02/26/17

Why Older People Are Vulnerable to Fraud, and How to Protect Them

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Older people who are active investors and who prefer unregulated investments may be more susceptible to investment fraud, a report published Thursday by the AARP Fraud Watch Network found.

The network, established in 2013 to help promote fraud prevention, commissioned a study late last summer that included telephone interviews with 200 known victims of investment fraud and 800 interviews with members of the investing public.

Doug Shadel, lead researcher for the network, said that relatively inexperienced people often invest money on their own these days, in part because of the decline in traditional pensions. At the same time, he said, technology makes it easier for scam artists to reach larger numbers of people, by telephone or email.

The report sought to pinpoint traits that may help explain why some people are more susceptible to investment fraud, Mr. Shadel said. Victims were more likely to be men 70 or older, and they tended to be risk takers. About half of fraud victims agreed that they did not mind taking chances with their money, as long as “there’s a chance it might pay off.”

And nearly half of fraud victims, compared with less than a third of general investors, agreed that “the most profitable financial returns are often found in investments that are not regulated by the government.”

Victims were more likely to report valuing wealth accumulation as a measure of success in life and being open to sales pitches, the research found.

Victims reported that they frequently received targeted telephone calls and emails from brokers and that they made five or more investment decisions a year. Also, they were more likely than general investors to respond to remote sales pitches, including those delivered in television commercials.

As many as 17 percent of Americans 65 and older report being the victim of financial exploitation, according to the Consumer Financial Protection Bureau. Estimates of annual losses are in the billions of dollars. One factor that may play a role is mild cognitive impairment, a condition that can be a precursor to dementia and can diminish an older person’s ability to make financial decisions.

Older people are at risk of being swindled not only by strangers, but also by people they know. Douglas Canada, a 78-year-old retiree in Nevada, sought help from the fraud network after he was tricked by an old acquaintance: He received a call in 2015 from a man who had been a co-worker three decades earlier. The man invited Mr. Canada and his wife to lunch to talk about an investment opportunity. The man and his date sported Rolex watches, and they even bought a diamond ring during the outing. “They really put on a good show,” Mr. Canada recalled.

The man told Mr. Canada that he had grown rich by buying and renovating foreclosed homes in another state. He invited Mr. Canada to invest, promising double-digit returns. Mr. Canada sent a cashier’s check for $40,000 — but has since been unable to contact the man. Mr. Canada has hired a lawyer and a private investigator, and he has written to the state authorities, but isn’t optimistic about getting his money back. “He’s a con man,” Mr. Canada said. “I was gullible, and I fell for it.”

Some scams — gold investing, real estate schemes, and even one involving leases on A.T.M.s — may sound improbable after the fact, Mr. Shadel said, but victims report being persuaded — sometimes, because of word of mouth from friends or family.

Recognizing that you may have a predisposition toward risky behavior, like being open to pitches, may help you avoid being taken in, Mr. Shadel said. “You can at least be aware of your psychological mind-set,” he said. Consumers can take a quiz, based on the study’s findings, on the fraud watch website.

Mr. Shadel urged consumers to deal only with regulated brokers and investments, and to “ask and check”: If you get a call from a broker, ask if he or she is registered with state and federal securities regulators, he said, “and then check to see if it’s true.”

You can check a broker’s background though Finra, the Financial Industry Regulatory Authority, using its online BrokerCheck tool at www.finra.org, or by calling 800-289-9999.

Maggie Flowers, associate director for economic security with the National Council on Aging, said that older people should be skeptical of any offers, particularly unsolicited ones. “Always ask for things in writing,” she said, “so you can think it through and talk through the options with a loved one or peers.”

Here are some questions and answers about older people and fraud:
Are older people at risk for fraud only if they are wealthy?

No, Ms. Flowers said. Scam artists know that many older people have fixed incomes, which may make them vulnerable to fraud because they are open to hearing about ways to make money and pay their bills.

Where can I learn more about protecting an older person from fraud?

The National Council on Aging offers tips on avoiding fraud at EconomicCheck.org.

The Consumer Financial Protection Bureau offers a “Money Smart” guide for older adults, and other resources, on its website.

What should I do if I think an older person has been a victim of financial fraud?

You should report it to the local police, and your state attorney general’s office.

You can also contact your local adult protective services agency. You can find a local agency that investigates reports of financial exploitation on the federal Eldercare Locator website or by calling 800-677-1116.

The Justice Department also offers an online “elder abuse resource road map.”

Complete Article HERE!

02/25/17

When You Love An Old Dog, Managing Care Can Be A Challenge

By Preeti N. Malani

The notion of dog years stems from the common belief that one year for a dog equals seven years for a human. Although canine aging is more nuanced than a simple formula, any dog lover knows that dogs’ lives pass far too quickly.

Even so, America’s 70 million dogs, like their human companions, are living longer, on average, because of better medical care and nutrition. Caring for elderly dogs can be heart-wrenching. Many pet owners struggle to understand when to pursue aggressive care and when to stop and help a beloved pet pass on.

“Older patients are the biggest challenge veterinarians face,” says Dr. Alicia Karas, an assistant professor of veterinary medicine at Tufts University. She argues for a holistic approach to older dogs, saying that “too often we focus on the affected body part or the results of an X-ray, not how an animal walks into the exam room.”

Pain tops the list of common health concerns for older dogs, with causes ranging from the routine, such as arthritis, to the more serious, such as cancer. As in humans, pain management can be complicated by other conditions. A dog with weak kidneys, for instance, may not be able to take common medicines like ibuprofen.

The benefits of a good rehabilitation program can be far-reaching. Older dogs may not make it outside for long walks, says Karas, but with rehabilitation, “three times a week the dog gets out and sees people who pet and love him.”

Older dogs, like their aging owners, may experience memory loss. “When we work up a pet for urinating in the house, we tend to focus on the kidneys, bladder and endocrine reasons,” she says. But it may be a case of “simply forgetting to go to the bathroom,” she explains. Anxiety is closely linked to impaired memory, and even minor changes in the household can be hard on older dogs.

While specialized care may seem ideal, Dr. Stephen Steep, a veterinarian in Oxford, Mich., tries to present a menu of options and to set realistic expectations of what can and can’t be done. “Here are some things you can do. If cost is not an issue, this is an option,” he says. “Here is another less aggressive option.” But the pet’s comfort is paramount, and Steep says he always considers whether or not a particular decision will improve quality of life.

When it comes to end-of-life discussions, Steep recognizes they’re inherently difficult. He likes to start with open-ended questions, noting that many owners aren’t aware of subtle changes. “How is your dog’s appetite?” he asks. “Is your dog sleeping through the night? How is he doing on long walks?”

Although Steep believes most owners understand there is a limit to their pet’s life, he feels people don’t always realize how old their pets really are. He tries to help them accept aging as a normal process, not a disease.

“People want to have dog pass away at home in their sleep, but that is rarely the case,” Steep says. “You get into a situation where the pet cannot go outside to urinate or defecate. He may be gasping for air due to heart failure or incapacitated due to memory loss.”

Still, some people just can’t let go. When Steep gets the sense that someone is pushing too hard, he tries to emphasize the pet’s comfort. “I’ll pull them into clinical activities like checking heart rates, monitoring water intake, to try and open their eyes,” Steep explains.

Most owners come to the realization that their dog is at the end of its life.

Although Karas recognizes the moral distress created by end-of-life decisions, she acknowledges the importance of euthanasia. “When I have no other options, I have a tool to alleviate suffering.”

When Andrew Shepherd’s 14-year-old English setter, Madison, developed seizures, he focused on maintaining her quality of life. Given her age and the lack of any obvious discomfort, Shepherd decided against an extensive work-up and instead focused on the dog’s symptoms, a decision their veterinarian supported.

During the following months, the seizures become more frequent, lasted longer and the dog appeared to be in pain. “She would yelp,” Shepherd recalls. “It was clearly not a pleasant experience.”

One day Madison suffered a protracted seizure while traveling in the back seat of Shepherd’s car. For him, this was the tipping point. “We couldn’t sacrifice her quality of life just to keep her around,” Shepherd explains. After that, it was about selecting the right moment to let Madison go.

Their final night together was a celebration of Madison’s life. The family comforted their dog, took pictures, shared their favorite Madison stories and made a list of all the nicknames they had for her.

Shepherd recalls crying as he took Madison to the veterinarian’s office for the last time. “Normally she hated going to the vet, but this time she didn’t fight at all,” he says. “She knew it was time.”

Complete Article HERE!

02/24/17

Exploring death through the isolation of VR

Confronting your own mortality is tough but helpful.

By Mona Lalwani

I‘m sitting on a field of tall, red grass staring straight ahead at a lone tree. Its leaves match the crimson landscape that stretches out before me. In the distance, a rusty orange forest fades into the background. There’s a gentle rustling of leaves, occasionally interrupted by the faint chirping of a bird, that forces me to breathe slower.

“Thank you for being here and being willing to consider moving towards the idea of dying and death,” a calm, male voice prepares me for the virtual meditative journey.

A hazy white light source rises in the distance as the voice walks me through the process of focusing on my breathing. I watch the blades of the grass swish to the left with the wind. The tree slowly starts to lose its leaves. “Feel the air around you,” the voice continues. “Feel yourself letting go as if you’re a tree dropping your leaves. The breeze takes the leaves away. Everything that you know and everything you cherish will be taken by the wind.”

As I let the weight of those words sink in, the blue sky slowly takes on a deep green hue, ushering in darker skies. Within moments, the field beneath me turns into a deep red lake that starts to rise around me. I gasp for air before I quickly remind myself that I have an Oculus Rift headset on my face.

When We Die is a virtual reality experience for perhaps the most difficult kind of contemplation: the end of life. The first half, with the metaphorical tree, presents the ephemerality of nature as a symbol of the finiteness of your own life. But the next chapter addresses the wider perception of death as a tragedy through real-life experiences.

In the second half, serene views of the cosmos shift the narrative from considering your own mortality to thinking about the process of dying as an inescapable reality for all. Celestial objects that dot the night sky reveal audio clips from a hospice worker, who shares her observations of death, and a neurologist, who grounds the experience in a physician’s approach to it.

“We wanted to create a safe space for people to have difficult conversations,” said Paula Ceballos, an NYU student who is a part of a trio that created When We Die for the school’s Interactive Telecommunications Program. “We find that in the Western culture death and dying and aging get put behind closed doors, and we wanted to bring it up and make you think about it.”

The fear of death, your own or a loved one’s, is deeply ingrained in the human psyche. It can drive the choices we make, yet it continues to be shrouded in mystery. Over the years, hundreds of research studies have probed the process of dying, the fear of confronting death and how the awareness of one’s own mortality has impacted religious, cultural and spiritual world views.

When We Die makes room for that spiritual contemplation with its abstract worlds: There are no physical bodies, only metaphors for the process of aging and dying. But the idea is rooted in a more practical understanding of the ways in which neglecting end-of-life processes can hamper the process of dying, especially for the elderly and the terminally ill.

“It leads to systemic challenges,” said Leslie Ruckman, an NYU student whose background in health care informed her work on When We Die. “There’s all this money that gets spent on treating patients in ICUs, and people [often] end up dying in hospitals even though advance directives might say they’d rather die at home. These are bigger issues that arise out of the inability to look at the end of life and not being able to define what a good death might look like.”

The VR experience relies on surreal visuals to make that happen. According to co-creator Dana Abrassart, when the group first started working on the project, they envisioned a James Turrell-style liminal space. But they quickly realized that a virtual take on the light and space movement would trigger motion sickness.

Nausea in a death-related experience would defeat the purpose of their work. So instead, the group found inspiration in Richard Mosse’s infrared imagery. “It’s this idea that there’s a light spectrum around us but the human eye can’t see it,” Ruckman told me. “We liked that as a parallel to this natural process that is always present and yet, we choose not to see it.”

Death is a constant. Yet its prevalence is hidden behind hospital doors. “In the US, there’s a sanitization of death,” Dr. Gayatri Devi, the neurologist whose voice floats through the cosmos in the second half of the VR experience, told me at her clinic in Manhattan. “Our current view of death might be a victim of industrialization and development. There’s less contact with ill people who are dying so they get sequestered and put in a different place. Whereas in India, for example, there is a philosophy of maintaining contact with family and contact with death is not uncommon.”

More than 80 percent of Americans with chronic illnesses would prefer to forego hospitalization, but according to the CDC, 70 percent of that population dies in a hospital or nursing home. Even in cases where patients have advance directives to avoid aggressive measures, a widespread study revealed that only 25 percent of the physicians were aware of their patients’ end-of-life choices. The discrepancies are jarring. Even though the rise of palliative care and hospice work in the past few years is starting to close that gap, the inability to talk about death continues to get in the way of making better choices.

“Death is not a contagious illness,” said Dr. Devi. “But in some ways, we treat it like one. We need to talk about it and get comfortable around it and maybe use VR to experience it. The better the conversation about death, the more likely we’ll be to allow more of us to die at home so we’re not scared of it.”

Conquering those fears has been the focus of recent psychological explorations in VR. While When We Die uses a light meditative touch to approach conversations around death, a Spanish research group recently simulated an out-of-body experience to tackle the full spectrum of thanatophobia (or the fear of dying) in an attempt to reduce anxiety.

“Death is not a contagious illness. But in some ways, we treat it like one. We need to talk about it and get comfortable around it and maybe use VR to experience it.” — Dr. Gayatri Devi

The idea of one’s own nonexistence has always been a tough one to conquer. “But it’s a reality and we can’t opt out of it,” said Dr. Devi. “When you allow yourself into that space of thinking you’re dead, where you lose agency over yourself — that can be a powerful experience. Allowing yourself to sit with that makes you vulnerable and to be able to think about death. You have to allow that to happen.”

While some might consider this exploration of death terrifying or even futile, in many cases the practical rewards offer the required motivation. Preparing beforehand, for instance, allows people to get their affairs in order, which unburdens families from making end-of-life decisions.

“When people are faced with death, if they haven’t done any preparation, there’s too much fear and anxiety to let anything else in,” Stephanie Hope, the hospice nurse who shares her experiences in When We Die told me. “It makes it important to talk to people who aren’t faced with that yet.”

Hope, who has been a hospice worker for about four years, points out that when people think about having limited time, they start to withdraw and often show an inclination to spend time with people they’re close to. She likens that purposeful shrinking of the world to a kind of intimacy and peace that can be felt in the aloneness of VR.

The isolation, which tends to be one of the biggest criticisms of the medium, lends itself to the deeply personal experience of contemplating death. “You’re in your own world and this is your moment,” said Hope. “So to think that that’s what it might be like at the end for you can be powerful thing.”

While the immersive possibilities of VR feel contemporary, tools that address the human predisposition to death have been around for centuries. John Troyer, director of the center for death and society at the University of Bath, traces the lineage of the visual format all the way back to mediumship. “For me, a lot of it, although a different kind of technology, has a relationship to this idea of connecting with the dead in some way,” he said. “To understand any kind of new tool that is supposed to help people think about death, we have to place it in context of the long history of tools that were created by humans to help other humans make sense of their mortality.”

Troyer pointed to theatrical experiences like phantasmagoria of the 19th century, which played with themes of monsters and death long before VR. The use of projection systems like magic lanterns turned those imaginative ideas into visual experiences for audiences, which in a way is comparable to the current applications of the immersive technology.

The visual trickery of present-day VR, however, is far more profound than its predecessors, both in terms of the visual display as well as its potential for real-world impact. Death-related VR experiences can help prepare people for the inevitable but can also be used to train hospice nurses. Hope believes that bringing VR headsets into nursing school simulation labs, where trainees already work with dummies to stage scenarios, could provide crucial insight into hospice work from a patient’s perspective.

While hospice workers are trained to care for the dying, physicians are primed to prevent death. “In medicine we’re taught to keep that heart beating,” said Dr. Devi. “There’s an attitude of ‘let’s do whatever we can to keep this person’s heart beating, even if that doesn’t improve their quality of life.’ But why are we putting our elderly or very ill patients through these aggressive ways when the outcome is not going to be a good-quality life?”

When We Die doesn’t address those questions directly. Instead, it gets at them with an acknowledgement of death as a potentially positive experience. There’s an inherent belief that dying is depressing. It continues to be a terrifying unknown because we lack experience in it. But as the VR experience reveals, the tragedy of death isn’t true for all.

Complete Article HERE!

02/23/17

Circle of life: Former Victoria maternity doctor now helps terminally ill people end their suffering

Dr. Stefanie Green in her Victoria office this week. Green, who started her career as a maternity doctor, has provided medical assistance in dying to 25 people over the past eight months, people who want to depart this life on their own terms in the face of painful and imminent death.

By Randy Shore

For Stefanie Green, the transition from baby doctor to helping people die was completely natural, providing care at different ends of life’s continuum. 

“I (originally) chose maternity and I liked the fact that it was happy medicine, and really I can’t think of a better job on the planet than delivering babies,” she said. “I was in in my 20s when I started, so it felt (like) really familiar territory because I was also getting married and having kids.”

But helping people to die is not so different when the dominant emotion is not sadness, but gratitude.

Green has provided medical assistance in dying to 25 people over the past seven months, people who want to depart this life on their own terms in the face of painful and imminent death.

“The overwhelming emotion in the room when I provide this care is relief and gratitude,” said Green, a Victoria-based physician with 20 years experience in maternity care. “There is a release from suffering. The family is overwhelmingly grateful. The patient is overwhelmingly grateful.

“There is a real satisfaction on the part of the patient, who has made an empowering decision and been able to fulfill it after years of pain and hopelessness.”

Death review panel

About 200 people in British Columbia have opted for a medically assisted death since last June 17 when Bill C-14 created a legal environment for assisted dying. More than 740 Canadians died with medical assistance in 2016.

With six-plus months of data now in hand, the B.C. Coroner’s Service — with representatives of the health regions and the provincial government — plans a Death Review Panel for later this month to assess the new process. A report will be made public later this year.

As a young doctor, Green took careful note of celebrated B.C. right-to-die cases, including the 1994 death of Sue Rodriguez and, more recently, the 2012 B.C. Supreme Court decision that would have allowed Gloria Taylor the right to end her life. But it wasn’t until Green took a break from her maternity practice two years ago that she considered changing the focus of her career.

“When I realized that our laws were truly about to change and there was an opportunity to work in this new field I really began to educate myself,” she said.

There is a release from suffering. The family is overwhelmingly grateful. The patient is overwhelmingly grateful’ — Stefanie Green, provider of medical assistance in dying

After attending the 2016 conference of the World Federation of Right to Die Societies in Amsterdam, Green felt sure of her new course.

“Talking to people in the field, they were talking about choreographing the death,” she said. “Everything I heard sounded a lot like preparing for a birth. I really saw how those skills were going to be transferrable from one to the other.”

“There’s an art to making sure everything is going as smoothly and safely as possible during a delivery while still understanding you aren’t the most important person in the room,” she said. “I find that is the skill I take the most with me to end-of-life care.”

Public demand

The new law appears to have tapped public demand, as almost one person per day receives medical assistance in dying in B.C. 

“When people come to me they have made a decision that they want this service,” said Green. “People are decided, courageous and very determined. They’ve made the leap.”

But not everyone who wants a medically assisted death can get it.

The federal law includes a criterion not found in the B.C. Supreme Court ruling, namely that the patient’s natural death “has become reasonably foreseeable.”

“It’s not exactly clear what that means,” said Green. “For someone who can’t make a clear case, it’s a difficult box to tick. I’ve had to say no to people and it’s the hardest part of the job, but I need to work within the law.” 

The vast majority of Green’s patients are in the terminal stages of cancer and many of the others are in end-stage failure of the heart, liver or lungs. Most remain lucid right to the end, and importantly able to consent or decline the procedure to their final moments of life.

With some neurodegenerative diseases, the accelerating loss of mental capacity can muddy the waters.

“When people come too late in the course of their disease, it’s a problem,” she explained. “It may be that they are well enough to make the decision when I meet them, but they decline so quickly that they become confused and we have to stop the process.”

MAiD becoming normalized

Green is convinced many people will come to view medical assistance in dying — MAiD for short — as it becomes a normal part of medical care in a continuum that includes prenatal and preventative care, aggressive therapy for illness, hand-holding when treatments aren’t working and palliative care for those who seek comfort at the end of their lives.

She is adamant that the obligation to provide care does not stop five weeks or even five seconds before death.

“MAiD is just another part of that spectrum. Some people really need to fight to the last breath and some people really need to call the shot at the end,” she said. “The Canadian public understands very well what this care is and 87 per cent of them support it. I think that’s very humane.”

Complete Article HERE!

02/22/17

End of life pain control important consideration

By DR. GIFFORD JONES
Woody Allen, when asked for his opinion about death, replied, “I don’t worry about dying, I just don’t want to be there when it happens!”

Unfortunately, Allen will be there and so will the rest of us. This week, I have a personal interest in the end of life.  And what can we all do to provide the best of care to loved ones near death?

Years ago I conducted a five-year battle to legalize heroin to ease the agony of dying cancer patients. Readers, at that time, sent me funds to help with costs. Finally, when heroin was legalized in 1998, $450,000 was left in the kitty, which I donated to the University of Toronto, Faculty of Medicine to establish the Gifford-Jones Professorship in pain control and palliative care. For an update of the current situation, I recently interviewed Dr. Jeff Myers, the current professor of palliative care.  

Myers and his colleagues have not been idle. Today, many doctors are being trained in palliative care. There are now more hospital beds to care for dying patients along with better symptom control. But some “ifs” remain. 

I asked Myers what was the stumbling block surrounding palliative care. He replied: “The reality is, 100 per cent of us will eventually die. So faced with this indisputable fact we must ensure we depart in the most humane way possible.”

This means total and effective palliative care for every person.

Myers reported one shocking problem. Some doctors are not providing adequate painkillers, even when patients have only a short time to live, for fear of causing addiction. This reasoning boggles my mind as years ago I heard this same asinine argument when I was trying to legalize heroin for patients in agony at death’s door.

Myers is concerned this reluctance will be compounded by the current epidemic of opioid drug deaths. Since doctors are being blamed for causing this problem by over-prescribing opioids, they may be less likely to prescribe them to dying patients. But from my research dying patients do not become addicted to painkillers when they are used for pain. Addiction occurs when drugs are used repeatedly for pleasure. So let’s stop blaming doctors for all of the opioid deaths.

Another major obstacle according to Myers is that medical students get very few hours of training in palliative care. This is concerning, given the universal need.

Today the Supreme Court of Canada and some U.S states have declared a legal right to request doctor assisted death. But we do not have a right to adequate palliative care.

The brutal truth is that for the majority of people palliative care is not an option as it is just not available. For example, today 40 per cent of cancer patients do not get palliative care during their final year of life. And, in some areas of the country, less than half of those who die in a hospital receive palliative care.

The problem will get worse as today 80 per cent of patients being treated in palliative care facilities are suffering from cancer. Since we are an aging population the demand for palliative care centers will increase.  

Dr. Francis W. Peabody, professor at The Harvard Medical School, is remembered for saying, “The secret of caring for the patient is caring for the patient.”

There is no better example than caring for loved ones at the end of life.

So what can be done to assure we leave this planet with the least possible trauma? The primary need is to fund the training of doctors and other medical personnel in palliative care.

Like Woody Allen we’d all prefer not to be there when death occurs. But unless we quickly discover Ponce de Leon’s Fountain of Youth, you can be assured you will be there sooner or later.

Complete Article HERE!

02/21/17

‘Treasure life’: wisdom from a former AIDS nurse

Wendy McNerthney, facing camera, who worked for more than 24 years at Bailey-Boushay House, hugs fellow registered nurse Hilary MacGregor at McNerthney’s retirement party.

By

Wendy McNerthney was the longest-serving nurse at the Bailey-Boushay House, the only local place that provided end-of-life care for patients with AIDS in the ’90s. In the first four years she was there, hundreds died and no patient was ever discharged.

 
It’s a little easier now.

But back in the early ’90s, someone died every 72 hours at the Bailey-Boushay House in Seattle’s Madison Valley.

AIDS. It was always AIDS. The year that Bailey-Boushay opened, it was the No. 1 cause of death for men aged 25 to 44 in the United States. Half the people who died of AIDS in King County died at the facility.

Wendy McNerthney was there for almost all of them, bearing witness to one of the worst health-crises the country — and the city — had ever seen.

“It was like a plague,” McNerthney, 64, said recently. “I just thought, I can take it one day at a time, one hour at a time. Many times I came home sobbing.

“But, I thought, ‘I can’t walk away.’ ”

After more than 24 years, though, McNerthney has retired from Bailey-Boushay. She was the longest-serving nurse the facility has had, having spent more than two decades tending to patients and sitting with partners who would eventually become patients themselves.

She comforted relatives who would come straight from the airport or the road, struggling to absorb what came in three, stunning blows: Their son was gay. Their son was sick. Their son was dying.

“It’s such a delicate moment,” McNerthney said. “I would say, ‘No matter what, put all that aside. He’s your son. You’ve got hours or days to tell them you love them.’ ”

Executive director Brian Knowles is going to miss that gift: “Wendy just looks around at everyone in the room and understands what they need,” he said. “And that is a very special thing.”

McNerthney arrived at Bailey-Boushay in October 1992, six months after it opened — the first facility in the country devoted to end-of-life care for people with AIDS.

She had taken her nursing exams in July of that year, and while she waited for her results, worked as a graduate nurse at a nursing home in North Seattle.

But she kept thinking about the patients at Bailey-Boushay, a place she had heard about from one of her professors.

“It sparked my curiosity,” she said. “I thought, ‘What a need for nurses, to help these people. And how wonderful to have a home for them.’

“They needed compassionate, caring nurses to care for them at the end of their lives. And I needed to learn more about AIDS.”

She arrived to find patients ranging in age from their 20s to their 70s. The average stay was four to six weeks, during which 80 percent of the patients burned with fevers that reached 103 degrees.

For the first four years she was there, no patient was ever discharged. They just died. One every 24 to 72 hours, adding up to about 300 deaths a year.

McNerthney administered cold packs and spent night shifts making protein milkshakes with two or three blenders going at once. She touched patients with lesions caused by Karposi’s sarcoma, a cancer that developed on lymph nodes. She stayed close.

“I wasn’t scared,” she said. “You learned good standards of care — hand-washing, gloves, gowns and isolation carts.

“You’re just there on the front lines.”

Most of the patients came straight from hospitals.

“There was no other place,” said Knowles, the executive director, adding that some home-care agencies and hospice facilities wouldn’t accept patients with AIDS. If they did, those patients received minimal or no care at all. Nurses refused to touch them. Dietary workers refused to go into their rooms and left their food trays stacked by the doors.

At Bailey-Boushay, 35 patients received round-the-clock care and were even allowed to bring in their own furniture. One patient’s room was featured in Metropolitan Home magazine.

Knowles called McNerthney “a connector.”

“She remembered everybody, and all the years she has been here, the sensitivity and the warmth …” he said. “She is so genuine. And when she looks at you, you can tell she’s right there with you. You can see it on her face.

“Many people can learn to be nurses, but there’s a compassion that has to be a part of you. You can’t pick that up anywhere.”

McNerthney was born in Winnipeg, Manitoba, and moved to Everett as a child. Her mother died when she was 15, and she looked after her younger siblings.

She was raised Lutheran, but religion didn’t matter to her when it came to caring for people who had been condemned from the pulpit, by politicians and by people in McNerthney’s own circle.

“I had no moral struggle with the disease,” she said. “It’s the people you were taking care of. So it was all about education.

“I wasn’t stern; I just quietly educated people who had valid questions. These aren’t AIDS patients. They are patients with AIDS.”

She also trained nurses who were new and nervous. Protect yourself, she told them. Go slowly. Try not to get distracted, “and don’t ever be hard on yourself,” she said. “You’re human.”

Even though the number of AIDS deaths has decreased and the disease is seemingly under medical control, things are no easier for McNerthney and her colleagues.

Bailey-Boushay now provides end-of-life care primarily to those with cancer, ALS and Huntington’s disease.

“There’s always a lot of tears,” McNerthney said. “We cry. But the patients are the ones that bounce you back.”

Now that she’s retired, she is planning a trip to Ireland with her husband, Pat, and might return to Bailey-Boushay as a volunteer. No matter her plans, the patients and the place will stay with her.

“Treasure life, treasure life,” she told me, when I asked what she had learned. “I feel so blessed that I could do this work, that I could help people who needed it.

“Anything you can do to help people, brighten their day, do it. Because you don’t know what the next day will bring.”

Or, she said, whether it will come at all.

Complete Article HERE!

02/20/17

How to Overcome the Fear of Death, Part 5

Finding Support

1

Determine if you need to seek help from a mental health therapist. If your fear of death has become so intense that it is interfering with your ability to carry out normal activities and enjoy your life, you should seek the help of a licensed mental health therapist. For example, if you start avoiding certain activities due to your fear of impending death, then it is time to get help.[23] Other signs that you may need to seek help include:

  • feeling disabled, panicky, or depressed because of your fear
  • feeling like your fear is unreasonable
  • dealing with the fear for more than 6 months

2

Understand what you can expect from a mental health therapist. A therapist can help you to better understand your fear of death and find ways to minimize it and hopefully overcome it. Keep in mind that dealing with a profound fear takes time and effort. It can take a while before your fears become manageable, but some people see a dramatic improvement in just 8-10 therapy sessions. Some of the strategies that your therapist might use include:[24]

  • Cognitive Behavioral Therapy: If you are afraid of dying, you may have certain thought processes that intensify your fear. Cognitive behavioral therapy is a method that therapists use to get you to challenge your thoughts and identify the emotions associated with those thoughts. For example, you may think to yourself, “I can’t fly because I am afraid the plane will crash and I will die.” Your therapist will challenge you to realize that this thought is unrealistic, perhaps by explaining that flying is actually safer than driving. Then, you will be challenge to revise the thought so that it is more realistic, such as, “People fly on planes every day and they are fine. I am sure that I will be fine too.”[25]
  • Exposure Therapy: If you are afraid of dying, you may start avoiding certain situations, activities, and places that intensify your fear. Exposure therapy will force you to confront that fear head on. In this type of therapy, your therapist will either ask you to imagine that you are in the situation you have been avoiding or they will ask you to actually put yourself into the situation. For example, if you have been avoiding flying because you are afraid the plane will crash and you will die, your therapist may ask you to imagine that you are on a plane and describe the way you feel. Later, your therapist may challenge you to actually fly on a plane.[26]
  • Medications: If your fear of dying is so profound that it is causing you to have severe anxiety, your therapist may refer you to a psychiatrist who can prescribe medicine that may help you. Keep in mind that the medicines used to treat anxiety associated with fear will only reduce your anxiety temporarily. They will not take care of the root cause.[27]

3

Share your thoughts on death and dying with others. It’s always good to talk to someone about your fears or anxiety. Others may be able to share similar concerns. They may also suggest methods that they’ve used for dealing with the associated stress.[28]

  • Find someone you trust and explain to her what you think and feel about death, and how long you’ve felt this way.

4

Visit a death café. Issues related to death and dying can be particularly difficult for people to talk about in general. It is important to find the right group with whom to share your ideas regarding these issues. [29] There are “death cafes,” which are groups of people who meet in cafes specifically to discuss issues around death. These are essentially support groups for people looking to handle their emotions around death. The groups determine together how to best live life in the face of death.

  • If you cannot find one of these cafes near you, consider starting your own. Odds are there will be lots of people in your area with concerns about death but who haven’t had the opportunity to share their concerns.

Look for Part 1 HERE!
Look for Part 2 HERE!
Look for Part 3 HERE!
Look for Part 4 HERE!