TIPs for Volunteers A quarterly publication for the Volunteers of TIP Hospice February- Apr

1. TIPs for VolunteersA quarterly publication for the Volunteers of TIP Hospice February- April 2008 Important dates: February—American Heart Month Women’s Heart Health Month March—National Social Work Month National Craft Month April—National Volunteer Week • Feb. 14—Valentines Day • Feb. 15—Women’s Heart Day • Feb. 18—Sew-In Bridgeton President’s Day • Mar. 8—International Women’s Day • Mar. 9—Day Light Savings Time • Mar. 17—St. Patrick’s Day • Sew-In Bridgeton • Mar. 20—First Day of Spring • Mar. 21—Purim • Mar. 23—Easter • Mar. 30—National Doctors’ Day • April 1 –April Fool’s Day • April 4-6—Make a Difference Day • April 7—World Health Day • April 10—National Siblings Day • April 15– World Social Worker’s Day • April 21—Sew-In Bridgeton • April 22—Earth Day; Natl. Jelly Bean Day • April 23– Professional Day • April 27-May 3—National Volunteer Week National Volunteer Week April 27-May 3, 2008 “Volunteers Change the World” Throughout history, volunteers have participated in the lives of individuals, organizations, and the larger community. Their time, talents, and resources have and continue to support, influence and ensure a healthy community’s social welfare. TIP Hospice takes this opportunity to thank all of its volunteers. Their participation enhances the lives of our patients and families as well as support the program as a whole. We could not do it without our volunteers. Many thanks!!! TIP Hospice c/o Mary Cable, MSW (mary.cable@vnatip.com) Bereavement and Volunteer Coordinator 3445 Bridgeland Drive, Ste. 117 Bridgeton, MO 63044 Phone: 314-344-3301 Fax: 314-298-8889 www.vnatip.com

2. Volunteer Updates Welcome! Alton Marianne Endicott, Special Projects Ashley Arnold, MSW Intern Bridgeton Diane Falk, Program Support Sr. Loretta Sigler, CPPS, Special Projects Centralia Leslie Williams, Patient/ Family Support Alicia Pigg, Patient/ Family Support Herrin/Murphysboro Kristin Murduck, Social Work Intern “You must be the change you wish to see in the world.” By Mahatma Ghandi Volunteer Coordinators Alton Norma Shaffer, MSW Anna Tim Corzine, MSW, LCSW Bridgeton, St. Peters, & Washington Mary Cable, MSW Carlinville Stephanie Dunphy. MSW Centralia Eric Williams, M. Th. Herrin & Murphysboro Tina Porter, BSW Mt. Carmel Brad Garner, Chaplain Special Thanks Alton Lisa Kruemmelbein is bringing comfort and smiles to the faces of patients through massages. Thanks for sharing your gifted hands. Anita Thomas, Mary Ann Clanton, and Connie Motl decorated paper bags with reindeer faces. The filled treat bags were delivered to patients and nursing homes, celebrating the holiday season. Marianne Endicott made bed gowns for our home patients. Bridgeton, St. Peters, Washington Lynn Davis, Clara Mae Hoguet, Karen Reed, Jo-Ann Reust, Patti Adams and Jacqie Davenport for their consistent gifting of time and energy making bed pads, heel and elbow protects, adult bibs, bed gowns, walker and wheel chair totes, and lap robes that the patients love. Sr. Loretta Sigler beautifully decorated gift bags with snow scenes and snowflakes. Barbara Groneck filled them with care items for the patients. Also, thanks to the nursing staff that delivered them!

3. VolunteersHelpingMake the Difference Alton An appreciation luncheon was held on December 1st recognizing the volunteers who make a difference in lives of hospice patients and their families. They enjoyed good food and fellowship. Thanks for sharing your time and talents with TIP Hospice. Centralia TIP Hospice Volunteers at the Greentree Assisted Living Center in Mt. Vernon, IL, continue to make wonderful craft projects every month for our patients. Dorothy McKeighan, a member of the Greentree group, was named as a “Christmas Angel” by the Mt. Vernon Register News. Our ladies were featured January 11, 2008, on the news segment called “Unsung Heroes” that was aired on WSIL TV3. Bridgeton, Great Rivers, Washington These TIP Hospice volunteers celebrated National Hospice Month in November with a luncheon. Each received the green and purple National Hospice Pin in appreciation for making the difference in the lives our patients/families as well as the program. The green in the ribbon reflects the growing awareness of the compassionate care that hospice provides and the peace that hospice brings; the purple serves to remind us of the right all people have to live with dignity and respect, even to the last moment of life.” Mt Carmel The Mt. Carmel office recognizes Laverne Sherman for many services in the community and thanks her for her service to TIP Hospice, including ofiice and patient/family support as well as special projects for patients. Irish Blessing May your day be touched by a bit of Irish luck, brightened by a song in your heart, and warmed by the smiles of people you love.

4. National Social Work MonthBuilding on Strengths: Help Starts Here March 2008By Mary Cable, MSW • Building on strengths is a basic social work principle. The “strengths perspective” focuses on utilizing individual and community resources, capabilities, support systems, and interests to meet challenges and overcome adversity. • Individuals, families and communities all have strengths. Strengths are the foundation for change and growth. Drawing strengths out, appreciating a wide variety of strengths, and focusing these strengths are essential in developing and promoting positive emotional health and social well-being. Social workers play an integral role in drawing from strengths to build and connect home, health, family, friends and the community. • Logo and theme information are from www.naswdc.org/pressroom/swMonth/2008 • “Strength does not come from physical capacity. It comes from an indomitable will.”By Mahatma Ghandi • Hospice Social Workers take a holistic, strength based psychosocial approach in working with the patient and family. The social, environmental, psychological, and economic aspects of each patient/family life are individually assessed. The social worker taps into the patient/ family strengths to: • Walk them through anticipatory grief, providing education and support as needed. • Assess options and guide them in making decisions about physical and emotional care. • Connect the patient or family with community resources such Medicaid, Medicare, private duty care, nursing homes, equipment, advance directives, funeral homes, etc. • Share their experience of loss, supporting helpful coping methods. • As a member of the interdisciplinary TIP Hospice Team, the social worker is an advocate for the patient and family needs, perspectives, wishes or decisions. They play a key role in the quality of care and are essential to the hope and health of their clients.

5. Quote of the Quarter:We are rich only through what we give, and poor only through what we refuse.Anne-Sophie Swetchine 1869 RESOURCE EXCHANGE Tele-Help Line for Caregivers (TLC) for Southern Illinois 1-866-438-7852 (help line) 8 am to 9 pm; 7 days a week TLC is a free telephone-based training and support program for caregivers (family, friends, neighbors) of older adults. Answers to questions, support and training are provided by professionals. TLC’s purpose is to prevent caregiver burnout. TLC Services: Knowledge: Get information about your loved one’s condition and connect with resources and services. Help & Support: Learn how to stay connected with family and friends as well as get help the support you need. Skills: Learn ways to put things together and solve problems when they come up. Managing Stress: Learn how to handle stress and negative feelings you might have from time to time. The tele-help line is sponsored by the National Institute of Nursing Research and National Institute of Aging. The TLC project is through the Department of Psychology, South Illinois University, Carbondale. For more information visit their website at www.tlc.siu.edu. RESOURCE EXCHANGE continued There are many resources on the internet for caregivers. The following are good resources for information, education and links to services and other resources. National Family Caregiver’s Association website is www.nfcacares.org. NFCA provides education, services and resources. 1-800-896-3650 or 1-301-942-6430. The National Family Caregiver Support Program provides the National Information & Assistance Care Line 1-866-432-4324, open during regular business hours. Services such as respite, case management, counseling, support groups, education and training, legal, financial, assistive technology and home modifications, and more are provided. The Department of Health and Human Services, Administration on Aging, works in conjunction with state Area Agencies on Aging and local providers to connect caregivers with information and local resources. Visit www.aoa.gov . Family Caregiver Alliance website www.caregiver.org has information, education, research, advocacy efforts, and services for caregivers. They can be contacted at 415-434-3388 or 800-445-8106. Continued on page 12.

6. Celebrating Life in Your Community • National Craft Month • March 2008 • Butterflies, blooming flowers and trees, and baby chicks announces spring with birth, renewal and hope. It is a time for celebrating and rejoicing. Foods and crafts are part of any celebration. Caregivers may have special crafts or hobbies that relax and nurture them. Supporting time for them to enjoy their activities is important. • Butterfly Craft • Supplies: • Coffee Filters (small or large, choose size • you wish to make) • Water Based Markers • Clothes Pins (small or large to coordinate • with coffee filters, need type with spring) • Spray Bottle with Water • Black Pipe Cleaners • Black acrylic craft paint • Tacky Glue • Optional: other embellishments such gem stones, glitter, small beads, etc.; Pin back to make a pin. • Instructions: • Dab markers all around the center of a coffee filter. • Spray lightly with water to blend colors. Let dry. • Paint clothes pins black or any color desire • Cut a 2" circle out of the middle of the  coffee filter.  • Pinch to form wings and clip with clothes pin. • Use ¼ to 1/3 of the pipe cleaner for the antenna; shape the antenna and glue it to the top end of the clothes pin • Decorate • Uses: • Glue pin on the back if wish to make a pin. • Glue or wirer to a barrette back • Glue a ribbon loop onto top to make a spring tree ornament • Attach a floral wire (twist around bottom of clothes pin) and insert into a house plant or bouquet of flowers

7. Volunteer Quarterly TrainingTIPS: 1. Record the time you spent on this training on February’s time sheet. 2. Attach this completed and signed sheet to your time sheet.Thanks! Topic: Caregivers Mary Cable, MSW Objectives: 1. To increase the ability to recognize when a caregiver needs support to prevent burnout. 2. To increase knowledge of what a caregiver needs to better care for themselves. 3. Increase knowledge of resources available to caregivers. 4. Volunteers appreciate that they are caregivers and recognize the need to care for themselves. Training Activity: • Read the quarterly training entitled • Below, share something you learned or an affirmation of something important to you on this topic. Volunteer Signature ______________________________ Date: ______________ Remember to turn this page in with your time sheet! Thanks! (fma_2008)

8. Caregivers The Big Picture on Caregivers The national support network identifies 1.2 million informal caregivers in Illinois, .6 million in Missouri, and 27.2 million in the United States. These caregivers assume care for the elderly (60+ years of age), those with disabilities of all ages, and grand parents raising grand children. The hours of care are staggering. The support network calculates the annual hours as follows—1.3 billion in Illinois, 583 million in Missouri, and 29 billion in the United States. Many, probably most, caregivers are sacrificing their financial stability, own health, and their own quality of life. The federal and state legislatures have worked in establishing financial and service supports for caregivers. There is still much work ahead at this level. (National Association of State Units on Aging and the National Conference of State Legislatures with support from the U.S. Administration on Aging; www.state.il.us/aging/caregivers/crc/htm; www.dhss.state.mo.us/Senior_Services/aaa.htm) Hospice Family Caregivers Primary caregivers have a major role in the delivery of hospice care. It is not unusual that the caregivers have been caregivers for an extended period of time. The patient and caregivers are now facing a new phase in unknown territory of care requirements. These committed caregivers are balancing the demanding and ever changing daily patient care of their loved one, multitude of home routine tasks some of which are new to them to be responsible for, and their own life responsibilities. Coping with the impending loss, keeping all medications and care needs completed, keeping family and friends updated, daily tasks of living, etc. stress caregivers. They often neglect their needs, struggle with their role in the family and care giving role, experience unrealistic expectations of themselves (self-imposed and other imposed), feel a lack of control and face unreasonable demands on them. These stresses do affect their ability to function. Hospice staff and volunteers assist in recognizing when a caregiver needs support and offers the support and/or facilitates linking caregivers to local resources. Hospice Volunteers and Staff are Caregivers Too! Being a part of patients’ and families lives at one of the most precious and intense times emotionally, physically, and spiritually is a privilege that gives meaning to our lives. However, that privilege brings both joy and pain. Hospice team members become involved and attached. Thus, they are not immune from caregiver burnout and need to care for themselves and know when they need support.

9. Caregivers continued • Recognizing When a Caregiver Needs Support • The caregiver is experiencing one or more of the following behaviors. • Being on the verge of tears or crying a lot • Irritable • Feeling helpless or hopeless (depressed) • Overreacting to minor nuisances • Feeling constantly exhausted (physically and emotionally) • Losing interest in activities previously enjoyed • Decrease in productivity (what you are able to do in a day) • Withdrawal from social contacts (friends, family) • Use or increased use of alcohol or stimulants • Nervous habits develop or increase • Change in eating patterns (weight gain or loss) • Change in sleeping patterns • more frequently ill • Increased use of medications for sleeplessness, anxiety, depression • Inability to relax • Scattered thinking • Feeling increasingly resentful • Being short tempered more frequently with loved one as providing care • Increasing thoughts and/or fear of impending death • How to Prevent Burnout and/or How to Take ofYourself • Emotionally • Ask for and/or accept help without allowing yourself to feel guilty (turn that mental tape off and substitute that help allows others to be apart of caring and meet their needs to care) • Participate in one or more caregiver support groups weekly (support, learn strategies for coping) • Select a trusted friend, co-worker, neighbor to talk about your feelings and frustrations. • Accept your feelings. Having negative feelings at times is normal and does mean you are bad person. Overcoming the negative self talk allows the caregiver some human slack.

10. Caregivers (continued) • Utilize community resources for information, education, support and services—such as local agency on aging, AARP, organizations specific to illness or disease. • Utilize internet web sites for caregivers—information, education, chat rooms, etc. • Journal or write stories of your emotions, what you are experiencing • Utilize counseling services—someone that will listen without judging, provide guidance and support in caring for self, teach you relaxation techniques, etc. Counseling is frequently covered under insurance. • Choose at least one activity daily (respite break) that re-kindles you such as a short walk, reading, bubble bath, meditation, phone call or cup of coffee with a friend, internet support, crossword puzzle, music, etc. • Develop new tools for coping, accentuating the positive. Laughing at and accepting our well intentioned but imperfect humannature will take a weight off anyone’s shoulders. • Physically • Set realistic goals for your care giving and know when you need assistance • Accept informal respite from family, friends, volunteers, neighbors • Hire private care assistance • Consider home delivered meals • Utilize respite video’s—the video’s are sing-a-longs with visual pictures or scenery; talking through relaxation steps, etc. for the patient. • Eat nutritiously, get sleep, and a little exercise. (exercise videos) • Keep your regular medical appointments and take medications. • Massages, manicures, hair care, etc. • Ask nursing staff to teach you how to care for loved one, especially how to prevent injuring yourself. Nursing staff may also have ideas on how to enlist cooperation of loved in their care. They also can provide information on the disease or illness and teach you what to expect.

11. Caregivers (continued) Spiritually • Continue your regular worship service. Members will offer help. Let them know exactly what would be helpful. It takes much to say I need help. But remember, we are meant to be interdependent not independent. Your faith community needs to be allowed to help. • Meditate or read • Listen to your favorite spiritual or inspirational music or sermons • At the end of each day, thank yourself and forgive yourself when needed. Letting Go Author unknown www.theribbon.com To "let go" does not mean to stop caring, it means I can't do it for someone else. To “let go” is not to cut myself off, it's the realization I can't control another. To "let go" is not to enable, but to allow learning from natural consequences. To "let go" is to admit powerlessness, which means the outcome is not in my hands. To "let go" is not to try to change or blame another, it's to make the most of myself. To "let go" is not to care for, but to care about. To "let go" is not to fix, but to be supportive. To "let go" is not to judge, but to allow another to be a human being. To "let go" is not to be in the middle arranging the outcomes, but to allow others to affect their own destinies. To "let go" is not to be protective, it's to permit another to face reality. To "let go" is not to deny, but to accept. To "let go" it not to nag, scold or argue, but instead to search out my own shortcomings, and correct them. To "let go" is not to adjust everything to my desires but to take each day as it comes and cherish myself in it. To "let go" is not to criticize and regulate anybody but to try to become what I dream I can be. To "let go" is not to regret the past, but to grow and live for the future. To "let go" is to fear less, and love more. References: www.nfcacares.org (1/17/08) www.ageingcarefl.org/caregiver/fourStages/StageThree/section01 (1/17/08) http://women.webmd.com/caregiver-recognizing-burnout (1/17/08)

12. Innovative Caregiving Resources Sells videotapes www.videorespite.com or 1-800-249-5600 Ageless Design’s Alzheimer’s Store Sells videotapes and other items that helps patients with memory difficulties. www.alzstore.com Caregiver’s Marketplace www.caregiversmarketplace.com Video tapes for caregivers to learn ways of caring for loved one as well as for teaching how to care for themselves. Libraries Often have classes on how to use internet. www.caregiverslibrary.org Organizations: Many of the organizations for specific health conditions have support groups for patients as well as caregivers such Alzheimer’s, ALS, cancer, etc. Contact information can be located on line and in phone books. They have websites with information, education, resources, and services. AARP Missouri State Office 1-888-389-5627 Illinois State Office 1-866-448-3613 The caregivers library has a Caregiver Self- Assessment Questionnaire published by the American Medical Association. The Beck self- assessment for depression is frequently used to assess the need for counseling. Books “Positive Caregiver Attitudes (Caregiver Survival Series),” by James R. Sherman “The Caregiver’s Survival Handbook: How to Care for Your Aging Parent Without Losing Yourself,” by Alexis Abramson “Taking Time for Me: Caregivers Can Effectively Deal with Stress,” by Katherine L..Karr “When Life Becomes Precious: The Essential Guide for Patients, Loved Ones, and Friend of Those Facing Serious Illness,” by Elise Babcock “The Emotional Survival Guide for Caregivers— Looking After Yourself and Your Family While Helping an Aging Parent,” by Barry J. Jacobs “Love, Honor, & Value—A Family Caregiver Speaks Out about the Choices & Challenges of Caregiving,” by Suzanne Mintz, President and Co-founder of the National Family Caregivers Association “Always on Call: When Illness Turns Families into Caregivers,” by Carol Levine Visit websites for further recommendations. Life is mostly froth and bubbles, two things stand like stone, kindness in another’s trouble, courage in your own. By Adam Lindsay Gordon Caregiver Resources(continued)