JFCS and Secure@Home were proud to partner with Greenwood Hospice Team to present on hospice myths and truths. The Greenwood Hospice Team addressed important misconceptions about hospice care and what it means and answered your questions like…

How do I know it is time for hospice care? How is it determined that someone qualifies for hospice?

How do I find the right hospice care for myself or my loved one?

Is there coordination between hospice and the patient’s personal physician?

What if there is no family at home with someone who needs hospice care?

How do you handle it if a patent has dementia and wants something that the family doesn’t want for them?

Presenters:
Beverly Mishkin, LCSW, Director of Senior Services & Case Management (JFCS)
Joy Simons, RN, CHPN : RN/Case Manager and Admissions Coordinator (Greenwood Hospice)
Edwin Arevalo,Jr. MDiv, MSCC : Chaplain/Spiritual & Bereavement Counselor (Greenwood Hospice)
Marcelle McGovern, LSW, MSW: Medical Social Worker (Greenwood Hospice)

View the full webinar recording below:

During the COVID-19 pandemic, many organizations, communities, and families have turned to Zoom as a way to connect virtually while remaining socially distant. But joining Zoom calls can be complicated and time-consuming, which discourages us from socializing with relatives and friends. These instructions can help you to join Zoom calls using a computer, a smartphone, or a regular cell phone so that you don’t miss out on virtual social gatherings.

Find the information for your Zoom call:

• If you are joining a meeting for an organization, a webinar, or any other large gathering, the Zoom information was likely emailed to you or written on a flyer
• If you are Zooming with a small group of friends or family members, the Zoom information may have been texted or emailed to you by one of the people you will be meeting with
• Zoom information typically includes a link (something like this: https://us04web.zoom.us/j/77031980384?pwd=VTExL1RhcVp3OFFwcVZTQnNoUHpJQT09)
• There may also be a meeting ID (e.g. 992 8642 1976) and a passcode (e.g. Zoom123)
• Zoom information also includes phone numbers (e.g. 646-814-2485) that you can dial to join the call if you do not have a smartphone or computer

Join a Zoom call from your computer:

• Click on the link for the Zoom call or highlight the link, copy it, and paste it into your browser
• To copy and paste the link: Hold down on the mouse while dragging it across the link à Press Control-C or Command-C (depending on your type of computer) à Open a new browser window and place your cursor in the search bar à Press Control-V or Command-V (depending on your type of computer)
• After opening the Zoom link, enter the Meeting ID and password if needed
• A window will pop up asking for this information if it is necessary
• Click “Join with computer audio” so you can hear the meeting
• To show your video, click on “Start video” in the bottom left corner of your Zoom screen
• Turn on your audio by clicking “Unmute” in the bottom left corner of your Zoom screen

Join a Zoom call using the app on your smartphone:

• Download the Zoom app by searching for it in the App Store on your smartphone
• Click on the link for the Zoom call
• If it is your first time using the Zoom app, windows will pop up asking you questions:
• Choose whether Zoom can access your camera (so you can be seen) by clicking “OK” or “Don’t Allow” when the window pops up
• Choose whether Zoom can access your microphone (so you can be heard) by clicking “OK” or “Don’t Allow” when the window pops up
• Decide whether you would like Zoom to send you notifications by pressing “OK” or “Don’t Allow” when the window pops up
• Select “Join with Video” or “Join without Video”
• After opening the Zoom link, enter the Meeting ID and password if needed
• A window will pop up asking for this information if it is necessary
• Click “Call using Internet audio” so you can hear the meeting
• To show your video, tap the screen and click on “Start video” in the bottom left corner
• Turn on your audio by tapping the screen and clicking “Unmute” in the bottom left corner

Join a Zoom call by dialing a phone number:

• Dial the number for your location (e.g. +1 646 476 1027 US – New York) – the numbers will be included in the Zoom call information
• Join the Zoom call as if you are on a phone call – You will only have audio

General Zoom Etiquette:

 To minimize background noise, mute yourself when you are not speaking by clicking “Mute” on the bottom left hand corner of your Zoom screen

• If you would like to get the host’s attention to speak, you can virtually “raise your hand”
• Click on “Participants” at the bottom middle of your Zoom screen à Click on the blue hand that says “Raise hand” à After you have spoken, click the blue hand again to “Lower hand”
• If you would like to type something in the chat, click “Chat” at the bottom middle of your Zoom screen and type your message
• All participants will be able to see your message unless you select a specific person to chat with by clicking on the “To” field above the chat box and picking a participant to message privately

Stay Safe and Happy Zooming!

Emmanuelle Farrell, MSW Intern

With summer in full swing and the pandemic limiting the number of cool places people can retreat to, it is extra important to review the essentials of summer heat safety. These tips are good for everyone to keep in mind, but are tailored specifically for seniors whose additional needs are not always included in traditional heat safety reminders.

• Keep cool. Rest in the middle of the day when it’s hottest and do chores and yardwork in the early mornings or evenings. If you do not have air conditioning, close your blinds or curtains during the day to block excess sun from heating your home.
• Keep hydrated by drinking plenty of water, sports drinks or juices as well as eating fruits and vegetables. Don’t only drink when you feel thirsty – this means you’re already on the road to dehydration, and many seniors experience a diminished sense of thirst that can keep them from always knowing when they need a drink. Limit your alcohol and caffeine intake as well in order to avoid their dehydrating (diuretic) effects.
• Check your medications for side effects that may emerge in the summer.
  • Diuretics (prescribed for conditions like glaucoma, high blood pressure, and edema) and laxatives cause you to lose fluids and become dehydrated faster.
  • NSAIDs, some antibiotics and sulfonlyureas (prescribed for diabetes management) can cause rashes where your skin is exposed to the sun.
  • Antipsychotics (prescribed for psychiatric management or sleep) can dull internal senses and prevent you from knowing if your body is getting too hot.
  • Anticholinergics (prescribed for COPD, incontinence, gastrointestinal disorders, and allergies/asthma) can cause you to sweat less, preventing your body from cooling itself.
  • Beta blockers cause slower heartbeats, which can get in the way of your body’s ability to respond to heat stress.
• The risk for heat-related illness increases with age and is even greater for those with health conditions such as heart and circulatory system problems, lung or kidney disease, infections, and those who are highly under- or overweight. Ask your doctor if you need to take any special precautions to stay safe this summer.
• Consider wearing a call button in case of emergencies. While some may find the idea uncomfortable, erring on the side of caution is a key part of summer safety. Another option is agreeing with a friend to check in with a phone call once a day.
• Know how it feels to have different heat-related illnesses and what you should do about them.
  • Heat exhaustion: Occurs when your body is struggling to maintain your normal temperature because of the increased heat outside. If your body can’t release the heat faster than it accepts it, your core temperature will begin to rise. This situation is dangerous to your health and requires immediate action.
    • Symptoms include dizziness/feeling faint, loss of consciousness, excessive sweating, weak heartbeat, nausea/vomiting, muscle cramps, headache, pale and cool skin, and a temperature higher than your baseline but lower than 103°.
    • To treat, start by moving to a cool place and drink water slowly. When you feel well enough, take a cool (not hot or cold) shower or bath, or place cool, damp cloths on your neck, armpits, groin and forehead. Get help if your symptoms do not improve after an hour, you vomit or lose consciousness or are concerned that you will.
  • Heat stroke: your body has exhausted all methods of cooling itself down, and your temperature is dangerously high. The situation is extremely dangerous and requires emergency medical treatment.
    • Symptoms include dizziness/feeling faint, loss of consciousness, no sweating, rapid and strong heartbeat, nausea/vomiting, headache, skin that’s hot, red and dry, and a temperature above 103°.
    • If you get heatstroke it’s unlikely you’ll be well enough to treat yourself, which is why it’s so important to pay attention to how you feel before the situation becomes dangerous. To treat someone else with heatstroke, call 911 immediately – the longer a person has heatstroke, the more likely they will not recover or will have lasting damage to their body when they do. While you wait, follow the dispatcher’s instructions, which will most likely be to bring the person to a cool place and place cool, damp cloths on their armpits, neck, groin and forehead. Do not attempt to give them anything to drink, especially if they are confused or unconscious; the person may accidentally breathe in the fluid (aspiration) which is also extremely dangerous. Medical professionals will rehydrate the person themselves using IV fluids.

Samantha Goldfarb, Intern

A recent article from AARP* told the story of a 70 year old woman, who had a medical emergency while out of town. According to the article, it required an “array of often-confusing calls and wide outreach to friends and neighbors that left her feeling vulnerable and terrified.” The article continues by outlining important steps to take if this should happen to you.

It is very helpful advice if you are physically and mentally capable of advocating for yourself, or if you have a concerns about an aging loved one who wants to remain in their home. Whether or not you are, the Secure@Home program can be an invaluable resource. Secure@Home is an aging-in-place program staffed by clinical social workers/geriatric care managers.

As a member of the program, if you do not have family or friends who could intervene on your behalf, you can list a Secure@Home care manager as your primary emergency contact. Though we do not make medical decisions for you, as a member, we would know who your medical care proxy is and how to reach them. We would have a list of your medications, physicians and additional emergency contacts. We would also have your advance directive on file and could transmit it to wherever you were hospitalized, and coordinate your follow up care with the hospital social worker. The Secure@Home program will follow you wherever you are.

We have received calls from people who are traveling and find themselves in a hospital. Sometimes their travel buddy or spouse calls us to find out what medications they are taking. And of course, when you are home, we will step in and manage your care locally. One of the AARP article recommendations was to “find a geriatric care manager” – and here we are! 

Andrea Gaynor, LCSW Geriatric Care Manager

The phrase “social distancing,” the action needed to reduce the risk of exposure to an illness or virus, has now become part of our vernacular. We’re advised to maintain a distance of 6 feet from others, avoid being in crowded areas (i.e., avoid shopping when stores are busy or use “senior” hours to shop), wash our hands for 20 seconds or longer both before and after an array of activities, and use online grocery service. While all this is meant to safeguard us as best as possible, we have become isolated out of necessity and safety.

One of the keys to remaining healthy during this crisis, both physically and mentally, is to find alternative outlets for socialization and stimulation. We need to follow a “normal” routine with regards to sleep/wake times, exercise, eating, etc. Limit the amount of news exposure and consider the source of where you are obtaining your news from, as some may be more sensational rather than factual. Constant exposure to the news can also increase one’s anxiety. 

Here are 12 activities that might be of interest, while remaining in the safety of your home:

Chair Yoga

“Visit” a Museum

De-stress by listening to a 20 minutes relaxation exercise  

Sign up for a free online class…one option is Covia: Well Connected

Here is one option: https://covia.org/wp-content/uploads/2019/12/Well-Connected-Winter2020-FINAL.pdf   

Join a chat room such as Bridge Club Live or Mah Jongg

“View” historic sites or take a walking tour of NYC

Learn a new skill or craft

Use this time to declutter your home (pick a room) or switch over your wardrobe for the spring season.

Try a new recipe that uses the ingredients and spices already in your home

Socialize with friends and family through Skype, Google Duo,of Facebook Messenger

Set up a regular time for a call with family or a friend daily

Beth Hammer, LCSW (Geriatric Care Manager)

We are all dealing with grief now—loss of normalcy; loss of connection; fear of economic toll, nervous anticipation of the future. For those in our community who are mourning the loss of a loved one, the grief is intense and even more isolating because we do not have the traditional community supports to provide some sense of stability. As holiday times approach, the Empty Chair has become the Empty Table and the Empty Room. What are some tools that can give you the support you need?

A VERY IMPORTANT REMINDER:  Everyone experiences grief in his/her own way. There is no right or wrong. Give yourself permission to do whatever feels right, and please be gentle with yourself.

Suggestions for Handling the Holidays:

• Nothing is normal for anyone this year. Think about what has helped you since the loss of your loved one; don’t do what you think you should but what feels right to you.
•  Connect, connect, connect—to your friends, your family, your community (of faith or otherwise).  Take advantage of technology old and new:  telephone calls, email, text, Facetime, Skype or Zoom.  JFCS will provide resources for virtual Passover seders, as well as other services and celebrations, in a future post.
• Tell your family and friends what you need, whether or not they ask. Don’t be shy—this is not a time for false reticence, you ARE strong but you still need others for support and help.
• Think of rituals that have meaning for you and turn to them as often as necessary—these can relate to the holiday or not. There won’t be a big family meal this year (that would have raised other issues for you as you grieve), but you can make dishes that you love or that bring back happy memories. You can share recipes, perhaps using technology as you go about your preparations, or sing songs together or tell stories of holidays past. Or you can do none of the above.
• Turn to prayers or readings from the holiday that have special meaning for you. Repeat them as often as needed for consolation.
• Sing special songs relating to the holiday as you wash your hands (for 20 seconds). In fact, listen to or make music as much as you can. Music leads to activity in multiple parts of the brain where we process emotion, memory, awareness, and attention. It can help short-circuit sadness by using these brain areas to bring up happy emotions and joyful memories as we tune our attention to the song. We also know that music can bring strong emotions and heartfelt tears to the surface, which can help us process the complex emotions we are experiencing at this time.

NOTE:  Memories, with their sweetness and their pain, are important tools for healing. You know that your loved one will never be forgotten. Relationships don’t end with death but, with time, they will become transformed. And there is nothing wrong with crying.

• Breathe.  Focus on all five of your senses, perhaps with particular reference to the upcoming holiday.  The sweet smell of a favorite food, the texture of special clothing, tablecloths or a reclining pillow, the sight or feeling of one small item related to the holiday that warms your heart, the clink of glasses of wine. Memories of holidays past will, of course, be painful without your loved one.   Try to access the positive ones.
• This is the time for spring holidays, with their connection to nature. Go outside as much as possible, if you can. Savor the sights of flowering trees or plants. Smell the smell of fresh green grass. Move your weary muscles. Remember that we are all part of the cycle of life.

Beverly Rubman, Chaplain