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Since 2017, our Iyashi Care team has had the privilege of assisting over one hundred older adults and their loved ones with the difficulties of living with serious illnesses and debilitating symptoms. However, understanding how palliative care can help can be a little confusing at first, and sometimes it might be difficult to just take that first step in asking for assistance. But Iyashi Care was created knowing that quality care requires a strong relationship between the patient and his/her healthcare team. We would like to share with you the stories of five older adults and how Iyashi Care has helped them.
Sachiko, a Japanese-speaking female
in her 80s, was injured years ago when a natural disaster hit her city while
she was living in Japan. This resulted in paraplegia, and Sachiko has suffered
from nerve pain ever since the accident. For years, physicians have told Sachiko
and her daughter Kazue that nothing could be done to treat the pain. Eventually,
Kazue reached out to the Iyashi Care team, and during one of her home visits, Sachiko
told the team, “Every day, I have sharp pain in my legs, but I was told that I
have to gaman (tolerate the pain) for
the rest of my life. But if you think you can help me, I am willing to try.” Dr.
Yanami, the team’s physician, prescribed new medication to manage her pain.
Kanako, the team’s social worker, and Joshua, the team’s registered nurse,
called and met with Sachiko regularly over the course of several months to
ensure she was responding to medication. For the first time since her injury,
Sachiko’s pain was lessened.
Jenny lives with her 90-year-old mother,
Elaine, who has short-term memory loss due to Alzheimer’s disease. As her
mother’s primary caregiver, Jenny was required to learn and familiarize herself
with her mother’s medical condition, which became overwhelming. However, Dr.
Yanami assisted Jenny in understanding her mother’s condition by providing insight
into Elaine’s condition and prognosis. Jenny says this allowed her to feel more
confident in caring for her mother and improved communication with her siblings
as she was able to better provide them with medical updates. One day, Elaine began to feel ill. Not wanting
to take her mother to the emergency department, Jenny called the Iyashi Care
team for immediate assistance. With knowledge of the family’s goals of care, Kanako
and Joshua then gave instructions on how to monitor the symptoms, when to call
again, and what to expect in the event that her symptoms escalated. Jenny was grateful
for Iyashi Care as the team’s involvement and availability allowed her to avoid
the most uncomfortable situation for her mother: an emergency room visit.
Joanne, living semi-independently in
an assisted living facility, is in her 90’s. With a host of medical conditions,
she has experienced years of suffering from chronic pain caused by major
arthritis and a chronic lung condition. Because of her chronic pain, Joanne was
unable to enjoy her arts and crafts with friends or spend quality time with her
grandchildren or great-grandchildren. However, things changed once the Iyashi
Care team began monitoring Joanne’s symptoms and managing her pain. Dr. Yanami
and Kanako would visit Joanne and her family every month to provide
consultation on the family’s caregiving concerns. During the last flu season, Joanne
developed a persistent cough that did not go away. Dr. Yanami promptly ordered
medications and equipment so she could heal at home while avoiding urgent care
or hospital admission. Joshua also contacted the family by phone in the
following weeks in between home visits to address any new symptoms she may have
developed, including her worsening pain, breathing problems, constipation,
anxiety, insomnia, and changes in mobility.
As soon as she entered retirement, Kiyoko
was diagnosed with diabetes in addition to pre-existing bladder problems and
kidney disease. With children who lived far away and none nearby who could
commit to being her primary caregiver, the Iyashi Care team met virtually
through phone calls and emails with all of Kiyoko’s children to provide timely
updates about their mother’s condition and advance care planning videos to
spark conversation about determining the best treatment in case of worsening
kidney function. The team also
coordinated with Kiyoko’s nephrologist (kidney doctor) to arrange a tour of
dialysis centers and nearby assisted living facilities to make it easier and
more convenient for her to attend appointments. One holiday season, when the
family was all gathered, Kiyoko’s kidney function worsened. Unsure if the
situation required calling 911, her children called the Iyashi Care team and
was able to get immediate assistance. Kiyoko was safely transferred to the
emergency department without having to call 911, and the day after Kiyoko left
the hospital, they were able to quickly schedule a visit with Dr. Yanami. The family
now feels more confident in their ability to make a joint decision in the event
that Kiyoko has a change in her condition.
Paul, a Nisei, has advanced
Parkinson’s disease, dementia, and recently fractured both his hip and spine after
a bad fall. Following intensive rehabilitation, he eventually returned to his assisted
living facility. However, his dementia worsened and the Iyashi Care team consulted
with his family members before they decided to transfer Paul to a memory care unit.
With multiple conditions, the Iyashi Care team kept close communication with
the family to provide frequent consultations as Paul’s conditions changed over
time. The Iyashi Care team also had multiple conversations with both Paul and
his family, to learn more about his life. With a better understanding of his history,
the Iyashi Care team was able to establish a strong, trusting relationship with
the patient, and allowing the team to more candidly discuss planning for the
future and Paul’s goals of care with his family.
Call 213.873.5791 to learn more about
how this program could help you.
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