November is National HomeCare and Hospice Month aswell as Home Care AideWeek. These events are cele-brated nationally eachNovember to honor the dedi-cated men and women whoprovide these needed serv-ices. Last year CommunityVNA provided 52,764 visits toour patients and over 3,171hours of community servicesthrough clinics and wellnessevents. “Caring for ourcommunity is a privilege, andwe are proud and honored tohave served to our communi-ties for over 60 years,” statedAlyce Brophy, President/CEOof Community VNA.

November serves not onlyas a celebration of theseprofessionals, but as a meansof increasing public aware-ness about home care andhospice services in thecommunity. Our team ofnurses, therapists, aides andother professionals delivercare and hospice in the home to individ-uals who require services because of acuteillness, long-term or chronic health condi-tions, disabilities or terminal illness.Whether you require home care orhospice, our experienced dedicated staffwill come to your home or place of resi-dence to create a plan to help manage andmonitor your symptoms, teach you aboutyour illness and caring for yourself, andmaximize your comfort. “All too often indi-viduals and families facing these types ofsituations don’t know where to turn for

help,” said Ms. Brophy.Home care and Hospice

services are covered byMedicare, Medicaid andmost managed and privateinsurances. Home healthcare not only is cost effec-tive but care effectivebecause it can assist inimprovement or symptomcontrol, reduce hospitaladmissions, readmissionsand emergency room visitsand lead to an improvedquality of life. Hospice isthere for those in need,providing care and comfortfor both the patient andtheir families who arecoping with life’s most chal-lenging transition.

As part of our celebra-tion CVNA will recognizethree individuals whoreceived top honors inpatient satisfaction last year:Mari Wells, Home CareNurse; Jennifer Allen,Physical Therapist; and Reva

Dhanda, Home Health Aide. All three ofthese individuals received accolades fromtheir patients and family members forgoing above and beyond in deliveringquality care with compassion and dedica-tion. That’s what Home Care and Hospiceis all about, delivering quality care to yourdoorstep when you need it. We hope youwill take the opportunity to join us insaying “Thank You” to those who deliveryour care and to our entire staff for theincredible job that they do.

Community Visiting Nurse

Association attained 99% patient

satisfaction in a recent survey by

Press Ganey, an independent

agency specializing in patient

feedback for the health care

industry.

“In order to monitor our

patients’ satisfaction with their

health care experience,we

partner with Press Ganey, a leader

in the industry, to collect feedback

from our patients,”noted Alyce

Brophy, President /CEO of

Community VNA.“Their surveys

are the industry’s most widely-

used approach to collecting

patient perspectives to measure

and improve quality of care.We

use the information from these

surveys to learn how we’re

succeeding and to identify areas

we need to improve. I am

extremely proud of our

employees,who continue our

strong commitment to patient

satisfaction and quality improve-

ment,” she added.“The agency

has been making great strides in

improving its patients’home care

experience. Patient satisfaction

continues to be a priority for the

agency.”

HIGH PATIENTSATISFACTIONRATINGS ACHIEVEDBY CVNA

Celebrating Home Careand Hospice Month

V o l 1 • N o . 6 • N O V E M B E R 2 0 1 0

MariWells, Home Care Nurse

Jennifer Allen, Physical Therapist

Reva Dhanda,Home Health Aide

Alzheimer’s disease (AD) is difficult to diagnose because symp-toms apparent to the patient or their loved ones usually occurat moderate to advanced stages of the disease, giving thedisease a good head start. In diagnosing, we look for evidencefrom a medical history and mental status exam that indicatesmajor impairment in learning and memory as well as at leastone of the following: Impairment in handling complex tasks,reason ability, spatial ability and orientation, and language. Thecognitive symptoms must significantly interfere with thepatient’s life, must represent a significant decline and beprogressive (not from delirium, systemic disease or majorpsychiatric diagnosis).

The key to early diagnosis of dementia is not waiting formajor symptoms to develop because by that point we arealready too late in making any significant improvement or inslowing down further decline. Identifying the risks factors forAlzheimer’s and then looking for early signs of MCI (minimalcognitive impairment) provides the best hope of early diagnosisand treatment.

Risk factors for Alzheimer’s Disease

Age is the biggest factor, the risk gradually increasing from age70, with the highest incidence among people 85 and older.Patients with a first-degree relative with dementia have a 10-30% increased risk of developing the disease. Atheroscleroticvascular disease has been linked to all dementia as well as AD.

Studies show that diabetes is associated with a 50-100%increase in risk of AD and 100-150% increased risk of vasculardementia. Other risk factors may include genetics, high bloodcholesterol and triglycerides, smoking, alcohol use, obesity,diets high in saturated fats, chronic renal failure and hyperten-sion. The less a patient does in maintaining social networks,mental activity and physical activity, the higher observed riskof AD. Also, higher levels of education have been associatedwith a reduced risk of AD.

The Alzheimer’s Association recommends thatanyone who exhibits several of the followingcriteria be further evaluated by a physician.

� MEMORY LOSS THAT DISRUPTS DAILY LIFE. This is one of the

most common signs of early AD. A typical age-related memory

loss would be sometimes forgetting names or appointments

but remembering them later. Forgetting important dates or

events, the names of very familiar people or asking the same

information over and over are signs of AD.

� DIFFICULTY PERFORMING FAMILIAR TASKS. Occasionally

needing help to use the microwave or DVD may be age

related, while difficulty driving to a familiar location or

forgetting the rules of your favorite game are signs of AD.

� PROBLEMSWITH LANGUAGE. Sometimes having trouble

finding the right word may be OK. Repeating yourself, strug-

gling with vocabulary regularly or stopping in mid-conversa-

tion and not being able to carry on are AD signs.

� LOSING TRACK OF TIME AND GETTING LOST. Temporary

confusion about the day of the week may be normal but

losing track of the seasons, forgetting where you are or how

you got there is not normal.

� POOR OR DECREASED JUDGMENT. Making a bad decision once

in a while could be acceptable, but carelessness with money

or paying less attention to grooming or cleanliness is not

acceptable.

� INABILITY TO THINK CONCEPTUALLY OR BEING TOO LITERAL.

People with AD may need to have information repeated or

things explained in simpler and more concrete terms.

� MISPLACING THINGS. People with AD may put things in

unusual places and have difficulty retracing their steps.

Sometimes they may accuse others of stealing. Misplacing

keys or the remote is a common problem.

� CHANGES IN MOOD OR BEHAVIOR. The elderly may develop

specific ways of doing things and become irritable when the

routine is upset. The AD patient will become confused, suspi-

cious, depressed, anxious or fearful when they are at home,

at work, with friends or in any place out of their comfort

zone.

� CHANGES IN PERSONALITY. Age-related changes don’t

usually include personality changes.

� LOSS OF INITIATIVE. We all may get weary of work, family

and social obligations at times. People with early AD may

avoid social situations that they would normally attend, they

may stop following their favorite team or remove themselves

from hobbies or work projects.

Family or friends are usually the first ones to notice thesechanges in a person. Early diagnosis is critical to staving offthe disease; the sooner steps are taken to treat a person, thebetter their outcome will be. Medications and cognitive inter-vention have all been shown to be more beneficial the earlierthey are begun.

Signs OfAlzheimer’s Disease

2

- Dr. Joseph T. Morandi, Medical Director, Community VNA and Community Care Hospice

Community Visiting Nurse Association is pleased to partnerwith The Center for Life Transitions of Bridgewater, NJ, to hosta series of free workshops where senior issues can bediscussed and addressed among family members and areaexperts. These workshops, held Tuesday evenings from 7-8:30PM in October and November, will feature leading area experts,including Anita Ciano, Hospice Manager of Community CareHospice, and Joan Smith, Rehabilitation Manager atCommunity VNA.

Anita’s workshop, “Being a Loving Presence: ProvidingPersonal and Spiritual Support,” will guide participants in endof life care. Joan’s session on “Safeguarding the Elderly” willeducate participants on putting proactive emergency systemsin place and ways to increase seniors’ independence.

The advice and expertise offered in all of the workshops isnot just for the caretakers, but also for those who are beingtaken care of, as senior care is a family affair. Additionalfeatured experts include elder care lawyers, authors, nursesand educators who are all experienced workshop leaders andappreciate the fact that participants want to leave with an“action plan.”

Workshops are free of charge, but registration is required.For more information, please visit www.centerforlifetransi-tions.net or call 908-203-0088. The Center is located at 191Church Road, Bridgewater, NJ.

Caregiver Stress During the Holidays

3

- Angela Calogero, Volunteer/Bereavement Coordinator for Community Care Hospice

It is no surprise that the stress related to the recent loss of aloved one permeates every aspect of our lives. Our eating andsleeping habits, our work situation and personal interactionsall seem to be covered in a layer of grief and sadness. Simplyput, we have been thrown off-balance.

In addition to our day-to-day activities the thought offacing a holiday without the presence of a spouse, parent,sibling, child and even a friend is daunting. How do wecope? Here are some suggestions:

� Consider doing only what is meaningful and special this year.

� Decide for yourself how you want to handle the days that are

special to you and communicate that to friends and family.

� Plan holiday shopping ahead of time and consider cutting back

on greeting cards.

� Ask for and accept offers of concrete assistance with holiday

chores.

Because holidays are times of traditions and ceremonies, youmay want to create special or new traditions that honor yourloss and help bridge the gap between the past and the future.

You could consider these ideas:

� Purchase a gift for your loved one and donate it to charity.

� Visit a place your loved one enjoyed.

� Donate money to a charity or cause that had specialmeaning to your loved one.

� Place a special ornament on the Christmas tree in memory ofyour loved one.

� Light a candle each day of the holiday to remember yourloved one.

And remember, if you try something new and it does not work,you do not have to keep doing it. Community Care Hospice willhost a Saturday morning workshop on “Coping with theHolidays for the Newly Bereaved” on Saturday, November 20,9AM-noon at the CVNA office. It will be facilitated by AudreyOxenhorn, L.C.S.W., a therapist in private practice, and AngelaCalogero, MA, MAPM, Volunteer/Bereavement Coordinator forCommunity Care Hospice. Call Angela by November 12th toregister at 908-725-9355, ext. # 2230.

Community Care Hospicewill hold its annual LightUp A Life ceremony onTuesday,December 7(rain/snow dateWednesday,December8th), at 5:30 PM atCommunity VNA,110West End Ave.,Somerville, NJ.Light Up A Life is a nationally-recognized Hospice

campaign where a tree is lit in memory of, or in living tributeto, loved ones and friends. Lights purchased not only lightup a tree, but also help to support the mission ofCommunity Care Hospice. For a contribution of $20 or more,a light will be lit on our tree,which will be decorated withred ribbons with the names of each honored individual.Donations will enable our hospice program to continue

to provide comfort to those individuals in need.CommunityCare Hospice provides care through an interdisciplinaryteam of experienced caregivers, including a medical director,registered nurses, a social worker, a chaplain, home healthaides and volunteers who work together to promotecomfort for those facing a life threatening illness.If you wish to recognize a loved one, please contact:

Community Care Hospice at 908-725-9355 or visit us on lineat http://www.communityvna.org/Light-Up-a-Life.

Taking CareofYour Parents

LIGHT UP A LIFE CEREMONY

Flu season is here and CommunityVisiting Nurse Association will beoffering vaccinations to individuals overthe age of 18 at various clinicsthroughout the communities we serve.Influenza (flu) is a contagious respira-tory illness caused by influenza viruses.It can cause mild to severe illness, andat times can even lead to death. Older

people, young children and people withcertain health conditions are at highrisk for flu complications such as pneu-monia, bronchitis and ear and sinusinfections. The Centers For DiseaseControl recommends for 2010 thateveryone over the age of six monthsreceive an influenza vaccination.

Flu viruses are thought to spreadmainly from person to person throughcoughing, sneezing or talking withsomeone who has the flu. They mayalso spread when we touch somethingthat has flu virus on it and then touchour mouth, eyes or nose.

Steps everyone can take to helpslow the spread of the flu:

� Cover your nose and mouth with a

tissue when you cough or sneeze.

� Wash your hands often with soap and

water.

� Avoid touching your eyes, nose and

mouth.

� Try to avoid close contact with others

with the flu.

� Stay home if you’re sick to avoid

spreading flu to others.

Last flu season saw the emergence ofthe H1N1 influenza virus, which causedthe first influenza global outbreak by anew flu virus in more than 40 years.This season the flu vaccine will protectagainst the 2009 H1N1 and two otherinfluenza viruses.

Remember, the best way to preventthe flu is by getting vaccinated eachyear. For a listing of public flu clinicsnear you, please visit www.communi-tyvna.org or www.INeedaFluShot.org.

For quality home andhospice care,pleasecontact CommunityVNAat 908-725-9355.

Welcometooursixtheditionof

AtHomewithCommunityVNA

How can you avoid the flu?

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