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Hospice What Everyone Should Know


									 Children of Aging Parents                                    SPRING 2006
AN    I N F O R M AT I V E       NEWSLETTER               FOR       CAREGIVERS

Hospice: What Everyone Should Know
Chances are someone you know would benefit from     Hospice care might be the right choice
hospice care. Do you know someone who has been      for this person and their family. Hospice
to a hospital emergency room several times in the   offers a wide range of services, including:
past 6 months? Someone who spends most of the       ☛ Personal care services
day in bed or in a chair? Who needs help bathing,   ☛ Nursing care
eating, dressing, or cooking? Who seems short of    ☛ Pain and symptom management
breath, even while                                  ☛ Social services
resting? Someone                                    ☛ Spiritual support and counseling
who is overwhelmed
                                                    ☛ Trained volunteers for support services
by the task of
                                                    ☛ Physical, occupational and speech
caring for them?
                                                    ☛ Dietician or nutritionist
                                                    ☛ 24-hour on-call availability
                                                    ☛ Respite care
                                                                            continued on page 3

By Lenore Sherman,
Executive Director, Contact                                 Spring 2006
Greater Philadelphia

                                                        Inside this Issue:
A Message
 from the                                               Hospice: What Everyone
                                                        Should Know.........................1

Executive Director                                      A Message from the
                                                        Executive Director...................2

By way of introduction, my name is Lenore Sherman.      What’s Your
I have been on the Contact Greater Philadelphia         Hospice I.Q.?.........................4
Board for several years and have recently been
asked to become Executive Director. By way of           Medicare’s Ounce
biographic information, I hold an MBA in Health         of Prevention........................5
Administration and have been the administrator of
                                                        Low Vision
mental health organizations, both medical/surgical
and psychiatric hospitals and, associate dean of
a graduate school of public health. So, Contact’s
                                                        CAPS Affiliated
work is in a field with which I have significant
                                                        Support Groups...................7-8
It is quite exciting to observe the Children of Aging
Parents’ hot line work in person. No one knows          Choosing a Medical
better than we how important it is to not only have     Alert System.........................11
a warm body on the end of the 1-800 number who
can identify and help access needed resources           Questions to ask
but, to just listen when sometimes we just want         when purchasing a
someone to “offer a warm shoulder.”                     medical alert system............11
Summers are a time when both our children and
aging parents make demands on us. It’s a time           What Is
when we may need that extra “shoulder” available        Incontinence?.....................12
through our support groups. Sometimes, it’s even
helpful to just stop to inventory and understand the    Diapers or
stresses placed on us to meet loved one’s needs.        Pull Ups?.............................15

        Please accept my best wishes for                Around the Country
             an enjoyable summer.                       Parenting Your
                                                        Parents Community

                    Lenore Sherman                      Valuable Resources
                                                        for Caregivers.....................22
continued from page 1                                                                                 3
In addition, hospice provides all incontinence    hospice education and information programs
supplies, all durable medical equipment such as   to professional and family caregivers, support
hospital beds, commodes, oxygen, etc. – and       groups, care facilities and other organizations
hospice partially pays for medications.           throughout the five-county southeastern
Last year, only                                                                  Pennsylvania
about 20 percent of                                                              area. If you or
patients who were                                                                your group would
eligible for hospice                                                             like to learn more
care in the state of                                                             about the many
Pennsylvania                                                                     benefits of
received it. About                                                               hospice care,
half of those who                                                                please call CAHC
did received it too                                                              at 215-552-0073
late to be of much                                                               or e-mail us at
help to them or                                                        
their caregivers.                                                                to schedule a free
Studies show that                                                                presentation. s
the biggest reason
why people don’t
receive hospice
care is because they
don’t know about it.
The Center to Advance Hospice Care (CAHC)’s       The Center to Advance Hospice Care is funded
mission is to change that. CAHC provides free     by the Home Care Hospice Foundation.

What’s your Hospice I.Q.?
 What you don’t know about hospice can hurt you – and your loved one.
Test your hospice savvy by answering the following true or false questions:
                                                                      services. When further curative treatment becomes
  1. Hospice care is free.                                            unrealistic, however, hospice intervention can
  2. Most Americans die at home.                                      vastly improve the patient’s quality of life – and
  3. Nine out of ten Americans suffer from long, debilitating         help the patient’s family in ways they could
     illnesses which ultimately cause their death.                    never have imagined.
  4. Hospice is only for patients with terminal cancer.               7 TRUE. Not only physical therapy, but also
  5. A patient must have a Living Will in order to receive            speech, occupational, music, and art therapies as
     hospice care.
                                                                      well. Any therapy previously used by the patient
  6. Hospice care is only for patients who are very close to death.   or conditions other than the hospice diagnosis
  7. A hospice patient can receive therapy for other conditions.      can be continued.
  8. Hospice care is not necessary for patients with
     Alzheimer’s or dementia.                                         8. FALSE. Alzheimer’s and dementia patients suffer
  9. Hospice care can continue indefinitely.                          from the same discomforts as those diagnosed
 10. In hospice, the patient and their family are actively
                                                                      with other ailments, with one notable difference:
     involved in all medical decisions.                               they are often unable to express their pain and
                                                                      discomfort in ways that their caregivers can
                                                                      understand. According to a report on end-of-life
Answers:                                                              care from The Hastings Center, this is a big reason
1. TRUE. The cost of all aspects of hospice care is                   why these patients are overlooked for hospice
completely covered by Medicare, Medicaid, and                         care. In advanced stage Alzheimer’s/dementia,
private insurance. In addition to skilled nursing                     patients are often unable to swallow. This
care, home health aides, social workers, spiritual                    brings into play the question about methods of
counseling of any faith, this includes things like                    feeding, the treatment of infections, and the
incontinence supplies, oxygen, hospital beds, many                    administration or withholding of CPR. Hospice
pain and symptom medications, and resources to                        professionals help families explore their choices
help the patient’s family through this difficult time.                and support them in their decisions.
2. FALSE. Most Americans say they would prefer                        9. TRUE. A patient can never outlive the hospice
to die at home, but at least 50 percent (some                         benefit. Hospice benefit periods run 90-90-60:
studies say 73 percent!) of all deaths in the U.S.                    Once a patient is approved for hospice, their first
occur in hospitals. Among patients in hospice                         benefit period is 90 days. After that time, they
care, only 9 percent died in hospitals.                               may be re-certified for another 90-day period
                                                                      with no interruption in service. After that, the
3. TRUE. Only 10 percent of all deaths occur suddenly.                re-certification takes place every 60 days. There
4. FALSE. According to the CDC, more than 50                          is no limit to the number of times a patient can
percent of primary hospice diagnoses are patients                     be re-certified for hospice care. When a patient
suffering from some form of cancer. This does not                     improves, he or she can be discharged from hospice
mean that hospice is exclusively for cancer patients.                 care. If a patient removes himself or herself from
Circulatory and heart disease diagnoses are close to                  hospice care, they are not eligible to re-enter it
30 percent. Other diagnoses include end-stage liver                   until the end of their original certification period.
or kidney disease, Parkinson’s, chronic obstructive                   EG: If a patient begins their first hospice
pulmonary disease (COPD), cerebro-vascular                            certification period on January 1 and wants to
disease (stroke). There are many other diagnoses                      go off hospice care on March 1, they are not
as well, including some labeled as “non-specific.”                    eligible to go back on hospice until the end of
5. FALSE. It is not necessary for a patient to have                   March, the end of their original 90-day period.
either of these in order to receive hospice care.                     10. TRUE. The patient, or the party they designate,
Some patients choose to remain “full code” and                        participates fully in the patient’s care plan. No
be resuscitated – and still remain on hospice.                        decisions about treatment are made without their
6. FALSE. In fact, studies show that half of all                      consent. Treatment options will be presented,
hospice patients are referred to hospice care far                     explained, and discussed, and the wishes of the
too late in their decline for them or their families                  patient or their designee will be respected.
to receive the full benefit of the range of hospice                   The Center to Advance Hospice Care is funded by the
                                                                      Home Care Hospice Foundation.
Medicare’s Ounce of Prevention
                                                                       with Medicare who qualifies for
                                                                       these services can get them
                                                                       whether they get their health
                                                                       benefits from Original Medicare
                                                                       or a Medicare private health
                                                                       plan (such as an HMO or PPO),
                                                                       though someone in a private
                                                                       plan may have different
                                                                       costs or need a referral to get
                                                                       specific services.
                                                                       To learn about all the preventive
                                                                       services covered by Medicare,
                                                                       and the various rules and
                                                                       guidelines for each, log on to
                                                                       Medicare Interactive at the
                                                                       Children of Aging Parents website
A well known axiom says that, “an ounce of prevention is               This internet resource is
worth a pound of cure.” Nowhere is this more evident than in           provided by the Medicare Rights
health care, where a simple screening or vaccination can save          Center, the largest independent
money, time and lives. Medicare covers a range of preventive           source of health care information
services, but many people with Medicare do not take advantage          and assistance in the United
of these benefits and not all doctors know when new preventive         States for people with Medicare. s
services have been added. It is important that everyone with
Medicare learns about these services, so they can get the best             To make a donation in memory or
health care possible.                                                    honor of someone, or to celebrate a
Medicare now covers an initial physical exam, or the                      special occasion, please send your
“Welcome-to-Medicare” exam. Anyone with Medicare can get                           contribution to:
this physical during the first six months after they enroll in             Children of Aging Parents
Medicare Part B. The exam covers the basics with height,                         P.O. Box 167
weight and blood pressure measurements. Also covered is an                  Richboro, PA 18954-0167
electrocardiogram (EKG), which measures the electrical signals           A personalized tribute card will be
that control heartbeat and screens for a variety of heart problems.    sent to the individual being honored or
                                                                          to the family of the person being
Medicare pays 80 percent of the exam’s cost, and either 80
percent or the entire cost of many other important types of
preventive services (in most cases, you must meet your Part B                       Questions?
deductible before Medicare will cover a preventive service).             Call 1-800-227-7294
The preventive services covered by Medicare include screenings
for health conditions like diabetes, glaucoma and breast cancer,
and vaccinations for flu, pneumonia and hepatitis B.
It is important to follow Medicare rules when getting preventive
care, to avoid extra costs. To get some preventive services covered,
you must meet certain age, gender or health requirements. To
get the majority of services, you must have both Medicare Parts
A and B. Some preventive services, like heart disease-related
tests, only require someone to have Medicare Part A. Anyone


M         illions of people have lost their vision
            due to accidents, disease or the aging
process. “Most haven’t lost their appetites or
their desire to remain independent in their own
                                                           have better safety habits when using knives or
                                                           cooking at the stovetop,” advises Tannenbaum.
                                                           There is no need for fear in the kitchen. Accidents
                                                           are caused by carelessness, not by low vision.
kitchen,” says Andrea Tannenbaum, president                You will not need any special equipment to be
of, an on-line Internet store           a successful low vision cook. Many common
with hundreds of products that promote a                   kitchen gadgets and appliances will be suitable.
convenient, comfortable and safe home                      The staff at Dynamic Living has gathered some
environment. “They would like to continue                  tips and ideas for your consideration.
preparing meals for themselves, their families
                                                           Organize the Kitchen
and friends. People who are blind or have low
                                                           In order to be able to find things consistently,
vision can be fabulous cooks, just like people
                                                           tools, spices and other items will need to be
who have the full use of their vision,” she notes.
                                                           stored away in the same place each time. “But
As with any cook, the low vision chef will develop         if a visitor puts something away improperly, you
techniques that make meal preparations easier              may need to find a different way to tackle the
and less time consuming. It is no more dangerous           task until the item shows up again,” suggests
for a person who is blind or has low vision than           Tannenbaum. “It will show up, just like it does in
it is for a person with sight. It is still inadvisable     kitchens where the cook has full use of their vision.”
to leave a potholder on the stove. It is still important
                                                           The same principal applies to storing groceries
to clean up spills quickly before they cause a fall.
                                                           and paper goods you use daily. Plan where to
“The difference may be that the person with                keep each item and be consistent.
low vision needs to be more organized and                                                     continued on page 9

  CAPS Affiliated
Caregiver Support Groups
      The caregiver support groups listed below are
        affiliated with Children of Aging Parents.
CAPS at Bakersfield              Cordia Senior Residence            NewSeasons at Cherry Hill        Dresher Estates
4909 Stockade Highway            865 N Cass Avenue                  490 Cooper Landing Road          1405 N. Limekiln Pike
Bakersfield, CA 93309            Westmont IL 60559                  Cherry Hill, NJ 08002            Dresher, PA 19025
2nd Tuesday, 7 p.m.              2nd Thursday, 7 p.m.               lst Tuesday, 7 p.m.              4th Tuesday, 10 a.m.
661-831-1132                     630-887-7000                       856-482-9395                     215-591-4000
Bella Vita                       River Bay Club                     Kingston Residence of Marion     Sunrise Senior Living
12729 Riverside Drive            99 Brackett Street                 464 James Way                    200 Sunrise Boulevard
North Sherman Oaks, CA 91607     Quincy, MA 02169                   Marion, OH 43302                 Exton, PA.
Call for meeting time and day.   1st Wednesday, 6 p.m.              Last Thursday, 2 P.M.            Last Thursday of month, 7 p.m.
1-818-760-2900                   617-472-4457                       740-389-2311                     610-594-0455
Heron House                      Coyne Healthcare Center            Office for Older Adults          New Seasons of Jenkintown
9731 Commerce Center             66 Webster Street                  246 Northland Drive              Summergate
Ft. Myers, FL 33908              Rockland, MA 02370                 Medina, OH 44256                 440 Old York Road-2nd Floor
2nd Tuesday, 7 p.m.              1st Wednesday, 6:30 p.m.           2nd Thursday, 7 p.m.             Jenkintown, PA 19046
239-278-0151                     781-871-0555                       330-723-9514                     3rd Tuesday, 7 p.m.
Share the Care Wellness Center   Marina Place                       Kingston Residence of Sylvania
Room A                           4 Seaport Drive                    4125 King Road                   Spring Mill Presbyterian Village
2005 Mizell Avenue               Quincy, MA 02171                   Sylvania, OH 43560               2002 Joshua Road
Winter Park, FL 32792            3rd Wednesday, 6-7 p.m.            2nd Monday, 6:30 p.m.            Lafayette Hills, PA 19444
3rd Monday, 7 p.m.               Dinner served                      419-824-4200                     3rd Tuesday, 7 p.m.
407-423-5311                     617-770-3264                                                        610-260-1175
                                                                    New Seasons Assisted Living
Provena St. Joseph Hospital      Alterra Clare Bridge of            Communities at Mountainview
MOB 2– St Luke Room 2nd fl.      Hamilton                           2232 29th Street SW
1975 Linlar Lane                 1645 Whitehorse-Mercerville Road   Allentown, PA 18103
Elgin, IL 60123                  Hamilton NJ 08619                  4th Wednesday, 7 p.m.
1st and 3rd Mondays, 7 p.m.      Call for meeting details           610-797-4651
847-695-3200 ext. 5767           609-586-4000
                                                                    New Seasons of Bensalem
Independence Village             CareOne at Hamilton                Hill House
1030 Aurora Avenue               1660 White Horse                   6400 Hulmeville Road
Napierville IL 60540             Hamilton Square Road               Bensalem, PA 19020
3rd Thursday of month, 7 pm      Hamilton, NJ 08690                 4th Saturday Every Other
630-357-3922                     Call for meeting details           Month, 11 a.m.
                                 609-586-4600                       215-752-9140
Adelaide Retirement Village
505 N. Adelaide Street           Princeton Senior Resource Center   Mill Run Assisted Living
Normal IL 61761                  Suzanne Patterson Center           1201 Wilson Avenue
Call for meeting details         45 Stockton Street                 Bristol, PA 19007
309-531-2117                     Princeton, NJ 08540                3rd Wednesday, 2 p.m.
                                 Call for dates and times           215-788-3310
Casa San Carlo Retirement
Community                                                           Living Care Home Services
420 N. Wolf Road                 Chelsea at Tinton Falls            875 N. Easton Road
Northlake, IL                    One Hathford Drive                 Doylestown PA 18901
3rd Wednesday, 6-7 p.m.          Tinton Falls, NJ 07701             Call for meeting details
708-492-3535                     4th Tuesday, 7 p.m.                215-348-4008
CAPS Support                      The Wayne Senior Center
Heathergate at Oxford Valley      108 Station Road
(near Oxford Valley Mall off      Wayne, PA 19087
Woodbourne Road)                  2nd & 4th Thursday, 3:15 p.m.
8101 Fonthill Road                610-688-6246
Langhorne PA 19047
1st Tuesday, 7:30 pm
                                  Spruce Manor Nursing &
                                  220 South 4th & Spruce Street
Riddle Memorial Hospital
1068 W. Baltimore Pike
Medical Library-Mezzanine Level
                                  West Reading, PA. 19611
                                  3rd Wednesday, 6 p.m.
Media, PA 19063
                                  Willow Lake Assisted Living
2nd Thursday, 7 p.m.
                                  1120 York Road
                                  Willow Grove PA 19090
The Residence at Glen Riddle      2nd Wednesday, 7:30 pm
263 Glen Riddle Road              215-830-0433                       The CAPSule is published four times a year.
Media, PA 19063                                                      Call 215-355-6611 or toll-free 1-800-227-7294 for
                                  The Oaks Assisted Living
Last Wednesday, 7 p.m.                                               copy deadlines and ad specifications.
                                  240 Barker Road
                                  Wyncote, PA 19095
Sterling Glen of Center City                                         Ad Size                                   Cost per         Cost per
                                  4th Wednesday, 5:30 p.m.
150 N. 20th Street                                                                                           Single Issue      Four Issues
Philadelphia, PA 19103                                               Business Card (3 3/4” W X 2 1/4” H)        $ 35            $ 100
                                  Evergreen Adult Day Program
2nd Monday, 7:30 p.m.
                                  551 E. Evergreen Avenue            1/4 Page (3 3/4” W X 4 7/8” H)             $ 50            $ 185
                                  Wyndmoor, PA. 19038                1/2 Page (7 3/4” W X 4 7/8” H)             $ 100           $ 325
Philadelphia Protestant Home      3rd Wednesday, 7 p.m.
6500 Tabor Road9                  215-233-6309                       Full Page (7 3/4” W X 10” H)               $ 195           $ 750
Philadelphia, PA                                                     Full Page Insert (8 1/2” W X 11” H)        $ 500           $1,600
                                  Poplar Estates Retirement Center
Call for details: 215-214-6638
                                  1310 Rosewood Drive
Temple East, Inc.                 Columbia, TN 37027
Neumann Medical Center            Call for dates and times           Helotes Counseling Center            Jewish Family and Children's
1741 Frankford Avenue             931-381-8405                       13438 Bandera Road, Suite 105B       Services, Inc.
4th Floor Adult Day Care Center                                      San Antonio, TX
                                  Sears Methodist Center                                                  12500 NW Military Drive
Philadelphia, PA 19125                                               2nd Thursday, 6:15 pm
                                  3202 S. Willis Street                                                   1st Thursday of each month
3rd Thursday, 2 p.m.                                                 Facilitator: Sylvia Moore, MA, LPC
                                  Abilene, Texas 79605                                                    first meeting 10/6/05 7 pm
215-291-2122                                                         210-695-1788
                                  Last Tuesday, 7 p.m.                                                    Contact: Dana L. Schilling 288-2724
Alterra Wynwood-                  325-692-6145                       Wesley Community Center              My Brother's Keeper
Northampton                                                          1406 Fitch Street
                                  Silver Standards, Brighton                                              Residential Care Home
65 Richboro-Newtown Road,                                            San Antonio, TX
                                  Gardens Assisted Living                                                 Kingsley Place Assisted Living
Route 322                                                            2nd & 4th Wednesday, 6 p.m.
                                  4401 Spicewood Springs Road                                             9000 Floyd Curl Drive
Richboro, PA 18954                                                   Bilingual Facilitator:
                                  Austin, TX 78759                                                        San Antonio, Texas 78240
4th Wednesday, 7:30 p.m.                                             Marie Bazan, BA
                                  3rd Tuesday, 6 p.m.                                                     3rd Tuesday, 6:30 p.m.
215-357-6565                                                         210-359-7687
                                  512-472-1845                                                            210-521-8668
Moses Taylor Hospital                                                Hearthstone Assisted Living
                                  Cedar Park Police Department                                            Richland Rehabilitation Center
700 Quincy Avenue                                                    6849 Crestway
                                  Conference Room                                                         and Eagle Assisted Living
Scranton, PA 18510                                                   San Antonio, TX
                                  911 Quest Parkway                                                       1745 Pike Avenue
2nd Thursday, 7 p.m.                                                 4th Thursday, 6:15 pm
                                                                                                          Richland, WA 99354
                                  Cedar Park, TX 78613               Faciliator: Jim Vaughn, MBA, CSA
570-340-2362                                                                                              Call for Details: 509-946-2717
                                  Second Tuesday, 6 p.m.             210-946-4994
Cordia Senior Residence           512-218-9555                                                            Laurel Oaks Retirement
865 N Cass Avenue                                                                                         Community
Westmont IL 60559                                                                                         1700 W. Bender Rd.
2nd Thursday, 7 p.m.                                                                                      Glendale, WI 53209
630-887-7000                                                                                              3rd Wednesday, 7:00 PM

 As the role of caregiving continually increases with the aging of America, many more support groups are needed.
  Please consider starting a CAPS affiliated support group in your work place, church, library, or other location.
continued from page 6                                                                                   9
When you can, store food in different types of       need at hand as you need it. “To prevent
containers. If you buy your canned goods in          bumps and bruises, keep cabinet doors either
varying sizes, you will be able to tell the peas     open flat or fully closed,” cautions Tannenbaum.
from the green beans. If that is not possible,       “Close drawers once the items have been
you can make up index cards with large print,        removed or stored away.”
strokes of color or Braille on them and secure
these cards around each container with a rubber
band. If you use cards on cans, keep them set
aside in a safe place as you consume the contents.
The cards then become a convenient shopping list!
Grocery shopping can be accomplished
different ways, depending on time and the
services available to you. “Many markets have
employees who will shop with you or you can
shop with a friend,” explains Tannenbaum.
“You can also shop online or by phone and
have the groceries delivered to your home.”
                                                     Touching food is okay if your hands are clean.
Food Preparation                                     Many cooks have always used their hands to
Consider prepared foods or frozen vegetables         squish out lumps in the batter or to kneed
to cut down on time spent in the kitchen.            dough. You may need to wash your hands a
Ask the butcher at the market to quarter the         little more frequently. Or you can get used to
chicken or cube the beef for you.                    the feel of textures at the end of a spatula or
Organize equipment and supplies before               spoon. Is it slower to stir because it is
beginning each task so you have what you             thickening? Is there more left in the bowl
                                                     because the surface isn’t smooth yet? If you
                                                     drop the batter or liquid from a spoon into the
                                                     pot, does the resulting drop sound right?
                                                     To pour a liquid, use your finger to align the
                                                     edge of the pot, pitcher or coffee pot with the
                                                     edge of the cup or bowl. Raise the pot slightly
                                                     and move the edge over the cup while you
                                                     pour. “Practicing over the sink a few times
                                                     should enable you to pour with confidence,”
                                                     suggests Tannenbaum. “Listen for the sounds
                                                     as the cup fills, feel the weight, estimate the
                                                     time; all are cues for when the cup will be
                                                     full.” An alternative is liquid level indicators
                                                     that beep when the liquid is close to the edge.
                                                     Use big print or color coded measuring spoons
                                                     and cups. Or mark the ones you use most
                                                     frequently with tactile cues that won’t wash off.
                                                     “Cookie trays make a terrific surface to prepare
                                                     food on,” suggests Tannenbaum. “Any spills or
                                                     runaway pieces are confined and can be
                                                     moved to a sink for easy cleanup. Similarly,
                                                     do your grating or chopping or slicing directly
                                                     into a bowl.”
                                                                                     continued on page 10
continued from page 9
A damp cloth or a Dycem non-slip mat can be                 keep it simple. For example, on a stove, mark
used to prevent bowls or plates from slipping               every 100 degrees. It will be easy enough to set the
away. There are also bowls specifically                     dial at quarter points once you are oriented properly.
designed with a non-slip base.                              Microwave templates can be etched or have
A Stir Chef automatic pot stirrer will keep an              tactile markings added as described above. Be
eye on sauces that need constant attention and              aware not to block heat sensitive portions of the
a Pan Holder will keep pan handles in the same              template. It is also possible to find inexpensive
place so you don’t have to feel for their position.         microwaves that still have dial features rather
                                                            than templates.
Cooking                                                     “Use your other senses, too,” advises Tannenbaum.
Use the end of the spatula or fork to locate                “Listen for when the eggs boil or feel the
meat in the fry pan before flipping.                        vibration of the boiling water on the handle.
Many appliance knobs and dials come with                    Does it smell like it is almost done cooking?”
existing tactile cues, like a raised letter, and            Or use a tactile or talking timer.
indent or even a screw. There should also be a              There’s no reason to be afraid to step into the
reference point on the background surface. If               kitchen to prepare a snack or a meal. For any
there is nothing there, or not enough variations,           cook, careful work habits will reduce accidents.
you can file a small notch, apply bump dots,                For the low vision cook, organization will go a
drops of glue or nail polish. If there is enough            long way to reducing frustration. Take your
room, you can use felt or Velcro dots to help               time, do some experimenting, have some fun.
you identify specific locations.                            Great meals are waiting for your creative touch!
“You can remove most knobs to apply a marking on   is an on-line store with hundreds of
the surface behind the knob,” notes Tannenbaum.             products that promote a convenient, comfortable and
Make sure you don’t obstruct the ability to re-seat         safe home environment. The store can be accessed at
                                                   or call 888-940-0605 for more
the knob properly. Use minimal markings to                  information. s

                                                              Are You Providing 24-Hour Care for
     Bucks County Area                                            an Elderly Family Member?
      Agency on Aging
 The AAA offers more than 20 programs to help older            Two Great                1. Your Loved one
                                                                                           receives quality care
    adults and their caregivers. Services include:             reasons to                  in a safe, supportive
 5 Care Management Services        5 Insurance Counseling      share the                   environment.
 5 Nursing Home Assessment         5 In-Home Services
 5 Health Promotion                5 Nutritional Services      caring with              2. You have time to
 5 Adult Day Care                  5 Transportation
 5 Employment Assistance           5 Senior Centers            BEELONG                     take care of yourself
    5                                                                                      so your loved one
      Retired and Senior Volunteer Program (Age55+)
                                                               Adult Day                   continues to benefit
      Phone: 215-348-0510 FAX: 215-348-9253                    Services                    from the care that
    Protective Services and TDD: 1-800-243-3767                                            only you can provide.
                                                                     Caring is our specialty. Call today.
     Office Hours: 8:30 AM–4:30 PM, Mon. – Fri.
                                                              BEELONG Adult Day Service
     Serving Older Adults and                                       Administrative Office: 215.322.2371
    Their Families for 40 Years                                Bristol    Fallington Huntingdon Valley Warrington
                                                            215.788.2408 215.295.6665 215.322.5946 215.343.6250
Choosing a Medical
Alert System                                 By Gregory Smith

There are several types of medical alert systems. Each company
seems to give you a different price, service, and explanation of
how they work.
So how do you choose a Personal Emergency Response System
(medical alert system) with the time finally comes? When
choosing a medical alarm you must first look at the company
and the services they provide. How reliable is their equipment?
Do they offer 24-hour assistance? How fast is their response?
These are just a few of the questions you have to ask yourself
before determining what service to go with.
Most medical alert systems are connected to your existing phone
line. They connect using standard telephone wires (similar to an
answering machine). Once the unit is hooked up, you’ll want to      Questions to ask when
test the system to ensure proper connectivity. When the unit is         purchasing a
activated (as you test), you will be able understand the volume     medical alert system:
at which the speaker operates. Most consoles use a very loud
speaker and sensitive microphone so you’ll be able to               ✦ How fast is the
communicate with an emergency operator throughout your                response?
entire home.                                                        ✦ Does the console have
                                                                      a rechargeable battery?
Most alarms also feature a wireless, water-proof transmitter
                                                                    ✦ Is the console
(normally you have a choice between a necklace or wrist strap)        attached to your
that interacts with the console when help is needed. The              existing phone line?
console, located near the telephone, will immediately call or       ✦ What if the phone is
notify a trained professional (when the emergency button is           busy during an
pressed) who will communicate with you over the console. The          emergency?
trained professional will then dispatch the appropriate help        ✦ Is the wireless
(ambulance, police, or fire departments). If there is no answer,      transmitter
help will be dispatched automatically.
                                                                    ✦ Is there a guarantee
The operator will also inform any friends or family members           on parts, labor, and
that you would like to be notified (this information is collected     services?
ahead of time). Medical alarms are great for expecting mothers,     ✦ How far can the
the elderly, handicapped, or diabetic patients.                       transmitter
                                                                      communicate with
                                                                      the console?
                                                                    ✦ What is the monthly
Most companies will rent the equipment to you for as long as          fee?
you need it – at no cost. The fees that you incur are usually for
                                                                    ✦ Any other charges.
the installation of the equipment, and the monitoring of that         Setup, Activation, or
equipment. To clarify, there is a monthly fee you pay to have         Termination Fees?
that equipment monitored 24-hours a day by a team of response
operators. The installation fee ranges from $0 - $100 and monthly   Greg Smith of MedScope
                                                                    America Corporation can be
monitoring fees range from $30 - $75. One company that I am
                                                                    reached at 1-800-645-2060 or
aware of that charges no installation fee for their medical alert   by e-mail at
system is MedScope America Corporation ( s

What Is Incontinence?
                                                                            By Noah Lam

   Urinary incontinence is the inability to
                                                   Incontinence is Treatable
                                                   The successful treatment of incontinence
  stop urine leakage. Incontinence can be
                                                   begins with an accurate diagnosis. Then you
embarrassing in that it interferes with living
                                                   and your doctor can discuss your treatment
  a normal, full life. But there are several
                                                   options. These may include certain
 ways to control it. This article explains the
                                                   medications, exercises and other therapy to
 different types of incontinence along with
                                                   help strengthen muscles, procedures to help
    management and treatment options.
                                                   stop leakage, or surgery. Incontinence can be
                                                   controlled and, in many cases, even cured.
Incontinence is Common                             Types of Incontinence
If you have trouble controlling your bladder,
                                                   There are different types of incontinence: urge
you are not alone. Loss of bladder control is a
                                                   (also known as overactive bladder), stress, and
common problem, shared by millions of
                                                   overflow. You may have only one type. Or you
Americans. Incontinence can rob you of sleep
                                                   may have urge incontinence along with one
and leave you exhausted. It can make travel
                                                   of the other types (mixed incontinence). All
awkward and keep you from enjoying physical
                                                   people with incontinence have bladder control
activity. Despite these frustrations, fewer than
                                                   problems. But each type of incontinence has
half the people with incontinence seek help.
                                                   its own pattern of signs and symptoms. You
Many feel too embarrassed, while others don’t
                                                   can identify your type by comparing these
realize that help is available.
                                                   typical patterns.               continued on page 14
continued from page 12                             When You’re Continent
People with urge incontinence or                   Continence means you have control over your
                                                   bladder. You can hold urine in or let it out
overactive bladder may:
                                                   when you choose. For example, you may be
• Wet themselves if they don’t get to a
                                                   in a situation where it is not convenient to
   bathroom immediately
                                                   get to the bathroom. Even if your brain gets
• Get up frequently during the night to urinate
                                                   the message that your bladder is getting full
• Go to the bathroom at least every two hours
                                                   and you feel the desire to urinate, you can
• Feel they have a weak bladder. Each drink
                                                   consciously tell your system to wait to expel
  of coffee, cola, or alcohol seems to cause
                                                   the urine until it is convenient.
  urination out of proportion to the amount
  they actually drink                              When You’re Incontinent
• Wet the bed at night                             Incontinence means loss of bladder control. It
People with stress incontinence may:               occurs when any part of the urinary system
• Leak urine when they cough, sneeze, or laugh     fails to function. Both men and women may
• Go to the bathroom more frequently in order      develop overactive bladder, stress incontinence,
   to avoid accidents                              overflow incontinence, or mixed incontinence.
• Avoid exercise because they are afraid it will   Women are more likely to develop incontinence
  cause leaks                                      than men because their internal organ structure
• Sleep through the night, but leak upon getting   is different to allow for childbirth. Pregnancy,
  up from bed in the morning                       childbirth, and decreased levels of the female
• Sometimes leak urine when they get up from       hormone estrogen can weaken pelvic floor
  a chair                                          muscles, allowing organs such as the bladder,
                                                   urethra, and uterus to shift out of place (prolapse).
People with overflow incontinence may:
                                                   This may cause incontinence and a feeling of
• Get up frequently during the night to urinate
                                                   pressure or that something is slipping. Men
• Take a long time to urinate and have a
                                                   have fewer incontinence problems because the
  weak, dribbling stream with no force
                                                   shape of the male urinary tract and longer
• Urinate small amounts and not feel
                                                   urethra offer more support.
  completely empty afterward
• Dribble urine throughout the day                 Urge Incontinence and
• Feel the urge to urinate, but sometimes can’t    Overactive Bladder
People with mixed incontinence have a              MEDICAL HISTORY
combination of the above signs and symptoms.       Your medical history may show that you have
                                                   been experiencing persistent and extreme
                                                   urgency, even after urinating. You may have
                                                   wet the bed as a child, because overactive
                                                   bladder can occur temporarily in childhood,
                                                        continued on page 15
continued from page 14                                                                                                         15
then reappear in adulthood. Overactive bladder
often reappears after menopause, because hormonal
changes can weaken the external sphincter.
                                                         Diapers or Pull Ups?
                                                        Buying Incontinence Products for Your Loved One
Your history may include prior pelvic surgery,
back problem, nerve problems, or infections.           Millions of Americans experience incontinence,
                                                       the loss of bladder or bowel control. Many of
Stress Incontinence                                    these people suffer in silence because they are too
                                                       embarrassed to talk about it, even to their doctor.
Stress incontinence occurs when pelvic floor
muscles have become weak and pelvic organs             If you know or suspect that your loved one is
slip down (prolapse). As a result, the bladder         experiencing difficulty with bladder or bowel control,
                                                       let them know they are not alone. Encourage
neck is not in the correct position. When              them to speak with their doctor to find out what
activity such as lifting heavy objects, coughing,      is causing the incontinence and what treatment
laughing, sneezing, or getting up from a chair         options may be available.
increases pressure on the abdominal cavity and         In addition to medical treatments, a doctor may
the bladder, the bladder neck opens. If the            recommend the use of absorbent undergarments
external sphincter is also weak, urine leakage         to help manage incontinence. Choosing the most
occurs. In people with mixed incontinence,             appropriate undergarment for your loved one’s
                                                       needs can help them manage their incontinence
overactive bladder is also present.
                                                       discreetly and comfortably.
                                                       The following guide will help you understand
Women who have had one or more pregnancies             some of the product options available and what
and deliveries often develop stress incontinence.      level of incontinence they are recommended for.
That’s because pregnancy and delivery may              Before shopping you should know the person’s
stretch, relax, and weaken the pelvic floor            waist and hip size to ensure a proper fit.
                                continued on page 16   Pull Ups/Underwear – Designed to pull on over the
                                                       hips like underwear. Some feature tear-away sides
                                                       for easy removal. Recommended for moderate to
                                                       heavy incontinence.
                                                       Briefs/Adult Diapers – Designed like a diaper.
                                                       These are fastened around the hips with adhesive
                                                       tabs for a secure fit. Recommended for moderate
                                                       to heavy incontinence.
                                                       Undergarments – Similar to briefs or diapers,
                                                       these are belted around the hips. Recommended
                                                       for moderate to heavy incontinence.
                                                       Pants – Most pants pull on over the hips like
                                                       underwear, and are designed for use with liners
                                                       or pads. They come in several styles including
                                                       panties and boxer shorts. Many styles are washable/
                                                       reusable. Recommended for light incontinence.
                                                       Liners, Pads, Guards and Drip Collectors – Designed
                                                       to be worn inside of underwear. These may be
                                                       worn with protective underwear or pants for added
                                                       protection. Recommended for light incontinence.
                                                       Underpads/Chair pads – These are designed to
                                                       protect bedding and furniture. Washable and
                                                       disposable pads are available.
                                                       HomeHealthWares has been delivering medical equipment and
                                                       supplies directly to the home since 1999. Their online store offers
                                                       reduced prices on more than 15,000 home medical and personal
                                                       care products, including a large selection of incontinence solutions.
                                                       Orders can be placed online 24 hours a day and usually arrive at
                                                       the home within two business days. To speak with a customer support
                                                       expert about incontinence solutions or other home medical supplies,
                                                       please call (800) 994-7771 or visit them at
continued from page 15                                  16
 muscles. Lowered estrogen levels during
menopause also weaken and thin these muscles
and surrounding tissues. Prior pelvic surgery
can affect the position and tone of the organs
and muscles. Men may experience temporary
stress incontinence after prostate surgery. You
may also notice your symptoms are worse if you
suffer from a cold, bronchitis, or allergies.

Overflow Incontinence
Overflow may result when scar tissue or prolapsed
organs make the urethra narrow, blocking urine
from flowing when you try to urinate. In women,
it may arise temporarily due to swelling after
pelvic surgery or childbirth. In men, it may be
caused by an enlarged prostate. Or it may occur
if the bladder stops contracting because of
medications, injured nerves, or overstretching of
the bladder tissue. As a result, the bladder stays
full, and constant pressure on the bladder neck
results in urine leakage. Some people with
overflow incontinence also have overactive
bladder (mixed incontinence).
                                 continued on page 18

           Around the Country
Finding assistance for your aging parents can       ✰ Mom/Dad fell and broke her/his hip and
be quite time consuming. With parents living           is being discharged home, what do we as
longer, children of aging parents are faced with       a family do?
making difficult decisions about how to care        ✰ Does Mom/Dad have advanced
for their parents and are seeking information to       directives?
help their parents live the highest quality of      ✰ Where can I find someone to help
life obtainable.
                                                       Mom/Dad while I go back to work?
Some frequently asked questions are:                ✰ What is Long Term Care Insurance?
  ✰ Is there an agency that can assist with
                                                   These are only some of the questions asked
     getting mom or dad help with prescriptions?
                                                   by today’s baby boomers caring for their
                                                   aging parents.                continued on page 19
continued from page 16                                                                                                       18
MEDICAL HISTORY                                                              to underwear and can be worn under
Your medical history may indicate that                                       normal clothing.
your urine stream is getting weaker, and                                     Adult Briefs – These are bulkier than pads
that it takes you a long time to urinate.                                    but are more absorbent. They’re fastened with
You may be experiencing a dull ache in the                                   self-adhesive tape.
lower abdomen, low back pain, or have
                                                                             Bed Pads – Bed pads protect the bed linens
accidents during the night. Women may have
                                                                             and mattress at night. They are available in
a feeling or fullness in the vagina. Causes
                                                                             different sizes and absorbencies.
include childbirth, previous pelvic surgery,
prostate problems, and diabetes, medications                                 Skin Care – Prolonged contact with urine is
that hinder bladder contractions, constipation,                              very irritating to the skin. Keeping yourself
nerve or muscle problems, and a history of                                   clean and dry will reduce skin rash and odor.
sexually transmitted disease.                                                Wash with mild non-deodorant soap and
                                                                             avoid harsh detergents. Special cleansers
Absorbent Products                                                           and protective creams and powders are
Products that absorb urine are available in both                             available. Specially formulated deodorant
disposable and reusable forms. They may be used                              tablets, taken daily, may further help
temporarily until your treatment has a chance to                             control odor.
work, if the treatment yields less than perfect
results, or if you undergo no treatment. By                                  Mr. Lam’s company, CWI Medical, is a full line
reducing wetness and odor, they help keep you                                medical supply company specializing in
mobile, functioning, and comfortable.                                        medical nutrition, incontinence and ambulatory
Absorbent Pads – Pads come in varying                                        products. It is located at s
degrees of absorbency. They’re attached

     Since 1977, Children of Aging Parents has established a national reputation as a leader in working with
  caregivers to find support and assistance in their difficult moments of caring for an aging parent or other loved
    one. We invite your organization to be come affiliated with CAPs in establishing a support group for your
      organization or community. Here are some of the benefits of affiliating your support group with CAPS;

  1. CAPS provides the only national not-for-profit helpline for the wide range
    of caregiving and aging issues. Many of our callers are seeking support
    groups and you will be recommended for callers from your local area.
  2. Your group will be listed on our Web-site, which
     is the number 1 most visited site when people seek information about
     caregiving issues.
  3. You will receive up to 10 copies of our quarterly newsletter which
     is written to provide helpful and practical information for the caregiver.
  4. CAPs will provide you with resources and materials to organize
     and support your group.
  5. You may attend CAPS bi-annual facilitators’ in-service training.
  6. CAPS groups provide increased public visibility for your organization
     and provide a valuable service for persons within your community.

    Your organization can be affiliated with CAPS for a one time affiliation fee of $100.00 and annual dues of $100.00
                                             Please call Karen Rosenberg 215-355-6611
continued from page 17                                                                            19

                                                                      Children of Aging Parents

                                                                      Caring for the caregiver
                                                                      for more than 25 years
                                                                        Won’t you please
                                                                        help us continue
                                                                         our mission to
                                                                       meet the needs of
                                                                           the growing
                                                                          population of
                                                                       caregivers? Send
Several companies have recognized a need to help provide               your tax-deductible
information and support to individuals in San Antonio and                contribution to:
the surrounding area. They have joined a nationwide
non-profit support agency called Children of Aging Parents
(CAPS). The purpose of CAPS is to assist children caring for
                                                                      Children of Aging Parents
their elderly parents by providing information, referrals and                P.O. Box 167
support and to assist them in managing the changes in the             Richboro, PA 118954-0167
family dynamics.
Along with the support groups in and around San Antonio,    
Oak Hills Church will be hosting Jim Comer, author of
Parenting Your Parents on September 9, 2006. In 1996 Jim
Comer moved back to Texas and made the transition from
child to parent of his parents. His father had suffered a
stroke and his mother had beginning Alzheimer’s. Jim
chronicles the ups and downs of becoming an overnight
parent in this heartwarming, often humorous talk, filled
with practical insights for those who face similar challenges.
Some topics Jim will cover include:
  ✰ Dealing with denial and asking the hard questions that
    parents – and children - don’t want to discuss.
  ✰ Keeping a sense of humor and perspective.
  ✰ Finding a geriatric care manager or home health agency
    that can help parents get the care they need at home.
  ✰ Getting the legal documents every family must have ––
    wills, powers of attorney and advanced directives.
  ✰ Learning about Long-Term Care insurance: can your
    parents qualify for it and afford the premiums?
                                                                      YOU ARE NOT ALONE!
  ✰ Finding an ethical elder law attorney to help plan for            Helpline: 1-800-227-7294
    their estate.                              continued on page 20
                                     continued from page 19                                           20

  Have You Renewed
  Your CAPS
    Remember, to continue
   receiving your copy of the
   CAPSule newsletter, your
    membership in Children
   of Aging Parents must be
     current. If you are not
       sure whether your
  membership is current, you
   can call 215-355-6611 or
                                    Following this engagement, a workshop will be conducted
       send an email to             at Park Hills Baptist Church on September 30, 2006. Speakers         will present 30 minute seminars on a variety of topics relevant
                                    to challenges faced today by children caring for their aging
                                    loved ones.
                                    During this event individuals will have the opportunity to
Online                              gather additional information from organizations on resources
                                    available within the community and the various ways to assist
Discussion                          their loved ones. Both of these venues are free to the public.
                                    Whether your parents are next door or in another town, you
Group for                           will need information, resources and support to help care for
                                    them. For more information about local support groups and
Caregivers                          about the event and the community resource fair please call
                                    Yolanda at Vitas 210-348-4000.
Children of Aging Parents has
                                    Editor’s note: This article was submitted by Dana L. Schilling
provided an online discussion
group for caregivers to share
                                    Marketing Director/Caregiver Comfort Keepers 3355 Cherry
experiences and get support.        Ridge #102 San Antonio, Texas 78230; 210-684-7080. s
To sign up, go to and
click on the “Join Now” button
on the left side of the page.            Support the
Once you have joined, any message     Caregivers in Your
you send will go to all other
group members. The more people           Community
who join and use the service, the
                                             If you would like to start a
more support each will be able to
                                         Children of Aging Parents Support
provide and obtain. So, join now
and see how other caregivers are         Group in your community, please
meeting the challenge.                       contact Karen Rosenberg at
     s s s s s s

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Isn’t that how your “Nest Egg” grew?                                                              and Medical Supply
       Now, you deserve to know                                                                    701 Bristol Pike • Croydon, Pennsylvania 19021
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❒  Elder Wealth Management              Rosemary
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of your estate these will be our                                                                    Full Pharmacy services accepting most
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                  Help a Friend
       Do you have a friend or relative whom you feel
     would find the CAPSule helpful? If so, send us his
       or her name and address and we will send an
     issue out free of charge. You can also send the
    information via email to
    Email Address:


    Street Address:

    City:                                              State:                  Zip:

    Your Name and Telephone:

    If you have more than one person you would                                                       CAPSule
    like to have the newsletter sent to, just put                                                    PO Box 167
    their information on another sheet of paper
    and include it with this form. Send it to:                                                       Richboro, PA 18954-0167

 Who We Are                    Valuable Resources
 Children of Aging Parents       Children of Aging Parents              for Caregivers:
 Lenore Sherman
 Executive Director              Eldercare Locator
                                  (A national directory of community services.)
 Karen Rosenberg
                                  1-800- 677-1116
 Director of Senior Services
 Board of Directors              Family Caregiver Alliance
 Dan Weintraub                    1-415-434-3388
 Chairman                         www. caregiver. org
 Joe Morrison                    National Alliance
 Vice Chairman
                                 for Caregiving
 Stephen Moyer                    1-301-718-8444
 Chuck Thompson
 Secretary                       National Family
 Reynolds Baldwin
                                 Caregivers Association
 Larry Hager            
 Robert Larson
 Larry Liberti
                                                                                    CAPSULE is published
 Patricia Markel
 Matt Musgnung                                                                      quarterly by Children of
 Audrey Tucker                                                                    Aging Parents, P.O. Box 167
                               Children of Aging Parents                            Richboro, PA 18954-0167.

Please consider a CAPS membership as a gesture of your support.
Your membership helps us to continue to care for those who care. CAPS relies
on annual membership dues, grants, bequests, deferred gifts, endowments, and
your “In Memoriam”donations. All are tax deductible and gratefully accepted. CAPS
members receive the bi-monthly newsletter. (Please call, or print and mail this form)

Email Address
Name                                                                        Phone
City                                                   State                      Zip Code

Send $25 (check or money order) for an individual caregiver membership to:

                                         Children of Aging Parents
                                         P.O. Box 167
                                         Richboro, PA 18954-0167
        Children of Aging Parents

   Other membership options are available. For information, please call CAPS at 800-227-7294
      or 215-355-6611, or visit our web site at www. and click on “Join.”

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