Show notes-

Mourning Dove Medical Presents Dr. G at the Heart of Healthcare 

National Assisted Living Week #NALW

ALF week September 10-16, 2023: "Season of Reflection" https://www.ahcancal.org/Education-Events/Pages/NALW.aspx

Special guest- Gus Fernandez pharmacist owner and administrator of La Jolla Senior Care Homes

Mission-Educate & Empower in three parts, helping listeners ‘SEE’ what’s needed to navigate the healthcare system.

1. Story (theme) Dr. G met Gus & Jennifer at community event, discussed families often in CRISIS MODE. Decision point comes quickly due to an illness. Discussed ways to prevent the crisis, hold their hand, educate on milestones of declining health of seniors and when to consider placement at a Board & Care. “Be prepared, study landscape”

2. Educate -Teaching point what is an RCFE? Residential Care Facility for the Elderly. A “home-like setting” with 24hour caregivers. Next best thing to home, 6 residents, “personalized and boutique” compared to a large Assisted Living community. RCFEs are heavily regulated on the State level by Title 22 in California https://www.cdss.ca.gov/inforesources/letters-regulations/legislation-and-regulations/community-care-licensing-regulations/residential

3. Empower -A valuable a resource lajollaseniorcarehomes.com

Website info https://mourningdovemedical.com

Video podcast https://youtu.be/8iIeoHGiOCU?si=fDVTQUgrOvb-ZkRD #hapc #EducateAndEmpower #PeaceOfMind #SeniorCare #BoardAndCare #NALW

Show notes-

Mourning Dove Medical Presents Dr. G at the Heart of Healthcare 

Special Guest Jason Swisher Physical Therapist & Owner at Coastal Mobile Therapy https://www.coastalmobiletherapy.com

Mission-Educate & Empower in three parts, helping listeners ‘SEE’ what’s needed to navigate the healthcare system.

1. Story (theme) Dr. G’s NFL son is receiving physical therapy PT after a surgery.

2. Educate -Teaching point PT is also an important component for seniors during the late stages of life. Beneficial for individuals with loss of ADL independence and at risk of falling. Hospice CoPs § 418.72 Condition of participation: Physical therapy, occupational therapy, and speech-language pathology. Physical therapy services, occupational therapy services, and speech-language pathology services must be available, and when provided, offered in a manner consistent with accepted standards of practice” https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-418 ; ARTICLE “Assessment of the effects of a multicomponent, individualized physiotherapy program in patients receiving hospice services in the home” https://www.cuanschutz.edu/graduate-programs/palliative-care/blog/palliative-care-blog/assessment-of-the-effects-of-a-multicomponent-individualized-physiotherapy-program-in-patients-receiving-hospice-services-in-the-home Bottom line “It certainly informs this author’s continued practice to allow physiotherapy referrals for incoming hospice patients for whom rehabilitative activities are an important part of maintaining quality of life for as long as possible.”

3. Empower -A valuable a resource https://www.coastalmobiletherapy.com

Website info https://mourningdovemedical.com

Hashtags #hapc #EducateAndEmpower #PeaceOfMind #PhysicalTherapy #Physiotherapy #EOL #ADL #Fall #NFL #LARams#SeattleSeaHawks

Show notes-

Mourning Dove Medical Presents Dr. G at the Heart of Healthcare 

Special Guest-Jason McDonald Executive Director of ActivCare Bressi Ranch https://activcareliving.com/activcare-locations/bressi-ranch-carlsbad-ca/

- Specifically memory care only

- Community structured with consideration for continuum of care as disease progresses

- Respite stays available for 30 days

Podcast Mission-Educate & Empower in three parts, helping listeners ‘SEE’ what’s needed to navigate the healthcare system.

1. Story (theme) What if you made a promise to never move your husband, wife, mother, father, sister, brother to a “facility” HOWEVER they’ve been diagnosed with mild cognitive impairment MCI or a form of dementia AND their current home is not serving them anymore? Caregivers are faced with making a challenging decision for their loved one.

2. Educate -(Teaching point) A Memory care provides a safe environment for continued socialization and enjoyment of the late stages of life by individuals suffering from MCI or dementia. It is BEST to make the decision in a timely manner. Hints that it may be time to move home to a memory care: disease progression to symptoms affecting activities of daily living ADLs, severe sundowning, wandering, falls, forgetfulness, etc.

3. Empower -Valuable a resources: Mild Cognitive Impairment defined https://www.alzheimers.gov/alzheimers-dementias/mild-cognitive-impairment# UCSF https://memory.ucsf.edu/dementia/mild-cognitive-impairment PHYSICIANS Dementia Care Aware CME will help you complete an important CHA~Cognitive Health Assessment so patients can take advantage of resources due advance care planning https://www.dementiacareaware.org

Website info https://mourningdovemedical.com

VIDEO podcast https://youtu.be/3CuIbOfhNSY?si=pYLJAFiTCSHU4JtK #hapc #EducateAndEmpower #PeaceOfMind #Dementia #MemoryCare #SeniorLiving #SeniorCare #Caregiver #Caregiving #Alzheimers #MildCognitiveImpairment

Show notes-

Mourning Dove Medical Presents Dr. G at the Heart of Healthcare 

Special Guest- Diane Logan NEW Regional Director of Operations at Mission Healthcare https://www.homewithmission.com

- Almost 3 decades of experience in Home Health transformed by 14 months working as Director of Patient Care Services for a local hospice agency.

-She learned the advantages of hospice care for patients and families who choose this type of palliative care sooner.

Mission of this podcast- Educate & Empower in three parts, helping listeners ‘SEE’ what’s needed to navigate the healthcare system.

1. Story (theme) Diane was new to hospice and would say, “I don’t know hospice, I am a home health nurse.” Now in her new role in home health leadership, she shares how working in hospice equipped her to educate home health nurses about hospice care.

2. Educate (Teaching point) It may be time for a new level of care that will support a dying patient and family more effectively. It takes listening and good communication skills.

Nurse Diane’s bedside clues to recognize Hospice Readiness:

- Missing or resisting treatments that are no longer working.

- Rehospitalization rates “keep going back in” for symptoms like shortness of breath, pain, nausea, vomiting, etc.

- Declines in physical, nutritional, and mental status;

- Loss of hope “I don’t want to do this anymore”; family resistant

- Recurrent infections;

- Check scores for objective data: PPS/KPS; FAST scale, ECOG performance status.

3. Empower -Valuable Resources THE CONVERSATION PROJECT https://theconversationproject.org Communication Skills Clinical Training for PHYSICIANS- CAPC Communication Skills https://www.capc.org/training/communication-skills/ EVERYONE The EOL Deck https://thedeathdeck.com/pages/eol-deck

Website info https://mourningdovemedical.com

Video podcast https://youtu.be/-7HspaWca4o?si=2ikWyq0uDJWbU-bk #hapc #EducateAndEmpower #PeaceOfMind #HomeHealth #hospice #Nursing #Conversation #CommunicationSkills #EOL

Show notes-

Mourning Dove Medical Presents Dr. G at the Heart of Healthcare 

Special guest Craig Dresang, CEO of YoloCares an affiliate of the CHN https://www.cahospicenetwork.org

- Dr. G met Craig Drasang at ELEVATE in Chicago where he was a panelist

- YoloCares recently in Hospice news YoloCares Breaks Down Barriers to Equitable Access Among Underserved Tribal, Rural Communities - Hospice News https://hospicenews.com/2023/08/11/yolocares-breaks-down-barriers-to-equitable-access-among-underserved-tribal-rural-communities/

Mission-Educate & Empower in three parts, helping listeners ‘SEE’ what’s needed to navigate the healthcare system.

1. Story (theme) Craig was a panelist at Hospice News ELEVATE in Chicago 2022, he discussed the industry and made a call of action for MHB reform (length of stay LOS example of Alzheimer’s patient who weighed 70lbs) and unification between for profit and non-profit hospice agencies to serve patients needs. MediCare Hospice Compare https://www.medicare.gov/care-compare/?redirect=true&providerType=Hospice

2. Educate -Teaching point (civil rights origins of hospice)CHN article https://spotlight.newsreview.com/california-hospice-association/community/dying-with-dignity-the-case-for-non-profit-hospices-and-the-makings-of-a-movement/

3. Empower -Valuable a resources https://yolocares.org Weatherbee Resources https://www.weatherbeeresources.com

Website info https://mourningdovemedical.com

Video podcast https://youtu.be/0zRJxzuC2jg?si=WT345tns2BQp4KMs #hapc #EducateAndEmpower #PeaceOfMind #NonProfit #hospice #palliativecare #civilrights

Show notes-

Mourning Dove Medical Presents Dr. G at the Heart of Healthcare 

Special returning guest

Lauren Templeton, DO, FAAHPM, HMDC is here to help Demystifying GOC. (previously on EPISODES 9 & 10)

- Hospice Medical Director of Hendrick Health https://www.hendrickhealth.org/services/hospice-care/

- Consultant of Weatherbee Resources https://education.hospicecompliance.com

This episode is for Caregivers, Patients, and Clinicians 💜

Mission-Educate & Empower in three parts, helping listeners ‘SEE’ what’s needed to navigate the healthcare system.

1. Story (theme) TGIF! Dr. G told Dr. T about series curating resources for caregivers and revisiting their myth busting video https://youtu.be/H08LUtdSj2U Dr. T mentioned a term "energy conservation" and we wanted to learn more. Dr. Templeton coined the term to define a goal-oriented mindset that aligns with the patient’s wishes.

2. Educate (Teaching point) Goals of Care GOC is prioritizing what matters most, it’s shared decision making, choosing what creates the BEST quality of life for the limited time remaining. It is a new identity, pivoting to symptom-based management with the support of hospice care. Examples discussed:

- Dialysis 3-5years pop

- AICD/Pacemaker deactivation

- Medication deprescribing—simplify

- Monitoring devices: pulse ox, frequent BP monitoring, finger sticks

3. Empower- Valuable a resources FOR CLINICIANS: Article “Perceptions of Barriers and Opportunities to Discussing Advance Care Planning with Hospice Patients and Their Families” https://www.cuanschutz.edu/graduate-programs/palliative-care/blog/palliative-care-blog/barriers-to-acp CAPC Symptom Management is FREE training https://www.capc.org/training/symptom-management/?utm_source=Center+to+Advance+Palliative+Care&utm_campaign=25504941a6-Symptom+Management+7.24.22&utm_medium=email&utm_term=0_31106acbde-25504941a6-378863377 5 courses for better symptom management in seriously ill patients: Anxiety, Constipation, Depression, Dyspnea, Nausea FOR CAREGIVERS: NHPCO CaringInfo https://www.caringinfo.org/planning/caregiving/ SYMPTOM MANAGEMENT INFO: CAPC Get Palliative Care https://getpalliativecare.org Great articles on the home page and “Disease Types” tab to help understand symptoms of various diseases that can benefit from palliative care https://getpalliativecare.org/whatis/disease-types/Website info https://mourningdovemedical.com

VIDEO podcast https://youtu.be/LxYfid3xZ3Y #hapc #EducateAndEmpower #PeaceOfMind #GoalsOfCare #SharedDecisionMaking #Caregiving #Caregiver #Mindset #Simplify #Pivot

Show notes-

Mourning Dove Medical Presents Dr. G at the Heart of Healthcare 

Special guest Gerard Soucy, RN, CHPN

😂Joke: A nurse and doctor went to a bar…

Nurse Gerald a husband and caregiver shares personal experience from 5 years caring for wife who suffered from Alzheimer’s disease. She was the most important patient he had. Jeanne Soucy lived February 18, 1946-January 14, 2016 “The happy heart is true” She was a nurse educator, wife, and mother.

Insights from our conversation:

Caregiver may have constant anxiety and self doubt

- Suffer from Loneliness

- Caregivjng comes at Great Costs: Emotional, Financial, Physical. Many challenges occur with healthcare system, even to healthcare professionals.

Mission-Educate & Empower in three parts, helping listeners ‘SEE’ what’s needed to navigate the healthcare system.

1. Story (theme) “Please don’t…” conversations between a loving husband and wife was documented in an Advance Directive form MOLST in Boston, Massachusetts.

Timeline

- 2010 diagnosed with Mild Cognitive Impairment MCI

-Advance Directive MOLST

-Jeanne attended adult day program and Nurse Gerard attended a support group.

- Jeanne died peacefully at home while receiving hospice care January 10, 2016 (same week as David Bowie)

-Green burial

2. Educate (Teaching point) 🍦 Functional decline measured with ice-cream; decision points for full-time caregiving needs and decision point for hospice care are crucial. As Alzheimer’s disease trajectory continued, Nurse Gerard’s wife’s health declined to need hospice care, and she had a peaceful death at the age 69.

3. Empower -Valuable a resources: 05/01/2017 “A death I nursed” Death Nurse Blog http://www.deathnurse.com/2017/05/a-death-i-nursed.html?m=1 Center to Advance Palliative Care CAPC Dementia Designation https://www.capc.org/training/best-practices-in-dementia-care-and-caregiver-support#:~:text=CAPC%20Designation,-Take%20all%20seven&text=Designation%20can%20be%20added%20to,best%20practices%20in%20dementia%20care. BOOK “The Story of Nursing and Its Power to Change Our World” by Sarah DiGregorio https://a.co/d/4ww58Ab Chapter 5 'Endings' includes Gerard Soucy Taking Care:

Website info https://mourningdovemedical.com

VIDEO podcast https://youtu.be/s5Q-P9Vze5s #hapc #EducateAndEmpower #PeaceOfMind #Alzheimers #Dementia #Caregiver #Caregiving #mandateCAPC #Nurse #Spouse #Husband #Wife

Show notes-

Mourning Dove Medical Presents Dr. G at the Heart of Healthcare 

Special guest

Aisha Adkins, MPA, CNP 

* Storyteller. Care partner. Thought Leader 

* Atlanta based 

* Mother Rosetta Linda Adkins passed away 07/07/23 @ 7pm

* 10 years caregiving

INTRO

Mourning Dove Medical Presents Dr. G at the Heart of Healthcare 

Mission-Educate & Empower in three parts, helping listeners ‘SEE’ what’s needed to navigate the healthcare system. 

1. Story (theme) Millennial Caregiver shifting identity, grief changing shape. We honor your mother’s memory and value the lessons learned from some of the challenges faced while navigating the caregiver lifestyle.

2. Educate: Teaching point Frontotemporal Dementia (https://medlineplus.gov/ency/article/000744.htm actor Bruce Willis in the news) 

3. Empower -A valuable a resource https://aishaadkins.com

Website info https://mourningdovemedical.com

VIDEO podcast 🔗 https://youtu.be/tD-ZLZJaUBg #hapc #EducateAndEmpower #PeaceOfMind #MillennialCaregiver #FrontotemporalDementia #Daughter #Grief #Mother #Anticipatory #Therapy #Legacy

Show notes-

Mourning Dove Medical Presents Dr. G at the Heart of Healthcare 

Special guests https://www.journeyfoundationfc.org/ourteam JFFC Founding Board Members:

Ricky Del Rosario, ASN, RN & Board Executive

Erin Del Rosario; MSN, RN & Board President

Amber Ford, Ed.D., LCSW & Board Executive

Meagan DeGuzman, BA & Board Executive

Jennifer A. Parga, MSW & Board Vice President

Not present: Martin DeGuzman, BA & Board Executive

JFFC a non- profit organization, whose mission is aimed at enhancing the wellbeing of caregivers of chronically and terminally ill patients through community engagement, education, advocacy, and philanthropy.

- Caregiver Relief Program CRP

- Fundraising (consider a donation today https://www.journeyfoundationfc.org)

INTRO

Mourning Dove Medical Presents Dr. G at the Heart of Healthcare

Mission-Educate & Empower in three parts, helping listeners ‘SEE’ what’s needed to navigate the healthcare system.

1. Story (theme) Caregiver CRISIS everywhere❗️”Caregiver’s don’t need breaks” was a myth busted during podcast EPISODE 10 https://youtu.be/H08LUtdSj2U ; Mother’s Day Instagram LIVE 05/07/2023 https://www.instagram.com/tv/Cr9czTYIhje/?igshid=MzRlODBiNWFlZA== and Father’s Day BONUS podcast EPISODE 11 guests discussed the life altering stressors of caregiving and the process of grief. Learned so much about the struggles of The Sandwich Generation during July’s podcast EPISODE 15.

2. Educate: Teaching point What’s available for caregivers? UCSD Center for Mindfulness (instant) https://cih.ucsd.edu/mindfulness/guided-audio-video “RESOURCES” section of Caregiver Connection Newsletter; article “Self-Care Isn’t Selfish: How to Care for Yourself Too” Written by Amber Ford, Ed.D, LCSW 1. Engage in Self-Care 2. Increase your social Network 3.Accept Support From Others

3. Empower -A valuable a resource! Consider donating to the non-profit Journey Foundation For Caregivers JFFC https://www.journeyfoundationfc.org 💜

Website info https://mourningdovemedical.com

VIDEO podcast 🔗 https://youtu.be/s23sd1-gLEU #hapc #EducateAndEmpower #PeaceOfMind #Caregiver #Mindfullness #Selfcare #Respite

Show notes-

Mourning Dove Medical Presents Dr. G at the Heart of Healthcare 

Special Guest Brenda-Lee Smith

- recently celebrated 5 year anniversary serving the Coastal San Diego region of Southern California 🥳

Mission-Educate & Empower in three parts, helping listeners ‘SEE’ what’s needed to navigate the healthcare system.

1. Story (theme) How we met: Mixer at a new ALF La Marea Senior Living, then reconnected at Silverado Memory Care 25th anniversary party. Collaborate concierge physician services before senior clients are moving home. Clients need a 602 form completed by a physician.

2. Educate (Teaching point) When is it time to call Oasis? Paperwork in order? Five Pillars for Successful Aging at Home:

- Nutrition

- Health & Wellness

- Housing

- Transportation

- Financial

National Aging in Place Council https://ageinplace.org

KNOWLEDGEABLE AGING https://youtu.be/CKnBZPjzaBw

3. Empower -A valuable a resource to Age with Joy. Home changes to meet your needs https://www.oasissenioradvisors.com/about-us

Website info https://mourningdovemedical.com

VIDEO episode available on our YouTube channel: https://youtu.be/of3xCu9iA5M #hapc #EducateAndEmpower #PeaceOfMind #SeniorCare #SeniorLiving #MemoryCare #IndependentLiving #Aging #AgeInPlace #Home