The Wise Guide Summer 2017

SPRING / SUMMER 2017

AN INSIGHTFUL APPROACH TO WELLNESS • FREE

Opioids...

Be Informed!

LightForce Laser Herbs, Our Local Bounty Urgent Care vs. Emergency Room

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Wise Guide | Spring / Summer 2017

SPRING / SUMMER 2017

Features

18

LightForce Laser

Relieves pain and enables healing

20 Opioids—Be Informed! ....you never saw it coming

American Cancer Society Programs.................................. 5 Regional Activities and Events........................................... 6 About the Cover................................................................. 9 Choosing a Successor Trustee/Disability Agent.............. 10 Small Business Advice, Is it Business or Personal?......... 13 Wise Investment Begins with the Right Financial Advisor!.14 Anti-Gravity Therapy with the AlterG................................. 16 LightForce Laser................................................................ 18 Opioids—Be Informed!................................................... 20 What is Post Acute Care?................................................. 22 Urgent Care or the Emergency Room?............................ 24 Women’s Health Care­—Beyond the Pap!....................... 26 Choosing a Rehabilitative Care Facility.......................... 28 Collaboration for Comprehensive Care......................... 30 Nurse Practitioners, the Bedrock of Primary Care.......... 32 Digestive System Imbalance............................................ 34 Integrative Wellness—Camas Center Clinic................... 36 Herbs, Our Local Bounty................................................. 38 Pets In Transition............................................................. 40 Homemade Water Kefir................................................... 42 Camp Lejeune.................................................................. 43 Stand Down? What’s a Stand Down?.............................. 45 Veterans Pages.............................................................44-49 No-Nonsense, Non-Traditional Counseling................... 50 New NIC in Post Falls Offers a Fresh Start..................... 52 Crossword and Sudoku...............................................54-55 Care, Cause and a Cure for Alzheimer’s.......................... 56 Alzheimer’s Association Support Groups....................... 58 I Turned Around and He Was Gone!.............................. 60 When Should I Enroll in Medicare?................................ 62 Wound Prevention for Your Loved Ones........................ 64 Elder Impact..................................................................... 66 Crossword & Sudoku Answers......................................... 66 The Soul is Timeless and Ageless.................................... 68 Run It By Tamara.............................................................. 70 Unsteady on Your Feet?................................................... 71 Help Wanted! Healthcare Employment......................... 78

Directory Listings

38

Herbs: Our Local Bounty

Herbs and plants as herbal medicine

Agencies, Free Referral Services & Volunteer Opportunities......................................... 72 Chiropractic, Counseling................................................. 72 Dental, Education & Recreation,..................................... 73 Financial & Asset Management, Gifts & Shopping........ 73 Hearing & Vision.............................................................. 73 Hospice, Hospitals & Medical Care................................. 74 Independent & Assisted Living, Adult Day Care............ 75 In-Home Health & Personal Care, Insurance, Legal....... 76 Nutrition, Personal Emergency Systems......................... 77 Pharmacies, Medical Equipment & Supplies.................. 77 Rehabilitation & Skilled Nursing.................................... 77 Veterinary & Animal Care................................................ 77 Wise Guide | www.TheWiseGuideOnline.com

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Hearing aids deliver proven quality-of-life benefits.

Research from the non-profit Better Hearing institute (BHI) shows that people who finally do get hearing aids to treat their hearing loss see “impressive improvements in their social, emotional, psychological and physical well-being.

1. It could increase your earning potential. If you have untreated hearing loss, there’s a good chance you aren’t reaching your full potential in the workplace, as you may be missing important items in conversation or unconsciously withdrawing yourself from your duties.

2. It could improve your social life. Whether you know it or not, hearing problems can cause you to communicate ineffectively with others, which can hinder relationship building. It may also cause you to decide not to participate in the activities or social gatherings that you otherwise would.

3. It could strengthen your relationship with your family. Communication is even more important in the intimate relationships you maintain with family members. When communication is interrupted by hearing loss, it can weaken those relationships unintentionally.

4. Today’s hearing aids have never been smaller. Just as computers and other high-tech instruments are getting smaller, so too are hearing aids. Some are even “invisible.” i.e., small enough to fit completely inside your ear canal where no one can see them.

5. Today’s hearing technology is more advanced than ever. Many people have misperceptions of hearing aids based on outdated information and anecdotes. The fact is, today’s best hearing aids are precision instruments with technology far more advanced than their predecessors, including features specifically designed to:

• Virtually eliminate feedback (buzzing and whistling) • Reduce listening effort and improve speech understanding in noise • Work easily and automatically with your phone • Connect wirelessly with TVs, computers and stereos to stream audio directly to the aids

23 E. Crawford Deer Park, WA 99006

www.eargeek.com 4

Wise Guide | Spring / Summer 2017

American Cancer Society Programs and Services Available for All Stages of Cancer Journey

T

he most comprehensive cancer organization in the world, the American Cancer Society, has programs and services to help people with cancer and their loved ones understand cancer, manage their lives through treatment and recovery, and find emotional support. Our help is free.

Often the best place to start when looking for support programs and services is to call our National Cancer Information Center at 1-800-227-2345 or visit cancer. org. NCIC provides information and support 24 hours a day, 365 days a year. Trained cancer information specialists take calls and participate in online chats, providing accurate information and connecting people with valuable services and resources in their communities.

Among the incredible programs and services available are: • Patient Lodging, a place to stay when the best hope for a cure is far from home; • Road To Recovery, volunteer drivers provide patients a ride to their potentially life-saving treatment; • Reach To Recovery, breast cancer support for people recently diagnosed; • Look Good Feel Better, help with the appearance related side effects of cancer treatment; and • Patient Navigation Services, assistance in navigating the health care system.

No other organization provides the scope of information, programs and services as the American Cancer Society – and Society programs are free for patients and their caregivers. Individuals interested in volunteering for these programs should contact the National Cancer Information Center.

Calls to action: •

Program 1-800-227-2345 into your phone and share it when you hear of a friend or loved one receiving a cancer diagnosis.

• Visit cancer.org to learn more about programs and services provided in your community.

• Join your local Relay For Life event to help fund these lifesaving programs. relayforlife.org American Cancer Society Spokane 920 N Washington Ste 200 Spokane WA 99201 509-455-3440 Wise Guide | www.TheWiseGuideOnline.com

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Activities and Events Ales for the Trail Microbrewery Festival

Baby Bottle Boomerang

Pick up a bottle on Mother’s Day May 14th, from your local church or during the week at 502 N. 2nd Street in Sandpoint and...return it full of coins currency or checks on Father’s Day June 18th. Life Choices Pregnancy Center is 100% funded by donations and your support helps us provide FREE options education, medical grade pregnancy tests, ultra-sound imaging, life skills, relationship and parenting classes, post abortive and miscarriage healing classes, sexual risk avoidance training to teens and a baby boutique filled with many items a new mom needs for her baby. www.lifechoicespc.org You may also text your secure donation to 208-209-7753.

Fore the Health of It - Golf Tournament

June 16th at Stoneridge Golf Course 11:30 am check-in 1:00 pm shotgun start.

More info at: newporthospitalandhealth.org or call 509-447-7928 x4373.

Aug. 12th 2:00-8:00 pm Live music, food, fun at McEuen Park, 420 E. Front Avenue, Coeur d’Alene. Enjoy great craft beer from the Northwest and raise funds for the North Idaho Centennial Trail. alesforthetrail.org Tickets available in advance and day of event.

The North Idaho Centennial Trail is a multi-use recreational trail system, that meanders for 24 miles from the Idaho/ Washington state line to Higgens Point on Lake Coeur d’Alene.

Idaho State Draft Horse & Mule International Show

September 22-25 Bonner County Fairgrounds, Sandpoint. Come see these gentle giants: log skidding, weight pulling, farm classes, driving classes, demonstrations, art & gear show. Call 208699-0816, www.idahodrafthorseshow.com

Walk to End Alzheimer’s

September 23 - Pullman, WA September 30 - Coeur d’Alene, ID October 7 - Spokane, WA See page 57 for details…

Garden of Artistry

July 21, 22 & 23 Annual Invitational Juried Fine Arts Show. Free Admission: Fri. 1-5, Sat. 10-5, Sun. 10-3 at the Ponderay Garden Center Hwy 95 (north of Walmart) Painters, sculptors, photographers and jewelers. Wide variety of styles, media & subject matter.

Opening Benefit Reception Hosted by Carousel of Smiles Friday Evening 6-8 pm. Contact: Director Gabe Gabel, 208-265-9613.

49th Annual Art on the Green Festival

North Idaho College August 4-6th A marketplace, performance space and a gathering place for friends and families, this yearly event is the high-light of the summer in Coeur d’Alene! Free entertainment on two stages all weekend. artonthegreencda.com

Festival of Sandpoint

August 3rd - 13th Join us for the 35th annual Festival at Sandpoint. Enjoy live music under the stars on the shores of Lake Pend Oreille.

For tickets and information contact 888-265-4554, www.festivalatsandpoint. com

Ponderay Garden Center

presents the

Garden of Artistry Invitational Fine Arts Show July 21, 22 & 23 Come meet over thirty artists and enjoy the work of some of the region’s finest painters, sculptors, photographers and jewelers. A rich variety of styles, media, and subject matter.

Art Show is open with Free Admission:

Fri. 1-5 pm • Sat.10 am-5 pm • Sun. 10 am-3 pm

Opening Benefit Reception Hosted by Carousel of Smiles Friday Evening 6-8 pm Please contact Gabe Gabel, Show Director at 208-265-9613 Ponderay Garden Center • Highway 95 (north of Walmart)

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Wise Guide | Spring / Summer 2017

NORTH IDAHO QUILTERS Presents

The Carousel of Smiles... a project to bring an antique carousel to Sandpoint will be the opening reception host for this summer’s Garden of Artistry at the Ponderay Gardens.

The Carousel, a circa 1920 Allan Herschell machine with 36 hand carved wooden horses is a true time capsule. It had been stored in its two trailers for 64 years, virtually untouched before being unloaded for the first time last December here in Sandpoint.

Friday, June 16th – 10am to 6pm Saturday, June 17th – 10am to 5pm Kootenai County Fairgrounds

4056 N. Government Way, Coeur d’Alene, Idaho (Enter off Kathleen St. for Free Parking)

It is a fully intact, 40’ diameter Golden Age Carousel. In addition to the 36 horses, there are two chariots, 14 rounding board art panels, and 14 interior art panels. The plan is to restore this incredible machine using many volunteers and artisans from the Sandpoint area, then find a permanent home here in Sandpoint.

Featured Quilter – Marianne Harwood

At the Garden of Artistry, several horses and other pieces of the carousel will be on display, and there will be discussions and information about the project and on how to get involved with this once in a lifetime project — The Carousel of Smiles — A CAROUSEL FOR SANDPOINT.

Over 275 Quilts on display!

Merchant Mall “Floral Fantasy” Raffle Quilt Fat Quarter Raffle Quilts of Valor Display “Door” Quilt Challenge Buy quilt-related items at the Country Store

Check out The Carousel of Smiles website

www.northidahoquilters.com

Admission $7 includes both days

www.the carouselofsmiles.org

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Activities and Events

The Wise Guide Spring/Summer 2017

Any Pie Contest!

Office: 208-263-5654

September 28 at 2:30 pm Prepare your favorite pie and bring it to Life Care of Sandpoint. A panel of official tasters will judge the pies and you can win some great prizes! Call 208-265-9299 for more information.

Scarecrow Competition!

First three weekends in October at Hickey Farms.

Sandpoint’s 1st pumpkin patch. The second annual scarecrow contest fundraiser for local wildlife. Each scarecrow entry fee $10. Guidelines will be posted in August and entry forms will be available on the American Heritage Wildlife Foundation web-site: www.ahwf.org Call 208-266-1488.

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Jonnie Bradley Editor The Wise Guide

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Donna Brosh Designer The Wise Guide Copyright ©2017, All Rights Reserved.

Idaho Elder Directory Alzheimer’s Resource Directory Just call 800 584-9916

during normal business hours View/download from our Website retirementpublishing.com > Idaho Publications

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. It is meant to serve as an information resource guide and not as a substitute for professional assistance. The Wise Guide, LLC is not responsible for the contents of any websites referenced within this directory, nor does it endorse any specific products or services referenced. No part of this directory 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.

August

Home Health • Bath Aide • Meal Prep • Housekeeping • Transportation • Med Reminders

Customize your own plan today!

Let the Sun Shine!

Medicaid Accepted

www.AugustHH.com

208-664-0858 8

Serving North Idaho since 1994

Wise Guide | Spring / Summer 2017

Mental HealtH & addictions treatMent, trauMa specialist, cHildren, adolescents, adults, couples and FaMilies Idaho & Montana Medicaid, BPA Funding, Veteran’s Services, Private Insurance, Sliding Fee Scale and Private Pay

6807 Cody Street • Bonners Ferry 208-267-0900 • rawlingscommunitycounseling.com

About the Cover Cover Artwork: “Dogs Laughing� by Susan Dalby

About the Artist

Sandpoint native Susan Dalby, has had a love for art from childhood that has remained with her all her life. Watercolor remains her favorite medium. She has participated in numerous group shows including many Pend Oreille Arts Council (POAC) Artwalks.

Susan was poster artist for the Sandpoint Wooden Boat Show for its first seven years and several times since. She was also chosen the Festival at Sandpoint poster artist in 2009.

Her colorful and detailed watercolors are inspired by the beauty of nature, from pines and wintry scenes of snow-capped mountains and skiers in the northern regions, to sun-splashed sand, palm trees, boats, beaches and those who inhabit them in the warmer climates.

She is also a glass artist: stained and beveled

Vaquero Viejo glass in windows and door panels; free-hanging art pieces, and various gift items, including earrings.

This work can be seen in Art Works Gallery in Sandpoint

Pelican

Winter Trees

Sand Creek

Snow, Swans, Hope

Scuba and the Artisan Gallery in Priest River, Idaho.

Several of her paintings can be viewed on Art Works website (www.sandpointartworks.com/susandalby.html) and FineArtAmerica, as well as in three galleries in Mexico.

Her glass creations, paintings and prints are in collections in Canada, Mexico and the U.S.

Originals and prints of her watercolors and commissioned glass pieces are available by contacting Susan directly through email: sjdalby@mindspring.com.

Summer Swans

Wise Guide | www.TheWiseGuideOnline.com

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by Jeffery J. Crandall, Attorney at Law, Crandall Law Group

Choosing a Successor Trustee/Disability Agent

E

very estate plan, whether built around a will or a revocable living trust (for probate avoidance), should include provisions granting another person the legal authority to manage your affairs if you become disabled, incapacitated or die. Those powers are granted under the revocable living trust (RLT), the last will and testament, a power of attorney for financial matters and a healthcare power of attorney.

One of the most important decisions you will make is your selection of the successor trustee, personal representative and agent under your financial and healthcare powers of attorney. While you can name different individuals or entities (such as attorneys, trust companies, financial institutions or other professional fiduciaries) to serve under each of those documents, for simplicity, we’ll refer to them in this article as the “trustee.” We have become increasingly convinced that this decision is a “business” decision, and not an emotional one.

Often, the individual chosen does not have the skill set, time, professionalism or integrity to carry out the role of a fiduciary.

Common Successor Trustee Problems

Over the years, we have watched the aftermath of choosing ill-equipped family members or friends for this role.

Here are some of the problems we have witnessed: • The trustee doesn’t know what he or she is doing and ends up being sued for mistakes • The trustee is already busy with his or her own life and can’t handle these additional duties • The trustee is power hungry and treats beneficiaries unequally 10

Wise Guide | Spring / Summer 2017

• • • • • • •

The trustee mismanages trust funds and loses your hardearned estate The trustee “borrows” trust funds and can never repay them The trustee refuses to do the job The trustee steals trust funds The trustee doesn’t uphold his or her fiduciary duties or follow the law The trustee is unfairly placed in the role of his or her sibling’s keeper The trustee is doing an adequate job but still faces suspicion and opposition from family members, eventually destroying family bonds

All of these examples are very real...and very detrimental to your estate plan! The business of choosing a trustee is not something to be taken lightly.

Duties of Your Successor Trustee Have you considered the duties of Your Successor Trustee?

A successor trustee is a “fiduciary.” That means he or she must always act in good faith and serve in a manner that is impartial, fair, and in the best interest of the beneficiaries. A trustee has a fiduciary responsibility to manage the trust assets as required by law (which generally includes the requirement to diversify the investments and sign a fiduciary investment policy) and to follow the terms of the trust. A breach of fiduciary responsibility would make the trustee liable to the beneficiaries for any damage caused.

Continued on Page 12

• Estate Planning (Wills and Trusts) • Asset Protection • Medicaid and VA Benefits Planning • Probate and Estate Administration • Gun Trusts

• Business Entities (Corporations, LLCs) • Purchase, Merger, or Sale of a Business • Business Succession Planning • General Business Counsel • Real Estate and Business Transactions

NEED A SPEAKER FOR YOUR GROUP OR ORGANIZATION?

Give us a call!

Jeff Crandall

Ryan Crandall

We offer complimentary consultations for Estate Planning and most other matters.

So don’t sit through a seminar with a bunch of strangers ... get personalized information from an experienced estate planning attorney in your own, private consultation.

To learn about protecting your wealth and loved ones with a Will or Trust....

Call Today to Schedule your No-Obligation, Complimentary Consultation!

8596 Wayne Drive, Suite B, Hayden, ID | 208.772.7111 Wise Guide | www.TheWiseGuideOnline.com crandalllawgroup.com

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Choosing a Successor Trustee/Disability Agent Continued from Page 10

______________________________________________________ Upon incapacity, your successor trustee would step in and make sure all of your bills are paid; that your investments are structured appropriately to ensure the proper income stream to meet your needs for your lifetime; pay for any necessary care, medical treatment, or alternate living arrangements (such as a rehabilitation center, assisted living facility, or skilled nursing facility). Your healthcare agent would also make healthcare decisions for you, including end of life decisions.

Upon death, your successor trustee is generally required to do the following: • • • • • • • • • • • • • • • • • •

•

Review the terms of your trust to determine your intent on distribution Pay all outstanding debts Fill out and submit claim forms for life insurance proceeds Pay all bills as they come in Notify the beneficiaries of your death and the existence of the trust Order Death Certificates Pay expenses of your last illness, funeral and memorial service Review mail and make notifications of death, as necessary Meet with your CPA regarding outstanding and upcoming tax issues Change the homeowner insurance on the home Have the home and any other real estate appraised Change the automobile insurance policy Obtain written date of death valuations for assets If necessary, work with family members to attempt to mediate disputes Change title on all assets If the home is to be sold, interview and hire an appropriate realtor Cancel subscriptions Determine if assets will be liquidated and distributed to beneficiaries or if assets will continue to be invested for the benefit of the beneficiaries Notify the Department of Health Services of your death and determine if they have a Medicaid claim

• • •

•

•

• •

•

•

Meet with your financial advisor to determine appropriate investment and/or liquidation of assets If you own a home, secure the home (i.e., change the locks and videotape the contents of the home) If “sub-trusts” need to be created for your beneficiaries, obtain the tax identification number for those trusts and determine appropriate funding Determine how retirement account proceeds should be distributed to cause the least tax consequences to your estate and your heirs Determine how personal possessions are to be distributed and facilitate that process, after appraisals are done, if necessary Meet/communicate with beneficiaries about how the administration will work and what to expect File an Affidavit of Death and applicable parent/child exemption forms with the County Assessor to avoid reassessment of property taxes If the home is to be sold, determine appropriate repairs to the home in contemplation of sale and hire the appropriate contractors for the work Coordinate filing of final income tax returns with family CPA/Accountant. When necessary, file IRS Form 706 (estate tax return).

In other words, it can be a lot of work! You hired a professional to prepare your estate plan and make sure your wishes are properly documented; it may be prudent to hire a professional to make sure your wishes are carried out. The decision as to which type of professional to hire also involves numerous considerations that should be fully evaluated.

At the Crandall Law Group, we offer complimentary consultations to explain these, and other important, considerations necessary to develop an estate plan that fits your unique needs and desires. __________________________________________________________________

Jeff Crandall is a business and estate planning attorney with over 30 years of experience in business, tax, estate planning, elder law and business succession planning. He is licensed in Idaho, Washington and California and has been practicing in the Coeur d’Alene area for over 20 years. Jeff loves helping people solve problems and, whenever possible, helping them to avoid problems in the first place.

Cough. Sniffle. Sneeze. No Antibiotics Please.

Many common infections are becoming resistant to antibiotics. It is estimated that more than half of antibiotics are unnecessarily prescribed.

The Northwest Hospital Alliance is a network of hospitals devoted to improving the health status of our communities by providing a collaborative approach to regional health care delivery. Our role is to coordinate strategies, relationships and services that will improve delivery, access and quality, of healthcare in our member communities.

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Wise Guide | Spring / Summer 2017

Small Business Advice, Is it Business or Personal?

by Ann Dutson-Sater Panhandle Accounting, LLC

B

usiness owners often overlook automobile mileage and expenses as viable tax deductions. The mileage rate set by the IRS for 2017 is 53.5 cents per mile driven for business purposes. If this is your first year of business, keep both mileage records as well as expenses for your automobile.

Expenses for your automobile include items such as mechanical repairs, tires, fuel/gas, licensing. At the end of the year, you can then evaluate whether to use the mileage rate allowed, or actual expenses for the use of the vehicle.

Keep a tablet in your car, and write down your miles (either odometer readings or total miles traveled) whenever you travel from your place of business for any business purpose.

Business purposes can include traveling to and from the business supply store to buy toner for your printer, trips to take potential customers to lunch, or driving to attend marketing meetings. Just make sure you are only counting the miles you spent traveling to and from your place of business. (This does NOT include your commute to work and back unless you “conduct business” en route.) You can find more information in Publication 463 on the IRS website at www.irs.gov

If you use your vehicle primarily for business with occasional or rare use for personal jaunts, it might be easier to note the mileage when you first began business use of the vehicle, and only record the miles of the occasional personal use. Either way, when you get in the car, get in the habit of thinking, is this business use or personal use today? Where am I going, what am I doing, is it business or personal? An example might be: The van is used for business, but you are helping a friend move over the weekend. You would record the weekend use as personal. The rest of the time, the only things to keep track of are gas, repairs/maintenance, tires, licensing.

Tip: An easy way to keep track of fuel usage is to have one debit or credit card used exclusively for business. That way you don’t have to keep a bunch of receipts since the expenditures are recorded either by the bank, or the credit card company. You can also use that same debit or credit card for other business expenses exclusively (meals and/or lodging when on a business trip, office supplies, etc.)

When managing a business, owners should spend their time focusing on building and growing their businesses, not on the day-in, day-out accounting tasks. That’s where Panhandle Accounting comes in; someone professional and experienced, keeping track of your finances, processing payroll, bookkeeping set-up and services, and tax preparation

and consulting so you can focus your attention on your customers and clients. “Call today and let’s see what I can do to help!” 208-290-6716. ___________________________________________________________________

Ann Dutson-Sater is a Sandpoint native. She holds a Bachelor’s degree in Business Administration with emphasis in Accounting, has been involved in the business world for over 25 years. Ann was the Bonner County Clerk of the District Court from 2013 to 2015.

And, she has volunteered her services to Pend Oreille Arts Council, Elks, Sandpoint Area Seniors, and Bonner County Historical Society. Ann enjoys helping start-up and small business owners.

Wise Guide | www.TheWiseGuideOnline.com

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Wise Investment Begins with the Right Financial Advisor!

by Cheryl Seifert, CERTIFIED FINANCIAL PLANNERTM

W

hen seeking a professional, the consumer will find a wide range of educational backgrounds in the field of money. Stockbrokers, accountants, lenders, and insurance agents are all called “financial advisors.” How can you tell them apart? One should not rely on a title alone but must learn the questions to ask a prospective broker or advisor.

Keep in mind that you are hiring them to help you.

Interview them for the job! Ask them to specifically explain their role with you, what they do, how they get paid and all of the costs you incur. What alternatives are available to you in working with them or with other resources? Who is actually managing your investments and what selection do they have available? Are you paying layers of costs for layers of management and can you select something with lower expenses? Are they a fiduciary, bound to make recommendations in your best interest? Ultimately, you 14

Wise Guide | Spring / Summer 2017

want information and advice that is competent and relevant to you, and it is empowering to know the variety of relationships from which you may select.

Stockbrokers are required to pass rigorous tests and register with the Securities Exchange Commission (called the FINRA Series 7, or Series 6 if selling only mutual funds or variable annuities). They work for a brokerage firm, mutual fund company, bank, insurance company and they sell you products and services of that company. They hope their products and services can help you, but they have sales requirements to meet to satisfy the boss they answer to — not you.

Brokers have traditionally been paid by commission on purchases and sales, “no trade, no pay.” Some products may pay a higher commission than others, and unlike insurance, where you don’t directly see the commission money missing from your account balance, the investment commission is deducted directly from your investment, but you may not find out how much that is until after the fact— unless you ask first.

Are you working with a sales person providing you financial products from what they have to offer (which may be limited) or with a professional advisor who has years of

experience with a wide range of products to consider? Who is their boss when it comes to professional financial advice to invest your money, you or their sales manager?

What you may not know is there are independent financial advisors who work as consultants, whom you hire to work for you — you are the boss. It takes more work to locate and identify these registered independent investment advisors whose marketing budget is dwarfed by the advertising power of the larger regional and national brands.

An experienced independent advisor knows how various financial companies operate, generally has lower overhead and gives clean advice with disclosure of costs and alternatives available to you. They work in a fiduciary capacity, advising you, their client, in your best interest.

You are the boss. They are free to select from a broad array

An experienced independent advisor knows how various financial companies operate, generally has lower overhead and gives clean advice with disclosure of costs and alternatives available to you. They work in a fiduciary capacity, advising you, their client, in your best interest. of investment products, not just the in-house solution.

Many registered independent advisors work on a fee basis, earning no commission, but rather a percentage of assets under management where they earn more if your investment balance grows. Their own income is directly affected by the advice they give. Some offer both or an hourly rate.

Lastly, when selecting a financial advisor, learn their career background in the financial arena, their relevant education and years of experience. Some financial advisors have guided people through market downturns and some have only experienced upward markets in their career.

Guidance from someone who has stayed in the business through good times and bad can give level-headed and helpful advice because they’ve made it through tough times, whereas many did not, or have only started in the job during the recent 7 year upward markets.

Be a savvy consumer, ask questions. In deciding to trust in investment advice, you can now make better informed decisions. Enjoy the confidence and comfort of working with a financial advisor who has made a sustainable choice in serving people who like to pay for quality, competent help with rates that are a good deal for what you need. ___________________________________________________________________

Cheryl Seifert, CFPÂŽ has helped investors for over 20 years.

Starting as a stockbroker in 1992, she achieved the CERTIFIED FINANCIAL PLANNERTM designation in 2011 and since 2015, as an independent financial advisor with Capital Financial Consultants Group, brings metropolitan wealth management skills to rural clients. She loves working together with investors, empowering them through financial education to create investment strategies that are aligned with their goals.

Sandpoint Boat by Susan Dalby (see cover artist page 9) www.sandpointartworks.com/susan-dalby.html Wise Guide | www.TheWiseGuideOnline.com

15

Anti-Gravity Therapy with the AlterG

by Amanda Thome, PT, DPT Idaho Pain Clinic

O

ne-hundred-million Americans suffer from chronic pain, according to the American Academy of Pain Medicine.

In fact, the leading cause of disability in Americans, under the age of forty-five, is back pain. Given these staggering statistics it is safe to assume we all know someone who suffers from a pain condition.

Not all pain is chronic in nature; pain may be acute or the result of an injury. Whether chronic or an acute condition, pain limits mobility. Lack of mobility and avoidance of activity interferes with daily living, and is often the beginning of a vicious cycle. Immobility leads to more pain from a sedentary lifestyle, decreased cardiovascular endurance, muscle weakness, weight gain and overall declining health.

One of the biggest challenges in treating acute or chronic pain is breaking this pain cycle.

Clinicians have until recently, relied upon the use of body weight support systems requiring either a cumbersome and uncomfortable harness to suspend the patient, or aquatic therapy for buoyancy, often limited by water depth.

Pool therapy was not appropriate for everyone due to fear, embarrassment in the water, surgical incisions and wounds,

or incontinence issues. The challenge became to offer body weight offloading by other means than a pool or a burdensome harness system.

The answer to the problem arrived in the form of the AlterG, an anti-gravity treadmill system using NASA developed technology. The AlterG allows patients to experience up to 80% weight offloading with precise control. This is all done from the ground up using differential air pressure to lift the patient without the need for a harness or pool. The AlterG system is so effective it is being used in the top rehabilitation facilities throughout the country, by top athletes in 5 Olympic training centers, and 29 NFL, 27 NBA, 23 MLB, 3 NHL, and 3 MLS teams. Studies have also demonstrated marked land speed increases for athletes through eight week interval training programs using the AlterG. Consider the fact that for every one pound a patient gains, it translates into an approximately four fold increase in ground reaction forces through the knee. Therefore, a patient with a five-pound weight gain will experience the equivalency of twenty additional pounds of force to their knees. The AlterG controls body weight in 1% increments allowing the patient to bear only 20% of their body weight. This reduction results in the patient’s ability to tolerate standing exercises, walking and even running, often pain free, in order to build strength, bone mineral density, cardiovascular health and also achieve weight loss through increased exercise and activity all without the jarring impact of full body weight.

In addition, the AlterG has been shown to be effective in treating patients with postoperative orthopedic surgeries of the hip, knee, ankles or feet as well as patients after stroke, with Parkinson’s, Multiple Sclerosis or those with a history of myocardial infarction or balance impairments.

Idaho Pain Clinic in Sandpoint has seen significant positive outcomes from their patients using the AlterG as a part of their physical therapy program. Recognizing the benefits the device offers to the general population, Idaho Pain Clinic even expanded the AlterG’s use to allow the public access to the machine under the supervision of a certified personal trainer.

If you would like to learn more about the AlterG we encourage you to visit www.idahopainclinic.com/pt to watch informational videos and links to information on the device.

And, to inquire about an appointment to see if the AlterG may help you, please give us a call at 208-263-9757. __________________________________________________________

Amanda Thome, PT, DPT graduated from Ursinus College in Collegeville, PA with her Bachelors of Science degree followed by her Doctorate in Physical Therapy from Columbia University in 2010.

Since graduation Amanda has had the opportunity to work for some of the top ranked rehabilitation facilities in the country. Her clinical experience includes the treatment of acute and chronic conditions, post surgical rehabilitation, as well as a special focus on neurological rehabilitation including stroke and spinal cord injury, balance and vestibular disorders, and acute and chronic pain conditions.

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Wise Guide | Spring / Summer 2017

Tired of Suffering?

We can help.

Our physicians are Board Certified and Fellowship Trained in pain management. Your procedures will be done in our newly accredited AAAHC surgery center where you will receive the highest standard of care. Our clinic offers a multidisciplinary approach to pain where our doctors work directly with our physical therapists to ensure you get the best results.

Don’t let pain slow you down!

Common conditions we treat:

• Back Pain • Neck Pain • Hip Pain

• Knee Pain • Elbow Pain • Arthritis

• Cancer Pain • Tension Headaches • Motor Vehicle Accidents

For more information about our providers & conditions we treat, please visit our website at

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OUR PROVIDERS: J. Sorin Ispirescu, MD Clinton Thome, MD Regina Kendra, ARNP A. Cipriana Niculaescu, PA-C Amanda Thome, DPT

LOCATIONS: Sandpoint, ID: 1327 Superior Street, Suite 101 Deer Park, WA: 11 E H Street, Suite F Newport, WA: 714 W Pine Street St. Maries, ID: 229 S. 7th St., 4th Floor, Suite 401

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17

LightForce Laser Photobiostimulation Relieves Pain & Enables Healing

by Dr. Daniel L. Moore, Moore Chiropractic

three time world triathlon champion and Dale Richardson, a professional golfer are users of the Class IV laser. This cutting edge, professional grade treatment is available to the public and I am very pleased to provide it in a small town environment where our lifestyles and day-to-day activities demand so much from our bodies.

The Science Behind Laser Therapy’s Benefits

A

few years back I suffered nerve injury to my left leg and had terrible radiating pain. Class IV laser therapy was recommended to me by a neurologist after medication and treatment failed. I had to travel to Boise to find the nearest facility offering Class IV laser treatment. It worked so well that I wanted to share it with my patients. Since then I have treated hundreds of patients with such great results that I have many health care practitioners stop in to see what deep laser therapy can do for their patients.

For those suffering from chronic, nagging pain, inflammation and lack of mobility, Class IV laser therapy offers fast, healing relief. We encourage those who have tried other forms of treatment without success to try the technology. Class IV laser therapy allows my patients to return to the activities they love while maintaining their healthy lifestyle. Recovery from injuries is much faster, often avoiding surgery altogether, not to mention the time associated with post-op healing. One of the greatest benefits I’ve found is that Class IV laser therapy allows the body to heal without the use of prescription drugs.

LightForce lasers are FDA approved, highly sought-after and endorsed by professional organizations such as The American Physical Therapy Association, The World Health Organization, and The International Organization for the Study of Pain. Many professional sports teams including the Seattle Seahawks use the LightForce laser. Lesley Paterson, a

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Wise Guide | Spring / Summer 2017

Peripheral neuropathy is a general term for diseases causing damage to the nerves outside of the brain and spinal cord. While diabetes is a frequent cause of neuropathy, it is not an exclusive cause. Nutrition deficiencies, chemical exposure, pressure on the nerves, injuries, and medications (such as those used in chemotherapy or to treat AIDS) can cause painful neuropathy.

In general, diabetic neuropathy is thought to be the result of chronic nerve damage caused by high blood sugars. Similar to how an electric wire is surrounded by insulation, our nerves are surrounded by a covering of cells called Schwann cells.

One theory suggests that excess sugar circulating throughout the body interacts with an enzyme in the Schwann cells (called aldose reductase), transforming the sugar into sorbitol.

This process draws water into the Schwann cells causing nerve swelling and damage resulting in pain. Unless the process is stopped and reversed, both the Schwann cells and the nerves they surround will die.

The application of photobiostimulation that the Class IV laser delivers to these cells prevents or reverses the biochemical processes that cause this damage. The increased circulation removes excess fluid from the Schwann cells removing any possible pressure necrosis (or death) to the rest of the nerve cell while providing a vehicle to remove cellular waste such as sorbitol.

Laser therapy applied to the affected nerve cells stimulates the mitochondria within the cell and increases the

State of the art technology for acute and chronic pain relief doesn’t have to mean a trip to the big city! respiratory rate of these individual cells. When this happens the intracellular metabolites do not have the opportunity to become depleted, and the production of any destructive protein kinases is halted.

Laser therapy generates a photochemical response in damaged tissue by a process called photobiomodulation. This process stimulates healing on a cellular level by enabling cells to more rapidly produce energy (ATP).

Deep tissue laser therapy is a non-invasive use of laser energy that promotes healing of damaged or dysfunctional tissue. This form of therapy helps your body use its own natural healing power by activating a positive cellular response, increasing microcirculation to reduce inflammation.

Laser therapy can alleviate pain and accelerate recovery from a wide variety of acute and chronic issues such as arthritis, tendonitis, neuropathy and plantar fasciitis. Knee, hip, neck and back pain have also been shown to respond extremely well to treatment with laser therapy.

Class IV lasers provide a deeper depth of tissue penetration unachievable with lower wattage lasers and are unrivaled by Class I, II, and III lasers. This is due to their ability to treat both superficial and deep tissue conditions.

The LightForce Class IV Laser was developed by leading laser scientists and engineers and we are proud to offer one of the very few Class IV LightForce Lasers in North Idaho.

We have already seen many of our patients benefit from this treatment with as few as two treatments. We are so confident that this exciting new treatment can help you that your first treatment is on us. Contact our office at (208) 2672506 to schedule your complimentary first treatment and start your road to a pain-free life today.

Visit danmooredc.com to see a short video on how the Class IV Laser works.

__________________________________________________________________

Daniel L. Moore D.C. has been in private practice for more than 30 years. His career began in Los Angeles, California in 1984. While working with Olympic athletes under Dr. John Thie, he mastered cutting-edge techniques like kinetic taping and Kinesiology.

A past board member of Boundary Community Hospital and Vice President of Boundary Community Ambulance, Dr. Moore currently works with several athletic teams at Bonners Ferry High School and is often seen on the sidelines during football, baseball and track events.

Dr. Moore’s advanced rehabilitation and athletic training has served Bonners Ferry and surrounding communities in North Idaho and Western Montana for over 20 years. He has continually led his field in the application of ground-breaking technologies including the LightForce Class IV Laser used in the treatment of nerve-related pain.

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19

Opioids—Be Informed!

[Jesse – 23 years-old] “Twenty-two year-olds are NOT suppose to go to sleep and die! We drank some wine, in celebration of my boyfriend graduating college but he kept nodding off so we went to bed earlier than usual. About 3:00 am I woke up and could feel he was cold and not breathing. I tried waking him up. I tried CPR. I called 911. He had promised me that he wouldn’t take anymore of those pain meds….”

[Casey- 16 years-old] “I’ve been sneaking pills from my grandma since I was thirteen. She hardly ever notices. Even if she does, my parents just blame it on her being old and not remembering.

I also make the rounds to my friends’ bathroom cabinets. Just a few here and there but it adds up. Unless I read that the script was filled a long time ago, then I take the whole bottle cause I figure they won’t even notice its missing.”

[Michelle – 36 years-old] “Good grades, good athlete, good girl, that was me. At seventeen, a soccer injury resulted in knee surgery and a prescription for hydrocodone. I’ve lost jobs and my drivers license to DUIs. My husband is threatening to divorce me and I’m afraid I might lose my kids to CPS. The other day I put my fist through a glass window to get oxys. I lie a lot for the addiction but I’m not lying when I say I don’t want to lose my family and I don’t want to die… but I can’t stop.”

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Wise Guide | Spring / Summer 2017

by Annabelle Payne, Director Pend Oreille County Counseling Services

W

hen was the last time you lost something important?

Now, take a moment, and imagine the thing you lost was yourself—you never saw it coming. Addiction happens for many reasons and at any time in someone’s life. It happens every day and at an increasingly alarming rate across the United States. The price for many, is death.

The Center for Disease Control (CDC) reported opioids claimed more than 33,000 lives in the United States in 2015, with over 3.5 million reporting non-medical use of prescription opioids.

Opiate-based medications are prescribed for pain management. For many this treatment works very well but it is important to be informed. Even if a drug is prescribed, there is the risk of addiction and for many medical conditions, opioids do not have to be the first line of treatment. Nonopioid medications and non-pharmacologic treatments such as cognitive behavior therapy also have good evidence for pain management.

When opiate-based medications are used, strictly follow the prescription and be mindful for symptoms of abuse and/ or addiction behaviors, such as the following: • Taking medication in a dose or frequency other than prescribed by a medical provider, often resulting in running out of medications early • Taking the medications when no longer medically needed • Seeking additional medications thru “doctor shopping,” illicit buys or theft.

• Exaggerating pain, lying or inflicting self-injury to obtain more medications • Mood swings or anxiety attacks due to non-prescribed medication use • Problems at work, school, relationships due to nonprescribed medication use • Intense cravings with inability to stop use • Withdrawal symptoms – muscle aches, restlessness, runny nose, irritability, restlessness. Often mistaken as having the flu but may actually be indication of physical dependency.

• Overdose - constricted or small pupils, vomiting, slow, erratic or absence of breath or pulse Get immediate medical help by calling 911 or going to the ER!

Did you know that Washington State has “Good Samaritan” laws that provide certain legal protections for people who need or seek medical help, in the event of an overdose? For more information see: http://stopoverdose.org/section/good-samaritan-law/

National Prescription Drug Take-Back Day is April 29, 2017 although unused prescriptions may be dropped off anytime in a Prescription Drop Box, located at the Pend

Oreille County’s Sheriff’s Office or at the Kalispel Public Safety building. For more information on safe disposal methods and why it is important: http://www.takebackyourmeds.org/what-you-can-do/faqs/

Other Resources: Washington Recovery Help Line (24-hour) call 1.866.789.1511 https://www.warecoveryhelpline.org/ Washington State DSHS https://www.dshs.wa.gov/bha/substance-use-treatment-services Pend Oreille County Counseling Services provides outpatient substance use disorder and mental health treatment, to include case management supports for inpatient treatment.

Counseling Services also partners with Newport Hospital and Health Services for medication-assisted treatment. Call 509.447.5651 pendoreilleco.org/your-government/counseling-services Wise Guide | www.TheWiseGuideOnline.com

21

What is Post Acute Care?

by Michael Meza, M.D. Director of Post Acute Care, Heritage Health

I

n the healthcare industry there has been more of a focus on Post Acute Care over the past several years. What is it and what does it mean to you? When someone is admitted to a hospital for an illness or accident, they are provided Acute Care. Once the patient is discharged from the hospital, whether going home with or without Home Health, being admitted to a Skilled Nursing Facility or other locations, they are considered to be in the Post Acute Care setting. This part of the process is critical as the patient continues to stabilize and work toward improving their overall health, minimizing the need to return to the Emergency Room and/or being

Post-Acute Care

readmitted to the hospital. The return to hospitalization increases the cost to the healthcare system and shows poor quality due to multiple factors. Certainly the patients do not want to return to the hospital. They want to get better and feel in control of their health.

In order for this to occur more frequently, we need to improve the system which cares for these patients in the Post Acute setting.

The first step to meeting these goals is to improve communication between the hospital staff and the care team taking care of the patients in the outpatient setting.

We need to do a better job of informing the next level of care about the person heading their way.

We need to discuss the questions such as, “Why were they admitted to the hospital? What happened in the hospital? What medications are they given upon discharged? What are the key action steps needing to take place for the patient to be successful in this transition of care? What should the outpatient provider look for as a sign of a problem or complication? Is the level of care appropriate for this situation and the best option to ensure a safe discharge?”

At any level of care it’s important to educate the patient about their disease process and give them the tools they need to take control of their health.

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Wise Guide | Spring / Summer 2017

At any level of care, it’s important to educate the patient about their disease process and give them the tools they need to take control of their health. For instance, learning about diabetes, high blood pressure, congestive heart failure or any number of illnesses that affect many of us. We must learn about the common complications. What should I watch out for? Who do I call for help? What should I eat and how should I exercise? This knowledge will empower the patient to regain control of his or her life and help them to take the next steps needed to improve their overall health.

The Post Acute Care team should help coordinate the care between healthcare providers. Who needs to be involved? What services are needed, when and for how long?

Facility. He also provided obstetrical care, including cesarean sections, and performed colonoscopies and EGDs for his patients.

He and his wife Casey moved to Coeur d’Alene in January 2012 and began focusing on care for the elderly. He enjoys seeing residents of “the greatest generation” in the Post Acute Care facilities, Skilled Nursing facilities, and Assisted Living facilities where they live, and building a health care team to support their needs. He works collaboratively with Kootenai Health through the Community Partners group to in-sure a smooth transition of care for patients discharged from the hospital to these types of facilities.

Dr. Meza is also the chairperson for the Quality / HIT committee for the newly formed Kootenai Care Network and is highly involved in the advancement of Tele-medicine on a state level.

Would Physical Therapy be helpful? Is Home Health an option? What is the best time to follow up with the Primary Care Provider or specialists?

We are very fortunate to have all the various levels of Post Acute Care in our own back yard. Starting from North Idaho Advance Care Hospital (NIACH), a Long Term Acute Care Hospital (LTACH), to Rehabilitation Hospital of the Northwest (RHN), an inpatient rehab facility, to many of the strongest Skilled Nursing Facilities in the state. Not to mention several Home Health agencies, Hospice and InHome Care organizations. We are also very fortunate to have over 20 Assisted Living Facilities in our area.

No matter what level of care you need, our communities have what it takes to provide you the best care possible, while getting you to the lowest level of care as soon as possible and for most, helping you get back home in the safest possible way. Our goal is to get you to the highest level of function for the longest time.

If you would like to learn more about the Heritage Health Post Acute Care team, please contact Dr. Meza and his staff at 208-620-5262. __________________________________________________________________

Dr. Meza graduated medical school from the University of Texas Southwestern in Dallas, Texas in 1993, followed by Family Practice residency at John Peter Smith Hospital in Forth Worth.

After graduation he moved to Orofino, Idaho and enjoyed 16 years practicing full spectrum family medicine, providing care in the clinic, hospital, emergency department and Skilled Nursing Wise Guide | www.TheWiseGuideOnline.com

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Knowing where to go during times of emergency is key. To learn more and to save a spot in line, go to: kootenaiurgentcare.com In a life-threatening/ emergency situation - call 911!

Urgent Care or the Emergency Room?

How do you choose where to go?

B

elow are symptoms to help you decide where to go if you are in need of urgent attention.

Broken Bones: Symptoms often include limited or inability to move a limb, intense pain, numbness, tingling and a visibly misshapen limb or joint.

Urgent Care: -Extremity injury with pain, swelling or bruising.

-Minor broken bones and fractures (i.e. wrist, ankle, hand or foot).

Emergency Room: -Compound Fracture (bone protruding through skin).

-Major broken bones (hips, femur, or significant deformity of a limb).

Cold & Flu: Influenza The “Flu� is a highly contagious respiratory illness caused by different strains of the flu virus. Symptoms include sudden onset, fever, sore throat, cough, and muscle aches.

It is important to seek treatment to avoid more serious complications such as bronchitis, sinus infections and pneumonia.

Urgent Care: An urgent care provider can diagnose the flu based on your symptoms. If diagnosed, antiviral medication may 24

Wise Guide | Spring / Summer 2017

be prescribed. Taken early on, these drugs may shorten the course of the flu and help prevent worsening and causing complications such as pneumonia, bronchitis etc.

Emergency Room: -Severe difficulty breathing -Confusion -Severe vomiting -Signs of dehydration

Bee Stings: While reactions to stings vary, it is important to recognize the signs and symptoms when medical care is needed. If you are stung, remove the stinger as soon as possible. Do not squeeze, which may result in more venom being injected into the body.

Wash the area thoroughly and apply ice. If pain persists for more than a few hours, seek medical care.

Urgent Care: -If you are unsure of how to treat a bee sting, do not hesitate to come into Kootenai Urgent Care to have the sting evaluated/treated.

Emergency Room: -Difficulty breathing -Anxiety or dizziness -Tightness in the throat -Tongue swelling

Cuts & Lacerations: A laceration is a cut usually caused by a sharp object or blunt force.

-Seizures or convulsions -Confusion

Sore Throat:

Urgent Care: -Most lacerations can be treated in an urgent care facility.

Emergency Room: -Blood loss is significant.

-If urgent care provider feels the laceration needs further evaluation.

Stomach Pain: There are many causes ranging from food poisoning, infection, inflammation, appendicitis and many other conditions and may often be accompanied by nausea, vomiting, cramping or aching in the abdomen and overall restlessness.

Urgent Care: If your abdominal pain is mild, or you have diarrhea and vomiting for more than 24 to 48 hours, a visit to urgent care can often help diagnose the root cause. However, if the pain does not subside within 30 minutes, it is best to seek emergency care.

Emergency Room: Severe or persistent localized pain in the abdomen can be an emergency.

High Fever: A fever generally occurs when you are sick, to activate the body’s immune system to fight off bacteria and viruses.

Fevers can also occur with heat exhaustion, sun-burns, some immunizations and some medications.

Urgent Care:

Inflammation caused by infections such as a cold or the flu. Typical symptoms are scratchiness, difficult or painful swallowing and swollen tonsils.

Urgent Care: If your sore throat doesn’t start to feel better within 2-5 days, an urgent care center can swab your throat, diagnose and prescribe antibiotics if necessary.

Emergency Room: -Restricted breathing.

Ear Infection: Occurs when one or both Eustachian tubes (small tubes connecting the ear to the back of the throat), become swollen or blocked and fluid builds up in the inner ear causing pain or discomfort, persistent feeling of pressure, hearing loss, ringing in the ear or discharge.

Urgent Care: Ear pain that persists longer than 1-3 days can often be treated with an antibiotic. The provider may also prescribe a decongestant to help relieve the pressure in the middle ear.

Ear infections being treated with an antibiotic should start feeling better within 2-3 days. If symptoms persist, a different antibiotic may be prescribed.

Emergency Room: -Stiff neck with inability to touch your chin to your neck.

-Confusion associated with ear complaints.

Treatment depends on the cause, (i.e. medication, heat exhaustion, etc.). If you have recently been in high temperatures and are not sweating, (heat exhaustion), your fever lasts for more than a couple of days, or cannot be treated effectively with over the counter cold medicine. It is important with any fever to drink plenty of fluids to avoid dehydration.

Sprains & Strains:

Emergency Room:

If you are experiencing numbness on or around the injured area or you are unable to walk without significant pain. Most do not require a trip to the Emergency Room.

-Stiff neck -Trouble breathing

A sprain occurs when a ligament, (the fibrous tissue that connects bones together), is torn. A strain occurs when a muscle or a tendon is torn. Most sprains and strains can be treated at home with rest, ice and elevation.

Urgent Care:

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25

Women’s Health Care Beyond the Pap!

by Dr. Kristin Algoe, Sandpoint Women’s Health at Bonner General Health

Y

ou may have seen your healthcare provider recently for your annual wellness exam, and they advised you that you no longer need a Pap test every year. Some women are upset with this recommendation. They feel they might miss a chance for early detection to discover something is wrong with their health before it becomes a larger problem. Some women are more than happy to skip a yearly visit to their gynecologist. Which take on this is right? Let me help you learn a little more about the current recommendations for women’s health care and screening for medical issues.

“First of all, what is a ‘Pap’?”

This term has been tied to the women’s annual wellness visit for a long time, but in truth, it is just one aspect of a wellness exam. A “Pap” is a test that was invented by Dr. Papanikolaou somewhere around 1930. It is sometimes called a “Pap smear” because the sample collected is ultimately “smeared” on a microscope slide for a doctor to look at who specializes in pathology. Today this test is a tool to screen for cervical cancer. The cervix is just one part of a woman’s reproductive anatomy. The test involves a small brush that collects a sample of cells from the cervix done during a pelvic examination.

It is true that current recommendations support a Pap test for women at intervals longer than one year. Often, most women are recommended to have a Pap once every three, or even every five, years. We have learned a lot about cervical cancer and how it may start and who is at greatest 26

Wise Guide | Spring / Summer 2017

risk. We have learned that cervical cancer is related to a virus called HPV or human papillomavirus. These recommended screening intervals are based on strong evidence, and on each individual’s history, which helps identify and treat women at highest risk and helps prevent over-testing in women at lower risk.

“If I don’t need a Pap then should I have a yearly visit?”

Most experts say yes, and we absolutely agree, and there are several reasons why. As we discussed, the Pap test is a screening test for just one cancer in one part of a woman’s body. A yearly visit is a great time to check in

The Pap test is a screening test for just one cancer in one part of a woman’s body. A yearly visit is a great time to check in with your healthcare provider and address many other opportunities to screen for disease. with your healthcare provider and address many other opportunities to screen for disease. You will likely discuss breast health and the right exams and/or imaging studies that can help decrease your risk for breast cancer. You may discuss screening for heart disease or diabetes by looking at your blood pressure, your weight, your cholesterol levels, or your blood sugar level. You may have a pelvic exam and

this exam looks not just at the cervix, but also evaluates your uterus, your ovaries, your vagina, and vulva. You may find an opportunity here to discuss your menstrual cycle or changes in your body that happen with menopause. You may want to discuss any issues you are having with your sexual health, or any concerns you have with your reproductive health. You can discuss screening and prevention of osteoporosis or of colon cancer. You can discuss diseases that may run in your family. You may have some time to just discuss being the healthiest self you can be. This is a great opportunity and there are so many things that can be accomplished at an annual visit. Don’t miss your chance!

Sandpoint Women’s Health at Bonner General Health offers routine wellness exams and many other gynecological services, including contraception, colposcopy, endometrial ablation, hysterectomy, menopause management, and much more. We also treat the following gynecological conditions: abnormal uterine bleeding, bladder issues and incontinence, pelvic organ prolapse, breast problems, pelvic pain, osteoporosis, urinary tract infections, and much more.

Sandpoint Women’s Health’s care team includes Dr. Kristin Algoe, Dr. Amelia Huntsberger, Dr. Jeffrey Johnson, Dr. Morgan Morton, and Laci Burk, FNP-BC. Visit us online at sandointwomenshealth.com Sandpoint Women’s Health is currently accepting new patients, call 208-263-2173 today for an appointment.

__________________________________________________________________________

Kristin Algoe, MD is Board Certified by the American College of Obstetrics and Gynecology. Dr. Algoe graduated from State University of New York at Buffalo School of Medicine and completed her residency at Dartmouth-Hitchcock Medical Center. During her residency, Dr. Algoe received several awards including, the “Arnold P. Gold Award for Excellence and Humanism in Teaching,” the “Award for Excellence in Laparoscopic Surgery,” and the “Resident Researcher Award.” After completing four years of OB/GYN residency training, she joined Sandpoint Women’s Health in 2009.

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27

Choosing a Rehabilitative Care Facility

by Stephen Chun, Marketing Coordinator Rehabilitation Hospital of the Northwest

W

hen recovering from a disabling injury or disease, rehabilitative care is significant to a patient’s healing process, helping to provide positive results in regaining or improving productivity and independence.

Choosing a rehabilitation facility for yourself or a loved one may be one of the most important and difficult decisions you have to make. When you talk about rehabilitation facilities, you may hear the terms skilled nursing, nursing homes, assisted living centers, and acute rehabilitation hospitals. These all may seem like equal choices for rehabilitative care, but they’re not.

Each of the aforementioned facilities has rehabilitation professionals on staff, but only one – the rehabilitation hospital -- specializes in rehabilitation, offering 24-hour rehabilitative nursing care, along with daily physician management and intensive rehabilitation therapies.

A national study shows that patients treated in inpatient rehabilitation hospitals have better long-term results than those treated in skilled nursing facilities. The study, which was commissioned by the ARA Research Institute, shows that patients treated in rehabilitation hospitals live longer, have less hospital and ER visits, and remain longer in their homes without additional outpatient services. These patients returned home from their initial stay two weeks earlier and remained home nearly two months longer. In addition, patients who were treated in inpatient rehabilitation hospitals experienced an 8 percent lower mortality rate and 5 percent fewer emergency room visits per year.

In addition, last spring, The American Heart Association/ American Stroke Association released guidelines strongly recommending that stroke patients be treated at inpatient rehabilitation facilities rather than skilled nursing facilities.

Choose a Nationally Recognized Hospital – It Matters!

Rehabilitation Hospital of the Northwest is ranked in the U.S. in the Top 10% for patient care. And, we’ve earned The Joint Commission’s Gold Seal of Approval.

3372 East Jenalan Ave • Post Falls ID 83854 • 208.262.8700

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Wise Guide | Spring / Summer 2017

RHN.ERNESTHEALTH.COM

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The guidelines highlight the effective and important aspects of an inpatient rehabilitation facility, including: •

• • •

Patients typically participate in at least 3 hours of rehabilitation a day from physical therapists, occupational therapists, and speech pathologists Nurses are continuously available Doctors typically visit daily So, how do you select a rehabilitation hospital that’s right for you or a loved one?

A good starting place is to discuss your options with your physician or healthcare provider. He or she is intimately involved with your health care and knows what your specific needs are. Your physician will know what type of rehabilitation will be required for your injury or illness. Ask for recommendations on rehabilitation hospitals, and then do some research: •

Start with an online search. Compile information and form questions. Review general information about rehabilitative care, and gather information from the hospital’s web site.

• Take a tour of the hospital. Observe the attitude of the staff, type of equipment, and the cleanliness of the facility.

By visiting, you can get a sense of the care provided, compassion for patient dignity, and involvement of family members. You may want to ask about:

- healthcare specialists who will be involved in

your care,

- nurse-to-patient ratio,

- longevity of the staff,

- certifications, and credentials of the staff,

- how large the hospital is,

- what services are provided,

- hospital accreditations and recognitions,

- patients’ results.

•

•

•

Note the location of the hospital. While the location should be considered, getting the best care for you or a loved one is most important. If you have to leave your hometown for treatment, check the hospital’s policy for overnight visitors and on-site available food services. Also, you can check the hospital’s proximity to hotels, grocery stores, and restaurants.

Determine if family members are involved in the patient’s care. Since family members help the patient transition back to his or her home and work life once they leave the hospital, it’s important that everyone – patient, family members, and hospital healthcare team – work together consistently to help the patient achieve the most independence possible.

Find out some “housekeeping” information, such as what language is spoken at the hospital, the types of insurance accepted, the hospital’s visitation hours, and anything else that can make your and your family’s stay more comfortable.

Don’t ever hesitate to research, observe, and ask questions to be sure you are treated at a facility that offers exemplary rehabilitative services in an environment that’s comfortable for you and your family.

In Post Falls, Idaho, Rehabilitation Hospital of the Northwest is a rehabilitation hospital that provides specialized rehabilitative services to patients throughout Idaho and surrounding states who are recovering from disabilities caused by injuries, illnesses, or chronic medical conditions. This includes strokes, orthopedic, brain and spinal cord injuries, along with chronic illnesses such as cerebral palsy, ALS (Lou Gehrig’s Disease), multiple sclerosis and Parkinson’s disease.

The hospital is consistently ranked in the Top 10% of inpatient rehabilitation facilities in the nation for its patient care by the Uniform Data System for Medical Rehabilitation (UDSMR). The UDSMR maintains the world’s largest database for medical rehabilitation outcomes. This means that in the Inland Northwest, patients don’t have to leave the area to receive the latest in technology and clinical protocols; it’s being provided right in our own community. __________________________________________________________________

Stephen Chun is the Marketing Coordinator for Northern Idaho Advanced Care Hospital and Rehabilitation Hospital of the Northwest in Post Falls. He recently moved to the Inland Northwest area with his wife, Dr. Megan Sakamoto-Chun, a Family Physician Resident at Sacred Heart Medical Center and Children’s Hospital in Spokane. Stephen received his Masters in Communication from Hawaii Pacific University and is a graduate of Beloit College.

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COEUR D’ALENE • 208-765-4961 • Interlake Medical 700 Ironwood Drive, Suite 220 SANDPOINT • 208-255-4389 • 123 S. Third Avenue Wise Guide | www.TheWiseGuideOnline.com

29

Collaboration for Comprehensive Care

by Tom Wilbur CEO, Newport Hospital and Health Services

B

eginning in 2009, Newport Hospital & Health Services (NHHS) and Pend Oreille County Counseling Services (POCCS) started working collaboratively to better support crisis mental health intervention within our community.

Recognizing that shared community need, we realized our organizations could do more to support comprehensive care delivery.

We both recognized early on the trajectory of healthcare reform would require better integration of primary medical and mental health & chemical dependency services. It certainly made sense to our providers. However, it became apparent that there were few programs for rural communities and realized any funding solution would require local support. Based upon our collaboration on patients in crisis, we also knew we would need to better understand how each other’s systems and cultures worked in order to foster staff relationships. Our goal was to not only enhance the care provided, but also foster joint ownership to better coordinate our care for patients with significant needs.

In 2012, NHHS received funds through a Regional Care Transitions Outreach grant from the Cambia Health Foundation. The goal under the grant was to identify patients with high risk chronic conditions and improve health outcomes and/or lower care delivery costs via implementing care transition services and better coordinating care.

Our goal under the grant was to identify individuals with mental or substance use disorders and jointly address issues that may be contributing to a physical health condition and try to build an integrated, collaborative care approach.

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The assumption was folks who don’t have access to first line treatments will typically obtain their care through more expensive service areas (i.e. the emergency room). By providing coordinated access to services and getting upstream to deliver care people need could also reduce the potential need for crisis intervention.

Both of us recognized a great deal of mental health and substance use treatment occurs in the primary care setting where providers often do not have the time, staff, or support to adequately address behavioral health needs. Our target was to ensure we would have mental health clinicians onsite to allow a warm hand-off between medical and mental health providers in the clinic. Our goal was two-fold: 1) eliminate the barrier of having the patient follow up at a second location with a referral for treatment (transition); and 2) create a means to allow mental health clinicians, medical providers, and the patient to have meaningful dialog and consultation on a regular basis. Good communication is paramount for quality care coordination, delivering good health outcomes, and creating a positive patient experience.

We started our initial work under the Cambia program by asking providers which patients they felt might benefit most from care coordination. From there, we eventually expanded

to serving 80 patients under the program and experienced a better than 60% yearover-year reduction in emergency room visits on those patients. After two years, our grant funds were depleted but both NHHS and POCCS witnessed measured success with the pilot. It was enough to justify our continued collaboration.

NHHS and POCCS have continued to jointly fund mental health providers in the medical clinic five days a week. It is for limited hours, but designed to continue to provide a warm hand-off, provider consultation, and on-site follow up with our shared patients when possible. The goal is to ensure coordinated behavioral health/ medical treatment is provided on the same day as patients are more likely to attend a joint appointment than drive to POCCS following their primary care visit.

The collaborative relationship between POCCS and NHHS continues to grow around the care coordination model. When NHHS opened its new primary care clinic (August 2016), we included permanent treatment areas for counseling services. Rather than meeting clients in a clinical exam room, counselors meet with them in a warm office environment with dimmable lights and more comfortable furniture. In fact, the entire clinic design promotes coordinated primary care services. Our exam rooms are located around a central core area that houses all providers and clinical support staff including care coordinators. The design is intended to promote communication and cohesion across the patient care team.

Since 1921, healthcare services in Newport relied on the provider-patient relationship. Our intent is to continue that focus, adapting to and meeting the needs of our community members as their healthcare needs change. __________________________________________________________________________________________

Tom Wilbur has been CEO at Newport Hospital and Health Services for the past 12 years. For 25 years he has operated facilities of all sizes - from small rural, to urban tertiary and teaching facilities. During his career, he has worked to develop systems of care and to recruit providers across the entire spectrum of healthcare service delivery. Tom has served on a number of Committees for the Washington State Hospital Association, including Strategic Planning, Rural Hospital (Chair), and Rural Health Quality Network (Chair), the Washington Health Services (WHS) Board, and as Chairman of the Eastern WA, Critical Access Hospital Network (15 rural hospitals). Tom received his Bachelors of Science in Business Administration from Eastern Washington University in 1987.

Newport Hospital and Health Services...your care community since 1921.

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NEWPORT HOSPITAL & HEALTH SERVICES 714 W. Pine St., Newport, WA • (509) 447-2441 www.NewportHospitalAndHealth.org Wise Guide | www.TheWiseGuideOnline.com

31

Nurse Practitioners, the Bedrock of Primary Care

by Cynthia Dalsing, Advanced Registered Nurse Practitioner Women’s Health Care

Tabitha Barron, MSN WHNP/ARNP Cynthia Dalsing, MSN CNM/ARNP

W

hen you need a physical exam or management of a medical issue, whom do you usually see? In our area, we are fortunate to have a sophisticated and wide range of medical services, available. Many will see a Nurse Practitioner, either by choice or as part of their medical care team. In Sandpoint, NPs provide primary care as well as work in specialty clinics, outpatient facilities and at our local hospital, Bonner General Health. They want to get better and feel in control of their health.

But, what are Nurse Practitioners? Nurse Practitioners are registered nurses with a Bachelor’s degree in nursing with additional education at a Master’s or Doctorate level. They have over 6 years of education to prepare them to practice in a variety of medical settings.

Nurse Practitioners are qualified and licensed to make medical diagnoses, prescribe medications, order and interpret radiology studies and lab work. They refer patients to other providers as they deem medically appropriate. In the state of Idaho, Nurse Practitioners can practice independently of a physician. They have independent practice in 22 states, and practice in all 50 states.

We are part of the solution for the health care crisis in our country. There are over 1000 Nurse Practitioners in the state of 32

Wise Guide | Spring / Summer 2017

Idaho, and this progressive state law recognizes us as Primary Care Providers. We practice in primary care and serve both rural and urban areas. Many NPs also work in specialty areas including women’s health, anesthesia, psychiatry, cardiology, orthopedics and pulmonary medicine.

Despite extensive education and a wide scope of medical capability, Nurse Practitioners still have barriers to providing the best and most cost effective care for their patients. These barriers to practice affect quality, costs and timely access to care.

Currently NPs are unable to refer a patient to Home Health, Hospice, or order diabetic shoes without that patient first seeing a physician. This requires an additional visit, additional cost, and a burden to both patient and the health care system.

Perhaps the most important barrier to care is the lack of pay parity. In Idaho an NP is paid 85% of what a physician is paid when performing the same service. When an NP owns and operates a medical clinic, they have the same expenses as any other medical clinic, but have to cover those same costs with 15% less income. In Oregon there is a pay parity requirement that has eliminated this disparity. When trying to recruit more NPs to come to Idaho, salary reimbursement

is important, especially when other states in the Northwest are competitive with the salaries they offer.

These barriers are being addressed at the federal level.

I was recently in Washington D.C. where I met with other Nurse Practitioners and Idaho legislators to discuss solutions.

Currently a bill is being introduced into the Senate that will allow NPs to refer for Home Health. This is Senate Bill 445.

There is also a resolution in the House, Res 1160, which will include NPs in the matrix that insurance companies use to measure health care outcomes. Health care is moving away from a fee-for-service payment structure to reimbursing health care providers for outcome measures. In other words the better care you give and the healthier your patients are, the better the state of Idaho will be graded on its health care. That also means Idaho would be able to receive more money for health care.

Currently this matrix is only measuring physicians who provide primary care. Since NPs provide primary care and in some communities are the bedrock of primary care, this insurance structure does not count the care provided by NPs.

According to the Institute of Medicine, NPs have been shown to have excellent outcomes and are cost effective. They are frequently the front line for access to health care. Insurance companies tend to follow the guidelines established nationally by following Medicare guidelines, so changing the language of the rules and regulations at the federal level will help provide better care at the local level.

Women’s Health Care Cynthia Dalsing, MSN, ARNP Tabitha Barron, MSN, ARNP Advanced Nurse Practitioners

Annual Exams & Pap Smears Well Woman Gynecology Birth Control Services Menopause Management

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1215 Michigan Street, Suite C Sandpoint, Idaho

__________________________________________________________________

Cynthia Dalsing, Tabitha Barron and Katie Sweeney are Master’s prepared Advanced Registered Nurse Practitioners. Cynthia received her Master’s degree from the University of Utah in 1981. She has practiced in both University settings and private practice. She has practiced in Sandpoint since 1995. She grew up all over the world as her father was in the Air Force. Tabitha received her Master’s degree from Arizona State University in 2011, and has practiced in Sandpoint over 2 years. She grew up in Oregon.

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33

Digestive System Imbalance

by Scott Porter, PharmD & Owner Sandpoint Super Drug

“A

ll disease begins in the gut,” Hippocrates is quoted as saying around 400 BC. He is referred to as the father of modern medicine. More than 2,000 years later, it is now estimated that 60 million Americans are affected by digestive diseases. This includes chronic constipation, acid reflux, and irritable bowel.

Hippocrates began to categorize illnesses as acute, chronic, and epidemic. Could our digestive disorders, like leaky gut, be reaching epidemic proportions?

The body typically maintains a wonderfully selective barrier to metabolic wastes and microbial toxins in the intestines. All while allowing in the nutrients we need for good health.

Modern medicine, processed foods and daily stress are contributing to imbalances in our digestive system and the breaking down of the protective intestinal barrier. This creates a permeability in our gut that has given rise to a discouraging epidemic.

Antibiotics and non-steroidal antiinflammatory drugs (NSAIDs), while very helpful for some health concerns, are major contributors to gut issues. Antibiotics kill infections, but they also destroy beneficial bacteria and promote growth of fungus. We now eat an absolutely astounding amount of sugar and flour products that feed such pathogens.

All of these changes compromise the intestinal barrier and allow absorption of serious toxic agents and chemicals.

These enter the blood and affect our organs and brain.

Nutrients that are not fully digested can also enter through the small intestine, giving rise to food sensitivities and allergies.

The body’s immune response will begin to tag some of these foods as foreign irritants. And thus begins the inflammatory immune response which further damages the gut lining. That’s why so many people are sensitive to dairy, gluten, eggs, and nuts and are complaining about arthritis related to inflammation.

Our liver can normally handle the daily amount of toxins life presents. But it can get overwhelmed by the additional toxins entering through the leaky gut walls. It becomes saturated and the lymphatic system begins to take on too heavy a burden.

We start to get bouts of either constipation or diarrhea, bloating, and gas. Fatigue, anxiety, and depression may start to arise. Unrelated symptoms will show up, such as colds and flu, skin rashes, brain fog, blood sugar and blood pressure issues, and weight gain.

Microbes begin to grow and develop and get forced into connective tissue around muscles and joints.

Our immune and endocrine system gets over stressed. This contributes to genetic mutations and ultimately cancer. This can lead to problems such as fibromyalgia, chronic fatigue, or diminished adrenal function.

Hippocrates also believed that bad digestion is the root of all evil. Élie Metchnikoff, who won the Nobel Prize in medicine for his work on immunity in 1908, said “Death begins in the colon.”

If your gut isn’t working right, then your body isn’t working right. This is reversible though. You can repair the accumulated damage.

It all starts with diet. One that eliminates flour, sweeteners, starches, bad vegetables oils, preservatives, and is low in carbohydrates. Generally a low inflammatory, high nutrient diet along with clinical grade probiotics and digestive enzymes is key.

You may also need to address overgrowth of detrimental gut bacteria, fungus, and yeast. Leaky gut and this intestinal dysbiosis, often go hand in hand. This will require more severe diet restrictions for a short period of time, along with support to tame down the overgrowth. In this case, probiotics can actually make things worse and may need to be eliminated.

Come on down to the pharmacy. I have handouts for you on diet and repair protocols, and we can talk about how to select effective probiotics. _______________________________________________________

Scott Porter, Pharm. D., is a functional medicine pharmacist at Sandpoint Super Drug. He emphasizes integrating diet, exercise, and nutrition with science-based medicine for optimal health and well-being.

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Boundary County Community Restorium

The Evolution of Medicine

Over the past 25 years, I have been involved in an evolution of medicine. A philosophy that is transitioning from a science of treating disease to a science of health.

My vision is that we take charge of our own health and return to a focus on well-being. That we address the underlying causes of disease and look at ourselves as a whole person, not just an isolated set of symptoms.

I believe in supporting our own unique expression of health and vitality, and addressing environmental and lifestyle factors that influence the emergence and progression of disease. — Scott Porter, PharmD

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35

CAREWellness—Camas FOR THE WHOLE PATIENTCenter Clinic Integrative AND THE WHOLE COMMUNITY. Welcome Dr. Rajeev Rajendra NOW ACCEPTING NEW MEDICAL AND DENTAL PATIENTS

by Dr. Rajeev Rajendra,  Primary Care & Women’s Health Medical Director  Comprehensive Dental Services Integrative Wellness, Camas  Clinical Massage Therapy Service Center Clinic

 Physical Therapy — land & aquatic  We accept most public and commercial insurances

 Chiropractic Services

APPOINTMENTS: 509-447-7111

M

K A LI S PE LTR I B E .COM/C LI N I C/M E D I C A L

1 8 2 1in N LEC LE RC Rmind D, STE # 1 and • CUSIC K , WA 9is 9 119the aintaining balance body, spirit essence of staying healthy and typically provides the best results. With this philosophy in mind, we at the Camas Center Clinic have been diversifying our approach to a more “Integrative” approach to modern medicine. As Bella Bleue quotes, “Your body holds deep wisdom. Trust in it. Learn from it. Nourish it. Watch your life transform and be healthy.”

Community Health for Everyone!

The Camas Center Clinic is open to everyone, as well as tribal members, inviting both scheduled, and walk-in appointments for adults and children of all ages, providing a wide array of health and wellness services. Since opening in 2008, the 77,000-square-foot wellness complex has become a hub of activity, with thousands of members and residents from throughout Pend Oreille County and outlying areas of Washington and Idaho.

We offer annual physicals for all eligible patients, Firefighters, Workers Compensation/Injury evaluations and recommendations for Kalispel Tribe Employees. DOT urine screens for new Kalispel employees are conducted and we have an ongoing program of input for the Childhood Early Learning Center (CELC) and advice regarding infection control.

Among other services, we provide Pelvic Exams and Cervical Cancer Screening; Well Child Exams and Sports Physicals; Immunizations for adults and kids; and we have an onsite Emergency Outpatient Pharmacy. Other care services include wound care, and infusion services such as intravenous fluids and intravenous antibiotics.

The Clinic offers nutritional education for those of us living with diabetes, hypertension, rheumatoid arthritis and 36

Wise Guide | Spring / Summer 2017

lupus. Additionally, we have a smoking cessation clinic and an elder’s clinics onsite.

Camas Center Clinic Vision Our vision for the future includes, but is not limited to, keeping the clinic open 5 days a week and expanding to offer these programs and services: • A Suboxone program as a rehab treatment program for opioid addiction, • Complete DOT and CDL physicals, • Introduce “tribal medicine” into clinical practice by partnering and learning from tribal elders, • Bringing in specialty care such as Nephrology, Cardiology, Rheumatology and Pulmonology, • Combining Nutrition and Exercise and providing consultative services for adults and children, • Adding Acupuncture as an ancillary service, • Increasing the scope of pharmacy services, • Introducing the concept of ionized water in the Clinic and at the Camas Health Center, • And resume X-ray services by April 2017.

For health care, we accept almost all insurances, and for those without insurance, we would be happy to work with you. Not to mention, it’s a gorgeous facility, complete with fitness and recreational offerings of four indoor pools, spa with all the trimmings, daycare, and deli serving healthy, delicious food for breakfast, lunch & dinner.

Come for the care and spend the day! You can also join the Center for a nominal fee and make us a regular part of maintaining your health and wellness. To learn more visit:

kalispeltribe.com/camas-center/our story Dr. Rajeev Rajendra, “Dr. Raj” to his patients, joined the Camas Clinic in March 2016. Dr. Raj believes that medical practice is a lifelong commitment, treating patients with the compassion we would expect for ourselves and our family members.

Dr. Raj earned a Master’s in Pharmacology and Toxicology at Rutgers University. He then trained in Internal Medicine at Indiana University Health, Ball Memorial Hospital and completed a Hematology Oncology Fellowship at the Fred Hutchinson Cancer

Research Center, University of Washington.

Dr. Raj holds board certifications from the American Board of Internal Medicine in Internal Medicine, Medical Oncology, and is board eligible in Hematology. His affiliations include: American Society of Hematology, American Society of Clinical Oncology, and American College of Physicians. He has to his credit several medical abstracts and manuscripts as well as awards for his medical research.

You may ask, “Where IS this place?” We are 30 minutes north of Newport. You can drive or you can also get here for a $1 donation by taking the Rural Resources wheelchair accessible vehicle - round trip from Newport, 6 departures & return trips every Monday through Thursday, except holidays.

Call 800-776-9026 for more information.

Kaltran, operated by the Kalispel Tribe of Indians is now providing Medicaid transportation services throughout Pend Oreille County to the Camas Center Clinic, Camas Path North and People’s Place. This service is free for current Medicaid patients.

Please call 509-447-7247 for more information or to schedule a ride.

CARE FOR THE WHOLE PATIENT AND THE WHOLE COMMUNITY. Welcome Dr. Rajeev Rajendra NOW ACCEPTING NEW MEDICAL AND DENTAL PATIENTS    

Primary Care & Women’s Health Comprehensive Dental Services Clinical Massage Therapy Service Chiropractic Services

 Physical Therapy — land & aquatic  We accept most public and commercial insurances

APPOINTMENTS: 509-447-7111 K A LI S PE LTR I B E .COM/C LI N I C/M E D I C A L 1 8 2 1 N LEC LE RC R D, STE # 1 • C U S I C K , WA 9 9 119

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37

Herbs, Our Local Bounty

by Christina Kettenring,* Wellness Manager Winter Ridge Natural Foods

O

ur Good Earth offers a treasure-trove of natural bounty for our enjoyment and also as a means to wellness. We are truly blessed to live an area that provides us visits to the forests and lakes and all of the herbs, plants and mushrooms we wish to pick. I fondly remember as a young girl walking in the woods with my mother, collecting ginger leaf for tea and a bounty of morel mushrooms, excited for our tasty dinner treat. I remember looking around as I picked huckleberries and witnessing all the varieties of trees and plants, knowing each one had it’s purpose for eating and healing.

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Herbs and plants as herbal medicine were used in ancient times and considered to be the only form of effective medicine. Herbs were used as poultices to clean wounds and prevent infections, made into teas and tinctures to heal everything from coughs to bleeding and more. It was also discovered that the roots of plants contained medicinal properties and were often stronger than the leaves.

Through the years, I have used herbal teas and tinctures to support my health and my children’s good health. Some of my favorites I have grown or collected.

Comfrey first came into my life when I was a young girl. I had injured my leg and my mother took some fresh comfrey leaf and made it into a poultice and placed it on the wound overnight. Rich in allantoin and mucilage, comfrey is valued for it’s soothing qualities, facilitating and activating the healing of damaged tissue. I became a believer in the morning when the poultice was removed and I saw how much it had helped me!

Catnip is another herb that grows wild locally. While it sends cats into spasms of cross-eyed pleasure, it has a very calming effect on people, young and old. It is a wonderful digestive aid used for indigestion and colic.

Chamomile is one of the best children’s herbs. It is used to treat colic, nervous stress, infections and stomach disorders. One of chamomile’s major constituents is azulen which contains a whole complex of anti-inflammatory properties. It’s medical action is most obvious in three major areas: the nervous system, the immune system, and the digestive system.

Dandelion is the first source of nectar in Spring for bees and other wildlife. It is such a wonderful herb as the entire plant is restorative. The root is stimulating to the liver and is also a good diuretic. It tones the kidneys. The leaves are high in vitamins and minerals and the flowers make a yummy wine. Dandelion is both food and medicine as the young tender roots can be added to stir-fries, soups and casseroles.

The leaves can be steamed or added to salad and can often be

Local * Natural * Delicious

found in the produce section if you don’t have enough in the yard! It is best to use herbs fresh if possible.

The single most important factor when purchasing herbs is getting the best quality possible. Producing potent and effective herbal extracts is meticulous work based upon

diligent study and understanding of traditional herbal medicine. You can’t get health and vitality from a pill or from a cup of herbal tea but from the practice of living healthfully everyday. Herbs have amazing healing powers to offer us and truly can support us in our day to day health goals.

“And God said, behold, I have given you every herb bearing seed, which is upon the face of all the earth, and every tree, in which is the fruit of a tree yielding seed, to you it shall be for food.” Genesis 1:29-30

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Christina Kettenring has been with Winter Ridge Natural Foods since 2010 and is the Wellness Manager. She is passionate about herbal remedies and alternative medicines. She loves spending time chatting with customers about healthy lifestyles and especially loves showing first time visitors around the store. *The author does not directly or indirectly dispense medical advice or prescribe the use of herbs as a form of treatment for sickness without medical approval. It is not the intent of the author to diagnose or prescribe.

In the event you use this information without your doctor’s approval, you are prescribing for yourself, which is your constitutional right, but the publisher and author assume no responsibility.

Wise Guide | www.TheWiseGuideOnline.com

39

Pets in Transition PAS Makes a Positive Difference in the Lives of Pets and People

PHOTO BY SHERYL R. GARRISON

P

anhandle Animal Shelter (PAS) goes beyond the stereotype of the tiny, cold kennel or cage with the sad animal peering through bars. With large community cat rooms and dog kennels more spacious than your average vacation kenneling facilities, PAS offers dogs and cats a comfortable and compassionate stay while in transition.

The shelter dogs and cats don’t stay in the facility for long.

The average length of stay for a cat is less than a month and for a dog is a little over one week. PAS operates with a core value of optimism and a strong foundation in supporting their community. This no-kill shelter strives to use innovative programming to help people and animals throughout the Inland Northwest.

On average the shelter will provide over a ton of dog and

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Sliding fee for uninsured We also take Medicaid, Medicare & most insurance www.kaniksuhealthservices.org

Bonners Ferry· Ponderay · Priest River · Sandpoint Pediatrics · Sandpoint VA

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Wise Guide | Spring / Summer 2017

cat food throughout the year to families who are temporarily struggling to feed their pets. In addition, they have dedicated over $60,000 towards spaying and neutering communityowned animals over the past six years. The goal is to reduce the number of dogs and cats entering the facility by offering services to humanely end overpopulation and to keep dogs and cats in their homes. Other programs that help do just that are the Helpline and Home-Home.

The Helpline was established to assist families who feel their only option is to surrender their pet to a shelter.

When people call the shelter to request information on surrendering, the Helpline representative will try to provide options or solutions to their challenges. This can include medical and behavior advice, items in need, or a recommendation to use the new website, www.home-home.org.

The Home to Home website allows pet owners to create a pet profile and post their pets for rehoming. PAS promotes the pet profiles on their Facebook page with over 10K followers. Through supporting owners in the difficult decision

“The Home to Home program recently helped us find a good home for our good girl! I highly recommend it! We were able to screen, meet, and choose the new family our good girl went to.”

to rehome their pets via Home to Home, the owners and their animals experience less stress and pets stay out of the shelter.

An owner who used Home to Home said this about her experience, “The Home to Home program recently helped us find a good home for our good girl! I highly recommend it!

We were able to screen, meet, and choose the new family our good girl went to. We imparted valuable information about

her to her new owners and have been able to keep in contact to make sure things have been going smoothly. It’s a service that made everything much less painful and less tedious. She loves her new home and we love knowing who she went to.”

PAS also believes in the power of educating and engaging our children. With educational programs like camps, field trips, and a class taught at the Forrest Bird Charter School, the shelter can make a positive impact on community children’s perceptions of animal shelters and demonstrate how they can make a positive difference in the lives of dogs and cats.

Feral and community cats play a big role in overpopulation and PAS has a solution. They work with community members to help manage, spay/neuter and return feral cats. Through a $25,000 grant from PetSmart Charities, they are prepared to “fix” 800 cats this year. PAS encourages community members to contact them for help.

At the core of the Panhandle Animal Shelter are their base services to help stray animals find their owners, as well as provide the basic care for each dog and cat entering the shelter. All dogs and cats receive vaccines including rabies, and they are spayed or neutered and micro-chipped before being adopted.

The helpful and far reaching services PAS offers are only possible due to the support of donors. In fact, donations are essential since the organization is not affiliated with the county or city and does not receive any tax support.

Shopping at and donating to their Thrift Store, located at the shelter, and through donating directly or through estate planning to PAS, makes a significant and meaningful impact on animals in need. Support PAS today to make a positive difference in the lives of homeless pets! pasidaho.org

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41

Homemade Water Kefir: Real Easy, Real Healthy, Really Tasty!

by Kelsey Steffen, Full of Days

H

ave you been seeing beverages like Kombucha, Kevita or drinks made with Apple Cider Vinegar lining the grocery store shelves lately? Do you ever wonder what the hype is all about with these new fermented drinks? You’re not alone, and I was surprised to find out that these drinks aren’t “new” at all...they’ve been around for centuries, but are only now making their way into mainstream stores.

So what’s the big deal with all these new drinks? Well, probiotics! These naturally fermented drinks are loaded with beneficial bacteria that can help give our immune system a boost, keeping us healthy and happy. Not to mention, they taste delicious!

Kombucha is made with sweet tea, and can have a stronger flavor than some like, and drinks made with apple cider vinegar have a similar “bite.” This is why it’s our recommendation to start with water kefir. Often found in stores under the name “Kevita”, water kefir is made with sugar, water and “grains.” It has a mildly sweet flavor, but takes on the taste of whatever is added to it. A small splash of lemonade makes it taste like...well, lemonade! Drop in a few frozen raspberries and some pineapple and you’ll have a sangria (probiotic) mocktail.

Water Kefir

We often serve water kefir to dinner guests without telling them exactly what they’re drinking. Once they’ve fallen in love with the taste, we let them know how good it is for them!

It’s usually not long after these visits, we learn our guests are making it themselves.

Fermented beverages are full of benefits. Beyond the probiotics, they’re also more beneficial to our bodies than plain water. Because water is devoid of electrolytes, too much can put unnecessary strain on our kidneys. Furthermore, too much water consumed just before, or during meals can upset proper pH balance in our stomach and interfere with the digestive process. But sipping on a probiotic drink like water kefir during meals can aid digestion because it provides lactic acid and digestive enzymes. __________________________________________________________________

After Kelsey and her husband became parents, they began looking at food differently. Studying the teachings of Weston A. Price, they do their best to maintain a traditional diet. There are many “ingredients” to a life Full of Days: nutrition, traditional diet, DIY recipes, essential oils, homemaking, reviews, tips and tricks, moneysaving strategies and everyday life. Kelsey is a regular contributor to Mother Earth News (Web & Print), and Delicious Obsessions.

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How to Make Water Kefir

Making water kefir at home is a breeze. And unlike buying it at the store, you can make it for mere pennies per serving. Once you’ve procured yourself some kefir grains (a living culture of bacteria and yeast), you simply mix together some sugar and water, add the grains and within 24-48 hours the grains have consumed the sugar, producing a delicious, probiotic beverage.

Ingredients

1/4 cup water kefir grains 8 cups filtered water (divided) 1/2 cup organic sugar

Directions 1. Boil one cup of water and add ½ cup sugar to a half gallon mason jar.

2. Add boiled water to sugar and stir until dissolved.

3. Add remaining 7 cups of cold water and stir in water kefir grains.

4. Cover loosely with tight knit cheesecloth or a coffee filter and secure with a rubber band.

5. Let sit at room temperature (68-76 degrees F is ideal) for 24-48 hours.

6. Once kefir has finished fermenting you should see tiny bubbles that float to the top when the jar is moved.

7. Using a non-metallic strainer, strain kefir grains out and start a new batch beginning with step one.

8. Refrigerate finished water kefir and flavor as you like (we enjoy a squeeze of fresh lemon or lime juice, or a drop or two of lemon or lime essential oil).

If you desire a fizzy, carbonated drink, you can second ferment your water kefir.

Bottom’s up!

Camp Lejeune: A Famous Landmark with Infamous Water

by Scott A. Thorsness, Director, Kootenai County Veteran Services

C

amp Lejeune in North Carolina began its mark on history in 1941 when the 1st Marine Division was set up there in the middle of a sandy pine forest. The installation was named after Major General John A. Lejeune, who was the 13th Commandant and Commanding General of the 2nd Army Division in World War I. Over the years, Camp Lejeune has grown to be a pivotal installation in the operation of the United States Marine Corps.

Then it happened! In the early 1980s, volatile organic compounds, trichloroethylene (TCE), a metal degreaser, and perchloroethylene (PCE), a dry cleaning agent, as well as benzene and vinyl chloride, were discovered in two on-base water supply systems at Camp Lejeune. The contaminated wells supplying the water systems were shut down in February 1985.

Since then, there has been a firestorm of debate. After much deliberation, research, changes to rules and laws, there is now a VA Rule establishing a Presumption of Service Connection for Diseases Associated with Exposure to Contamination in the Water Supply at Camp Lejeune.

The Veterans Administration (VA) has established eight diseases associated with exposure to the water supply at Camp Lejeune.

The listed diseases are as follows: 1. Adult leukemia 2. Aplastic anemia and other myelodysplastic syndromes 3. Bladder cancer 4. Kidney cancer 5. Liver cancer 6. Multiple myeloma 7. Non-Hodgkin’s lymphoma 8. Parkinson’s disease

It is critical to note that to pursue a claim for one of the above conditions, the active duty, reserve and National Guard member must have served at Camp Lejeune for a minimum of 30 days (cumulative) between August 1, 1953 and December 31, 1987.

If you choose to submit a disability claim, it is paramount that you collect the necessary information to support the disability application. A definitive diagnosis from a medical care provider of one or more of the conditions listed above and validation that the military member was “on-station” for the necessary amount of time and during the affected periods.

To assist with this process, there are County Veteran Service Officers ready and able to help you through this process. We also have a State Veteran Service Officer who is also available to provide the same assistance. They are listed in the pages of this magazine.

To get more information on this subject, the VA has posted some helpful information and also provides information on additional resources and benefits due to the Camp Lejeune Water Contamination. That information can be obtained by visiting the following internet link.

http://www.publichealth.va.gov/exposures/camp-lejeune/ __________________________________________________________________

Scott served in the Unites States Air Force as a 2P071 Precision Measurement Equipment Laboratory Craftsman from 1988 to 2012. His duty assignments include Hickam AFB, HI,15th Component Aircraft Maintenance Squadron; Bitburg AB, Germany, 36th Maintenance Squadron; Ramstein AB, Germany, 86th Maintenance Squadron; Mountain Home AFB, ID, 366th Maintenance Squadron; Osan AB, Republic of Korea, 51st Maintenance Squadron; McChord AFB, WA, 62nd Maintenance Squadron; and Aviano AB, Italy, 31st Maintenance Squadron.

Scott was born and raised in Coeur d’Alene, graduating from CDA High School in 1988. He has an Associate of Applied Science Degree in Electronic Systems Technology. After completing his military service, he returned to his home town in April of 2012. He has been working with Kootenai County since June of 2012.

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VETERANS EVENTS Women Warriors & the Cowgirls Retreat May 19, 20 & 21 Held annually at the Back of the Bluff Ranch, Green Bluff, WA www.cowgirlsandwomenwarriors.org For info: Mary DeLateur 509-893-4737 or email mary.

Delateur@va.gov Can’t participate? You can sponsor someone else’s attendance and donations are welcome.

Vietnam Traveling Wall, known as The Wall That Heals is a 250-foot replica of the Vietnam Veterans Memorial with a mobile Education Center. The exhibit will be open 24 hours a day with full security and is free to the public. The Wall That Heals honors the more than three million Americans who served in the U.S. Armed forces in the Vietnam War and it bears the names of the more than 58,000 men and women who made the ultimate sacrifice in Vietnam. 2017 marks the 35th year of the Vietnam War Memorial in Washington, D.C. The Traveling Wall replica will be on display in 3 areas within our region: May 24-30 at City View Cemetery, 1300 N. Oregon Ave., Pasco, WA August 24-27 at Mirabeau Point Park in

Spokane Valley, WA September 7-10 at 2000 Hwy 93 in South Kalispell, MT (north of Rosauer’s) The Wall that Heals will arrive in Kalispell on Sept 5th with Patriot Guard Motorcycle escort from Washington.

Every Morning Sept 7th thru 10th at 10:00 AM will be a Flag Ceremony and Speakers, Wreath Laying Ceremonies will be on the morning of the 7th.

To learn more: thewallthatheals.org FREE Heavy Equipment Operator Training Course being offered June 9th - June 30th,in Coeur d’Alene.

For more info contact: Russ rivera@ITD.idaho.gov 208-334-8152 or Connie haggerty@ITD.idaho.gov 509-868-7588 44

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3rd Annual Thomas A. Biddle Foundation SOAR Fundraiser & Motorcycle Ride for the support of veteran’s families left behind due to PTSD Suicide and to increase awareness of PTSD. Held at and Hosted by the American Legion Riders & American Legion Post 10, 208 N. Wenatchee Ave. Wenatchee, WA July 15th - Dinner & Fundraiser: Registration 4 pm, Social Hour & View Auction Items 5 pm, 6 pm Dinner, Auction, Games & Music July 16th - Breakfast & Motorcycle Ride - 8:00 am Registration for Riders and Vehicles & Breakfast, 10 am Ride to Lake Wenatchee.

For more info: tabfoundation@hotmail.com & Thomas A Biddle Foundation on Facebook Peaceful Warriors - a FREE Ranch Retreat for Women Veterans September 28-October 1, 2017 - Wolf Springs Ranch, St. Maries, ID Women veterans, active duty, reservist or retired connecting and working with horses, yoga, traditional crafts, massage, campfire circles, journaling, preparing and eating fresh, farm-style food, communing with nature and fellow women veterans. www.lifeskillsranchprogram.org Deadline to sign up Sept. 1st.

Salty Flak: Combat and Readjustment & Adjust Fire: Tools for Readjustment are a dual program for War Zone Veterans: Gulf War to Present Day. Designed to help with the adjustments of returning to civilian life.

Held over 12 weeks every Tuesday 5-7 pm at the Spokane Vet Center. Blaine P. Bart, MS is facilitating 509-444-8387, blaine.bart@va.gov

Stand Down?

What’s a Stand Down?

M

y neighbor asked this question. I thought for a moment, ‘How do I explain a Stand Down to someone who hasn’t been in the military?’ According to Veterans Affairs: “Stand Downs are typically one- to three-day events providing supplies and services to homeless veterans…” That is undeniably true. But anyone who has been to a Stand Down will tell you, Stand Downs are so much more than that.

Stand Downs are an opportunity for all veterans to share an aspect of military culture that most vets miss, and have difficulty defining to those who haven’t served in the military.

Stand Downs are filled with brothers and sisters in arms caring for brothers and sisters in arms. Stand Downs are steeped in camaraderie, that special bond of trust, friendship, and kinship that is developed during long hours in tough conditions, best understood by someone who has “been there and done that.”

Stand Downs are centered around the needs of homeless veterans, and frequently the needs of homeless vets are met by those who haven’t served but care greatly about veterans.

The resource providers at Stand Downs are a mix of veterans and civilians who unite to meet the needs of the underserved homeless veterans. They might provide haircuts, health care for service animals, dental screenings, opportunities for housing, the very long list goes on. One intangible and incredibly valuable experience they provide for the veterans attending the Stand Down is acknowledgment of their service and sacrifice. And, the understanding that frequently, the veteran continues to pay for his or her service to the nation long after they’ve rendered their last salute, or put away their uniform for the last time.

Stand Downs serve homeless veterans - and all veterans - by uniting us. We may be Soldiers, Sailors, Airmen and Marines but at the Stand Down we’re vets first. We’re united across eras, conflicts, service, state lines and party lines. In fact, at the Stand Down, we’re united across all lines of division as veterans and those that support veterans.

Stand Downs are more than “free stuff.” Stand Downs are a family friendly event that provide resources to homeless veterans. Those working or providing services at the Stand Downs treat veterans with dignity, respect and honor while acknowledging the service the veteran has provided the nation. Also, Stand Downs are fun! There’s great food and entertainment provided by locals who give their all to put a smile on a vet’s face. An unexpected benefit many experience at a Stand Down is meeting another vet as strangers and leaving as friends.

Instead of explaining all this to my neighbor, I encouraged him to volunteer at the Stand Down, just as I encourage all vets, but especially homeless vets, to attend the Stand Down. In fact, I’d like to see homeless vets escorted to the front of the line. To the vets facing the challenge of homelessness, know that the Stand Down team, resource providers, volunteers and all the other vets are there with you — and for you — and “We’ve got your back!”

Senior Living Community

208.665.1600 www.bestlandcda.com

606 E. Best Ave. • Coeur d’Alene, Idaho

Donate. Shop. Change a life.

Goodwill taught me

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This page brought to you by:

THE ART OF REDIRECTION COUNSELING Counselors who Ride

We Salute Our Veterans . . .

RESOURCES

If you are a veteran or partner of a veteran, these organizations are here to help with free assistance. Call any of them and they can connect you with the services you are seeking.

Need to talk to someone NOW?

Combat Call Center/Crisis Line - 1-877-927-8987 Veterans Crisis Line: 1-800-273-8255 Press 1 Confidential Online Chat: VeteransCrisisLine.net

VA Outreach Centers

Spokane Vet Center 509-444-8387 Kalispell Vet Center 406-257-7308 or 877-927-8387 Missoula Vet Center 406-721-4918 Walla Walla Vet Center - 509-526-8387 Spokane Mobile Vet Center - they come to your area!

Call your local VFW for schedule.

Veterans Transportation Services - for FREE transportation to VA Medical Centers, Outpatient Clinics (CBOC’s) & authorized VA appointments 509-434-7527

CBOC’s and Rural Health Clinics Colville Rural Health Clinic 509-684-3701 1200 E. Columbia, Colville, WA Coeur d’Alene CBOC 208-665-1700 915 W. Emma Ave., Coeur d’Alene Grangeville Outpatient Clinic 208-983-4671 711 EW. North Street., Grangeville Kalispell CBOC 406-758-2700 Three Mile Professional Bldg.

31 Three Mile Dr., Ste. 102, Kalispell, MT Lewiston CBOC 208-746-7784 1630 23rd Ave., Bldg. 2, Lewiston Libby Veterans Clinic 406-293-8711 211 E. 2nd Street, Libby, MT Missoula CBOC 406-493-3700 2687 Palmer St., Ste. C, Missoula, MT Sandpoint Veterans’ Clinic 208-263-0450 420 N. 2nd Ave., Ste. 200, Sandpoint 46

Wise Guide | Spring / Summer 2017

Online Resources va.gov/homeless Each VA medical center has a homeless coordinator and programs that help veterans establish or maintain safe, stable housing. Call VA’s National Call Center for Homeless Veterans 1-877-424-3838, 24/7. oefoif.va.gov Toll-free line and website that provide information about health care, dental care, education and other benefits for OEF/OIF/OND veterans. 1-877-222-8387 ptsd.va.gov VA’s center of excellence for research and education on the prevention, understanding and treatment of PTSD. 1-802-296-6300 caregiver.va.gov Provides support for caregivers of veterans and information about services that may be available to them. 1-855-260-3274 Art of Redirection Counseling “Counselors Who Ride” offering non-traditional counseling. Army One Source & TRICARE provider, 208-267-9228 artofredirection.com In commemoration of the 75th anniversary of the beginning of World War II, the Museum of North Idaho (115 Northwest Blvd., Coeur d’Alene) is featuring an exhibit The Military and Community which explores the influence of the military in our region. Since North Idaho was the home of Fort Sherman (18781898) and Farragut Naval Training Station (1942 to 1945), the military had a direct impact on the social and economic development of the area. The exhibit will run April 1 through October 31st. Visit museumni.org for more information.

This page brought to you by:

“For their valiant courage in defending the cause of freedom, we honor our Veterans.”

Veterans Stand Downs Coeur d’Alene, ID - May 16th Kootenai County Fairgrounds, 8-2

VA MEDICAL CENTERS & TRANSPORTATION

Kalipell, MT - June 10th, Evergreen Fire Hall, 9-3

Walla Walla VA Medical Center 888-687-8863 77 Wainwright Dr., Walla Walla, WA DAV Van Schedule: Thursdays: 6:00AM departs State Veterans Home 821 21st Ave., Lewiston Picks up: Clarkston, Pomeroy, Dayton,Waitsburg & Dixie, WA APPOINTMENTS FOR RIDES MUST BE MADE 72 HRS. IN ADVANCE Call DAV Transportation Office Walla Walla VA Med. Ctr.: 888-687-8863 x22529

Wenatchee, WA - August 11th at the Armory on 5th St., 8-3

Spokane VA Medical Center 800-325-7940 4815 N. Assembly St., Spokane, WA DAV Van Schedules: Wednesdays & Fridays: 6:00 AM departs State Veterans Home, 821 21st Ave., Lewiston Wednesdays - Picks up: Genesee, Moscow, Viola, Potlatch, Tensed, Plummer & Worley Fridays - Picks up: Uniontown, Colton, Pullman, Colfax, Steptoe, Rosalia & Spangle, WA Noxon & Libby DAV Van Schedules: Mondays, Wednesdays and Fridays - (Noxon Van) Picks up: Noxon, Bull River Junction, Clark Fork, Hope, Sandpoint, LaClede, Priest River, Newport, Diamond Lake, Chattaroy, Spokane VA. Tuesdays and Thursdays - (Libby Van) Picks up: Libby, Bonners Ferry, Sandpoint, LaClede, Priest River, Newport, Diamond Lake, Chattaroy, Spokane VA. APPOINTMENTS FOR RIDES MUST BE MADE 72 HRS. IN ADVANCE. Call DAV Transportation Office at the Spokane VA Med. Ctr. 800-325-7940

Moses Lake, WA - September 16th Grant County Fairgrounds, 9-2 Libby, MT - October 7-8th in the Armory, 9-3 Kennewick, WA - November 9th City of Kennewick Event Center, 9-3

North Idaho

A DAY OF APPRECIATION FOR ALL VETERANS HOUSING EMPLOYMENT PANCAKE BREAKFAST TEXAS ROADHOUSE LUNCH VETERINARY (limited) MEDICAL/DENTAL HAIRCUTS MILITARY SURPLUS

0800 to 1400hrs

ADMISSION: Military or V.A. ID or DD214

Kootenai County Fairgrounds 4056 N. Government Way • Coeur d’Alene, ID 83815 For more information contact: Eric Swanbeck 208.664.3095 To Volunteer visit: www.KootenaiUnitedWay.org

VAMC Mobile Health Clinic

Days & Locations: Moscow - Fairgrounds - Last Monday Pullman - WSU Alumni Center - Last Tuesday Osburn - VFW Post - Last Wednesday & Thursday To be seen by the mobile health clinic, a veteran must call the Mann-Grandstaff (Spokane) VAMC and ask for an appointment. 1-800-325-7940 or 1-509-434-7000 The VAMC tries to schedule all of these appointments for the last week of each month.

May 13, 2017

Thank You to our Proud Sponsors!

Hauser Lake Rod & Gun Club

Stand Down 2016 11 x 17.indd 1

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This page brought to you by:

These Veterans Service Officers are here for you: “Heroes never die. They live in our hearts forever. Thank you for your service and sacrifice.”

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

Boundary County

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

MONTANA Montana State VSOs

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

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

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

Tyler Anderson 208-265-0193 Ext. 4079 613 Ridley Village Road, Ste. C, Sandpoint email: tyler.anderson@labor.idaho.gov 48

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This page brought to you by:

READ THIS!

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.

“If you are a Veteran....Thank you!

If you are not a Veteran...Thank one!

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

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.

Clearwater County

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

Moscow

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

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 220 E. 5th St., Moscow M-F 8:30 AM -12 noon, 1:00 - 4:30 PM email: jbeyer@latah.id.org

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

Lewiston

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

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.

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No-Nonsense, Non-Traditional Counseling

by Rob & Kathy Wenzel Art of Redirection Counseling

O

nce upon a time, long ago, we had dreams of how we’d like our life to turn out, but no one told us how stinking hard it was going to be! Day in and day out, one thing after another, with no end in sight, some of us turned to drugs, others to alcohol. Many used sex and a lot of us used food, all in attempts to self-medicate to feel better or at least numb enough, just to get by and wondering, “What happened here?”

“Why is my life so messed up?”

A common challenge most of us face, is we have to work to make an income. The Work Ethic in America is, our “adult” goes to work, focusing on the task at hand and gets the job done. When we go home, the other part of us kicks in and we just want to chill and relax, but the spouse, kids and home all need our attention. “I’ve worked all day, I should be able to just eat and veg in front of the TV or computer all evening…”

We have learned to become self-serving and hypersensitive at home and it’s just a matter of time before we blow a gasket!

Judging by our family’s reaction and the stuff that doesn’t get done around the house, we soon find this doesn’t work, but do

50

Wise Guide | Spring / Summer 2017

we really care? How would we change it anyway? No one seems to have an answer. It’s time to find out why, how, where, when and, most importantly, what to do about it all.

One of the tools taught by Rob and Kathy at Art of Redirection Counseling is The Reverse Work Ethic. They teach an understanding of how to keep our “Adult” mode on when we go home, to continue being focused and productive, giving

the spouse, kids and home the attention needed, regaining a sense of accomplishment and satisfaction. This is where our real job lies, at home.

“As professional counselors, we want you to know we are

‘real’ people, passionate about life, each other and helping others. We don’t look down our noses or think people aren’t good enough. Like many of you, we’re parents of a blended family, amateur gardeners, local Firefighters, ride Harleys, hunt, fish, canoe and other exhilarating activities.”

“We’ve ‘been there’ in our own lives and want to come along side you and your spouse and help you with the hard stuff like real communication, intimacy issues, anger problems, immaturity, pornography addiction, ED, blended family issues, challenging children and more. We can help you grow and learn how to have the passionate, vibrant

Rob and Kathy are relationship specialists with over 50 years combined counseling experience as well as 30 years of parenting with a blended family and navigating through marriage conflicts themselves. relationships you want and need! We are all about saving marriages one couple at a time. Let us help you understand and overcome the challenges you face and have the life and relationships you truly desire!”

Rob and Kathy are relationship specialists with over 50 years combined counseling experience as well as 30 years of parenting with a blended family and navigating through marriage conflicts themselves. They approach counseling and consulting very differently, with a focus on self-accountability and teaching the tools needed to get the job done.

Whether you are experiencing marriage conflicts, parenting issues or dependence on some form of self-medication or just wanting a better, healthier life, they can help.

Rob also addresses specific men’s issues to help men grow and mature through life’s trials that seem to destroy their will to carry on and thrive. Kathy busts their chops and reinforces the same tools taught by Rob. She also specializes in helping couples, individual women, children and families with a different level of understanding, valuable tools and

clear direction for productive change.

Rob & Kathy, also known as the “Counselors who Ride,” bring their own style of counseling to North Idaho. Good old-fashioned values and country wisdom mixed with a “Can Do!” supportive attitude and real tools that help make productive changes for those willing to come in and do the work.

Is your life where you want it to be?

Give us a call at 208-267-9228 or shoot us an email to ArtofRedirection@msn.com and let’s see what we can do! Check out our website ArtofRedirection.com for more information. We are honored to serve all Veterans and 1st Responders regardless of ability or inability to pay for sessions. __________________________________________________

After 33 years of counseling in a city environment, Rob & Kathy Wenzel felt it was time to move for a better way of life, and to raise their youngest daughter in a small town, with good old fashion values, where almost everyone knows each other. They moved from Colorado Springs, CO to Bonners Ferry, ID in May of 2015, where they have an office for clients throughout the region and also provide services, via telephone and online/Skype, to those outside the North Idaho area.

Addus Has All the Home Care Services You Need

Two locations serving all of Northern Idaho Lewiston Branch

Coeur d’Alene Branch

Latah, Clearwater, Nez Perce & Lewis Counties

Kootenai, Shoshone, Benewah, Bonner & Boundary Counties

208.746.8881

208.667.2309

www.addus.com

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New NIC Center in Post Falls Offers a Fresh Start

by Kaye Thornbrugh

A

t 66 years old, Jerry Gafkin is poised to cross a special item off his bucket list: getting his GED. It’s an uncommon bucket-list goal, maybe, but for Gafkin, it’s important that he makes it happen.“You don’t know how much time you have left,” he said.

Currently retired, Gafkin wants to become a peer support specialist—a person who draws on their own life experiences to support individuals with struggles related to mental health, psychological trauma or substance abuse. Because he will need a GED to become certified, Gafkin decided it was time to get back to his studies.

To that end, he takes classes three days a week at North Idaho College’s

52

Adult Education Center in Post Falls, which was recently relocated to the Idaho Department of Labor building at 600 N. Thornton Street. It’s one of five centers serving Idaho’s five northern counties; the other centers are located in Coeur d’Alene, Sandpoint, Bonners Ferry and Silver Valley. Some center locations offer both day and night classes.

Laura Umthun, NIC Adult Education Center director, says the centers serve three primary populations: students who want to earn a GED; NIC students with skills below the high school graduate level in reading, writing, or math; and any adult students who want to upgrade their foundational skills. On an individual level, Adult Education

Wise Guide | Spring / Summer 2017

students are endlessly diverse. Each has their own reason for enrolling.

“There are as many reasons for taking GED classes as there are students,” said Barbara Jackson, an instructor at the Post Falls center. “Some became parents at an early age. Some were incarcerated. Some had learning

“There are as many reasons for taking GED classes as there are students.” disabilities that their schools didn’t accommodate, or an illness. Some may have been homeless.”

Jerry Gafkin, for example, married when he was 17 years old, which pushed his education to the wayside. When he went back to school, intending to finish, a teacher called him stupid. He walked out that day and never returned. But now, all these years later, the NIC Post Falls Adult Education Center is helping him to finish what he started—and embark on a new career path at the same time.

Mimi Hiibel, another student at the center, stopped attending school when she was in the third grade. She and her younger brother had been removed from their father’s care and placed with their adult sister, who neglected to send them to school. Hiibel says that she essentially had to become a mom to her little brother. As she got older, she never returned to school. “It’s extremely sad that a kid can drop out at such a young age and nobody cares,” Hiibel said.

Having left school at such a young age, it seemed impossible for her to go back—but a friend encouraged her to do just that, which led her to the center.

Between working and being a single mom to her two kids, it’s been hard for

TUTORS NEEDED

Photo by Tom Greene

NIC Adult Education Instructor Barbara Jackson (right) helps Jerry Gafkin prepare for his GED test. At 66, Gafkin decided to finish what he started.

Volunteers are needed to assist students in basic skill building for reading, writing, and math at any of NIC’s Adult Education Centers as tutors. Volunteers should enjoy working with adult learners and possess good reading, writing or math skills. Volunteers must be available a minimum of two hours per week.

Those interested should contact Marty Bruner at the Adult Education Center at 208-665-5069 or marty.bruner@nic.edu or stop by the center to complete a tutor application form.

Hibbel to make time for her studies. But she’s been attending GED classes for a year, and so far, she’s passed every subject but math. The goal of earning her GED is in sight. “If I can drop out in the third grade and go back, with two children, anyone can,” Hiibel said.

To be eligible for Adult Education classes, prospective students must be 16 years or older, not currently enrolled in any public high school and have skills below the high school graduate level. Instruction is completely free, including course materials.

Gafkin said that the Adult Education staff has been welcoming and supportive. “There’s a care that I didn’t get when I was in school,” he said. “Barbara [Jackson] is one of those special people who you never think you’re going to meet. She cares about her students. She makes it easy for me to go [to class].”

For more information about NIC Adult Education Center’s orientation and skills review, call 208-665-5099.

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53

Crossword Going to the Dogs Across 1 Moo ___ pork (Chinese dish) 4 In addition 8 Dog star?

13 Wordplays 15 Norse god of discord 16 Little green man 17 Hammett pooch 18 Gardener’s purchase 19 Blind parts 20 Burlesque bit 21 Pacify 23 Brewer’s need 25 Food additive 26 Scottish cap 29 Film genre 31 Odorless gas 33 G.I.’s address 36 Impertinent 39 Chipping choice 40 Sheep dogs 44 Kind of admiral 45 Skin problem 46 Nay’s opposite 47 Sign up 50 Lose traction 52 Slalom curve 53 Canon camera model 55 With 48 Down, long-haired gun dog 58 Cowboy hat 61 Type of tide 63 Steakhouse selection 66 Roof overhang 67 Fish part 68 Love to pieces 69 Ripens 70 “I’m ___ your tricks!�

71 Stocky short-haired dog with a

brindled coat 72 Plain and simple 73 Medium claim

54

Down 1 Luxurious resorts 2 Eskimo dog 3 Loosen, as laces 4 Large dog used as a guide for the blind 5 Roller coaster feature 6 Bypass 7 Snockered 8 Hound with short legs and long ears 9 Model Macpherson 10 Actress Vardalos 11 Fast plane 12 Ft. parts 14 “Paradise Lost� figure 22 Sailor’s assent 24 Slugger Sammy 26 Dawdle 27 Positive pole 28 The brainy bunch 30 Pipe problem 32 Make haste

Wise Guide | Spring / Summer 2017

33 Concur 34 Hammer parts 35 Tough tests 37 Vital force of Chinese medicine 38 Hankerings 41 Hosp. picture 42 Toy dog 43 It grows on you 48 See 55 Across 49 Little piggy 51 Wild dog of Australia 54 Fulton’s power 56 Paris divider 57 Puts a stop to 58 Moistureless 59 Wise guy 60 Walkie-talkie word 62 Alka-Seltzer sound 63 Groovy 64 Chapel vow 65 Bagel topper

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Sudoku

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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 66.

Geezer Forum Meets every 2nd & 4th Tuesday from 2:30 - 4:00 PM at Columbia Bank, 414 Church St., Sandpoint. Informal meeting to explore issues of aging. Speakers and open discussion. Sponsored by ElderAdvocates, hosted by Paul Graves.

Everyone is welcome!

Wise Guide | www.TheWiseGuideOnline.com

55

Care, Cause and a Cure for Alzheimer’s

by Bob Le Roy Executive Director of the Alzheimer’s Association Washington State Chapter

A

lzheimer’s disease is complicated. It is often said that no two cases are alike. We often do not know who has it or what causes it. We cannot prevent it, and we cannot cure it.

At the Washington State Chapter, however, our work is really quite simple. Its essence can be found in the three “c”s: Care, Cause, and Cure.

For us, Care is manifest in the programs and services we provide to those we serve, including our toll-free, 24/7 Helpline, assistance to family and caregiver support groups, customized and ongoing care consultation for individuals and families, and continuing education and training for family and professional caregivers.

Our commitment to the Cause of Alzheimer’s is reflected in the passion and persistence of thousands of volunteer advocates—our faces and voices to their elected officials at all levels of government.

We are bringing the world together in search of a Cure for Alzheimer’s disease. The Alzheimer’s Association is the largest non-profit funder of Alzheimer’s research in the world. Since we began funding research in 1982, we have provided over $350 million to more than 2,300 best-of-field investigators. Our International Research Grant Program funds investigations that advance understanding of Alzheimer’s disease, help identify new treatment strategies, provide 56

Wise Guide | Spring / Summer 2017

information to improve care for people with dementia, and further knowledge of brain health and disease prevention. The grant program is structured to emphasize and nurture new ideas and innovative approaches.

As host of the annual Alzheimer’s Association International Conference (AAIC), we convene the world’s largest gathering of Alzheimer’s and dementia researchers to create an international discussion of the latest findings in the field. This dialogue fuels new ideas that may one day result in treatments to change the course of the disease. This year’s AAIC will be held July 16-20 in London, England. I look forward to attending and sharing my experience with you.

We lead the World Wide Alzheimer’s Disease Neuroimaging Initiative (WW-ADNI), a consortium of international investigators working to establish globally recognized standards for identifying and diagnosing the disease. Working with the National Institute on Aging, we engaged groups of scientists to examine the diagnostic criteria for Alzheimer’s disease—which were established more than 25 years ago—and proposed new criteria, including the use of the latest advances in biomarker research.

Our Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association is a bi-monthly, peer-reviewed journal covering all aspects of Alzheimer’s research, from basic science to clinical care.

The Journal is recognized by researchers and scholars around the world as a premier source of information on the disease.

The greatest obstacle, other than funding, to advancing research is the lack of participation in clinical trials.

Today, at least 50,000 volunteers—both with and without Alzheimer’s disease—are urgently needed to participate in more than 130 actively-enrolling trials about Alzheimer’s and other dementias. In 2010, we launched TrialMatch, a free, confidential, interactive, online service to connect eligible volunteers with clinical trials. TrialMatch accelerates the enrollment process and allows people with Alzheimer’s to play a more active role in their own treatment while contributing to scientific discovery.

I believe there is a fourth “c”—in which you play an integral role—Collaboration. We have the best chance to realize our vision of a world without Alzheimer’s when we work together. If you would like to learn more about Alzheimer’s research, please visit alz.org/research. If you would like to support our Care, Cause, and Cure, please let us hear from you. _____________________________________________________ Bob Le Roy has been the Executive Director of the Alzheimer’s Association Washington State Chapter Serving Washington & Northern Idaho since July, 2011. He joined the Association as President & Chief Executive Officer of the Greater Pennsylvania Chapter in 2008, bringing with him more than 35 years experience as a development professional and change agent in the not-for-profit sector and financial services industry.

JOIN THE FIGHT FOR ALZHEIMER’S FIRST SURVIVOR START A TEAM

COEUR D’ALENE, ID - 9/30 PULLMAN , WA - 9/23 SPOKANE, WA - 10/7

Register today at alz.org/walk 800.272.3900 | waevents@alz.org

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57

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

Benewah Community Hospital, St. Maries 229 S. 7th Street (Tamarack Room, near the ER) 3rd Fridays @ 3:00 PM Facilitators: Aline Rohde, MSW 208-659-6719 Dawn Cook, LPN 208-651-2165

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

The Inn at Guardian Angel Homes, Post Falls 1136 E. Mullan Avenue 2nd Thursdays @ 5:30 - 7:00 PM Facilitator: Anita Grimm, RN 208-777-7797 (Dinner Free & Provided by Guardian Angels) 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 208-769-9560 Sandpoint Senior Center, Sandpoint 820 Main Street 1st & 3rd Thursdays @ 1:00 - 2:00 PM Facilitator: Jan Griffitts 208-290-1973 (Free respite care at DayBreak Center next door with advanced reservation - 208-265-8127) 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 x8314

YOUNGER ONSET

(younger than 65 yrs. old) Bakery By The Lake, Coeur d’Alene N.W. Corner of 7th & Front Streets across from public library 3rd Tuesdays @ 3:30 - 5:00 PM Facilitator: Ene Gaines 208-415-0366

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

TELEPHONE

24/7 Caregiver Support: 800-272-3900

ONLINE

ALZConnected.or An online social networking community for people with Alzheimer’s, their caregivers and others affected by the disease.

ALZ.org for more valuable resources!

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.

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 Whitworth Presbyterian Church 312 N. Hawthorne Road 2nd Mondays @ 1:00 - 2:30 PM Facilitator: Christine Ambrose, RN 509-456-0456 x8313 Providence Adult Day Health 6018 N. Astor St. (not affiliated with Alzheimer’s Assn.)

1:00 - 2:30 PM 2nd Mondays - Designed for All Caregivers 3rd Mondays - Male Caregivers Only 4th Mondays - Female Caregivers Only Facilitators: Oscar Haunt, MSW & Hannah Teachman Adult daycare available at no charge if pre-arranged 509-590-3965

SPOKANE SOUTH

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 selftalk; 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 x8314 for the schedule.

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

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 Wise Guide | www.TheWiseGuideOnline.com

59

I Turned Around and He Was Gone!

Project Lifesaver comes to Kootenai County

D

o you know someone who tends to wander if not watched? Caregivers of those with Alzheimer’s or dementia face a disturbing future as according to the Alzheimer’s Association, 40% of those afflicted will begin to wander. Nearly half will die and many become injured if they are not located within 24 hours. Autism is the nation’s fastest growing developmental disorder. Today’s statistics show that 1 in 110 children have autism. As a caregiver or parent, you know it only takes a second for them to disappear.

About Project Lifesaver

The Kootenai County Sheriff’s Office has brought the Project Lifesaver program to its service area. Designed to track and rescue individuals with cognitive conditions, the service answers a critical need for protecting people at risk for wandering, including those with Alzheimer’s, Autism, Down Syndrome and Dementia.

Project Lifesaver International, the leading organization in electronic search and rescue (SAR) programs, conducts mandatory training and provides certification, ongoing management and support to the Kootenai County Sheriff’s Office. The training includes teaching public safety officials how to use the equipment and how to gain the trust of and communicate with people who wander, as well as to ensure that caregivers are well versed in the program. All of which are essential to a successful rescue.

Project Lifesaver also develops public outreach programs to educate others about the issue of wandering, and they 60

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constantly work toward developing public policy and effective law enforcement response to help save lives and “bring loved ones home.”

How Does Project Lifesaver Work?

Unlike other rather costly personal security systems, Project Lifesaver is not GPS or satellite based. Clients enrolled in the service will wear a wrist-watch sized radio transmitter on their wrist or ankle. The transmitter constantly emits a radio frequency signal, which can be tracked regardless of where the person has wandered, even into a densely wooded area, a marsh, a concrete structure such as a garage, or a building constructed with steel.

DO YOU KNOW SOMEONE WHO WANDERS?

When someone goes missing, caregivers call 911 and the appropriate locally trained law enforcement agency is dispatched to the area. The average rescue time is approximately a half hour.

How Can You Help?

Engaging in Project Lifesaver is a not for profit endeavor for the Kootenai County Sheriff and a wonderful way to help families whose loved ones may wander.

Donations for this very worthwhile and lifesaving service are requested. Funds go specifically to the purchase of the wrist band transmitters, which are essentially “on loan” to the family for as long as needed, then returned and given to the next family in need. All other costs involved in the program are absorbed by the Kootenai County Sheriff’s Office. Your family may not need this service now, or ever, but you can help a family who does have a child or adult who wanders by donating.

For more information or to donate, please call the Kootenai County Sheriff’s Office at 208-446-2250

WE CAN HELP KEEP YOUR LOVED ONES SAFE!

For those with • ALZHEIMER’S • DEMENTIA • AUTISM • DEVELOPMENTAL DISABILITIES

Kootenai County Sheriff’s Office introduces: • More reliable and affordable than GPS based systems.

• Works everywhere, reception is not a problem.

• Average rescue time approximately 1/2 hour.

• Available to Kootenai County residents.

You Can Help a Family!

Donate by calling Kootenai County Sheriff’s Office: 208-446-2250 Help us help more families bring loved ones home.

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61

When Should I Enroll in Medicare?

Why would Mike sign up before he quits working?

by Carey Spears, RHU Spears Insurance, Inc.

A

startling ten-thousand (10,000) Baby Boomers are retiring every day. No wonder I am frequently asked: I will be turning 65 this year, but intend to continue working for several more years, and have medical coverage through my employer. Am I required to sign up for Medicare Part A (hospitalization coverage)? The simple answer is: No, you are not required to enroll in Medicare Part A — but you probably should.

For the following examples and explanations, we’ll call our 65-year old inquiring friend “Mike” — and we will consider the three distinct Medicare enrollment periods: initial, general, and special.

The “initial seven month enrollment period” begins three months prior to one’s 65th birth month. If Mike remains employed and is covered by a group medical plan, but does not enroll in the Medicare program at age 65 and then decides years later to enroll, he may be subject to costly penalties.

To avoid penalty, he will need to demonstrate continuity of coverage upon enrollment in the program. In other words, Mike cannot terminate group coverage, remain uninsured for a year or two and then sign up for Medicare without paying a penalty.

Mike may enroll in Medicare Part A at any point in time while covered under a group plan. Should Mike’s employerbased coverage expire, he will have eight months (referred to as the “special enrollment period”) to enroll in Medicare without being subject to penalties.

Medicare Doesn’t Cover Everything!

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• Medicare Supplement • Medicare Advantage (MA / MAPD) • Part D Drug Plans Offices in Coeur d’Alene & Sandpoint for your convenience.

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Wise Guide | Spring / Summer 2017

Three reasons: 1) Mike has worked for over 10 years and paid the 1.45% Medicare tax, so he will not be required to pay a monthly premium for Medicare Part A (which could run as high as $413 per month for someone who has not been employed for 10+years). 2) Why would Mike choose to bother proving continuity of coverage, when he can sign up while still employed at no cost to him? 3) Medicare Part A may actually offer superior (or supplemental) coverage to his group plan.

Some companies have a corporate policy for employees (or their spouses) who become eligible for Medicare. Mike should compare his employer’s group-plan with the benefits/ costs to Medicare Parts A, B, and D to effectively coordinate coverage under two separate plans. It would then be wise to review the details with Medicare before making a final decision because mistakes can be costly and irreversible.

A few other considerations •

•

•

•

•

If a 65-year-old, or his or her spouse, is covered by an employer’s group health plan with 20 or more participants, Medicare will become the secondary payer.* From a Medicare perspective, COBRA is not considered a health insurance plan and thus cannot be used to show continuity of coverage.

Upon enrolling in Medicare, a plan participant is no longer eligible to contribute to a health savings account (HSA).

A person currently receiving Social Security benefits will automatically be enrolled in Medicare Parts A and B at age 65.

If a retiree wants health care coverage, Medicare is pretty much the only game in town. *In this case, Mike should enroll in both Medicare Parts A and B

Call Carey today for an appointment!

208-610-8096

Serving North Idaho

What if Mike’s employer does not offer a group plan?

If Mike does not have coverage and wants to avoid potential penalties, he should sign up for Medicare Part A during his initial enrollment period. During this time, and since he enrolled in Part A, Mike may also obtain Medicare Part B (doctor visits) at a monthly cost of $134.00.

(Depending on Mike’s annual income, Part B premiums could increase by as much as 220% if he doesn’t enroll during the initial enrollment period.)

One thing is crystal clear; federal entitlement programs are complicated, and being uninformed can be costly.

If Mike does not enroll when he turns 65, he may do so in future years during the “general enrollment period” from January 1st through March 31st., and coverage will subsequently begin on July 1st. However, he will be responsible for a 10% premium bump for the rest of his life, for each year after he turned 65 that he failed to carry insurance.

Part D (prescription drug coverage) enrollment mirrors Part B: Mike must be entitled to Part A and/or enrolled in Part B to qualify for Part D. The 2017 prescription drug premium national average is around $35.63 per month and, based on his income, this may increase by an additional

187% if he does not enroll in Part D when he becomes eligible. Of course, rules concerning continuity of coverage (“credible coverage”) and penalties also apply. As a matter of fact, in order to meet continuity of care requirements, Mike must show that current coverage is at least equivalent to the Medicare drug plan being considered.

Summary

One thing is crystal clear; federal entitlement programs are complicated, and being uniformed can be costly. The best advice I can give is know your options and coordinate coverage between your employer/union and Medicare.

Finally, if you have worked for 10 or more years, there is simply no benefit to delaying signing up for Medicare Part A.

Portions reprinted with permission from: Healthview Services, Inc., 150a Andover St. Danvers, MA 01923.

Information also available at www.Medicare.gov __________________________________________________________________

Carey Spears, RHU is a licensed Life/Health insurance agent with over 20 years experience with Senior products such as Medicare Supplements, Part D Prescription plans and Medicare Advantage Plans. With offices in Sandpoint and Coeur d’Alene, she offers ‘no obligation’ consultations for individuals as well as providing group presentations on the Beginners Guide into Medicare! If you are considering a retirement date or turning 65 in the next year, call Carey at 208-610-8096 to learn the right steps in securing your Health Care options.

Wise Guide | www.TheWiseGuideOnline.com

63

Wound Prevention for Your Loved Ones

by Deanne Boyd RN, Director of Nursing Services Life Care Center of Sandpoint

W

e are seeing more and more families caring for their mothers, fathers, grandparents in the home setting and would like to provide them with some suggestions to help keep their loved ones’ skin healthy. There are a few simple techniques that we can add to our daily lives which can markedly reduce the risk for pressure sores (bed sores).

As we age, our skin becomes more fragile and prone to bruising, cuts, and areas of pressure-related sores. These pressure-related sore areas are mostly seen over boney prominences on the body, but can also be found in less common areas that we do not always think to check. A few examples of these are: the tops and tips of the toes, mid spine, elbows, and between the gluteal cheeks.

Now that we know where to look let’s talk about some simple quick daily tasks that can minimize the development of these pressure-related sores. Check your loved ones shoes for a proper fit. When removing their shoes after being out on the town did you notice any red areas on their feet? If so, this might be a good time to look into shoes made from a flexible cloth material or possibly a wide toe box. A good foot rub with lotion for approximately 5 minutes to each foot will not only win your loved one’s heart, but will also help improve the circulation to their feet and aid with early detection of areas beginning to develop sores.

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Does your loved one have a favorite chair or recliner they like to sit in for long periods of time? It is always a good rule of thumb to “off load” or reposition off of your bottom approximately every 2 hours. This will help displace the weight of the body off the tailbone and shift to another part of the buttocks. This can be as easy as using a small pillow to prop up one hip or the other, or encouraging your loved one to lay down on their side to rest. Making sure their entire body is supported with pillows for comfort will often help with their willingness to reposition.

As we get older we will often lean on our elbows to support our upper body especially towards the end of the day as we fatigue. Paying attention to how your loved one sits and what they are resting their arms on can be vital in preventing pressure-related sores to their elbows. This can include padded wheelchair arms, adding sheep skin covers to wheelchair arms, or opting for padded arm chairs rather than wooden arm chairs is always a good and inexpensive fix.

Again here is another area where massage is a great tool.

Adding into your evening routine a time to apply lotion and inspection their elbows is not only a great time to reminisce about the day’s events but helps promote circulation and prevention of sore elbows.

Unfortunately, as we age “accidents” will happen. This is the number one cause of pressure-related sores in most settings whether at home, in the hospital, or any care facility. Something to keep in mind to head this off is to assist your loved one to the restroom regularly. It is recommended that people be offered the restroom every 2-3 hours to help prevent accidents.

Have them wear a good absorbing undergarment, not only for their dignity, but also to keep the moisture from the skin as much as possible. A good barrier cream after each “accident” will help prevent the acidity from burning the skin making it more fragile and susceptible to pressure-related sores.

If your loved one starts to complain of discomfort in any one area this would be a good time to have a look. We know that this can be difficult for our loved ones, and we can offer alternatives or even make a doctor’s appointment if they feel uncomfortable having you check personal areas.

Overall, while assisting our loved ones with their daily activities, be vigilant about looking for those “red spots” and ask yourself, “How did that get there and how can I help relieve the pressure?” Things like off-loading, providing extra padding, creating barriers for moisture, and massage are all excellent ways that are not too time intensive or costly and can help your loved one have healthy skin and be comfortable. ___________________________________________________________________

Deanne Boyd is currently the Director of Nursing for Life Care Centers of America in Sandpoint. She began in geriatrics 20 years ago, starting as a Certified Nursing Assist while obtaining her nursing license. Deanne has experience in critical care as an ER Nurse and Surgical Services Nurse with Bonner General Health. She enjoys working with the aging population and building relationships with them and their families.

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At Life Care Center of Sandpoint, we offer personalized care programs designed to turn your wellness goals into achievements.

• 24-hour Skilled Care • Inpatient and Outpatient Rehabilitation • On-Site Physician • Respite Services • Wound Management

Joint Commission accredited

208-265-9299

1125 North Division Street Sandpoint, ID 83864 www.LCCA.com

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Resident Resident Lorna Lorna and and Granddaughter Granddaughter Demarie Demarie

65

ElderImpact

by Marie Villeza, Founder ElderImpact.org

W

ould you believe that more than 40% of American seniors don’t use the internet at all? When surveyed, many said it’s too difficult or that they don’t believe it’s relevant to their lives. It got me wondering about those who are online; do they miss out on important information because they don’t know how to find it, or don’t even realize it’s out there?

All too often, aging means doing less – from the things seniors “used� to do through new developments that must be “beyond their time� – but we don’t believe in that. We’re dedicated to identifying resources to keep seniors healthy, connected, and up on today’s news and developments.

I’m Marie, and I’m behind the ElderImpact helm. I was inspired to start this site after I watched my son teach my father how to play Angry Birds (TM) on his smartphone, and it dawned on me, “We need to bring the generations together so they can usher each other into the future, breaking down the walls of fear and time.�

Our mission is to empower seniors against ageism by making handy the information they need to keep controlling their own lives. Our team works to incorporate market research with senior needs. We want technology to be accessible, we want social calendars to be bustling, and we want everyone to have access to the medical attention and other resources they need. We want younger generations to see that they can help dismantle ageism.

We don’t want there to be any victims. We want to impact the elderly so that they can keep impacting the world.

Since your site has already done an excellent job providing online information for seniors — thewiseguideonline.com — and for that, I thank you! I thought you might share my concerns.

I’ve been gathering some of the most valuable and unique senior resources that I think could really benefit your audience.

Senior-Friendly Remodeling http://www.homeadvisor.com/r/senior-friendly-remodeling/#.

WNlTPxiZNEI

11 Exercise Ideas for Seniors http://www.everydayhealth.com/senior-health-photos/exercise-ideas-forseniors.aspx

The Guide to Buying Used Accessible Vehicles http://www.lagrangecountrydodge.com/blog/2016/october/12/guidebuying-used-accessible-vehicles.htm

Never Too Old to Find New Friends: Socializing Tips for Seniors http://www.aarp.org/relationships/friends/info-04-2011/never-too-old-forfriends.html

Safe Sex for Seniors: 7 Essential Tips https://seniorplanet.org/safe-sex-for-seniors-the-facts-no-ones-giving-you/

Staying Sharp As You Age: Maintaining Cognitive Health https://www.ucdmc.ucdavis.edu/medicalcenter/ healthtips/2010-2011/09/20100909_staying-sharp.html The more we connect the generations, the greater benefit to all.

Go online and check out the resources there, designed with older adults in mind.

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2 % , $ / 6 ( $ 6 ' < ( ( 7 < ( 3 + 1 ( $ 6 . , , 5 2 1 9 ( ( 6 5 (

Wise Guide | Spring / Summer 2017

( 1 - , / , ( 1 / $ 7 6 ( 7 $ 0 + $ 1 ( , 5 2 1 ( 5 ' 6 < ( $ ' , 6 + 1 ( $ 3 * , / / 2 1 7 2 ( 6 3

Puzzles on pages 54-55

Wise Guide | www.TheWiseGuideOnline.com

67

The Soul is Timeless and Ageless

by Jan Noyes, Volunteer Ombudsman Area Agency on Aging of North Idaho

I

had a friend whom I’ve known since I was a teenager, way back when. I saw him move through the stages of his life as a student, a soldier, a husband and father, a high school teacher and coach, and an intrepid traveler. He retired on a fixed income, writing poems and songs, playing the guitar, the harmonica, and learning the violin.

My friend’s life, of course, had its ups and downs, but he maintained a positive attitude, an intellectual curiosity, and a will to live life as fully as he was capable. Problem was, he had a failing body. His once strong legs that hiked mountains,

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

Aging & Disability Resource Center Resource Information & Referrals Family Caregiver Support Programs Long Term Care Ombudsman Adult Protection Services Care Transitions from Hospital to Home

     

In-Home Support Services Community Support Services Long Term Options Counseling Volunteer Opportunities Medicare Fraud Education Medicare “Extra Help”

Call us to learn about available resources in your community!

2120 N Lakewood Dr, Ste B ۰ Coeur d’Alene, ID 83814

208-667-3179 • 800-786-5536 www.aaani.org PROUDLY SERVING BENEWAH, BONNER, BOUNDARY, KOOTENAI, & SHOSHONE COUNTIES

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ran track, and danced around a boxing ring suffered from peripheral neuropathy, and he spent most of his time in a wheelchair. Ten stents kept his arteries open and a pacemaker kept his heart beating a steady rhythm.

He always had a keen wit and a hearty laugh, but he told me he could cry at the drop of a hat, perhaps because aging taught him compassion and to be unafraid of being authentic. Even though we constantly look for ways to live longer, our culture is often lacking in respect for age. It’s common to joke about it as if it’s something to be ridiculed. We forget that wisdom often comes with the experience of growing older. My friend was overflowing with wisdom.

I recently spent time with him after many years apart and he reminded me, simply by being who he always was, that the body is not the soul that lives inside. The body may fall apart, even the mind may falter, but the soul is timeless and ageless.

Besides the violin, the harmonica, the guitar, writing poems and keeping in contact with friends on Facebook, he decided on a new venture: to write a book. He said if he could choose another time to live, he’d be a lawman in the Old West or maybe a wagon master leading pioneers across the country to a new life. So, naturally, his story was about a cowboy turned lawman who led his family from Missouri west. Pretty good story too. He finished his story just before he had a stroke and a heart attack.

At first, this might sound like a sad story, but he was a happy man full of life right up to the end. When I get tired of the snow, or sad that my husband is no longer with me, or I don’t know what I’m going to do with the rest of my life, I think of him. He was, and is, a role model for living life to the maximum no matter what.

As a long-term care ombudsman for the Area Agency on Aging of North Idaho, I’ve met hundreds of people who can no longer live independently. It’s our job to resolve problems and to see that the residents have a quality life as well as quality care. The residents of long term

care deserve our attention and respect.

There is expertise, experience and wisdom within those elders, like there was in my friend, even when it’s hidden by infirmity.

The role of the ombudsmen is to visit each and every community in our area to ensure the residents are being properly cared for and their concerns are heard. If there are issues, the resident or their family member can bring it to the attention of the ombudsman during a visit or by calling 208-667-3179.

____________________________________________

Jan Noyes holds a degree in education and has used her teaching skills in public schools, adult education, workshops and seminars for church and civic groups, and corporations.

Jan has been an ombudsman with the Area Agency on Aging for ten years, recruiting and training new ombudsmen. Jan also acts as an ombudsman, visiting facilities and advocating for their resident rights, quality of care and quality of life.

5% DI

S

Your North Idaho Recumbent Dealer

M COUNT Wiseention !

Guid e

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

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

208-818-5491

Respite Care Program Kootenai Health offers a positive part-time

care environment for adults with disabilities and seniors who are receiving care at home. Open weekdays, the program provides a safe, caring environment where participants can spend all or part of their day while their usual caregiver is unavailable or attending to other duties. Staff are specially trained in caring for the mental and medical needs of participants while providing activities that engage their interest and help reduce social isolation.

For more information, call (208) 625-5354 or visit kh.org

(208) 625-5354 or visit kh.org

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Run It By Tamara

by Tamara Jacobson, Compassionate Care Referral Services, Inc.

Q

From a concerned Mother in North Idaho: “I have a daughter in her upper 40’s who lives in Alaska. She has battled MS for ten years, and recently has struggled living on her own. She has had some falls lately and we are talking about a move down here to be closer to family.

Are there Assisted Living Facilities or other places that might work for her health situation?”

A

I have received a number of calls seeking assistance for the younger generation who are coping with chronic conditions needing some outside help.

While most Assisted Living Facilities are geared toward serving the elderly, there are a few larger facilities who have peers your daughter’s age and some smaller Certified Family Home options that specialize in chronic diseases as well as. We can discuss what is best for your daughter, depending on the level of care she needs.

Q

From a distressed daughter whose mother has sudden dementia symptoms: “I had to take my Mother to the Emergency Room this morning after being up with her all night, she was pacing and seeing things that weren’t there. The hospital says I will have a hard time finding an Assisted Living facility with her behaviors so they have suggested one place who will come evaluate her for placement. I feel very rushed. Do you have a suggestion?”

Your Only Locally Owned Referral Service

A personal approach to evaluating senior care choices to fit your needs and budget.

NO FEES. NO PRESSURE.

Tamara Jacobson Senior Care Consultant

(208) 660-9982

www.CompassionateCareReferral.com

A

You did the right thing taking your Mom to the ER. Now is the time to get a diagnosis of the type of dementia affecting your Mother. If you are feeling pressured to make a decision too quickly, it okay to say, “Let’s slow down,” giving you have a chance to deter-mine what would be best for your mother’s care.

There are several choices for memory care ranging from the very small care home to larger facilities. Together we will work to find a place where you can be confident your Mother will receive the care and understanding you desire.

Is it time to make a change? Tamara can help you learn about and understand options to find what works best for your current and future needs.

If you would like to submit a questions and ‘Run It By Tamara’ regarding senior care issues, please email to: RunItByTamara@outlook.com or call 208-660-9982.

There is something so encouraging and comforting just sharing our concerns with one another. I look forward to hearing from you! ___________________________________ Tamara Jacobson, a Senior Care Consultant and founder of Compassionate Care Referral Services, Inc., CompassionateCareReferral.com

Tamara formed the company as a way to connect area seniors and services in a personal but professional manner. Straight forward comparisons are discussed to fit the individuality of her client.

Confused About In-Home Care?

Home HEALTH CARE • Doctor’s order required

• No doctor’s order required usually

• Some private insurance

• Some private insurance (insurance assessment is required) • Long term care insurance • Medicaid (must qualify first and a nurse is sent to provide assessment)

• Medicare (60 days) • Medicare HMO’s • Medicaid • Short term for medical recovery wound treatment, medication administration and/or infusions, therapies.

• Performed by Nurses, Physical, Occupational & Speech Therapists, CNA’s 70

PERSONAL Home Care

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• Term is longer - can be lifetime. Assistance with laundry, meals, housekeeping, medication prep, transportation.

• Performed by CNAs or caregivers

Unsteady on Your Feet?

S

urveys conducted nationwide tell us that the #1 priority of older adults is availability to services, and #2 is aging in place in their own homes. The main reason people leave their homes is from the most common household accident — a fall. If you have fallen, more than once, there could be a number of reasons. Find out what is going on!

Why did you fall? Were you trying to step in or out of the tub? Trip over an upturned carpet or linoleum? Slip on a wet spot on the floor? Woke up in the night and tripped over the dog?

Leaned over to put on your shoes and lost your balance? Lost your footing on the steps? All these things can be addressed.

If the house has “dangerous” features or ones difficult to manage such as door knobs that you can’t turn, light bulbs you can’t reach to replace, cleaning you just can’t do any longer like crawling around the kitchen floor, wringing out a mop, carrying the vacuum up or down the stairs, emptying the vacuum. These things really are fairly easy fixes, but somebody has to help you with them and/or change things in such a way as to eliminate the problem. Face it, you are probably beyond fixing it yourself. You need some help. We all get older and as we age there are simply things in our world that fight back.

Things we just can’t do any longer, or don’t want to do.

Are you feeling unsteady on your feet? Balance issues are huge. They come from a variety of causes, and the primary one is lack of strength. Fit & Fall classes are WONDERFUL for this. They are free and held all over the region by the Health District. Find one and sign up. There’s also a Sit & Be Fit program on TV mid-day on public television.

Could your balance be inner ear related? Something as simple as wax build up can mess up your equilibrium. There are several options for free ear exams, or you could go to your doctor.

A look into the ear is a normal part of any wellness exam.

Are you vitamin deficient through inadequate diet? As you age, your metabolism changes and you may need more of some things and less of others. How do you find out about these things? The doctor is a good place to start. A doctor and/ or dietician can run a few simple tests and figure it out.

Eating better and staying active while making sure the house isn’t a hostile place can allow you to remain in your home. If you don’t do those things, recognize that you are headed in a direction of dependence on others, possibly moving somewhere “safer,” or moving in with family, putting others at ease, while eventually risking loss of your independence altogether.

Or consider that there is absolutely nothing wrong with choosing to sell your home and move into an independent living situation where meals are prepared and cleaning done. You could be spending your golden years enjoying the company of others, going on excursions, dancing, volunteering, playing cards on a rainy day, sharing growing a garden, going shopping, having a good time.

You can do both. It’s your choice. But if you lose the ability to be mobile through a slow decline from not asking for help, not maintaining your health and your home, and not being a part of the vibrant life going on around you, you’ve only yourself to blame.

Weren’t you a responsible adult at a younger age? Why does that have to change? Be responsible now, take action and live a long HEALTHY and HAPPY life.

By the way, you don’t have to make these decisions alone.

Start by contacting the various agencies listed in this magazine.

They exist solely to help Wise Guide | www.TheWiseGuideOnline.com

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Directory Listings

Agencies, Free Referral Services & Volunteer Opportunities AARP Idaho.................................................................. 208-855-4004 3080 E. Gentry Way, Ste. 100, Meridian facebook.com/AARPIdaho AARP Idaho is a nonprofit, nonpartisan organization, with a membership of more than 175,000 in Idaho that serves as a voice and an advocate to protect consumers and improve the lives of Idahoans age 50 and over.

Alzheimer’s Association Inland NW Chapter N. Idaho Office.................................................. 208-666-2996 x8314 24-Hour Help line........................................................ 800-272-3900 alz.org P.J.Christo, RN; email: pj.christo@alz.org 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.

Area Agency on Aging of North Idaho.........................208-667-3179 Toll Free....................................................................... 800-786-5536 2120 Lakewood Dr., Ste. B, CdA • aaani.org AAANI is a grant funded agency providing services for seniors including information on in-home and community services, senior center meals, home delivered meals, homemaker, respite for family caregivers, legal assistance, adult protection, long term care ombudsman, long term care options counseling, hospital to home care transition, and volunteer opportunities.

Compassionate Care Referral Service.......................... 208-660-9982 compassionatecarereferral.com I can refer you to the best fit for your Assisted Living, Senior, and Disabled Care Services. Through mutual discussion and needs assessment, I will create for you a customized short list of possible solutions.

Goodwill Industries - Workforce & Family Services 204 Larkspur St., Ponderay.......................................... 208-265-1984 1221 W. Ironwood Dr., Ste. 101, Coeur d’Alene........... 208-667-6463 130 E. Third Ave., Spokane, WA.................................... 509-462-0513 discovergoodwill.org Goodwill has been helping people in the Inland Northwest overcome barriers to independence since 1939. Goodwill provides employment programs, independent living services, supportive services for veterans who are homeless, youth mentoring and more. Programs are funded by our retail thrift stores.

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.

SHIBA (Senior Health Insurance Benefits Advisors).. 800-247-4422 2005 Ironwood Pkwy, Ste. 143, Coeur d’Alene doi.idaho.gov/shiba/shibahealth.aspx SHIBA is a division of the Department of Insurance. SHIBA counselors offer free education and assistance about Medicare benefits, plan choices and billing. SHIBA counseling is done by phone, email, or at community partner locations throughout Idaho.

Chiropractic Moore Chiropractic 6843 Main St., Bonners Ferry...................................... 208-267-2506 315 E. Missoula Ave, Ste. 4, Troy, MT .......................... 406-295-5252 danmooredc.com Providing gentle, effective, quality care that’s affordable for everyone.

Dr. Daniel Moore has over 25 years experience utilizing the latest techniques and chiropractic physiotherapy technologies ensuring the fastest recovery time possible. Come see why over 4,000 patients have trusted Dr. Moore with their health!

Counseling Art of Redirection Counseling..................................... 208-267-9228 6821 Main St., STE C, Bonners Ferry ArtofRedirection.com We provide non-traditional individual and couples counseling to gain clear understanding of someone’s current situation, how they got there and focused direction for productive change. We specialize in ad-dressing intimacy, addiction and communication issues and difficult topics of electronic, pornographic and sexual addictions.

Heritage Health Mental Health................................... 208-769-4222 2025 W. Park Pl., Ste B, Coeur d’Alene Family Support Services................................................ 208-620-5210 2201 Ironwood Pl., Ste.100, Coeur d’Alene myheritagehealth.org We offer and provide excellent, affordable mental health services to individuals and families with unique situations and needs. A collaborative integrated care model with Family Support Services ,helps clients discover and strive to reach their full potential through care coordination with medical providers.

Life Choices Pregnancy Center.....................................208-263-7621 502 N. 2nd Ave., Sandpoint lifechoicespc.org Offering free & confidential pregnancy testing, ultrasound imaging, options education and parenting/life skills for women and men facing unplanned pregnancy, assistance for women struggling with past abortion or miscarriage, and guidance for young ladies who are wrestling with sexual integrity.

Pend Oreille County Counseling Services ...................509-447-5651 After Hours Crisis Services: 866-847-8540 105 S. Garden Ave., Newport, WA pendoreilleco.org/your-government/counseling-services Outreach Offices: Cutter Theater in Metalline Falls & Selkirk School District. Providing quality integrated behavioral healthcare (mental health and chemical dependency), and supportive services for adults, adolescents, children and families of Pend Oreille County. We promote the values of consumer driven recovery, resiliency and selfdetermination, working collaboratively to provide outpatient, crisis, prevention and psycho education services.

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Rawlings Community Counseling................................208-267-0900 6807 Cody St., Bonners Ferry rawlingscommunitycounseling.com Mental health counseling for children, adolescents, adults, couples and families. Offering addiction treatment, case management, and EMDR Therapy for trauma treatment. We accept most insurance, Medicaid and a sliding fee scale is available.

Dental

Cheryl Seifert, CERTIFIED FINANCIAL PLANNER TM Capital Financial Consultants Group ......................... 208-255-2766 123 S. Third Ave., Ste. 7, Sandpoint capitalfin.com Let me help you get on track with your financial goals, increase your understanding of investments, and how to use them along with your other income and assets for a sound future. Together we can create a retirement plan – for individuals, couples or businesses – that will be done with your best interest in mind.

Heritage Health Dental Care........................................208-620-5250 Appointments in both locations 1090 W. Park Pl., Coeur d’Alene 413 Pine Street, Wallace myheritagehealth.org Our patients benefit from our skilled, caring staff, advanced technology, and modern dental treatments. Whether you are bringing your family in for a regular check up or are in need of restorative dental care, you can trust us to keep your smile looking its best!

Panhandle Accounting, LLC.........................................208-290-6716 panhandleaccounting.com A professional and experienced accounting firm providing bookkeeping set up, payroll processing, bank reconciliations, tax return preparation and filing, and consultation services for small businesses. Helping business owners concentrate on their customers while taking care of the bookkeeping & “back office” details.

Education & Recreation

Goodwill Industries Retail Stores 204 Larkspur St., Ponderay.......................................... 208-265-1980 1212 N. 4th St., Coeur d’Alene..................................... 208-664-2552 317 Seltice Way, Ste. A, Post Falls................................ 208-773-6181 202 E. Third Ave., Spokane ......................................... 509-444-2396 9832 N. Nevada, Spokane ............................................509-466-2012 13721 E. Sprague Ave., Spokane...................................509-928-4032 2927 E. 27th Ave., Spokane .........................................509-321-0478 168 N. Main, Colville....................................................509-684-6162 Goodwill Outlet Store 1406 E. Front St., Spokane ..........................................509-279-2916 Online Shopping with Goodwill: shopgoodwill.com stores.ebay.com/gwspokane etsy.com/shop/GoodwillSpokane Goodwill has been helping people in the Inland Northwest overcome barriers to independence since 1939. Goodwill provides employment programs, independent living services, supportive services for veterans who are homeless, youth mentoring and more. Programs are funded by our retail thrift stores.

North Idaho College..........................................877-404-4536 x1705 Bonners Ferry: 791 Main St. ........................................ 208-267-3878 Silver Valley: 323 Main St. Kellogg.............................. 208-783-1254 Sandpoint: 102 S. Euclid.............................................. 208-263-4594 Parker Career & Technical Education Facility............. 208-769-3448 7064 W. Lancaster Rd., Rathdrum • nic.edu North Idaho College is committed to bringing educational opportunities to the communities we serve. Our outreach locations offer admissions and advising assistance, financial aid and career counseling, credit and non-credit classes, testing and tutoring services, and a welcoming and supportive staff.

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 and play on many models of the most stable and comfortable bikes and trikes in the world. Call for appointments.

Financial & Asset Management AARP Idaho.................................................................. 208-855-4004 3080 E. Gentry Way, Ste. 100, Meridian facebook.com/AARPIdaho AARP Idaho is a nonprofit, nonpartisan organization, with a membership of more than 175,000 in Idaho that serves as a voice and an advocate to protect consumers and improve the lives of Idahoans age 50 and over.

“I may be disabled, but I can try to do anything” Multiple Sclerosis Advocate Meeting Monthly Call or email for more details: beth@mswobbles.com

208-818-2150

Gifts & Shopping

Hospice of North Idaho Thrift Stores 1823 N. 4th St, Coeur d’Alene......................................208-667-5128 503 E. Seltice Way #5, Post Falls...................................208-773-5076 honi.org Shop our huge selection of high quality, gently used items from furniture, books, electronics, craft sup-plies, kitchenware, linens, clothing, shoes, accessories, and much more. All proceeds go to Hospice of North Idaho, the community’s non-profit hospice.

Panhandle Animal Shelter Thrift Store........................208-263-0706 870 Kootenai Cutoff Rd., Ponderay PAS.org Open seven days a week offering low-cost, quality items - a wide selection of clothing for the whole family, housewares, art, furniture, movies, books, athletic equipment and more. 100% of the proceeds benefit the animal shelter! Make a positive difference, donate your gently used items, seven days a week.

Quilter’s Guild???

Hearing & Vision Audiology Research Associates 700 Ironwood Dr., Ste. 220, Cd’A.................................208-765-4961 123 S. 3rd Ave., Ste. 9, Sandpoint................................ 208-255-4389 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 and each hearing aid comes with 3 to 5 years free batteries.

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Directory Listings

Hearing Center of Deer Park........................................509 276-8859 23 E. Crawford, Deer Park Toll Free........................... 844 327-4335 eargeek.com The HEARING CENTER is committed to providing outstanding customer service and superior products. We offer complete audiometric hearing evaluations, consultations, full service repair & custom hearing protection. We specialize in Workman’s Comp and WA Labor & Industry claims.

Idaho Commission for the Blind & Visually Impaired ......................................................................................208-769-1419 229 E. Locust Ave., Coeur d’Alene • 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 • ilacblind.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 Bonner Community Hospice........................................ 208-265-1179 A service of Bonner General Health 520 N. 3rd. Ave., Sandpoint • bonnergeneral.org Caring for terminally ill patients and their families in Bonner and Boundary counties. Services include pain management, specialized nursing care, bathing and personal care, chaplaincy, supportive counseling, medical supplies and equipment. Covered by Medicare, Medicaid and most private insurance.

Hospice of North Idaho............................................... 208-772-7994 9493 N. Government Way, Hayden • honi.org We provide end-of-life care to anyone in our community regardless of their ability to pay. We are a non-profit hospice serving the seriously ill and those touched by loss since 1981.

Hospitals & Medical Care Bonner General Health.................................................208-263-1441 520 N. 3rd Ave., Sandpoint Bonner General Immediate Care..................................208-265-3751 400 Schweitzer Plaza Rd., Ponderay • bonnergeneral.org Your community hospital providing quality, compassionate care in a comfortable, healing environment. We provide a full range of healthcare services, including home health, hospice, physical, occupational and speech therapy, radiology, laboratory, surgery, and emergency services.

Heritage Health Medical Centers 1090 N. Park Pl.,Coeur d’Alene.................................... 208-292-0292 117 Terrill Loop, Mullan.............................................. 208-783-1267 925 E. Poston Ave., Post Falls....................................... 208-618-0787 14775 N. Kimo Ct., Ste.B, Rathdrum........................... 208-687-5627 Mountain Health Care, 740 McKinley, Kellogg........... 208-783-1267 myheritagehealth.org Our Primary Care Providers (PCPs) have a broad set of skills and are able to diagnose and treat most conditions and ailments: Chronic Disease Management, Diagnostic Services, Express Care/walk-ins, Minor Outpatient Surgery, Routine Medical Care, Women’s Health, Wellness Care—at affordable prices.

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Camas Center Clinic...................................................... 509-447-7111 1821 W. LeClerc Rd. #1, Cusick, WA kalispeltribe.com/camas-center-clinic The Camas Center Clinic offers comprehensive healthcare including: medical, dental, chiropractic, physical therapy and massage therapy.

The clinic is open to the general public and accepts most major commercial and public insurance carriers. Ride Monday-Thursday round-trip from Newport to Clinic. Suggested donation $1.Call 800776-9026 for more info.

Idaho Pain Clinic......................................................... 208-263-9757 11 E. H St., Ste. F, Deer Park, WA 714 W. Pine Street, Newport ,WA 1327 Superior St., Ste. 101 Sandpoint, ID 229 S. 7th St., Ste. 401, St. Maries, ID idahopainclinic.com Idaho Pain Clinic is a leader in non-operative orthopedics, pain management research, diagnostic procedures and techniques, and effective treatment. Our physicians are board certified and fellowship trained in pain management and offer the most advanced treatment options available in the U.S. Kaniksu Health Services............................................... 208-263-7101 6615 Comanche St., Bonners Ferry 30410 Hwy 200, Ponderay 6509 Hwy 2, Ste. 101, Priest River Pediatrics...................................................................... 208-265-2242 420 N. 2nd Ave., Ste. 100, Sandpoint VA Clinic....................................................................... 208-263-0450 420 N. 2nd Ave., Ste. 200, Sandpoint kaniksuhealthservices.org Kaniksu Health Services is a nonprofit community health center which plays a vital role in Idaho’s safety net by providing medical, dental, behavioral health and VA services to the residents of Bonner & Boundary Counties.

Kootenai Urgent Care Coeur d’Alene.................................................................208-667-9110 700 Ironwood Drive, Ste 170E Hayden, 566 W. Prairie Avenue.....................................208-772-9110 Post Falls........................................................................208-777-9110 1300 E. Mullan Ave., Ste 600 kootenaiurgentcare.com Kootenai Urgent Care of Coeur d’Alene, Post Falls and Hayden specializes in cost effective medical care for minor accidents, injuries or illnesses, including: sprains, minor fractures, sports injuries, infections, burns, and illnesses. Save your spot in line at kootenaiurgentcare.com.

Newport Hospital & Health Services............................509-447-2441 714 W. Pine St., Newport, WA • phd1.org We provide 24-hour care when you need it! Two primary care clinics offer same day/walk-in appointments. Other services: Emergency; General Surgery; Obstetrics; Anesthesia; Diagnostic Imaging; Laboratory; Physical, Speech, & Occupational Therapy; Acute Care; Swing Bed; Long Term Care; Assisted Living.

North Idaho Advanced Care Hospital......................... 208-262-2800 600 N. Cecil, Post Falls 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.

Pain Management of North Idaho................................208-765-4807 1686 W. Riverstone Dr., Coeur d’Alene cdapain.com Pain Management of North Idaho is Coeur d’Alene’s only comprehensive Pain Management Center where patients have access to two fellowship-trained interventional pain physicians and a multidisciplinary team.

Rehabilitation Hospital of the Northwest 3372 E. Jenalan Ave., Post Falls....................................208-262-8700 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.

Selkirk Family Medicine & Women’s Health............... 208-263-1299 1215 Michigan St., STE C, Sandpoint In addition to women’s health, Cynthia and Tabitha are excited to announce that Katie Sweeney, FNP, will be joining our practice. Katie will offer full family medicine for women, men, and children. Katie joins Cynthia and Tabitha partnering with patients to take an active role in their health care.

Independent & Assisted Living, Adult Day Care Affinity at Coeur d’Alene............................................... 208-667-1100 3594 N. Cederblom St., Coeur d’Alene AffinityatCDA.com We are among the first communities in a brand-new category of senior living that was designed for people age 55 and over. It features an abundance of amenities found in higher-priced communities — without the higher price.

Honeysuckle Place Senior Living................................ 208-762-4097 660 W. Honeysuckle Ave., Hayden, ID enlivant.com Enlivant communities have a rich heritage of helping seniors thrive.

We offer an individualized approach to senior care, designed to make sure each resident has their personal health and wellness needs attended to. Private apartments, chef-prepared meals, enriching activities, pet friendly. Come visit!

Kootenai Health Senior Care Program........................ 208-625-5353 521 W. Emma St., Coeur d’Alene kh.org/seniorcare A community based program to meet the social needs of seniors and respite needs of their caregivers. Activities address the special interests of participants, provided in a safe, loving environment by caring professionals. Private pay & funding sources available through Area Agency on Aging, VA or Medicaid.

The Lodge Assisted Living........................................... 208-457-3403 52 N. Cedar St., Post Falls 58 N. Cedar St., Post Falls 3989 N. Player Dr., Coeur d’Alene • lodgeliving.net We provide the most dignified environment for aging members of our community. Our highly trained staff and loving environment is perfect for you or your loved one with additional care needs. Our communities are custom built and locally owned offering comfort, security, convenience to our family of residents.

River Mountain Village Assisted Living........................509-447-2903 608 W. Second Ave., Newport, WA • phd1.org A beautiful 42 unit studio & one-bedroom apartment community for an active, independent lifestyle. En-joy the cozy fireplace, a stroll along a lovely landscaped walking path, and a variety of daily activities to meet the individual needs of our residents.

Bestland Senior Living Community............................ 208-665-1600 606 E. Best Ave., Coeur d’Alene • bestlandcda.com Bestland Senior Living offers 3 home-cooked meals per day, weekly housekeeping with linens, transportation, all utilities, wi-fi, and cable TV at one low rate. We are a smaller community offering residents a warm and loving atmosphere where they truly feel at home!

Boundary Community Restorium............................... 208-267-2453 6619 Kaniksu St., Bonners Ferry boundarycountyid.us Our facility accommodates 52 residents with 24-hour care, homecooked meals, help with shopping, medications, and bathing, rides to appointments. All inclusive rates. Medicaid accepted. We offer an array of activities for our residents and adult daycare is available.

Brookdale at Coeur d’Alene......................................... 208-667-6490 205 E. Anton Ave., Coeur d’Alene • brookdale.com We offer newly remodeled, all inclusive, independent and assisted living; studios, deluxe studios, one and two bedroom apartment and stand-alone cottages. We pride ourselves on a full, active, life enrichment program, delicious meals presented restaurant style, housekeeping, transportation to appointments, shopping and other excursions.

Harmony House Assisted Living..................................208-704-2502 Four Homes in Hayden, ID harmonyhousealf.com Providing a safe, comfortable home for those with Mental Illness, Traumatic Brain Injury or Developmental Disability. A family atmosphere, quality care, structured activities and positive counseling help residents develop life skills to reach their fullest potential in a community setting.

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Directory Listings Bonner General Health Home Health Services .................................................. 208-265-1007 520 N. 3rd Ave., Sandpoint • bonnergeneral.org Providing skilled, intermittent care in the home. Services include skilled nursing care; physical, occupational and speech-language therapies; medical social services and certified home health aid services. Covered by Medicare, Medicaid and most private insurance.

Rose Terrace Country Homes.......................................208-623-6154 5672 W. Rhode Island, Spirit Lake Rose Terrace Cottages.................................................. 208-665-0580 632 N. 21st St., Coeur d’Alene • roseterrace.org Our quaint, home-style facilities offer a compassionate, caring environment with well trained staff 24/7. Nurses available 7 days a week, wonderful meals and fun activities. Private and semi-private rooms. Medicaid accepted.

Boundary Personal Care...............................................208-267-5070 6821 Main Street, Bonners Ferry Dawn Pownall is all about her hometown. A Medicaid and Veteran approved Agency we hire and screen local caregivers (even family members) to provide assistance for Seniors struggling with tasks or the disabled of any age. If you are selecting an Agency to provide care, or know someone who needs help give us a ring. There is no obligation.

We simply love what we do!

North Idaho Home Health.......................................... 208-667-7494 850 W. Kathleen, Coeur d’Alene amy.bartoo@LHCgroup.com We provide skilled nursing, physical therapy, occupational therapy, speech therapy and medical social work. Proud to serve Kootenai County since 1979. Jayco Certified. 4.5 Star rating.

In-Home Health & Personal Care

Insurance

AAging Better In-Home Care 601 E. Seltice Way, STE 101, Post Falls 208-777-0308 1207 Michigan, STE A, Sandpoint 208-263-7889 aagingbetter.com One of the largest local and veteran-owned care companies since 1997, providing a full suite of caregiving services for clients from 2 months to 102 years old. Customized care and well-trained, FBI background-checked employees ensures our clients live and thrive safely in their homes. Call now for a free consultation!

Spears Insurance, Inc.................................................... 208-610-8096 102 S. Euclid Ave., Ste. 103, Sandpoint 1121 Mullan Ave., Ste. 208, Coeur d’Alene cspears4insurance.com There are many types of benefit plans. Which one is right for you?

Let’s first understand the basics of Medicare in plain simple language, and then discuss other factors to finding the right coverage for you.

Call me today to schedule your appointment. Serving ALL of NORTH IDAHO!

Addus Health Care........................................................208-667-2309 850 W. Ironwood Dr., Ste. 101, Coeur d’Alene addus.com Since 1979 we have been providing quality in-home care; companionship, light housekeeping, meal preparation; transportation to appointments, bathing assistance, medication reminders. Our costeffective services are designed to improve health and well-being and make your choice easier to remain independent at home.

Advanced Care Northwest, LLC .................................. 208-263-3225 Serving All of North Idaho advancedcarenorthwest.com Promoting safe and independent living, we are committed to providing compassionate and enjoyable personal care services to Seniors, Children, and Individuals with intellectual and developmental disABILITIES. Accepting BlueCross/TrueBlue, Medicaid/Medicare, Veteran, and most Private Insurance carriers.

Call today for a FREE in-home consultation!

August Home Health, Inc ........................................... 208-664-0858 Toll free..................................................................... 1-800-664-0838 2005 Ironwood Pkwy #227, Coeur d’Alene augusthh.com New clients call Lynn our Supervising Nurse to schedule a visit! A Medicaid and Veteran approved Agency we hire and screen local caregivers (even family members) to provide assistance for Seniors struggling with tasks or the disabled of any age. If you are selecting an Agency to provide care, or know someone who needs help give us a ring. There is no obligation. We simply love what we do!

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Legal Crandall Law Group......................................................208-772-7111 8596 Wayne Dr., Ste. B, Hayden crandalllawgroup.com The Crandall Law Group is a boutique law firm offering highly specialized, top quality legal services to clients in the Inland Northwest region in the areas of estate planning, business, elder law, probates, guardianships, tax and business succession planning. We offer free initial consultations during which we will review your estate, discuss your needs, and explain your planning options.

Coyle & Wytychak Elder Law....................................... 208-765-3595 314 E. Garden Ave., Coeur d’Alene cwelp.com Since 1987, Coyle & Wytychak Elder Law, PLLC has provided the senior and disabled population of North Idaho and their families with individualized service to help them through difficult issues related to Estate Planning, Probates, Trusts, Guardianship, and planning for Long Term Care and Public Benefits.

Nutrition

Rehabilitation & Skilled Nursing

Full of Days everydayfull.com It’s not about “half-empty” or “half-full;” for us it’s about pulling up a chair and sharing a cup…Welcome to our lives, where Days Become a Life…welcome to Full of Days. Traditional living, real food recipes, DIY, and everyday stories.

Life Care Centers of North Idaho 500 W. Aqua Ave., Coeur d’Alene.................................. 208-762-1122 1125 N. Division St., Sandpoint.................................. 208-265-9299 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. Respite stay is also available.

Semi-private and private rooms. Schedule your tour today!

Winter Ridge Natural Foods Market.............................208-265-8135 703 Lake St., Sandpoint winterridgefoods.com Winter Ridge is Sandpoint’s largest natural foods market. We are here to provide you with the finest quality fresh, natural, organic and whole foods, nutritional products, body care products and health information in a fun, comfortable, clean and safe environment.

Personal Emergency Systems Kootenai Health Lifeline .............................................208-625-5020 2003 Kootenai Health Way, Coeur d’Alene pfairfield@kh.org Leader of personal emergency response services - the only non-profit provider in North Idaho. Lifeline provides peace of mind and access to emergency help at the touch of a button.

Project Lifesaver........................................................... 208-446-2250 Kootenai County Sheriff’s Office Radio transmitter-based personal locator system helps bring loved ones home. Works everywhere, reducing rescue time to approx. 30 minutes. Kootenai County families of those who wander (Alzheimer’s, Dementia, Autism, Developmental Disabilities) PLEASE CONTACT US! Also seeking donations to expand this proven national program.

Pharmacies, Medical Equipment & Supplies Medicine Man Pharmacy Bonners Ferry 6452 Main St. (in Super-1) ......................................................................................208-267-4021 Sandpoint 624 Larch St. (in Super-1)......................... 208-597-7466 Rathdrum 15837 Westwood Dr. (in Super-1)..............208-687-5717 Hayden 8093 N. Cornerstone Drive............................ 208-762-9355 Hayden 240 W. Hayden Ave (in Super-1)..................... 208-772-3311 Coeur d’Alene 305 W. Kathleen (in Super-1).............. 208-765-2268 Coeur d’Alene 1114 Ironwood Drive.............................208-666-2502 Post Falls 802 E. Medical Court................................... 208-773-3566 Post Falls 805 E. Polston Ave. (in Super-1)................. 208-777-7732 medmanpharmacy.com At Medicine Man Pharmacy we work to improve your health and the health of our community. You’ll find more than a place to fill your prescriptions: You’ll receive personalized care, answers to your questions and exceptional customer service. Visit our website to find a Medicine Man near you.

Sandpoint Super Drug................................................. 208-263-1408 604 N. 5th Ave., Sandpoint superdrugsandpoint.com We strive to provide the highest quality home health care equipment, supplies and services, while being competitive on product and pricing.

We offer goods and services unique to our community, with the comfort and independence of our customers in mind. Medicare approved!

Newport Hospital Long Term Care & Skilled Nursing......................................................... 509-447-2464 714 W. Pine St., Newport, WA • phd1.org Our Long Term Care offers both long and short term skilled nursing and restorative care. We provide skilled nursing 24 hours a day, coordinating care with local physicians.

Rehabilitation Hospital of the Northwest....................208-262-8700 3372 E. Jenalan Ave., Post Falls, ID rhn.ernesthelath.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.

Veterinary & Animal Care Bonners Ferry Veterinary Clinic....................................208-267-7502 Emergency Phone.........................................................208-444-1024 6657 Main St., Bonners Ferry Let us help you care for your favorite four-legged friends! Our clinic provides complete veterinary services for healthy pets and for sick or injured animals, including horses and livestock. We provide an on-call emergency service in addition to our regular hours.

Panhandle Animal Shelter 870 Kootenai Cut-Off Rd., Ponderay pasidaho.org Adoptions, strays, and ferals … 208-265-PAWS (7297) Helpline for support and resources to keep your family together…

208-217-4453 Home to Home, www.home-home.org, to find or place a pet without setting a paw inside a shelter… 208-217-4453 Panhandle Animal Shelter (PAS) is a no-kill shelter providing care to homeless dogs and cats and assistance to owners who require help with their pets. All dogs and cats receive vaccines including rabies, and are spayed or neutered and micro-chipped before being adopted.

Complete Veterinary Services for Small & Large Animals Roland H. Hall, DVM 24-HOUR EMERGENCY Chad A. Burt, DVM 208-444-1024

Jill Lang, DVM

8:30 - 5:00 M-F 8:30 - 1:00 Sat.

208-267-7502

6657 MAIN BONNERS FERRY

Bonners Ferry Veterinary Clinic Wise Guide | www.TheWiseGuideOnline.com

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HELP WANTED!

Employment Opportunities Abound in Health Care

H

ome care agencies and facilities are struggling to provide care to people throughout our entire region.

As residents are choosing to age in place in their own homes, they may find themselves in need of assistance.

Some may need help with simple activities of daily living (laundry, cleaning, meal preparation) while others may be recovering from illness, injury or surgery.

And, not everyone who needs some assistance in the home are elderly. According to the 2010 census, 65% of our residents throughout the N. Idaho, E. Washington & W. Montana communities are over 40 years old! And, 75% of all residents are considered “rural.”

With this substantial aging population in our rural neighborhoods, it is a challenge for local companies and agencies to provide basic home care to all the folks that certainly need it. Now, compound that with the scarcity of caregivers, and many people are unable to receive the support they need to stay healthy and safe at home. Families are having to make difficult decisions to ensure their loved ones are safe and sound.

Local skilled nursing and assisted living facilities often have a waiting list, and yet some are not able to fill all of their available space as they do not have enough caregivers, certified nursing assistants and registered nurses to attend to the residents. Now, if a family’s medical crisis does occurs, their loved one may have to complete their recovery and rehabilitation at a facility 60+ miles away due to the shortage of caregivers within facilities in the local area.

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More and more the local companies supporting the population needing assistance are having to become creative in their ways of attracting, hiring and retaining caregivers and nurses. Health insurance, flexibility in hours and signon bonuses are some of the incentives companies offer to new employees. But sadly, that is not enough to find, let alone retain, quality, caring people to take care of our friends and families.

For those seeking employment, they should ask, “Where else can you find a job with only a genuine desire to help others and absolutely no experience?” Many companies will hire (with background screening) and train on the job! Many agencies and facilities hire people with little to no experience and provide the trainings to give a new employee enough skills, proper certification and confidence to be a successful caregiver. And, many offer benefits within just a few months of employment.

Entry-level positions also give new employees the opportunity to find out if health care is a good fit for them.

Many go on to obtain degrees in areas of specialization (various therapies, nursing, radiology, dietician, social work, etc.) simply from being on the job and learning what therapies and services are being offered to patients.

Have you or someone you know considered employment in health care? Now is an excellent time to enter the field. Review the Wise Guide’s Directory and contact an agency, company or other organization and make a difference for members of our community, and see if the rapidly growing healthcare industry is for you.

Wise Guide | www.TheWiseGuideOnline.com

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Grief Loss Support, Griefand and Loss Support, Palliative Care & & Palliative Care Hospice Services Hospice Services

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