Category Archives: Guest Blogs

Prepare and Empower People with Parkinson’s to Get the Best Possible Care When Hospitalized

By Kate Kelsall, MSW, blogger at Shake, Rattle and Roll: An Insider’s View of Parkinson’s disease and DBS

Medication-ManagementThe challenges involved in hospitalization of the person with Parkinson’s Disease (PD) can be overwhelming for the patient and family. These problems may include medication mismanagement and the lack of training of the hospital staff about how to care for persons with PD. Typically, a person with Parkinson’s sees a neurologist for diagnosis and treatment and many people go for years without a proper diagnosis. The neurologist deals with the neurolgocial condition, while the primary care provider deals with everything else. A patient, or those who act as patient advocates, attempt to keep the neurologist and the primary care provider (PCP) informed about the medical condition of the patient and also try to keep the doctor communicating.

Many of the difficulties that you will encounter as a person with Parkinson’s while in the hospital relate to medications. Some patients take PD meds around the clock from every two hours to every five hours. The PD meds help the patient manage the symptoms of tremor, bradykinesia, stiffness, and rigidity.

The problems include the following:

  • Wrong medications being dispensed
  • Correct medications not being dispensed on a timely basis or not at all
  • Patient’s medication is not stocked by the hospital.


Provide a typed list of patient’s medications and make sure it is written into the doctor’s orders. List should include:

–Name of medication including whether it is standard or long-acting form (CR)

–Strength of dosage

–Specific times that medication should be administered (specify exact times such as 7 AM, 11 AM, 3 PM, 7 PM instead of four times a day)

–Whether medication should be administered with or without food, before, during or after meals

–Whether the medication can be crushed

In case the patient’s medication is not stocked in the hospital, patient may want to bring his/her own medication from home in its original prescription bottles and give to nursing staff to administer.

Problem: Some PD patients find their PD symptoms worsen while in the hospital.

One possible cause is the introduction of new medications in the hospital and how they interact with PD medications and anesthesia.

Solutions: Become an informed patient. Develop a list of medications that should not be administered with patient’s current PD medications. For example, certain drugs block dopamine receptors and worsen PD symptoms.

Find out if patient’s PD meds need to be temporarily stopped before surgery.

It is often difficult for the patient to act in the capacity as his own advocate. Get a Patient Advocate involved. Arrange for someone (or several people doing shifts) to be with the patient round the clock or at least 16 hours/day, as an advocate. The advocate’s role is to monitor the patient’s care, including the medication, to ask questions and act as spokesperson and educate the staff about PD.

Problem: Often the medical staff doesn’t have the experience and training to care for PD patients. There are many family members of PD patients who attend support groups and conferences on PD resulting in some of the family members being better informed about PD than some who work in a hospital setting. In addition, the family members live with the patient and attend the patient’s doctor appointments so they have become educated on the health care of their own family member, but not educated on the needs of all patients.

Solution: Educate the hospital staff. Order the free Aware and Care Kit from the National Parkinson’s Foundation. The free Aware in Care Kit can be requested at or by calling 1-800-4PD-INFO (473-4636). The kit is large enough to fit the Parkinson’s medication and provides tools and information to share with hospital staff during a planned or emergency hospital stay. The kit includes the following:

Hospital Action Plan
Read about how to prepare for your next hospital visit—whether it is planned or an emergency.

Parkinson’s Disease ID Bracelet
Wear your bracelet at all times in case you are in an emergency situation and cannot communicate.

Medical Alert Card
Fill in your card with emergency contact information and place in your wallet.

Medication Form
Complete this form and keep copies in your kit for use at the hospital.

Parkinson’s Disease Fact Sheet
Share the facts about Parkinson’s with hospital staff and ask that a copy be placed in your chart.

I Have Parkinson’s Reminder Slips
Share vital information about Parkinson’s disease with every member of your care team in the hospital.

Kate Kelsall blogs about Parkinson’s disease on Shake, Rattle and Roll: An Insider’s View of Parkinson’s and DBS. She was named a top health blogger by Wellsphere.


New Medical Image Viewing and Management Aids Patients and Caregivers

Despite advancements in technology, there are still many hurdles when it comes to accessing and viewing your medical images including CT, MRI, X-ray and ultrasound scans.

Nephosity is one company attempting to bring these walls down, by providing a mobile and web-based platform for patients and their caregivers to manage their medical images securely and efficiently. The platform, called Jack Imaging, is free for patients and caregivers to use and creates the ability to share medical images with doctors, including for second opinions and remote consults.

Take Control of Your Medical Images

To give you an idea of why medical imaging is so complicated (and why you, as the caregiver, often pick up those easy-to-lose CDs), we have created an original chart to illustrate the various stakeholders involved in our healthcare imaging, and how your loved one’s images flow through the system. 


For example, when your loved one receives a digital X-ray or MRI, those scans are stored within the picture archiving and communication system (PACS) of that same facility. With this system, your loved one is dependent upon the imaging center as well as his/her doctor (who typically receives a text-only report, stating the findings from the scan) to share the information gleaned in the images. In short, you and your loved one rarely receive the information directly.

In addition, when there is a need to transfer these images (e.g., when you go to a new doctor) or get access to them in the future, it can be a long, complicated process. When images are difficult to access, it impacts the patient—and possibly their caregiver or other advocate—and their ability to have the best possible outcome for their treatment and care.

Modern Medical Image Sharing

To remedy these issues, Jack Imaging has made images available online to you, anywhere, anytime. All you need to do is upload your images, or ask Jack Imaging to collect your records on your loved one’s behalf. Once your imaging records are loaded, you’re ready to share them with your doctor, ask for a second opinion or even receive a remote consult. You can also easily view our images on your iPad, alongside your doctor, for greatest engagement and understanding of your loved one’s condition. Nephosity received FDA clearance for the iPad last year.

Jack Imaging is a platform for medical image viewing, sharing and collaboration that empowers patients – and you, their caregivers – to take control of their medical images, and save the time and emotional burden of dealing with lost CDs, records, the cost of replacing or retaking medical scans.

Nephosity (the company behind Jack Imaging) was founded with the objective to fix the U.S. healthcare system – beginning with medical imaging. By making images available to patients and their doctors, Nephosity saves time and money for patients, caretakers, doctors and our healthcare system at large. For more information, please visit or



Resolve to Brush and Floss

So many New Year’s resolutions are tall orders: start a business, lose weight, check an item off your bucket list. Why not give yourself an easy resolution this year? Simply commit to flossing your teeth daily. It sounds funny, but humor can make the lifelong process of oral health a rewarding daily practice. It is essential to establish good daily dental practices that can lead to years of healthy teeth and gums.

smileAs we age, it is more important to take good care of our teeth when there are specific concerns and issues that can arise. For example, many medications can lead to dry mouth which can in turn to lead to faster gum recession which make teeth more susceptible to cavities. Daily brushing and flossing are important and senior dental services can make it easier to keep dental disease at bay. For people who cannot get to the dentist because of decreased mobility and chronic conditions, there are in home options to consider that address the specific dental conditions that come with age.

In home dental providers are available to fill this gap and treat the dental issues specific to this population. Make sure that you or a loved one receive the best in senior home dental care by reviewing this expert checklist:

1. Getting into a dentist’s office can be difficult for an elder adult. A mobile dental provider will bring the office directly to the patient’s familiar environment, easing any worries about making it to an appointment and sitting in the dentist’s chair.

2. Ask the visiting dentist if there are any affordable dental plans or specialized discounts to help the senior patient save money on dental treatments, procedures and services. Keep in mind that in some instances there might be a slightly higher cost for the convenience and comfort of a home visit from the dentist.

3. Verify that the dentist coming to your home has the latest training in geriatric dentistry and the latest tools to make the dental process easier and less painful.

4. Be sure to ask the dental care provider about issues affecting seniors like dry mouth, gingivitis, and cavities and have them educate you about unique conditions for older adults.

5. Whether you or a loved one is uninsured or under-insured, the home dental provider should be able to meet your need with no pre-existing condition exclusions.

Gabrielle Mahler, DMD, was trained at the University of Medicine and Dentistry of New Jersey. She went on to do her residency in the Advanced Education of General Dentistry at Columbia University. She has been providing mobile geriatric dentistry to the senior community for 8 years. The warm and loving manner with which she treats patients makes her a favorite practitioner among the families that she works with.

Heart Attack at 25: The Struggle of Getting Better

Guest Blog by Jeffrey Wolf, Content Writer for Homewatch International, Inc.

I was the youngest person there by at least 20 years, possibly by 40 – that’s what the nurses told me my third day in. At 25, I was among the youngest adult patients admitted to the cardiac wing of the hospital in a long time. A man in his 20s shouldn’t need cardiac care and shouldn’t have a heart attack. For several days, the doctors even danced around the term “heart attack,” saying they needed more tests to be sure.

But yes, I’d had a heart attack while lying on my bed reading the latest “Harry Potter” novel. I wasn’t your typical cardiac patient. I wasn’t an 80-year-old man in need of elder care, I wasn’t morbidly obese (although I was overweight), I didn’t have high blood pressure, and I didn’t smoke or take recreational drugs. My heart attack happened because I had a very rare illness as a baby called Kawasaki disease. I believe I was the 47th case in the country. In 50 percent of patients, Kawasaki causes cardiac problems later in life. So by the flip of a coin, my heart suddenly sped up on a July afternoon and I finished the new Harry Potter book that night in a hospital bed.

While I am decades younger than other cardiac patients, many things are the same. I take many of the same medications and I have an internal cardiac defibrillator (ICD) in my chest. The medications and my condition mean I have to eat a different diet. The blood thinners mean I can’t have too much vitamin K – the vitamin found in green, leafy vegetables. While I can eat asparagus, broccoli and spinach, I can’t overdo it. If I do, I get a splitting headache. It could also cause uncontrolled bleeding or even a stroke. It’s the same with alcohol, because that also manipulates what blood thinners do. While I miss having a drink with friends, the headache isn’t worth the booze.

Additionally, I have four stents in my heart. These little lattice-work cylinders keep an artery open and blood flowing properly. The blood thinners ensure the red blood cells don’t get caught and cause a blockage. I also take blood pressure medication, so I have to avoid foods high in salt. One of my favorite things to eat in the world is chips and salsa. But I don’t buy chips anymore because of the sodium. I sometimes indulge myself at Mexican restaurants, but I avoid the chip aisle at the grocery store.

When I got out of the hospital I went through cardiac rehab for several weeks. I wasn’t allowed to drive during that time, so friends and family drove me there three or four times a week. One time I took the bus. Several of the others in cardiac rehab also took public transportation, but I could tell it put stress on them. At the start of each class, old men surrounded me as technicians hooked up heart monitors to our chests. Then we’d exercise while they monitored us. Some of the men struggled and could barely go above a shuffle as we all built up our stamina. It wasn’t just the old men who had trouble. A heart attack, like any sort of heart disease, drains you. For weeks afterward I got tired very easily.

As we walked on our treadmills, the techs played videos about cardiac health, showing us what to do if something went wrong. Have nitroglycerin ready; make sure you take all your medications; eat well and exercise. It was stuff you always hear on TV, but now I was just like these old men, a very depressing realization. I found myself dwelling on the things I couldn’t do any more and the new limitations on my life because my body failed me. It didn’t help that some of the men in the class were on their second or even third time around. Is this what lay in store for me? I was only 25, not 85.

When you feel this way, you want to rely on friends and family, but the heart attack hurts them as well. My parents were fits of worry – my mom paced when I was around and my father couldn’t sleep. My friends shrugged awkwardly and didn’t know what to say. Many people around me treated me like glass.

I eventually got out of my funk and I am very happy now. The medications help keep me healthy and I exercise daily. But I still think about the old men who walked beside me on the treadmills. I was a young man and my friends weren’t 85 and sick like me. My family hadn’t moved out of town. What’s it like for the older heart patients who don’t have that type of support system? Now that I work for Homewatch CareGivers, I know that we can create a circle of support for those older people so they don’t have to recover alone.

A heart attack doesn’t stop when they stabilize your heartbeat in the emergency room. You always remember it and it changes how you live. You have a scar on your chest and a pill case in your pocket. You feel lonely, even if you have friends and family around who can help. But what if you don’t have that? It’s important to know there are trained caregivers who can help, giving you what you don’t even know you need. Seven years ago, my life changed on a Saturday in July when all I wanted to do was read how Harry Potter overcame his next challenge. It changes for heart patients every day, but it’s not something you have to face alone.

Jeffrey Wolf is the Content Writer for Homewatch International, Inc. in Denver, Colorado.

I Thought It Was My Job – The Stress of Caring for Mom

When I started taking care of my mom I thought it was something that I needed to do. You can’t make up for all that parents do for you in a lifetime in just a few short years so I saw it as a calling. I thought it was my job. In life, there’s a kind of symmetry. You’re supposed to care downward for your kids and upwards for your parents.

It was running me ragged but I didn’t feel like I was getting burned out. I never asked for help directly, but my friends told me I was going to burn out. Thanks to them, I got help and I’m so glad for it.

Let me go back a bit and kind of fill in the background. My name is Chris and I’m the father of two boys. Gabriel is 9 and turns 10 in October and Nash just turned 5. My mom, whose name is Natalie (and the kids call Grandma), will turn 88 in August. We lost my father two years ago mid-June. He spent two weeks in the ICU after having a heart attack. They were all set to put in a pacemaker, and he had woken up and was talking, when they discovered he had a septic infection on the morning of the surgery. They lost him.

It was tough and it was kind of a rollercoaster.

Once we got his service taken care of and life got back to “normal,” Mom finally went into the tests we’d been putting off. She’d been having chest pains and just two months after we lost Dad, the doctors decided Mom needed quadruple-bypass surgery. She spent the next few months recovering.

Ideally someone in her situation would exercise as much as possible, and she did the required rehab – but only 36 weeks is covered by insurance. As a result we’re just trying to maintain. I don’t expect we’re going to see any marathon running in her future.

Mom now spends most of her time in bed. She has a lot of pain management issues – her hips and back hurt when she puts weight on them – even sitting up can cause her pain. So she spends most of her time horizontal. The pain meds also make her tired and drowsy because she’s on so much of them. I think she sleeps a lot.

I don’t think we’d be in the spot we are now if Dad hadn’t died. They were very symbiotic. They went everywhere and did everything together. This wasn’t because they needed to, it’s because they wanted to. My mom commented one time that she was not a woman’s woman. She said, I never had knitting clubs or bridge clubs – your father and I did things together. He didn’t do those things either – he never really went out with the boys or things like that. They weren’t clingy, but just liked each other’s company. I invited Dad to lunch one and day and he said, let me see what your mom’s doing. I kind of thought maybe it would be just him and me and he told me: “I’m not going to go anywhere without your mother.”

I don’t really mind doing things for my mom and I’m not a stranger to stress. I’m an air traffic controller in Kansas City. It’s the kind of job that has periods of boredom punctuated by moments of extreme terror. My father was a flight instructor in the Navy in WWII and I started flying lessons in college. He and I flew together. Aviation is something I enjoy and that helps make my job less stressful.

Once again – I thought caring for Mom was my job. She liked it too. I’m an only child and I think she’d rather I do everything around her house. She’d rather have me changing her sheets instead of a stranger. She’d rather have me go grocery shopping instead of a stranger.

After Dad died and she got sick we looked at moving her into a facility. A friend of mine helps to run one so we went and visited but it didn’t fit for a couple of reasons. First, Mom is still a fairly private person and, whether she is right or wrong on this, her perception in living in a large building with essentially 300 apartments in it and coming to a community area to eat was a loss of privacy. Second, the apartments were about a third of the size of the place she’s in now. She wasn’t sure she wanted to downsize and she also didn’t want to go through the emotions of moving and getting rid of things. Also, she’s not an invalid. She still drives her car. She can get in and out of the bathtub and bed. She cooks her own food and can go to the bathroom on her own.

But my friends knew I needed help. I was with my boys, tromping around the woods in a park. We were literally wading through creeks and chasing frogs when my friend texted me about an in-home care option. I said, sure, it’s worth learning about. Within five minutes, a text rang in from Patty Garrett asking when we could get together. In case you don’t know, Patty runs the Homewatch CareGivers in Kansas City.

Since Patty has come into out lives I think it’s turned out to be a great benefit. The time that mom and I spend together is now is quality time – it’s not just being together while I’m taking out the trash or cooking or whatnot. Mom used to say, why don’t you sit down? And it’s because I had a short amount of time to get a lot done.

The woman coming in is also a good person for mom to talk to. If I was not there – Mom kind of said she didn’t have a reason to get up.

Our caregiver comes in for four hours a day three days a week. They’ve inventoried her pantry and fridge, cleaned and folded the laundry, gone shopping. Sometimes they just sit out on the patio together and watch the world go by.

This is way better than having her in a facility. I think moving her at this point would be a lot of upheaval and this staves that off for a while. And this keeps her in her home.

I traveled for work last week for the first time in a long time and it was nice to know that somebody was going to check in on Mom.

Patty used to say, we’re anxious to give you back your relationship and I thought that was touchy feely, but that’s exactly what’s it’s been.


Chris Followell and his family live in Kansas City where he works as an air traffic controller.

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