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
Inside this Issue:
from the Hospice: What Everyone
Executive Director A Message from the
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
mental health organizations, both medical/surgical
and psychiatric hospitals and, associate dean of
a graduate school of public health. So, Contact’s
work is in a field with which I have significant
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
Lenore Sherman Valuable Resources
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 firstname.lastname@example.org
their caregivers. to schedule a free
Studies show that presentation. s
the biggest reason
why people don’t
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
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
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 Dynamic-Living.com, 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
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.
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
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.
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
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 Dynamic-Living.com 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
www.dynamic-living.com 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
✦ 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 email@example.com.
system is MedScope America Corporation (www.medscope.org). 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
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
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 www.HomeHealthWares.com.
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 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
PARENTING YOUR PARENTS – COMMUNITY
RESOURCES...GETTING THE HELP YOU NEED
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
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 www.cwimedical.com. s
degrees of absorbency. They’re attached
BECOME A CAPS AFFILIATED SUPPORT GROUP FOR CAREGIVERS
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 www.caps4caregivers.com, which
is the number 1 most visited site when people seek information about
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
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
Along with the support groups in and around San Antonio, www.caps4caregivers.org
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
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
firstname.lastname@example.org. will present 30 minute seminars on a variety of topics relevant
to challenges faced today by children caring for their aging
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
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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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@example.com.
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:
Executive Director Eldercare Locator
(A national directory of community services.)
Director of Senior Services www.aoa.gov/elderpage/locator.html
Board of Directors Family Caregiver Alliance
Dan Weintraub 1-415-434-3388
Chairman www. caregiver. org
Joe Morrison National Alliance
Stephen Moyer 1-301-718-8444
Secretary National Family
Larry Hager www.nfcacares.org
CAPSULE is published
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)
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. CAPS4caregivers.org and click on “Join.”