Author Archives: Elissa Bell

5 Essential Legal Documents: ‘A Loving Thing to Do”

As the number of U.S. coronavirus cases and related fatalities climb, the pandemic has given us a blunt reminder to get our financial affairs in order. But what does that mean for the average person?

    Tresi Moore Weeks, founder of the Weeks Law Firm in Plano, Texas, has dedicated her career to helping families plan for healthcare and financial questions that are necessary part of every life. She refers clients to PyxisCare Management for care coordination services.

As an attorney who practices estate and special needs planning, Weeks understands the issues first-hand — she navigated end-of-life decisions with her own mother, who died of cancer.

Most people don’t want to think about it. We think we will live forever,” she says. “Sometimes it makes people feel uncomfortable. Some people just don’t understand the importance of planning and that it makes it so much easier for their families.

“I tell my clients that they are leaving a loving legacy for their family members, that it’s a loving thing to do.”

Weeks credits Texas Gov. Greg Abbott with temporarily suspending in-person notary rules this spring to allow legal documents to be notarized by video conference. The change makes it easier for families to sign or update documents during the ongoing pandemic, when social distancing is critical for older people and others with health concerns.

She shared her list of the essential legal documents that every adult should maintain:

1. Durable Power of Attorney. This document authorizes another person to act on another’s behalf and grants them the power to sign the person’s name, pay bills and handle financial and other business matters.

2. Medical Power of Attorney. This document is signed by a competent adult and designates a trusted person, or agent, to make health and medical decisions for on the person’s behalf should that person be unable to make such decisions.

3. HIPPA Release. Named for the Health Insurance Portability and Accountability Act of 1996, this document notifies medical providers that they have permission to share protected health information with the listed person or persons.

4. Directive to Physicians. Also known as a “living will,” this document states whether the person wishes to remain on life support if there is no chance of survival without it.  are come into play if a person is brain dead or at the end stage of a terminal illness.

“It takes that terrible decision away from the family,” Weeks says. “To me, that’s a very loving thing to do.”

5. Will or Living Revocable Trust. A will lays out how assets should be distributed after person’s death; a living revocable trust takes effect immediately and appoints a trustee who can handle affairs if the person becomes incapacitated or dies. Weeks says both documents, if done correctly, may reduce unnecessary court involvement in a person’s estate and often reduce expenses for surviving family members.

Similar documents are needed for families with children living with disabilities, Weeks says. A Special Needs Trust can be created to hold assets for the child without preventing the child from qualifying for public benefits, such as Medicaid.

A last bit of advice: Update your documents regularly. Weeks asks her clients to revisit key documents every three years.

“Setting all this out reduces stress and potential conflict among your survivors,” she says. “The relationships are most important. You may not eliminate all conflict, but you can reduce the risk significantly.”

Meet the Team: Duyen N., Personal Health Nurse

“I enjoy teaching people how to optimize their health and best utilize the healthcare system. I want to help them achieve their health goals and manage their chronic conditions so they don’t end up in the hospital.”

Duyen N. moved more than 8,000 miles, worked 11 part-time jobs to pay her way through nursing school, and spent five years in one of the nation’s busiest hospitals to prepare for her best role yet.

Duyen is PyxisCare Management’s first Personal Health Nurse. The new position is embedded in an employer’s organization and allows Nguyen to proactively engage with a client’s employees, build relationships and collaborate to improve overall health.

It’s more than coincidence,” Duyen says. “I feel like this role is really meant for me.

Duyen grew up in Vietnam and was inspired to study nursing at age 16 when her older brother was partially paralyzed in an accident. She admired the way nurses supported his recovery and saw the profession as a way to build a better life.

During nursing school, Duyen met an exchange student who encouraged her to apply for a U.S. student visa. That move led her to enroll in the nursing program at Dallas County’s El Centro College, to take English classes, and then to earn a Bachelor of Science in Nursing degree from The University of Texas at Arlington.

Since then, Duyen has worked in Parkland Hospital’s psychiatry-medicine and emergency departments and in the Texas Health Presbyterian Hospital Dallas emergency room. She founded the Dallas-Fort Worth chapter of the Vietnamese American Nurses Association to unite providers and promote community health through outreach, research, education and disease prevention.

Her PyxisCare role draws upon her extensive professional experience while casting her as the team’s health coach rather than a one-time care provider for the employees.

I enjoy teaching people how to optimize their health and best utilize the healthcare system,” Duyen says. “I want to help them achieve their health goals and manage their chronic conditions so they don’t end up in the hospital.

Duyen works from an onsite office, scheduling general information sessions and one-on-one meetings to create a personal relationship with employees and understand their health histories, discuss goals and learn whether they have primary care providers. She wants them to “own” their personal medical information and to understand why legal documents like powers of attorney and living wills are needed.

It’s a smart business decision, too,” she says.

Employees who see a regular primary care provider, eat healthy foods and maintain an active lifestyle generally are happier and more productive at work, Duyen says. Those who are willing to minimize consumption of high-salt, high-sugar foods often can reduce negative effects of chronic conditions like hypertension and diabetes. They generally miss less work and have lower insurance costs, she says.

“The employees have been very interested. I told them I want them to live their optimum life and that I will be here for them.”

Must-Have Online Mental Health, Well-Being Resources

Must-Have Online Mental Health, Well-Being Resources

A year ago, fewer than 10 percent of all Americans had tried                                          telemedicine, a virtual visit with a healthcare provider over computer, phone or other device. That was so 2019.

Today, as we embrace social distancing to limit spread of a deadly virus, patients and providers are making telemedicine the new normal.

More mental health and well-being services are available online, too, providing a helpful resource when an in-person visit carries its own healthcare risks. We think these services are worth checking out:

Ginger, https://www.ginger.io

Offered largely as an employer benefit, Ginger boasts on-demand access to behavioral health coaching, video therapy, and video psychiatry that the website says is clinically proven to reduce symptoms of stress, anxiety, and depression. The service is named for the ginger root, a preventative health remedy that originates from Southeast Asia and is commonly used at the first sign of illness, before things get worse. The site advertises one-on-one video or phone sessions “through the privacy of an app.”

Modern Health, https://www.joinmodernhealth.com/

Another employer-offered benefit, Modern Health offers face-to-face and virtual support from professional coaches and therapists, plus unlimited evidence-based digital programs, all within a single platform. The support ranges from financial advice to coaching for healthy living. The pitch to employers is that the service can contribute to a more productive workforce.

Headspace, https://www.headspace.com/

With a slogan of “Meditation Made Simple,” Headspace offers users an interface that teaches meditation and mindfulness, tools that can bring calm with sessions as short as one minute, it says. The site offers free services for the unemployed during COVID-19 and a free trial for everyone else. But be aware that if you don’t cancel within two weeks you will be charged the annual subscription of $69.99. The service offers a $12.99 monthly rate and pricing for students or families.

Have another favorite website for virtual mental health and well-being support? Share your tips with us at info@pyxiscare.com.

Bridging the Distance: Leveraging Technology to Curb Stress, Combat Isolation

Bridging the Distance: Leveraging Technology to Curb Stress, Combat Isolation

Two months into our social distancing routine, those of us who avoided                                COVID-19 may have moved beyond the initial period of fear and stress and settled into to the blahs, boredom and a longing for the interactions we enjoyed with friends and acquaintances.

And though many of us may have bouts of loneliness, social isolation can have a truly negative impact on the immunity and psycho-social well-being of older people and others living apart from family and friends, researchers say.

A May 2020 Gallop report found that the number of U.S. adults who evaluate their lives well enough to be considered “thriving” has dropped to 46.4 percent, matching the low point measured in November 2008 during the Great Recession. The rating was similar across age groups.

But the affects may be more intense for thousands of older adults with ongoing health concerns who are at higher risk for severe illness from COVID-19 infection. They have been instructed to limit fact-to-face contact, ending once-routine visits with grandparents and older loved ones.

Research has linked persistent feelings of social isolation and loneliness with higher risk of developing certain mental and physical health conditions like heart disease, high blood pressure, anxiety, depression and even premature death.

“Loneliness also triggers a stress response that there is an imbalance in our social homeostasis,” 

Dr. Stephanie Cacioppo, director of the Brain Dynamics Laboratory at the University of Chicago’s Pritzker School of Medicine, told ABC News for a recent story.

This imbalance has been associated with increased inflammation and a hyper activation of the immune system, which some experts say contributes to some of the chronic illnesses to which older adults already are more vulnerable.

In New York City, Health Commissioner Dr. Oxiris Barbot told the New York Post this month that prolonged stress related to this coronavirus as a potentially significant factor in some 5,000 unexplained deaths in the city between mid-March and May.

Thankfully, we have tools to bring us closer to our loved ones living in group settings, assisted living centers and nursing homes. Phone calls, handwritten notes and small gifts, like flowers, are appreciated more than ever, says Dr. Alicia Arbaje, an internal medicine and geriatrics specialist at Johns Hopkins Medicine.

But it’s also important that caregivers and family members take the time to show seniors how to use technology to stay in touch with others.

Online worship services, for example, can be important in the lives of seniors who were accustomed to attending church activities, she says. Smartphones, laptops or tablet computers can be used for video chats with family members and friends. Those same devices can be used for telemedicine visits with trusted healthcare providers who often have important relationships with their patients.

The bottom line: When we can’t stay in touch in person, we can use technology to bridge the distance. But we need to take the time to make sure that those entrusted to our care feel confident enough to use tech tools, too.

Meet the Team: Laura Jones, Client Services Manager

Meet the Team:

Laura Jones, Client Services Manager

 

“Our approach is truly holistic. Being able to be part of a company that does that type of thing is incredible.”

Have you ever looked back on your life and thought that the sum of your experience prepared you for a career that you did not know was possible? I feel that way about my role as the PyxisCare Client Services Manager.

Since 2017, I have led a team of accomplished Nurse Client Advocates who take a holistic approach to evaluating clients’ needs.

I coach our team on how to develop comprehensive solutions by considering five interrelated aspects of care: medical, financial, environmental, psycho-social and legal needs. We strive for the highest levels of customer service and improved health and quality of life for the individuals and families we serve.

We brainstorm about ways to assist our clients with often complicated needs and think outside the box by bouncing ideas off each other rather than saying it must be done a certain way. We work together to development the best outcomes for each client.

We do extensive training around understanding personality types and communications preferences, and I match our Nurse Client Advocates with the clients they can serve best. Some clients want just the facts, a solution to a dilemma. Others need more conversation and interaction. We have to understand whether they prefer a text message or a phone call. It’s finding that space that works best for each person.

I learned about PyxisCare in 2014 through a former colleague who I had worked with at a hospice agency. I was attracted by the opportunity to work directly with clients and make a positive impact on their lives.

My father was an anesthesiologist. I worked in his office as an insurance clerk. As life progressed, I worked as a receptionist for gynecologist and an orthodontist. My family lived in Nacogdoches for a time, and there I had another great opportunity to work for the County Court at Law, where I learned a lot about the legal aspects of caring for others.

Insurance is one of the big questions for our clients. Options have changed so dramatically over the past few years, and there are so many choices with supplemental policies and prescription policies. Even year-to-year, the policies change. We can help our clients evaluate the best option for each individual.

We’re also experts at finding federal, state and local benefits. We have the experience to know how various benefits would affect a specific client and how to help them access those resources.

The changes we can help people make in their lives are inspiring and rewarding. It’s not always a big thing, but when our team finds a benefit that helps a client, for example, pay the electric bill or pay for a cell phone and learn to use it, that can make a huge difference in their quality of life.

We had a young client who was in a wheelchair. More than anything, this person wanted to go to a WWE Wrestling event. He lived in an outlying community and didn’t have the resources to attend this type of thing on his own

PyxisCare connected him with Easter Seals, and they provided the tickets for a caregiver and him to go to a match. We arranged transportation. It was just an outside-the-box experience that helped improve his quality of life. To him it was huge.

Being able to be part of a company that does that type of thing is incredible.

In the current COVID-19 environment, we are doing everything we can virtually – by phone, sometimes with Facetime. We are monitoring clients and making sure that there are appropriate caregivers in the home, making sure pharmacies are delivering medications, and scheduling food deliveries, among other needs.

The feedback is usually so, so grateful. People truly appreciate that you are helping them. You build trust with clients, and they know that they can count on the entire PyxisCare team to be warm, kind and caring.

I love the company. I love the mission. And I just see the potential as being unlimited.

 

 

 

 

 

Covid-19: Transitioning from WHAT NOW?! to…. WHAT’S NEXT?

There’s no shortage of information about COVID-19, and right now it’s important that we hear every fact and every opinion on the unfurling of this terrible disease on our friends, our family and our world.  It’s critical that we stay keenly aware of the latest news on flattening the curve, local virus peak times, and guidance on how we can stay safe.

But that’s not what this blog is about.

I won’t take up valuable time telling you the things you already know about social distancing and how to wash your hands.  We are still in crisis mode as a country and I’m certain you have the basic skills to stay as safe as possible. And I pray that you are healthy and well.

Because the big question is… WHAT’S NEXT?

One thing is for certain, COVID-19 will leave its mark on our society for many years, perhaps decades to come. For almost 20 years now we have been going through TSA airport checkpoints as a result of the 9-11 attacks.  So as a society we know how to adjust to tragedy. We need to be thinking ahead to what long-term effects we will be experiencing from this silent, invisible health threat.

For instance, did COVID-19 just make working from home acceptable – or preferable — for the long term?  Was this the test that proved that we could all use zoom to achieve just as much? Or more? And will this mean we will work in smaller buildings and overhead will be lower for those who pivot to a remote workforce?

How long will we need to wear masks?  Will we have our temperatures taken before entering public places? Cities have grown larger and more crowded; does this event mark a population shift to more rural areas? I can think of a million questions with no answers, but it helps to think and plan ahead.

We’ve lost a lot of control over our lives over the past months, and that’s unsettling for most of us who are accustomed to running businesses, our own lives, and managing the schedules of children or parents. The stats for care giving just went up exponentially.  We all just went into caregiver mode, far beyond what could have been imagined—home schooling, supporting at-risk relatives and friends, and behaving as if everyone we come into contact with could be carrying a deadly virus.  It’s surreal, really.

Regardless of your feelings or lack of control, you DO have an important role. We all need to be on high alert for the emotional well-being of our friends and family members, as well as ourselves.  While some might think it’s fun to be “off work” or to have more time to bake, many of us are struggling with our new, isolating reality. And many of us are quietly struggling with our newfound, or unwanted duties.

Over the past few months, we at PyxisCare have spent valuable time with individual and corporate clients supporting their ability to be safe and to sustain their lifestyles.  Our clients are often the most vulnerable, with medical complications that put them at heightened risk. Our nurses have been employing every digital tool at our disposal for client families so they can stay in touch with loved ones, safely. And our corporate clients have needed a range of resources, from FAQs about COVID-19, to guidance on medical leave and how to protect their employees from this aggressive disease.

The first question right after physical safety is about emotional support.  Most insurance companies right now are revising or allowing flexibility in their policies to accommodate COVID-related needs, both emotional and medical. Call and ask your insurance carrier or ask your employer.  And never be afraid to ask if you can help a friend.

 

While the past few weeks have been a challenge, working together with our team of Nurse Client Advocates and clients has made me proud of who we are.  And I’m certain that together, we can handle whatever comes next.

 

Food as Medicine: How vegetables, legumes and fish can help keep our bodies strong

 

Global leaders are imploring us to stay home and stay healthy as a way to slow transmission of coronavirus. Whenever possible, healthcare providers urge us to only seek medical care in a clinic when home remedies can’t help.

It is more important than ever that we give our bodies – and the bodies of those we care for – every opportunity to be as strong and germ-resistant as they can be. Now is the time for us to be intentional about the foods we consume and how they affect our “gut health.”

PyxisCare Nurse Client Advocates think about gut health frequently as they help clients manage chronic conditions, from diabetes or Parkinson’s disease to disabilities. They urge clients to eat diets rich in vegetables, poultry and fish with less meat and dairy.

Research has shown that such foods may help reduce or eliminate symptoms associated with gastrointestinal illness, depression and even autoimmune disorders, such as Type 1 diabetes, rheumatoid arthritis, lupus or Crohn’s disease.

The term “gut health,” long understood in Asian medicine, has become increasingly common over the past decade in Western literature as researchers highlighted the negative impacts of highly processed foods loaded with sugar and starch and chemical additives like flavor enhancers and food colorings, according to a March 2011 BMC Medicine article.

Our wish at PyxisCare is to help clients manage chronic conditions through healthy foods, in addition to other physician recommendations, to ensure that beneficial enzymes and microbes get to the gastro-intestinal track. Recent research published in the Feb. 17 journal Gut found that the Mediterranean diet altered the gut microbiome in older people, reducing frailty and improving overall health.

Popularized in the 1960s as a path toward reducing heart disease, the Mediterranean Diet regimen is plant-based, not meat-centered. Its main components, according to the Mayo Clinic, are:

  • Daily consumption of vegetables, fruits, whole grains and healthy fats
  • Weekly intake of fish, poultry, beans and eggs
  • Moderate portions of dairy products
  • Limited intake of red meat

The diet also includes healthy fats that are found in olive oil, fatty fish like salmon and tuna, and nuts and seeds. It also allows for red wine in moderation and calls for daily physical activity.

American Psychiatric Association research has established the connection between the Mediterranean Diet and decreased likelihood of depression later in life. That is likely because gut bacteria manufacture about 95 percent of the body’s supply of serotonin, which influences both mood and GI activity, the American Psychological Association reported as early as 2012.

Other research highlighted in the January 2020 edition of Medical News Today has focused on the autoimmune protocol diet as a way to reduce inflammation and combat other symptoms such as pain, swelling, skin changes and fever. Advocates describe the AIP diet as one centered on lean proteins, vegetables, fruits, nuts and seeds.

Shifting our diet toward a focus on gut-friendly foods can be a challenge for anyone in a managed-care environment and for people with limited access to transportation or fresh food.  PyxisCare’s Nurse Client Advocates excel at thinking outside the box and figuring out how clients can access services they need, including healthy meals. Contact us at info@pyxiscare.com to see how we can help.

We help our nation and the world today by staying as healthy as we can. If that means eating a weekly tuna fish sandwich and making sure the people we care for eat more olive oil than butter, that’s an easy switch we can make.

Fiduciaries: Self-care for Those Managing Others’ Affairs

 

As each of us navigates our personal needs during the coronavirus pandemic, we at PyxisCare honor those serving in a fiduciary role who have the responsibility for making wise decisions on  behalf of their clients. Partnering with fiduciaries for client care management is one of our  essential  missions, and we know that those professionals may be        feeling extra stress in these days. Psycho-social care, in fact, is one of the five aspects of the PyxisCare Management model. Our team members  also provide                                                                                                    support to address medical environmental, legal and financial needs for clients.  We’ll do a deeper dive into those topics in future weeks.

Throughout this current situation, please know that we:

  • Are in touch with each PyxisCare client and are monitoring their needs.
  • We are staying in touch with the various organizations and providers that serve our clients.
  • We will keep lines of communication open if any care needs change.

PyxisCare is able to respond with additional resources and providers if a client’s situation changes.

Thinking of our fiduciary colleagues, the CDC offers some clear guidance on the impact of stress and says coping with tense times can make you, the people you care about and your community stronger. Be aware of these tell-tale signs:

  • Fear and worry about your own health and the health of your loved ones
  • Changes in sleep or eating patterns
  • Difficulty sleeping or concentrating
  • Worsening of chronic health problems
  • Increased use of alcohol, tobacco, or other drugs

How to support yourself

  • Take breaks from news stories, including social media. Hearing about the pandemic repeatedly can wear on you.
  • Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
  • Make time to unwind. Try to do some other activities you enjoy.
  • Connect with others. Talk with people you trust about your concerns and how you are feeling.
  • Call your healthcare provider if stress gets in the way of your daily activities for several days in a row.

For more information, see https://www.cdc.gov/coronavirus/2019-ncov/prepare/managing-stress-anxiety.html

 

2020 Tech Trends in Managing Elder Care

     

A friend’s 77-year-old mother had close call recently.  She slipped in her bathtub but caught herself on the rim and managed to get up without injury.

But it was enough of a wake-up call that my friend immediately arranged for the installation of a handrail and began wondering what other precautions she needed to take to make sure her mom would be safe.

I think about geriatric safety all the time because of PyxisCare, but helping my friend with her mother inspired me to tell her story and share some resources. My thoughts turned to Amazon’s Alexa. If she can build my grocery list and play my favorite Beatles songs, can Alexa also help aging parents summon help when they need it?

(If Kennan Thompson can spoof it on SNL, it must be legit: https://youtu.be/YvT_gqs5ETk )

In this era of smart phones, wearable technology and voice activation, certainly we can leverage our everyday technology to improve care for our loved ones.

AGING IN PLACE

AARP’s “2020 Tech and the 50+ Survey” found that 76 percent of adults age 50 and up want to age in place, or in their own home. This generation has embraced smart phones, tablets and interactive TVs in much the same way as their younger counterparts.

Older Americans use their phones to keep up with friends across social networks, search the Internet and map their way to a location. About 53 percent would prefer to have their health care needs managed by a combination of face-to-face care from a medical professional and health care technology, the AARP survey showed.

When non-emergent health concerns arise, this generation embraces a virtual consultation over the phone or video chat with a credentialed expert, similar to the service provided by PyxisCare’s expert Nurse Client Advocates. Telemedicine reduces the wait time for appointments and means no waiting in crowded reception areas with other patients who could potentially be contagious.

[ https://www.usatoday.com/story/tech/columnist/2019/10/31/tech-help-parents-grandparents-age-in-place/4097921002/ ]

If you’d like to know more, below is a list of some of my favorite tech solutions now trending in 2020 for elder care:

[ https://support.apple.com/en-us/HT208944 ]

  • Myia Health’s home monitoring kit for patients managing congestive heart failure. The company is partnering with Mercy Virtual, a Missouri-based virtual hospital that operates solely through the use of telemedicine, to send patients a kit filled with sensors and wearables, including a ring that tracks sleep, a wireless weight scale and a connected blood pressure cuff.

[ https://www.cnbc.com/2019/09/01/myia-and-other-smart-device-makers-are-tracking-chronic-illnesses.html ]