How can a smart phone be used to help others?

Yes, I’ve posted a blog about how caregivers can use some iPhone apps during the course of their care with their loved ones, but those apps can enhance the experience of caring. They do not replace real presence. It’s one thing to hand the phone over to a loved one so he or she can watch a You Tube clip of a classic movie while the caregiver completes another task. It’s a whole different experience to watch the clip together, to share the moment as one.

If my mom had a choice between a week of text messages from me wishing her a good night or a 30 minute back rub, I know she’d take the back rub. Caring touch is deeper. In some cases touch (in the form of massage) can diminish pain and anxiety. The research backs that up. As a culture, we’re still accumulating data for the positive effects of mobile apps and smart phones devices.

The National Alliance for Caregiving and United Healthcare “found more than two-thirds of family caregivers who have used some form of technology to help them with caregiving believe web-based and mobile technologies designed to facilitate caregiving would be helpful to them.” The article doesn’t indicate the kinds of technologies that would help. I’m sure there are many effective uses that will benefit caregivers (and already do), but we need to consider the patients too.

If an insurance company offered to give my mom a tablet device with cool apps to document her daily blood pressure and caloric intake for three months OR biweekly visits from a professional trained in guided imagery and massage, she just may go with the real person. In fact, charting the data would require more work for her; whereas, the holistic practitioner would allow her time for self-care and rejuvenation. Each option promotes health, but different individuals may select one choice over the other.

So as we move further into this age of technology, how do we ensure that tech doesn’t replace the importance of touch? How do we balance the two?

Heart Disease, Cancer, and unintentional injuries are the leading causes of death among men in the U.S. according to the CDC website.

19% of men under the age of 65 do not have medical insurance.

33% of men 20 years of age and older are considered obese.

31% of men 20 years of age and older have hypertension.

12% of men 18 years of age and over are in fair or poor health.

(Data retrieved from CDC Website.)

It makes sense to talk about healthy activities that inspire change in some of these trends during Men’s Health Month.

I asked some of my male colleagues what they do to stay healthy:

• Yousef said, “I find that staying physically active boosts my mental health. After working out or playing sports, I’m in an overall better mood and tend to be more relaxed.” He adds, “I believe a healthy man has some sort of release to attribute to a portion of his good health: sports, work, intimacy, hobbies…the more you have, the better you are.”

• Alex said, “I take few vitamin supplements and I started going to the gym at least three times per week. I also get together with my friends at least 2-3 times per week to clear my head and for the laughs.”

• Carlos shared a cute story about his son who forgot to wash his hands after coming in contact with poison ivy. “Then he went to the bathroom,” Carlos said. “Hand washing is real important to him and to me now!”

No matter if it’s something as simple as hand washing (one of the most effective ways to decrease infection) or as disciplined as a regular exercise regimen, there are endless activities one can do to achieve better health.

Make an appointment for a general physical if you haven’t seen your doctor in a while. (If  you don’t have insurance, seek out free or community clinics. Know your options.) Learn to meditate to decrease stress. Take a walk a couple of times per week. Be social. Laugh with your friends. Just do it! Be healthy!

It was enlightening to hear from colleagues about their thoughts on health, especially since most of our conversations revolve mostly around work processes and tech-related themes. (Thank you, Carlos, Alex and Yousef!)

As the month of June continues please consider talking to your male friends, colleagues and family members about the importance of healthy choices. Ask them what they do to stay healthy. Encourage them, support them, join them.

Visit the Men’s Health Month for general information.

Check out the CDC website  for more info on Men’s Health.

What will you do to celebrate Men’s Health Month? What actions are you taking to improve your physical, mental, emotional and spiritual health?

It’s an exciting time to be a nurse because we are strengthening our collegiality in order to improve health care. We have so much to give. We are innovators. We are the glue.

I encourage all nurses to remember to take care of yourselves. It’s impossible for us to teach caregivers about self-care if we don’t practice it ourselves. The wonderful thing about self-care is that it doesn’t have to cost a thing. An entry in a journal to reflect on a hard day at work. Ten minutes of meditation during a break. Listening to a song on your iPhone or iPod that makes you smile. Tap into your personal creativity as a nurse. It will strenghten your practice, feed your soul, relieve your stress … one moment at a time.

Nurses rock!

The following are some links to various nursing scholars’ websites. Nurses are doing some amazing things around the world. Check it out!

Lorraine M. Wright explores the concept of how nurses can help to soften suffering.

Jean Watson promotes caring in nursing.

Margaret Newman discusses how nursing can be transformative by observing patterns.

Also, this Thursday, May 12th at noon marks the 12th Annual Worldwide Commemorative Moment for Nursing’s Florence Nightingale. More info here which includes ways nurses can celebrate this important week.

Enjoy your week!

(photo by Marcus Bernales)

Humor heals. Research shows that laughter may boost the immune system and circulatory system, improve oxygenation, relax muscles, and stimulate the release of endorphins in the body which may help to relieve pain. (Source: Laughter Therapy Article)

1. Watch a You Tube clip of The Marx Brothers, Charlie Chaplin, The Three Stooges, “I Love Lucy” or any clip with physical comedy. Click on this link for my favorite clip.

2. Read your loved one a funny story. Try reading it in a silly voice.

3. Put on some music and host a dance party. This works for a wheelchair-bound or bed-bound individual as well. Repetitive movements can also be considered exercise, if done safely.

4. Make some funny faces. Buy a clown nose.

5. Reminisce about favorite childhood stories with your loved one.

6. Laugh. Laugh for ten seconds. Laugh as hard as you can without injuring yourself.

7. Look at some old family photographs together. Do any patterns emerge? Is Uncle Joe always wearing a plaid shirt? Did Great Aunt Lorraine pose in every picture?

8. Host a surprise party for your loved one. It doesn’t have to be a birthday or holiday to invite people to gather together in celebration of love and life.

9. Put a silly picture in a frame near your family member that makes him or her smile.

10. Go to http://www.CuteOverload.com, especially if your loved one is an animal lover.

I know this because throughout our relationship, I frequently tried encouraging my father to initiate some healthy behaviors that he didn’t think were necessary in that moment. Anyone else have a stubborn parent?

“Dad, you should really quit smoking!” I never liked when he smoked in the car when my mom was a passenger.

I said something like that to him when my mom had a bout of bronchitis one year. I was the quintessential nurse/daughter to my father.

Our pattern of healthy suggestions and stubborn responses started long before I became a nurse. I remember sitting at his favorite spot on the couch when I was 11 years old. He left a pack of cigarettes on the end table. I defiantly broke each cigarette in half, then placed them back in the pack before he came back in the room. I stayed close by playing with my dolls, expecting a big reaction. It never happened. When he discovered them broken up, he never conveyed how annoyed he was with me. He calmly threw the broken pack away and bought another one. It frustrated me that he never got the point. And he didn’t yell at me for doing it because he knew his actions were unhealthy.

To engage me in a talk about his smoking would have given me a chance to share with him all the things I learned about smoking in health class as an 11-year-old (as well as the additional information I acquired as an adult in nursing school).” No,” he must have thought. “It’s better not to discuss it all.” He eventually quit smoking after he retired. I was so proud of him for kicking his long-term nicotine habit.

Our discussion about advanced directives would probably have had a similar tone. He would have been watching one of his sports channels. I would casually have mentioned something during one the of the commercials. He’d have nodded his head. Then the game would have returned and I’d have lost him again for the next ten minutes, while the Cavs scored another three- pointer. At the next break, I would have planned to have the living will papers out of my purse into his hands. A-ha! He didn’t think he could weasel his way out of it that quickly, did he? I didn’t expect a refusal to take the papers from my hand.

He’d tell me to place them on the kitchen table, “I’ll look at them later, honey,” he’d say. Then, I’d have found them in the same place I left them on my next visit. How very frustrating! Sound familiar to anyone?

Unfortunately, I never had the chance to have that discussion with my dad. He passed away over a year ago.

I share this imagined story because time and again, I hear from caregivers who express their frustration with loved ones who aren’t necessarily engaging themselves in the most  healthy behavoirs. I’ve also heard reluctance from family members who dread talking about end-of-life issues with their elderly parents. I sense the worry in those caregivers’ voices.

Initiating discussions about health issues may not be easy with some family members. It may not even seem that those discussions are helpful, but it’s an opportunity. It’s an opportunity let someone you care about know that you’re concerned for their well-being, their health, their future and that you will support him or her during those times when their health may be declining. I think that’s all we can expect as caregivers.

My father would have eventually gotten around to reading the living will documents had I brought it up again … and again. That was his pattern. It would have taken him even more time to actually sign them, but I would have done what I thought was helpful, to the best of my ability. That is my pattern.

We’re all just trying to help.

I feel it’s crucial to have advanced directives, including a living will and a durable power of attorney or health care proxy in place, should my mother require hospitalization. It will take me some time to travel to her in such an occurrence. Knowing that a health care proxy is in place would ease my mind that her wishes are being followed if she cannot speak for herself.

It eases my mother’s mind, too.

On a recent visit to Ohio, near the one-year anniversary of my father’s death, I cautiously broached the topic with her.

We were at a lovely diner full of lush, green plants. The sun was shining through the window. We had just finished our chicken dumpling soups. It was our last day together and I had just helped her with her taxes earlier in the day—for the first time, she would be filing as a single person.

I figured if we were on a roll organizing her financial matters I may as well keep along those lines of open communication.

“Mom,” I said, “I’m sure you’ve heard about a Living Will and Durable Power of Attorney.” (In Ohio, we use the term Durable Power of Attorney as opposed to Health Care Proxy, which is what we say in New York. They mean the same thing.)

“Do you mean for my finances?” she asked, “because I’ve been thinking about that.”

“A Durable Power of Attorney is a person who can make medical decisions for you in the event that you cannot do so for yourself,” I replied. “ That person is someone who can follow your wishes. Someone who can speak for you.”

“Yeah, I’ve been thinking about that, too. I have papers about that from when I had my knee surgery,” she said.

“Mom, I just think it may be a good idea to think about those papers again, if you feel comfortable.”

My mom expressed her preference to  initiate the process, as it would make her feel relieved knowing that me or my brother have the authority to carry out her wishes.

As we moved on to our main lunch dish we continued to talk about the advanced directives. She even began to talk about her considerations for pre-funeral planning, as well as how she would like to organize finances for the future. The initial topic she proposed above. She guided the rest of the discussion on her own.

I sometimes wonder if it’s actually the adult child who has reluctance to discuss these matters as opposed to the senior parent. It’s not easy hearing your healthy adult parent mention her own funeral wishes, but it also has a sense of decompression. The “talk” relieves all this perceived built-up pressure imagined in one’s mind. It wasn’t as difficult as I thought it would be. In fact, it has given us a clearer path to more honest, direct communication regarding important issues in our lives.

My mom now feels taken care of by her family. Her children know what she wants. My brother and I feel at ease because we understand her wishes in advance, as opposed to the worry of fumbling through difficult decisions in a time of crisis.

You can initiate advanced directives, living wills and health care proxy forms on your own in my many states via internet-available forms, but please ensure they are appropriate sites. Talk to a physician or health care professional if you are not sure. You may even want to ask your physician if he or she carries living will documents at the office. Be aware that each state’s documents are different and that you may need to have a witnesses or a notary public present at the signing of the documents.

Here are some more links regarding the topic of advanced directives:

AARP’s Advanced Directives Article

The US Living Will Registry

As my colleague, Paula Wilson, mentioned at the close of her blog. Advanced directives are not only important for the elderly, but for each and every one of us.

(photo by q thomas bower)

Did you know today is International Women’s Day?

According to the International Women’s Day website: “It’s a day to celebrate the economic, political, and social achievements of women from the past, present, and future.” This event is celebrated globally with many activities in major cities across the world. I wasn’t even aware that it’s considered a national holiday in other countries like China, Russia and Bulgaria.

Although there is no one theme under which everyone celebrates International Women’s Day, the United Nations has chosen the following:

Equal Access To Education, Training, Science, and Technology:

Pathway To Decent Work For Women

As I reflect on this theme, I can’t help but apply it to the work of many inspiring nurses who surround me each day. We, as nurses, utilize all of these concepts in our daily work. We use our foundation of nursing science to provide the best possible care. We use our knowledge to orient each other to the numerous specialties in our nursing discipline. We also train patients or caregivers how to feel comfortable changing a colostomy bag or administering medications via a feeding tube. We strive to continue our education so that we can support evidence-based practices and enhance our therapeutic communication with patients and their caregivers. And we use technology every day in the form of machines for intravenous fluids or wound vac devices as well as our tablets or computers for documentation into electronic health records. Nurses are a very innovative group of individuals that I’m inspired to work with and have been grateful to learn from throughout my career. All of this wouldn’t have been possible without the hard work of nurses past.

Lillian Wald, a graduate nurse in the late 19th century, made one of the first VNSNY home care visits. She may not have had the technology that we have today, but she utilized her educational observations about health and hygiene to care for women, children and immigrants to our country. She established a norm in the community that compassionate care for individuals was necessary for the betterment of the future. She even advocated for children with physical and learning disabilities so they could obtain an education. Her work made ripple effects throughout the community. It allowed future nurses to gain momentum to improve health care conditions. We still feel those ripple effects today as they are the momentum that continues to carry home care forward. (Source: http://www.vnsny.org/community/our-history/lillian-wald/)

Is there a historical woman in your past who has made it possible for you to do the work you are doing today?

What can you do in your own life to make a positive ripple effect in your family or community?

Wishing all women a Happy International Women’s Day!

There are many recurring themes in all of those stories. Each depict caregivers as selfless, compassionate, hard-working, resilient individuals who are truly inspiring to their friends and family around them.

Many have given up their weekend free time or even their jobs to care for someone. One husband gave up his dental practice to care for his wife. Another mother stood by her young son after he had a stroke. One story celebrated the magnificence of a hired caregiver who became an extended member of his client’s family.

Some of the caregiver stories stress the importance of advocating for their loved one. For example, the “MomCologist” has championed for her young daughter, who was diagnosed with cancer, by learning about her daughter’s cancer, treatments, lumbar punctures and more while keeping notes about day-to-day medical events. She also had to quit her job in order to be with her daughter.

All of the stories exemplify the power of love.

It’s important for caregivers and those who know caregivers to continue to share their experiences. Health care organizations need to know what caregivers are going through in order to provide necessary education and support. Politicians need to know about all of the sacrifices that are made to care for someone, so that policies can be created to make things easier for caregivers. Not everyone is able to quit his or her job. Other caregivers need to hear about the hardship and joy of supporting a loved one through illness, so they don’t feel isolated.

Keep telling your stories!

1. Cleveland Clinic Stress Meditations (Cost: $1.99) You can choose from eight different meditations including a Body Scan Relaxation, a Mindfulness Meditation and a Calm Mind Meditation. Play the tracks for yourself to ease stress, or for your loved one, to promote comfort and healing.

2. Crock-Pot Slow Cooker Recipe Finder (Cost: FREE ) In A Caregiver’s Cookbook, I recommended using a slow cooker to create tasty meals with minimal preparation and cook times. This app allows you to find some recipes for a slow cooker with ease. You can search by meal course, ingredient or even size of the meal, in quarts. Unfortunately, recipes are not specific to health conditions, so use with caution. (As soon as I find an app with that function, I’ll post it here.)

3. Green Smoothies (Cost: $1.99) This app allows you to create smoothies from ingredients available to you. Nutritional information is also listed for each smoothie.

4. Family Health Notebook (Cost: $0.99) Log medical appointments for you and your loved ones including doctor’s name, reason for visit, symptoms, diagnosis by physician and treatment or medications ordered during the visit. You can also write additional notes pertaining to the visit, then email the entire encounter to yourself or other family members.

5. Mindfulness Meditation (Cost: $1.99) Need help learning how to be more mindful? Try this app to practice mindfulness in 5 to 40 minute increments. The app also includes useful tips to cultivate mindfulness.

Test them out and tell me what you think. Do you have any suggestions for apps that are useful for caregivers? Please share them below.

(photo by Adam Jenkins)

A generational issue exists between me and my mom. She’s sixty-four years old (about to turn sixty-five in April) and I’m…well, I’m a member of Generation X. She says she’s too “old school” for computers.  Her concerns about buying a personal computer are not only cost, but also the overwhelming feeling that comes with having to learn something new. It seems very complicated to her at this time in her life. She told me that she doesn’t understand how people can spend so much time online. “Isn’t it taking the place of real interaction with people?”

I don’t think my mom is wrong and I know many individuals with a similar sentiment. I’ve referred individuals to the VNSNY website for more information about an issue and discover they don’t have a computer either. Most of them were my mom’s age or older. They may have a different perspective about technology.

I didn’t grow up with an iPad in my hands or even own a cell phone in high school for texting; but, I was exposed to vintage gaming technology of the Atari and Nintendo variety. Weren’t those the first computers, anyway? My brother insisted we always get the latest version of Pitfall which was traded in for Castlevania, then upgraded to Super Mario Bros. Eventually, my private elementary school caught on to the computer trend. My eighth grade teacher, Sr. Juliette, taught us BASIC programming on the new APPLE computers the school bought. I received an “A” for being able to make a little man wave hello. Unfortunately, computer classes were only an elective in high school. I opted for Drama Class. No regrets.

We eventually got a computer in our home but the processing unit was so slow in the late eighties that my brother and I rarely used it. The internet didn’t quite exist then, so my brother typed up some of his college papers with it and I mostly played Family Feud. It was just another TV screen to my mom. She had no use for a computer. My mom was a housewife and it wasn’t exactly complementary toward activities she enjoyed back then. Sure, she could have logged her recipes on a floppy disk, but it was more efficient to hand write and file them in her tin recipe box. Plus, the other women in my neighborhood weren’t sharing floppy disks of City Chicken ingredients.

So when my brother and I left home, my parents barely turned the computer on. Our departure created a gap. My brother and I were exposed to the ever advancing technology around us. My parents were very comfortable still using the yellow pages to find an address or going to the bank to pay their bills. They eventually got a DVD player with surround sound speakers to watch their beloved music DVDs, but they didn’t need a computer to enjoy the things they loved. Only in the last few years did they even accept the value of a cell phone in case of an emergency. Anyone have a similar experience with their parents?

“Dad, you can call someone on the road if you get a flat tire.” He was the proud breadwinner of the family and he knew how to change a tire. What was the phone going to do that he couldn’t?

And then my father passed away. As the rest of my family shared photos on Facebook, I imagined my mom sat in her house with her thoughts. I live nine hours away from her by car and other family members work during the day. I thought about how technology had permeated all of our lives with the exception of my mom.

If my mom just owned a computer, I could buy her a web-cam so we can chat via Skype every few days. I could send her articles to lift her spirits and help her with Medicare enrollment. She recently told me she called Medicare for information and, ‘They kept telling me to go online.” (Good one, Medicare!) So, each time I visit her, I share a little more about the benefits of tech. Last time, we listened to a podcast about women’s health from my iPhone that she really enjoyed.

“See, mom, if you have a computer or a smart phone then you can listen to these things, too, and we can chat about it. There’s so much you can do online!”

I’ve shown her my family’s Facebook pages and the pictures of all the nurses I talk with on Twitter all over the nation. I think she would find value in browsing online at cooking sites or women’s health sites. Wouldn’t she feel less lonely? She could be more connected. Or am I projecting my own concerns on her?

I don’t think I’m alone when I imagine the ways technology can enhance my communication with her. A recent study by the National Alliance for CareGiving and UnitedHealthcare stated caregivers, especially long distance caregivers, want to use a device, like a smart phone with video functions or a computer with a web-cam, to be able to see loved ones when they couldn’t be with them.

In the same study, 69% of caregivers were open to using smartphones with apps for caregivers. I love apps, especially apps that can be adapted for use in caregiving. (Have you read my blog about ten iPhone apps for creative caregivers?)

I would even go as far to encourage my mom to get her own smart phone or iPad with a Face Time-like app that she can use when she goes to her medical appointments so I can participate in her doctor’s appointments.

Of course, I understand that she needs to find comfort in her tech use. And I also don’t want her to feel that a web-cam replaces my real presence. Nothing can replace our joy when are together. We laugh, we eat, we take naps. She’s also still transitioning into life as a widow, which already requires so much adaptation. Her new experiences with tech can be just another overwhelming task.

We’ve agreed on texting for now. My mom has heard me talking so much about the brilliant uses of my iPhone that she purchased a mobile phone with a touch screen and a medication reminder option. She loves it!

She also appreciates when various family members text her throughout the day. My family and I also send her pictures of the family or pets or beautiful flowers. One of her favorite things to do is use the automatic feature on her photo album to look at her beautiful photos on a three second delay. Her collection is growing.

She and I very often end our day by wishing each other, “Goldbugs!” My iPhone once autocorrected “Goodnight” to “Goldbugs”, so it’s been our running joke. She’s using text speak, too: OMG! LOL!

I’d say my mom is finally understanding the benefits of technology, or maybe, technology has finally figured out how best to accomodate a sixty-four year old housewife.

Do you know a tech savvy caregiver who may benefit from an iPad? Do you have a story you can share about a caregiver that you would like to honor?

VNSNY is hosting a contest to celebrate caregivers. The top three winners will receive an iPad, iPod Touch, or an iPod Shuffle. All are very caregiver-appropriate tools to enhance caregiving at home or from a distance.

For details about this contest, go to http://contest.vnsny.org

Good luck! I’ll be cheering everyone on!