The Wise Guide Spring 2018 - N.Central Idaho & S.E. Washington

SPRING/SUMMER 2018

A N I N S I G H T F U L A P P R O A C H T O H E A LT H

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Bullies and Youth Transition Their Targets Services What is Immunizations Rheumatoid forArthritis Adults

Kinetisense - The– After a Stroke Future is Here!

Finding Words Veterans Serving Veterans

Spring / Summer 2018 Features About the Cover................................................................... 5 What is Rheumatoid Arthritis............................................ 6 Nursing Home—A Stereotype That No Longer Exists..... 8 Bullies and Their Targets.................................................... 10 “We Belong!” An Anti-Bullying Campaign..................... 12 Evaluating Assisted Living............................................... 14

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What Is “Personal Safety?”............................................... 16

What is Rheumatoid Arthritis?

The most common type of arthritis

Osteoporosis and Vertebral Augmentation.................... 18 After a Stroke—Finding the Right Words........................ 20 Veterans Pages.................................................................. 22 Idaho County Veterans Outreach, Grangeville............... 26 Exploring Veterans’ Pathways to Justice.......................... 28 I Think I Have Alzheimer’s Disease................................. 30 Useful Links for Aging in Place....................................... 31 Alzheimer’s Association Support Groups....................... 32 Is There a Dentist in the House?............................................34 Chronic Kidney Disease Matters..................................... 36 How to Select a Community to Meet Your Needs..............38 Autism & Asperger’s......................................................... 41

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Crossword & Sudoku....................................................... 42

Bullies and Their Targets

Bullying can happen anywhere, to anyone

Free Community Meals................................................... 43 Keeping Appointments.................................................... 44 Marines of the Palouse Golf Tournament....................... 44

Descriptive Advertisers’ Directory........ 45

20 After a Stroke – Finding Words

Finding the right word can be difficult

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The Wise Guide Spring / Summer 2018 Office: 208-263-5654 Email: info@thewiseguideonline.com www.TheWiseGuideOnline.com Jonnie Bradley Editor The Wise Guide

Donna Brosh Designer The Wise Guide Copyright Š2018, 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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About the Cover Cover Artwork:

“Grandpa’s Little Helper” by Ma Brown Robbins

About the Artist

Ma Brown Robbins, a Visual Artist for over 52 years, was born in Kellogg, Idaho. She began drawing at a very young age and once she found paints, brushes and canvas, painting soon became a life long love. After high school she began taking several workshops and going to art galleries to study the variety of works, striving to learn through daily drawing and painting.

Ma is proficient in several mediums but prefers acrylic & oil on canvas and other interesting materials such as stone, feathers, metal and more.

Ma often competes in juried art shows and many summer art shows throughout the Western USA. She has won several Best in Shows, Reserves in Show, People’s Choice & other unique honors, such as the Award of Acceptance at the 108th CLWA showing in New York, NY. Ma notes, “Attending the reception was an honor providing me the opportunity to meet many of the other artists accepted to the show.”

She thoroughly enjoys doing commissions and selling art through organizations such as the Rocky Mountain Elk Foundation

Marla working on a custom piece

The Last One Out 18”x24” oil on canvas

among other venues and galleries. Her work can be found on her website: western-art.com and at “Gallery Northwest,” 217 W. Sherman Ave., Coeur d’Alene, ID. Bluebird on a Leaf Ma enjoys the challenges of painting wildlife, 8”x18” acrylic, framed under glass portraits, landscapes, domestic animals, florals and especially commissions. “Each new painting helps me grow toward more accomplishments in the life and world of art.”

With blessings and dedication, I have sold art worldwide. I continue striving to become a better artist each day, looking forward to the next inspiration and the happy struggles and lessons it brings. Teaching art for 32+ years is both challenging and rewarding. It brings enjoyment and fellowship in guiding students in their goals to find their own rewards in creating a pleasing work of art. I love to help new and intermediate artists discover a love for painting while learning and having fun at the same time! With God’s Blessings, I plan to continue painting, showing and teaching art for many years to come!” ­ —Sincerely, Ma Brown Robbins

Custom orders welcome! On Moonlight Raccoons canvas, feathers, rock, saws & more!

13” x 16” acrylic Originals, artists proofs & limited on thin shale rock edition canvas and watercolor All oil paintings are available in prints are available.

Diamond T. Truck & Grizzlies 22”x28” oil on canvas

To purchase work, email: marlarobbins12@gmail.com or call 208-687-0175.

two sizes of Limited Edition Giclee Prints, original size and a smaller size, each numbered 1 to 80 only.

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What is Rheumatoid Arthritis?

by Zeeshan Afzal, MD Tri-State Rheumatology

R

heumatoid Arthritis (RA) is an immune driven inflammatory disease that attacks the body’s joints and is the most common type of autoimmune arthritis. The small joints of the hands, feet, and wrists are most commonly affected, but RA may involve any joint in the body. RA is a systemic disease and can involve multiple organ systems including skin, cardiovascular, lungs, eyes, and may increase risk of malignancies such as lymphoma.

Early Signs & Symptoms

RA often begins between 40 to 60 years old. RA symptoms may come and go, and include: • Pain, stiffness, and swelling of joints • Limited motion and function of joints • More than one joint is affected • Stiffness that is worse in the morning and may improve with activity

Treatment

Once a patient receives a diagnosis and determination of where they are in the spectrum of the disease, a treatment plan with enough power to match the disease should be chosen and should provide good or excellent relief of symptoms to allow patients to keep functioning at, or near, normal levels. The goal

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of treatment is to stop inflammation, relieve symptoms, reduce complications, prevent joint damage, and improve overall quality of life.

It is essential to establish a treatment plan early in the disease. Damage occurs early in most patients as 50% show joint space narrowing or erosions in the first 2 years. By 10 years, 50% of young working untreated patients are disabled. When damage begins early, aggressive treatment should be started early in the disease using the safest treatment plan that matches the aggressiveness of the disease. Then, close monitoring for adverse effects and disease activity must occur and prescriptions should be monitored for revisions as needed.

Some of the most critical elements of a treatment plan are assessment and therapy. Assessment includes reviewing current activity, morning stiffness, fatigue, and diagnostic test results; determining the degree of damage, range of motion, and deformities; and reviewing prior medication responses and side effects. Therapy includes patients receiving education about RA as well as proper exercises and medications to treat RA. It is very important for patients to be physically active, most of the time, after a RA diagnosis through conditioning and strengthening exercises to increase range of motion.

Remember—early intervention can make a difference!

Tri-State Rheumatology provides treatment of immunological disorders that can cause arthritis, rheumatoid arthritis, lupus, scleroderma, and other conditions and offers state-of-the-art infusion therapy. ___________________________________________________________________

Dr. Zeeshan Afzal has extensive training in the treatment of arthritis, inflammatory diseases, and advanced areas of rheumatology for diverse patient populations. He received his Bachelor of Medicine and Bachelor of Surgery in 2013 and then completed his residency in Internal Medicine. He continued his training as a Fellow in Rheumatology and is board certified through the American Board of Internal Medicine. Dr. Afzal is currently accepting new referral patients at Tri-State Rheumatology.

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Nursing Home — A Stereotype That No Longer Exists

by Tosha Killinger Community Relations Director Regency Pullman

W

hen people speak of senior care, many use the words “Nursing Home,” to encompass all levels of senior care.

This stereotype is long gone given the options for senior care today. Skilled Nursing Facilities (SNF) are required for higher levels of care, and have little resemblance to the “nursing homes” of the past. And, Assisted Living Communities (ALF) have been developed as a wonderful option for senior care — the days of the stereotypes of nursing homes are over.

Skilled Nursing Facilities offer short-term stays for individuals who need additional rehabilitation following illness, injury or surgery and include in-house Physical Therapy and Occupational Therapy. A SNF is an option when the patient requires the care of a licensed nurse 7 days per

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week and/or a therapist 5 days per week. Typically, a patient will stay at a SNF when it is considered unsafe for them to go home and their levels of required care are higher than what can be offered at an Assisted Living Community.

As an alternative means of care, Assisted Living Communities offer senior residents a way to stay mostly independent with only a small amount of assistance. Many Assisted Living Communities include in their pricing: 3 meals per day, transportation, weekly housekeeping with linen change, water, sewer, garbage, heat, air conditioning and cable. The only thing not included in pricing is a telephone as the majority of people use cellular phones in today’s world.

A Negotiated Service Plan is instituted when additional services are needed. This includes a buffet of options such as medication assistance, escorts to/from meals, stand-by assistance with bathing, personal laundry done by staff, toileting and transfers. Negotiated Service Plans are customized for each individual. They are called “negotiated” because the level of assistance can change frequently, sometimes weekly, depending on the needs of the individual.

In Assisted Living Communities, a licensed nurse (RN) is on call 365 days per year, 24 hours per day and on the premises 40 hours per week. Assisted Living also requires 24-

hour licensed care staff and Medication Technicians on site.

Access to assistance at any time of the day or night is just a push button or pull cord away, still with the feeling of living independently.

Many of the newer Assisted Living Communities have been likened to an upscale hotel. Individual apartments are the norm with options being a studio, one-bedroom, or even twobedroom apartment. Amenities typically include an on-site Beauty/Barbershop, Ice Cream Parlor, Theatre Room, Billiards Room, Courtyard, Library and Computer Rooms. Add to that a vast array of daily activities including games, arts and crafts, and short trips and it can feel very luxurious.

There are times when a Skilled Nursing Facility is needed, however, seniors have options. Schedule a tour with an Assisted Living Community and be awed by the choices seniors now have in their retirement years. You will see that the term “nursing home” no longer holds the same meaning it did in days gone by. _________________________________________________________________

Tosha Killinger was raised in Pullman, graduated from PHS, then attended WWCC, where she received her Associate of Arts Degree.

She then transferred to LCSC graduating with a Bachelor of Social Work. Tosha began working for Regency Pullman in July 2008 where she discovered her passion for working with the elderly population.

Tosha has 2 children: Hailee, 19, completing her first year at WSU; and Mason, 15, currently a freshman at PHS.

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Bullies and Their Targets

B

ullying behaviors present concerns for both the person being bullied and the person engaging in the bullying behaviors across all settings, including at school, at home, and at work. Bullying is a conscious action taken to induce physical or psychological pain and to create a sense of inferiority in the target, and superiority of the bully in the eyes of the onlookers.

Bullying can take place in several different forms; direct (that which occurs in the presence of the target), and indirect (spreading rumors, undermining the achievements or efforts of the target). Types of bullying include physical, verbal, relational (damaging reputation), and damage to property.

Common Characteristics of Bullies and Their Targets

There are several identified “types” of bullies which include aggressive bullies, passive bullies, and those whom have been targets of bullying themselves. In general, bullies have several personality traits in common including being physically strong, coercive, lacking empathy for their targets, and being motivated by the power and desire to dominate others.

Additionally, the targets of bullying frequently possess a set of common characteristics such as anxious and depressed affects, demonstrable fear, as well as a negative view of themselves.

The largest category of individuals in a bullying situation are the onlookers. These individuals can be greatly impacted by bullying behaviors and have either a positive or a negative impact in a bullying situation. A multitude of issues and behaviors influence how they will react to a bullying situation,

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by Sequoia Counseling Services, Inc.

including their relationships with both the bully and the target, as well as their own self confidence and sense of safety and security within the setting.

Age and Setting are Not Factors

It is important to recognize that bullying is not just something that happens in children, and that it can occur throughout adulthood at work and in other settings. It can include verbal abuse, sabotaging the target’s job or work relationships, or over asserting authority over others. The effects of being allowed to bully and being bullied can last throughout someone’s life if not addressed properly during the early years when the behaviors first become apparent.

Bullying can also be done electronically by threatening, spreading rumors, even viruses or directly damaging stored information. The anonymity of social media has made it a common method of bullying, and the lack of direct confrontation between the bully and the target make it sometimes seem to empower the bully to say and do things that they might not say directly.

Bullying and the Incidence of Suicide

While the media has over-publicized the incidence of bullying leading to suicide, there is no evidence that bullying directly causes suicidal behaviors. Bullying can be identified as one among many risk factors which place a young person at increased risk of suicide-related behaviors. When a person

When Preventative Programs are Not Enough

is involved in bullying, either as the bully, the target, or an onlooker, the likelihood of that contributing to increases in feelings of helplessness and hopelessness can be seen as a significant risk factor in suicidal behavior. In general, youth who both bully others and are bullied are at greatest risk for subsequent behavioral, mental health, and academic problems throughout their lives.

Therapy can be helpful for all individuals involved in bullying situations. For those who have been the target of bullying, the sense of hopelessness and helplessness can be overwhelming. Having a qualified therapist who is able to provide a safe place to learn to effectively express emotions, learn assertiveness and boundary setting skills, and assist the person in building their own sense of self confidence can be instrumental in decreasing the impact of bullying. There are also benefits of therapy for those who are bullies to others. The therapist can assist the person in becoming more aware of the impact that their behaviors have on others. Making connections between their own experiences and how that has impacted their behaviors can also be instrumental, as the person processes their own emotional wounds and learns ways of communicating and interacting with others in a more socially effective and appropriate manner.

The impacts of bullying are seen throughout our society.

It takes all of us working together to mitigate it and its long term effects.

In general, youth who both bully others and are bullied are at greatest risk for subsequent behavioral, mental health, and academic problems throughout their lives.

What Can Be Done?

We all have a part in decreasing the negative impacts of bullying. A system wide approach is the most effective in dealing with bullying across all domains. This begins at home, with parents modeling and teaching children positive and appropriate ways of interacting with others to avoid being a bully or being bullied by others. At the school level, implementation of programs that focus on positive behaviors, set universal expectations for everyone at the school, and assist staff in implementing school-wide prevention activities.

Programs focused on restorative justice and “making things right,” as opposed to suspension and expulsion for bullying behaviors provide the best results. Community members can take a role in preventing bullying through making concerted efforts to advocate for and mentor children, assisting them by modeling and teaching positive and appropriate methods of interacting with peers and adults across a variety of settings.

_________________________________________________________________

Sequoia Counseling Services, Inc. is a private counseling agency, offering individual and family therapy services for adults, children, and families. We have been serving participants in the Lewis Clark Valley for 15 years. We also offer Community Based Rehabilitation Services in the home, community, and school settings. We have a Certified Family Support Specialist on staff and also offer case management services to those who qualify. Our group respite care program for parents of children with Serious Emotional Disturbances offers a chance for these children to experience a wide variety of community events in a safe space with caring staff members. For information on any of the services offered by our agency, please call 208.798.1646 or email sequoia3@sequoiacounselingservices.com.

Sequoia Counseling Services, Inc.

Accepting private insurances, employee assistance programs, Idaho Medicaid.

531 Bryden Avenue Lewiston, Idaho

208-798-1646

Sequoia3@SequoiaCounselingServices.com

• Individual and Family Therapy focused on depression, grief, anger, peer difficulties, behavioral problems, trauma, crisis and family stressors • Help identifying, accessing and utilizing needed medical, behavioral, or social services • Community-Based Rehabilitation Services for children & adults • Case Management • Family Support Services • Group Respite Care Wise Guide | www.TheWiseGuideOnline.com

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“We Belong!” An Anti-Bullying Campaign

by Kristi Sharpe, CPP Community Coordinator, Clarkston EPIC (Empowering People & Impacting Choices)

T

he kids at Lincoln Middle School (LMS) have taken matters into their own hands! When asked what the biggest problems that students were facing at school, during the Washington Prevention Summit in Yakima in November of 2017, it wasn’t hard for the attending 24 members of the LMS Kindness Club to answer: it’s bullying and unkind behavior.

The Kindness Club began in the fall of 2015 with the intention of creating a stronger culture of kindness to reduce stress and ultimately lower the risk of kids using drugs and alcohol. The Kindness Club now consists of 40 members from students in both the 7th and 8th grades, lead by two Youth Advisors who oversee the process. The students meet every Friday for half an hour to plan pro-social activities and implement campaigns to promote kindness and to prevent destructive behaviors. The activities are funded by the local

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coalition named Clarkston EPIC (Empowering People & Impacting Choices) and by the Clarkston School District.

The mission of the EPIC coalition is to empower people with knowledge to build a more resilient and protective community for the well-being of our youth. As a part of that mission, the inclusion of youth being part of the solution, is vital.

One of their solutions? An anti-bullying campaign called, “We Belong.” This is the new culture being created at Lincoln Middle School, and one that is being built to last with support from everyone, from teachers to the superintendent of the district. The “We Belong” idea was founded on the basis that all humans have an innate need to feel like they belong. The lack of civility and unkind behavior that commonly swirls around a middle school environment eats away at the core of that feeling, and so these students decided to do something about it. “We Belong” signs, and posters made by students promoting inclusion, grace the hallways at LMS as a reminder to include and be kind to everyone. Word of mouth has spread, and this message is now resonating at the elementary level and even in

the high school. The ultimate goal of the campaign is to help students feel taken care of, safe to be themselves, and have a strong sense of belonging.

Some examples of pro-social activities include: • “Mix-it-up Lunch” where students sit with kids they don’t usually sit with • Playing Bingo at lunch • Making Gingerbread houses together • Outdoor games • High Fives in the hallway • Celebrations once a month for those who have no Choice Cards (Choice Cards are given out when a student makes a bad choice)

As a result of these efforts, fewer and fewer kids are receiving choice cards and the celebrations just keep getting bigger. More and more kids want to be involved in the Kindness Club, as it is seen as an honor. Kids who want to participate must maintain a C average or better, inspiring kids to get, or keep their grades up. Six members of the Kindness Club will compete with this yearlong project at the Spring Youth Conference in Grand Mound, Washington, in May.

Now when a student is disciplined for unkind behavior, a strong message is sent conveying that we don’t tolerate that here, we all belong to the same team. We all deserve to belong. A side effect of this heartfelt message, is that it reminds us as adults to be kind as well; kind to others, kind to ourselves, and to live with a little more grace and humility. These kids are a shining example of how each and every one of us can make a difference, and how to make this world a little brighter place to live in.

For more information: Visit us at facebook.com/ClarkstonEPIC Website: asotincountycommunityservices.com or contact Kristi Sharpe at 509-758-3181, sharpe@cableone.net ___________________________________________________________________

Kristi Sharpe, CPP, is a Certified Prevention Professional with 9 years of substance abuse prevention experience working with communities in creating an environment where youth thrive and cope in healthy ways. Kristi received her Associates Degree from Walla Walla Community College and earned her CPP in May of 2015. She is employed by Asotin County Community Services and is the coordinator for prevention efforts in Clarkston, WA

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Evaluating Assisted Living

by Daniel L. Dunham Executive Director Brookside Landing, Orofino ID

T

he first foray into the question of care for the elderly is all about how much care, how soon, and finally, where?

Families can choose to care for their loved ones themselves at the loved one’s home, or at a family member’s home. In addition to the family, help from Home Care agencies can also provide care at home. Assisted Living is the next logical alternative for helping a loved one remain independent and active when residing at home is not feasible.

The roots of Assisted Living do not run very deep. Most practitioners accept 1979 as the birth year of what has become Assisted Living. One article denotes 1979-1986 as the time period of a paradigm shift away from nursing homes to an idealistic base of a better situation for the elderly (Wilson, 2007). The idealistic view was rather utopian in nature with good physical care of the building environment, a nice place to live, coupled with activities and entertainment. Add great food and good nutrition and you have the ideal setting for our elderly.

One trend I have noticed in families is the inclination to ‘wait and see.’ The by-product of this inclination is to wait too long. It is possible to wait long enough that the need for care becomes greater than an assisted living facility can provide. Some of where this line is drawn is common sense; some is governed by directives from the state agency that licenses care facilities.

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There are two major factors to consider when evaluating the type of care needed. First, are the loved one’s needs for care increasing and how well are they being met? Second, what are the capabilities of the friend or family member who is providing the care? Are they able to provide adequate care, and what about their stress level and the effect on that caregiver’s own health? As with any decision, there are many pluses and minuses to contemplate.

Let’s examine the pluses of living in a care facility. There are many improvements to quality of life included in taking up residency in a facility. Companionship may or may not be considered. I see this element ignored sometimes, and at other times it is the most important issue. In an organized living setting there are opportunities for activities, entertainment, and even the simple action of sharing meal time. Other pluses to consider are having a safe environment, supervised nutrition, housekeeping, and help as needed with daily living activities such as dressing, hygiene, and transportation.

It is very important that you do not wait too long to make this decision. I have researched some articles addressing this and I am happy to share them with you. We can study them together considering your specific situation. Just because you start the process does not mean you have to jump in. It does mean you will be prepared, know what to look for, and what your options are because time waits for no one.

The quest for senior living involves environment, services, autonomy, and value. Everyone wants a nice place to live, services that include entertainment, the autonomy of remaining as independent as possible, and of course they want this all for a good value.

Assisted Living facilities can provide a network of friends.

This may be a group of friends that move to a facility together, or developing friendships once they have moved into a facility.

One article is a primer about how friends play a big part in living a longer, healthier life. The standard fare for health and long life has long included doctors, medication (both natural and synthetic), self-help books, healthy eating habits, vitamins, exercise, and avoiding things that are bad for you.

This article details studies involving the role of friendship in the grand scheme of things, www.nytimes.com/2009/04/21/ health/21well.html

One of the studies cited in the article purports a 22% improvement in length of life among those with a circle of friends. Another study found a correlation between friendship and health issues; that friends have similar health issues. Yet another study connects brain health being impacted more by friendship than by family relationships.

“People with stronger friendship networks feel like there is someone they can turn to,” said Karen A. Roberto, Director of the Center for Gerontology at Virginia Tech. “Friendship is an undervalued resource. The consistent message of these studies is that friends make your life better.”

“Social isolation can lead to feelings of loneliness, fear of others, or negative self-esteem. Lack of consistent human contact can also cause conflict with the (peripheral) friends the socially isolated person may occasionally talk to or cause problems with family members.” https://en.wikipedia.org/wiki/Social_isolation.

This is not an absolute, meaning just because you spend time alone this will be the case. It is more a possibility than an absolute.

Physical activity can reduce the feelings of isolation.

This is very apparent in our Fit and Fall class we hold at Brookside Landing at 2 PM every Wednesday and Friday. Not only do many of our residents participate, we have many regular visitors to the class from the outside community.

Feelings of loneliness can negatively affect both physical and mental health. People tend to report feelings of physical or mental distress more when they feel lonely than if they are busy and involved. Again, this is not an absolute cause and effect, but the trend is significant enough to note a strong relationship between the two.

Perceived loneliness contributes to cognitive decline and risk of dementia. There are studies that connect not only the fact of being lonely, but also the perception of being

A Premier Retirement Community

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lonely, to cognitive decline and links to dementia. If activity and companionship can help with this, it is imperative we seek it out and make it happen.

I think there are three things you should appraise when evaluating an assisted living facility. It should be apparent that the facility has direction and purpose beyond being a workplace environment. Obviously there must be work completed, but the environment should be a home.

In order to accomplish this all important mission of creating a home for this segment of our population, three things should be apparent: •

• •

It is critical that the facility personnel have strength of selfmastery. The need for this should be obvious that in order to deal with others, whose needs are great at times, one must have extremely good self-control. This will manifest as kindness, gentleness, and patience even when events are stressful or even chaotic.

Facility personnel must have a highly developed strength of action. When action is needed, it is needed now, not later.

Finally it is vital that the facility personnel practice strength of relationship. A warm, nurturing, home environment cannot exist without a strong sense of relationship. Staff must connect with residents, residents must connect with staff, and residents should develop a sense of care and camaraderie with each other.

Relationship takes time. Without time spent together, there can be no real relationship. (Jones, 1995)

Brookside Landing provides excellent care in the scenic small town setting of Orofino, ID. We live where others come for vacation! Come visit our home at Brookside Landing and let’s consider your options together. ___________________________________________________________________

Daniel L Dunham has been the Executive Director at Brookside Landing in Orofino, Idaho for over two years. He holds a Bachelor’s Degree in Business management, a Master’s Degree in Health Services Management and has completed his Doctoral course work in Organizational Leadership with an emphasis on how to pay for healthcare.

• Independent living • Assisted living with customized care packages • No long-term commitment, give it a try!

• Quiet “brookside” setting just

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a block from charming downtown Orofino.

Offering the amenities of big city communities, in a scenic small town setting.

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15

What is “Personal Safety?’”

by Deputy Chris Johnston Crime Prevention Unit Spokane County Sheriff’s Office

In Partnership with the Community.

Dedicated to Your Safety.

Hi Everyone!

I’d like to take this opportunity to speak to you about personal safety. Let’s start by answering the question, “what is personal safety?” Now, I’m sure if you looked in a dictionary, there are likely several definitions that could be used to describe what it means. First, I want to point out that personal safety is not self-defense. I think of self-defense as physical tactics that one might employ to defend themselves, if they were being attacked physically. An arm bar, a leg sweep, or strikes like punching and kicking. There is a proper way to employ these techniques, and, if properly used, they can be effective.

That being said, let’s get back to my original question: What is personal safety? I have created a definition that I think

accurately answers this question. Personal safety is “the art of avoiding self-defense.” To clarify what that means, it’s really quite simple- if we do our best to make good decisions in our day-to-day lives, we can effectively reduce the chances of becoming the victim of an attack. Another strong belief that I have is that to be prepared does not make us paranoid; instead, it helps us confidently avoid the need. Upon donning my patrol uniform and gear, I gain 27 pounds. Each piece of my duty gear has a purpose, and allows me to be prepared for whatever situation that I might face. Let’s discuss some simple ways for you and your loved ones to be prepared, and don’t worry, I won’t ask you to carry 27 pounds of gear like I do…

• The MOST powerful set of personal safety tools humans

have is our senses. All too often, people choose to ignore that underlying, subconscious feeling that something is wrong.

Don’t do that! If something feels amiss, it’s always best to err on the side of caution and trust your instincts.

• Walk with “purpose!” When moving about in your daily

life, pay attention to what is going on around you. Avoid distractions like talking on the phone or texting, updating your Facebook or Twitter feeds, and my personal favorite, stopping every 30 seconds to take a selfie. It’s best to have your head up, your eyes open, and your ears open, too (turn down that iPod).

• Don’t be afraid to react! For example, if you think you’re

being followed, abruptly change direction. Also, don’t be afraid to look directly at the person who is putting you in fear, as this accomplishes two things: First, it sends a message that you will not be an “easy” or “willing” victim. Second, it allows you to get a good description of the person, should something happen. The idea here is to move confidently, and make yourself a hard target.

• Use the buddy system whenever possible. We’ve been

hearing this throughout our entire lives, and that’s because it really is good advice. When I respond to any call that is potentially dangerous, I always request a backup, or “cover” officer. The reason why is simple: more eyes, more ears, and another set of hands should something go wrong. As an added bonus, it creates a deterrent in the mind of the attacker.

• Let people know where you’re going, and when you’re

expecting to return. I’ll use myself as an example once again; when dispatching myself on a service call, I always let the communications center know the call type, where I’m going, when I arrive, and when I leave. This gives other first responders the best chance of reaching me quickly should an emergent situation occur.

Wise Guide | Spring / Summer 2018

• Property is NEVER worth your safety! If someone demands

your wallet or purse, you’re faced with an immediate choice: comply or resist. As a general rule, compliance is best to ensure your personal safety. For example, if someone is armed with a weapon and demands your purse, GIVE IT TO THEM! In fact, throw it at them, and flee. There shouldn’t be anything in a purse that isn’t replaceable, however the person carrying that purse is irreplaceable. Assume that someone is armed and dangerous, even if you don’t see a weapon. People who commit these types of crimes are often desperate, and MUST be considered dangerous. To that end, you do have the legal right to use force to protect yourself and others if you feel threatened.

• Make some noise! Noise draws attention, and bad guys don’t

like attention. If you’re able to shout, do it. Another great way to make noise is with a personal alarm. They’re inexpensive, easy to carry, simple to deploy, and they are LOUD!

• Other tools. There are a myriad of other tools we can use to

defend ourselves, such as pepper spray, stun guns, TASERS, edged weapons, and even firearms. If we are considering using any of these, we are now in “self-defense” mode. These are all fine options, but make sure that you train and practice with whatever you select on a regular basis so you know that you’re capable of using it/ them under stress. Also, I advise you to take the time to learn the laws in your state as they relate to self-defense and the use of force. During my career, I have seen people get arrested and

receive criminal charges for using force in an unlawful manner (such as using a firearm to protect property).

• Do some drills, and practice for the “what if?” Have you

ever taken the time to ask yourself, “what would I do if this happened? How would I react? Am I prepared?” It’s worth mentioning one more time that this does not equal paranoia.

Being prepared includes knowing as much information in advance as possible!

These are just a few ideas that you can use to help yourself stay safe. On behalf of the Spokane County Sheriff’s Office and the Spokane Valley Police Department, I sincerely hope that you and your loved ones are enjoying the beautiful summer weather! As always… be safe!

____________________________________________________________________

Deputy Chris Johnston, Spokane County Sheriff’s Office. 11 years of experience in law enforcement, including response and investigations of burglary, assault, robbery, theft, homicide, traffic, drugs, sex crimes, and various domestic violence crimes. Currently assigned to the Crime Prevention Unit for the City of Spokane Valley, maintains certification as an emergency vehicle operations instructor, Crisis Intervention Team, and public instruction on topics such as personal safety, self-defense, workplace violence prevention, active shooter survival, crime prevention through environmental design, and verbal de-escalation techniques.

Deputy Chris Johnston, Crime Prevention Unit

SCSO/SVPD 389-2771

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Osteoporosis and Vertebral Augmentation

Vertebral Augmentation

This is a minimally invasive procedure that can alleviate a large portion of the pain caused by compression fractures. It can also stabilize the fracture as well.

by Dr. Jessica Jameson Axis Spine Center

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steoporosis is a disease that gradually weakens bones and increases the risk for fractures. Osteoporosis and osteopenia (low bone density) affects an estimated 54 million Americans, according to the National Osteoporosis Foundation. Left untreated, osteoporosis can progress silently and painlessly. Often times the first sign of these problems is fracture of a bone.

Severe osteoporosis can cause fractures of the hip and wrist but can also cause compression fractures in the spine.

This occurs when the spine bone, or vertebral body, collapses.

This causes severe pain, deformity, and loss of height. It can also cause nerve compression. These fractures can be diagnosed with x-ray, CT scans, or MRIs. While osteoporosis is the most common cause, these fractures may also be caused by trauma or metastatic tumors.

Some people have a higher chance of getting the disease because of: • Race: White and Asian women have the greatest risk.

• Age: The chances are higher for women over 50 and go up with age.

• Weight: Women under 127 pounds are at higher risk.

• Smokers: People who smoke lose bone thickness faster than nonsmokers.

• Gender: Women develop osteoporosis more often than men, although men do make up 20% of those with the condition.

Compression fractures occur in more than 750,000 patients per year in the United States, are more frequent than hip fractures, and often result in prolonged disability.

The symptoms of vertebral compression fractures may include any of the following, alone or in combination: • Sudden onset of back pain • An increase of pain intensity while standing or walking • A decrease in pain intensity while lying on the back • Limited spinal mobility • Eventual height loss • Eventual deformity and disability

Until recently, doctors were limited in how they could treat osteoporosis-related spine fractures. Pain medications, bed rest, bracing or invasive spinal surgery were the only options available. This meant that patients had to endure a great deal of pain while they simply waited for their fracture to potentially heal. Today there are promising therapeutic treatments for compression fractures. These procedures are called vertebral augmentation.

Wise Guide | Spring / Summer 2018

How is Vertebral Augmentation Performed?

This is typically performed under local anesthesia sometimes with a small amount of sedation. Using image guidance x-rays, a small incision is made and a probe is placed into the vertebral space where the fracture is located. The bone is drilled and a cavity is created for cement to be placed in.

Sometimes a balloon is used to create the space and expand the bone. The spaces created by the drill are then filled with PMMA which is an orthopedic cement that binds the fracture.

The cement hardens quickly, providing strength and stability to the vertebra, restoring height, and relieving pain.

After the procedure you are able to get back to your regular activities with minimal down time. Pain relief from this procedure occurs rapidly.

Benefits of Vertebral Augmentation

Limitations in the traditional treatments of vertebral compression fractures have led to the refinement of such procedures as vertebral augmentation. These procedures provide options for compression fractures and are designed to relieve pain, reduce and stabilize fractures, reduce spinal deformity, and stop the “downward spiral” of untreated osteoporosis.

Additional benefits of these procedures include: • Short surgical time • Only sedation or local anesthesia required • No hospital stay • Patients can quickly return to the normal activities of daily living • No bracing required

Complication rates for vertebral augmentation have been estimated at less than 2 percent for osteoporotic fractures.

Screening for osteoporosis is very important. Bone density scans are typically covered by insurance and are important for detecting and monitoring osteoporosis. Be sure to ask your primary care physician about this important screening tool! ____________________________________________________________________

Dr. Jameson received her medical degree from Michigan State University and completed her internship at David Grant USAF Medical Center, Travis Air Force Base, California. After spending four years as a United States Air Force Flight Surgeon, Dr. Jameson completed her residency in Anesthesia at University of Iowa College of Medicine, Iowa City. She continued her education with a Harvard fellowship in Pain Medicine at Beth Israel Deaconess Medical Center, Boston, MA and became board certified in both anesthesiology and pain management by the American Board of Anesthesiology.

Services Offered Include: • Minimally Invasive Surgery

Jessica Jameson, MD Interventional Pain Physician

Roland Kent, MD Spine Surgeon

• Motion Preservation • Revision Spine Care • Deformity Correction • Complex Spinal Trauma Care

Molly Liter, ARNP Nurse Practitioner

Jeanean Rasmussen, PA-C Physician Assistant

• Sacroiliac (SI) Joint Care • Spine Injections • Joint Injections • Botox for Migraines • Medical Weight Loss • Cancer Pain Treatment • Vertebral Augmentation • Platelet Rich Plasma • Stem Cell Therapy • Spinal Cord Stimulation

Jennifer Torok NP-C Nurse Practitioner

Axis Spine Center is the region’s ONLY comprehensive spine center. We are owned and operated by board-certified and fellowship trained spine physicians. We are committed to improving each patient’s quality of life by increasing daily functioning and empowering patients to achieve their goals.

1641 E. Polson Avenue Suite 101 Post Falls, ID 83854 (p) 208-457-4208 axisspinecenter.com

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After a Stroke – Finding the Right Words

by Leticia Morales, Speech Pathologist Corpus Christi Rehabilitation Hospital

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t’s common to struggle at times to find the right word during a conversation. But for an individual who has had a stroke, finding the right word may be much more difficult.

Aphasia can be a side effect of a stroke, which can affect a person’s ability to communicate by impairing the ability to speak, read, listen or write. It doesn’t affect intelligence, however. When a person with aphasia has word-finding difficulty, it’s called anomia. Anomia is a common symptom of aphasia that makes it difficult to find the words or ideas that a person may wish to share.

Anomia can be really frustrating for individuals because they know what they want to say, but they just can’t find the words. It can make a conversation difficult because sometimes the word will come and sometimes it won’t.

There are various causes to word-finding problems in patients with aphasia, and they may present differently. For example, a person may not be clear on the meaning of a word so he or she may not be able to complete a task that requires knowing what the word means. Another person may not be able to identify a family member or name an item in a photo. Another may know a word and recognize it in print, but may not be able to pronounce the sounds to say it, or an individual may say a word that’s a little bit off from the right word (i.e. poon versus spoon).

When these types of things happen in a conversation, the person who is speaking to the stroke survivor may want to jump in quickly to supply the word. But in reality, that can be more of a hindrance than a help. It would be more beneficial to help the person find the word they are looking for rather than supplying it.

Wise Guide | Spring / Summer 2018

To best communicate with someone under these circumstances, consider these following suggestions: • Be patient. Allow plenty of time for a response. Talk with the individual, not for him or her • Give the person time to respond and don’t rush him or her • Ask “yes” or “no” questions that can be answered simply and without a lot of explanation • Ask questions that can help zone in on what the individual wants to say. For example, if you were talking about flowers, ask “Is it in our yard?”

• Use photographs or pictures to help provide cues • Write your cues – such as a letter or a drawing – on a piece of paper to share • Confirm and repeat back what the person has said.

Use paraphrases or key words to be sure that you’re understanding properly • Use gestures as you ask questions

The most important thing is to not “talk down” to an individual. Be respectful and provide emotional support showing that you recognize that the person knows what he or she wants to say. And remember that every word doesn’t have to be perfect, so downplay errors. Not all words need to be said perfectly to communicate. __________________________________________________________________

Leticia Morales is a speech pathologist at Corpus Christi Rehabilitation Hospital, a sister facility of Rehabilitation Hospital of the Northwest. These hospitals provide specialized rehabilitative care to patients recovering from disabilities caused by injuries, illnesses, or chronic medical conditions. For more information, visit RHN.ernesthealth.com, call 208-262-8700 or visit the hospital at 3372 E Jenalan Ave., Post Falls, ID.

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These Veterans Service Officers are here for you: NORTH IDAHO Idaho State VSO

Darryl Heisey 208-446-1092/1094 120 E. Railroad Ave., Post Falls M-F 8:30 AM - 5:00 PM email: Darryl.Heisey@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

MONTANA

Montana State VSO National Guard Armory • 406-755-3795 2989 Hwy. 93 North, Kalispell Appts. M & F, walk-ins welcome Wed., Tues. is outreach, Thurs. closed.

Carolyn Collins email: carolcollins@mt.gov

Ryan Keeler, 406-755-3795 email: rkeeler@mt.gov

Boundary County John Tucker 208-267-8611 6635 Lincoln St., Bonners Ferry Thursdays 9:00 AM - 1:00 PM email: jtucker@bonnercountyid.gov

Bryan T. Zipp email: bzipp@mt.gov

Kootenai County Scott A. Thorsness, Director 208-446-1090/1092 120 E. Railroad Ave., Post Falls M-F 8:30 AM - 5:00 PM email: sthorsness@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

‘If the wings are traveling faster than the fuselage it has to be a helicopter – and therefore, unsafe.’

–Fixed Wing Pilot

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

‘Never tell the Platoon Sergeant you have Nothing to do.’

–Unknown Infantry Recruit

READ THIS!

NORTH CENTRAL IDAHO Idaho State VSO

Bob Cooper 208-750-3690 821 21st Ave., Lewiston M-F 8:00 AM - 5:00 PM email: bob.cooper@veterans.idaho.gov

Idaho State VSO

Joseph Riener 208-750-3690 821 21st Ave., Lewiston M-F 8:00 AM - 4:30 PM email: joseph.riener@veterans.idaho.gov

Clearwater County

Fran Palasso 208-476-7378 330 Michigan Ave., Orofino M-TH 9:00 AM - 2:00 PM email: vsoclearwater@gmail.com

Idaho County

Camden Schacher 208-983-0239 320 W. Main Rm 29 M-F 8:30 AM -5:00 PM (appointments) Grangeville (Courthouse) email: cschacher@idahocounty.org

Latah County

June Beyer 208-883-7209 Latah County Annex 200 S. Almon St., Ste. 103 M-F 8:30 AM -12 noon, 1:00 - 4:30 PM email: jbeyer@latah.id.org

Veteran Service Officers (VSO’s) are trained, certified and accredited 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.

Nez Perce County

Please call the Idaho State VSO offices in Lewiston: 208-750-3690

Nez Perce Tribe Veteran Benefit Specialist

Mary S. Taylor 208-621-4738 271 B Street, Lapwai M-F 8:00 AM - 4:30 PM email: mtaylor@nezperce.org

Idaho Department of Labor - Veterans Reps.

Moscow

Dave Darrow 208-882-7571 Ext. 3743 Veteran Services Representative 530 S. Asbury St., Ste 1, Moscow email: dave.darrow@labor.idaho.gov

Lewiston

Don Erickson Disabled Veterans Outreach Program (DVOP) Phone: (208) 799-5000 Ext. 3526 1158 Idaho St., Lewiston email: donald.erickson@labor.idaho.gov

Lewis County

Michelle A. Lyons 208-937-9248 510 Oak St. Room #1, Nezperce M-F 9:00 AM -12 noon, 1:00 - 5 PM Wednesdays & Fridays Drop-ins email: mlyons@lewiscountyid.org

‘Five second fuses last about three seconds.’

–Infantry Journal

NOTE: The Department of Motor Vehicles now offers a Veteran Designator on Idaho State Drivers Licenses. The veteran must provide proof of an Honorable discharge from the Armed Forces.

The NorthWest Service Dog Alliance (NWSDA) Bugles Across America

By law, every honorably discharged veteran has the right to a military honor guard at their memorial service. The honor guard must consist of at least 2 members of the military who fold and present the U.S. flag to the family and arrange for the sounding of taps, either live or recorded.

Tom Day founded Bugles Across America in 2000. Provides musicians free of charge to sound taps at military funerals. Families can request a bugler at buglesacrossamerica.org and a notice is then sent to volunteers in the area. More than 4000 people of all ages, in all 50 states and several countries have registered as volunteer buglers.

Despite the groups name, bugles aren’t the only instrument used to perform taps; trumpets, cornets and glugelhorns are also played.

VA Dental Insurance Program

Everyone enrolled in the VA Healthcare System is eligible for the VA Dental Insurance Program, and family members are eligible for enrollment if the veteran is rated 100% Permanent and Total and the family members are enrolled in ChampVA. More information can be found at www.va.gov/healthbenefits/VADIP/.

Youth Summer Camp!

YMCA Camp Reed has special scholarship funding 2018 for children, grades 1-9, from military families. June 24-29 - Fan Lake, North of Spokane. Current and active duty personnel from all service branches. Army, Navy, Marines, Air Force, Coast Guard, National Guard and reserve units whose members have been active with drills over the past year are encouraged to apply. Voted the Inlander’s Best Kids’ Camp since 2006. We wish to honor our military service families by offering these exclusive scholarships: it is our way of saying thank you for your service! Funds are available on a first come, first served basis. Don’t wait! Call now for more information 509-720-5630.

is a non-profit that helps educate, establish and maintain partnerships to share information about the rights and needs of Service Dog teams, Service Dogs and the abilities of those with disabilities. The NWSDA believes in CARES! Consult, Advocate, Reach, Educate, and Support. That is the best way to “Embark on Change One Dog at a Time!”

NWSDA has launched a campaign, Unleashed, to bring awareness to the issues handlers and Service Dogs teams face each day. Come join us to share ideas. Service Dogs are welcome provided they are task trained to aid a disability and public access ready. Meetings are held the last Friday of each month from 4-5:30 PM. Locations may vary so please go to nwsdalliance.wixsite.com or facebook.com/groups/ 1840902172819572 for current information.

FREE COFFEE at G.I. Java Veterans Center, 1203 N. 4th, Coeur d’Alene Why Coffee? Coffee is part of our mission. It is universally recognized as a tool for socialization. Many of our wartraumatized vets isolate themselves and do not socialize. We provide free coffee to draw them to the Vet Center and hope, over time, that they will feel comfortable enough to interact with other veterans and if needed, join a peer support group. We also provide coffee to the public so that the community will come to the Vet Center and see the plight of many of our veterans, and donate to support our cause. Lastly, coffee is available as a convenience to those veterans attending the Vet Center and group meetings. vetcenter.org

EVENTS Veterans Stand Downs

Coeur d’Alene, ID - May 12th Kootenai County Fairgrounds, 8-1 Kalispell, MT - June 9th, Evergreen Fire Hall, 9-3 Wenatchee, WA - August 4th at the Armory on 5th St., 8-3 Helena, MT - August 18th, L&C County Fairgrounds, 10 AM Moses Lake, WA - September 29th Grant County Fairgrounds, 9-2 Libby, MT - October 6-7th in the Armory, 9-3 Kennewick, WA - November 9th City of Kennewick Event Center, 9-3

If you provide service to veterans, you’ll want to attend: Serving Those Who Served - 3rd Annual Veterans Resource Providers Conference -

August 1&2 from 8:00 AM - 5:00 PM - Wenatchee Convention Center, 121 N. Wenatchee Ave. Breakout cluster topics: suicide prevention, PTSD/TBI, Vocational Rehab., Service Animals, Homelessness, SOAR/TANF, Veterans Court, Healthcare, and MUCH more. Host hotel: Wenatchee Center Hotel - 509662-1234. For more info: MelissaR@dva.wa.gov

Salute to Service Resource Fair

River Park Square Mall, Spokane - May 19, 2018, 1:00 - 6:00 PM. Local Agencies, Community Partners and Businesses offering information and assistance toveterans, active duty, guard, reserve personnel, families, and caregivers. —Then stay for the Lilac Festival’s 80th Armed Forces Torchlight Parade & Cruzin’ the Falls Car Show!

3rd Annual Fallen Heroes Benefit Ride -

June 16, 2018 Registration at Curley’s at Hauser Junction 9:30 AM, Ride starts 11:00 AM. Early Registration $20 at https://2018fhride. eventbrite.com $25 at event

FREE BREAKFAST for veterans every Tuesday - 8:00 AM - Garden Plaza (off Mullan) in Post Falls.

Centennial Celebration American Legion - 100th Department of Idaho Convention July 12-15, 2018,

Hosted by American Legion Post 113Red Lion Down Town in Boise, ID for more information contact First Vice Commander, Steve North at snowth5401@gmail.com

86th Military Order of the Purple Heart & 85th MOPH Auxiliary National Convention - July 30-August 3,

2018, Red Lion Inn, Spokane, WA - for more info: mophnationalconvention.org

Peaceful Warriors - a FREE Ranch Retreat for Women Veterans

September 28 - October 1, 2018 Wolf Springs Ranch, St. Maries, ID Women veterans, active duty, reservist or retired connecting and working with horses, sharing meals, traditional crafts, massage, campfire circles, journaling, preparing and eating fresh farmstyle food, communing with nature and fellow women veterans. wwwlifeskillsranchprogram.org Deadline to sign up Sept. 1st

Time of Remembrance w/ Fallen Heroes Project -

September 28-30, 2018 - Red Lion Hotel at the Park, Spokane, WA Gather, remember, honor and celebrate the lives of the over 400 families from the WA/ID/OR region who have lost a loved one in the service since 9/11.

Contact: wa.remembrance@gmail.com

Vietnam War Commemoration and Welcome Home Event

October 2, 2018, Spokane Vet Center, 13109 E. Mirabeau Pkwy., Spokane Valley, WA To recognize, thank and honor U.S. military Vietnam War Veterans. Family members are welcome. Event time: 1 PM to completion. U.S. Veterans who served from 11/1/1955 - 5/15/1975 eligible for lapel pin. Call 509-444-8387 to sign up for lapel pin.

EVENTS March for the Fallen

September 8th - 8:30 AM - Riverside State Park 7 Mile Trailhead. Ruck, Run, March, Walk. Register at MarchForTheFallen.com or email info@gruntwearclothing.com

Ironclad Art Competition

July 14th - 4:00 PM at The Big Noise Show event, Cruiser’s Bar and Grille on Seltice Way, Stateline/Post Falls. Create a piece of art with Metal or Wood and enter to win big prizes ($15,000 Scholarship to Oxarc Welding School, Tools of the Trades) Reception w/potential employers fun and opportunities. Info: Estelle Nelson 509994-6016, estelle@heroeventsupport.com

Dog Fest Walk n’ Roll

Dog Fest North Idaho is celebrating the community of people and dogs that make it possible for Canine Companions to place assistance dogs with children, adults and veterans free of charge. These highly trained assistance dogs make a profound impact through the jobs they do, including opening doors, picking up dropped items, alerting to sounds and much more.

Event will be held July 28, 2018 at Forrest M. Bird Charter Schools. Call Lilly Mitsui 208-304-4490 or Alyse Ruggles 509-939-4004 for information!

Idaho County Veterans Outreach and Community Center, Grangeville, Idaho

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Veterans Serving Veterans

t the junction of US Highway 95 and Idaho Highway 13 lies the community of Grangeville, Idaho, county seat of Idaho County and commercial center for the Camas Prairie and Gateway to the Wilderness. As such, it is a haven for outdoorsmen and women, and has become a magnet for veterans and military retirees.

Veterans are supported in the community by a VA clinic, a county service officer, a visiting state service officer and several veterans service organizations. What the community lacked was a physical location for veterans to meet and enjoy the camaraderie of fellow service members.

Idaho National Guard soldiers take a break for lunch at the Idaho County Veterans Center.

Enter the Idaho County Veterans Association, a collaboration between the American Legion, Veterans of Foreign Wars and other veterans service groups. Their first mission - find property suitable for both a veterans lodge and community center. A vacant storefront was located and through the skill and determination of a team of hard working volunteers – coupled with the generosity of local donors – the Idaho County Veterans Outreach and Community Center opened its doors in 2016.

The Center serves heroes ranging from WWII, Korea, Vietnam and the Cold War to young veterans returning from service in Iraq, Afghanistan and the Global War on Terror. It also offers services to the community including a spacious hall for community events and a family oriented activity center with music and social activities.

Because it’s open every day, the volunteer staff is able to reach out to all vets where and when they need assistance.

They have made a difference in the lives of many who didn’t know where to turn, helping a Vietnam Vet get long overdue support and counseling, working with others to find assistance for severe PTSD, assisting young families in need to apply for emergency grants and reaching into their own pockets to help homeless vets find shelter or gas money to get to family or friends who had a place from them to stay. Many veterans come to the Center almost daily just for the camaraderie.

“The Canteen Grill” opened in March 2016, as a means to bring in revenue to pay for the cost of operations. They

serve lunch on weekdays to the public and free breakfasts to veterans twice a month. In conjunction with a local church, they host special dinners, some free for Veterans, others open to the public. They host lunches and holiday meals for the local National Guard detachment.

Through the generous donations of local citizens and organizations, the association has been able to host some amazing events like the Vietnam Veterans Welcome Home and Recognition Day last June. It was attended by veterans from around North Central Idaho, plus travelers from Texas, Pennsylvania and Washington State. Over 200 veterans and family members were treated to a wonderful meal of barbecue and the Welcome Home they so richly deserved. Most were deeply touched and there was much healing that day.

The second annual Vietnam Veterans Welcome Home and Recognition Day is scheduled for June 16, 2018, starting at 2 pm at the Center.

Donations to the Five generations of veterans (WWII, Iraqi Freedom, Desert Storm, association also helped Vietnam and Korea-era) put the sponsor an Operation Horses game on hold for a quick photo op. and Heroes (OHH) event in Grangeville. OHH is a nationwide program that brings together therapists specializing in equine assisted therapy and veterans to provide PTSD treatment using the power of horses. Food, beverages and support items were paid for through donations to the Veterans Association.

On your next trip through Grangeville, you are invited to stop by the Idaho County Veterans Outreach and Community Center and Canteen Grill at 318 East Main, to check out the displays of military memorabilia and enjoy a tasty meal. The Center is open Monday - Friday from 9 am to 4 pm, later on Thursdays and Fridays and everybody is welcome. Contact phone number is 208-983-9387 and on Facebook @IDCOVetsCenter.

Vintage Grangeville fire engine announces the Vietnam Veterans Welcome Home and Recognition Day in June 2017.

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Exploring Veterans’ Pathways to Justice—Involvement

by Elizabeth Thompson Tollefsbol and Dr. Faith Lutze Washington State University

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ver 20 million Americans were veterans of the armed services in 2015 (U.S. Department of Veterans Affairs, 2016). According to the 2015 data from the Bureau of Justice Statistics (BJS), veterans made up approximately 8% of the incarcerated population in the U.S. from 2011-2012. Most of those incarcerated veterans (77%) received military honorable discharges or discharged under honorable conditions, therefore becoming defendants in the criminal justice system was likely unanticipated for many of those men and women. Yet an estimated 43% of veterans in prison during that time had 4 or more prior arrests, and 22% of veterans had one prior arrest.

Had these particular veterans received targeted interventions based on their unique circumstances after their first arrests, perhaps the subsequent arrests would not have occurred.

Recently, a growing awareness of veterans’ circumstances and the risk factors that steer many into the justice system have brought a new research-based focus to justice-involved veterans.

Much of the research indicates military service, in general, has a positive impact on service-members’ lives, perhaps providing more protective benefits than risk elements regarding criminal behavior (Bouffard, 2003; Brooke & Gau, 2018).

WSU researchers are seeking women and men veterans of the U.S. military to interview for this project.

On the other hand, the data also indicates that veterans often face an uphill battle upon returning to civilian life, with numerous challenges reintegrating back into their families and communities. This frequently sets many veterans up for failure, nudging them toward behavior that can put them at odds with the law. These challenges may include substance addiction and abuse; homelessness; unemployment; injury, including traumatic brain injury (TBI), Post-Traumatic Stress Disorder (PTSD), and “moral injury,” which can be summed up as a violation of one’s personal code of right and wrong;

Wise Guide | Spring / Summer 2018

and a host of other hardships (Brown et al., 2015; Brown et al., 2016). Research indicates the veterans’ path from military service to the justice system should be viewed as the result of various factors that influence individuals in varying degrees.

Additionally, while many of the challenges facing women overlap with those of men, research suggests the two groups often face challenges more distinctive to their specific genders (Iverson et al., 2017; Scoglio et al., 2017). For instance, mental health and substance abuse issues are more common among justice-involved women than men. Women are also more likely to be the single parent of minor children, adding unique complications to their experiences with the justice system, including determining who will take care of their children while they are completing their sentences, maintaining close bonds with their children throughout their sentencing, and, for those who face incarceration, reintegrating back into families once they are released.

Considering the distinctly different experiences women and men encounter from birth throughout their lives, it is no surprise that women and men often find themselves on different pathways to justice-involvement. How do the factors that lead to justice involvement for women compare to those of men? The number of women has dramatically increased in the criminal justice system and has created momentum for both policymakers and researchers to evaluate women in their own right.

Researchers at Washington State University (WSU) are interested in exploring the role that military experience may have in subsequent justice-involvement. Additionally, the combined influence of gender and specific military experience is the focus of this project. By learning more about what led veterans to the justice system, the hope is to create more effective policies to assist veterans before they become involved in the justice system.

Some questions being explored include: What factors connected to military service encourage people to enlist? Do they differ for women and men? Do those factors that push one toward volunteering for the military, in a sense, “follow” women and men and continue to exert influence over their lives for years and decades? What life experiences lead veterans to the justice system? Furthermore, does serving in the military strengthen or weaken the influence of specific life experiences after leaving the military?

WSU researchers are seeking women and men veterans

of the U.S. military to interview for this project. Participants must live in Washington State, be veterans of the U.S. military, and either be current defendants in the justice system, or have previously been a defendant in the justice system (since leaving the military). This study has been approved by Washington State University’s Institutional Review Board; all information provided in interviews will be kept confidential; and the identities of participants will be kept anonymous. If you would like to learn more about participating in this study, please contact Elizabeth Thompson Tollefsbol or Dr. Faith Lutze at 509-335-2272 or via email at e_thompson@wsu.edu or lutze@wsu.edu. __________________________________________________________________

Elizabeth Thompson Tollefsbol is a PhD candidate in the Department of Criminal Justice and Criminology at Washington State University and an adjunct instructor of criminal justice and sociology. Her areas of interest include justice-involved veterans, gender responsivity and path-ways research, offender assessment, and policy effectiveness within the justice system.

Faith E. Lutze, Ph.D., is a Professor and Graduate Director in the Department of Criminal Justice and Criminology at Washington State University. Her current research interests include community

corrections, homelessness and reentry, correctional industries and offender employment, incarcerated veterans with traumatic brain injury, drug courts, and gender and justice with an emphasis on masculinity. Dr. Lutze is the author of the book, The Professional Lives of Community Corrections Officers: The Invisible Side of Reentry (2014) and has published the results of her research in various journals including Criminal Justice and Behavior, Justice Quarterly, Crime & Delinquency, Criminology and Public Policy, Journal of Offender Rehabilitation, and the Journal of Criminal Justice. She teaches courses on gender and justice, violence toward women, and corrections. She is active in the community supporting violence prevention programs, promoting equality, and serving her rural community as an emergency medical technician.

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I Think I Have Alzheimer’s Disease: How do I Get Evaluated?

by P.J. Christo, MS, RN Outreach Coordinator Alzheimer’s Association Coeur d’Alene

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lzheimer’s disease typically begins in the part of the brain that affects learning; therefore, the most common early symptom is difficulty remembering newly-learned information. Although, having trouble with your memory does not mean you have Alzheimer’s or another type of dementia.

Many health issues can cause problems with memory and thinking, including treatable conditions like depression, drug interactions, thyroid problems, excess use of alcohol or certain vitamin deficiencies. Some of these may be reversible, so if you are experiencing memory loss, it’s important to get checked by your doctor. Here are some things to keep in mind as you go through this process:

The first step in following up on symptoms is finding a doctor with whom you feel comfortable. Many people first contact their regular primary care physician about their concerns regarding memory loss. Primary care doctors often oversee the diagnostic process, but they may also refer you to a specialist. If you prefer to see someone with advanced training in dementia, ask to be referred to a health care provider who specializes in the diagnosis and treatment of memory loss. If you need assistance finding a doctor with experience evaluating memory problems, our local Alzheimer’s Association chapter can help.

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Specialists include: • Neurologists, who specialize in diseases of the brain and nervous system • Psychiatrists, who specialize in disorders that affect mood or the way the mind works • Neuro-psychologists with special training in testing memory and other mental functions

Your health care provider will do a thorough review of your medical history. Your physician will want to know about any current and past illnesses, any medications you are taking, and your family medical history. We recommend bringing a list of symptoms, when they began, and how frequently they occur. It is also a good idea to take all medications to the visit, both over-the-counter and prescription. Most importantly, have a family member present to help you provide accurate input

while answering the doctor’s questions honestly and to the best of your ability.

There is no single test that shows a person has Alzheimer’s. While physicians can almost always determine if a person has dementia, there are many causes and types of memory loss, making it difficult to make an exact diagnosis.

Instead, a careful medical examination and testing will often be used to rule out other causes of dementia-like symptoms.

Mental status/cognitive testing is often the starting point in the evaluation of memory. These tests will measure your ability to solve simple problems and other thinking skills.

• The Alzheimer’s Association suggests the use of three validated patient assessment tools: the General Practitioner Assessment of Cognition (GPCOG), the Memory Impairment Screen (MIS) and the Mini-CogTM. • Some health care providers and specialists may use more involved cognitive screening tests such as the Montreal Cognitive Assessment (MoCA) or The Saint Louis University Mental Status Examination (SLUMS).

During a neurological exam, the physician will closely evaluate you for problems that may signal brain disorders other than Alzheimer’s. The physician may test reflexes, coordination, muscle tone/strength, eye movement, speech, and sensation. The neurological exam may also include a noninvasive brain imaging study, such as an MRI. These types of tests are primarily used to rule out other conditions that may

cause symptoms similar to Alzheimer’s but require different treatment or are reversible.

Early testing and diagnosis is of utmost importance.

Being in denial or delaying evaluation for any reason is not to your advantage. The most important thing to note is that getting an evaluation early is key to treatment of any physical disorder, including memory loss. Do not delay — you may have a condition that’s treatable and reversible!

If you have any questions or concerns, please do not hesitate to contact the Alzheimer’s Association’s free 24/7 helpline any time, day or night: 1-800-272-3900. You may also contact the local Chapter in Coeur d’Alene for assistance at: 208-666-2996. ____________________________________________________________________

A Chicago native, PJ Christo received a BA Education and BS Nursing from Southern Illinois University, and a MS in Physiology from the University of Arizona. PJ worked many years as an RN in hospitals, a Charge Nurse in Neurology at Letterman Army Medical Center, and ICU at the VA San Francisco. In 1997 she became employed by the Alzheimer’s Association and coordinates support groups, answers the helpline, presents educational programs, does care consultations and assists with fundraising for Alzheimer’s disease - a national epidemic and defining disease of the Baby Boomers. Her duties encompass the greater Spokane region, all of northern Idaho from Lewiston/Clarkston Valley to Montana and to the Canadian border and the Palouse. The satisfaction of helping families in her community is what keeps her uplifted, determined, and encouraged.

Useful Links for Aging in Place More and more seniors are homeowners these days. It’s wonderful that older generations are able to stay in their homes, and there are considerations they should keep in mind when doing so. Below are some online resources, courtesy of ElderImpact.org, that may help people make informed decisions about aging in place.

• Guide to Room-by-Room Repairs for Easy Accessibility for Disabled Loved Ones

www.homeadvisor.com/r/home-accessibility-room-to-room-guide • Technology, Gadgets For Seniors Aging in Place

www.aarp.org/home-family/personal-technology/info-2014/is-this-the-end-of-the-nursing-home • The Boomer’s Ultimate Guide to Adding Value to Your Home

www.improvenet.com/a/the-boomers-ultimate-guide-to-adding-value-to-your-home

• Modifying Outdoor Spaces for Senior Safety

www.seniorhomes.com/w/modifying-outdoor-spaces-for-senior-safety

• 5 Fall Prevention Ideas for Bathroom Showers

www.angieslist.com/articles/5-fall-prevention-ideas-bathroom-showers • 26 Home Security Tips for Seniors

billfish-security.squarespace.com/26-home-security-tips-for-seniors • Getting a Pet Can Improve Aging in Place

www.aginginplace.org/seniors-and-pets • The Senior’s Guide to Moving in with a Roommate

www.redfin.com/blog/seniors-guide-moving-in-with-roommate Wise Guide | www.TheWiseGuideOnline.com

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.

IDAHO PANHANDLE

NORTHWEST MONTANA

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

Immanuel Lutheran Church, Kalispell Buffalo Hill Terrace, 40 Claremont Street 3rd Monday @ 3:00 PM Call 406-849-6207 for information

Trinity Baptist Church “Fireside Room” 711 Fairview Dr., Moscow 2nd Thursday @ 1:00 - 2:30 PM Facilitators: Tammie Poe 208-874-2667 & Dr. Ira Srivastava 208-297-0189 Sandpoint Senior Center, Sandpoint 820 Main Street 1st & 3rd Thursdays @ 1:00 - 2:00 PM Facilitators: Jan Griffitts 208-290-1973 & Liz Price 208-263-7889 (Free respite care at DayBreak Center next door with advanced reservation - 208-265-8127) St. George’s Parish Hall 2004 N. Lucas St., Post Falls 1st Wednesdays @ 2-2:30 PM Facilitators: Rosemary McDougall, RN 208-699-6060 & Cheryl Thompson 208-699-7548 Orofino & Cottonwood Areas: Sister Barbara will help form a group in Cottonwood or Orofino - call her at: 208-962-3251

EARLY STAGE SOCIAL ENGAGEMENT for people with dementia & their family.

Please contact Coeur d’Alene branch office to register 208-666-2996

Wise Guide | Spring / Summer 2018

Presbyterian Church of Polson 301 4th Ave. East 2nd Wednesday @ 1:30 PM Facilitator: Arlene 406-849-6207

TELEPHONE 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!

POWERFUL TOOLS FOR CAREGIVERS CLASSES Classes provide a practical approach to dealing with caregiver stress, prioritization, challenging family communication and planning. In the six weekly classes, caregivers develop a wealth of self-care tools to: reduce personal stress; change negative self-talk; communicate their needs to family members and healthcare or service providers; communicate more effectively in challenging situations; recognize the messages in their emotions, deal with difficult feelings; and make tough caregiving decisions. Class participants also received a copy the The Caregiver Helpbook, developed specifically for the class. Classes are offered in Coeur d’Alene & Regionally.

If you are interested, please call 208-666-2996 for the schedule.

MEMORY CAFÉ Living with memory issues…You are not alone!

This is a new offering by volunteers and the Alzheimer’s Association. People with the memory loss are welcome to come and feel comfortable in a casual gathering to provide socialization, interaction and fellowship.

Socialization creates confidence and a sense of belonging and well-being. Open to ALL stages of the disease. If the person can physically go out and drink coffee, then they are welcome, but of course, they should be accompanied by their family member/ friend. It is designed to provide a lovely afternoon in the company of others with whom they can identify.

This is not a support group, it is purely an opportunity for those with dementia and their caregiver to enjoy companionship.

Longboard Coffee Company 5417 Government Way, Coeur d’Alene 2nd & 4th Mondays at 1:00 PM Kokanee Coffee Company 509 N. 5th Avenue, Sandpoint 2nd & 4th Tuesdays from 2:00 - 3:30 PM

EASTERN WASHINGTON: SPOKANE NORTH Church of the Nazarene 9004 N. Country Homes Blvd.

Last Thursdays of each month @ 6:30 - 8:00 PM Facilitators: Gene Engelbrecht 509-842-6034, Dawn Keig, PhD 509-808-4076 Spokane Valley United Methodist Church “Fireplace Room” 115 N. Raymond Rd. 1st & 3rd Tuesdays from 1:00 - 2:30 PM Facilitator: Carley Olland 509-981-3161 Whitworth Presbyterian Church 312 N. Hawthorne Road 2nd Mondays @ 1:00 - 2:30 PM Facilitator: Christine Ambrose, RN 509-456-0456 x8313

SPOKANE SOUTH First Presbyterian Church 318 S. Cedar Street 3rd Tuesdays @1:30 - 3:00 PM Facilitator: Beth Priest 509-590-3965

SPOKANE VALLEY Good Samaritan Village 17121 E. 8th Avnue 1st & 3rd Tuesdays @ 1:00 - 2:30 PM Facilitators: Kathleen Burzynski 509-924-6161, Patricia Garcia 509-789-4377

EARLY STAGE SUPPORT GROUP

Meets monthly at the Spokane Alzheimer’s Association office in the afternoons. This group is for people with dementia and their care partners. This is a closed group and there is a screening process for admission. For more information, please call the chapter office at 509-4560456 x8314

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Is There a Dentist in the House?

by Tammie Poe Director of Sales & Marketing Good Samaritan Society—Moscow

G

ood Samaritan Society—Moscow Village strives to provide healthcare that meets the needs of the whole body. One of the uncommon services we provide comes from our partnership with Dr. Rich Bailey, DDS. Dr. Bailey was frustrated by the lack of preventative dental care for seniors and out of that frustration, a novel idea was born.

Although he approached several local skilled nursing facilities with his idea, Good Sam administrator Jamie Berg was the first one to say “Yes!” to his new plan—mobile dentist care. Now instead of trying to see patients in a traditional office setting, Dr. Bailey and his staff bring the dentist chair to Good Sam. Nearly every resident in skilled nursing care is seen on a daily basis by dental assistants who provide preventative care like brushing and flossing. Dr. Bailey also comes to Good Sam on a regular basis to provide restorative care.

“Lack of preventative dental care for seniors presents the perfect storm for tooth decay. Compounded by medication and a lack of dexterity, the potential for decay and bone loss exposes the most vulnerable part of the tooth at the worst time.” says Dr. Bailey. “The mouth is the gateway to the body. Most seniors are at a stage where they can’t do basic

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preventative care on their own so bringing the care to them ensures consistency and a properly trained staff who speak ‘dental’ language.”

The idea for a mobile dentistry service came to Dr. Bailey while practicing in Lewiston. He saw seniors on a sporadic basis in his office and noted that once things started to go downhill a healthy mouth could quickly be filled with cavities.

The idea for a mobile dentistry service came to Dr. Bailey while practicing in Lewiston. He saw seniors on a sporadic basis in his office and noted that once things started to go downhill a healthy mouth could quickly be filled with cavities. He hoped to stem the tide of oral deterioration by training the staff at various care facilities, but high CNA turnover and lack of proper training did little to affect the changes he wanted to see. He obsessed over solutions that would make a lasting difference and be sustainable.

Slowly the idea of taking the dental services to the seniors, rather than them coming to him, began to take shape. Over the next couple of years he continually refined his program until he felt it was ready to put into place. Initially, his idea was met with rejection from every quad-cities skilled nursing facility except Good Samaritan Society - Moscow. Dr. Bailey states, “I was thrilled when Jamie said ‘yes’ to the program. It is a service that goes beyond the call of duty and Jamie recognized the benefits for her residents.”

Good Samaritan provided him with a place to offer restorative services and made it possible for his staff to do preventative care. In the beginning he tried to run it like a standard dental practice, including keeping a schedule.

However, he quickly found that, “Getting rid of the schedule took the stress out of the situation. It allows us to focus on one

“Julia Rogers is all smiles after her cleaning with dental assistant Lori Abendroth”.

resident at a time and cater to their needs.”

He trains his staff on the specifics of each individual and creates care plans to ensure they receive the care they need and want.

His staff is at Good Samaritan every day and they see about 12 people an hour, performing basic preventative care like brushing, flossing and charting. Not only do they know how to interact with the

residents, they also know what denture sores look like and the signs of tooth decay and can alert Dr. Bailey when a resident is in need of more extensive care.

Dr. Bailey adds, “We’ve seen a night and day difference since starting the program and we are so grateful to partner with Good Samaritan Society to provide this next level kind of care.”

_____________________________________________

Tammie works as Sales & Marketing Director at Good Samaritan Society in Moscow, Idaho. She has 20+ years working in sales & marketing including 14 years of experience in international business. She has been with Good Samaritan Society since 2015.

Wyouhencaresomeone about needs caring for.

To learn more, call (208) 882-6560.

All faiths or beliefs are welcome.

Wise Guide | www.TheWiseGuideOnline.com

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Chronic Kidney Disease Matters : ullttss Hhave T C A u F aann AAdd ee e

by Meghana Awad, MD Tri-State Kidney & Hypertension

C

eerriicc D sseeaass i i m m A D A y y n nee iiddn iilllliioon iicc K M K M 0 0 33 n hrroon C Ch

hronic kidney disease (CKD) is the presence of kidney damage or decreased kidney function for a period of three months or more. These kidney bean shaped organs, located on either side of your spine under the lower ribs, play a vital role in your body including: •

Remove waste

•

Regulate water

•

Balance chemicals including sodium, potassium, calcium, and phosphorus

•

Produce hormones that help regulate blood pressure

•

Keep bones healthy by regulating calcium, phosphorus, and producing an active form of vitamin D

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There are often no signs or symptoms in the early stages of CKD, but the two most common causes include diabetes and hypertension. CKD typically starts slow and progresses over a number of years. If diagnosed and treated early, CKD may be slowed or stopped. However, if CKD continues to worsen over time, it may require dialysis, a kidney transplant, or lead to kidney failure, also known as end-stage renal disease (ESRD). Knowing the warning signs and risk factors of CKD could save your life.

Warning Signs & Symptoms • • •

High blood pressure Puffiness of eyes and feet Excessive foaming of urine

• • • • •

Passage of blood or tea colored urine Loss of appetite Fatigue Persistent itching Difficulty urinating or making less amount of urine

Risk Factors Preventable • Diabetes • Hypertension • History of acute kidney injury • Frequent NSAID use Non-Preventable • Age 60 or older • Race (African Americans, Native Americans, Hispanics, and Asians have a higher risk) • Family history of kidney disease, diabetes, or hypertension

Stages of CKD

Stage 1: Below normal to mild loss of kidney function Stage 2: Mild to moderate loss of kidney function Stage 3: Moderate to severe loss of kidney function Stage 4: Severe loss of kidney function Stage 5: Kidney failure, requiring dialysis

Living with CKD

• • • • • •

To manage CKD, the following is recommended: Make lifestyle changes, such as healthy eating, to prevent additional kidney damage Maintain a proper low sodium diet including fruits, vegetables, and eating less processed foods Stay active through proper exercise Use medications prescribed to slow CKD progression (i.e., drugs to lower blood pressure) Work on weight loss if you are overweight Work on optimizing diabetes and hypertension control

If you have been diagnosed with kidney disease and/or hypertension, or require renal replacement therapy (including dialysis and renal transplant patients), there are local options available to you for treatment. While you may be referred to a nephrology specialist for a variety of reasons, consider choosing Tri-State Kidney & Hypertension.

___________________________________________________________________

Dr. Meghana Awad completed medical school in Nasik, India.

She then completed an infectious disease fellowship, in addition to an internal medicine residency, and nephrology fellowship. She is certified by the American Board of Internal Medicine (top 10%) and is a member of the American Society of Nephrology. She stood first among a class of 120 in her second year of medical school with honors in Pharmacology. Dr. Awad is available at Tri-State Kidney & Hypertension. northern Idaho from Lewiston/Clarkston Valley to Montana and to the Canadian border and the Palouse. The satisfaction of helping families in her community is what keeps her uplifted, determined, and encouraged.

Wise Guide | www.TheWiseGuideOnline.com

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How to Select a Community to Meet Your Needs Assisted Living Community

by Sharon Heuett Community Relations and Admissions Director Royal Plaza Retirement & Rehabilitation Center

W

hether you are seeking full service care, assisted living, or independent living for yourself or a loved one, a primary consideration is whether the community provides a continuum of care that bridges the gap between hospital and home. The search for quality care can sometimes be confusing and overwhelming. Following are some guidelines to help you in your quest.

Full Service/Skilled Nursing Care

Look for a community that has an interdisciplinary team that partners with you, your family and the physician to create an individualized program. The team’s purpose is to assist you in making the most informed and appropriate decisions whether the needs are minimal or extensive and may include rehabilitation, such as physical, occupation and speech therapy.

From the moment you enter a facility, the team of nurses, caregivers, therapists, dietitians, and social workers are committed to addressing your specific needs. Skilled therapists partner with you and your family to create tailored plans that incorporate individual preferences, abilities, and goals. The team will strive to empower your loved one to meet their recovery goals and regain a quality of life, and will work together to achieve your loved ones highest level of functioning.

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When considering an assisted living facility, be sure the community is committed to helping residents remain as self-sufficient as possible, in a safe environment with the assurance of assistance when needed. Always inquire about the range of services a facility provides and make sure that they meet the needs for you loved one.

A combination of housing, meals, personal care and support, social activities, 24-hour supervision, and healthrelated services should be provided. Most facilities will strive to provide independence, security, hospitality and exceptional service with a goal to bring residents, families, staff, and healthcare professionals together to create a senior care environment where residents enjoy living, families enjoy visiting and employees enjoy working.

Private apartments may offer the independence that your loved one is accustomed to, along with the security of knowing that the community is staffed 24-hours a day while they feel free to get involved in the abundant social activities.

Retirement cottages are designed for comfort and convenience and residents usually can enjoy all of the amenities of their communities with just a little more autonomy.

Independent Living

This lifestyle offers residents a safe living environment, with minimal assistance and is ideal for individuals who can still live independently but enjoy having access to assistance when needed. For those who are able to care themselves, independent living is an option and yet can provide some assistance with activities of daily living.

When investigating facilities for yourself or a loved one, ask questions about the skilled nursing services, rehabilitation services, post-acute care, assisted living, independent living, memory care, social services, amenities, activities, meals and dining, visitors and pets, smoking policy, center rules, their billing process and rates and payment options.

Choosing the right facility for your loved one’s healthcare needs often comes at an unexpected time and with a variety of stressful decisions.

and appropriate decision regarding your loved ones health and care. For more information, call Royal Plaza Retirement and Rehabilitation Center at 208-746-2800 or 208-746-2855 or stop by for a tour and lunch at 2870 Juniper Dr. Lewiston, ID 83501 or visit our web sites at www.royalplazahealthandrehab.com or www.royalplazaretirement.com _________________________________________________________________

Choosing the right facility for your loved one’s healthcare needs often comes at an unexpected time and with a variety of stressful decisions. Explore web sites, make phone calls, send email, and better yet, go for a tour of several facilities before making a decision.

At Royal Plaza, we’re proud of our heritage, our tradition, and our quality resident-driven care. Since opening our doors in 1986, Royal Plaza has become one of the premier skilled nursing and retirement facilities in Idaho.

Our full service skilled nursing and rehabilitation facility offers 24-hour licensed nursing, quality CNA staff, and comprehensive therapies to meet your needs. Our retirement center is dedicated to enhancing and enriching the lives of our seniors. Our first priority is to make you feel at home.

We are here to assist you in making the most informed

Sharon Heuett has lived in the Lewis-Clark valley all of her life and has worked at Royal Plaza for 23 years. She began her career at Royal Plaza as an aide in 1995, and then graduated to working as an office assistant and doing tours and admissions, and the last three years as the Director of Community Relations and Admissions.

Some of the things Sharon does at Royal Plaza include leading exercise classes for the residents, helping with parties, organizing special events with speakers from the community, decorating for special holidays, working on special events, such as The Relay for Life, The Alzheimer’s Walk and going out in the community to let folks know about Royal Plaza Retirement and Rehabilitation Center and what a wonderful place it is to live and for rehabilitation.

Sharon says, “Being a senior myself, at age 73, it has been such a rewarding experience to be able to continue working, especially at the Royal Plaza!”

We are a full-service community. Our first priority is to make you feel at home!

The mission of Royal Plaza Retirement and Rehabilitation Center is to assist each resident in reaching his or her desired potential.That’s our.....

We also offer • Independent Living Cottages • Assisted Living to fit your needs • Respite and Hospice Care

Commitment to Caring

5-star rated quality & comprehensive care to meet your needs: • Extensive Rehabilitation • 24-Hour Skilled Nursing • Long & Short Term Care • Restorative Nursing • Physical, Occupational and Speech Therapies

Call or stop for a free lunch and tour.

Ask about our rent and veterans’ specials!

2870 Juniper Drive, Lewiston, Idaho Health & Rehab: 208-746-2855 • Retirement: 208-746-2800 RoyalPlazaHealthAndRehab.com • RoyalPlazaRetirement.com

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Autism & Aspergers:

The Diagnosis and Quest for Knowledge

by J. Tau, Author of Raising Buckshot: A Family’s Experience with Autism

O

ur son “fell through the cracks” until he was five years old. The defining moment that something needed to be done, to help him exist without acting aggressively toward school mates, was when he entered kindergarten. Before this time, I had searched for a book that would help me understand why his behavior was so non-communicative, manipulative, and full of disdain.

I looked to family members for examples and found a few cases, but nothing explained why or how they overcame obstacles to function in society. Some people suggested books written by doctors, but I wanted stories about situations and why they occurred and how the parent or caregiver dealt with the circumstances and/or behaviors.

When Gareth attended first grade, I became tired of repeatedly describing agonizing and occasionally funny

Lulu.com

In Raising Buckshot: A Family’s Experience with Autism, a loving mother shares the story of raising a child with special needs. seasoned with humor and hope, J.Tau reminisces over the trials and victories bringing up her autistic son, a story that is sure to inspire.

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situations with Gareth, but they helped people understand our challenges. I began writing the stories I had told to others about his behavior. I named my book Raising Buckshot: A Family’s Experience with Autism and gave the collection to his teachers to read so they might glimpse where our son was coming from when he acted up in their class.

Being a military family, we didn’t stay in one place long.

Three years was the norm, just enough time to get established and then be uprooted to begin the settlement process anew.

It was maddening and we took all precautions to ensure our son’s comfort and non-irritation, steps that served to keep us isolated from other families and their children.

Speaking to people about different behaviors they experienced with family members, I realized Autism and Aspergers have always been with us. These were names to attach to the actions, identified in recent years as variations along a spectrum of behaviors, and would be used to describe large segments of people who didn’t fit into other categories.

Looking back to my own childhood, I recalled attending school with a boy who lacked social graces and was viewed as “slow” - but he was a genius. Because he wasn’t like everyone else, he was labeled by many classmates and shunned from first grade on.

My own experience of attending first grade harbored aversion to “learn and conform.” My school photo showed a girl that seemed to have been surprised by the photographer’s flash-bulb. By second grade I had adapted and entered society willingly, ready to learn with fellow students to achieve good grades, as well as make friends and blend into life.

“Being on the spectrum” is a phrase that describes Autism and Aspergers, however I believe we are all functioning amidst its varying colors. Imagining us as hues within a spectrum is a way of thinking of people as variations within the range of color. Most consider themselves to be “normal” - whatever that might entail. They have a color palate with near equal divisions, or what appears to be; characteristics of intelligence, social interaction, verbal command, etc. Moving away from that middle point offsets the balance to where the person may possess an intelligence that is greater than the average person, but their ability to relate socially might cause them to be labeled as an introvert or something else. People are now being encouraged to embrace being different more than ever before, and this is a move in the right direction of acceptance of the individual who isn’t “the same” as others.

I have met people who presented characteristics of “being on the spectrum” but who have adapted so they can function in society and carve out a life, while maintaining an impression of “normalcy.” A few years ago, I worked for

a company where one of the officials presented “different” behavioral characteristics. He could recite laws and governing dialog verbatim, by heart. He was very successful in his field and earned a comfortable living. Upon meeting him, I noticed he didn’t make eye contact with me.

“He doesn’t like women.” A coworker whispered to me when he walked past my desk. I smiled at her misunderstanding, for it was clear he was on the spectrum. It wasn’t an inability to look women in the eye, but apparently women produced too much stimuli for him to address them as he would men. I came to adore this person for his traits, success in business, and kindness toward his employees.

When people tell me they have a family member with Aspergers, I understand that person to have mental gifts few can comprehend. They usually excel at one thing or a range of talents, often lacking social skills that “normal” people believe everyone should possess. I believe we should look beyond attributes that are absent, and better use the time and resources to employ the gifts and skills our people with Autism and Aspergers possess.

One point that needs to be made is the need for early intervention by people who are educated and trained to work

with young children with Autism and Aspergers. They bridge the gap for the child who may be isolated and comfortable in the world they hold as truth to the reality of human life in every day settings. Parents are key in working with these professionals and assisting their children in accepting and using new skills. Other people who help children comprehend their life situations will be grandparents, extended family members, caregivers, and pets. All play major roles in helping the child accept concepts of life they find alien, but that they need to recognize or adapt to in order to survive in this lifetime.

Early efforts are essential to help with a smooth transition from the “spectrum” world to everyday life, ultimately assisting the individual to be a successful adult. That is the goal of everyone.

A few online resources that may be of interest to readers: autismspeaks.org, and there are local chapters of thearc.org, such as arc-spokane.org ___________________________________________________ J.Tau writes outside of Spokane, Washington where she lives with her family and two magnificent mousers.

Living With Parkinson’s Disease, From Someone Who Is

by John P. Smith, Parkinson’s Resource Center, Clarkston WA

P

arkinson’s Disease (PD) is one of most difficult diseases to diagnose and live with. Most people with PD, like me, have the disease 10 to 15 years prior to being diagnosed, or misdiagnosed. By the time a person is diagnosed, the disease has progressed substantially, and it effects everyone differently with symptoms and speed of progression.

Like myself, it started with non-motor symptoms such as depression, loss of smell, speech, swallowing issues, anxiety, sleep disorders, head fog (blurriness, light headedness).

Then came the balance issues, affected gait, inability to walk, tremors. Medications don’t seem to work well, and you’re stuck dealing with the side effects they create, such as compulsive behaviors, dyskinesias, PBA (Pseudo Bulbar Affect)—that’s when a person cries and laughs, at the same time for no apparent reason.

But then I had Deep Brain Stimulation Surgery (DBS).

DBS doesn’t get rid of all these symptoms, but it took away the tremors, the pain from tremors and the head fog, and it changed my life. There is no cure for Parkinson’s Disease as of yet, but hope is there for the near future.

Having PD is extremely exhausting both physically and mentally. That’s one major reason to stay focused on life.

With support from family, friends, caregivers and the right doctors, living with PD can become a manageable disease.

A positive environment is a must, along with a Neurologist specializing in movement disorders. These are the people

you want on your team. Remember, maintain a positive attitude (even though it’s hard), have positive support, and stay active, busy and productive. With these in mind, you will never surrender and you will live a long life. Sometimes I forget to take my own advice! —John P. Smith

LC Valley Parkinson’s Support Group

meets every 2nd Monday at 1:30 pm St. Joseph’s Rehab 1250 Idaho Street, Lewiston (Basement Conference Room)

Facilitator: Jennifer Ford Call 208-799-5219 for more information.

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Crossword Bears Across

Down 1 Bear back scratchers 2 Summation 3 French romance 4 Big bear 5 Perfume brand by Dana 6 Decorative pitchers 7 Chinese dynasty 8 Historic period 9 Rite of passage 10 Bump off

42

12 Gossips 14 Juicer 15 Lennon’s Yoko 18 ___ room 23 New Rochelle college 25 Query 26 In the cellar 28 Klutz’s cry 30 Diner’s card 31 Bonanza finds 32 Cozy retreat 33 Lump of mush 34 Scowl 35 Light beige 37 “What was ___ think?�

38 Irene of “Fame�

41 Pool division 44 Trans-Siberian Railroad city 47 Troop grp.

48 Good name for a bear 51 Tristan’s love 53 Alleviated 55 Campers, for short

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56 Locales 58 Lists 59 Roast host 60 Cold spot for bears 61 Kyat part 62 Common Market letters 63 Picnic staple 65 Ages and ages 68 Painter’s medium 69 Roll of dough

Copyright Š2017 PuzzleJunction.com

1 La-la lead-in 4 Telecom giant 7 Rancher’s concern 11 Sleep acronym 12 Sticking point?

13 Operatic passage 16 Author Umberto 17 Bear’s down time 19 ___ de Cologne 20 Sky-blue 21 Golden rule word 22 Squirt 24 La ___ opera house 27 Capital on a fjord 29 Bear’s snack 33 Secluded valley 36 Cry of encouragement to foxhounds 39 Bard’s “before�

40 Type of anesthetic 42 Bake sale org.

43 Subdues, with “down�

45 “Days of ___ Lives�

46 Soak up 49 Necessary 50 Kodiak bears, among others 52 Bellicose deity 54 Scorches 57 Sharpshooter name 61 Coin in CancĂşn 64 Opinions 66 Cousin of an ostrich 67 Bears like it here 70 Half an antiaircraft gun?

71 Bears of Maine like it here 72 Chisholm Trail town 73 Modern (Prefix) 74 Fuse together 75 Compass dir.

76 Ringgit part

Sudoku

How to Play Sudoku To solve the Sudoku puzzle, each row, column and box must contain the numbers 1 to 9.

Crossword and Sodoku answers on page 47.

Thank You! Wise Guide | www.TheWiseGuideOnline.com

43

Keeping Appointments

E

veryone is busy in this day and age. Everyone has things they would rather be doing than going to the doctor, dentist, or other sometimes less-than-fun appointments. And so does that doctor, dentist, other professional have things he or she could be doing if you hadn’t made an appointment that day. It’s no different on their side.

It’s just like being stood up for a date. Nobody likes that because it’s a waste of time, sitting there waiting for someone who either forgot about you, or had something else they’d rather be doing. And, that makes you feel insignificant and disrespected.

Making an appointment, setting a date, those are promises we make. Let’s be respectful of each other and keep our promises to go to that appointment, even if an opportunity to do something you’d rather be doing comes up!

Marines of the Palouse 2nd Annual Golf Tournament/Scramble July 21, 2018 10 am Tee Time Moscow Elks Lodge Golf Club Moscow, ID Food, refreshments and prizes!

509-336-3006 to sign up!

https://www.marinesofthepalouse.org/golf-tournament-1 contact@marinesofthepalouse.org

44

Wise Guide | Spring / Summer 2018

Directory Listings

Aging and Disability Resource Center/ N. Central Idaho Area Agency on Aging............208-746-3351 124 New 6th St., Lewiston, ID cap4action.org/PSAgencyOnAging Providing information and assistance for people of all ages, incomes and disabilities enabling them to plan for present and future long-term care needs. Assisting older Americans and their families in making informed decisions and choices about life.

Aging & Long Term Care....................................509-758-2355 744 5th, Clarkston, WA Providing Family Caregiver Support Services and Senior Information & Assistance. Our Assistance and Case Management services and information are free to the public.

Alzheimer’s Association, Washington State Chapter Serving Washington & North Idaho................. 208-666-2996 alz.org/inlandnorthwest P.J.Christo, RN; email: pj.christo@alz.org 24-Hour Help line............................................. 800-272-3900 We connect families to needed programs, products and services, provide Dementia Information, Local Support Groups, State and Federal Advocacy, educational programs, workshops and lectures for caregivers, families and the general public.

Board of Community Guardian.........................208-750-2080 Nez Perce County, Lewiston, ID We are a last resort for anyone (often with dementia or debilitation) without family or friends to care for them. If you know of anyone like this, or would care to serve as a guardian or conservator, please call Stephanie at 208-750-2080.

Disability Action Center NW 330 5th St., Lewiston, ID...................................208-746-9033 505 N. Main St., Moscow, ID..............................208-883-0523 dacnw.org DAC NW is the local Center for Independent Living which offers a variety of services from peer-to-peer independent living support, medical equipment exchange, help with selfadvocacy, and access to assistive technology.

LC Valley Parkinson’s Resource Center 509-254-3024 731 5th St., Clarkston, WA facebook.com/pg/ LCValleyParkinsonsResource Working to help enhance the lives of those affected by Parkinson’s Disease through education, empowerment and resources. Our all volunteer staff is supported by donations and fundraisers held to increase awareness of the disease.

Pullman Community Council on Aging............509-339-4000 pullmancomcoa.org pullmancomcoa@gmail.com A non-profit group of citizens and professionals advocating for Pullman’s senior citizens since 1973. PCCoA Community Service programs include “Guide to Senior Services” for Pullman and Whitman County, Pullman Meals on Wheels, and Senior Chore Service for Pullman residents.

Retirement Publishing.......................................800-584-9916 retirementpublishing.com Keeping Idaho seniors informed of their options with our FREE publications: Idaho Elder Directory, North Idaho Retirement, Assisted Living in Idaho, Alzheimer’s Resource Directory. Call toll free during regular business hours for your FREE copy or visit our Web site.

Counseling, Family & Youth Services Clarkston EPIC................................................... 509-758-3181 Asotin County Community Services 549 5th St., STE A Clarkston, WA ksharpe@co.asotin.wa.us Clarkston EPIC’s mission is to increase knowledge to build a more resilient and protective community for the well-being of our youth.

Sequoia Counseling Services............................ 208-798-1646 531 Bryden Ave., Lewiston, ID sequoiacounselingservices.com Participants and family members know best what they need.

We strive to assist them in identifying and attaining those needs by offering a wide range of individual and family therapies, case management & family support services in our office and in the community.

Disability & Recreation Canine Companions for Independence facebook.com/caninecompanions A non-profit organizations providing expertly-trained assistance dogs free of charge to children, veterans and adults with disabilities. Contact them if you are seeking a companion canine, wish to donate or volunteer.

Agencies, Free Referral Services & Volunteer Opportunities

5% DI

SC

Your North Idaho Recumbent Dealer

M OUNT Wiseention !

Guid e

Home of the comfortable, affordable, reliable and fun way to bicycle!

Gary Dagastine Call or email for appointment gary@nwrecumbentcycles.com

208-818-5491 Wise Guide | www.TheWiseGuideOnline.com

45

Directory Listings NorthWest Recumbent Cycles............................ 208-818-5491 Gary@NWrecumbentcycles.com We specialize in getting anyone riding cycles, especially those with special needs. We build custom bikes and trikes for those with almost any disability. Come on out to Post Falls, ID and play on many models of the most stable and comfortable bikes and trikes in the world. Call for appointments.

Hearing & Vision Hearing Aid Source............................................ 509-751-9440 644 6th St., STE B, Clarkston, WA • hearingtricities.com Serving North Idaho for over 20 years. We help you hear better! Hearing evaluations for adults and children. We sell the most advanced digital hearing aids available. Each new digital hearing aid comes with a 30-day trial program, 3 year warranties and 3 years free batteries. Appointments on Tuesdays - call to schedule today!

Idaho Commission for the Blind & Visually Impaired...........................................208-799-5009 1118 F St., Lewiston, ID • gworthington@icbvi.idaho.gov ICBVI is a state agency that provides free independent living training and offers adaptive aids, such as magnifiers and talking devices, to help individuals who are struggling with vision loss to be more independent in their homes and the community.

Lilac Blind.......................................................... 509-328-9116 1212 N. Howard St., Spokane, WA • lilacblind.org Lilac Services for the Blind provides individualized training in alternative techniques and strategies, adaptive aids and optical devices, and continuing support to help individuals maintain independence and safety at home and in their communities.

Serving Eastern and North Central Washington.

Hospice Friends of Hospice.............................................509-332-4414 Gladish Community Center 115 NW State St., Ste. 117, Pullman, WA • friendsofhospice.net Offering a wide range of services to ease suffering at the end of life.

Willow Center Lewiston/Clarkston ........................................... 208-791-7192 Moscow/Pullman...............................................208-669-0730 willow-center.org Making a profound difference in the lives of grieving children by helping assist them with hope and healing. Offering a unique program of peer support to assist children, teens & families after the death of someone close.

Hospitals & Medical Care Axis Spine Center 208-457-4208 1641 E. Polston Ave., Ste 101, Post Falls axisspinecenter.com The region’s ONLY comprehensive spine center, owned and operated by board-certified and fellowship trained spine physicians. Dr. Kent and Dr. Jameson are committed to improving each patient’s quality of life by increasing daily functioning and empowering their patients to achieve their goals.

46

Wise Guide | Spring / Summer 2018

North Idaho Advanced Care Hospital............... 208-262-2800 600 N. Cecil, Post Falls, ID NIACH.ernesthealth.com We hold a Joint Commission “Gold Seal of Approval” and 5th in the nation rating for care of diseases associated with respiratory failure (COPD, pneumonia, cystic fibrosis, etc.).

Our 40-bed facility provides long-term acute care and critical care services for patients recovering from serious illnesses or injuries.

Tri-State Memorial Hospital & Medical Campus .................... ........................................................................... 509-758-5511 1221 Highland Ave., Clarkston, WA • tristatehospital.org Tri-State Memorial Hospital & Medical Campus is committed to caring for you with the latest in medical technology and techniques, yet true healing takes place when expert medical care is combined with a smile, a caring touch, a kind word.

Independent Living, Assisted Living, Memory Care & Respite Care Brookdale.......................................................... 208-746-8676 2975 Juniper Dr., Lewiston, ID • brookdale.com Offering seniors the independence of a private home plus the type of supportive aid they need with daily tasks. Residents live as members of a family of friends in resort-style comfort with personalized care.

Brookside Landing.............................................208-476-2000 431 Johnson Ave., Orofino, ID facebook.com/pg/BrooksideLanding We are a Premier Retirement Community offering independent and assisted living with all the amenities of larger communities, in a scenic small town setting. Located just a block from the town. We live where people come for vacation to appreciate all that nature offers.

Good Samaritan, Fairview Village Estates........ 208-882-6560 403 Samaritan Lane, Moscow • good-sam.com/moscow Independent Living, part of the Good Samaritan Society Moscow, offers modern one & two bedroom apartments and duplexes for independent seniors. You can be part of the Good Samaritan network and transition to our Moscow Village Campus as needs change.

Good Samaritan, Moscow Village..................... 208-882-6560 640 N. Eisenhower, Moscow, ID • good-sam.com/moscow A continuum of care community that provides post-acute rehabilitative and long-term skilled nursing care including a memory care unit. Also offers assisted living apartments and independent living apartments & duplexes, all located on 22 beautifully landscaped acres in northern Idaho, nestled between Moscow Mountain and the rolling hills of the Palouse.

Royal Plaza Retirement & Rehabilitation Center.....................

208-746-2800 2870 Juniper Dr., Lewiston royalplazaretirement.com • royalplazahealthandrehab.com Our mission at Royal Plaza Retirement and Rehabilitation Center is to assist each resident in reaching his or her desired potential. That’s our: Commitment to Caring.

Long-Term, Skilled Nursing & Restorative/ Rehabilitative Care Avalon Care Center ...........................................509-332-1566 1310 NW Deane St., Pullman, WA avalonhealthcare.com We are a premier provider for post acute care and rehabilitation services with 24-hour nursing, wound care, therapy services, family support services, comprehensive restorative programming, and discharge planning. Our individual approach to care puts residents and their choices first.

Good Samaritan, Moscow Village..................... 208-882-6560 640 N. Eisenhower, Moscow, ID • good-sam.com/moscow A continuum of care community that provides post-acute rehabilitative and long-term skilled nursing care including a memory care unit. Also offers assisted living apartments and independent living apartments & duplexes, all located on 22 beautifully landscaped acres in northern Idaho, nestled between Moscow Mountain and the rolling hills of the Palouse.

Life Care Center of Lewiston..............................208-798-8500 325 Warner Dr., Lewiston, ID LCCA.com Life Care Centers of North Idaho specialize in long term care, special needs and dementia care, post-operative and acute illness restorative nursing and therapy, 24/7 admissions. Fulltime on-site physician. Respite stay is also available. Semiprivate and private rooms. Schedule your tour today!

Rehabilitation Hospital of the Northwest ........208-262-8700 3372 E. Jenalan Ave., Post Falls, ID rhn.ernesthealth.com We provide intensive physical rehabilitation services to patients recovering from strokes, brain, spinal cord and orthopedic injuries and other impairments as a result of injuries or illness. Also treated are cerebral palsy, ALS (Lou Gehrig’s Disease) multiple sclerosis & Parkinson’s disease.

Royal Plaza Retirement & Rehabilitation Center..................... .......................................................................... 208-746-2800 2870 Juniper Dr., Lewiston royalplazaretirement.com royalplazahealthandrehab.com Our mission at Royal Plaza Retirement and Rehabilitation Center is to assist each resident in reaching his or her desired potential. That’s our: Commitment to Caring.

Legal Idaho Legal Aid Services .................................. 208-743-1556 633 Main St., Ste 103, Lewiston, ID Idaho Legal Aid has attorneys available to assist you at NO COST if you qualify. Call us to determine if you are eligible and schedule an appointment with an attorney in person, or by phone.

Crossword and Sudoku Answers 7 5 ( ( 6 * / 2 %

5 ( & $ 3 / 2 8 5

3 ( < ( $ &

$ 0 2 8 5 , 2 ( 1 & $ 5 8 , 6 6 2 / / $ ' : (

& + $ 7 6 / $ 1 ( 2 , /

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7 $ % 8

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( + : $ ( 5 1 5 ( 6 & $ 6 , & .

7 $ 2 5 % $ 5 6 2 , ( : 7 2 1 ( 1 , 6 6 (

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2 1

Puzzles on pages 43

Wise Guide | www.TheWiseGuideOnline.com

47

Five-Star Quality Care Full-Time On-Site Physician | Therapy Offered 7 Days a Week Skilled Nursing and Long-Term Care | Memory Care Unit Certified Wound Care Services Call today to schedule a tour.

208.798.8500

LifeCareCenterOfLewiston.com 325 Warner Dr. | Lewiston, ID

6236

Joint Commission accredited