CNPNWO Blog

Caregiver Retreat

2012-01-31T13:41:00.000-08:00

Caregiver Retreat is a day of learning, praying and relaxing for people of all faiths.

Date: Friday, March 2, 2012
Time: 9:30 a.m. – 2:00 p.m. (Lunch included)
Location: Rosary Care Center, 6832 Convent Boulevard Sylvania, Ohio
Fee: :Donation Only

To register or for more information:
419.824.3533
franciscanvillage@sistersosf.org
www.sylvania Franciscanvillage.org

Faith Community Nursing: Scope and Standards of Practice 2nd Edition

2012-01-31T13:27:00.000-08:00

Sponsor: Good Samaritan Hospital Health Ministry Program, Dayton OH, Norton Health Care and St. Elizabeth Health Care Health Ministry Program , Northern Kentucky.
Date: Saturday, March 24, 2012
Time: 9:00 a.m. to 3:30 p.m.
Location: Atrium Medical Center, Educational Services-Professional Building, One Medical Drive, Middletown, OH
Faculty Alyson J. Breisch, RN, MSN
Fee: $35.00
Contact Hours: Yes
Registration Required by March 14th; E Mail or call Sharon for Registration form
Contact Person: Sharon Becker sbecker@gshdayton.org or call 937 227 9452

Brown Bag Lunch Series: New Techniques in Pain Management

2012-01-27T12:52:00.000-08:00

Sponsor: CPWREHAB
Date: Thursday, February 9, 2012
Time: Noon
Presenter: Lisa Wonnell-Chizmar RN, BSN, MSN, CNP
Location: CPWRehab, 3130 Central Park West Dr. Toledo
Fee: Free
Lunch and Beverage will be provided
Contact Hours: No
Please call to register: 419 841 9622

Road to Recovery

2012-01-27T07:15:00.000-08:00

Sponsor: American Cancer Society of Lucas County.

Date: April 18, 2012 Informational Session
Time: 1:00 p.m. to 3:00 p.m.
Location: Perrysburg American Cancer Society office
Fee: Free
Contact Hours: No

Currently, we are working to establish a Road to Recovery program in Lucas County, which is a program dedicated to assuring patients get to and from their cancer treatment by volunteer drivers. We are working diligently to recruit an additional coordinator and drivers to the program to ensure we can accommodate the needs of all our patients and make sure they all have access to care. We will be holding a 2 hour informational training on the Road to Recovery program

Where can you help? We are looking for as many opportunities to present this program to groups of individuals or by passing on our flier which I will attach to this email. If you have any groups (support groups, parish nurse groups, churches, volunteer organizations, etc) that we can present too, please let me know and I will make sure I am there to relay the information and see if anyone is interested in assisting the cancer patients in Lucas County.

Please feel free to ask any questions and I will be sure to answer them promptly. I appreciate your time and support of establishing the Road to Recovery program in Lucas County.

Contact:Samantha Knox | Community Resource Navigator | East Central Division
740 Commerce Dr Suite B, Perrysburg, OH 43551
Email Samantha.Knox@cancer.org
18882276446 ext 8060 | fax: 877-227-2838

2011 Lucas County Health Assessment Results

2012-01-13T08:27:00.000-08:00

Sponsor: Healthy Lucas County, A Coalition of Health Minded Organizations
Date: Friday, February 17, 2012
Time: 8:00 a.m. to Noon
Location: The Toledo Hospital, Education Center Auditorium, Park free in the Harris McIntosh/Jobst Tower Parking garages
Fee: Free
Contact Hours: No
Receive a free CD Copy of the Full Report
Reservations Requested: Jodi Sheaves via E mail sheavesj@co.lucas.oh.us

Scientists in Congregations 5 Part Series

2012-01-07T11:52:00.000-08:00

Sponsor: Sylvania United Church of Christ
Date: February 20, 2012
Date: March19, 2012
Date: April 16
Date. May 21, 2012
Time: 6:00 p.m. (Drop in Dinner: 7:00 p.m. Lecture
February Speaker: Rev. Dr. Julian A. Davies and Dr. Al Compaan
February Topic: Our faith , our scriptures and the Big Bang, stellar evolution, and the geological record"
March Topic: "Our faith, our scriptures and what Darwin and our DNA tell us"
March Speaker: TBA
April Topic: "What does it mean to be a human person? What the Bible says and what modern biology/medicine tells us"
Speaker: TBA
May Topic: “What does it mean to be a member of human society?”
May Speaker: Rev. Jim Bacik
Location: Sylvania United Church of Christ, 740 Erie Street, Sylvania
Fee: Free Will Offering for Drop in Dinner
Contact Hours: No
Contact: Cathy Hunter Director of Health Ministries at 419 882 0048

Seasonal Flu Guidelines from CDC

2011-12-30T04:37:00.000-08:00

http://www.cdc.gov/flu/

Check out the CDC Web Site for guidelines for Seasonal Flu: Symptoms, Prevention Posters etc.

New Location of Suitably Attired

2011-12-22T03:06:00.000-08:00

Suitably Attired is housed within Toledo Area Ministries (TAM)

TAM New Location: 3043 Monroe St., Toledo 43606

TAM Phone number is 419-242-7401.

Directions: To drop off clothes, you need to drive past the TAM building, turn right on Detroit and turn right again on Bancroft until a short distance later you come to a street called Loreli or something that begins with L. Turn right on that street and go just a short distance until you see a very large overhead door as part of an L shaped building and park there. A buzzer is available to announce your arrival.That is where drop offs are taken.

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HMA Annual Meeting and Conference

2011-12-20T14:34:00.000-08:00

Save The Date: June 3 - 5, 2012

Title: Faith Communities: Claiming a Pivotal Role in Healthcare

Location: Scarritt-Bennett Center
In the heart of Nashville, Tennessee

Ovarian Cancer Connection Brown Bag Lunch Series

2011-12-20T14:19:00.000-08:00

Sponsor: CPW Rehab
Date: Thursday, January 12, 2012
Time: Noon
Location CPW Rehab, 3130 Central Park West, Toledo, OH
Presenter: Gini Steinke, President Ovarian Cancer Connection
Fee: Free
Contact: Hours: No
Contact: 419-841-9622
cbinkley@cpwrehab.com
www.cpwrehab.com

FASD: Strategies for Success (Fetal Alcohol Spectrum Disorders)

2011-12-13T13:00:00.000-08:00

Sponsor: Double ARC/NOFAS Ohio
Date:Tuesday, March 13, 2012
Time: 9:00 a.m. to 3:30 p.m.
Location: Double ARC 3837 Secor Road, Toledo
Fee: $129
Contact Hours: 5
Registration Required
Contact: Double ARC 419 479 3060

FASD It's All About the Brain (Fetal Alcohol Spectrum Disorders)

2011-12-13T12:54:00.000-08:00

Sponsor: Double ARC/NOFAS Ohio
Date:Tuesday, January 24, 2012
Time: 9:00 a.m. to 3:30 p.m.
Location: Double ARC 3837 Secor Road, Toledo
Fee: $129
Contact Hours: 5
Registration Required
Contact: Double ARC 419 479 3060

How to Say "No" Without Saying 'No"

2011-12-13T12:43:00.000-08:00

Sponsor: Double ARC/NOFAS Ohio
Date: Thursday, April 19, 2012
Time: 6:00 p.m. to 8 p.m.
Location: Double ARC 3837 Secor Road, Toledo
Fee: $45.00
Contact Hours: 2
Registration Required
Contact: Double ARC 419 479 3060

FASD in Adolescents

2011-12-13T12:35:00.000-08:00

Sponsor: Double ARC/NOFAS Ohio
Date: May 8, 2012
Time: 6:00 p.m. to 8 p.m.
Location: Double ARC 3837 Secor Road, Toledo
Fee: $45.00
Contact Hours: 2
Registration Required
Contact: Double ARC 419 479 3060

Pastoral Responses to Human Trafficking from a Multi-Faith Perspective

2011-11-21T07:00:00.000-08:00

Sponsors: Sisters of the Diocese of Toledo and their Associates and Friends
Date: January 11, 2012
Times: 9:00 a.m. to noon or 2:00 p.m. to 5:00 p.m.
Location: The Evergreen Room iRosary Care Center, 6832 Convent Blvd. Sylvania
Fee: $20 and can be paid by check or cash.
Contact Hours: No
Registration Required:
Contact: Sister Geraldine Nowak, 6832 Convent Blvd. Sylvania, OH 43560
e-mail: gnowak@bex.net
Call 419-517-8973.

Brown Bag Lecture: The Power of Touch

2011-11-12T06:13:00.000-08:00

Sponsor: CPW Rehab
Date: December 14, 2011
Tine: Noon
Presenter: Barb Wilkins, Massage Therapist and Registered Occupational Therapist
Location: CPW Rehab. 3130 Central Park West Dr, Toledo, OH
Fee: Free
Contact Hours: No
Registration; 419 841 9622

Care Giver Meetings: Come learn how to help your loved ones in their life journey

2011-11-08T16:00:00.000-08:00

Sponsor: Caregiver Resources Group, LLC
Date: Second Tuesday of each month
Time: 7:00 p.m. to 8:30 p.m.
Location: Eleanor Kahle Senior Center
1315 Hillcrest Avenue, Toledo, OH
Facilitator: Mr. Chris Cremean, LSW
Fee: Free
Registration Required for each seminar
Call 419 206-5979

Healthy U Program: It's never too late to learn how to be healthy

2011-11-08T15:57:00.000-08:00

Sponsor: Area Office on Aging of Northwest Ohio
Date: Six week program designed for people with chronic conditions
Time: 2 ½ hours a week
Schedule this class in your faith community.
Fee: Free
Contact: Call Rebecca Liebes at the Area Office on Aging: 419 725 6969 or
E mail: rliebes@areaofficeonaging.com
Website: http://www.areaofficeonaging.com/

Group Exercise

2011-11-08T15:55:00.000-08:00

Sponsor: Parish Nurse Ministry of Central Toledo
Dates: Tuesdays & Thursdays
Time: 10:30 a.m. to 11:30 a.m.
Location: St. Martin de Porres Church, 1119 W. Bancroft St., Toledo, OH
Donation Suggested: $1.00 per class
Contact: Kathy Jeffery at 419 242 1598

Sister to Sister Breast Cancer Prevention

2011-10-07T04:52:00.000-07:00

Komen Support Groups "Circle of Friends"
Sponsors.: Susan B, Koment and the University of Toledo
Date: October 22, 2011
Time: 10:00 a.m. to Noon
Location: Friendship Baptist CHurch, 5301 Nebraska Ave., Toledo
Fee: :Free
Contact Hours: No
Registration Required
Contact: Call Erika Payton
419 540 5256

Hospitals consider role of faith-based groups

2011-09-22T08:08:00.000-07:00

Centers for Disease Control and Prevention
National Institutes of Health
By Suzanne Hoholik
The Columbus Dispatch Wednesday September 21, 2011 3:53 AM

As health-care costs continue to skyrocket, federal officials are looking for ways to improve patient care and lower expenses.

Yesterday, they invited leaders from 16 hospital systems, including OhioHealth, to the White House to discuss how working with faith-based groups can do both.

At the event, hospital executives, doctors and others discussed programs that work in their communities.

For example, OhioHealth has been working with 43 local congregations for 20 years. Each congregation has a volunteer nurse who works with the hospital system.

OhioHealth provides them with training and educational materials on issues including diabetes, nutrition, interacting with doctors and living with chronic diseases.

The nurses share this information with people in their congregations.

“They volunteer their professional time to be part of the congregation’s health ministry,” said Lea Blackburn, system director of community partnership at OhioHealth.

OhioHealth was the only Ohio hospital system invited to the meeting.

The inspiration for the White House meeting is a program at Methodist LeBonheur Hospital in Memphis, Tenn., which involves almost 400 congregations.

The partnership, created about five years ago, trains volunteer liaisons from each congregation to provide support to patients.

“A person is assigned to them from the church to make sure they understand what their doctor is saying and that they get the next steps of care,” said Mara Vanderslice Kelly, acting director of Faith-based and Neighborhood Partnerships for the U.S. Department of Health and Human Services.

She said the program has saved the Memphis hospital $4 million, reduced mortality by 50 percent and cut hospital readmissions by 20 percent. Federal officials said they hoped yesterday’s meeting will get other hospitals to include similar programs.

“These are partnerships to increase access to care and build a better integration of care and be able to reduce the overall cost of care,” said the Rev. Keith Vesper, vice president of mission and ministry at OhioHealth.

shoholik@dispatch.com

Seeking Volunteer RN's for Cherry Street Mission Nursing Clinic

2011-09-15T17:00:00.000-07:00

Location: Cherry Street Mission, Cherry Street, Toledo, OH

Seeking RN's to Volunteer for 5-6 hours per week.

Orientation and Support Available

You would not be working alone.

Cherry Street is a great [place to be-- the staff is awesome and very helpful. This mission is very progressive, and has some great programs to rehabilitate the homeless. If you interest we would be glad to have them come to an orientation to Cherry Street Mission.

Contact Martha Pituch at 419-882-0371, preferably in evening

Diabetes Support Groups (Day and Evening)

2011-09-15T16:16:00.000-07:00

Day Group,
Date: 3rd Wednesday of the month
Tim3: 9:30-11:30 am,
Location: Heatherdowns Library, 3285 Glanzman Ave., Toledo

Evening Group,
Date: 3rd Tuesday of the month,
Time: 6:30-8:15 pm, Sanger Library, 3030 Central Ave., Toledo
Fee: Free
Contact: Lynn Godfrey, BSN, RN, CDE, Certified Diabetic Educator, 419-383-4395.

Open to all with diabetes, their families, friends & others.

White House Blog - Walking in Health with Parish Nurses.

2011-09-15T16:13:00.000-07:00

Across the country, parish nurses are helping congregations walk in health towards a more active lifestyle. Parish nurses, or Faith Community Nurses, are health experts who work within specific congregations to provide the tools, resources, and support necessary to make healthy decisions and stay active. In their capacity as health counselors, advocates, educators, and providers of spiritual care, they are on the frontlines of congregational health, working with church members to address healing of the body, mind and spirit.

Poised to guide parishioners toward more physical activity, parish nurses have responded to the First Lady’s Let’s Move! challenge to walk 3 million miles as part of her initiative to reverse the trend of childhood obesity within a generation. Parish nurses are leading energized, creative community walking programs across the country. The Rev. Dr. Deborah Patterson, Executive Director of the International Parish Nurse Resource Center says, “When a parish nurse is leading a walking program, the average number of miles walked per congregation increases dramatically!”

“All it takes is a little bit of organization to get people excited about physical activity” noted Rebekah Seymour, parish nurse of First Baptist Church in Nederland, Texas. Rebekah, with the help of a team of volunteers, planned and carried out a church-wide walking program called “Walk Across Texas” with Texas-sized success. After constructing a giant map of Texas on which individuals, groups, and families could track their weekly progress and offering prizes for those who crossed the state first, the community of First Baptist walked over 225,000 miles. Not only did the walking adventure encourage physical activity, it nurtured community and inspired congregants to get up, get moving and adopt healthy habits that will benefit them for the rest of their lives.

At Mount Calvary Lutheran Church in Brentwood, Missouri, parish nurse Nancy Merila with her congregation conducted a virtual “Walk to Bethlehem.” Miles were counted, with the use of inexpensive pedometers, by using 15 to 30 minute increments. Participants marked their miles on a big world map pinned to the community wall and Merila enhanced the experience by stamping passports for the countries the congregation virtually “walked” through each week and provided a travelogue of educational facts and images about each country. She added inspirational prayer cards and bible verses to encourage reflection and inspiration during daily walks as, she notes, “It’s impossible to address health issues without taking a holistic approach. If people aren’t physically, emotionally and spiritually engaged, they will never make lasting changes in their lives.”

These are only a few of the many examples of parish nurses guiding congregations in the healthy practices that will support the community they serve in becoming a place of health and well-being. “People like taking part in physical activity, but often times they don’t know where to start. By making walking programs fun and educationally and spiritually fulfilling, we can really provide a sustainable solution to the problem of obesity,” says Nancy Merila.

Read more about the great activities faith-based and neighborhood organizations are leading across the country to get people moving. To learn more about the Let’s Move Faith and Communities initiative or share your success story, email us at partnerships@hhs.govor call (202) 358-3595.

Heidi Christensen is the Associate Director for Community Engagement at the Center for Faith-based and Neighborhood Partnerships at the U.S. Department of Health and Human Services

Gentle Worship Service

2011-08-08T14:55:00.000-07:00

Date: 3rd Sunday of Every Month

Time: 1:30 p.m.

Location: Grace Lutheran Church 4441 Monroe St. Toledo, 43603

Worship service for families who have a family members with special needs.

This might mean an adult or child living with memory loss, Autism, physical or other issues making them 'differently' abled.

Contact for further information: 419 474 6403

View Web site for more information on this special service http://www.gracelutherantoledo.org/

A Support Group for Military Families

2011-06-23T05:34:00.000-07:00

Date: The last Monday of every month

Time: 6:30-7:30 pm.

Location: Grace Lutheran Church, 4441 Monroe Street (near on-ramp to 475 East, just east of Secor Road) in Toledo, Ohio.

Contacts: Barb Laraway at 419.460.9032 and Dawn Heisler at 419.699.3439 / dheisler7@bex.net

This is a place to share emotions, frustrations, anxieties and other related issues and to know you are not going through these circumstances alonE. Parents and spouses can obtain information on health care, financial aid, careers, education and or a reference for professional aid. This support group is to help support outreach in helping military families cope with the pressures and stresses of war-causing mental and physical injury to a loved one.

Topics: Depression, anxiety, sleep disorder, alcohol/drug use, stress, fear, anger, violence, hopelessness, eating disorders, unemployment, low self esteem and lack of memory/focus.

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CLIENTS OF PARISH NURSES NEEDED FOR RESEARCH STUDY

2011-02-21T12:17:00.000-08:00

The purpose of this study is to:
• Identify how parish nurses implement Healthy People 2010 goals
• Rate client satisfaction with parish nursing care
To qualify for participation:
• You must be a client of the parish nurse
• You must be fluent in English
• You must have at least a 7th grade reading level
• You must have access to a computer with internet
Participation will require you to:
• Answer some questions about yourself
• Answer some questions about the parish nurse services
• Answer some questions about your satisfaction with the care you receive from your parish nurse
Participation will take about 20 minutes!

This survey is on-line. If you are interested in participating in this study, please access the survey through the following website “https://www.surveymonkey.com/s/kingm1”. If you have any questions, please call:

Michalene A. King, PhD, RN, CNE
Assistant Professor of Nursing
Duquesne University School of Nursing
516 Fisher Hall
Pittsburgh, PA 15282
412-396-6544 (office) 740-381-3528 (cell)

Nurses Without Borders

2011-02-08T07:19:00.000-08:00

Nurses Without Borders
By KAREN STABINER

Ryan T. Conaty for The New York Times
We tend to think of nurses as yet another item on that expensive list labeled “medical care,” but around the country about 15,000 nurses, most of them acting as volunteers, provide elderly support services free of charge. The members of the faith community nurse movement, as it’s called, are available to anyone, regardless of religion. In many communities, getting help is simply a matter of picking up the telephone.

While they do not offer prolonged, direct nursing care, the list of things they do provide is a long one, including finding volunteers to help with driving, providing respite care for caregivers, and helping the elderly to navigate everything from housing to insurance to the health care system. Once those resources are in place, faith community nurses often continue to check in on patients on a regular basis.

The Rev. Deborah L. Patterson, executive director of the International Parish Nurse Resource Center in St. Louis, said the nurses do not charge for their help because “that is totally opposed to the ethos of this work, just as a pastor or chaplain would not charge for a home visit or a hospital call.” Faith community nurses don’t even inquire about finances, she added. “It is assumed that people will first use the resources they have available, and this will be a support beyond that,” she said.

Faith community nurses began their work in response to the realization that “older folks were falling through the cracks,” Dr. Patterson said. Helping the aging population continues to be their primary focus.

Indeed, said Dr. Patterson, these “nurses are encouraged to reach out to the neighborhood and beyond — and most do through community health fairs, food pantries, women’s shelters and other services, as well as accepting referrals for folks who need help.”

“This profession is to help people, not harass them,” Dr. Patterson added. “If a parish nurse is acting professionally, they would respect anyone’s request to keep their religious beliefs private.”

Still, religious groups generally provide the financial foundation for the nurses’ work. One St. Louis-area church has supported a nurse for over 20 years with donations from churchgoers. The Deaconess Foundation, also in St. Louis, has provided over $2 million during the last 20 years to pay nurses’ salaries and benefits and to hire administrative staff.

Where to find some extra help in your area? The Web site of the International Parish Nurse Resource Center offers links to similar groups around the country, as well as a directory of statewide coordinators affiliated with hospitals, congregations and other groups. The Health Ministries Association, which also has a faith community nurse network, offers a roster as well.

On the East Coast, the Shleimut program provides services “within the culture of the Jewish tradition,” said Roberta Schweitzer, who has been a congregational nurse for synagogues since the late 1980s. And the Union for Reform Judaism provides guidelines for congregations wishing to create programs of their own.
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Lucas County Colorectal Cancer Coalition

2011-02-04T03:27:00.000-08:00

Visit the Web site below to find out about Colorectal Screenings, MD's Risk Assessment etc.

http://www.toledocolonhealth.org/

NHLBI Health Information Now Available at Your Fingertips

2010-11-16T16:29:00.000-08:00

The National Heart, Lung, and Blood Institute (NHLBI) has updated its Web site and added more digital information including podcasts, educational videos, Web applications and downloadable fact sheets.

Browse the updated http://emall.nhlbihin.net/ to locate NHLBI materials and find out how to access NHLBI resources, from clinical practice guidelines to fact sheets, including:

Downloading specific educational materials for self-printing
Using content in newsletters and on Web sites
Ordering print materials in limited quantities
Ordering printers' disks, to use when locally printing large quantities
Materials may also be ordered in printed form at no charge in limited quantities. If you need materials in larger quantities, we can provide a printer's disk, which you can take to a local printer.

To assist you in planning for future information needs, the NHLBI Health Information Center Information Specialists are available to provide solutions and support via live chat, phone or e-mail.

Best Food to Donate Flyer

2010-10-28T08:27:00.000-07:00

Do you want copies of the "Best Food to Donate Flyer"? Contact one of the people below for colored flyers. They will provide you with as many colored flyers as you need before your next food drive.

Tony Maziarz
CHC Grant Coordinator
Toledo-Lucas County Health Department
635 N. Erie Street
Toledo, OH 43604
PH: 419-213-4168
FX: 419-213-4119
maziarza@co.lucas.oh.us

Carey (Neumeier) Ardner
CHC Grant Coordinator
Toledo-Lucas County Health Department
635 N. Erie Street
Toledo, OH 43604
PH: 419-213-4169
FX: 419-213-4119
neumeierc@co.lucas.oh.us

Thought Provoking Article on End of Life Issues

2010-06-21T12:05:00.000-07:00

What Broke My Father’s Heart by Katy Butler
Published in the New York Times Magazine Section, June 20, 2010

One October afternoon three years ago while I was visiting my parents, my mother made a request I dreaded and longed to fulfill. She had just poured me a cup of Earl Grey from her Japanese iron teapot, shaped like a little pumpkin; outside, two cardinals splashed in the birdbath in the weak Connecticut sunlight. Her white hair was gathered at the nape of her neck, and her voice was low. “Please help me get Jeff’s pacemaker turned off,” she said, using my father’s first name. I nodded, and my heart knocked.
Upstairs, my 85-year-old father, Jeffrey, a retired Wesleyan University professor who suffered from dementia, lay napping in what was once their shared bedroom. Sewn into a hump of skin and muscle below his right clavicle was the pacemaker that helped his heart outlive his brain. The size of a pocket watch, it had kept his heart beating rhythmically for nearly five years. Its battery was expected to last five more.
After tea, I knew, my mother would help him from his narrow bed with its mattress encased in waterproof plastic. She would take him to the toilet, change his diaper and lead him tottering to the couch, where he would sit mutely for hours, pretending to read Joyce Carol Oates, the book falling in his lap as he stared out the window.
I don’t like describing what dementia did to my father — and indirectly to my mother — without telling you first that my parents loved each other, and I loved them. That my mother, Valerie, could stain a deck and sew an evening dress from a photo in Vogue and thought of my father as her best friend. That my father had never given up easily on anything.
Born in South Africa, he lost his left arm in World War II, but built floor-to-ceiling bookcases for our living room; earned a Ph.D. from Oxford; coached rugby; and with my two brothers as crew, sailed his beloved Rhodes 19 on Long Island Sound. When I was a child, he woke me, chortling, with his gloss on a verse from “The Rubaiyat of Omar Khayyam”: “Awake, my little one! Before life’s liquor in its cup be dry!” At bedtime he tucked me in, quoting “Hamlet” : “May flights of angels sing thee to thy rest!”
Now I would look at him and think of Anton Chekhov, who died of tuberculosis in 1904. “Whenever there is someone in a family who has long been ill, and hopelessly ill,” he wrote, “there come painful moments when all timidly, secretly, at the bottom of their hearts long for his death.” A century later, my mother and I had come to long for the machine in my father’s chest to fail.
Until 2001, my two brothers and I — all living in California — assumed that our parents would enjoy long, robust old ages capped by some brief, undefined final illness. Thanks to their own healthful habits and a panoply of medical advances — vaccines, antibiotics, airport defibrillators, 911 networks and the like — they weren’t likely to die prematurely of the pneumonias, influenzas and heart attacks that decimated previous generations. They walked every day. My mother practiced yoga. My father was writing a history of his birthplace, a small South African town.
In short, they were seemingly among the lucky ones for whom the American medical system, despite its fragmentation, inequity and waste, works quite well. Medicare and supplemental insurance paid for their specialists and their trusted Middletown internist, the lean, bespectacled Robert Fales, who, like them, was skeptical of medical overdoing. “I bonded with your parents, and you don’t bond with everybody,” he once told me. “It’s easier to understand someone if they just tell it like it is from their heart and their soul.”
They were also stoics and religious agnostics. They signed living wills and durable power-of-attorney documents for health care. My mother, who watched friends die slowly of cancer, had an underlined copy of the Hemlock Society’s “Final Exit” in her bookcase. Even so, I watched them lose control of their lives to a set of perverse financial incentives — for cardiologists, hospitals and especially the manufacturers of advanced medical devices — skewed to promote maximum treatment. At a point hard to precisely define, they stopped being beneficiaries of the war on sudden death and became its victims.
Things took their first unexpected turn on Nov. 13, 2001, when my father — then 79, pacemakerless and seemingly healthy — collapsed on my parents’ kitchen floor in Middletown, making burbling sounds. He had suffered a stroke.
He came home six weeks later permanently incapable of completing a sentence. But as I’ve said, he didn’t give up easily, and he doggedly learned again how to fasten his belt; to peck out sentences on his computer; to walk alone, one foot dragging, to the university pool for water aerobics. He never again put on a shirt without help or looked at the book he had been writing. One day he haltingly told my mother, “I don’t know who I am anymore.”
His stroke devastated two lives. The day before, my mother was an upper-middle-class housewife who practiced calligraphy in her spare time. Afterward, she was one of tens of millions of people in America, most of them women, who help care for an older family member.
Their numbers grow each day. Thanks to advanced medical technologies, elderly people now survive repeated health crises that once killed them, and so the “oldest old” have become the nation’s most rapidly growing age group. Nearly a third of Americans over 85 have dementia (a condition whose prevalence rises in direct relationship to longevity). Half need help with at least one practical, life-sustaining activity, like getting dressed or making breakfast. Even though a capable woman was hired to give my dad showers, my 77-year-old mother found herself on duty more than 80 hours a week. Her blood pressure rose and her weight fell. On a routine visit to Dr. Fales, she burst into tears. She was put on sleeping pills and antidepressants.
My father said he came to believe that she would have been better off if he had died. “She’d have weeped the weep of a widow,” he told me in his garbled, poststroke speech, on a walk we took together in the fall of 2002. “And then she would have been all right.” It was hard to tell which of them was suffering more.
As we shuffled through the fallen leaves that day, I thought of my father’s father, Ernest Butler. He was 79 when he died in 1965, before pacemakers, implanted cardiac defibrillators, stents and replacement heart valves routinely staved off death among the very old. After completing some long-unfinished chairs, he cleaned his woodshop, had a heart attack and died two days later in a plain hospital bed. As I held my dad’s soft, mottled hand, I vainly wished him a similar merciful death.
A few days before Christmas that year, after a vigorous session of water exercises, my father developed a painful inguinal (intestinal) hernia. My mother took him to Fales, who sent them to a local surgeon, who sent them to a cardiologist for a preoperative clearance. After an electrocardiogram recorded my father’s slow heartbeat — a longstanding and symptomless condition not uncommon in the very old — the cardiologist, John Rogan, refused to clear my dad for surgery unless he received a pacemaker.
Without the device, Dr. Rogan told me later, my father could have died from cardiac arrest during surgery or perhaps within a few months. It was the second time Rogan had seen my father. The first time, about a year before, he recommended the device for the same slow heartbeat. That time, my then-competent and prestroke father expressed extreme reluctance, on the advice of Fales, who considered it overtreatment.
My father’s medical conservatism, I have since learned, is not unusual. According to an analysis by the Dartmouth Atlas medical-research group, patients are far more likely than their doctors to reject aggressive treatments when fully informed of pros, cons and alternatives — information, one study suggests, that nearly half of patients say they don’t get. And although many doctors assume that people want to extend their lives, many do not. In a 1997 study in The Journal of the American Geriatrics Society, 30 percent of seriously ill people surveyed in a hospital said they would “rather die” than live permanently in a nursing home. In a 2008 study in The Journal of the American College of Cardiology, 28 percent of patients with advanced heart failure said they would trade one day of excellent health for another two years in their current state.
When Rogan suggested the pacemaker for the second time, my father was too stroke-damaged to discuss, and perhaps even to weigh, his tradeoffs. The decision fell to my mother — anxious to relieve my father’s pain, exhausted with caregiving, deferential to doctors and no expert on high-tech medicine. She said yes. One of the most important medical decisions of my father’s life was over in minutes. Dr. Fales was notified by fax.
Fales loved my parents, knew their suffering close at hand, continued to oppose a pacemaker and wasn’t alarmed by death. If he had had the chance to sit down with my parents, he could have explained that the pacemaker’s battery would last 10 years and asked whether my father wanted to live to be 89 in his nearly mute and dependent state. He could have discussed the option of using a temporary external pacemaker that, I later learned, could have seen my dad safely through surgery. But my mother never consulted Fales. And the system would have effectively penalized him if she had. Medicare would have paid him a standard office-visit rate of $54 for what would undoubtedly have been a long meeting — and nothing for phone calls to work out a plan with Rogan and the surgeon.
Medicare has made minor improvements since then, and in the House version of the health care reform bill debated last year, much better payments for such conversations were included. But after the provision was distorted as reimbursement for “death panels,” it was dropped. In my father’s case, there was only a brief informed-consent process, covering the boilerplate risks of minor surgery, handled by the general surgeon.
I believe that my father’s doctors did their best within a compartmentalized and time-pressured medical system. But in the absence of any other guiding hand, there is no doubt that economics helped shape the wider context in which doctors made decisions. Had we been at the Mayo Clinic — where doctors are salaried, medical records are electronically organized and care is coordinated by a single doctor — things might have turned out differently. But Middletown is part of the fee-for-service medical economy. Doctors peddle their wares on a piecework basis; communication among them is haphazard; thinking is often short term; nobody makes money when medical interventions are declined; and nobody is in charge except the marketplace.
And so on Jan. 2, 2003, at Middlesex Hospital, the surgeon implanted my father’s pacemaker using local anesthetic. Medicare paid him $461 and the hospital a flat fee of about $12,000, of which an estimated $7,500 went to St. Jude Medical, the maker of the device. The hernia was fixed a few days later.
It was a case study in what primary-care doctors have long bemoaned: that Medicare rewards doctors far better for doing procedures than for assessing whether they should be done at all. The incentives for overtreatment continue, said Dr. Ted Epperly, the board chairman of the American Academy of Family Physicians, because those who profit from them — specialists, hospitals, drug companies and the medical-device manufacturers — spend money lobbying Congress and the public to keep it that way.
Last year, doctors, hospitals, drug companies, medical-equipment manufacturers and other medical professionals spent $545 million on lobbying, according to the Center for Responsive Politics. This may help explain why researchers estimate that 20 to 30 percent of Medicare’s $510 billion budget goes for unnecessary tests and treatment. Why cost-containment received short shrift in health care reform. Why physicians like Fales net an average of $173,000 a year, while noninvasive cardiologists like Rogan net about $419,000.
The system rewarded nobody for saying “no” or even “wait” — not even my frugal, intelligent, Consumer-Reports-reading mother. Medicare and supplemental insurance covered almost every penny of my father’s pacemaker. My mother was given more government-mandated consumer information when she bought a new Camry a year later.
And so my father’s electronically managed heart — now requiring frequent monitoring, paid by Medicare — became part of the $24 billion worldwide cardiac-device industry and an indirect subsidizer of the fiscal health of American hospitals. The profit margins that manufacturers earn on cardiac devices is close to 30 percent. Cardiac procedures and diagnostics generate about 20 percent of hospital revenues and 30 percent of profits.
Shortly after New Year’s 2003, my mother belatedly called and told me about the operations, which went off without a hitch. She didn’t call earlier, she said, because she didn’t want to worry me. My heart sank, but I said nothing. It is one thing to silently hope that your beloved father’s heart might fail. It is another to actively abet his death.
The pacemaker bought my parents two years of limbo, two of purgatory and two of hell. At first they soldiered on, with my father no better and no worse. My mother reread Jon Kabat-Zinn’s “Full Catastrophe Living,” bought a self-help book on patience and rose each morning to meditate.
In 2005, the age-related degeneration that had slowed my father’s heart attacked his eyes, lungs, bladder and bowels. Clots as narrow as a single human hair lodged in tiny blood vessels in his brain, killing clusters of neurons by depriving them of oxygen. Long partly deaf, he began losing his sight to wet macular degeneration, requiring ocular injections that cost nearly $2,000 each. A few months later, he forgot his way home from the university pool. He grew incontinent. He was collapsing physically, like an ancient, shored-up house.
In the summer of 2006, he fell in the driveway and suffered a brain hemorrhage. Not long afterward, he spent a full weekend compulsively brushing and rebrushing his teeth. “The Jeff I married . . . is no longer the same person,” my mother wrote in the journal a social worker had suggested she keep. “My life is in ruins. This is horrible, and I have lasted for five years.” His pacemaker kept on ticking.
When bioethicists debate life-extending technologies, the effects on people like my mother rarely enter the calculus. But a 2007 Ohio State University study of the DNA of family caregivers of people with Alzheimer’s disease showed that the ends of their chromosomes, called telomeres, had degraded enough to reflect a four-to-eight-year shortening of lifespan. By that reckoning, every year that the pacemaker gave my irreparably damaged father took from my then-vigorous mother an equal year.
When my mother was upset, she meditated or cleaned house. When I was upset, I Googled. In 2006, I discovered that pacemakers could be deactivated without surgery. Nurses, doctors and even device salesmen had done so, usually at deathbeds. A white ceramic device, like a TV remote and shaped like the wands that children use to blow bubbles, could be placed around the hump on my father’s chest. Press a few buttons and the electrical pulses that ran down the leads to his heart would slow until they were no longer effective. My father’s heart, I learned, would probably not stop. It would just return to its old, slow rhythm. If he was lucky, he might suffer cardiac arrest and die within weeks, perhaps in his sleep. If he was unlucky, he might linger painfully for months while his lagging heart failed to suffuse his vital organs with sufficient oxygenated blood.
If we did nothing, his pacemaker would not stop for years. Like the tireless charmed brooms in Disney’s “Fantasia,” it would prompt my father’s heart to beat after he became too demented to speak, sit up or eat. It would keep his heart pulsing after he drew his last breath. If he was buried, it would send signals to his dead heart in the coffin. If he was cremated, it would have to be cut from his chest first, to prevent it from exploding and damaging the walls or hurting an attendant.
On the Internet, I discovered that the pacemaker — somewhat like the ventilator, defibrillator and feeding tube — was first an exotic, stopgap device, used to carry a handful of patients through a brief medical crisis. Then it morphed into a battery-powered, implantable and routine treatment. When Medicare approved the pacemaker for reimbursement in 1966, the market exploded. Today pacemakers are implanted annually in more than 400,000 Americans, about 80 percent of whom are over 65. According to calculations by the Dartmouth Atlas research group using Medicare data, nearly a fifth of new recipients who receive pacemakers annually — 76,000 — are over 80. The typical patient with a cardiac device today is an elderly person suffering from at least one other severe chronic illness.
Over the years, as technology has improved, the battery life of these devices lengthened. The list of heart conditions for which they are recommended has grown. In 1984, the treatment guidelines from the American College of Cardiology declared that pacemakers were strongly recommended as “indicated” or mildly approved as “reasonable” for 56 heart conditions and “not indicated” for 31 more. By 2008, the list for which they were strongly or mildly recommended expanded to 88, with most of the increase in the lukewarm “reasonable” category.
The research backing the expansion of diagnoses was weak. Over all, only 5 percent of the positive recommendations were supported by research from multiple double-blind randomized studies, the gold standard of evidence-based medicine. And 58 percent were based on no studies at all, only a “consensus of expert opinion.” Of the 17 cardiologists who wrote the 2008 guidelines, 11 received financing from cardiac-device makers or worked at institutions receiving it. Seven, due to the extent of their financial connections, were recused from voting on the guidelines they helped write.
This pattern — a paucity of scientific support and a plethora of industry connections — holds across almost all cardiac treatments, according to the cardiologist Pierluigi Tricoci of Duke University’s Clinical Research Institute. Last year in The Journal of the American Medical Association, Tricoci and his co-authors wrote that only 11 percent of 2,700 widely used cardiac-treatment guidelines were based on that gold standard. Most were based only on expert opinion.
Experts are as vulnerable to conflicts of interest as researchers are, the authors warned, because “expert clinicians are also those who are likely to receive honoraria, speakers bureau [fees], consulting fees or research support from industry.” They called the current cardiac-research agenda “strongly influenced by industry’s natural desire to introduce new products.”
Perhaps it’s no surprise that I also discovered others puzzling over cardiologists who recommended pacemakers for relatives with advanced dementia. “78-year-old mother-in-law has dementia; severe short-term memory issues,” read an Internet post by “soninlaw” on Elderhope.com, a caregivers’ site, in 2007. “On a routine trip to her cardiologist, doctor decides she needs a pacemaker. . . . Anyone have a similar encounter?”
By the summer of 2007, my dad had forgotten the purpose of a dinner napkin and had to be coached to remove his slippers before he tried to put on his shoes. After a lifetime of promoting my father’s health, my mother reversed course. On a routine visit, she asked Rogan to deactivate the pacemaker. “It was hard,” she later told me. “I was doing for Jeff what I would have wanted Jeff to do for me.” Rogan soon made it clear he was morally opposed. “It would have been like putting a pillow over your father’s head,” he later told me.
Not long afterward, my mother declined additional medical tests and refused to put my father on a new anti-dementia drug and a blood thinner with troublesome side effects. “I take responsibility for whatever,” she wrote in her journal that summer. “Enough of all this overkill! It’s killing me! Talk about quality of life — what about mine?”
Then came the autumn day when she asked for my help, and I said yes. I told myself that we were simply trying to undo a terrible medical mistake. I reminded myself that my dad had rejected a pacemaker when his faculties were intact. I imagined, as a bioethicist had suggested, having a 15-minute conversation with my independent, predementia father in which I saw him shaking his head in horror over any further extension of what was not a “life,” but a prolonged and attenuated dying. None of it helped. I knew that once he died, I would dream of him and miss his mute, loving smiles. I wanted to melt into the arms of the father I once had and ask him to handle this. Instead, I felt as if I were signing on as his executioner and that I had no choice.
Over the next five months, my mother and I learned many things. We were told, by the Hemlock Society’s successor, Compassion and Choices, that as my father’s medical proxy, my mother had the legal right to ask for the withdrawal of any treatment and that the pacemaker was, in theory at least, a form of medical treatment. We learned that although my father’s living will requested no life support if he were comatose or dying, it said nothing about dementia and did not define a pacemaker as life support. We learned that if we called 911, emergency medical technicians would not honor my father’s do-not-resuscitate order unless he wore a state-issued orange hospital bracelet. We also learned that no cardiology association had given its members clear guidance on when, or whether, deactivating pacemakers was ethical.
(Last month that changed. The Heart Rhythm Society and the American Heart Association issued guidelines declaring that patients or their legal surrogates have the moral and legal right to request the withdrawal of any medical treatment, including an implanted cardiac device. It said that deactivating a pacemaker was neither euthanasia nor assisted suicide, and that a doctor could not be compelled to do so in violation of his moral values. In such cases, it continued, doctors “cannot abandon the patient but should involve a colleague who is willing to carry out the procedure.” This came, of course, too late for us.)
In the spring of 2008, things got even worse. My father took to roaring like a lion at his caregivers. At home in California, I searched the Internet for a sympathetic cardiologist and a caregiver to put my Dad to bed at night. My frayed mother began to shout at him, and their nighttime scenes were heartbreaking and frightening. An Alzheimer’s Association support-group leader suggested that my brothers and I fly out together and institutionalize my father. This leader did not know my mother’s formidable will and had never heard her speak about her wedding vows or her love.
Meanwhile my father drifted into what nurses call “the dwindles”: not sick enough to qualify for hospice care, but sick enough to never get better. He fell repeatedly at night and my mother could not pick him up. Finally, he was weak enough to qualify for palliative care, and a team of nurses and social workers visited the house. His chest grew wheezy. My mother did not request antibiotics. In mid-April 2008, he was taken by ambulance to Middlesex Hospital’s hospice wing, suffering from pneumonia.
Pneumonia was once called “the old man’s friend” for its promise of an easy death. That’s not what I saw when I flew in. On morphine, unreachable, his eyes shut, my beloved father was breathing as hard and regularly as a machine.
My mother sat holding his hand, weeping and begging for forgiveness for her impatience. She sat by him in agony. She beseeched his doctors and nurses to increase his morphine dose and to turn off the pacemaker. It was a weekend, and the doctor on call at Rogan’s cardiology practice refused authorization, saying that my father “might die immediately.” And so came five days of hard labor. My mother and I stayed by him in shifts, while his breathing became increasingly ragged and his feet slowly started to turn blue. I began drafting an appeal to the hospital ethics committee. My brothers flew in.
On a Tuesday afternoon, with my mother at his side, my father stopped breathing. A hospice nurse hung a blue light on the outside of his hospital door. Inside his chest, his pacemaker was still quietly pulsing.
After his memorial service in the Wesleyan University chapel, I carried a box from the crematory into the woods of an old convent where he and I often walked. It was late April, overcast and cold. By the side of a stream, I opened the box, scooped out a handful of ashes and threw them into the swirling water. There were some curious spiraled metal wires, perhaps the leads of his pacemaker, mixed with the white dust and pieces of bone.
A year later, I took my mother to meet a heart surgeon in a windowless treatment room at Brigham and Women’s Hospital in Boston. She was 84, with two leaking heart valves. Her cardiologist had recommended open-heart surgery, and I was hoping to find a less invasive approach. When the surgeon asked us why we were there, my mother said, “To ask questions.” She was no longer a trusting and deferential patient. Like me, she no longer saw doctors — perhaps with the exception of Fales — as healers or her fiduciaries. They were now skilled technicians with their own agendas. But I couldn’t help feeling that something precious — our old faith in a doctor’s calling, perhaps, or in a healing that is more than a financial transaction or a reflexive fixing of broken parts — had been lost.
The surgeon was forthright: without open-heart surgery, there was a 50-50 chance my mother would die within two years. If she survived the operation, she would probably live to be 90. And the risks? He shrugged. Months of recovery. A 5 percent chance of stroke. Some possibility, he acknowledged at my prompting, of postoperative cognitive decline. (More than half of heart-bypass patients suffer at least a 20 percent reduction in mental function.) My mother lifted her trouser leg to reveal an anklet of orange plastic: her do-not-resuscitate bracelet. The doctor recoiled. No, he would not operate with that bracelet in place. It would not be fair to his team. She would be revived if she collapsed. “If I have a stroke,” my mother said, nearly in tears, “I want you to let me go.” What about a minor stroke, he said — a little weakness on one side?
I kept my mouth shut. I was there to get her the information she needed and to support whatever decision she made. If she emerged from surgery intellectually damaged, I would bring her to a nursing home in California and try to care for her the way she had cared for my father at such cost to her own health. The thought terrified me.
The doctor sent her up a floor for an echocardiogram. A half-hour later, my mother came back to the waiting room and put on her black coat. “No,” she said brightly, with the clarity of purpose she had shown when she asked me to have the pacemaker deactivated. “I will not do it.”
She spent the spring and summer arranging house repairs, thinning out my father’s bookcases and throwing out the files he collected so lovingly for the book he never finished writing. She told someone that she didn’t want to leave a mess for her kids. Her chest pain worsened, and her breathlessness grew severe. “I’m aching to garden,” she wrote in her journal. “But so it goes. ACCEPT ACCEPT ACCEPT.”
Last August, she had a heart attack and returned home under hospice care. One evening a month later, another heart attack. One of my brothers followed her ambulance to the hospice wing where we had sat for days by my father’s bed. The next morning, she took off her silver earrings and told the nurses she wanted to stop eating and drinking, that she wanted to die and never go home. Death came to her an hour later, while my brother was on the phone to me in California — almost as mercifully as it had come to my paternal grandfather. She was continent and lucid to her end.
A week later, at the same crematory near Long Island Sound, my brothers and I watched through a plate-glass window as a cardboard box containing her body, dressed in a scarlet silk ao dai she had sewn herself, slid into the flames. The next day, the undertaker delivered a plastic box to the house where, for 45 of their 61 years together, my parents had loved and looked after each other, humanly and imperfectly. There were no bits of metal mixed with the fine white powder and the small pieces of her bones.

Katy Butler lives in Mill Valley, Calif., and teaches memoir writing at the Esalen Institute in Big Sur.

A version of this article appeared in print on June 20, 2010, on page MM38 of the Sunday Magazine.

Hope and Healing Web site

2010-06-21T11:57:00.000-07:00

Sponsor: United Methodist Church

Very Interesting stories and Information about Hope, Healing, Parish Nursing etc.

Visit the Web site: http://www.hopeandhealing.org/default.aspx

Lifesaving Devices Can Cause Havoc at Life’s End

2010-05-18T10:11:00.000-07:00

By BARRY MEIER
Published: May 13, 2010 in the New York Times

When her father’s cancer became terminal, Carol Filak realized that making his final days comfortable involved something she had never thought about — turning off his heart defibrillator.

Dr. Wellman said about 2 percent of patients at the Hospice of the Western Reserve in Cleveland had defibrillators implanted.
A doctor friend told Ms. Filak about horrible scenes he had witnessed in which a defibrillator had shocked a dying patient, causing pain and terrifying family members gathered at the bedside.
But when Ms. Filak tried to get the device deactivated, she was bounced around for weeks by her father’s doctors, including his cardiologist, she said.
“All I thought about was getting this thing shut off,” said Ms. Filak, who is the director of the student health clinic at George Mason University in Fairfax, Va.
Defibrillators are a modern medical miracle, small implants that save lives by sending an electrical jolt to interrupt a potentially fatal heart rhythm and restore normal beating. But with a rapidly growing number of patients in this country getting the devices, they are increasingly posing a bionic challenge near life’s end, for both patients and their families.
Specialists say that a failing heart often begins to beat in the same type of wildly erratic rhythm that a defibrillator is programmed to recognize and intercept with a jolt. And though doctors and patients routinely discuss end-of-life issues like withdrawing medications and resuscitation attempts, studies suggest that what to do about a defibrillator rarely comes up.
On Friday, the Heart Rhythm Society, a professional group representing cardiologists who implant heart devices like defibrillators, plans to issue guidelines in an effort to promote such talks. Among other things, the guidelines, which were developed with other medical organizations, emphasize that doctors should discuss possible device deactivation with patients at the time of implantation and periodically afterward.
Other groups have issued guidelines in recent years but evidence suggests that they have not taken hold. A study published in March by researchers from the Mount Sinai School of Medicine in New York found that only 10 percent of some 400 hospices that responded to a survey had formal policies in place to discuss defibrillator deactivation. About 60 percent of patients in the hospices with defibrillators still had the shocking function active, the survey found.
“Doctors are not comfortable with these discussions,” said Dr. Nathan Goldstein, who led the Mount Sinai team. “They are used to thinking about these devices as saving lives.”
Meanwhile, some dying patients have chosen, when asked, to keep the device active, particularly if it has fired before, saving the patient’s life.
“Some patients are reluctant to turning it off when they perceive it as something that has saved them,” said Dr. Charles Wellman, chief medical officer of the Hospice of the Western Reserve in Cleveland.
An estimated 650,000 people in this country have either a defibrillator or a more complex device that combines a defibrillator and a pacemaker. That number is expected to grow because of the aging population and the use of such implants in a broader class of heart patients. About 10,000 patients a month now get the devices, often for the first time.
The lives of many of these patients, who have heart disease or genetic conditions that put them at risk of sudden cardiac arrest, will be extended by the implants. But while their heart problems may not kill them, they will eventually succumb, be it due to accidents, illnesses like cancer or simply old age.
An earlier study by Dr. Goldstein of Mount Sinai that was based on interviews with relatives of recently deceased patients who had defibrillators found that a quarter of the terminally ill patients received shocks in the last month of their lives, including several patients who were shocked in their last minutes.
While implanting a defibrillator requires surgery, turning one off can be done simply by using an external computer programmer.

Dr. Rachael Lampert, a professor at Yale School of Medicine who led the group that wrote the guidelines being released Friday, says physicians have not addressed the issue more directly in part because medicine is so specialized.

“It is a difficult issue because care is so compartmentalized,” Dr. Lampert said.
Some medical facilities like the Hospice of the Western Reserve have had policies in place. “We realized that we had to address this in some fashion,” said Dr. Wellman, who said his facility adopted its first policy about a decade ago. He estimates that 2 percent of the terminally ill patients the hospice treats have defibrillators.
Discussions with patients or their relatives begin as soon as practical, Dr. Wellman said. About 20 percent of the patients who are asked choose to keep the device active, he said. In those cases hospice workers will frequently tape a large magnet to a patient’s chest when it is clear that he or she is dying, because a strong magnetic field will deactivate the device, Dr. Wellman explained.
While some physicians are addressing the defibrillator issue, the experience of Ms. Filak, the health clinic administrator at George Mason, suggests that the failure of physicians to do so can cause immense distress to a patient’s family.
Ms. Filak said she learned about the prospect that her dying father, Joseph Hoffman, might get shocked by his device soon after his terminal bile duct cancer was diagnosed in late 2008. At that time, Mr. Hoffman was given from two to six months to live, and Ms. Filak said she soon raised the issue of shutting off his defibrillator.
The heart specialist put her off, saying the problem was not her father’s heart but cancer and they could talk about it later, she said.
Her father’s oncologist also would not turn off the unit, saying it was the cardiologist’s call, and a hospice nurse who was treating him at his New Jersey home, also deferred to the heart specialist, she said.
“Because it was cancer and not heart-related, they didn’t want to get involved,” Ms. Filak said. “They never asked him about it.”
Meanwhile, time was passing and, as the end of Mr. Hoffman’s life drew closer, Ms. Filak became more perturbed about what might unfold.
“Could you imagine, we are all at his bedside and see him jerking around,” she said. “It would have been horrible. My mother. I could not imagine what she would do.”
Finally, on a January day last year, Mr. Hoffman slipped into a coma. Ms. Filak immediately called his cardiologist and demanded that he send someone to switch off the device. About six hours later a technician arrived to do so. Mr. Hoffman, who was 81, died peacefully the next day.

Funding to Assist Lucas County Residents with Home Access Modifications

2010-01-06T07:38:00.000-08:00

Sponsor: The Ability Center of Greater Toledo

Examples of Projects: Entry Ramps, Low rise steps, Handrails, grab bars, wheelchair lifts

Eligibility Requirements: Lucas County Resident, Income requirements, may be a renter or homeowner

Funds to assist residents in Wood, Ottawa, Fulton, Henry, Defiance and Williams County will arrive in early 2010

For More Information and/or an application, contact

The Ability Center of Greater Toledo
5605 Monroe Street
Sylvania, OH 43560-2702
(419) 885-5733 or 866 885 5733 (Toll free)

The Blanchard Valley Hospital Breast Cancer Support Group

2009-12-31T06:13:00.000-08:00

Date: The second Tuesday of every month
Time: 6:30-8:00pm
Location: The Conference Room in the new EasternWoods Outpatient Center, 15900 Medical Dr. South, Findlay, OH 45840
Fee: Free
Contact: Barbara Deerwester RN, 419-423-5282

Request to complete a questionnaire

2009-07-29T12:27:00.000-07:00

I am an Assistant Professor of Nursing at Duquesne University. I am conducting a study with parish nurses and their clients.

Phase I of my study involves testing a questionnaire about parish nursing practice and Healthy People 2010 goals. I am asking for parish nurses to complete this questionnaire.

If you are interested in participating in this study, please contact me at kingm1@duq.edu or 740-381-3528 (cell phone) and I will explain the procedure for participation.

Thank you,
Michalene A. King, PhD, RN
Mercy Parish Nurse and Health Ministry Program
1515 Locust Street - Suite 705, Pittsburgh, PA 15219
(O) 412.232.7997 ~ (C) 412.310.0521

Request from Drs. Harold Koenig and Verna Benner Carson

2009-05-15T19:06:00.000-07:00

Drs. Koenig and Carson are beginning a second edition of Parish Nursing: Stories of Service and Care and would like to invite you to send your stories.

Dr. Carson writes, "We want to expand our focus beyond those initial nurses [included in the 1st edition] to include the voices and stories of other parish nurses, including those who are practicing internationally. We would be honored to hear and include your story in this book. The process that we used in the first edition was to send out a questionnaire that guided the nurses as they told their stories. In addition, I communicated with them via email throughout the project. When the book was published everyone who participated received a complimentary copy of the book as a token of our appreciation for their generous sharing."

For more information about participation, please contact Dr. Carson vcars10@comcast.net or Dr. Koenig koenig@geri.duke.edu

Share your thoughts about "The Alzheimer's Project"

2009-05-15T07:53:00.000-07:00

The premiere of the groundbreaking HBO documentary series "The Alzheimer's Project" is over, but the films are available online at www.alz.org/HBO.

(If you missed any of the episodes, they will also air throughout May on HBO and HBO2.) What do you think about the series? Join our community of caregivers and people living with Alzheimer's who are talking about "The Alzheimer's Project."

Share your thoughts about "The Alzheimer's Project" http://alzheimers.infopop.cc/eve/forums

See news articles about the series http://alz.org/news_and_events_in_the_news.asp

Exercise and Problem Solving

2009-05-15T07:48:00.000-07:00

Sponsor: The Alzheimer’s Association, Northwest Ohio Chapter; Ohio Department of Aging; and Benjamin Rose Institute are working together to offer a new program for people with memory loss and their caregivers.

Date: Ongoing

Fee: Free

Description: This program combines a gentle exercise program, education, and problem solving to try to help people improve their abilities. In order to be involved in this program, the individual with memory loss and caregiver must both participate.

Contact: 1-800-272-3900 and ask for more information about the “RDAD Program

Equipment Loan

2009-04-20T08:52:00.000-07:00

Sponsor: Ability Center of Greater Toledo

Serving People With Disabilities

Items: assistive equipment may be borrowed for up to 90 days.

Contact: Amy Kerchevall at 419 885 5733 ext 253

Times: 8:30 a.m.to 4:00 p.m.

Days: Monday through Friday

Searching for A Speaker for Your Group

2009-03-25T11:52:00.000-07:00

Sponsor: Swan Creek Retirement Village, Maumee Ohio
Topics: Varied
Fee: Free
Includes room and program
Contact: Kim Smith, Church Visitation Director 419 482 0619

Cancer Connection of Northwest Ohio

2009-03-13T08:51:00.000-07:00

Sponsor: The Cancer Collaborative of Northwest Ohio
Date: Third Thursday of every month
Time: Noon to 1:00 p.m.
Speakers; Jean Schoen and Joy MacLeod
Location: The Victory Center, 5532 WOHest Central Ave., Suite B,, Toledo
Brown Bag Lunch
No pre-registration required
Contact: 419 531 7600 Penny McCloskey, The Senior Coordinator for the Cancer Collaborative
pmccloskey@victorycenter.org

National Health Ministry Healthy Living Survey

2009-02-09T11:52:00.000-08:00

Sponsor: National Health Ministries
You are invited to participate in a Health Living Survey.

National Health Ministries - Healthy Living Survey is an ongoing effort from the office of National Health Ministries to seek input on health related issues and to take a "snapshot" of the health and well-being of folks who are kind enough to provide data through our surveys.
We periodically gather information and sometimes opinions on issues related to health, healthy living and healthy aging, and rather than ask each time for new participants, we thought it might be helpful to have a list of folks who had already indicated they were willing to share information with us.

These data and input are very helpful as we develop new resources and as we look at trends in health and healthy living. We are also interested in how boomers and elders are experiencing retirement and the second half of life.

As you register on this site, your contact information and demographic characteristics will be recorded so that you will only be asked to respond to those surveys that are relevant for your demographics and or living situation. For instance, if we are seeking information about rural incidence of seasonal flu, and you live in urban Newark, we won't bother you.

Please note that we welcome participation for folks of any faith group. This will not be a scientifically drawn research group, but, something called a convenience sample.

http://www.surveymonkey.com/s.aspx?sm=HheV2ZYezZMCLyfdH2l_2bGQ_3d_3d

United Church of Christ Faith Community Nurse Network

2008-12-24T05:47:00.000-08:00

Sponsor: United Church of Christ

Help us prepare for the coming Faith Community Nurse Network that will be a part of the new UCC Online Community (a virtual "Facebook"/"Myspace" for the UCC) to be unveiled in January of 2009.

Contact: baylorb@ucc.org.
Barbara T. Baylor, MPH, CHES
Minister for Health Care Justice

Lifestyle and Exercise Classes

2008-11-21T12:17:00.000-08:00

Sponsor: YWCA Healthy Connections
Healthy Connections brings holistic health awareness to women by providing educational, community and fitness resources.
Dates: Tuesdays and Thursdays
Time: 5:30 p.m. to 7:00 p.m.
New Session starts every eight weeks
Fee: $16.00 for entire 8 week session
Location: YWCA of Greater Toledo, 1018 Jefferson Ave., Toledo, OH
Contact: Cindy Roach at 419 241 3235

Emotions Anonymous 12 Step Program

2008-11-16T15:06:00.000-08:00

Date: Tuesdays
Time: 9:30 a.m. to 10:30 a.m.
Location: Trinity United Methodist Church, 301 W. Market St. Lima OH
Date: Sundays
Time 6:00 p.m. to 7:00 p.m.
Location: St. Rita's Medical Center, Classroom 3, 718 W Market St. Lima, OH
Fee: Free
Local Contact: 419 999 6283 or by E mail eainlima@aol.com
Worldwide Contact Information 651 647 9712 or www.emotionanonymous.org

Ovarian Cancer Support Group

2008-11-16T14:46:00.000-08:00

Sponsor: ProMedica Cancer Institute
Title: "Getting Ovar It"
Date: November 20, 2008 (first meeting) and every third Thursday
Time: 7:00 p.m. to 8:30 p.m.
Location: Hickman Cancer Institute, Flower Hospital, Sylvania, OH
Fee: Free
Contact: Patti Kaiser, outreach coordinator 419 824 8822
Also available by teleconferencing, call Patti for details

Does your baby cry too much? Hotline

2008-11-06T03:28:00.000-08:00

Sponsor: St. Vincent Mercy Children's Hospital

Time: 24 hour/7 days a week hotline

Call: 419 251 5555 or toll free 1 877 251 5437 ask for extension 1 5555

For more information on the St. Vincent Mercy Children's Shaken Baby Syndrome Prevention Program or to request a speaker for your faith community call 419 251 8103

HOPEKEEPERS. Do you live with chronic illness or pain?

2008-11-05T10:49:00.000-08:00

Sponsor: McCord Road Christian Church and Affiliated with Rest Ministries (www.restministries.org

Subject: Study/Support Group entitled "When Chronic Illness Enters Your Life"

Date: Monday November 10, 2008 and every second Monday of the month

Time: 7:00 p.m. to 9:00 p.m.

Location: McCord Road Christian Church, 4765 N. McCord Road, Sylvania, OH

Contact Person: Call or email Melissa at 419-350-6402/ mambort@jhu.edu.

Don't miss this chance to grow spiritually while surrounded by others who share similar circumstances, unrevealed answers, & even joys in the midst of living with illness or pain.

Health Companion: a software tool

2008-10-10T09:17:00.000-07:00

Description: This software package is a tool for consumers to use to organize and manage their healthcare expenses. The software not only manages medical expenses, it collects data, but also plans and analyzes doctors’ appointments, healthcare expenditures and insurance benefits and prescriptions.
Fee: Free for one month trial period, purchase software $39.00
Web site stabilix.com when on web site select products

Be a Guardian Angel… Be a Volunteer Guardian

2008-08-15T09:54:00.001-07:00

Title: Volunteer Guardianship Program

The program provides a service by which trained volunteer guardians are court appointed for indigent older adults who are deemed incompetent for Lucas County Probate Court. These individuals are age 60 and over, and reside in a nursing home within Lucas County.

Contact: Lutheran Social Services of Northwest OH, Carol Pack, Christine Miller or Monica Slovak, @ 419-243-9178, or you may visit www.lssnwo.org.

Hospice Five Minute Video

2008-08-15T09:39:00.000-07:00

Sponsor: Odyssey Health Care, Maumee OH
Title: "Hospice: It's About Living"
Fee: Free to Faith Community Nurses
Contact: Call 419-887-6700

The Art of Healing: for Cancer Survivors and Guests

2008-08-01T09:52:00.000-07:00

Sponsor: St. Vincent Mercy Medical Center
Topic: Laugh group to share and talk about cancer survival through different art techniques
Date: First Thursday of each month
Time: 6:30 p.m. to 8:15 p.m.
Location: St. Anne Mercy Hospital, Conference Room 1, 3404 West Sylvania Ave, Toledo, OH
Fee: Free and all supplies are provided
Reservations are required
Contact: Jennifer Balogh 419 467 4622 or Nancy Keller 419 251 4153

The Physical Activity Guidelines Advisory Committee Report, 2008

2008-06-24T09:56:00.000-07:00

You can access the report by copying and pasting the
Report link:

http://www.health.gov/paguidelines/

The 683-page report can be viewed or downloaded in its entirety or by individual chapter.

The report presents and summarizes the Advisory Committee's review of science
relating physical activity to a variety of health outcomes. It also
addresses the benefits of physical activity for particular subgroups of the
population such as children and youth, pregnant and postpartum women,
persons with disabilities, and individuals with some chronic conditions.

Breast Cancer Support Group

2008-04-17T16:33:00.000-07:00

Sponsor: Blanchard Valley Health System
Date: 2nd Tuesday of Each Month
Time: 6;30 p.m to 8:00 p.m.
Location: Blanchard Valley Hospital, Donnel Patient Pavilion, Aller, Beckett and Davis Meeting Rooms. 1900 South Main St. Findlay, OH
Fee: Free
Contact: Barbara Deerwest Woman Wise Dept. at BVH: 419-423-5282
or Nancy Cash at 419 422 3812

West Toledo Bereavement Support Group Expands

2008-03-03T12:33:00.001-08:00

Date: The Fourth Thursday of Each Month
Time: 11:00 a.m. to 12:30 p.m.
Date: The Second Tuesday of Each Month
Time: 6:30 p.m. to 8:00 p.m.
Location: Christ the King Parish Center Meeting Room
4100 Harvest Lane, Toledo, 43623
Fee: Free
Contact: Terry McKown at 419 475 4348
“He who has no time to mourn, has no time to heal”... John Donne

Ability Center Ramp Program

2008-02-01T12:55:00.000-08:00

Sponsor: Ability Center of Greater Toledo
Program: Minor Home Modifications (examples: ramps, handrails, wheelchair lifts, bathroom modifications etc.)
Elligiblty: Children and Adults living with disabilities in Lucas, Wood, Ottawa, Fulton, WIlliams, Henry and Defiance Counties
Income Eligibility requirement: Total family income 35% of average median income of county where they reside.
Contact: Ability Center of Greater Toledo, Mary Kowalik 866 885 5733 (toll free) or mkowalik@abilitycenter.org

Alzheimer's Association Caregiver Notebook

2008-01-03T10:08:00.000-08:00

Visit the Alzheimer's Association Web site www.alz.org

NEW! Caregiver Notebook

Get a FREE copy of the Alzheimer's Association's first-ever guide for those who care for people with dementia. Over 100 pages of information, how-to tips, checklists and resources.

The Caregiver Notebook pilot was made possible by funding from Evercare.

Spiritual Support for Family or Friends Brochure

2007-12-07T12:16:00.000-08:00

Download a free brochure Offering Spiritual Support for Family or Friends

http://www.caringinfo.org/UserFiles/File/faith_brochure.pdf

Sponsors: Caring Connections a program of the National Hospice and Palliative Care Organization, Grant from Robert Wood Johnson Foundation
Fee: Free

Other Brochures are also available from www.caringinfor.org

Accessible Living through Home Modifications

2007-12-06T11:06:00.000-08:00

Sponsor: CGA Home Modifications, L.L.C.
Speaker: Gina Arroyo, COTA/L (Occupational Therapist)
Program: For Seniors or Parish Nurses on Home Safety and Fall Prevention
Location: Available to speak to groups at faith commuities
Fee: Free
Contact: Gina Arroyo 419-822-7762 or e-mail at gc_arroyo@sbcglobal.net .

Interim Health Care Program Offerings

2007-12-05T10:42:00.000-08:00

Dates: Winter of 2007-2008
Sponsor: Interim Health Care Toledo Office, covering Lucas, Wood and Fulton Counties
Program Offerings: "Living with a New Joint", "Building Mental Strength" and "COPD"
Location: Speaker will come to your faith community to speak to a group
Call: Deb Arthur at Interim Health Care to schedule a program 419 578 4698
or e-mail Deb at daurthur@interimheathcare-tso.com
Fee: Free

Engage Life Seminar Series: Educational Opportunities for Adults and Seniors

2007-12-02T16:48:00.000-08:00

Sponsor: West Park Place
Location: 3501 Executive Parkway, Toledo, OH, 43606 or at your Faith Community
Topics:" Understanding the Changing Dynamic of Retirement",
"How to talk with your Parents about Retirement",
"Mind Matters: Brian Fitness & Healthy Aging",
"Cooking for One: How to keep it Simple and Keep it Healthy",
"Feed Your MInd: How to Cook the Brain-Healthy Way"
Contact: Jessica or Stephanie
Phone: 419 531 9211
E-Mail wppcrconsultant@seniorstar.com

The Managed Care Advocacy Program

2007-11-21T04:36:00.000-08:00

The Managed Care Advocacy Program, a ministry of Toledo Area Ministries, works with seniors about issues concerning Medicare, Medicaid, private insurance and prescription drug coverage.

Many plans have changed or are no longer available. It is wise to have a comparison done of current, Medicare-approved prescription drug companies, to determine which might best suit your current needs. The Managed Care Advocacy Program offers this service to seniors, free of charge.

The open enrollment for Medicare Part D - Prescription Drug Coverage - is November 15 through December 31, 2007. Any new enrollments or change in plans will be effective January 1, 2008.

If you'd like more information concerning Medicare, Medicaid, private insurance or Medicare Prescription Drug coverage, please call us at 419/244-3587 or by e-mail at MCAP@tamohio.org.

Zostavax (Shingles Vaccine) Information

2007-11-20T10:51:00.000-08:00

Shingles vaccine – with the recent occurrence of shingles among several people in Sylvania, Ohio, everyone is reminded of what a painful and debilitating condition shingles can be. There is a vaccine, zostavax, that can prevent 50% of the cases of shingles and reduce the pain and severity if one does get shingles. Any person older than 60 who has had chickenpox at any time and who has not had shingles, should get the vaccine unless they are getting chemotherapy or have a transplant or have AIDS. The cost of the vaccine is $150 – 200 and may be covered by your insurance. Cathy Hunter published this information in her newsletter to church members. Cathy Hunter 419 882 0048 or by e-mail Cathy@sylvaniaucc.org.

Survey about Health Insurance in the USA

2007-11-18T09:47:00.000-08:00

Sponsor: Health Ministry Association

Rising health care costs, insurance premiums and deductibles are making health care difficult to afford for many who live in the U.S. Forty-eight million people because of job status or loss, or benefit reduction have no health insurance at all, and this number grows with each day.

Last week we sent an electronic newsletter from National Health Ministries seeking information about a number of health related issues. I am asking for your help in particular in gathering personal experiences related to health care, health care coverage and access to care.

The newsletter included a link to a survey (see below) designed to collect information to help us understand how issues connected to health care coverage are affecting the lives of the people - both adults and children. Although the problems related to healthcare in the US are huge, they are not insurmountable. All of our individual experiences help highlight the pressing need for some type of reform.

If you have not taken time to complete the survey, please consider sharing your thoughts and experiences. Be assured that this information and any personal stories that are collected will never be used in any way that identifies the person or congregation or community from which it came.

Thank you for your very important help. Copy and Paste the URl below to take the survey

http://www.surveymonkey.com/s.aspx?sm=7vOAF0lrZFO1UcbhzMXnKQ_3d_3d%20%20%20