehabilitation is the LiteGait®. This gait training device simultaneously controls weight bearing, posture and balance over a treadmill or floor and facilitates the training of coordinated lower extremity movement.

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Also utilized is a mock home suite in which occupational therapists help patients practice the skills they need at home, from preparing meals in the kitchen to brushing their teeth in the bathroom, making the bed to doing laundry. Speech therapists provide specialty services as well, using VitalStim® therapy to help retrain the muscles used in swallowing. This is especially helpful for patients with a neurological diagnosis such as stroke. Other services at the facility include respite care, complex wound care, restorative nursing, nutritional management, pain management, IV therapy, cardiac care and podiatry services. Designed to make residents feel at home during their stay, amenities include a beauty and barber salon, landscaped courtyards, a library, a private dining room for meals with family and friends, an ice cream parlor, cable TV, free Wi-Fi, a varied activity program and a wheelchair-accessible bus. Regular activities consist of monthly birthday celebrations, bingo and specially planned outings. Life Care Center of Sandpoint opened in 1997 and is owned by Life Care Centers of America, a nationwide health care company. Headquartered in Tennessee, Life Care, along with sister company Century Park, operates or manages more that 260 skilled nursing, rehabilitation, Alzheimer’s and senior living campuses in 28 states. For more information about Life Care Center of Sandpoint, please call 208-265-9299, or visit LifeCareCenterofSandpoint.com


Experience quality living with our premier continuum-of-care services. No matter where you are in life, we are here to meet your needs.

1125 N. Division Street LifeCareCenterOfSandpoint.com


1123 North Division Street TheBridgeAtSandpoint.com



www.TheWiseGuideOnline.com | Wise Guide 37

Virtual Estate Planning in the Time of COVID-19 by Ryan J. Crandall, J.D., Crandall Law Group


s the coronavirus fills our news channels and social media feeds, and as governments, hospitals, and municipalities grapple with how to address the growing crisis, it has become increasingly clear that, for the immediate future, our customary ways of life have been dramatically altered. One significant change is that we are experiencing less social interaction and we’re making fewer trips outside of our homes or offices. Many of us may find ourselves in a situation where we or our loved ones are required to quarantine or self-isolate. The significant impact of COVID-19 has undoubtedly left many of us wondering, “What could happen to me, and how could this affect my family and loved ones?” “What if I become seriously ill, or worse?” The stark reality is that it appears many of us will be personally impacted by the coronavirus. It is now more important than ever that each of us has an up-to-date estate plan and that we all have our affairs in order.

Everyone should have an estate plan, especially now Whether you are young or old, married or single, high health risk or low risk, you should have an estate plan. This has long been true, even before the rise of COVID-19. But it’s especially true now. A properly constructed estate plan should be centered around a will or trust that identifies your heirs and facilitates an easy administration of your estate. It is an immense benefit to those you leave behind to have memorialized these important decisions and to have created a mechanism for your wishes to be carried out without great expense or conflict. Equally important are the elements of an estate plan that deal with your potential incapacity. If you end up in the hospital 38 Wise Guide | 2020 Edition

or quarantined, you may not have the ability to manage your affairs, which is why it is critical to have prepared financial and medical powers of attorney in advance. A power of attorney goes into effect if you become incapacitated and allows a trusted individual to make decisions for you and act on your behalf.

Virtual estate planning services As many businesses close their doors and communities go on lockdown, you may wonder how you can go about getting these important documents in place. Fortunately, technological advances and videoconferencing have made it possible to meet with an estate planning attorney face-to-face using your computer or smart phone. Quite fortuitously, the State of Idaho passed a law in January of this year authorizing the use of virtual notary services via videoconferencing, meaning you can have your documents witnessed and notarized without ever having to step out of your living room. At Crandall Law Group, we are pleased to now be offering our boutique estate planning services virtually to all clients. So, give yourself some peace of mind in these troubling times by putting your estate plan in order. You can get started today by contacting us to schedule your complimentary (virtual) consultation.

Ryan Crandall is an attorney and estate planner with a passion for helping individuals and families prepare for the future. Ryan believes that one of a lawyer’s primary roles is to be an educator and counselor. At Crandall Law Group, he works hard to discover his clients’ goals and explain, in easy to understand terms, the strategies that can be used to accomplish their objectives.


Get personalized information from an experienced estate planning attorney from the comfort of your own home.


ACTIVATE YOUR BODY’S NATURAL HEALING POWER Can Regenerative Therapy Help Me? Regenerative medicine helps to create new cells in existing healthy tissues, and repair tissues in areas that are injured or damaged. The cells naturally work to reduce inflammation, prevent cell death, prevent infection, and generate new blood vessels and tissue. Regenerative therapy has successfully treated a wide range of orthopedic conditions, including soft tissue injuries involving tendons and ligaments, as well as arthritis. At Axis Spine Center, we use regenerative medicine to treat pain in tendons, ligaments, joints, the neck, the back, and so much more!

Why Regenerative Therapy? Regenerative therapy can be an effective and less invasive alternative to surgery. Regenerative therapies activate your body’s natural healing power, using your own cells to grow new tissue. Benefits of this type of therapy include increased healing potential, decreased

pain, increased function, faster recovery time, and less time away from sports or daily activities.

What are Stem Cells? Stem cells are early-stage cells that have the potential to develop into other specialized types of cells. They are found all around the body in various tissues and organs. At Axis Spine Center, we utilize stem cells from bone marrow typically harvested from the iliac crest (the hip bone). Effective stem cell treatments are only possible using your own stem cells. Stem cells from other (donor) sources will be treated by your body as a foreign substance and will be rejected and eliminated.

Why Bone Marrow? Stem cells harvested from bone marrow are specifically prepared to regenerate soft tissue. They are ready to be used in a patient after a short process involving minimal manipulation of the cells. Our physicians concentrate the harvested stem cells by separating them from blood-clotting agents and other cells in

an FDA-approved device. Bone marrow also contains growth factors and proteins that optimize the environment for stem cells. Other sources of stem cells include adipose, or fat. These cells do not meet the FDA guidelines involving minimal manipulation and, therefore, are not used at Axis Spine Center.

What is PRP? PRP stands for Platelet-Rich Plasma. Plasma that is rich in platelets contains growth factors, anti-inflammatories, and proteins that attract stem cells to a specific location. This promotes healing, reduces inflammation, and helps regain function. PRP injections are different from stem cell injections in that PRP injections attract stem cells present in the body to the injection site, while stem cell injections deposit stem cells directly to the injection site.

What Will My Experience Be? From the initial consultation, to the end of your treatment, you will be guided by board certified, fellowship-trained physicians and their teams. Throughout the procedure, our team will keep you updated on your progress and listen to your feedback, ensuring the highest quality of care. You are the highest priority here at Axis Spine Center.

When Will I Feel Relief? Concentrated stem cells and PRP need time to address the factors that are causing the pain, and then stimulate the body to respond. Improvement is gradual and can take up to 6 months to reach full effect. Because each patient is different, and each treatment area produces different results, these results may vary. 40 Wise Guide | 2020 Edition

208.457.4208 regenerative@axisspinecenter.com www.axisspinecenter.com 7600 N. Mineral Dr. Suite 450 Coeur d’Alene, ID 83815


Axis Spine Center Offers 2 Regenerative Therapy Treatments: • Stem Cell Injections • PRP Injections

“I’m back to lifting and playing racquetball, and golf, and all the things that I love... I would absolutely do it over again... I would recommend Axis Spine...“ – Patient, Dr. Erin Elliot Post Falls, Idaho


Our Physicians Our board certified, fellowship-trained physicians are recognized experts in the field of regenerative medicine and educate other physicians nationally on these treatments. They are dedicated to providing you with the best possible experience, while staying within the FDA’s guidelines of medicine to ensure the highest quality of care.




pring carries the promise of sweet-smelling blooms, pops of vibrant color and the warmth of new beginnings. But for many, that promise is a hazy dream. Runny noses, watery eyes and aching heads become the reality as seasonal allergies rain down on your fun like a sneeze on a good meal. Luckily, there’s hope for seasonal allergy sufferers. It’s possible to alleviate or even eliminate your allergy symptoms this year without inconvenient doctor visits or costly medications. Below are four simple and natural ways you can overcome your allergies to feel your best this spring.

PUT OUT THE POLLEN When pollen counts are high, stay indoors with the windows shut. The milder weather may tempt you to let in the pleasant breeze, but doing so might fill your house with more sneezeinducing, comfort-crushing pollen grains. Change your HVAC filter often, and consider using HEPA filter air purifiers to trap any pollen that does make it inside. You can monitor your area’s pollen count by visiting www.aaaai.org or by downloading the smartphone app for regular alerts.

WASH IT AWAY Pollen can be a sneaky, savvy and tricky pest. It travels great distances unseen and affixes to parts of you—your hair, your clothes and your nose. So shutting out the wind may not be enough to bar pollen from your living space. After spending time outdoors, be sure to wash yourself and your clothes thoroughly. Remember that your dog or cat could be the most pollenated thing in your house. Keep them wiped down or rinsed off so that snuggling won’t lead to sneezing.

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WATER—DRINK MORE, BREATHE MORE During pollen high tide, water can be your best weapon. Drinking more water can keep your mucus thin and your nasal passages clear. Breathing water in the form of steam can also diffuse mucus, which will cause it to drain, carrying away any allergens or pathogens you might have inhaled. A hot cup of tea is a great way to get hydration and steam all at once! And for a nose that’s already compromised, a nasal rinse kit or neti pot can do the trick. Just be sure to follow the product’s directions.

TRY NATURAL MEDICINAL TREATMENTS Over-the-counter or prescription antihistamines are the go-to for many who are suffering from allergies, but research has shown that natural alternatives can be just as effective. Butterbur extract that is UPA-free and the plant Phleum Pretense, or Timothy Grass, are two natural alternatives to traditional antihistamines that may help reduce or dispel seasonal allergy symptoms. Research the possible side effects of these treatments, and always consult your doctor before starting a new herbal or medicinal regimen. Along with the above tips, it’s important to maintain a nutritious diet and an active lifestyle for a balanced immune system. Always remain in communication with your care providers while trying new home remedies or alternative treatments. Traditional antihistamines may still be necessary for managing your persistent moderate-to-severe allergy symptoms. The spring season is all about growth and change. Don’t let seasonal allergies shackle your comfort and well-being for yet another year. This is your time to take control of your body and drink in all the beautiful sensations of the season! With healthy seniors in mind, this is an article sponsored by Life Care Center of Coeur d’Alene.

What’s Holding You Back? by Royal Life Centers


elf-destruction is fueled by fear. Whether it is fear of things not working out, fear of failing, or even fear of things working out. It seems insane to think that you may be holding yourself back from succeeding, but this occurrence is much more common than anyone is willing to admit. Our subconscious mind is active without our conscious mind making those connections. What’s holding you back from being the best version of yourself? You. Feelings of shame, embarrassment, and pride are strong deterrents when it comes to admitting you need help. The very help you can receive is blocked by your own fear in asking for that help. The scenarios you draw up in your mind to justify your own compliance in self-destruction are far more detrimental than the moments of emotion that arise before you take action. Choosing your next right move will bring a wave of relief and self-esteem to an otherwise lost individual. Where do you start? Just take the next small task as it comes and decide to do the right thing for your well-being. Self-destruction is no stranger to those suffering with a substance use disorder. Those who choose to use substances are on a perpetual mission to escape their reality. This “solution” blankets all emotions and keeps you in a state of numbness— removing the happy emotions along with the uncomfortable. Your reality becomes empty; your life begins to revolve around feeling okay. On this mission, you choose to ignore the real solution: you won’t want or need to escape your reality, if your reality is enjoyable. At Royal Life Centers, we are here if you need help. We exist solely to help you and are completely focused on your happiness. We work

with you to help you re-build a healthy, happy, and meaningful life in sobriety. Our programs run on a holistic model, meaning we attend to all aspects of who you are— mind, body, and spirit, so that we can provide a transformative healing experience. Our hopes for you are to start living a life that you want to participate in fully, a life where you feel in control, motivated, successful, and above all: happy. Our comprehensive treatment fuses together intensive therapies along with unparalleled services to get you back on track. We help you with anything from handling legal issues to medication management, obtaining your GED, resume building & interview skills, job placement, and finding a program of recovery that works for you. Our licensed and highly trained staff members are here to guide you through the recovery process and set you up for success. The individualized treatment we provide is completely customizable; we tailor treatment to fit your needs, goals, interests, and circumstances. Because We Care, our number one goal at Royal Life Centers is to help you find a purpose driven life, free from self-destruction.

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BECAUSE WE CARE. www.TheWiseGuideOnline.com | Wise Guide 43

Occupational Therapy: Bringing you Independence by Katherine Campbell, MS, OTR/L, Newport Hospital


hat is occupational therapy? What can you do for me that other therapies can’t? These are two important questions I am asked on a weekly basis as an occupational therapist in rural health care. Let’s explore that first question, “What is occupational therapy?” One of the main goals of occupational therapy is to help patients become more independent in their daily life through occupations, which primarily involve activities of daily living (ADLs) such as dressing, functional mobility, personal hygiene, bathing, or toileting.

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Occupational therapists can also help develop skills necessary for work, and/or leisure, which may have been compromised from an injury, disability, or diagnosis. Having these skills compromised can change the way a person performs them, putting their overall independence at risk, and even putting their job at risk if left untreated. For example, occupational therapy helped one of my patients who suffered from a common condition for over 10 years. This person opted to try a conservative method first rather than having surgery. The patient’s biggest concern was being unable to get their life back due to pain, limited sensation, weakness and lost fine motor dexterity. A formal evaluation was conducted. The results indicated deficits with dressing, health, wellbeing, leisure, work activities and overall mental health. These deficits stemmed from the symptoms of their condition. It was clear that this patient would benefit from occupational therapy services for several reasons. Limited sensation and increased pain prevented this person from performing everyday tasks at home such as being able to dress efficiently and effectively. Their mental health was compromised as these symptoms prevented them from being truly independent, having to ask for help and relying on others daily for simple tasks. This patient also suffered from fatigue and restlessness because they had to work harder to accomplish tasks for work and home. Ultimately, with occupational therapy support, using activities that were meaningful and purposeful to the patient, they were able to improve their skills and feel good about life again. They were able to increase their independence, decrease their dependency on others for daily tasks and returned to work. They were more confident in their skills, and were able to enjoy activities once viewed as difficult and/or unpleasant. It is important for me as an occupational therapist to see the whole person; their emotional, spiritual, mental, and physical health. I seek to determine what is limiting their ability to complete ADLs, as well as instrumental activities of daily living (IADLs), which include taking care of other people, health management, home management, rest/sleep, work activities, leisure, education, and social participation activities. I am not only focused on a patient’s physical limitations that impact

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their day-to-day routine; there is always more to what is going on than the physical aspect. This well rounded, client-centered approach assists in developing the perfect plan of care that will meet each patient’s goals, and provide them with the most successful outcomes. Now, I would like to address the second question, “What can you do for me that other therapies can’t?” I can help patients develop and improve the skills discussed, along with boosting self-confidence so they can live a more independent, joyful life. This may be through the use of adaptive equipment (reacher, sock aid, shoe horn, long handled sponge, etc.) for those who are post-stroke, have increased back pain, limited movement, a total hip arthroplasty, or other limiting conditions. I can assist them by decreasing symptoms of pain, swelling, stiffness and/ or balance concerns impacting their daily lives. This will enable them to be independent and thrive in their community. I can also assist in providing new strategies that will help them in completing difficult activities. Working with patients as a team approach to meeting their personal and therapeutic goals is important and will produce the greatest results. As an occupational therapist working in rural health care I am here for patients who may not have had the opportunity to access these services. I understand that life can be different after an injury, disability, and/or diagnosis and that it can impact a majority of one’s life. I am here to help patients, to the best of my ability, get some of that life back through occupational therapy. Katherine Campbell completed her undergraduate degree in Therapeutic Recreation at Eastern Washington University in Cheney, Washington. She graduated Summa cum laude in 2016. Katherine went on to pursue her Master’s degree in Occupational Therapy at the University of Mary in Bismarck, North Dakota, graduating in 2018. She completed her fieldwork throughout the Midwest and Eastern Washington. Currently, Katherine works in acute care and outpatient therapy at Newport Hospital and Health Services in Newport, Washington serving her local community since March of 2019.

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It Helps to Have SMART Goals by Becca Teeters, WISe Youth Peer Partner Pend Oreille County Counseling Services


o, what is depression? Is it the sadness and loss when a family pet dies, or feeling like one is spinning out of control after a break up …or maybe it’s that physical pain and heaviness in the chest and head that makes it hard to move or even just breathe, whenever I think no one really cares about me. These feelings are a normal part of life but when it is long lasting and starts affecting the ability to function in important areas of life, such as school or work, then it may actually be a Major Depressive disorder. Major Depression is a medical condition representing a more intensive and long lasting effect on mood. Symptoms often range from changes in appetite/weight, sleep, energy, feelings of irritability or anger, to feelings of hopelessness, even suicidal thoughts. Depression can happen to anyone. You could be the 4.0 student, captain of the football team and everything is going great and Depression may still touch your life.

As a parent, it can be scary to hear your child has been diagnosed with depression, you might think that it is your fault. As a youth you might start to think, what is wrong with me? Will I ever be “normal” again? Are my friends going to still like me? How much is this going to change me? These questions and feelings are normal. Just know a diagnosis primarily serves to inform of a medical condition and advise as to treatment decision. Always remember, the diagnosis is not the person.

Photo by Bailey Martin

Depression is treatable and something one can overcome and recover from. One of the treatment options is counseling with the use of peer support services. A Peer Specialist is a person who has received mental health services and is in recovery. They provide support from the perspective of a “peer” with helping a youth in their recovery. I am a Youth Peer Support Specialist. My difficult experiences as a youth have given me a unique opportunity to both better understand and connect with youth who may be experiencing depression. As Peer Specialist, I can help youth in working their own recovery journey. For example, I support youth in making SMART goals. A SMART goal breaks up a big goal into smaller goals. I found that doing this makes achieving that bigger goal less daunting, especially for someone who is feeling hopeless. I also look for what is “alive” for the youth. I believe this to be the most helpful technique. If playing music is what is “alive” in the youth, then that can be a big part to their recovery. And too, I advocate for the youth to make sure their voice is being heard regarding treatment decisions about their care. From my own personal experiences as a teenager, as well as what I have learned working with youth — the best thing someone can do is just listen. A youth might be experiencing hopelessness and cannot see how things could possibly get better. Let them know they are not being judged and that they are heard and not alone. If you or someone you know is considering suicide, get help from a crisis responder or a suicide prevention hotline. National Suicide Prevention Lifeline at 800-273-8255 or text “Heal” to the Crisis Text Line at 741741 46 Wise Guide | 2020 Edition

What Does a Home Health Medical Social Worker Do? by Melissa Owens, Licensed Master Social Worker North Idaho Home Health


n a nutshell, I provide individuals and families with psychosocial support when faced with illness, but it’s far more involved than that. A doctor orders social work services for a variety of reasons including addressing needs such as access to community resources, assistance with advance directives, need for counseling, need for caregiver support and long term care planning. Each patient has a unique and different experience. Some patients need help with making phone calls or completing necessary paperwork. Other patients have unpaid family caregivers, often times their children or significant others, who need support and assistance with making important life decisions. Many patients need access to appropriate level of care in order to maintain their independence. As a Licensed Master Social Worker, I am able to provide an array of services for home health patients. A visit from a social worker can fill many needs. I am blessed to be a shoulder to cry on, a conduit of information to allow someone to remain in their own home, an advocate, a mediator between family members and a clinician providing evidenced based strategies to assist patients and their families to cope with feelings of loss and grief. Short term counseling has become a great need within the home, especially in times of community hardship where access to immediate services is limited. Some patients are just “thirsty for conversation” and they appreciate a smiling face. While other members of the home health team such as nurses and physical therapists focus on the individual patient, social workers are able to work with the whole family system. I am able to assist with

resources for grandchildren, assist a wife/husband with accessing VA benefits, provide short term counseling to family members and address many other needs of the patient’s support system. Within the social workers ethical code is self determination, which means whatever the patient feels is a benefit to them is something I can address. From applying for disability, assisting with gathering appropriate documentation for various applications, placement assistance, help with accessing low income housing all the way to finding ways to acquire glasses and even hearing aids. I drop off and pick up applications, I meet with community supports to ensure I have the appropriate information and I provide professional recommendations. I work within many systems to address and advocate for my patient’s needs. One visit can make a difference. Referrals can be made during visits for meals on wheels, caregiver assistance and Medicaid programs. In a world where many feel overwhelmed, I am available to help break things down into simple and easy steps. The best part is, they don’t have to continue through the process alone. They can have a social worker walk alongside them through their difficult times. We all need to feel heard and understood. A social worker helps through providing dignity and respect. Melissa Owens is a Licensed Master Social Worker. She graduated from Boise State University with her Master’s Degree in Social Work in 2013. She has over 6 years experience providing in-home therapeutic interventions for medically home bound individuals with North Idaho Home Health. She has worked with students, homeless population and at risk children in the community. She enjoys dialectical behavior therapy and mindfulness as intervention styles. She loves to hike with her dogs and explore all the great Northwest has to offer.

www.TheWiseGuideOnline.com | Wise Guide 47



by Katherine Monroe Coyle, CELA, Attorney at Law, Coyle & Wytychak Elder Law


s the senior population of North Idaho grows, so too do the options that seniors have in choosing professionals to assist them with all aspects of their lives. Our community is certainly fortunate to have so many options for seniors for all of their needs: financial planning, physicians, long term care facilities, in-home care providers, and attorneys, to mention a few. However, as the choices expand, it can become more difficult to choose the professional that can best serve the needs of the senior. As far as attorneys go, there are different attorneys for different types of law; criminal defense, family law, bankruptcy, personal injury, etc. In the 1980’s and 1990’s, to meet the needs of seniors “Elder Law” grew from estate planning and disability law into its own legal field in order to address the varied and constantly changing legal challenges that senior citizens face. “Elder Law” is defined by the National Elder Law Foundation as the legal practice of counseling and representing older persons and their representatives about the legal aspects of health and long term care planning, public benefits, surrogate decision-making, legal capacity, disposition and administration of estates, and the implementation of these decisions concerning such matters, giving due consideration to applicable tax consequences of the action, or the need for more sophisticated tax expertise. In 1994, the National Elder Law Foundation began certifying attorneys as experts in Elder Law, known as “CELAs.” In order to become a CELA, an applicant must have practiced law

for at least five years. Specifically, the attorney has to have shown “substantial involvement” in Elder Law, proving the amount of time devoted to Elder Law issues, such as health and personal care planning, pre-mortem legal planning, fiduciary representation, legal capacity counseling, public benefits advice, special needs counseling, insurance, residence rights advocacy, housing counseling, employment and retirement advice, counseling with regard to age or disability discrimination, litigation and administrative advocacy, and other senior-related legal areas. Additionally, the applicant must prove that he or she participated in at least forty-five hours of continuing legal education in Elder-Law related courses. The applicant is also subject to a peer review by his or her colleagues, and must provide at least five attorney references. Finally, the applicant sits for a day-long essay examination which is proctored twice per year. The CELA examination is notoriously difficult, with recent pass rates as low as 14 to 33 percent. As of April of 2020, only five attorneys practicing in Idaho are certified as CELAs, including this writer. I was honored to become certified in 2015. In order to maintain my status as a CELA, I continue to show substantial involvement in Elder Law, and must take additional Continuing Education Credits in Elder Law. I am pleased to announce that my associate attorney, Rebecca Eyman, plans to set for the CELA exam this fall. Once she passes, we will be the only firm with two CELAs in Idaho. What does having a Certified Elder Law Attorney mean for you?

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The National Elder Law Foundation states on its website that the CELA certification has frequently been referred to as “the gold standard� for Elder Law and special needs practitioners. This reflects the hard work and proof required before an attorney can proudly proclaim that he or she holds the valued designation. In 2020, there are only about 500 CELAs in the country, so not every community has someone who has been certified. Having a CELA as your attorney for these very complicated issues relating to planning for end of life is your surest method of independently confirming that she (or he) is more than just qualified. After all, you and your family deserve the best legal representation available.

Katherine (Kate) Monroe Coyle is a Certified Elder Law Attorney at Wytychak Elder Law, PLLC. She has been practicing Elder Law in North Idaho since 2008. Kate is a graduate of the University of Montana and Gonzaga University School of Law. She enjoys running, biking, skiing, cooking, reading, and spending time with her dogs Wilbur and Odie.

www.TheWiseGuideOnline.com | Wise Guide 49

The Perfect Medicine by Dr. Kersting, Medical Director Camas Medical Center


hat do you think the perfect medicine is? Here are a few clues: It has been around forever. It is readily available, and there is never a shortage of it, even though it is in amazingly high demand. It has few to no side effects and is incredibly cheap compared to most of today’s costly medications. It processes benefits to almost every body system. Any guesses as to what this medicine is? It’s exercise! Let’s look at some of the ways exercise makes you healthier. Exercise increases levels of endorphins, dopamine, norepinephrine and serotonin. These are the fancy names for chemicals that make you feel better and relax. In fact, exercise has been found to be equally as effective as an antidepressant for depression. Studies have shown that when people exercise, they have more energy, think clearer, have better memory and sleep better. Smokers who begin to exercise find it easier to stop smoking. Increasing evidence supports that exercise is vital to improving and maintaining mental health. Exercise has multiple benefits for your heart. High blood pressure is a major risk factor for heart disease. Exercise acts like medications that lower your blood pressure and slow your heart rate at rest and while exercising. Being overweight places stress on your heart and is a risk factor for both stroke and heart disease. Physical activity is an essential component of weight loss and maintaining a healthy weight. A combination of aerobic exercise (walking, running, swimming and other heartpumping exercise) and strength training (weight lifting, resistance training) is considered the best for heart health. Exercise improves muscles’ ability to draw oxygen from the blood. This process reduces the need for the heart to work harder to pump more blood to your muscles and hence allows your heart to last longer. 50 Wise Guide | 2020 Edition

There are many other medical benefits of exercise. For example, exercise can reduce your risk of osteoporosis by strengthening your bones. Regular exercise can reduce your risk of developing diabetes by over 50% because it allows your muscles to better respond to insulin. Regular exercise reduces inflammation in the body, which reduces many diseases. Studies have shown exercise significantly reduces your risk for many cancers. If you want to support a long, healthy life, you need to actively exercise. How much do we need to exercise to gain all of these wonderful health benefits? The Center for Disease Control and Prevention recommends that all adults get 150 minutes of moderate-intensity physical activity every week. Some sources state that 10,000 steps meets the 150-minute a week requirement. Unfortunately, not even half of American adults achieve that goal. Most national and international health authorities do not have a daily step count requirement, but research has unanimously concluded that the more activity you can do in a day, the better. Studies show that exercise is almost always part of people’s New Year’s resolutions, however, most people have already broken these resolutions by February. Setting goals that you can accomplish and maintain is an important part of sticking to an exercise routine. Exercise should be a permanent part of your lifestyle and not just a fad. Tracking your exercise helps you maintain a routine. This can be as easy as using a paper journal

or using a Fitbit, Apple Watch or an app on your smart phone. Try not to be rigid in your goals. If something stops you from exercising for a few days, it is okay to start back up again with out feeling guilty. When you stand, you burn between 100200 calories an hour. When sitting, you only burn 60-130 calories an hour. Think about how fast that adds up! You could burn between 120-210 more calories just by swapping three hours of sitting for standing. Research shows that by reducing your time spent sitting, you can reduce your chances of cancer, type 2 diabetes, cardiovascular disease, and back pain. There are multiple ways to look at exercise other then working out at a gym, running long distances, or using home exercise equipment. Get your family involved. Play a game of tag, hide-and-goseek, or go on a family walk or bike ride. In the winter, build a snowman or fort or go sledding. Park farther away from your work place or the grocery store to increase your walking distance. Think about walking or biking to work. Use the stairs instead of the elevator. In the summer, plant a garden to keep you active or mow your lawn with a push mower. Get a dog. Studies show that people who own a dog may live longer because their dogs encourage them to go on walks each day. The Camas Center is an incredible fitness center right here in our community. Swimming or playing in the pool is a great form of exercise that is easier on your joints. Shoot baskets in the gym or play a game of pickle ball. The Camas Center has weight lifting and exercise equipment and staff to help teach you how to use it correctly. Join an exercise class if having an exercise partner keeps you motivated. We probably all need to exercise more. We can achieve this goal by finding an exercise program we enjoy and can sustain. Get the whole family involved and demonstrate healthy exercise habits to your children. Children have a higher likelihood of exercising throughout their life if they learn good habits from their parents. Fill your “exercise” prescription now and begin to enjoy all of its health benefits. Come to the Camas Center! Open to the public year ‘round.


Dr. Clayton W. Kersting, M.D., is the Medical Director of the Camas Medical • Routine visits, including • Referral to specialists Center. Dr. Kersting office is a board certified family the physician with over thirty years diagnosis andexperience treatment illnesses of comprehensive medical in of a rural setting. He• Pharmacy/prescription oversees physician assistants• and engages program with medical teams in clinical and for inpatient Suboxone clinicsettings. patients, inclu Dr. Kersting alsoservices instructs medical students and residents, physician assistants, • Lab day delivery and nurse practitioners at various colleges and universities in the region.

• Well child care • Immunizations • Women’s gynecological care

• Minor surgical procedu

Naturopathic Medicine – Treating the Cause, Not Just the Symptoms


ost people don’t know what to think when they hear I’m a “naturopathic doctor.” What is Naturopathic Medicine and how is it different from conventional or “Allopathic” medicine you ask? In essence, a naturopathic physician has quite a large toolkit to draw from. We learn conventional medicine such as pathology, pharmaceuticals, minor surgery, etc. and then we learn, what one may describe as more traditional type medicine, such as counseling, exercise and nutrition therapies, herbal medicine, and much more. My goal is to find and treat the underlying *cause* of your disease or condition, meanwhile teaching you, the patient, how to recognize and prevent any further infirmity. In more than a decade of practice, I’ve seen the benefits of Naturopathic Medicine come to fruition in my patients. From newborn children needing dietary assistance, to seeing thyroid disease reversed, to inspiring hope in cancer victims, the reach of Naturopathic Medicine is nearly limitless. I am not of the mindset that one should avoid all means of allopathic medicine, because it truly has its place in the spectrum of disease management. I simply desire every patient have access and opportunity to meet with a holistic-minded physician who may look at their condition and person in a different light than conventional medicine may. So what are some of these wonderful therapies I’ve been alluding to? As stated earlier, my goal is to uncover the cause of the disease and treat from the ground up. I generally start with lifestyle and nutrition modifications as groundwork for the supplemental therapies that may come after. I tend to work with herbs and nutrients in the form of capsules, teas, or tinctures. Some “non-product” treatments include hydrotherapy (watertherapy), stress management (counseling), and exercise prescriptions. I will typically run some basic labs alongside more specific labs to get a better picture of a patient’s overall health. I talk my patient through the labs to help them understand the connections between different body systems and why they may feel or function a certain way. We then formulate a treatment plan together, based on the patient’s finances and capacity for lifestyle changes. The follow-up is similar, in that we review the changes or additions made in the past visits and check on progress. At

by Dr. Beth McQuinn, Naturopath, Camas Center Clinic

each step of the process, the patient and physician are working as a team allowing the patient to take responsibility for their health and well-being. Interestingly enough, the world of Naturopathic Medicine is continually expanding. There are ongoing studies from prominent universities on the efficacy and safety of many historical remedies and newer nutrient therapies. Yet, there will always be resistance against things that seem new or unknown. The FDA is in the process of rescinding rights for many of the commonly utilized naturopathic therapies included in our dispensary. This puts into perspective the breadth of therapies available to a Naturopathic Physician. Although many incredible resources may be taken from us, we have a wide variety of therapeutic tools still accessible in lieu of those lost. I often encourage my patients to take a stroll through their backyard and recognize the medicine available to them in arm’s reach. Medicine doesn’t need to be fancy, or expensive, but it must be useful and effective and leave the patient feeling well on the other side of it. That is one of my goals as a Naturopathic Physician: to create a holistic environment, beginning with the patient’s story, walking them through explanation of disease process versus wellness and ending with the best scenario of health for that patient. I hope this is what each patient will come to expect from their physician, whomever that may be.

Dr. Beth McQuinn is a Naturopathic Physician at Camas Center Clinic in Cusick, WA. In her leisure time, she enjoys nature in the form of hiking, running, equestrian and family activities with her community friends and family. In 2018 she and her husband purchased Bear Paw Camp, thus they moved from Western WA to Newport. Beth has an adventurous husband and three busy kids who love life right alongside her.

CARE FOR THE WHOLE PATIENT AND THE WHOLE COMMUNITY. Welcome Dr. Kersting, MD NOW ACCEPTING NEW PATIENTS • Routine office visits, including the diagnosis and treatment of illnesses • Suboxone program • Lab services • Well child care • Immunizations • Women’s gynecological care

• Referral to specialists • Pharmacy/prescription assistance for clinic patients, including same day delivery • Minor surgical procedures

APPOINTMENTS: 509.447.7111 CAMASCENTERCLINIC.ORG 1821 N LECLERC RD, STE #1 • CUSICK WA 99119 www.TheWiseGuideOnline.com | Wise Guide 51

The Value of Home Care for America’s Aging Seniors by FirstLight Home Care of Spokane and Coeur d’Alene

52 Wise Guide | 2020 Edition


merica’s population is aging quickly. This year 2020, 56 million Americans will be age 65 and older; by 2050, that number will reach 84 million. At the same time, the number of potential family caregivers is decreasing due to demographic shifts and the increasing geographical distance between seniors and their families. These and other factors mean that more people may need to look beyond their immediate families for care as they get older. More Americans are requiring care than ever before. Statistics show that 40 percent of adults 65 and older currently need assistance with daily living activities. And it’s projected that nearly 70 percent of Americans who reach age 65 will not be able to care for themselves without assistance at some point in their lives. Home care can be a valuable solution to help meet these growing needs by keeping seniors independent, safe and living at home – where nine out of 10 seniors prefer to be.

What is home care?

Understanding your home care options

Non-medical home care can help aging seniors maintain healthy and active lifestyles for as long as possible in the comfort of their own home — wherever home may be. Services emphasize preventive care that supports seniors’ wellbeing. Home care sends trained caregivers into homes to help seniors manage the necessary activities of daily living, such as bathing, dressing and meal preparation. Home care services also provide companionship and support around the home with tasks such as medication reminders, laundry and light housekeeping, errands and transportation. Home care is an essential part of our overall health care continuum because it provides a cost-effective alternative to institutional long-term care and it helps alleviate the strain often put on acute care facilities.

There are a couple of different options to consider when it comes to selecting a home care provider. One option is employer-based home care. These are agencies in which caregivers are direct employees, not contractors. These agencies are licensed and regulated by their states; they provide important employee protections; and they recruit, screen, hire and train their caregivers. Another option is home care registries. Registries serve as a middleman, offering lists of caregivers and referring those caregivers to clients. Registries often utilize caregivers as independent contractors, rather than employees. Additionally, anyone who hires from a registry may be considered the caregiver’s employer, assuming certain responsibilities, risks and liabilities. FirstLight Home Care is a leading provider of non-medical home care, helping individuals achieve the quality of life they deserve. Our professional caregivers provide care at private residences, independent and assisted living communities, and other healthcare facility settings.

What are the benefits of home care? Home care can help in many ways: • It gives seniors a choice to age in the place they call home while maintaining dignity and independence. • It can ensure that seniors maintain healthy routines, avoid accidents and injuries, manage chronic conditions and follow the care plans provided by their doctors. • Because caregivers help seniors maintain healthy lifestyles, this can lead to fewer doctor visits, prevent a trip to the hospital or keep seniors from going into a nursing home, which can all lower overall healthcare costs. • Home care provides peace of mind to family caregivers and can reduce the emotional and physical stress of the person providing care.

This article is provided by Brad Leggat and Matt Zastrow, owners of FirstLight Home Care of Spokane and Coeur d’Alene. For more information, visit www.coeurdalene. FirstLightHomeCare.com or call (208)758-8090.

www.TheWiseGuideOnline.com | Wise Guide 53


ou’re so busy, I didn’t want to bother you.” Sound familiar? And, you can’t help but wonder just what else is not being addressed. Caring for an older loved one has many challenges, and even more so if you are not local to them. This is where Senior Concierge can be invaluable. If you are reading this, then you’re likely the family member of a senior or you’re an aging adult yourself. Perhaps you feel as if you need help either for yourself or your loved one and don’t necessarily want to pursue assisted living facilities. With over a decade of caring for seniors, we are ready to help you take care of the elderly loved ones in your life. Senior Concierge can help with the mail, serve meals, provide non-emergency medical transportation, run errands and just spend time with them when they need a helping hand all while promoting independence and dignity. Give us your to-do list, and we’ll take care of it! Whether your needs are simple or challenging, we will develop a personalize program of support services tailored for you! Door-THROUGH-Door service. Not only do we provide transportation, we are companions for medical visits, every step of the way. From home to inside the office, and assistance with check-in and check-out paperwork. If appropriate, we remain present during the consultation so that we can act as an extra set of eyes and ears, helping your loved one remember and ensuring follow-up care instructions are clearly understood and implemented. Following the appointment, we can also take care of any prescription needs with the client’s local pharmacy. Errands need to be done lest they be overlooked. Sometimes accompanied by the client, sometimes not. Grocery shopping, picking up prescriptions, going to the post office, drop off/pick up of alterations and dry-cleaning, bank errands, gift shopping, can be done regularly, or on an as needed basis. Home Management. As you probably are aware, there are things that need attention, but may go unnoticed, or are just simply too much hassle for a loved one to manage. Senior Concierge takes notice and gets things done. Maybe a faucet is leaking, the house needs cleaning, bed linens changed, or even the litter box. Some of the things we do range widely from: • Fall Prevention Interventions • Security/Safety Checks • Home Organization • House Cleaning • Meal Preparation • Manage Mail • Medication Reminders • Wardrobe Organizing

Peace of Mind is

Priceless by Rick Bennett, Owner, Senior Concierge

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Many seniors are snowbirds, and escape from the winter cold to warmer climates. While you are enjoying the warmer weather, we can look after those empty homes, including those precious pets during visits. House checkups (daily or less frequently, depending upon the needs), plant maintenance, pet care and dog walking are all within our talents. Need something other than what I’ve mentioned? Give us a call at 208-704-4400. We will go out of our way to accommodate any needs requested. Based in Coeur d’Alene, we serve roughly a 25 mile radius, covering Post Falls and the Spokane area. We can go further with additional fees for mileage and travel time. Wondering about rates? General pricing is on our website: SeniorConcierge.org. Most of our services are charged hourly, however, since our services are always tailored to each individual and are non-traditional, a firm price will be quoted once we understand the scope of your needs during an initial complimentary consultation. Let’s Talk! - If you would like to see if the services we provide are a good fit for you and your family, or ask some clarifying questions to see if what we provide is the best solution for you, let’s have a “get acquainted call” at 208-704-4400 so I can hear and learn more about your current situation. Rick Bennett made the choice to leave his corporate job to care for his beloved mother who suffered from Alzheimer’s. It is through that personal devotion; he is able to relate to seniors and their specific care needs. His insight and compassion enabled him to create a service that makes our clients feel right at home, feel empowered, to live life and enjoy it as independently as possible. Rick has over 30 years of business consulting and professional services experience with a specialty in dementia care and has trained over 500 health care groups and individual care providers.


WE’VE GOT YOU COVERED Transportation | Errands | Home Management | House & Pet Sitting Senior Concierge can help with the mail, serve meals, provide non-emergency medical transportation, run errands and just spend time with them when they need a helping hand all while promoting independence and dignity. Give us your to-do list, and we’ll take care of it! Whether your needs are simple or challenging, we will develop a personalize program of support services tailored for you!

Door-THROUGH-Door service Providing not only transportation, but companionship for medical visits, and assistance with paperwork, acting as an extra set of eyes and ears.

Errands Grocery shopping, picking up prescriptions, going to the post office, drop off/pick up of alterations and dry-cleaning, bank errands, gift shopping, with or without the client.

HOME MANAGEMENT Senior Concierge takes notice of those little things that might need attention: a leaky faucet, house cleaning, changing bed linens, or even cleaning the litter box.

Some of the things we do • Fall Prevention Interventions • Security/Safety Checks • Home organization

Whether your needs are simple or challenging, we will develop a personalized program of support services tailored for you!

• House Cleaning

Call us today 208-704-4400 to tailor our services to your situation.

• Manage mail

• Meal preparation • Medication Reminders • Wardrobe organizing

208.704.4400 | info@bennettseniorservices.com | seniorconcierge.org www.TheWiseGuideOnline.com | Wise Guide 55

What Happens at the North Idaho Memory Clinic (NIMC)?

Some Facts About

MEMORY Myth or Fact?

Memory loss is ‘normal’ as we get older. While a slowing of ‘retrieval’ is universal as we age, the actual loss of memory is not part of normal aging and is caused by some other problem. An evaluation to find out what that problem might be is very important because often it can be partly or even completely reversed!

How is memory loss evaluated? Since there are hundreds of causes of memory loss, a complete evaluation is vitally important to search for reversible causes and to initiate early treatment when available. Here are some components to a memory evaluation: • A personal history of when memory loss started and how it is affecting daily function. It is also helpful to hear from loved ones or friends to compare what changes they may have noticed. • Review of past medical problems and family medical history. • A basic physical exam focusing on neurologic changes. • A careful review of medications in use. • Blood testing to look for nutritional, endocrine (hormonal) and other metabolic imbalances that can contribute to memory changes. • Interviews to measure cognitive (memory) function in standardized ways to determine what part of memory is still functioning well, and what parts may not be functioning as well as before. This is referred to as ‘neurocognitive testing’ and typically takes a few hours over 2-3 visits. • Brain imaging studies may be included (CT or MRI scan) depending on other findings. The results of all these tests give a picture of the underlying ‘root causes’ of memory loss so that therapy can be tailored to the person’s specific needs.

Who Performs Memory Evaluations? Primary Care Providers (PCPs) often do memory ‘screening’ tests as part of Annual Wellness Exams (this is included in Medicare benefits now). If a concern is raised during the screening exam, then the person may be further evaluated by their PCP or referred for more complete evaluation to a specialist (geriatrician, geriatric psychiatrist or neurologist), or to a team of specialists, such as at the North Idaho Memory Clinic.

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The mission of NIMC is to properly diagnose and promote optimal treatment pathways for those with dementia and related illnesses. We provide an in-depth approach to the assessment, diagnosis and treatment of memory problems of all causes. Each patient is seen and evaluated by a team of memory professionals consisting of a physician, a neuropsychologist and medical/clinical social workers. Careful assessment is KEY to finding the various contributing factors to memory loss so that proper and comprehensive intervention steps can be taken to improve memory and quality of life. The patient will be offered tailored treatment depending on the findings of the medical assessment. Treatments vary due to the hundreds of possible causes of memory loss. Every person is unique and so is their path of therapy and support. Educational resources are also provided to assist in managing dayto-day living as independently as possible. Memory loss syndromes often involve not only the person affected with memory change, but their family as well. We provide support for those affected with memory loss as well as their families. Together, we become a ‘team with you’ to optimize well-being and independence.

Is North Idaho Memory Clinic Right for You? • Have you noticed more trouble maintaining independent living due to memory problems? • Are multiple family members concerned with changes in your memory? • Is there a family history of memory loss, dementia or Alzheimer’s disease? • Have you noticed subtle changes in behavior, personality, mood or work habits in yourself or a loved one? • Are you or a loved one frequently misplacing items, getting lost in familiar places or unable to locate a parked car? Any serious financial errors? • Are you in need of education and support services to help care for a family member or loved one? • Have you or a loved one been diagnosed with a memory loss illness and now experiencing difficulty remaining independent in the community?

Who Can Be Seen at NIMC? Anyone who has a concern about their memory can be evaluated at NIMC. Often patients are referred by their Primary Care Provider, but individuals can also self-refer. All of the NIMC providers are licensed medical professionals in the State of Idaho and most medical insurances pay for the NIMC evaluation. NIMC is located at 296 W. Sunset Avenue, Suite 15 in Coeur d’Alene. For more information please call 208-666-0357 or visit our website www.nimemoryclinic.com

Speech — Pure Gold, Barbara’s Story

by Barbara Powell, a resident at The Lodge Assisted Living


hen I learned to talk as a small child, it was discovered that I was tongue tied. Hardly anyone could understand me. In addition to being tongue tied I was extremely shy. I had these two disabilities when I started school. One day I overheard my mother and father talking. My father said that he thought they should take me to the doctor and have my tongue ‘clipped.’ This would enable me to speak more clearly. The thought of having my tongue cut scared me so badly that I determined to teach myself to speak correctly. There was a sitcom on the radio. It was about a teen age boy by the name of Henry Aldridge. This radio program always began with the mother calling, “Henry! Henry Aldridge!” Henry responded by answering, “Coming Mother!” Our family always listened to this program. It was a part of our life. These phrases were spoken loudly and clearly. The name “Henry Aldridge” would be a perfect name to begin my determined effort to speak correctly. I began my journey by learning to say “Henry Aldridge” loud and clear. My parents saw that I was beginning to speak correctly. The ‘clipping of the tongue’ was never mentioned to me. Throughout the years, I wrote words down and marked the accent and vowel sounds. I cannot remember ever sharing my self-taught accomplishment with anyone. I was a very shy person. At the age of 35, a friend told me that there was to be an allday healing service the following Saturday at Bishop Lynch High School. I went to this healing service and stayed all day. I took part in everything. I did not talk to anyone or say anything all day long. It was a nice day. Not long after this healing service I began to notice that I was not so shy. I started to express my thoughts and opinions. I determined that I would “step out” and speak even if I was wrong or thought that I might sound stupid. I joined the Toastmasters, not to make public speeches, but to learn to talk to people on a one to one basis and to be able to express myself to other individuals in an intelligent way. Toastmasters are generally self-confident, educated people on their way up in their companies. I did not fit into any of these categories. I had a story to tell, but no one knew that. I had a very serious reason for being there, but no one knew that either. A lot of the members did not want me in the group but I hung in there because I was learning. If I was a person who gave up easily, I would still be tongue tied. A really pretty, educated woman, who was an excellent speaker,


208-457-3403 www.LodgeLiving.net

told me that I was the worst speaker that she had ever heard. She said, “If you say, ‘uh…uh…uh… one more time, I think I will scream.” I went a couple more times to the meetings and then I quit. When I tell my story, people always say that it was terrible for Jill to say that to me. My answer is, “I know that Jill was not trying to do me any favors but she did help me tremendously.” I don’t believe that I ever said ‘uh…uh…uh…’ again. Another member of our chapter, a wonderful girl by the name of Janet, came to my house 2 or 3 times and asked me to come back. However, I felt that my time was up. It was time for me to move on. I had learned a great deal. I had gotten what I needed. All through my life, I keep running into ‘Janets.’ They are truly kind people. I didn’t qualify to be with this gifted group of people. I needed them for a period of time. Armed with what I had learned at Toastmasters, I enrolled in a class for Public Speaking at the community college. Miss Clara, our teacher, nor anyone else in my class knew that I had been in Toastmasters. The class was predictable and fun. I got a lot of good feedback and good grades from Miss Clara. At the end of the year, I got that ‘A’ on my report card. Miss Clara liked me and my speaking. I have used what I learned at Toastmasters and the community college many times during the last 30 years. Most people think that I am just talking normally and that I may be a little aggressive. But then, they don’t know my story and they don’t know where I came from. They probably have never even heard of Henry Aldridge... Please call for a tour of our “HOMES,” at The Lodge, for truly they are… And, if you know someone would like to join our circle of love in one of our homes as a resident, an employee, or a volunteer, please contact Linda at 208-755-3637 or linda@lodgeliving.net. And, we are delighted to schedule around school commitments for our employees who are reaching ever upward. Call us!!

Locally owned and operated

Four Convenient Communities: Welcome to a place • The Lodge at Riverside Harbor 1 & 2 —52 & 58 N. Cedar Street, Post Falls, ID you’ll truly love to call home. • The Lodge at Fairway Forest 1 & 2 —3989 & 3991 N. Player Dr., Coeur d’Alene, ID www.TheWiseGuideOnline.com | Wise Guide 57

Meeting the Needs of Our Community


by Kim Ransier, Director, Hospice of North Idaho

ospice of North Idaho began serving our community in 1981 and has continued to address the growing needs of end of live care since that time. While we began with inhome hospice care, we have listened to the needs of our community and expanded our services to Bereavement Care, Children’s Grief Services, Palliative Care and now Caregiver Support. The need for increased caregiver support was identified by our nurses as a major issue in keeping patients at home during their end of life journey. In a national survey, 92% of Americans do want to die a peaceful death surrounded by friends and family in their own home — and this is the mission of Hospice of North Idaho. Being a primary caregiver can be very exhausting both physically and emotionally. In a recent study about caregivers in America we learned some startling facts; most Americans will be caregivers at least once in their life, on average caregiving lasts over 4 years, elderly adults will spend more than 10 years as a caregiver. Other facts we uncovered were that more than 60% of caregivers had to learn medication management on their own, 67% never received any training on caregiving and 44% reported significant clinical depression. Clearly this is a need in our community! Knowing how to properly turn someone who is bed ridden, or how to practice proper body mechanics are just two of the issues identified. Also, most caregivers experience isolation as taking care of their loved one becomes all consuming. To address these issues Hospice of North Idaho has started a Caregivers Support Program consisting of a special support group and a skills lab designed to meet these needs. The Caregivers Support Group is a series of meetings within a supportive environment with others who are going through a similar experience. You are encouraged to discuss your struggles, share resources and care for yourself. The Caregivers Skills Workshop is a hands-on learning experience where you will learn skills from Hospice registered nurses and certified nursing assistants. These classes include Body Mechanics, The Importance of Skin Care, Care of the Bedbound Patient, Dementia Skills, Environmental Safety and Community Resources. Each class is 90 minutes in duration and demonstration of those learned skills provides the confidence needed to care for your loved one, and for yourself. In conversation with a gentleman who is taking the end of life journey with his ill wife and becoming her caregiver, he asked her nurse, “I ran a business for 40 years, I do not know anything about being my wife’s caregiver. Will you teach me?” Her answer was, “Yes, we are here to meet her needs and yours too. That is what we do at Hospice of North Idaho.” The next scheduled class is the Caregiver Support Group to be held August 13-September 17, and the Skills Lab follows on October 1-November 5. Hospice of North Idaho provides these classes free of charge to our community. Register by calling 208-772-7992. Kim Ransier has provided positive, compassionate, business expertise to Hospice of North Idaho since 2013. She is a graduate of Leadership Coeur d’Alene and has received numerous awards for her work in, leadership and business development. She holds degrees in nursing and healthcare administration. Kim remains passionate in continuing the 39 year tradition of quality end of life care throughout our communities.

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www.TheWiseGuideOnline.com | Wise Guide 59

Is a Prosthodontist in Your Future?

by Brett Matteson, DDS, ACP, Lakeview Dental Clinic


aking care of your teeth and gums is important to create a beautiful smile. Not only are you maintaining good oral health, but these habits also decrease the risk of gum disease, tooth decay, bad breath, and more. Consistency with oral hygiene helps with the protection of your teeth as you get older. In recent years, dental professionals have found that there is also a link between your oral health and overall health. Having healthy teeth and gums, could contribute to reducing the risk of other medical conditions. Cardiovascular Disease: The risk of stroke and heart attack goes up with chronic inflammation due to gum disease. The bacteria in your mouth can contribute to systemic inflammation. Protect your heart by avoiding serious infections in your gums. Diabetes Control: Diabetes plays a part in the development of gum disease. At the same time, gum disease makes it more difficult to control the symptoms of diabetes. When infection is present in the body, it increases insulin resistance and affects the control of blood sugar. As a result, gum disease infections can increase the diabetes symptoms you are experiencing. Preterm Labor: Expectant mothers should be extra careful about protecting their oral health. It has been found that gum disease can contribute to an increase in preterm delivery which results in low birth weight. According to the National Institute of Dental and Craniofacial Research, it is estimated that as many as 18% of preterm births are connected to oral infections. Dental experts have theorized that the toxins from oral bacteria move through the bloodstream and into the placenta, which affects the fetal development. The first positive step toward improving your dental health is making an appointment and walking in the door. For some, dental visits may incite fear or stress, but we make every attempt 60 Wise Guide | 2020 Edition

to understand and minimize your anxiety while meeting your needs. Getting you to optimal oral health is our number one priority. That means understanding your goals and limitations, both physical and financial. As a board certified prosthodontist, I specialize in restoring and correcting your teeth. However, not everything can be restored. There are times that the optimal treatment may be to have the teeth taken out. Edentulism (loss of teeth) affects oral and general health in addition to quality of life. The absence of teeth limits a patient’s ability to perform two essential tasks in life: speaking and eating. These deficiencies result in a handicap. A person may make significant adjustments to compensate for the deficiencies, such as restricting what you eat, because your can no longer chew or have difficulty swallowing/choking. You may limit socialization due to both appearance and difficulty speaking. Both disability and handicap have been associated with a negative impact on psychosocial well-being, especially when considering elders. Think of a family member or friend who lived well beyond their life expectancy without his or her teeth. How may have his/her quality of life been improved by being able to eat more solid food, speak more clearly, and feel more confident interacting socially? A denture should be considered when it will improve quality of life, but there are now so many options. • Conventional dentures rest on the gums – which by their nature move. It is well known in the dental literature that with conventional dentures patients are only able to function at 10%. Edentulism causes progressive bone loss. Treatment with dentures is limited and detrimental changes continue overtime; these include lack of stability and retention, soreness and pain, and further loss of function. • Implant Over Dentures: Snap on dentures are an alternative treatment option for edentulism that promises to overcome many of the limitations with conventional dentures. Studies have compared the use of dentures to snap-on dentures to restore edentulous patients, especially the use of mandibular snap-on dentures retained by two implants. Indeed, the use of two implants on the mandibular have

Visit www.lakeviewdental.com for our Quarterly Specials!

benefits; better chewing, decrease resorption of the residual ridges, improved stability and retention, and patient’s quality of life and satisfaction. • Hybrid, All-on-Four: Full mouth dental implants provide a stable foundation on which we can build a “superstructure” – the fixed bridge of the All-on-Four implant concept. This arrangement of dental implants and prosthesis transmit the forces the jaws generate directly to the food — translating in the ability to eat steak! • Among all patients who had similar numbers of implants placed, those who received an implant over-denture were less satisfied and had lower quality of life than the patients who had a fixed prosthesis. Chronic oral inflammation can negatively affect your quality of life. Modern dentistry has evolved to help improve your overall physical and mental health, while working with anxiety and other limitations. When considering full-mouth rehabilitation, seeking a board-certified prosthodontist can help with all of your dental needs while ensuring optimal outcomes. To learn more about the scope of our services, go to our website: lakeviewdentalclinic.com/about/what-is-a-prosthodontist. Brett Matteson, DDS, FACP, obtained a bachelor’s degree in biology at La Sierra University, completed his Doctor of Dental Surgery degree in 2006 at Loma Linda School of Dentistry, and in 2010 completed his Advanced Education in Prosthodontics certification through the U.S. Army® program at Fort Gordon. One year after completing his training as a prosthodontist, Dr. Matteson became board certified, a status which he has maintained to this day. Dr. Matteson is a member of the American Dental Association®, a Diplomate of the American Board of Prosthodontics, and a Fellow in the American Academy of Prosthodontics. He is also an Eagle Scout, received several awards while in dental school and also received five Army commendation medals during his military service. Dr. Matteson, the first prosthodontics specialist in the area in 2017, is committed to improving the quality of dentistry in our region. His additional training enables him to provide total care to each of his patients. www.TheWiseGuideOnline.com | Wise Guide 61

Citizen Soldier for Life — Find A Track to Follow! by Matt Ranstrom, Idaho State VSO


re you a National Guard member, one of their immediate family, Veteran and Service Members from Dept. of Defense components, a Retiree from service, or even someone considering signing up for service or the Guard? You need to know about the Citizen Soldier for Life (CSFL) program! Citizen Soldier for Life is an Army National Guard program that focuses on providing Career Readiness Standards and Financial Literacy training. Preparing Soldiers for the dual role of service and citizen through career and financial readiness is the foun-dation for a culture that inspires service to the Nation, bolsters community relationships and strengthens the Citizen Soldier for Life concept. Citizen Soldier for Life Career Readiness Counselors, located throughout all 54 states, territories and District of Columbia, are ready to assist with your career and financial goals, connect with local employers and identify opportunities for success.

How Can Citizen Soldier for Life Help You? Citizen Soldier for Life assists Service members to complete their Career Readiness Standards and equips them with the knowledge, tools and skills to achieve their career goal. Areas of emphasis include: • Resume Development • Interview Guidance • Military Skills Translation • Budget Creation • Individual Counseling • Financial Literacy The biggest challenge during transition from active duty is applying translating skills acquired in the military to civilian life. Many times veterans and active military do not see how this can be done. When you are seeking reintegration, go to the experts.

What are the steps? • First, start with the Veterans Rep. at the Department of Labor. Their whole reason for being is to assist in skills assessment, skills building, resume writing, and job placement. • Second, go to the local CSFL office at the National Guard at 5453 E. Seltice Way in Post Falls and meet with John Stensrud if you are in Idaho. If you’re in E. Washington, Ty Corbett is your guy. He is the Employer Support of the Guard and Reserve (ESGR) Employer Outreach Director at the National Guard Readiness Center, 1629 N. Rebecca St., Spokane. These counselors are invaluable through knowledge, experience, and their connections within the communities. • Third, seek out the local colleges, they all have veterans advisors, marketing departments and program education counselors who can help you navigate through higher education. Let’s talk more about the CSFL program. The dedicated counselors are there to help personalize career progression whether you are still active military or are seeking post-military skill translation. Here are some examples: It might be hard to translate your knowledge and training about how much aviation fuel is pumped from an air tanker aircraft at 20,000 feet; or how a marksman weapon handler equates to how fast one can type on a computer. This one-on-one personalized counseling is the reason for the CSFL program. Meetings are individualized and the goals of the military member are reviewed. If an 18 year old guardsman wants to be an automobile mechanic, it is the CSFL counselor’s goal to point them on the certification process to achieve the goal. If a veteran is under-employed and in need of help launching a new career, it may take a fresh pair of CSFL counselor eyes and their knowledge to rewrite and polish a resume. If a military dependent has lost self-worth and is thinking of going back to college, wondering how to pay for it, a CSFL counselor would know about FAFSA, Yellow Ribbon, scholarships, grants and other budget tools available. Sitting down with an individual plan for a career, education, military career and translation of military service will go a long way to helping get back on track— or find a track to follow. The CSFL program not only helps those serving or who have served, it also is a promotional tool for helping recruits who are thinking of joining. Instead of a fire and forget method utilized too often in the military recruitment, CSFL counselors are helpful in many aspects. Experience gained combined with the knowledge from the Dept. of Labor, creates a support entity with individualized advice which can be instrumental in changing a person’s life, career, education goals, budget considerations... the CSFL counselor may be the one person who has actually sat down and listened to a current military, veteran or prospective military person. Here’s a link to more details about the CSFL program: https://community.apan.org/wg/csfl/ army-national-guard-citizen-soldier-for-life/ And, a link for the ESGR: https://esgr.mil

Matt Ranstrom is from Sequim, Washington, and retired in Liberty Lake after a 23-year Air Force career. He transitioned from the military with education degrees from NIC, U of I and Gonzaga and applied his educational wisdom with a calling to service North Idaho with AmeriCorps and CSFL programs. Matt is currently a Post Falls Veteran Service Officer and is married with two wonderful daughters. 62 Wise Guide | 2020 Edition

Veterans Service Officers (VSOs) are trained, certified and accredited to be ADVOCATES FOR YOU! They are NOT VA employees. Assistance is FREE. Contact them BEFORE you call the VA. It will save you a lot of grief.

These Veterans Service Officers are here for you:


MONTANA Montana State VSOs

Scott A. Thorsness, Director 208-446-1092 120 E. Railroad Ave., Post Falls M-F 8:30 AM - 5:00 PM email: scott.thorsness@veterans.idaho.gov Matt Ranstrom 208-446-1092 120 E. Railroad Ave., Post Falls M-F 8:30 AM - 5:00 PM email: matt.ranstrom@veterans.idaho.gov

Bonner County Bryan Hult 208-255-5291 1500 Hwy 2, Ste. 122, Sandpoint M-TH 8-5 (call/email for appointment) email: bhult@bonnercountyid.gov

Boundary County Ronald Self 208-267-8611 6635 Lincoln St., Bonners Ferry Wed & Thur 8:00 AM - 1:00 PM email: veterans@boundarycountyid.org

Kootenai County Thomas Freeman 208-446-1090 120 E. Railroad Ave., Post Falls M-F 8:30 AM - 5:00 PM email: tfreeman@kcgov.us

Shoshone County Susan Hendrixson 208-752-3331 700 Bank St., Suite 120, Wallace M-Thurs. 9:00 AM - 5:00 PM email: commsec@co.shoshone.id.us

Carolyn Collins Ryan Keeler Bryan T. Zipp National Guard Armory 406-755-3795 2989 Hwy. 93 North, Kalispell Appts. M & F, walk-ins welcome Wed., Tues. is outreach, Thurs. closed.

WASHINGTON Washington State VSO Spokane County Regional Veterans Service Center 509-477-3690 1117 N. Evergreen, STE 2, Spokane M-F 8-4

Idaho Department of Labor - Veterans Reps. Benewah/Kootenai/Shoshone Counties

Robert Shoeman 208-457-8789 Ext. 3993 600 N. Thornton St., Post Falls email: robert.shoeman@labor.idaho.gov

Bonner/Boundary Counties

Justin Offerman 208-263-7544 Ext. 3713 613 Ridley Village Road, Ste. C Sandpoint email: justin.offerman@labor.idaho.gov

www.TheWiseGuideOnline.com | Wise Guide 63

Veterans Events & Services

Veteran Identification Cards:

Pend Oreille Valley Quilts for Veterans A group of people gather together, monthly during the winter months to create quilts to honor our veterans. It’s a great group of quilters who learn from each other. Won’t you join them? 3rd Fridays at 11:00 am - Hospitality House on Washington Street in Newport, WA

www.va.gov/records/get-veteran-id-cards In addition to their specific purpose, these ID cards proved you are a veteran and may be used to get Veterans’ discounts at stores, restaurants and various businesses: Dept. of Defense (DoD) Card A Department of Defense (DoD) Identification Card is used to show your military status and to get access to services at military bases. Veteran Health ID Card (VHIC) When you’re enrolled in VA health care, you get a Veteran Health Identification Card (VHIC) that you use to check in to your appointments at VA medical centers.

Idaho Female Veterans Network Celebrate Your Service! Join the Idaho Female Veterans Network group on Facebook to communicate with other Idaho female veterans: https://www.facebook.com/ groups/1890181957956259/ Monthly Meetings - Come out and enjoy the camaraderie and friendship of other women who have served! 2nd Tuesday of Each Month at the VFW Post 3603 (1225 E. 3rd Ave., Post Falls)

Saturdays – Doors open at Noon Games 1-4pm New Management! New Experienced Fun Caller! New Games! Progressive Jackpots! Bring your friends! Bigger Crowds = Bigger Payouts Must be 18 or older to play. Minimum buy-in of $10. Open to the public. Smoke-free ADA Accessible. American Legion Post 143 1138 E. Poleline Ave., Post Falls (208) 773-9054

Veteran ID Card (VIC) A Veteran ID Card (VIC) is a form of photo ID. Veteran’s designation on a state-issued driver’s license or ID All 50 states and Puerto Rico offer a Veteran designation (an identifying mark) printed on state-issued driver’s licenses or IDs. The type of Veteran designation may vary from state to state. Before you apply for these things, have you talked with your Veterans Service Officer (VSO)? If you aren’t a big fan of tackling these things on your own, and not sure what documentation you’ll need, that’s what VSO’s do – they answer questions and help you apply for whatever you seek.

Veteran’s Day on Wednesday, November 11th, 2020 (8:00 am until 5:00 pm) Lakeview Dental Clinic will be offering FREE Exams, FREE X-Rays, FREE Cleanings & FREE Fillings to all Veterans! Watch for our Sign-up notification in September 2020. Refreshments will be served.

Passenger Discount for Military Veterans Veterans of the United States Military receive a 10% discount on the lowest available rail fare on most Amtrak trains. Veterans must have served in one of the following branches: • Army • Marine Corps • Navy • Air Force • Coast Guard Just use the Fare Finder at the beginning of your search and select “Military Veteran” for each passenger as appropriate to receive the discount. Restrictions may apply. 64 Wise Guide | 2020 Edition

The VA is hiring in a big way! Go to this site and investigate:

vacareers.va.gov Did you know you may qualify for a Discharge Upgrade?: www.va.gov/discharge-upgrade-instructions • Answer a series of questions to get customized step-by-step instructions on how to apply for a discharge upgrade or correction. If your application goes through and your discharge is upgraded, you’ll be eligible for the VA benefits you earned during your period of service. • All branches of the military consider you to have a strong case for a discharge upgrade if you can show your discharge was connected to any of these categories: • Mental health conditions, including post traumatic stress disorder (PTSD) • Traumatic brain injury (TBI) • Sexual assault or harassment during military service (at VA, we refer to this as military sexual trauma or MST) • Sexual orientation (including under the Don’t Ask, Don’t Tell policy)

Old Fashioned Caring Meets 21st Century Connection with Compassionate Service to Seniors and their Caregivers!


n Site for Seniors is a non-profit, faith-based agency serving the needs of homebound seniors through medical house calls, advocacy for frail seniors, and respite care for family and caregivers. We support the needs of the ‘whole person,’ whether physical, emotional, spiritual or social need. We provide care, compassion and connection for the most vulnerable in our community! On Site for Seniors has been serving CDA and the five northern counties of Idaho since 2008.

On-Site Person-Centered Medical Care

The medical component of On Site for Seniors includes oldfashioned ‘house call medicine,’ but has also included ‘telemedicine’ for over five years to adults who are unable to leave their homes due to chronic medical illnesses.

What is Telemedicine?

Telemedicine is an interactive 2-way audio-video connection between the medical practitioner and the patient. As we all move toward performing more telemedicine visits to keep the most frail individuals safe, the ‘digital divide’ has become more apparent. Many aging adults lack computer experience or internet capability, especially in rural areas. To bridge this gap, we have collected and loaded simple tools onto mobile devices (smart phones or computer tablets) that can be loaned out to patients without internet capability and can easily be used for video visits. Through generous donations and grant support, we have been able to make this equipment available to our community. With special electronic medical equipment, we perform physical exams over a private platform to allow heart, lung, ear, and dermatologic (skin) exams over the internet. This became even more essential during the COVID crisis as we made these specialized kits available at no cost to the medical practices in our community in order to serve more people at risk of severe illness.

Respite Care (taking a ‘rest!’)

On Site for Seniors also supports families in need of respite care or time for self-care by providing a safe, friendly place for loved ones to spend time at the Bennett House located at 296 W. Sunset Avenue in Coeur d’Alene. Currently, we are the only free-standing Adult Day Program in Kootenai County and are open Monday through Friday from 8 AM to 6 PM.

The Bennett House meets the special needs of family caregivers to have respite time (or a “break”) from the caregiving role. Caregiving can become an overwhelming task and many caregivers suffer from stress that can trigger depression and other health problems. Whether the caregiver needs time for grocery shopping, outside work, or just free time to re-energize, the Bennett House offers a safe, comfortable, and fun place for loved ones to spend a few hours or the whole day. The Bennett House offers a variety of activities that provide for cares of daily living, wholesome nutrition, and social needs of older adults. Participation can enhance the senior’s quality of life and help exhausted caregivers to recharge emotionally, spiritually, and physically from their busy schedules.


We welcome visitors to come enjoy the music, movie days, various games, hot lunch, and the always popular balloon toss (we don’t call it exercise)! Mentally stimulating activities are so important to maintain memory and vitality. We focus on individualized attention and engagement in favorite pastimes of the guests during their time at Bennett House. We often hear families say how much more alert and happy their loved ones seem after a day with us!

How is Adult Day Center paid for?

Bennett House Adult Day Center is supported through VA benefits for qualifying veterans. Please see your VA benefits coordinator for more information. Area Agency on Aging also offers funding to help cover the cost of respite care at the Bennett House. Some insurances will cover respite care at the Adult Day Center. An hourly rate for services is available for private pay as well as some scholarships and donated grants that help cover the costs of services and supplies.


Volunteers are “key” to On Site for Seniors and Bennett House services as well. Caring and compassionate volunteers help with activities, games, socializing, spiritual support, and prayers for those in need. If you have a passion to spread hope to aging individuals, On Site is where you can make a huge difference in the life of a senior and their caregiver! Give us a call to find out more at 208-967-4771.

www.TheWiseGuideOnline.com | Wise Guide 65

Choosing Medicare Coverage – It Depends. by Noreen Brisson, Volunteer Services Coordinator Senior Health Insurance Benefits Advisors (SHIBA)


hether you are just starting Medicare, or already on it, choosing and changing your benefits can be confusing. It seems the answers to many – or even most – questions about Medicare are “It depends.” So let’s sort through a few common questions about Medigap plans and Medicare Advantage plans. •W  hich is better – a Medigap plan or a Medicare Advantage plan? It depends. • What are advantages of Medicare Advantage plans? It depends

66 Wise Guide | 2020 Edition

Medigap, also known as Medicare Supplement plans, and Medicare Advantage plans work differently. Medigap plans fill in gaps or supplement Traditional Medicare Part A & B payments for care & services. They are totally optional plans purchased from an agent or insurance company, and are identified by letters A-N. All plans with the same letter offer the same coverage. They can be used at any facility or service that accepts Medicare. This makes them portable, which is useful for people who migrate seasonally, or travel extensively, and can reasonably expect to need Medical

treatment while away from home. With Medigap plans, you pay premiums for the following each month: (1) Original Medicare (Part A & B) premiums to Social Security, (2) the Medigap premium to the Medigap company, and (3) Part D plan premium to the company if you are choosing to enroll in Prescription Drug coverage. Medigap companies may pay their share of costs directly to a service provider, or by paying clients for the appropriate costs. Medicare Advantage Plans are plans issued by insurance companies offering benefits as good as or better than Medicare. These plans replace traditional Medicare for the clients. Medicare pays the company for managing the care and covering for Part A & Part B related expenses. The company determines whether services are authorized, the providers members can use, and pays providers for their services. Medicare Advantage plans generally have co-pays for basic services and must have an out-of-pocket maximum. This can make costs of care lower and offer protection against unlimited medical costs for people who cannot afford or qualify for a Medigap plan. They may offer benefits excluded from Original Medicare such as some dental, vision and hearing benefits, fitness benefits, transportation to medical appointments, and meals when recovering from procedures. They are available with and without drug (Part D) coverage and people with End Stage Renal Disease (ESRD) are excluded from having Medicare Advantage plans until 2021. • Which Medigap/Supplement plan or Medicare Advantage should I choose? It depends. Selecting a Medigap and Part D plan to go with Traditional Medicare, or a Medicare Advantage plan generally depends on

what is available where you live, the amount of care & coverage you expect to need, and what you can afford and what you are willing to pay for. Both types of plans vary widely in cost and coverage options. Medigap and Part D plans are available statewide for the same rates. Medicare Advantage plans vary by service areas based on counties. In Idaho, they are not available to residents of 11 counties, including Benewah, Clearwater, Lewis and Idaho in Central and Northern Idaho. Coverage of drugs by Part D and Medicare Advantage plans can change – reviewing your options for the following year during the Annual Enrollment Period (AEP) from October 15- December 7 of each year is the best way to know you have the best coverage available for your personal situation. So what are YOUR best choices for Medicare coverage? It depends. But Idaho SHIBA offers free, unbiased Medicare counseling, workshops, and presentations to help you find the answers. For more information, please call the SHIBA Medicare Helpline at 800-247-4422 or visit doi.idaho.gov/shiba Noreen Brisson is a Volunteer Services Coordinator with the Senior Health Insurance Benefits Advisors (SHIBA) program in Coeur d’Alene. She has been a member of the Department of Insurance and SHIBA staff for over 8 years and loves winter, her granddog, and helping fellow Idahoans learn about Medicare.

Let us help you! Free, Unbiased Medicare Counseling

Call SHIBA Senior Health Insurance Benefits Advisors (SHIBA) A service of the Idaho Department of Insurance • Understand your Medicare preventive & wellness benefits • Extra Help & Part D assistance • Workshops & individual counseling

This project was supported, in part by grant number 1802IDMISH, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201

1-800-247-4422 SHIBA.idaho.gov www.TheWiseGuideOnline.com | Wise Guide 67

Parkinson’s Disease is Complicated by A.C. Woolnough, Ambassador World Parkinson Congress, Barcelona 2022


oday is the youngest you’re going to be for the rest of your life. It is the oldest you’ve ever been as well. Why introduce time for an article about Parkinson’s disease? One reason is the single biggest risk factor for Parkinson’s is age. The older you get, the greater chance of being diagnosed. However, between 1020% of diagnoses is for Young Onset Parkinson’s disease (YOPD)— meaning 50 years or younger. No matter what age, PD is chronic (it isn’t going away) and it is progressive (it is going to get worse). The most obvious symptoms are the motor difficulties—gait and balance issues, tremor, dyskinesia (large uncontrollable movements) and freezing. Most people are unaware there are numerous nonmotor symptoms as well; pain, depression, constipation, loss of smell, facial masking, soft voice, small handwriting, memory problems, other cognitive issues and many more. Diagnosis of Parkinson’s is complicated because symptoms vary person to person. Since there is no cure, various therapies are used to treat symptoms, including a plethora of drugs and exercise. Exercise has been shown to be one of the most effective (certainly the most cost effective) means to slow the progression of the disease. The most effective exercise is a combination of physical, cognitive, and social. That is why a program called Rock Steady Boxing is becoming one

of the most popular. Using the moves, the exercises and the training regimen of boxers in a non-contact group format, all the domains for PD exercise are addressed. As one person put it, “You move to keep moving.” Support groups are another means to combat the disease. Sharing and learning from each other, guest speakers, practicing large physical movements and other activities make up a typical meeting. Some groups have a smaller support group focused on the needs and experiences of care partners. I have been fortunate to be a member of two patient advisory councils, an Ambassador for two World Parkinson Congresses, a presenter at more than five PD conferences, a participant in more than twentyfive studies, written a monthly PD column, and been an advocate on Capitol Hill. If you have a question or concern about Parkinson’s, feel free to email me at acwooly@gmail.com. If I can’t help you, I’ll steer you in the direction of someone who can.

Parkinson’s Support Groups Want to start a Parkinson’s support group in your community or connect with our social services manager for a personalized Navigation Session? Contact Sarah Winter, MSW, LICSW at 206.946.6517 or sarah@nwpf.org

COEUR D’ALENE Lake City Center, 1916 N Lakewood Drive 1st Friday of the month at 1 - 2:30 pm Contact: Beth Hatcher 208-635-5243 Email: cdapsg@hotmail.com Women with Parkinson’s Affinity Apartments, 3594 N. Cederblom Street 3rd Friday at 1 pm. A casual get-together. Free to people with Parkinson’s and their caregivers.


Gateway Community Center 1203 Hwy 2 West, United Way Conference Room Parkinson’s Disease Support Group of Flathead Valley 3rd Wednesday of the month at 3 - 4:30 pm Contact: Marjory McClaren 406-250-5577 Email: marjmccl@yahoo.com Contact: Lynnell Gravelle 406-756-7250 Email: lynnell@arspt.com 4th Wednesday of the month at 3 - 4:30 pm Contact: Lynn Woods 406-420-2321 Email: lynwoods@gmail.com This is a new group forming now to address the needs of Parkinson’s Care Partners. Please join us!

SANDPOINT East Bonner County Library meeting room, 1407 Cedar St., 2nd Mondays at 2 - 3:30 pm. Contact: A.C. Woolnough 208-304-5756 Email: acwooly@gmail.com

68 Wise Guide | 2020 Edition


Check www.NWPF.org for details Caregiver Support Group Follow us on Facebook! Parkinson’s Resource Center | 1420 E @NW Parkinson’s Foundation Sprague Ave, Ste 103 3rd Wednesdays at 11:30 am - 1 pm Contact: Halle Goodwin, MSOL 509-443-3361 Email: halle@nwpf.org

Women Affected by PD Support Group Riverview Retirement, Dining Room 1801 E Upriver Drive, 1st Thursdays at 1 - 2:30 pm Bring your lunch and join this group of remarkable women living well with Parkinson’s. Contact: Sally Sullivan 509-499-5113 Email: 22sullys@gmail.com Parkinson’s Support Group Touchmark on South Hill, 2929 S Waterford Drive 3rd Wednesdays at 2:30 - 4 pm Contact: Lori McCormick 509-321-8130 Email: lori.mccormick@touchmark.com Parkinson’s Connect Parkinson’s Resource Center, 1420 E. Sprague Ave., Suite 103 Last Tuesdays at 4 - 6:30 pm Great for new to community or newly diagnosed. Friends and family welcome! Share experiences, ask questions of peers in a relaxed, unstructured fun social setting. Anyone with a Parkinson’s-like disorder is welcome. Contact: Halle Goodwin, MSOL 509-443-3361 Email: halle@nwpf.org

Hospice, It’s Your Choice by Melissa Becker, Community Outreach Coordinator Auburn Crest Hospice


ho wouldn’t want extra support when it truly matters? There are times in our lives when we really do need help; the birth of a child, post-surgical care, and even more at the end of life. Hospice is here to provide a team of endof-life medical professionals, and some ancillary staff as well, to help aid not just the patient, but the whole family. We say, “It takes a village to raise a child,” it feels like it takes a village on the other end as well! The members of that team for Auburn Crest Hospice include; a physician, RNs, LPNs, CNAs, Chaplains, Social Workers, Volunteers, Community Outreach Coordinators, and Bereavement Specialists. There are many payer sources for hospice care. These include; Medicare, Medicaid, VA, and many private insurances. For those who have no coverage, perhaps a young person with an incurable cancer, we find most hospice companies cover the expense of care at no charge. Did you catch the plural word ‘companies?’ YES! There is more than one hospice company. Many believe there is just HOSPICE, when there are actually many companies nationwide to choose from. In our beautiful area of Northern Idaho, there are a handful of hospice companies. A few are for-profit and a couple are non-profit. So what’s the difference? Well, practically NOTHING! Each company gets reimbursed the same amount from the payer sources listed above. The process is similar to when your doctor submits a claim to your insurance provider. It is YOUR choice which of these hospice companies you’d like caring for you or your loved one. It’s your insurance benefit. And, just like when you go to your doctor and they write you a prescription and they ask you what pharmacy you want it sent to, your doctor should ask you which hospice you’d like the order sent to. See, to be admitted to hospice you need a doctor’s order. This order states that if the patient’s prognosis continues at the same progression, it is possible the patient will pass away in 6 months or less. Even if that physician guessed wrong there are endless benefit periods and care will not cease until it is no longer needed. Sometimes that even means a celebration of a graduation from hospice care! Our area is blessed with the abundant knowledge of hospice by the wonderful caring staff who are employed in our area. Each hospice offers FREE consultations. In fact, each hospice here offers FREE care. So again we ask, “What IS the difference between non-profit and forprofit hospices?” Well, the non-profit companies can fundraise. They do so with various community-funded fundraisers. The for-profits cannot fundraise. Instead, they are tasked with providing excellent service and care at the reimbursement rates provided by Medicare, Medicaid, VA and the Private Insurance companies. The for-profit companies incur any

costs that exceed the reimbursed amount. Neither a for-profit, nor a nonprofit are the bad guys here. All are simply trying their best to provide the Northern Idaho area with the best possible care at the end-of-life. Each are to be commended for their efforts because the testimonials for all involved are often filled with wonderful accolades and appreciation for the love shown to the patient and their family during such a heart wrenching time. It’s often said to have been a beautiful time as well. While a loved one can remain present and focused on creating lasting memories, the hospice team can come in and do all the clinical care along with bereavement care for the family. One question asked often in our community is about the Schneidmiller Hospice House and who can use it. The ‘House’ is operated by Hospice of North Idaho. In order to use the House one must be signed onto their care. If a patient is with another hospice company and wishes to use the House they can transfer their care to Hospice of North Idaho. The House is only to be used for end-of-life acute care needs and short term respite needs. Statistically 90% of people want to die at home, wherever they call home, whether it be at their personal residence, an assisted living, or a skilled nursing home. The Hospice House provides an option for those who fall outside of normal circumstances in a well-kept and comforting setting. It has served our community well. It’s understandable at the time of needing hospice one’s head could be spinning with the news they’ve just received. But what if, just what if, we could in some way mentally prepare ourselves? The way to be prepared is to be educated. It’s much easier to talk about the events that may lead to one’s passing from this earth when it seems like a far off event. Hopefully that is where you find yourself today reading this article. Take comfort, even if it isn’t, that there are wonderful options here in our community that can help you through this difficult time. A hospice nurse once said, “You don’t get to choose how you come into this world, but you should get to choose how you leave it.” At Auburn Crest Hospice we whole-heartedly feel that way; it is the patient’s choice from start to finish how they want to receive care from our team. We hope you’ll consider our team when end-of-life care is needed. When choice matters, choose Auburn Crest.

Melissa Becker has worked in the senior care industry for 12 years. Half of that time with Auburn Crest Hospice as one of their Community Outreach Coordinators. The thing she loves most about her job is fulfilling the ‘choose to live moments’ for their patients. These are bucket list type wishes including zip lining, parasailing, flying in an airplane, and having an art show.

Serving north Idaho for over a decade! When Choice Matters,

Choose Auburn Crest Hospice!


6541 Main St Bonners Ferry, ID 83805 Phone: (208) 267-0579 Fax: (208) 267-0582

1221 Ironwood Dr #102 Coeur d’Alene, ID 83814 Phone: (208) 665-8111 Fax: (208) 665-8112

www.TheWiseGuideOnline.com | Wise Guide 69

What’s New in Alzheimer’s Research? by Joel Loiacono, Regional Director, E. WA & N. ID Alzheimer’s Association


t’s an exciting time in the field of Alzheimer’s disease and dementia research. News headlines nearly every week talk about possible breakthroughs, emerging treatments, ways to prevent the disease and more. The Alzheimer’s Association is at the forefront, as the world’s largest nonprofit funder of Alzheimer’s and dementia research. Here are the five most important discoveries from the latest in dementia science: 1. Lifestyle may play a major role in reducing risk. We’re told that eating a healthy diet and exercising are good for overall health, but did you know that these habits may reduce one’s risk for cognitive decline and dementia? Research from last year’s Alzheimer’s Association International Conference suggested that making multiple healthy lifestyle choices — including eating a lowfat, high-vegetable diet, not smoking, getting regular exercise and engaging in cognitive stimulation — may decrease dementia risk and may even offset increased risk caused by genes or exposure to air pollution. Researchers also learned that intensive high blood pressure treatment can significantly reduce the occurrence of mild cognitive impairment, which often leads to dementia. 2. A blood test is on the horizon. Researchers are working at full speed to develop a simple blood test that can detect signs of Alzheimer’s early and accurately. Blood tests are cheaper, easier to administer, less invasive and more accessible than many advanced technologies currently available for Alzheimer’s research and diagnosis. Once these tests become available in doctors’ offices, they may play a role in early detection of dementia, which gives people more time to plan for the future, build a support network and participate in clinical trials. 3. Alzheimer’s is different in men and women. Two-thirds of people living with Alzheimer’s disease in the U.S. are women, but scientists aren’t exactly sure why. This year, researchers learned about a number of differences between men and women that may impact the disease’s progression and a person’s risk for developing the disease, including newly identified sex-specific risk genes, sex-based differences in how Alzheimer’s may spread in the brain and cognitive benefits for women who participate in the paid workforce. 4. Vision and hearing loss may increase dementia risk. Most older adults experience some form of vision and/or hearing loss later in life. New research suggests these sensory impairments may increase risk for cognitive decline and Alzheimer’s, especially if you experience

both. Sensory impairment screening may help identify older adults at higher risk of developing dementia, thereby encouraging early detection. This new knowledge opens the possibility that preventing or correcting sensory impairments may reduce dementia risk. 5. Researchers are looking at new drug targets. Researchers are taking a fresh look at the possible causes for dementia and how drugs might be used to stop the disease in its tracks. More than 500 new candidate drug targets have been identified that address everything from reducing inflammation in the brain to protecting nerve cell health. Clinical studies like these accelerate progress and provide valuable insight into potential treatments and methods of prevention; however, there are a few obstacles researchers face. First and foremost is a lack of funding. Although funding has improved greatly over the last few years, more is needed if we are to find an effective treatment for Alzheimer’s disease by 2025 (the ambitious goal set by the National Plan to Address Alzheimer’s Disease and Other Dementia).Those wishing to help with funding can do so by participating in the Walk to End Alzheimer’s or getting involved as an advocate, urging legislators to increase federal funding for Alzheimer’s research at the National Institutes of Health. Recruiting and retaining trial participants is also a hurdle for many studies. People living with dementia, their caregivers and healthy volunteers are needed to continue this important research. If you or someone you know is interested in participating in research studies, our TrialMatch service is a good place to start. TrialMatch is a free, easy-to-use online matching service that generates customized lists of studies a person may be eligible to participate in based on user-provided information. For more information, please visit www.alz.org/trialmatch. To keep up with the latest developments in Alzheimer’s and dementia science, visit alz.org/research or sign up for our weekly enewsletter at alz.org/enews.

Joel Loiacono has been with the Alzheimer’s Association for nearly 20 years and currently serves as the Regional Director for Eastern Washington and Northern Idaho. He holds a Master’s in Public Administration and a certificate in health care administration from Eastern Washington University.

Caring for someone with Alzheimer’s or dementia?

You're not alone. We're here to help. 70 Wise Guide | 2020 Edition

24/7 Helpline

1.800.272.3900 alzwa.org

Alzheimer’s Association Support Groups WHY STRUGGLE ALONE?

Attendees share their knowledge and experience of what works and what doesn’t in caring for themselves and loved ones. Groups are facilitated by professionals and are confidential. Come — learn — and get solutions.

24/7 HELPLINE: 800-272-3900 ONLINE: ALZConnected.org

An online social networking community for people with Alzheimer’s, their caregivers and others affected by the disease. ALZ.org for more valuable resources!

IDAHO PANHANDLE • Kootenai Health Medical Center, Coeur d’Alene Main Building - Main Floor Classrooms 3rd Saturday @ 1:30 - 3:30 PM Facilitators: Arlene Sleigh 208-772-2542, Connie Clark, CSA 208-660-2030 • St. George’s Parish Hall 2004 N. Lucas St., Post Falls 1st Wednesdays @ 2-2:30 PM Facilitators: Rosemary McDougall, RN 208-699-6060 & Ene Gaines 208-970-8471 • Sandpoint Senior Center, Sandpoint 820 Main Street 1st & 3rd Thursdays @ 1:00 - 2:00 PM Facilitators: Jan Griffitts 208-290-1973 & Liz Price 208-946-6849 (Free respite care at DayBreak Center next door with advanced reservation - 208-265-8127)

MEMORY CAFÉ Who: Persons diagnosed with Alzheimer’s or related Dementia and care partners. What: A casual and FREE gathering to provide socialization, interaction and fellowship, creating a sense of belonging, well-being and confidence. • Kroc Center Café 1765 W. Golf Course Rd., Coeur d’Alene 2nd & 4th Mondays at 1:00 PM • Skyway Café at Felts Field 6105 E. Rutter Ave., Spokane 1st & 3rd Mondays from 10:00 -11:30 AM

EARLY STAGE SOCIAL ENGAGEMENT for people with dementia & their family. Please contact Coeur d’Alene branch office to register 208-666-2996

EASTERN WA: SPOKANE NORTH • Church of the Nazarene 9004 N. Country Homes Blvd. Last Thursdays of each month @ 6:30 - 8:00 PM Facilitator: Gene Engelbrecht 509-842-6034 • Whitworth Presbyterian Church 312 N. Hawthorne Road 2nd Mondays @ 1:00 - 2:30 PM Facilitator: Paul Dionne 509-290-1816

DEER PARK • St. Mary’s Presentation Catholic Church 602 E. 6th St., Deer park 2nd Wednesdays @ 1:00 - 2:30 PM Facilitator: Paul J. Dionne 509-290-1816

SPOKANE SOUTH • First Presbyterian Church 318 S. Cedar Street 3rd Tuesdays @1:30 - 3:00 PM Facilitators: Beth Priest 509-590-3965 & Norma Juarez 509-389-5458

SPOKANE VALLEY • Spokane Valley Senior Center Center Place, Room 235 2426 N. Discovery 2nd Thursdays from 1:00-2:30 PM Facilitator: Carley Jo 509-981-3161

NORTHWEST MONTANA • Immanuel Lutheran Church, Kalispell Buffalo Hill Terrace, 40 Claremont Street 3rd Monday @ 3:00 PM Call 406-849-6207 for information • Presbyterian Church of Polson 301 4th Ave. East 2nd Wednesday @ 1:30 PM Facilitator: Arlene 406-849-6207

www.TheWiseGuideOnline.com | Wise Guide 71

Crossword The Games People Play Across

72 Wise Guide | 2020 Edition













Down 1 2 3 4 5 6 7 8 9 10 11 12 13 17 22 24 26 27 30 32 34

Old World lizard Not shy Rub the wrong way Herb in stuffing Combat gear Sapphire or ruby, e.g. Classic card game Years and years Come out of denial Game of “splats� Author ___ Stanley Gardner “Let it stand� Border on Dealer’s call in poker Music genre Pickled delicacy Bullfight cheer Hacienda room Like some scientists Trick-taking card game Singer Tori

35 Ceremony 36 Auto pioneer 37 Part of the eye 38 Simple pencil game 43 Game you can’t play left-handed 45 A Gershwin 49 Actress Benaderet 51 Work unit 53 Hotel freebie 56 Limerick 58 Stun gun 60 Kind of layer 61 English university city 62 Parker of “Daniel Boone� fame 63 Physics units 64 Monopoly token 65 Roe source 67 Movie pooch 71 Sapporo sash 72 Carnival city 73 Witch’s work

Copyright Š2020/2021 PuzzleJunction.com

1 National competitor 5 Malaria symptom 9 Simians 13 Ancient marketplace 14 Nevada city 15 Bar game item 16 One of the oldest board games know to man 18 Eight furlongs 19 Thurman of “The Avengers� 20 “The Name of the Rose� writer 21 Small piano 23 A fisherman may spin one 25 Greek god of love 28 Polo Grounds legend 29 German spa 31 Reindeer herder 33 Slot machine symbol 36 Jesse James was one 39 Biblical high priest 40 Parisian pal 41 Year in Nero’s reign 42 Quick swim 44 “Wheel of Fortune� buy 46 Auction unit 47 Holiday mo. 48 Court ploy 50 Ultimatum words 52 Took a load off 53 Like some rumors 54 Elevator part 55 Pendulum’s path 57 Word of honor 59 Tiger’s game 63 Wealth 66 Carte start 68 Tappan ___ Bridge 69 Bohemian 70 Game of ringers, maybe 74 Ruination 75 Anne Nichols hero 76 Looks after 77 Bygone blade 78 Last name in fashion 79 Hands out pink slips





How to Play Sudoku

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To solve the Sudoku puzzle, each row, column and box must contain the numbers 1 to 9. Crossword and Sodoku answers on page 77 Y0040_GHHHXDFEN_20_C

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www.TheWiseGuideOnline.com | Wise Guide 73

Older Americans Act & Dementia by P.J. Christo, MS, RN, Outreach Coordinator Alzheimer’s Association, Coeur d’Alene


he Older Americans Act (OAA) was designed to connect older adults and their caregivers with services that allowed better health, independence and dignity as they age. Are you taking advantage of its benefits?

What is the OAA? The OAA was enacted in 1965 to expand and improve the services available to Americans aged 60 and older. The law focuses on delivering home- and community-based programs and supports, including nutritional programs, in-home services, transportation, legal services, elder abuse prevention and caregiver support. Services are targeted at older adults with economic and social needs, such as low income individuals and families, minority populations and those with limited English proficiency, residents in rural areas and those who are at higher risk for needing long-term care. 74 Wise Guide | 2020 Edition

What services are available from the OAA? The OAA programs are divided primarily into four areas: supportive services, nutrition and meals services, disease prevention and health promotion, and the National Family Caregiver Support Program. Examples of services include the long term care Ombudsman program; transportation, outreach, and case management services; and in-home services such as home health aides and chore maintenance. In North Idaho, the Area Agency of Aging of North Idaho is partially funded by the OAA and provides services such as home-delivered meals, homemaker services, family caregiver respite, referrals to community programs, adult protective services and a long-term care Ombudsman who advocates for resident rights in assisted living and skilled nursing facilities. There are five other Area Agencies on Aging across the state. Go to aging.idaho.gov for more information on these services.

Are individuals with Alzheimer’s covered under the OAA? Yes, many individuals with Alzheimer’s and other dementias receive vital assistance and support under the OAA—and many Alzheimer’s caregivers receive respite care, so long as they are over the age of 60. These services help maintain an individual’s independence and allow people to stay in their homes and community for a longer period of time than might otherwise be possible.

What about people living with younger-onset dementia? Currently, only Americans over the age of 60 are eligible for OAA programs, but the Alzheimer’s Association and volunteer advocates from across the country are working to change that. Individuals living with younger-onset dementia face unique challenges. They may be parenting young children at home or still be working as the primary income provider for their family. The stigma of the disease often affects the person’s well-being and quality of life. Due to their young age, they may have more trouble receiving an accurate diagnosis. They also face barriers to accessing care and support services, as many programs, like those provided by the OAA, are targeted specifically to older adults. Last year, the bipartisan Younger-Onset Alzheimer’s Disease Act was introduced to Congress to address these disparities. The act would allow individuals diagnosed with Alzheimer’s disease or other types of dementia before age 60 to receive supports and services under the OAA. This would be an

enormous help to the roughly 200,000 people in the U.S. living with younger-onset dementia. With the support of Congressman Russ Fulcher, the U.S. House of Representatives passed this bipartisan legislation in October 2019. At the time this article was written, similar legislation was pending in the Senate.

How do I access services? If you are a caregiver or are interested in learning more about what OAA services are available to you, the best way to learn more is to contact your local Area Agency on Aging. In North Idaho, visit www.aaani.org or call (208) 667-3179. If you are looking for more information or support related to Alzheimer’s or dementia, contact the local chapter of the Alzheimer’s Association in Coeur d’Alene at (208) 666-2996 or call their free 24/7 helpline at 1-800-272-3900.

P.J. Christo, RN, MS is an Outreach Coordinator for the Alzheimer’s Association, where she has spent the last 20+ years of her career helping people impacted by dementia across North Idaho and in Spokane and Whitman counties. Prior to working for the Alzheimer’s Association, PJ worked as an RN in many capacities, from a heart transplant unit to Charge Nurse for inpatient Neurology, for both the private sector as well as active duty military and the VA. She holds a BS in both Nursing & Education from Southern Illinois University and an MS in Physiology from the University of Arizona.

Together we can help you find solutions to issues facing aging adults!

• • • • •

Aging & Disability Resource Center Resource Information & Referrals Long Term Care Ombudsman Adult Protection Services Home Delivered Meals Information

• • • • • • • • •

Family Caregiver Support Programs In-Home Support Services Community Support Services Options Counseling Medicare Fraud Education Medicare “Extra Help” Care Transitions from Hospital to Home Honoring Choices Program Fit & Fall Information

Call us to learn about available resources in your community! 208-667-3179




www.TheWiseGuideOnline.com | Wise Guide 75

Yoga! What Style Do You Choose?

by Sarah Digre, LMT, RYT 200, Hayden Yoga & Massage

Yang Yoga is Not for Every Body

Have you heard that yoga can help with stress, movement, and pain reduction, then go to the gym or find a fast paced, hot room with bodies moving in synchronized knots? Power yoga, Vinyasa or any style of yoga that is more focused on muscle movement, has many benefits but they are not for every body, especially bodies already suffering from chronic pain, dysfunction or injury. These “Yang” styles of yoga have similar benefits to working out; fast paced movements bring blood flow to muscles. Strength built with intentional movement is a great place to develop focus and connection with your body. However, as you watch the sweat dripping down arthritic knees you may be thinking, “Is this really the best thing for me?” or perhaps you don’t ever make it to class because it is too intimidating.

Yoga is all about balance. There are different intentions and goals for each style of yoga. When choosing a yoga type, consider your goals and your body’s current abilities. In a world full of stress our nervous systems are often overwhelmed. Adding extra physical strain, adrenaline, and cortisol hormones through fast movements continues a pattern of stress. If fast-paced, strength-focused yoga isn’t for you, what other options are there?

Yin Yoga IS for Every Body!

Yin yoga is a slow style of yoga that targets the joints and deep connective tissues in the body, while allowing the mind to calm in stillness. It’s appropriate for many different body types and abilities. Yin practices holding poses for 2-10 minutes giving your mind and body time to release. It’s a great

Customized Massage For Medical Needs

Yoga for all levels and body types

76 Wise Guide | 2020 Edition

208•696•1330 HAYDENYOGA.COM

way for beginners to get to know their bodies and start a simple meditation. Flexibility is the quality of movement without pain or injury. Increasing flexibility for the average body doesn’t mean arching your back so your head meets your toes. Increasing flexibility usually means a little more mobility to compliment and support our daily movements; being able to turn your spine and neck with reduced pain. Creating a little bit of healthy stress on joints, tendons and ligaments helps bring blood flow to stagnant spaces. The tighter a joint gets the less movement and blood flow it receives. When someone is experiencing chronic pain and movement dysfunction it is often in the joints and nervous system, not muscles. If pain reduction and stress relief is the main goal of yoga, it makes sense to shift the focus in our body from muscles to our joints, nervous system and the deep connective tissues holding it all together. Joints in our body include the spine, hips, shoulders and knees. Joints and their surrounding tissues are protective and usually won’t release in a space of active movement. Holding poses for an extended period of time gives the body space to let go. This release happens not just in the muscles but through deep connective tissues, joints, tendons and ligaments. This opening allows for new opportunities of movement, flexibility and stability throughout the whole body. It helps bring fresh blood flow to tight spaces that are usually not very vascular. This is a great

way to relieve chronic pain and increase movement. All while giving the nervous system a chance to recharge and reset. Nerve pain can often be reduced or released with increased blood flow to surrounding connective tissues. As we age, the blood flow to these spaces reduces, causing extra connective tissue, and arthritic build up around the joints, which leads to reduced mobility, pain and injury. To shift the blood flow, mobility, stability and flexibility to the joints, we need to slow down. Slowing down gives your nervous system and connective tissues time to release for a longer lasting result. You might not break a sweat with Yin yoga, but it has its own kind of challenges. It’s appropriate for all body types, catering to each body’s optimal release opportunities. Teachers guide students through different ways to be present with their body and their breath. This can build perseverance all while maintaining a safe space emotionally and physically. By the end of each session it

is common to feel complete peace within yourself; your nervous system is more integrated with your physical body and the connection is very grounding. Yin brings a balance to your body and life. When do we have the chance to just let go? Give yourself the opportunity to connect your mind, body and spirit. Slow down and see what benefits you notice. Our space is quickly becoming the yoga hub of Northern Idaho. Whether you’re located in Coeur d’Alene, Post Falls, Rathdrum, and even Sandpoint, Idaho, our Yoga studio is created for you. Our yoga instructors are professionally trained and educated to help with your healing and movement in your body. Hayden Yoga & Massage offers a variety of classes and each teacher specializes in their own techniques. Come join us for a relaxing and fun Massage or Yoga Class! Schedule your Massage or Yoga Class on our website: HaydenYoga.com, on the MindBody app. or call 208-696-1330.

Sarah Digre is a Licensed Massage Therapist and Yoga Instructor and has worked as a full time therapist for over 10 years. Her education includes completion of the Professional and Master Bodyworker Program with Steiner Education Group and a 10-week series of Structural Integration courses with Jason and Nancy Prince of Structura Body Therapies. Sarah obtained her yoga training at the Vedansha Institute of Vedic Science and Alternative Medicine in Rishikesh, India.

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www.TheWiseGuideOnline.com | Wise Guide 77

Agencies & Free Referral Services Alzheimer’s Association...................... Pg 70

Advertisers’ Directory

Independent & Assisted Living, Memory Care, Adult Day Care Bennett House..................................... Pg 65

Area Agency on Aging of North Idaho......................................... Pg 75

Boundary County Community Restorium........................ Pg 77

Compassionate Care Referral Service..................................... Pg 4

The Bridge Assisted Living................. Pg 37

Fostering ID/WA.................................. Pg 23 North Idaho CASA............................... Pg 11 Northwest Parkinson’s Foundation.......................................... Pg 68 Pend Oreille County Prevention and Wellness Initiative ... Pgs 9, 29 SHIBA (Senior Health Insurance Benefits Advisors)............................... Pg 67

The Lodge Assisted Living.................. Pg 57

Hearing & Vision Audiology Research Associates......... Pg 22 Eye Clinic of Sandpoint........................ Pg 26

In-Home Personal Care Access Care at Home........................... Pg 30 Advanced Care Northwest, LLC ........ Pg 48

Holistic Health Heather Holistics, Naturopathic Clinic............................. Pg 27

FirstLight Home Care.......................... Pg 53 Senior Concierge................................. Pg 55

Camas Center Clinic............................ Pg 51

Chiropractic, Massage Therapy & Yoga

Hospice Auburn Crest Hospice......................... Pg 69

In-Home, In-Patient & Out-Patient Skilled Nursing & Rehabilitation

Camas Center Clinic............................ Pg 51 Hayden Yoga & Massage....................... Pg 76

Bonner General Health Community Hospice............................ Pg 21

Bonner General Health Home Health Services......................... Pg 21

Moore Chiropractic............................. Pg 31

Hospice of North Idaho........................ Pg 59

Life Care Center of Coeur d’Alene..... Pg 42

Counseling & Support Colonial Clinic...................................... Pg 73

Hospitals, Medical Care, Pain Management & Physical Therapy

The Human Connection........................ Pg 15

Axis Spine Center......................... Pgs 41, 80

Peer Spokane....................................... Pg 33

Bonner General Health....................... Pg 21

Pend Oreille County Counseling Services ........................... Pg 46

Camas Center Clinic............................ Pg 51

Royal Life Centers............................... Pg 43

Inland Northwest Research/ Selkirk Neurology............................... Pg 19

Bonner General Behavioral Health.... Pg 21

Spokane Falls Recovery Center .... Pgs 7, 79


Life Care Center of Sandpoint............ Pg 37 Mountain Valley of Cascadia.............. Pg 66 North Idaho Home Health.................. Pg 47

Cornerstone Physical Therapy........... Pg 13

Newport Hospital & Health Services.................................... Pg 45

Rehabilitation Hospital of the Northwest................................ Pg 17

Medical Equipment, Products & Supplies Wheelchairs & More/ Western Medical Specialties.............. Pg 36


Camas Center Dental Clinic................ Pg 51

North Idaho Advanced Care Hospital ...................................... Pg 17

Veterans Resources/Service Offices... Pgs 62-64

Lakeview Dental................................. Pg 61

North Idaho Memory Clinic................ Pg 56

Veterinary & Animal Care

On Site for Seniors.............................. Pg 65

Financial Planning, Insurance & Legal

Pain Management of North Idaho..... Pg 25

Bonners Ferry Veterinary Clinic.......... Pg 44

Crandall Law Group............................ Pg 39

5% DI


Coyle & Wytychak Elder Law............. Pg 49 Humana............................................... Pg 73 Spears Insurance, Inc.......................... Pg 35

Fun Stuff – Recreation, Shopping Hospice of North Idaho Thrift Stores......................................... Pg 59 Kalispel Park.......................................... Pg 2 NorthWest Recumbent Cycles............ Pg 78 78 Wise Guide | 2020 Edition

Your North Idaho Recumbent Dealer

M COUNT Wiseention ! Guid e

Home of the comfortable, affordable, reliable and fun way to bicycle! Gary Dagastine Call or email for appointment gary@nwrecumbentcycles.com


Services Include PHP, IOP, OP and DUI/SUD Assessment Services • Individual Therapy • Individual Assessments • Group Therapy • Yoga & Meditation • Massage Therapy • Nutritional & Dietary Therapy • Adventure Therapy

www.TheWiseGuideOnline.com | Wise Guide 79

ADAM MILLS, DC Chiropractor



Physical Therapist

Interventional Pain Physician


ROLAND KENT, MD Spine Surgeon


Interventional Pain Physician


The region’s ONLY comprehensive spine center. Owned and operated by board certified, fellowship trained spine physicians committed to improving your quality of life by increasing daily functioning and empowering you to achieve your goals.


Get in Touch 208-457-4208 info@axisspinecenter.com axisspinecenter.com

80 Wise Guide | 2020 Edition

7600 N. Mineral Drive Suite 450 Coeur d’Alene, ID 83815

Profile for Jonnie Bradley

The Wise Guide Spring/Summer 2020  

The Health And Wellness Resource For North Idaho And Neighboring Communities In Washington And Montana.

The Wise Guide Spring/Summer 2020  

The Health And Wellness Resource For North Idaho And Neighboring Communities In Washington And Montana.


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