April is the month of spring things: gentle rain, flowers blooming, baby animals, outdoor festivals, and warmer temperatures. Here in northern Arizona (especially in our small village), we are beyond ready for spring things! The infamous atmospheric river that has dropped so much rain and snow this year seems to be subsiding now that April is here. I’m pretty sure the snow on our street will be around for a while longer. Such good news for Lake Mary, local reservoirs, wells, and springs. But my gardening will certainly have to wait (see photo – that’s my garden area). I know I will appreciate digging in the dirt with even more gusto after this long snow-packed winter. Meanwhile, I’m tending to indoor spring cleaning and more esoteric plantings. I’m hoping that spring is gently coming your way and that you are planting seeds of wellness and joy for the coming months in 2023.
Now for the News:
- This Month is Special: The entire month of April is dedicated to Stress Awareness. Are you feeling stressed at work? Would you recognize the signs and symptoms and know how to cope with stress in daily life? When stress is sustained over time, it can lead to mental health challenges such as depression, anxiety, or suicidal ideation. There are many resources to access including the National Alliance on Mental Illness (NAMI) and 988 Suicide and Crisis Lifeline.
- This Month’s Special Day: Our special day within Stress Awareness Month is National Healthcare Decisions Day (NHDD), held on April 16th. One of Further Shore’s founding principles is to encourage advance directive preparation ahead of a crisis. Our preferred instrument for doing this a document called The Five Wishes, designed and provided by the nonprofit agency, Aging with Dignity. The Five Wishes is a legal instrument providing what is often referred to as “a living will with heart and soul.” It is America’s most popular advance directive and provides a way to express personal, emotional, and spiritual preferences in addition to medical wishes. The booklet style format offers a place to designate a healthcare agent to carry out the patient’s wishes if they are unable to speak on their own due to advanced illness or injury. Coaching about how to fill this out is available on request (firstname.lastname@example.org). Even though completing advance directives may be stressful, the resulting peace of mind for self and loved ones is worth whatever temporary discomfort might arise. Please consider completing this important step in the month of April!
- On the Blog: The A,B,C’s for Living Well now has three (3) new posts! “T” is for Testing – Part 1 What’s Testing My Patience? is ready to read, along with Parts 2 (Testing 1,2,3) and 3 (Time to Test the Water). You also can view the current, and all past newsletters here.
- Understanding Healthcare Considerations:
- Curative Care – This type of care offers treatment protocols to cure a disease or promote recovery from illness, injury, or other impairment. It may include oversight and care offered by physicians, nurses, dieticians, physical, speech, or occupational therapists, disease specialists, or other adjunct healthcare professionals. Protocols may include surgery, medications, chemotherapy, radiation, use of assistive devices, and various therapeutic treatments that can be taken at home, in clinical settings, or in the hospital. Natural, holistic, complementary, or alternative medicine places the focus on curing via supporting the body’s natural healing ability through boosting the immune system to restore a healthy balance. This kind curative care is offered by naturopaths, chiropractors, osteopaths, hypnotherapists, acupuncturists, doctors of Traditional Chinese Medicine (TCM), Ayurvedic doctors, and others trained in natural healing techniques.
- Palliative Care – Also known as comfort care, palliative care can be offered with or without curative intention. This kind of care offers relief for the uncomfortable symptoms of illness, injury, and physical decline. It can be offered as an adjunct to curative treatments in clinical settings or at home and can include medication, surgery, or radiation, physical therapy to relieve symptoms or side effects and counseling for stress reduction. Some natural forms of both curative and palliative care include aromatherapy, herbal remedies, hydrotherapy, bodywork, Reiki, sound healing, acupuncture, music therapy, pet therapy, and meditation or yoga. Patients experiencing pain, fatigue, anxiety, depression, nausea, weight loss, muscle weakness, insomnia, shortness of breath, or an inability to complete daily living activities may find benefit from palliative care. This kind of care is appropriate for acute or chronic illness or injury; for post-surgical patients both in the hospital setting and at home; for declining mental or physical conditions; and at end of life.
- Hospice Care – This is a specialized care that offers comfort measures and places a focus on quality of life for those with life-limiting illness. In the United States, hospice care is a Medicare supported service available to patients with a prognosis of six months (or less). Care is usually provided to the patient at home. Some communities also have in-patient hospice homes. The interdisciplinary hospice team includes a medical director (physician), nurse, certified nursing assistant or home health aide, social worker, bereavement specialist, volunteers, and chaplain. Hospice patients must cease curative medical treatments but can receive many forms of palliative care including natural care, medication, surgery, or radiation to palliate uncomfortable symptoms. Hospice physicians may deprescribe several medications so that end of life medications can support optimal patient comfort. Home health aides and nurses provide support services and education about how to recognize and palliate patient discomfort. Friend and family caregivers are also supported by services from the social worker, volunteers, and chaplaincy if desired.
- Life Supportive Care – The normal standard of care in medical emergencies is to start life support. Some devices and interventions that are life supportive include intubation, mechanical ventilator, dialysis, cardio-pulmonary resuscitation (CPR), feeding tubes, automated external defibrillator (AED) and more. In the event of an accident or illness when the lungs, heart, or brain ceases to work, life support will be started by medics unless it is verbally declined by the patient; or the patient has left a written instruction not to start it. One other circumstance where life support would not start is if the patient’s medical power of attorney (agent, representative, proxy, designee, etc.) with written legal permission to do so, declines the life supportive treatment on the patient’s behalf. If life support has been started and the patient remains nonresponsive with a life-limiting prognosis, next of kin is usually designated to make the decision to continue or withdraw life support. Patients can relieve loved ones of that responsibility by having a living will in writing to describe what kind of life support is desired, its duration, given the prognosis, and/or a do not resuscitate (DNR) order. Completing The Five Wishes will clarify, in detail, the kind of life support desired in a life-limiting circumstance.
- Pandemic tidbit: Eric Topol, MD, and his colleagues have completed an in-depth study about the findings, mechanisms, and recommendations for Long Covid. Among their findings, 65 million individuals worldwide are diagnosed with Long Covid; the syndrome includes over 200 symptoms encompassing multiple organ systems and can result in disabling chronic symptoms. The report concludes the need for more diagnostics, clinical trials, and treatments, as most patients have very few options for treatment other than “Pacing” to include the 4 P’s – prioritize, plan, pace, position (position means attending to healthy body mechanics). Pacing can also include the 3 D’s (delete, delegate, defer; in other words, saying “NO”). Another study discovered that individuals experiencing multiple COVID-19 infections are more prone to medical complications and to be diagnosed with Long Covid despite vaccination status. Persons over age 65 and those who are immunocompromised are particularly at risk.
- Movies that Move Us: In keeping with NHDD’s invitation to complete advance directives, Arizona Public Media provides this month’s informative and beautiful film, Passing On. Scott Simon narrates this original documentary comprised of compelling, sensitive, and personal stories that frankly discuss the topics of death, dying, and end-of-life planning. Watch it now to learn more about the value of palliative care, end-of-life planning and what it takes to make these difficult decisions. A shout out of “THANKS” to Jack Pelton (Asheville, NC), for this recommendation.
- Quote of the Month: “Preparing for death is one of the most empowering things you can do. Thinking about death clarifies your life.” ~ Candy Chang, Creator of “Before I Die”
May all beings be safe, well, happy, and content.