Voice – Martinez Tribune https://martineztribune.com The website of the Martinez Tribune. Tue, 25 Jun 2019 19:43:35 +0000 en-US hourly 1 https://wordpress.org/?v=5.2.4 Things to remember when a senior with dementia is delirious https://martineztribune.com/2019/06/25/things-to-remember-when-a-senior-with-dementia-is-delirious/ https://martineztribune.com/2019/06/25/things-to-remember-when-a-senior-with-dementia-is-delirious/#comments Tue, 25 Jun 2019 19:42:07 +0000 https://martineztribune.com/?p=12217 BY PURNIMA SREENIVASAN Delirium is not dementia nor depression. As we revisit Dementia and Alzheimer’s this month dedicated to its awareness, delirium becomes more significant than ever. With growing research on delirium, hospitalization risks, along with morbidities and mortalities related to it, it’s time to understand why we must revisit dementia in the context of …

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BY PURNIMA SREENIVASAN

Delirium is not dementia nor depression. As we revisit Dementia and Alzheimer’s this month dedicated to its awareness, delirium becomes more significant than ever. With growing research on delirium, hospitalization risks, along with morbidities and mortalities related to it, it’s time to understand why we must revisit dementia in the context of delirium.

Delirium is limited not only to the hospitals, but in the community as well. A condition associated with acute brain failure associated with autonomic dysfunction, motor dysfunction and homeostatic failure, according to the National Institutes of Health.

It is a serious disturbance in mental abilities that results in confused thinking and reduced awareness of the environment, per the Mayo Clinic. 

Dementia and delirium are separate entities, though a continuing delirium might cause further cognitive loss. Delirium is often irreversible, affecting cognition permanently. There are many causes of delirium.

Here are some things to remember when a senior with dementia is delirious:

  1. Families need to know if the senior is delirious during and after hospitalizations, as treatments could sometimes harm more then than help.
  2. Decision making is not the right thing when a senior is confused and is diagnosed with delirium.
  3. Re-Evaluating medications, and the person as a whole, is critical to the improvement of a senior from delirium.
  4.  Discharge planning must be considered, wisely and properly, with a delirious senior with dementia.
  5.  Nutrition, physical safety, security, love, and compassion are all ways to treat delirium as well.
  6. No one senior with delirium is the same as the other. Individualized treatment is a must. Families must ask for, and understand all treatment modalities.
  7. Continuous care is far beneficial than fragmented care. This means caring for a senior with dementia and delirium continues beyond the hospital walls.
  8. Risk of harm or injury is higher during delirium and caution is a must to prevent catastrophic changes and incidents.
  9. Alertness and quick identification of root cause is related to recovery and thus a regular uninhibited open-ended discussion with the provider is key in healing from delirium to quite an extent.
  10. Understanding the importance of social, psychological, physical, environmental determinants are absolute essentials. This means reconciling not just chemical drugs, but also the structure and foundations of a senior’s life at home.
  11. Lack of speech, vision, hearing, taste, touch can further worsen delirium at times, hence these should be discussed and conveyed with the provider.
  12. Families or responsible parties must be a part of the entire process, once the senior with cognitive challenges has been diagnosed with delirium.
  13. Diagnosing delirium correctly and not missing it in context of dementia should be a priority of all providers.
  14. It is important to understand that delirium can be a reason for sudden decline and require more hands-on care, new morbidities, and even sudden mortalities. 
  15. Delirium in dementia could become a financial burden, with poor care, as the senior will have be at a higher level of care at the time of discharge. This is also a cause of stress, and a crisis trigger for health issues in the people related to the senior.

Looking back at some of the things described, a commonality is the need for efficient identification and diagnosis. To commit an error is a whirlpool of sorrows to befall on the senior and their immediate caregivers, families and communities. We live in a world where access to care time is being shortened, it’s time to shorten the time to determine the causes of delirium and treatment.

There are advance directives and other choices to be made. However caution must be exercised when a senior with dementia is delirious. Our population is aging and in years to come we will need to depend on better care.

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Helping seniors cope with memory loss https://martineztribune.com/2019/06/14/helping-seniors-cope-with-memory-loss/ Fri, 14 Jun 2019 22:44:09 +0000 https://martineztribune.com/?p=12114 BY PURNIMA SREENIVASAN Memory loss is not a normal part of aging. We as humans must age, and then leave this earth. In this journey, which we face as beings of highest intelligence, our coping mechanisms are largely different and changeable, which makes us become dependent on them, giving us a reason to either thrive …

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BY PURNIMA SREENIVASAN

Memory loss is not a normal part of aging. We as humans must age, and then leave this earth. In this journey, which we face as beings of highest intelligence, our coping mechanisms are largely different and changeable, which makes us become dependent on them, giving us a reason to either thrive or decline.

How are we coping with our health needs ? How do we know we are doing well ? How are we improvising our very own needs and wants ? What structure do we follow ? Where do we harness the power to keep going on ?

And then when we find out we are losing our keys, cannot keep track of our finances, or remember our address. Daily chores are confusing, we forget when we had our last meal. Then what do we do ?

Over the years these things intrigued me. They were part of my path to understanding how the brains of seniors who now face cognitive issues truly continue to function. Many were not aware, some were aware only because of their spouses or families or friends letting them know, while others never knew as this is still considered a taboo.

Why this makes it important is because of the potential to find solutions, solve problems, reach new goals and develop new programs and resources, while saving lives and giving everyone a chance towards a better quality of life.  

Here are ways seniors both cope and don’t cope with memory loss: 

  1. As they have a set routine, everything seems normal in the beginning and easy as always, until later….
  2. Some confide in their providers early as they believe in the power of communications and are curious to give themselves permission to be understood.
  3. Some seek the comfort of the families, familiar people, such that their disabilities are hidden until later. Unfortunately too late in some instances.
  4. Find resources for themselves.
  5. Stop committing to certain activities in the fear of being found out. Or camouflage at such very well. 
  6. Struggle to balance a check book or finances and forget to pay bills. In some cases falling into financial trouble through scams, fraud, debts and lack of control of money through unnecessary spending.
  7. Become isolated, solitary and refusing to be social. Or more social, flamboyant.
  8. Start losing weight, with no proper nutrition, empty pantries, inability to make decisions to buy or choose healthy foods. Or gain weight by eating unhealthy foods and neglecting exercise.
  9. Become suspicious of little things, confronting caregivers or providers. Or being overly friendly to prevent people from knowing their problems.
  10. Lack of motivation, become depressed leading to poor appetite and its effects on aging.  
  11. Lack of hygiene, or vice versa, such as obsessing over certain things. 
  12. Hording issues or minimalist living.
  13. Inability to understand. Confusion and difficulty in comprehending.
  14. Experiencing increased falls and encountering more hazards at both home and outside.
  15. Safety issues, security risks, wandering around and confused.
  16. Lack of sleep or oversleeping.
  17. Losing friends or experiencing further isolation.
  18. Apprehensive of community resources, despite the need to ask for help. Boredom, self-medication and lack of seeking the much required comprehensive geriatric care.

It is sad that a lot of seniors will be going through this. We are destined to have a growing aging population. At some time, our world will have more seniors and cognitive issues will become an unmanageable challenge. What we commit now will be realized much later. It’s time to start somewhere. Let’s make these things a part of a health care assessment. By doing so, we will be making a positive impact on global healthy aging economics, senior living and longevity.

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Finding ways to cope with a recently diagnosed spouse’s dementia https://martineztribune.com/2019/06/08/finding-ways-to-cope-with-a-recently-diagnosed-spouses-dementia/ Sat, 08 Jun 2019 16:52:12 +0000 https://martineztribune.com/?p=12075 BY PURNIMA SREENIVASAN Why is caregiving so tough ? Why are there caregiver crises ? Why is there such a need for caregiving ? In today’s world, we are the first generation to share our planet with more elderly humans than we are with children less than five.  While the aging population is living longer …

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BY PURNIMA SREENIVASAN

Why is caregiving so tough ? Why are there caregiver crises ? Why is there such a need for caregiving ?

In today’s world, we are the first generation to share our planet with more elderly humans than we are with children less than five. 

While the aging population is living longer we must understand that with aging comes the burden of caregiving. This caregiving is not just limited to chronic diseases but also to diseases and conditions where there is no cure, let alone an accurate diagnosis. With this comes the burden of a journey in a caregiver’s life that begins with the very first conversation with a beloved family member, friend or life partner now having the dreaded incurable disease.

What if the condition was dementia or Alzheimer’s ? If we give it a thought for just a moment, the reality will open up vistas that existed, which we never knew before.

What is the momentary realization ? Was it appropriate ? How helpful was the information ? Were we compassionate enough ? Did we understand the phases of a life being hit with the unknown ? Who were we truly talking to ? What did we discover in this context ? These are all things that we’ll be addressing in upcoming articles.

How do we then find ways to cope ? When we are ourselves the receiver, the believer, the giver, the resource. Because it will lay the foundation to better caregiving, in the journey we may face……

  1. Have a non-face to face conversation as a beginning.
  2. Determine the priorities we must respect, in order to respect others.
  3. Reach out for resources in the community. There are organizations supporting the various types of dementia.
  4. Think of the disease as not the person. For the person is the same, it is the disease that makes someone seem and look different.
  5. Take time for oneself. A few minutes or more, depending on your needs.
  6. Plan for help from volunteers, or religious institutions one might belong to.
  7. Concentrate on the well-being of both parties, for medicine is only one percent of the pie.
  8. Make resting, meditation and self-love a necessity as the well-being of caregivers directly relates to the quality of care provided.
  9. Find meetings to attend. Information sharing is helpful in many ways, and can have a profound effect on the alleviation of mental burdens and other crises.  
  10. Keep a personal diary. Recollect and reminisce the positives.
  11. Seek counseling for yourself if needed.
  12. Keep in touch with the providers of a spouse. Meet regularly, and ask questions. No question is incorrect, for a healthy exchange of ideas and finding better solutions.
  13. Have a meeting with extended family. Keeping conversations open can be very useful.
  14. Continue your personal interests, if you can. Personal time well spent equates to a positive attitude to caregiving.
  15. Continue the activities with your spouse as much as possible. Keep the daily routines normal. Change is hard and people with cognitive issues prefer routine.
  16. Bring freshness into the home. Buy flowers, read a new book, join a club.
  17. Be alert to healthcare needs. Keep appointments to continue proper health care.
  18. Follow preventative measures for both yourself and spouse.
  19. Consult with your own provider about any concerns.
  20. Invest in spiritual, emotional, psychological and sociological well-being.

There are a myriad of ways in which one can think through this, however we must remember that being patient is important. No one is similar in any way and we all have to go through this process in our own unique manner of coping.

Our world needs more care, not only in living but also in end of life. Some things are better planned in advance, but planning never means things turn out the way one envisions retirement. Coping with a recently diagnosed spouse with dementia is not a necessity but a part of health care delivery. Making time to address these determinants of life will help us better relate to our communities, countries and our world.

This article is dedicated to Alzheimer’s & Brain Awareness Month.

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New Graduate ? Now You Can Get Health Plans Through Covered CA https://martineztribune.com/2019/06/04/new-graduate-you-can-get-health-plans-through-covered-ca/ Wed, 05 Jun 2019 00:41:10 +0000 https://martineztribune.com/?p=11938 It’s college graduation season, and congrats to the class of 2019! The moment they’ve worked so hard for is finally here! They’re ready to walk across that stage, grab that diploma and begin the rest of their lives. But life can be complicated, and it’s imperative to have the important things — like one’s health …

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It’s college graduation season, and congrats to the class of 2019! The moment they’ve worked so hard for is finally here! They’re ready to walk across that stage, grab that diploma and begin the rest of their lives. But life can be complicated, and it’s imperative to have the important things — like one’s health — covered. Graduation can mean that college students are coming off a school-sponsored health plan, or turning 26, the limit for when they can remain on parents’ health plans.

Transitioning into Covered California health plans is relatively simple through the Special Enrollment process, and graduating college students may even qualify for financial help to pay for monthly health care costs – often for about $50 per month.

As an older college student, Saul Guevara had to think about some of those things even before he graduated from the University of Southern California earlier this month in Los Angeles with a Master’s Degree in Communication Management. Now 28, Guevara has been a Covered California consumer for the past two years while finishing work toward his degree.

“I chose to become a Covered California consumer because I learned that I qualified for federal subsidies to pay for my monthly health care payment,” Guevara said. “I’m paying $109 a month now instead of $316. Covered California has allowed me to get my medical needs met with the same primary care physician at a fraction of the cost.”

Guevara will begin working for the federal government this summer and plans to keep his Covered California coverage until he gets a health plan through his employer. Working part-time is a reality for many college graduates, as is getting married and starting your own business.

“Congratulations to all of this year’s college graduates for all you have accomplished,” said Covered California Executive Director Peter V. Lee. “But amidst all the changes in your life, make sure you always know what you will be doing for health care. If you are leaving your coverage behind when you graduate, then you may be eligible to enroll during Covered California’s ongoing special-enrollment period. Taking care of your health gives you the freedom to pursue your dreams.”

There are currently more than 336,000 Californians between the ages of 18 and 34 enrolled health plans through Covered California, and they are receiving quality, name-brand insurance coverage without breaking their banks.

The following circumstances are among the more common reasons people become eligible for Covered California Special Enrollment:

  • Losing health coverage because you have lost or changed jobs.
  • Turning 26-years-old.
  • Getting married or entering a domestic partnership.
  • Having a baby or adopting a child.
  • Moving and gaining access to new Covered California health insurance plans that were not available where you previously lived.
  • Becoming a citizen, a U.S. national or a lawfully present individual.

If you qualify under any of these conditions, you are eligible to get health insurance coverage and join your fellow Californians in having one less thing to worry about. Make sure you take advantage of the financial help available to you and your family. For more information on special-enrollment rules, visit http://www.CoveredCA.com/individuals-and-families/getting-covered/special-enrollment. Those who qualify for Medi-Cal may enroll through Covered California year-round.                                                                  

Eligible consumers who are interested in signing up should go to www.CoveredCA.com where they can get help to enroll. They can explore their options and find out if they qualify for financial help by using the Shop and Compare Tool. They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/ and searching among 800 storefronts statewide, or more than 17,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages. In addition, consumers can reach the Covered California service center by calling (800) 300-1506.

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The importance of Nutrition and it’s role in aging https://martineztribune.com/2019/05/31/the-importance-of-nutrition-and-its-role-in-aging/ Fri, 31 May 2019 14:12:12 +0000 https://martineztribune.com/?p=11933 BY PURNIMA SREENIVASAN As humans transform over the course of their lifespan, a major change we, our families and communities notice is our health. Then what is health ? What are the factors that help us transform into an energetic youth and what really happens as we age ? Along with physical activity, mindfulness and …

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BY PURNIMA SREENIVASAN

As humans transform over the course of their lifespan, a major change we, our families and communities notice is our health. Then what is health ? What are the factors that help us transform into an energetic youth and what really happens as we age ?

Along with physical activity, mindfulness and mental well-being, nutrition also plays a key role. Research shows us the benefits of anti-inflammatory, phytonutrient rich diet, devoid of chemicals, hormones, and other additives.

The very food we consume in our stages of life, play a vital role in the way we age. However as we age, nutrition and requirements change. Here below are some ways to think about nutrition in aging:

  1. Color matters, plates, platter and all.
  2. Taste matters, but taste differs widely like smell, and taste changes with aging.
  3. Medications do have an effect on taste and can indirectly affect nutrition.
  4. Surrounding, eating alone or in a gathering does affect nutritional needs.
  5. Ability to swallow/cognitive abilities can hamper nutrition and can cause further decline in the elderly if not addressed.
  6. Temperatures of both cooked food and raw foods do matter !
  7. Water is essential to nutrition, however understanding one’s health conditions is crucial to prevention of deterioration in health due to excess or poor water consumption.
  8. Coffee, soda, tea are not part of nutrition.
  9. Antioxidants in plant products, vegetables and fruits, do help with anti-aging.
  10. Portions must be right for stages of aging, hospitalization, activity levels, and more.
  11. Lack of appropriate nutrition can lead to deconditioning of an aging body.
  12. Freshness is superior to canned, frozen foods.
  13. Watch the sodium in your diet. Ask your provider about this.
  14. Healthy fats are essential, like proteins.
  15. Proteins are the building blocks of a human body…  It’s intake portions must be justified.
  16. All nutrients are essential to life, even carbohydrates or micronutrients, like calcium and iron.
  17. A diet rich in some and deficient in some can cause deterioration in health.
  18. Sleep does affect appetite. Consult a provider to understand more.
  19. Weight changes can affect nutrition as some debilitating chronic health conditions like diabetes, heart disease and others can cause sudden changes.  
  20. Vision can be affected by nutrition.

Yes, brain does play a vital role in nutrition. Inclusion of nutrition in meal planning and shopping to actually savoring the food is a journey. This journey began millions of years ago, as we humans began our lives as cave men and continues to evolve with time. The fascination of culinary skills is beyond the feast. What we must remember is in this journey we must not forget our elderly. Well, the next time we order or prepare a meal, let us take a moment to think how this may play when we age.

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Aging Health Education in the 21st century and beyond https://martineztribune.com/2019/05/24/11791/ Fri, 24 May 2019 14:00:27 +0000 https://martineztribune.com/?p=11791 BY PURNIMA SREENIVASAN As the number of aged in the world grow to more than a billion by 2030, health education in aging or Aging Health Education will play a very vital role in addressing the very definition of health as declared by WHO. Who will be the benefactors ? Who will be the receivers …

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BY PURNIMA SREENIVASAN

As the number of aged in the world grow to more than a billion by 2030, health education in aging or Aging Health Education will play a very vital role in addressing the very definition of health as declared by WHO.

Who will be the benefactors ? Who will be the receivers ? Who will be the mediators ? Who will be the examples ? Is a pivotal question we must answer now in order to face the increasing aged population estimated to cross 3.1 billion in the year 2100 !

Will we be ready ? Now, in the future, or in the far distant future ?   

Here are some key takeaways of aging health education:  

  1. Controls the risks and rates of morbidity and mortality that affect all seniors.
  2. Creation of a path to open learning and understanding of the needs of our older adults.
  3. Helps address disparities in aging and healthy aging we see in our communities.
  4. Grows opportunities to improve the care we provide to our elderly.
  5. Announces the beginning of a new era where the aged no longer have to scour for resources.
  6. Validates the importance of partnerships between communities, aged, families and life’s simple pleasures of aging.
  7. Sows the seed for better research so better treatment methods and sciences in advancement of healthy aging.
  8. Answers the current and future problems in aging, as a family, community, country, and world.
  9. Brings forth into light the unknowns of aging that need to be addressed.
  10. Challenges humans to improve communities to better serve the world.

The benefits to humans, adults and children caring for seniors, the seniors, the general population is immense.

Incorporating it in the curriculums of our daily lives, aging health education can and will answer many questions.

It may take us a long time to figure this out, but starting now is essential as aging encompasses many issues. We started last week with our article on Discharge planning, one of the aging health education topics, next week, we address more skin and bone of aging health education. If this resonates with you all, feel free to send us a reply, we would love to hear from you.

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Understanding cognitive issues connected with senior aging https://martineztribune.com/2019/05/17/understanding-cognitive-issues-connected-with-senior-aging/ Fri, 17 May 2019 14:00:16 +0000 https://martineztribune.com/?p=11672 BY PURNIMA SREENIVASAN Years ago, a very fine lady had left our office and started to drive out of the parking lot. She had great driving skills but she never reached home. A daughter struggling to come to terms with her step-dad, just fifty six, couldn’t handle his car dealer business any more, or another …

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BY PURNIMA SREENIVASAN

Years ago, a very fine lady had left our office and started to drive out of the parking lot. She had great driving skills but she never reached home. A daughter struggling to come to terms with her step-dad, just fifty six, couldn’t handle his car dealer business any more, or another very unfortunate story of a man who suddenly started speaking inappropriately, gambling his money off, shopping and hoarding.

All these people had one thing in common, a family that loved them and never imagined watching these events unfold in front of them so rapidly, so soon. Why ? How ?

Humans are living longer than decades ago all across the world. By 2030, our elderly populations will be more than millennials and caring for elderly is already expensive and causing global economies to rethink.

Not many non-elderly suffer from cognitive issues, but when they do, the effects are sometimes very scary for their families, communities as to themselves.

So how do we address this, so one can get diagnosed correctly, receive support and live an adequate healthy life despite there being no cure ?

Here is a checklist:

  1. Knowing what is normal and abnormal aging.
  2. Understanding that not all cognitive issues present themselves with memory loss.
  3. Being open to understanding human body changes in the aging process.
  4. Receiving regular annual health visits, and being open with personal and specialist health care professionals.
  5. Seeking help at the first mention / clue pertaining to a possible cognitive issue, like losing keys, directions, monies, shopping sprees, personality changes, sleep issues, habits, communications, gait, appetite, emotions, suspicious behaviors.
  6. Looking for signs of depression, apathy, speech problems, loneliness, sadness, inability to return back to normal state post-bereavement .
  7. Watching for signs of loss to smell, taste, vision, hearing and touch.
  8. Paying attention to dressing, cleanliness, nutrition, any hoarding issues, sudden anger/ shame or avoidance, new anxiety/ inhibition, forgetfulness, inability to complete daily chores/ work, personal, family, community or organizational changes.
  9. Finding new attention/ sudden interest in risky things like gambling, alcohol, drugs etc.
  10. Noticing decline suddenly or slowly with no specific reasons.

The varied spectrum of the social, psychological, biological, physiological, mental, emotional impacts on  cognition, can sometimes make it confusing, harder or longer than usual in seeking the right help, treatment and care. Many times these issues are masked out of guilt or covered up by a loving family member.

However our duty lies in education, information, collaboration and continuous contribution to this issue.   

We would love to hear from you. Please share other ways, that may have helped ? We sincerely appreciate your input and look forward to supporting our seniors and their families.

This article is in observance of Older Americans Month.

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Benefits of preparing a discharge plan for hospitalized seniors https://martineztribune.com/2019/05/10/benefits-of-preparing-a-discharge-plan-for-hospitalized-seniors/ Sat, 11 May 2019 01:04:01 +0000 https://martineztribune.com/?p=11549 BY PURNIMA SREENIVASAN What is post discharge planning ? Is it the same as pre-discharge planning ? They are not exactly the same, but may have some similarities between them. Why do we care ? Why is it important ? Does it make any difference ? Is it a difficult process ? What resources are …

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BY PURNIMA SREENIVASAN

What is post discharge planning ? Is it the same as pre-discharge planning ?
They are not exactly the same, but may have some similarities between them.

Why do we care ? Why is it important ? Does it make any difference ? Is it a difficult process ? What resources are out there ?

During my decades of practice in geriatrics, I came across numerous scenarios of people needing information on post discharge planning. While seniors and families were helped immensely by Social Services, resources at the hospital where people were discharged either to their own homes or to senior living facilities or communities with home health, home care, hospice or rehabilitation, there were a lot of questions and issues I had to figure out, plan, solve, and help proactively with forward thinking.

Here is a checklist of information you may want to carry with you, as a senior or family member plan the next journey for their beloved:

  1. Have you had contact with the home health, home care, rehabilitation, hospice as suggested by the hospital ?
  2. Is your insurance covering these services and if so, how much ? What is your part of payment ?
  3. Have you kept track of the progress as charted by home health, home care, hospice, rehabilitation ?
  4. Are you recuperating as planned ?
  5. Have your milestones been mapped, correctly ?
  6. What were your goals vs. the organizations or companies providing ancillary care ?
  7. Have you had follow up lab-work done at the appropriate time post discharge ?
  8. How has your nutrition been ? Is it right on target as supposed to be or has it become an issue ?
  9. Has your primary doctor kept in touch with you during, pre and post hospitalization at the hospital or a facility ?
  10. When are you supposed to follow-up with the doctors, health professionals, dentists or outpatient health services ?
  11. Are you in need of extra help or are you alone ?
  12. Do you have tools like telephone, safety installations, safety chains or bracelets with your condition inscribed on them ?
  13. Are you in contact with local senior resources and services like the area agency on aging ?
  14. Are you struggling with poly-pharmacy ( multiple pharmacies / duplicate prescriptions ) ?
  15. Is the medication adequate and appropriate ?
  16. Have you asked your pharmacist about new drug-drug interactions, wrong combinations or incomplete prescriptions ?
  17. Who manages your care at home or facility or community ?
  18. Do you think you are in a safe place with safe hands and feel secure, safe and comfortable ?
  19. Are you ready to make some life decisions like advance directives if not completed previously, or do you feel more confused, in pain or down and depressed ?
  20. Are you the same person before, during and after hospitalization ? Do you feel you have declined, aged, become more confused or just feeling more tired lately ??

There are many more, and we will explore those in the coming weeks ….

Hope this will help you and your beloved senior about how frail a senior’s health is and could be.

Post discharge planning does not end here, as according to research the risk for re-hospitalizations, the simultaneous presence of multiple chronic diseases or conditions in a patient, and mortalities are higher in the days to months after a recent hospitalization. Quality of life is a key denominator of the social, medical, community, economic, and environmental determinants of life.

Looking forward to your feedback, thoughts, insights, challenges, input and ideas. Please feel free to write to us.

Happy Mother’s Day to All !

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Learning The Basics of California’s Laws – For New Residents https://martineztribune.com/2019/03/11/learning-the-basics-of-californias-laws-for-new-residents/ Mon, 11 Mar 2019 19:06:13 +0000 https://martineztribune.com/?p=10911 BY HELEN LAME´ Of late, California has made a lot of exciting new changes in its lawbook that places more value on the worth of individuals. Located in the Western U. S. coastline, it is also the home of Hollywood. Initially a Republican state, of late this has been thoroughly Democratic, and that is showing …

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BY HELEN LAME´

Of late, California has made a lot of exciting new changes in its lawbook that places more value on the worth of individuals. Located in the Western U. S. coastline, it is also the home of Hollywood. Initially a Republican state, of late this has been thoroughly Democratic, and that is showing in the results.

Here are 10 laws you should know about California, especially if you are a new resident here.

1. DUI Threshold

Like in other states in the US, the ‘per se’ blood alcohol concentration limit is 0.08 per cent, but the punishment is the most stringent here as compared to the other states. There are regular sobriety checkpoints.

A first offense without physical injuries involved means $2,000 in fines and assessments along with 48 hours in prison, a three-month compulsory alcohol education program and suspension of license for a few months.

In case of a third offense within a 10-year period, the prison term increases to 16 months, along with a monetary penalty of $18,000 and a 30-month alcohol treatment program. In addition, there are a host of open container laws which you should be mindful about.

2. No Cash for Bail

A lot of suspects are able to walk out if they have the cash on them to pay bail, meaning that it is mostly the poor who populate the prison. To even out the system, prisoners will now be evaluated in terms of the risk they pose in pre-trial assessments.

The dangerous individuals or those with higher flight risk will become “high risk,” and the bail mechanism will be worked out accordingly. While this is a welcome move to correct the social injustice that often lies behind incarceration, the critics of the law say that it will place too much power in the hands of the prosecutors and courts.

To locate a loved one who you suspect might have been imprisoned, you will need the assistance of a seasoned attorney, or use a reliable database such as PrisonRoster.

3. Divorce

An average Californian has to wait or 6 months getting a divorce. Also, in California, without any kind of legal agreement, each spouse would be entitled to 50 per cent of all the marital assets.

4. Comparative Negligence for Injuries

This is a unique California law by which even a plaintiff deemed responsible for causing some form of injury might get some compensation. Regardless of the ethicality of it, California has a system of a “pure’” form of comparative negligence according to which each party is assigned proportional damages (decided on the basis of level of fault of each party).

5. Age of Majority and Emancipation

While Californian kids may have the appearance of being freer than kids in other US states, the age of majority here is 18 nonetheless. However, they can pursue emancipation, that is freedom from their guardians, once they turn 14.

6. Gambling

California allows forms of public gambling like Indian casinos, state lottery, charitable gambling, card-clubs, etc. However, games like faro, monte, roulette, etc. are illegal in California and can attract stringent penalties.

7. No Soda for Kids

America has a major obesity problem among kids. In order to tackle that, California became the first state to outlaw soda as a standard component in kids’ meals. The included beverage would be plain water, flavored milk, sparkling water, non-dairy milk substitute like soy milk, or milk. This is an enforceable penalty attracting fines up to $300 on third violation. However, any of the above-mentioned standard choices can be replaced with soda upon request from the customer.

8. Changes in Gun Laws

There are efforts to ensure stricter gun control regulations. The age limit for buying shotguns, rifles and handguns is to be raised to 21 years. Also, in a welcome move, those individuals convicted of domestic violence will be barred from owning a gun for life.

9. Employee Privacy

In an effort to even out the opportunities for job applicants, employers are no longer allowed to ask for certain information from their applicants as part of background check. According to the recent SB1412 bill, employers can no longer ask applicants to disclose any information in the written form or verbally regarding arrests or detention that did not result in any conviction, or information regarding participation in or referral to pretrial or post-trial diversion programmes, or regarding convictions that have been dismissed or closed by the law.Statutes of limitation

10. Statutes of Limitation

California has statutes of limitation which bars people from filing civil suits after 2-3 years. This becomes a bit complicated when it comes to filing complaints against offenders for sexual misdemeanours, especially those exploiting their professional capacities, because often the survivors take years to speak up. Nevertheless, if it is something which you know should be addressed, do not waste your time filing a suit.

Parting Thoughts

The best thing about California is that it is a state that never stays still, and welcoming new people while trying its best to not compromise on making lives better for everyone is an exciting thing to look at.

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The 8 California Laws Every Resident Must Know https://martineztribune.com/2019/03/07/the-8-california-laws-every-resident-must-know/ Thu, 07 Mar 2019 15:00:29 +0000 https://martineztribune.com/?p=10873 BY HELEN LAME´ January 1 wan’t just the beginning of a new year, it was also the day on which California ushered in new laws. Here are eight of the newest Californian laws that came into effect on January 1, 2019 and which you must be aware of. After all, these laws could change your …

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BY HELEN LAME´

January 1 wan’t just the beginning of a new year, it was also the day on which California ushered in new laws. Here are eight of the newest Californian laws that came into effect on January 1, 2019 and which you must be aware of. After all, these laws could change your life. Resources such as PrisonFinder could be instrumental in finding your friends and family members who might have fallen to any of these new laws. Better still, be aware, and be safe.

1. Worker Pay

With California’s minimum wage climbing up to the maximum of $15 per hour, this year, the base hourly wage is now pegged at $12 for companies with 26 employees or more and $11 for micro-mini businesses. Small businesses will achieve the minimum wage of $15 on January 1, 2023. However, this law also provides for a postponement in wage increase, should there be an economic crisis.

Come 2022, a full-time worker getting a minimum wage can see his income increasing from $20,000 a year to $30,000 a year.

2. Gender Identification

Californians who neither fall in the male category nor female but a third gender can now opt for a driver’s license by subscribing to the new “non-binary” gender category, as Senate Bill 179 states. It will be symbolized by the letter “X.”

However, under the First Step Act, if health care workers in this state “wilfully and repeatedly” refuse to use the “preferred name” of a transgender patient, they could be punished under law, ranging from a monetary penalty to jailtime.

3. Gun Control

Already one of the strictest laws on gun control in the United States, California continues to make it more stringent. Through the Senate Bill 1100, the age limit for buying rifles and shotguns has been increased from 18 to 21, as is the case with handguns.

For anyone wanting to possess concealed carry weapons, it is mandatory to undergo at least eight hours’ training and pass a live-fire test of shooting. These will come through with Assembly Bill 2103.

If a Californian citizen is convicted of misdemeanour domestic violence, he or she will no longer be allowed to own a weapon, under Assembly Bill 3129.

4. Climate Change

Lawmakers in California now believe that at least 60% of energy must be produced from solar, wind and other renewable sources. Electricity generation from fossil fuels will be completely phased out by 2045. California is America’s second state after Hawaii to make this commitment. 

Yet another law prevents the Trump administration from increasing oil drilling at the California coast. It seeks to do this by blocking new pipelines and other related construction in the state waters.

5. Sexual Misconduct

After the #MeToo movement against sexual harassment at the workplace gathered sufficient momentum, enormous changes were brought in to protect workers from this while at work. For instance, earlier, organizations that settle issues of workplace harassment with their employees can now no longer keep such employees from discussing it with other colleagues. In fact, they were forced to sign a non-disparagement agreement to this effect.

But with Senate Bill 820 coming into effect, this no longer holds good. Now, a victim might still not want his or her name to be disclosed, but the perpetrator’s name has to be made public. 

Under Senate Bill 1300, workers no longer have to sign a release of liability as a pre-condition of continued employment or as a trade-off for a bonus. And this might be the most constructive law of them all: Senate Bill 1343 says that all California employeeswill be given sexual harassment training twice a year.

Those who have been sexually assaulted stand to seek civil damages from such experienced for up to 10 years, according to Assembly Bill 1619. With Senate Bill 826 coming into effect, California’s public companies will mandatorily need to have at least one woman director on their boards by the end of 2019.

6. Police Shootings

The public outrage and protests over frequent police shootings forced the California government to take cognizance of the problem and step up accountability and transparency in matters of civilians being killed by officers.

Senate Bill 1421 gives the public total access to internal investigations into incidents of the police killing or injuring individuals, apart from opens public access to internal investigations of incidents where police killed or seriously injured someone, as well as findings supported by evidence of sexual assault and of telling lies at the workplace.

Beginning July 2019, under Assembly Bill 748, law enforcement agencies will be required to release audio or video footage as evidence of a shooting or other incidents where force was used within 45 days.

7. Education Laws

By December 2019, all schools will have to put into effect a set of procedures that prevent students from bullying and cyberbullying their classmates. According to SB-830, the California Department of Education will be required to list all instructional materials and resources relating to media literacy on its official website.

Besides, former and present students will no longer be subject to paying any debts raised by public schools or school districts, under AB-1974.

8. Electric Scooters

Riding electric scooters is a rage these days, as the streets of California will testify to. Now, Assembly Bill 2989 allows individuals 18 years or more to ride these scooters unaided by helmets, on city streets. They will have to adhere to a speed limit of a maximum of 35 miles per hour.

Concluding Remarks

With the above laws, the lives of Californian residents have been improved, making them safer and the State an easier place to live in. It is therefore necessary for all residents of this state to know the scope of each of these laws that will make a difference to their life.

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