Tag Archives: patient

From Patients to Caregivers

February 25, 2013 by
Photography by Bill Sitzmann

Margaret Ludwick spends her days sitting in a wheelchair at a senior care center in Elkhorn. She never speaks. The only expressive motion involves her hands—she constantly puts her long, tapered fingers together like a church steeple. Her big blue eyes stare straight ahead but focus on nothing. No one can reach her anymore, not her daughters, not her husband.

Alzheimer’s, the most common form of dementia in adults 65 and over, robs even the most intelligent people of their brain and eventually destroys their body. There is no cure. There is no pill to prevent it. There’s not even a test to definitively diagnose it. Effective treatments have proven as elusive as the disease, itself.

“We do have medications that may help with symptoms in some patients, especially in the early stages of Alzheimer’s,” says Dr. Daniel Murman, a specialist in geriatric neurology at The Nebraska Medical Center. “But they don’t truly slow down the disease process.”

According to researchers, the number of Americans living with Alzheimer’s will triple in the next 40 years, which means 13.8 million will have the disease by 2050 (Chicago Health and Aging Project research as reported by nbcnews.com).

Awareness of symptoms is crucial for early intervention.

“Memory loss and changes in behavior are not a normal part of aging,” stresses Deborah Conley, a clinical nurse specialist in gerontology at Methodist Health Systems who teaches other nurses and caregivers about Alzheimer’s. “I would urge family members to take [their loved one] to a family physician first, seek as much information as possible, and start making your plans.” An assessment that includes the person’s medical history, brain imaging, and a neurological exam can result in a diagnosis that’s about 85 percent accurate for Alzheimer’s.

Ludwick, a registered nurse, who worked at Immanuel Hospital for years, never received an extensive workup.

 “I would urge family members to take [their loved one] to a family physician first, seek as much information as possible, and start making your plans.” – Deborah Conley, clinical nurse specialist in gerontology at Methodist Health Systems

“I first noticed something was wrong about 15 years ago, when Mom was 70,” explains Ludwick’s daughter, Jean Jetter of Omaha. “It was the day I moved into my new house. Mom put things in odd places, like a box labeled ‘kitchen’ would wind up in the bedroom. And she stood smack in the middle of the doorway as the movers tried to carry large pieces of furniture inside, and she just stared at them.”

As Ludwick’s behavior grew worse, Jetter begged her father, Thomas, to get her mother help.

“He didn’t want to hear it. He kept saying, ‘This will get better.’ He had medical and financial Power of Attorney. Dad worked full-time, and she was home alone. This went on for eight years.”

Ludwick’s steady decline rendered her unable to fix a meal or even peel a banana. She lost control of bodily functions. After she was found wandering the neighborhood on several occasions, Jetter was finally able to call Adult Protective Services and get her mother into an adult daycare program. After breaking a hip two years ago, Ludwick arrived at the Life Care Center of Elkhorn.

“This is such a sad, but not unfamiliar case,” says Conley, who began working with Alzheimer’s patients in the mid-’70s. “Even in 2013, people do not know what to do, where to turn.”

Dr. Murman adds, “There is still a stigma attached to Alzheimer’s. People don’t like to hear the ‘A’ word. But it’s much better to be open and specific about it.”

A specific diagnosis may rule out Alzheimer’s.

“Depression can mimic the symptoms of Alzheimer’s…symptoms like mistrust, hallucinations, apathy, social isolation,” explains Dr. Arun Sharma, a geriatric psychiatrist with Alegent Creighton Health. “But we can treat that. We can treat depression.”

Dr. Sharma helped establish a 22-bed, short-term residential facility called Heritage Center at Immanuel Hospital to better diagnose the reasons for a person’s memory loss. Once a patient is stabilized and receives a proper care plan, they can return home. The more doctors learn, the faster a cure will come.

“I see something exciting in the next five to 10 years,” says Dr. Sharma. “If we identify and isolate the protein believed responsible for Alzheimer’s, perhaps we can do a blood test to catch the disease early.”

 “There is still a stigma attached to Alzheimer’s. People don’t like to hear the ‘A’ word. But it’s much better to be open and specific about it.” – Dr. Daniel Murman, specialist in geriatric neurology at The Nebraska Medical Center

But what about a cure? With 78 million Baby Boomers coming down the pike—10,000 of them turning 65 each day—this country faces an epidemic. And what about the psychological, financial, and emotional toll on the caregivers, who are very often family members? They, too, feel isolated.

“It was an impossible situation for me. I couldn’t get her the help she needed,” says Jetter, who bore the brunt of the family crisis since her married sister lives in Dallas. “Now that Mom is at [the nursing home], I can take a breather and concentrate on Dad, who also has mental issues.”

In recent weeks, her father, Thomas, has been admitted as a permanent resident of Life Care Center of Elkhorn as well.

What about her own family?

“I have no one. No husband, no boyfriend. I mean, what boyfriend would put up with all this?” asks Jean, who’s been shuttling between one parent and the other for years, all the while trying to run her own business. The situation has obviously taken a huge personal toll.

Conley has two words for anyone facing similar circumstances: Alzheimer’s Association. The Midlands chapter has support groups, tons of information, and can gently guide the adult child or spouse. They even have a 24/7 hotline: 800-272-3900.

For anyone dealing with Alzheimer’s, that number could become a lifeline.

Nancy Wilson-Hintz

January 25, 2013 by
Photography by Bill Sitzmann

NOVA Treatment Community’s mission is to be passionate about providing treatment services, education programs, and foster care services for children, adolescents, adults, and families, as well as help empower individuals and families to experience a life without substance use, family turmoil, and other problems that adversely affect their lives. This is a mission that NOVA’s newest executive director, Nancy Wilson-Hintz, is excited to be a part of.

The Omaha native and Daniel J. Gross Catholic High School alumna has always loved volunteer work, feeling it’s important to give back to the community in which she lives. Her favorite volunteer work is anything involving advocacy for those who are unable to advocate for themselves—especially working with vulnerable children and adults. Such advocacy led to her graduation from the University of Nebraska-Lincoln with a bachelor’s degree from the College of Public Affairs and Community Services/Criminal Justice and into volunteering with the Nebraska Foster Care Review Office, which oversees child abuse and neglect cases in the child welfare and court systems.

“It is an honor to work with all of the devoted professional people who make it possible for individuals seeking empowerment to have that opportunity.”

Wilson-Hintz worked as a juvenile probation officer and then an adult probation officer for Nebraska State Probation until 1998 when she switched to the nonprofit world. She became the founder and first executive director for CASA (Court-Appointed Special Advocate) of Douglas County, a nonprofit organization that advocates for abused and neglected children in the foster care system. CASA volunteers act as a child’s voice in and out of the courtroom, ensuring that the child is receiving all necessary services.

She explains that she chose the nonprofit career path because she believes strongly in “working for the greater good.”In 2006, Wilson-Hintz was asked to be on the NOVA Board of Directors by another board member who was also a CASA volunteer. “Serving on the NOVA Board of Directors provided me with great insight into the workings and mission of the organization. It also helped in transitioning to the NOVA executive director position last fall and taking over the legacy of Eleanor Devlin, NOVA’s founder and executive director of almost 30 years.”

NOVA—which stands for New Options, Values, and Achievements—is a treatment community with adolescent and adult residential programs for substance abuse and mental health problems, outpatient and intensive outpatient services, and foster care services for those who need the support and tools to live a safe, comfortable life.

Wilson-Hintz with NOVA dog, Chance.

Wilson-Hintz with NOVA dog, Chance.

As executive director, Wilson-Hintz says she looks forward to increasing public awareness and funding sources regarding the variety of behavioral health programs and services NOVA offers. “I’m [also] looking forward to networking with NOVA staff, board of directors, funders, and other community organizations that provide behavioral health services,” she says. “It is an honor to work with all of the devoted professional people who make it possible for individuals seeking empowerment to have that opportunity.”

One such devoted “professional” at NOVA with whom Wilson-Hintz works is actually a rescued Border Collie named Chance, who lives with one of NOVA’s Youth Residential Supervisors. “[Chance] was adopted from the Humane Society twice and then returned to the Nebraska Border Collie Rescue, where he lived in foster care for four months before NOVA’s staff adopted him,” she explains.

Chance was named such because he, too, was given a second chance in life to find a loving family and a safe home, which Wilson-Hintz believes makes him a perfect mascot for the organization. As someone who has always thought animals to be extremely helpful in therapy, Wilson-Hintz says that Chance has done an outstanding job making the kids who come to NOVA’s facility feel at home. “He runs to the door to greet the kids each morning, then checks in with staff and spends almost his whole time with the kids…He brings a sense of peace, love, and devotion to the NOVA community.”

“My ultimate goal is to save children and adults from falling through system cracks by ensuring that no one is denied behavioral health services.”

Second chances aren’t just for Chance and the people who come to NOVA though. Wilson-Hintz also displays her faith in second chances in her personal life, as she has adopted three dogs—Petey, Monty, and Jackie—and given them a loving home with her and husband Michael Hintz.

Wilson-Hintz adopted Petey, a 12-year-old Norfolk Terrier, from the Nebraska Humane Society when he was 3 after he was found sick and suffering from a gunshot wound on an Iowa highway in the middle of winter. But she says, he has fully recovered and has been her “inseparable buddy” ever since.

She found Monty, a 6-year-old Miniature Pinscher/Terrier mix, tied up to a dilapidated trailer in a small Nebraska town two years ago. “He was living in deplorable conditions, and it broke my heart to see the hurt and desperation in his eyes,” she says. “I asked if I could have Monty, and the owner agreed to let me take him.” She had planned to take Monty to the Humane Society, but when she brought him home, she fell in love with him.

Today, Wilson-Hintz and Monty are volunteers with Domesti-PUPS, a nonprofit organization that provides service dogs, pet therapy programs, classroom dogs, and educational programs. “Monty and I currently go to a nursing home monthly to visit the residents there. Troubled adults and children quickly connect with Monty because, I believe, they instinctively know that he understands them.”20130108_bs_0027 copy

Her most recent addition was Jackie, a 2-year-old English Setter/Lab mix, whom she adopted from the Humane Society after being her foster parent for two weeks. “Jackie was one of the nine rescued pups from a breeder in Illinois. She was not socialized to humans and extremely fearful of everyone and everything. What I thought would just be a short foster care situation ended up being a permanent one.” According to Wilson-Hintz, Jackie’s social skills have gotten so good that she now acts just like a normal puppy, which means lots of destroyed remotes, cell phones, and shoes for Wilson-Hintz and her husband. But they’re always patient in working with her and enjoy watching her progress.

With such compassion for those who need help, both human and animal alike, there’s no doubt that Wilson-Hintz will continue to expand and better NOVA’s services as executive director. Over the next year specifically, she plans to focus on foster care awareness and foster parent recruitment, as there is a continuous need for stable homes for abused and neglected children who can’t live with their biological families. Although NOVA currently provides foster care homes and family support services, there’s also a great need to increase community outreach, which is why Wilson-Hintz is making foster care awareness one of her top priorities.

She has several plans for NOVA’s future as well. Her two main goals for the next five to 10 years are to broaden financial opportunities and increase program stability by building on past successes and implementing new forward-thinking options. “My ultimate goal is to save children and adults from falling through system cracks by ensuring that no one is denied behavioral health services simply because they do not qualify for funding through the state or other programs, do not have insurance, or are not able to pay out-of-pocket expenses.”

Surviving Heart Disease

Photography by Bill Sitzmann

As a young woman of just 38 years old, Dionne Whitfield didn’t fit the typical description of a heart disease patient. But there she was, standing in front of the cardiologist, still tired and breathless after undergoing a treadmill test, trying to grasp the news that she had three major blockages.

She didn’t hear much after that. All she could think about was that she didn’t want to become a mere statistic. That she still wanted to have a family and live to see her potential children grow up. What was going to happen to her, she thought.

One week later, in August of 2012, Whitfield was back in the hospital undergoing triple bypass surgery. Today, Whitfield is doing great, and with age on her side, she is determined to take control of her health and her life again.

Looking back, she knows now that her unhealthy lifestyle habits were bound to catch up with her eventually. At 352 pounds, she ate whatever she wanted, often grabbing fast food along the way. She rarely exercised, and she had settled for the fact that she was overweight and nothing was going to change that. She was also African-American, a population that tends to have greater prevalence of risk factors for heart disease than Caucasian women.

“This has been a big eye-opening experience for me, and I don’t want to go back.” – Dionne Whitfield, heart disease patient

Whitfield’s attitude about her weight and health has done an about-face since then. Her attitude actually started to change with several warning signs shortly before the news of her blockages. In early January of last year, she learned that she was borderline diabetic. Concerned, Whitfield began attending group exercise classes and the pounds began to fall off. Motivated by her success, she began to make exercise a priority.

Then came her second warning. In July, she started becoming so short of breath that she could barely make the short walk from her office to the car. When things didn’t get better, she consulted with her doctor, who referred her to cardiologist Edmund Fiksinkski, M.D., at Nebraska Methodist Hospital, who performed the cardiac testing in which the blockages were found.

Whitfield’s surgery was performed by John Batter, M.D., cardiothoracic surgeon at Nebraska Methodist Hospital. After surgery, she underwent six weeks of supervised cardiac rehabilitation. Whitfield exercises on her own now but is still considered in a recovery phase for the next year and follows a moderate exercise program while her arteries heal.

“Dionne has done great,” says Susana Harrington, a nurse practitioner at Nebraska Methodist Hospital, who worked with Dionne throughout her recovery. “She really owned it and became more determined than ever to lead a healthy lifestyle.”

“This has been a big eye-opening experience for me, and I don’t want to go back,” says Whitfield. She continues to work out regularly, watches what she eats, and even reads labels now before putting food in her grocery basket.

She has also lost more than 72 pounds and is determined to double that. “I feel so much better now,” says Whitfield. “I’m not breathless now, and exercising is getting easier.”

 “She really owned it and became more determined than ever to lead a healthy lifestyle.” – Susana Harrington, nurse practitioner at Nebraska Methodist Hospital

What women need to learn from this is that the development of cardiovascular disease is a lifelong process and that prevention is a lifelong effort, says Amy Arouni, M.D., cardiologist at Alegent Creighton Health. Controlling your risk factors very early in life can help prevent the development of heart disease later. This includes quitting smoking if you smoke, maintaining a healthy weight, exercising regularly, eating a diet low in saturated fats with lots of fruits and vegetables, and watching your blood pressure and cholesterol. In fact, women can lower their heart disease risk by as much as 82 percent just by leading a healthy lifestyle, according to the National Institutes of Health.

Prevention is important because heart disease is the No. 1 killer of all women, claiming the lives of approximately a half million women each year.

The main difference between men and women is that women are more likely to develop heart disease in their 60s and 70s, about 10 years later in life than men.

That’s because after menopause, risk factors tend to rise in women, especially blood pressure and cholesterol levels and rates of obesity, says Eugenia Raichlin, M.D., cardiologist at The Nebraska Medical Center. Other risk factors such as smoking, diabetes, and family history also raise a woman’s risk.

“The longer you wait, the greater the potential to suffer significant damage to the heart.” – Amy Arouni, M.D., cardiologist at Alegent Creighton Health

The consequences of heart disease also tend to be more severe in women. For instance, “a greater number of women die of sudden cardiac death before their arrival at a hospital (52 percent) compared to 42 percent of men,” says Dr. Raichlin. “Women often require more hospitalizations compared to men, have lower ratings of general well-being, and limitations in their abilities to perform activities of daily living. As a result, heart disease in women presents a unique and difficult challenge for physicians.”

In addition to prevention, women should also be aware of the symptoms of heart disease and the subtle changes in their bodies, says Dr. Arouni. “Unlike men, women’s symptoms tend to be more vague and atypical and may include mild neck, shoulder, upper back, or abdominal discomfort; shortness of breath; nausea or vomiting; sweating; lightheadedness or dizziness; extreme fatigue and/or a jaw ache that travels down the neck,” she says. “Because the symptoms tend to be vague, oftentimes, women will stay at home and ride it out.”

This is one of the key areas where women go wrong. “Getting help quickly is critical,” says Dr. Arouni. “The longer you wait, the greater the potential to suffer significant damage to the heart.”

While the development of heart disease in a woman’s 30s is less common, it does happen, especially when other risk factors are involved such as family history, obesity, or diabetes.

Whitfield feels fortunate that she and her doctors took her symptoms seriously and that she sought help early on. Now, she hopes she can help other women avoid the same fate by taking control of their health at a young age. “I feel very grateful to my family and friends and to the doctors and nurses that helped me get through this,” she says. “When you’re young, you don’t think anything can happen to you, but now I know differently. I don’t take my health for granted anymore.”