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the daytime shift. As a result the cost went up to about $10,000 per how much stress this places on the spouses and families. If a patient
month. How are most families and patients expected to be able to of mine is the caretaker, I proactively advise them to consider seeing
afford this? They can’t. At least not for any extended period of time. a counselor. If they show signs of stress they may need an outlet to
Medicaid will not pay until you have exhausted all your finances, help them deal with the hard road that lies ahead.
and if you are the spouse of an Alzheimer’s patient, now your money According to the National Institute of Health it is projected
to live has been expended. that the prevalence of Alzheimer’s will nearly quadruple in the next
A third major problem seems to be that none of these facilities, at 50 years, by which time approximately 1 in 45 Americans will be
least here in Naples, have the ability to deal with end stage dementia afflicted with the disease. A local Alzheimer’s organization quoted
patients. Twice we received a notice from two separate sites stating something like one in every 33 people in Naples has Alzheimer’s.
that she had 45 days to leave the facility. Their reason was that she The proposed costs are expected to double by 2040. How could the
required too much help for their ALF and needed to go to another average person pay for ALF and nursing homes? How could they
site as her degree of dementia was beyond what they could handle. afford companions? To qualify for Medicaid personal financial assets
This became what I define as a slow progressive death which was need to be spent. My parents were fortunate to be able to afford this.
torture for my family to witness and I can only imagine what it was Why aren’t these medical necessities covered by Medicare?
like for my mother. She was no longer walking or eating and was States other than Florida are addressing giving people with
bedridden by that point. While at her third facility I went to visit and terminal diseases the choice of facilitating death. People need
was astonished to discover multiple brand new severe bedsores that to consider this for humane reasons. Take my mother’s case for
were open and not being cared for adequately in my opinion. Where example. She was no longer eating, talking, walking and her body
was the care and attention she so desperately needed? I rarely yell was physically breaking down. Hospice could do nothing until she
but I found myself in an argument with the administrator and was showed signs of discomfort. My father, my sister and I had to sit
shocked at how they defended their level of care as appropriate and and watch my mother slowly die. It took eight days. Eight long
acceptable. And yet again we received our second “eviction notice”. days. Towards the end, Hospice thankfully started to administer
By this time she was declared severely end stage in Alzheimer’s morphine when she was showing signs of respiratory failure and
pain. Somehow, my mother took her last breath when we were all
and deemed terminal; therefore, Hospice took over her care.
Needless to say wound care was started and she was transferred with her. It was as if she knew.
to hospice house within the same 24 hours. Avow Hospice is a Some additional facts per Alzheimers.org: Alzheimer’s afflicts
wonderful organization which helps those with terminal conditions. about five million Americans. Two-thirds involved are women.
Every 67 seconds someone develops Alzheimer’s. It is the 6th
Our family will always be grateful for their help. There is only
one problem with Hospice in the State of Florida. They legally ding cause of death in America. We need to do something more.
lea
cannot facilitate death or cause death. They can only make those Will you step up if we can get these issues to our representatives? I
dying more comfortable during the process. Alzheimer’s though is am asking you to think about these issues and tell others about them.
different from terminal cancers or other life ending illnesses. With If this article can spark interest and action, then others suffering
Alzheimer’s, the issue involves a complete loss in the quality of life. with Alzheimer’s may have more available options.
Since our state has no law to allow a humane end to a patient’s life Dr. Sciavolino-Day wrote this within the month following her
when there is obviously no quality of life remaining, an Alzheimer’s mother’s death and wishes to thank her husband, Michael Day, for his
patient and their family are stuck in a most difficult position. help with the editing of this very personal yet important article during
this difficult time. Dr. Sciavolino-Day is an Internal Medicine Physician
As you may already be aware, Alzheimer’s is a progressive
wor
neurological condition that usually afflicts those above age 65. king at Advance Medical Center in Naples.
Symptoms might start with difficulty remembering new information
just learned, and as it progresses, confusion, disorientation, problems RAISE YOUR VOICE
with walking, speech and swallowing occur. There is no diagnostic Please consider writing to your elected representatives if you
test for this so it is diagnosed by medical evaluation, memory testing want them to address these important issues that are affecting
and brain imaging with an MRI. Treatments available may offer a more families each year. Their names and information are listed
temporary slowing of the disease, but at this time there is no cure. below. More information about Alzheimer’s is also available on
Continuing brain stimulation exercises such as word finding puzzles, Alzheimers.org. Their hotline is 800.272.3900.
bingo and games are encouraged though.
When I am seeing a patient with dementia I attempt to have Senator Bill Nelson: Billnelson.senate.gov
them answer my questions directly and not have a family member 716 Senate Hart Ofice Building, Washington, DC 20510
answer for them. This is the only way that I can really see how they 202.224.5274
Senator Marco Rubio: rubio.senate.gov
are changing over time. What a family member tells me is important 284 Russell Senate Ofice Building, Washington, DC 20510
though as it paints a more thorough picture of what is going on at 202.224.3041
home. Sometimes family members get upset with me or insulted Congressman Curt Clawson: Clawson.house.gov
that I do this, but it really is important to try and have the patient 1123 Longworth House Ofice Building,
speak. I also stop and take the time to ask the caretaker how they Washington, DC 20515
are doing and make sure that they are getting breaks for themselves. 202.225.2536
Asking about support systems is important as well as I have realized
Life in Naples | January 2015 49
month. How are most families and patients expected to be able to of mine is the caretaker, I proactively advise them to consider seeing
afford this? They can’t. At least not for any extended period of time. a counselor. If they show signs of stress they may need an outlet to
Medicaid will not pay until you have exhausted all your finances, help them deal with the hard road that lies ahead.
and if you are the spouse of an Alzheimer’s patient, now your money According to the National Institute of Health it is projected
to live has been expended. that the prevalence of Alzheimer’s will nearly quadruple in the next
A third major problem seems to be that none of these facilities, at 50 years, by which time approximately 1 in 45 Americans will be
least here in Naples, have the ability to deal with end stage dementia afflicted with the disease. A local Alzheimer’s organization quoted
patients. Twice we received a notice from two separate sites stating something like one in every 33 people in Naples has Alzheimer’s.
that she had 45 days to leave the facility. Their reason was that she The proposed costs are expected to double by 2040. How could the
required too much help for their ALF and needed to go to another average person pay for ALF and nursing homes? How could they
site as her degree of dementia was beyond what they could handle. afford companions? To qualify for Medicaid personal financial assets
This became what I define as a slow progressive death which was need to be spent. My parents were fortunate to be able to afford this.
torture for my family to witness and I can only imagine what it was Why aren’t these medical necessities covered by Medicare?
like for my mother. She was no longer walking or eating and was States other than Florida are addressing giving people with
bedridden by that point. While at her third facility I went to visit and terminal diseases the choice of facilitating death. People need
was astonished to discover multiple brand new severe bedsores that to consider this for humane reasons. Take my mother’s case for
were open and not being cared for adequately in my opinion. Where example. She was no longer eating, talking, walking and her body
was the care and attention she so desperately needed? I rarely yell was physically breaking down. Hospice could do nothing until she
but I found myself in an argument with the administrator and was showed signs of discomfort. My father, my sister and I had to sit
shocked at how they defended their level of care as appropriate and and watch my mother slowly die. It took eight days. Eight long
acceptable. And yet again we received our second “eviction notice”. days. Towards the end, Hospice thankfully started to administer
By this time she was declared severely end stage in Alzheimer’s morphine when she was showing signs of respiratory failure and
pain. Somehow, my mother took her last breath when we were all
and deemed terminal; therefore, Hospice took over her care.
Needless to say wound care was started and she was transferred with her. It was as if she knew.
to hospice house within the same 24 hours. Avow Hospice is a Some additional facts per Alzheimers.org: Alzheimer’s afflicts
wonderful organization which helps those with terminal conditions. about five million Americans. Two-thirds involved are women.
Every 67 seconds someone develops Alzheimer’s. It is the 6th
Our family will always be grateful for their help. There is only
one problem with Hospice in the State of Florida. They legally ding cause of death in America. We need to do something more.
lea
cannot facilitate death or cause death. They can only make those Will you step up if we can get these issues to our representatives? I
dying more comfortable during the process. Alzheimer’s though is am asking you to think about these issues and tell others about them.
different from terminal cancers or other life ending illnesses. With If this article can spark interest and action, then others suffering
Alzheimer’s, the issue involves a complete loss in the quality of life. with Alzheimer’s may have more available options.
Since our state has no law to allow a humane end to a patient’s life Dr. Sciavolino-Day wrote this within the month following her
when there is obviously no quality of life remaining, an Alzheimer’s mother’s death and wishes to thank her husband, Michael Day, for his
patient and their family are stuck in a most difficult position. help with the editing of this very personal yet important article during
this difficult time. Dr. Sciavolino-Day is an Internal Medicine Physician
As you may already be aware, Alzheimer’s is a progressive
wor
neurological condition that usually afflicts those above age 65. king at Advance Medical Center in Naples.
Symptoms might start with difficulty remembering new information
just learned, and as it progresses, confusion, disorientation, problems RAISE YOUR VOICE
with walking, speech and swallowing occur. There is no diagnostic Please consider writing to your elected representatives if you
test for this so it is diagnosed by medical evaluation, memory testing want them to address these important issues that are affecting
and brain imaging with an MRI. Treatments available may offer a more families each year. Their names and information are listed
temporary slowing of the disease, but at this time there is no cure. below. More information about Alzheimer’s is also available on
Continuing brain stimulation exercises such as word finding puzzles, Alzheimers.org. Their hotline is 800.272.3900.
bingo and games are encouraged though.
When I am seeing a patient with dementia I attempt to have Senator Bill Nelson: Billnelson.senate.gov
them answer my questions directly and not have a family member 716 Senate Hart Ofice Building, Washington, DC 20510
answer for them. This is the only way that I can really see how they 202.224.5274
Senator Marco Rubio: rubio.senate.gov
are changing over time. What a family member tells me is important 284 Russell Senate Ofice Building, Washington, DC 20510
though as it paints a more thorough picture of what is going on at 202.224.3041
home. Sometimes family members get upset with me or insulted Congressman Curt Clawson: Clawson.house.gov
that I do this, but it really is important to try and have the patient 1123 Longworth House Ofice Building,
speak. I also stop and take the time to ask the caretaker how they Washington, DC 20515
are doing and make sure that they are getting breaks for themselves. 202.225.2536
Asking about support systems is important as well as I have realized
Life in Naples | January 2015 49
