Friday, November 20, 2015

DVD resources for caregivers: Teepa Snow

Excellent DVDs for caregivers paid and unpaid. Our Community Home Support volunteers attended a presentation based on work by Teepa Snow.

Learn with Teepa Snow 

 Why hospitals are the most dangerous place for people with dementia, and how you can positively
impact the outcome of your loved one's stay - Which possible problems may arise, and how to overcome them - How to ask the right questions and make the best choices when speaking to medical staff - Which drugs are commonly prescribed in hospitals that can have severe side effects for your person with dementia - How to detect pain and find comforting solutions - Which items to discuss with family members and how to work as a team throughout this journey

Tuesday, November 10, 2015

Dementia: A Caregiver’s Guide


A non-profit, this looks like the type of book CCAC should be buying and giving to clients and their families.

Toronto Star
... the vast majority of families affected by dementia will never set foot in the Baycrest Centre. So Baycrest is reaching out to them. It has just published Dementia: A Caregiver’s Guidea 138-page book ($27.99) designed to share its knowledge and techniques with the 8 million informal caregivers — spouses, adult children, siblings and friends — who provide 75 per cent of dementia care in Canada.

About Baycrest

Baycrest Health Sciences is a global leader in geriatric residential living, healthcare, research, innovation and education, with a special focus on brain health and aging.

 As an academic health sciences centre fully affiliated with the University of Toronto, Baycrest provides an exemplary care experience for aging clients combined with an extensive clinical training program for students and one of the world’s top research institutes in cognitive neuroscience. Through its commercial and consulting arms, Baycrest is marketing its sought-after expertise and innovation to other healthcare organizations and long-term care homes, both in Canada and internationally. - See more

Wednesday, October 28, 2015

Interesting press release on SAD


The clocks “fall back” November 1, 2015 which means that there will be less day lightMany people chalk up feeling blue in winter as simply a fact of cold weather and lack of sunshine. But 4 to 6 percent of people may have a winter depression which is clinically referred to as Seasonal Affective Disorder.  Another 10 to 20 percent may have mild SAD. SAD is
four times more common in women than in men. Although some children and teenagers get SAD, it usually doesn't start in people younger than age 20. Your chance of getting SAD goes down as you get older. SAD is also more common the farther north you go. For example, it's seven times more common in Washington State than in Florida. Dr. Sanam Hafeez is a neuro-Psychologist in NYC (Manhattan and Forest Hills, Queens), and treats patients in her practice who display and express mood changes once October rolls around. 

Dr. Hafeez explains that, “In most cases, seasonal affective disorder symptoms appear during late fall or early winter and go away during the sunnier days of spring and summer. However, some people with the opposite pattern have symptoms that begin in spring or summer. In either case, symptoms may start out mild and become more severe as the season progresses.” 
The following are symptoms to look for to see if you are suffering from SAD

  • Depression
  • Hopelessness
  • Anxiety
  • Loss of energy
  • Heavy, "leaden" feeling in the arms or legs
  • Social withdrawal
  • Oversleeping
  • Loss of interest in activities you once enjoyed
  • Appetite changes, especially a craving for foods high in carbohydrates
  • Weight gain
  • Difficulty concentrating

How is SAD treated?
Many people with SAD will find that their symptoms respond to a very specific treatment called bright light therapy. For people who are not severely depressed and are unable—or unwilling—to use antidepressant medications, light therapy may be the best initial treatment option says Dr. Hafeez.
Light therapy consists of regular, daily exposure to a “light box,” which artificially simulates high-intensity sunlight. Practically, this means that a person will spend approximately 30 minutes sitting in front of this device shortly after they awaken in the morning. If patients do not improve, a second exposure of 20-30 minutes may be added in the early afternoon.  Treatment usually continues from the time of year that a person’s symptoms begin, such as in fall, on a daily basis throughout the winter months. Because light boxes are created to provide a specific type of light, they are expensive and may not be covered by insurance. Unfortunately, having lots of lamps in one’s house and spending extra time outside is not as effective as this more expensive treatment.
Dr. Hafeez states that, “Side effects of light therapy are uncommon and usually reversible when the intensity of light therapy is decreased. The most commonly experienced side effects include irritability, eyestrain, headaches, nausea and fatigue.”
Scientific studies have shown light therapy to be very effective when compared to placebo and as effective as antidepressants in many cases of non-severe SAD. Light therapy may also work faster than antidepressants for some people with notable effects beginning with in a few days of starting treatment. Other people may find that it takes a few weeks for light therapy to work, which can also be the case for most people who take antidepressant medications. Although not explicitly recommended, some people may elect for treatment with both light therapy and antidepressant medications.  The combination of these treatments may be synergistic and a more robust way to address the symptoms of SAD.
In her practice Dr. Hafeez has found that antidepressant medications have been useful in treating people with SAD. Of the antidepressants, fluoxetine (Prozac) and bupropion (Wellbutrin) have been studied in the treatment of SAD and shown to be effective. The U.S. Food and Drug Administration (FDA) has approved these medications for treatment of major depressive disorder.  Dr. Hafeez cautions that, “Any person considering treatment with an antidepressant medication should discuss the benefits and risks of treatment with their doctors.”

Individuals with a predisposition to bipolar disorder should be more cautious in approaching treatment for SAD and depression in general. Light therapy, like antidepressant therapy has been associated with increased risk of experiencing a manic episode. The specifics of this are beyond the scope of this review and again, should be discussed with one’s doctors.
Finally, a healthy lifestyle, including regular exercise, a good diet and a strong social network, is also likely to help you cope with SAD.

Sanam Hafeez Psy.D
New York State Licensed Neuropsychologist and School Psychologist

Dr. Sanam Hafeez is a New York City based Neuropsychologist and School Psychologist.  She is also the founder and director of Comprehensive Consultation Psychological Services, P.C.  She is currently a teaching faculty member at Columbia University.

Saturday, October 10, 2015

Indicator Results for Canadian Hospitals

Find out the results of your healthcare system

Explore your health system

Explore indicators to better understand your health system and the health of Canadians. Search by hospital, long-term care organization, city, health region, province or territory.
Perth and Smiths Falls Hospital

Tuesday, October 6, 2015

How much does a Physician Assistant earn in the US?

 Alexandria, Va.—Compensation for America’s physician assistants (PAs), recognized as one of the top professions in the country, continues to rise, according to new data released today from the 2015 American Academy of Physician Assistants (AAPA) Salary Survey. The median base salary for a PA in 2014 rose to $93,800 a year, a $3,800 increase from 2012. The survey found that in addition to salary, more than half (54%) of all PAs received monetary bonuses and more than 75 percent of PAs receive some other form of additional compensation, such as research stipends, profit sharing, student loan repayment, paid relocation, tuition reimbursement or signing bonuses.

Press Release from AAPA 

The AAPA survey provides high-quality, detailed information on PA compensation and benefits, including base salary, hourly wages and bonus, by region, specialty, employer, setting and experience.

Highlights of the AAPA Salary Survey 2015 include:

  • PAs at critical access hospitals ($115,000), industrial facilities ($115,000), and hospital emergency departments ($101,920) reported the highest median compensation levels. 
  • PAs in the cardiovascular and cardiothoracic surgery specialty reported the highest median base salary ($117,000) followed by interventional radiology ($105,500), emergency medicine ($102,960) and pediatric surgery ($102,500). 
  • PAs with less than one year of experience had a base salary of $85,000, which rose to $89,000 for those with 2 to 4 years, and $96,000 for those with 5 to 9 years’ experience. 
AAPA administered the online survey between February and March, 2015. More than 10,000 AAPA members and nonmembers responded. The sample closely resembles the PA population, with an overrepresentation of responses from AAPA members. More information on the AAPA Salary Survey 2015.

Sunday, September 27, 2015

Senior drivers in the news: testing should start at age 70

Seniors are complaining about the new test rules for Ontario drivers over age 80. I think they should begin at age 70, and all should be road-tested. We restrict new drivers, older drivers tend to get lulled into bad habits. That, and the physical deterioration of old age. I have had a pinched nerve, and couldn't check my blind spot. I stopped driving.
There are many horrible drivers out there. I cannot imagine they get better with age, either!
Kelly Egan, an Ottawa Citizen writer, seems to be advocating!

Senior driver's licence renewal program

Feb. 18, 2014 - Ontario searched high and wide for an easy screening test to help determine if older drivers should be yanked off the road for incompetence. For those over 80, it boiled ...

One day last week, Ken MacLennan rose tentatively to the podium in courtroom 13, a wise old man against the world. On April 21, those rules are to be adjusted. Ontario is asking older drivers to take a vision test, have a driving-record review, join a group education class and take a couple of cognitive tests — basically to ensure their faculties are intact.
MacLennan, like many of his vintage, believes he is being singled out only on the basis of age, though his cohorts tend to drive less, slower and safer than other age groups.

The Canadian Automobile Association is set to launch an online tool to help seniors stay safe behind the wheel. CAA’s senior’s driving website or ‘portal’ to be announced on Tuesday ...

Egan: Deaths among plus-50 motorcyclists soaring across Ontario

Ottawa Citizen-Jun 23, 2015
In 1972, there were 3.7 million licensed drivers in Ontario and 1,934 ... (Of the 55 motorcyclists who died in 2012, 22 were 45 or older. ... twice writing off the motorcycle, including once at the age of 16. 

Wednesday, September 23, 2015

Healthcare appointment #46 –ingrown eyelash follicle

#46 Sept. 22 Eyelid Surgical Centre appointment for 1:30

Hubby's had an ingrown eyelash coming back. We were sent to Ottawa to have it lasered and removed. It irritates the eye and was becoming more frequent after the optometrist removed it three times.
As we age, things just break down. Thank goodness for our healthcare system.

11:45 left the house.

1:04 Arrived. There were 3 forms to fill in, and booties to put on.

They were rerunning a documentary on the Galapogos Isl., highlighting the manner by which Darwin noticed the variation in species, which evolved from island to island, depending up on conditions.
The frigate bird ate the wren, wren uses small stick, branch to dig out grubs. It would have been great to watch, except the room arrangement did not suit the placement of the TVs compared to the chairs.

2:00 Nurse ushered us into the room. BP: 142/85 She told us we'd see Dr. McKewen- anesthetist for pain, discomfort.

2:41 still waiting...I got pretty bored, and my back was hurting.

2:52 Dr. MacDonald arrived: examined the eye, used the microscope, marked the spot. He explained it may or may not be the same follicle. We may have to come back. I hope not. He'd removed one of his own eyelashes similarly ingrown, and it did not return.

They whisked him away into the operating room. The secretary told me 30 minutes. I went outside to sit in the sunshine in the car.
There was a car there, motor running A/C on, while a husband waited for his wife. They left at 3:25. What does Climate Change mean to people with money to burn? Anything? It was a warm day, but not hot. Only 23 C. the high temperature.

2:30 The secretary left, only two cars left in the parking lot, aside from mine. The nurse waved me in, I peeked and could see her. Hubby still had his IV in, they were feeding him a snack, as he'd fasted since 5:30 a.m., and he had a muffin and juice. I hadn't eaten since 10:00 a.m. and was peckish but anxious to beat the rush hour traffic.
Drivers are crazy out there

2:42 Nurse removed his IV, taped him up, gave him an appointment for follow-up, and off we went. Crazy drivers on the road. He can't drive for 24 hours. He has a GP appointment at 11:00 a.m. the next day, Wednesday.

5:01 Arrived Perth to get cream Rx filled. I popped over to buy some frozen dinners.

6:00 Home. Nuked some meals. Relaxed.
I took a photo of his eye. Always good to have an idea of what it looked like post-surgery in case there were complications. There was some bruising under the corner of the eye.

Monday, September 21, 2015

Perth Hospital has a room devoted to palliative care

People are reluctant to use palliative care in institutions. Many patients want to die at home, at the expensive of their caregivers. This is a good balance of care for patient and family. Hospice buildings are far too expensive, with donor fatigue. The government is not supporting this financially, nor are taxpayers.
A place to talk about things that should have been talked about years ago, those things you always meant to say, but could never find the words, or time, or strength, and now get said because the sands in the hour glass are running preciously low.

Friday, September 11, 2015

What really matter at end of life: TED talk

"You can always find a shock of beauty and meaning in what life you have left."
BJ Miller is a hospice doctor who thinks deeply about how to create a dignified, graceful end of life for his patients.