Shoes and Slippers for Swollen Feet

Shoes and Slippers for Swollen Feet


My mom’s very first sign of liver cirrhosis was edema –

fluid buildup in the ankles, feet and legs.





As I discussed in my post on cirrhosis of the liver, my mom suffered with swollen feet, ankles and legs from early on in her disease process.

In fact, swollen feet (edema) is extremely common among many diseases, including heart and kidney disease.  It can also be caused venous insufficiency (poor circulation), blood clots, and many different kinds of medication.  If you are reading this and you or a loved one has developed chronic edema, please make sure this addressed by a physician.


As my mom’s feet and ankles became more swollen, she was unable to wear most of her shoes. 

She had a pair of favorite slippers, which she wore every day at home; they were big, loose slippers, but they offered no stability and could easily come off.  She also wore a pair of running shoes, which she wore tied very loosely when she went out. 

It was difficult for her to bend and move, so my dad helped her put on and tie up her shoes whenever she needed to leave the house.  My dad has a sore back, so this was an additional strain.  Eventually, the laces of the running shoes could not be tied at all, and it very uncomfortable for Mom to squeeze her swollen feet into them, even with the laces spread open.

When she was admitted to the hospital, she was offered long socks with grips; but they only had one size, and were not meant for  legs and feet which were so swollen and sore.  It was almost impossible for my dad to put them on her, and they were just too tight.  The hospital also offered her some disposable adjustable slippers, but they were so flimsy and difficult to adjust that they were completely useless.

Mom could not stand to wear the hospital grip socks or the flimsy disposable slippers, so she wore her old big slippers from home most of the time. 

They were not really safe because they did not fit properly and offered no support, but it was all she had. The slippers were more of a hindrance than anything as she shuffled to the bathroom and around the ward with her walker. I can remember family members commenting and asking if she was okay walking in those, but no one had any immediate better solutions.




Specialized Footwear for Swollen Feet


In my research of products to help make life easier when suffering with symptoms of serious illness, I came across  specialized footwear for people who have edema or who have difficulty doing up laces due to other issues such as painful joints.

I wish I had thought to investigate these products when my mom needed them, but there was so much going on, and so many other immediate needs, that it just never occurred to me.  I see now in hindsight, that special slippers and shoes would have really made a difference for both my parents at that time.

If your loved one can’t fit into their regular shoes, or has difficulty tying laces (or has to ask someone else to help them with their shoes all the time), it would be a good idea to look at some footwear designed for this purpose.






Shoes and Slippers with VELCRO® Strap Brand Closures


There are special shoes and slippers with VELCRO® strap brand closures that can help make swollen feet feel better.

These shoes and slipper can be put on easily and adjusted to the foot width to accommodate swelling.

Many of them also have non-slip or non-skid soles to help prevent accidental falls and injuries.


















I highly recommend considering purchasing a pair of slippers and a couple pair of shoes that will fit, support and be easily adjusted.  It may seem like a small thing, but I know from personal experience that it can make a big difference, in comfort and mobility for the patient and the convenience and peace of mind for the caregiver.

These slippers and shoes are available in a wide selection, in both women’s and men’s styles.



Socks for Swollen Feet and Non-Slip Socks



  Also, if the task of putting on a sock is a chore, or it is impossible to find any that feel comfortable, consider a wider fitting non-constrictive hospital-style sock with grips.  These socks can be put on with relative ease and offer traction for patients who need sip prevention.






Thanks for visiting and reading … I hope this article provided some helpful ideas.  I welcome your comments below.







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Right to Die: Canadian News

Right to Die News from Canada: This Could Change Everything


One of the recommendations in this week’s federal committee report on assisted death could change the way Canada treats public health institutions. The report called on federal and provincial governments to “ensure that all publicly funded health care institutions provide medical assistance in dying.”

“If a health care facility is publicly funded, it must provide [medical assistance in dying],” the report says.

That’s a big deal: There’s no question individuals have the right to conscientiously object to procedures that contravene their beliefs.

“If you get public funding, the position in this report is you have an obligation to provide all legal services,” said Dalhousie University’s Jocelyn Downie, who co-authored a provincial-territorial report on assisted death last year. This recommendation suggests institutions such as hospitals don’t have that same right to conscientious objection.

It comes down to access, said Rob Oliphant, who co-chaired the committee that wrote the report.

“We want to ensure that Canadians who desire this medical service can get it,” he said.

If a patient’s staying in a hospital that doesn’t provide assisted death, the hospital can bring someone in who will, Oliphant added.

See the full story, further reading and videos at Global News

Please leave a comment below to share your thoughts on this news and the right to die.


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Right to Die: Jennifer Holm’s Exit Plan

About this blog






Choosing a Medical Walker


Choosing the Right Medical Walker




If your loved one is feeling weak and unsteady, it may be time to consider a walking aid. 

My mother became quite weak and unbalanced as a result of extended periods of being bedridden and muscle wasting.  She first began to use a walker when it was provided in the hospital for her to use to get to the bathroom and to walk in the hallway if she was able.

It can be difficult to see someone you knew as able bodied suddenly using (and needing) a walking aid because it is a stark reminder of their illness and disability.  This was early enough in the disease that Mom was having some periods of stability; so when she was discharged from the hospital, it was necessary to look into purchasing her own walker.


My parents purchased a terrific walker with a basket and a seat, and Mom found it very useful for when she was able to go out for short walks and visits, and for attending medical appointments.  Her walker was a “rollator” type, meaning it had wheels on it.  Hers was a four-wheel walker which allowed her to place weight on the walker as she  moved.

Later on, when Mom was back in the hospital, she brought her own walker with her, and was glad to have it with her, as it was the proper size and she was used to it.



Good Example:  The Drive Medical Adjustable Height Rollator with 6″ Wheels  includes an adjustable seat and handlebar height and offers great comfort and support.


The rollator frame’s height can be adjusted from 18in. to 22in. in 1in. increments and the height of handles adjusts from 29.5in. to 38in. This aluminum frame rollator comes with deluxe loop brakes for added security and features removable, padded backrest and padded seat with zippered pouch. It requires only simple, tool-free assembly.  You can see more details on the Drive Rollator here.





Considerations for Choosing Your Medical Walker



Will you be using it outdoors as well as indoors?

If using it outdoors you should consider looking at a rollator with larger wheels on it as they will be more stable outside. Wider wheels also track better over rougher surfaces.



Will you be lifting onto a bus, up stairs, or into a vehicle? 

Lighter weight walkers are better if you are lifting the walker. You also want to look at whether you have to remove the basket before it can be folded and if so how easy is it to remove.



Do you have limited space for storing it?

If you have a small home you should look at walkers that fold up smaller and can stand on their own when folded so they can easily be stored in a closet or hallway.



Note that basic walkers (without wheels) are also an option.  They are called “standard walkers,” and are designed  for people for whom stability is a significant concern.



Recommended Basic Walker – The Invacare I-Class Dual-Release Lightweight Folding Walker comes with a deep, wide frame with a large number of height adjustments. The walker features a lower side brace for added stability and is easy to lift and maneuver. It has anti-rattle silencers that provide quieter operation and PVC handgrips for comfort and long-lasting wear. 


The drawback with standard walkers is that you must pick up and move it as you walk.  Most people end up choosing between two-wheel and four-wheel walkers.




Fitting Your Walker


The walker should be adusted so that it fits your arms comfortably. This will reduce stress on your shoulders and back as you use the walker. To tell if your walker is the correct height, step inside your walker and:


  • Check your elbow bend. Keeping your shoulders relaxed, place your hands on the grips. Your elbows should bend at a comfortable angle of about 15 degrees.


  • Check your wrist height. Stand inside the walker and relax your arms at your sides. The top of your walker should line up with the crease on the inside of your wrist.


  • The height of the seat will vary from person to person and depend on leg strength; tall people with good leg strength sometimes prefer a lower seat, even though they might be measured for a higher one.


  • Shorter individuals might be measured for a low seat, but prefer a taller one because they have bad knees or poor leg strength. For them, the less they have to bend, the better. Generally, however, when sitting on the seat, your feet should be flat on the floor.


  • Walkers have adjustable arms that allow you to raise or lower the push handles.



A good rule of thumb for knowing if your walker fits you is to stand in front of your it in a relaxed but upright position. You don’t want to strain to point that you are creating discomfort while standing, but you do want to get better at remaining aware of your posture and striving to improve it. Standing straight, allow your arms to fall loosely at your sides. The top of the push handle should meet at the approximate location of your wrist. If the push handle is closer to your fingertips, the walker is too short and needs to be adjusted. If the push handles are closer to your elbow, the walker is too high. In both cases, you will need to adjust your walker so that it fits your properly (If you have already adjusted it and there is no adjustability left, you might need a new walker).



Keep in mind that walkers are not meant to be pushed in front of you like a shopping cart. Otherwise if you stumble the walker can push forward and you could fall. When you walk with your walker you should be standing in next to the seat.


Often people feel like the handles on their walker are too low but when you stand properly next to it you’ll find those handles are higher than you thought. Try standing next to the walker with arms at your side and to look for the handles to be at wrist-watch height. If they line up with your watch you should be good to go!




Walker Accessories


Accessories can make it easier to use your walker.


Trays can help you carry food, drinks and other items to a table. A pouch attached to the side can carry books or magazines. Some walkers can also be fitted with seats or baskets.



Some Ideas –

The Nova Ortho-Med Tray  is a convenient way to transport food and other personal items. The tray features a cup holder that prevents drinks from spilling. This is easy to installs with 4 attachable clamps. This tray can fit to 4080 and 4090 series folding walkers.









EZ-ACCESS ories Walker Carryon, Front Mount, 2.25 Pounds


EZ Access Walker Carry-On – Durable, lightweight, water-resistant nylon design and three deep pockets make this front mounted bag a necessity for every walker! Allows hands-free transportation of personal items. Custom designed detachable beverage holder.

Drive Medical Walker Basket, White



The Drive Medical Walker Basket  features a cup holder and a plastic tray. This basket can complement any 1″ folding walkers to make transporting personal goods easy.

Be sure not to overload your walker.




Remember that whichever walker you choose, make sure you maintain it. Worn-out or loose rubber caps or grips and loose or excessively tight brakes may increase your risk of falling while using a walker.


If you think it might be time for a walker, take some time to think about your physical needs, and how and where you will be using it.  Walkers come in a variety of configurations these days, most fold for storage and transporting and all help keep people who are unsteady on their feet stay safe while walking and standing by providing a stable device to put their weight on. Where they will differ is in their design.


View medical walkers on Amazon.






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End of Life Nutrition


End of Life Nutrition






Palliative feeding can be challenging.


When my mom was very ill from cirrhosis of the liver, she required assistance with eating. 


Due to her confusion, sleepiness, lack of coordination and shaky hands, it was important to have someone with her at mealtimes to help out.  At this late stage, mom was too ill to receive nutritional benefit from the food, but eating was still a pleasurable activity, and helped us family members feel that we were doing something to help. 


It is a natural instinct to want to feed someone you love, even when you know intellectually that the person’s body is too ill to make use of the nutrients.  The doctor explained that in the presence of serious advanced illness such as hers, the body obtains energy by breaking down its own muscle and fat, rather than by processing the food.


Being a liver patient with fluid accumulation who was pre-diabetic, she had been on a low salt, low sugar diet with limited fluids for many months.  Now, in Palliative Care, all of Mom’s previous dietary restrictions were lifted.  The  decision to no longer continue curative or life-prolonging therapies meant here was no further benefit in limiting her food choices or fluid intake, and it had become important to allow her to enjoy eating and drinking again.


Fortunately, Mom still had a good appetite, and really enjoyed thinking about, requesting, and eating foods that she had not had in a very long time. And let me tell you, she was not asking for vegetables!  She ate sushi, taco chips, donuts, pizza, fast food hamburgers, candy, butter tarts and drank mango juice.  Providing her with these treats and helping her to enjoy them was a bright spot for all of us.  Although bittersweet, this was an activity which lightened the atmosphere quite a bit.


Mealtimes presented some challenges, though.  Mom’s reflexes were poor, and she would often suddenly lose alertness.


We had to make sure she remained fully awake (sometimes she looked like she was, but was “somewhere else”).  It was explained to us that there was a high risk of asphyxiation if she did not swallow properly, and that would be a very serious situation.




These are some things to keep in mind with palliative feeding:

  • Ensure the person is sitting comfortably and upright to make swallowing comfortable.


  • Provide finger foods when eating with cutlery has become difficult.


Image result for finger foods for dementia patients
  • Use a spoon whenever practical as opposed to a fork.


  • Offer small amounts of food, placed at the front of the mouth, allowing the person time to swallow before offering another bite.




If your loved one is experiencing a complete lack of appetite, on the other hand, it is important to remember that people with advanced illnesses can be comfortable with little or no food intake for weeks or months. That is because people who are seriously ill often do not experience hunger or thirst in the way that healthy people do. Forcing someone to eat in these situations can make them feel nauseated and may contribute to feelings of distress.


Family and friends often find a person’s complete lack of appetite and weight loss worrisome. It is a natural instinct to encourage the person to eat and drink more, thinking that the person will feel stronger and live longer, but if your doctor has told you that this is not the case, you must come to terms with this.  This is the time to let the patient make the decisions about what to eat, when to eat or whether to eat or drink at all.



If you are feeding someone who doesn’t have much appetite, here are some tips to consider:



  • Prepare several small meals during the day, as opposed to three larger ones.
  • Avoid spicy foods if the person can no longer tolerate them.
  • Avoid cooking odors if they are troublesome.
  • Do not be surprised if the person craves certain foods some days, and has no interest in them on others.
  • Try not to get frustrated if the person asks for a certain food and then loses interest by the time the food arrives.
  • Let the person decide how much, what, and when they will eat.
  • Recognize that individuals with serious illnesses often become full quickly, sometimes after just a few bites of food.
  • Try not to push the person to eat more, as a feeling of fullness, nausea or vomiting may result.
  • Try not to make mealtimes a time of tension about eating and food. Rather, focus on sharing time together.
  • Remember that a rejection of food is not a rejection of you.
  • Unless a health provider asks for updates on weight, do not routinely keep track of weight.




We often brought meal replacement drinks for my mom in the hospital and hospice for when she wasn’t eating much.  Of course, it did not change the trajectory of her disease, but she enjoyed them (and we felt good about it).

(left) Boost Very High Calorie Nutritional Energy Drink






Some other items that made things easier for all of us:


Maddadapt II Built-Up Cutlery For people with upper extremity weakness or reduced range of motion. These stainless steel utensils feature built-up handles for people with arthritis, weak grasps or other hand limitations. Their contoured shape makes them easier to hold and use.



Spillproof Kennedy Cup with Lid – lightweight spill-proof drinking cup that is used with a straw. The patented design allows the cup to be easily filled with up to 7 ounces of warm or cold liquid. Once the lid is screwed on the liquid will not spill out even if the cup is turned completely upside down. This means an end to messy spills and new independence to those who have difficulty using conventional cups.




Metal Pill Crusher Easily crush hard-to-swallow pills into powder that can be mixed into food or drinks with this heavy-duty die-cast crusher. The chrome-plated zinc with aluminum and stainless steel fillings is corrosion resistant and built to last.




Terry Crumb Catcher Bib




Pivot Tilt-top Overbed Table (U-Base) – this unique table top tilts with the angle of the mast to provide a flat surface regardless of the angle of the mast. It also closes flat for easy under-bed storage. The U-shape base (sometimes referred to as C-Base) overbed table not only provides a convenient table for bed-bound seniors, but also accommodates most room seating by leaving room for your feet while seated in a chair or wheelchair.








In summary, remember that nutrition is almost always compromised in the final phase of progressive terminal illness, and that providing calories cannot change that because the body is not able to use them for energy or to build muscle, fat and so on. 


It is a natural instinct to encourage the person to eat and drink more, thinking that the person will feel stronger and live longer, but this is simply not the case.  From personal experience, I can tell you that this can be a very difficult concept for loved ones to internalize.  


Even if  high-calorie supplements are provided, they won’t make a difference. As I learned from the hospice care team, the recommended approach to feeding at the end of life is to “feed for comfort.” Simply provide small amounts of favorite foods as requested by the patient.




Recommended Reading:

 A surprisingly warm and informative resource on hospice and other end-of-life care options. Individuals approaching the end of life, and their loved ones, face many challenges–but as hospice nurse Karen Whitley Bell reassures us, this difficult time also offers an opportunity to explore and rediscover a richer meaning in life.
Drawing on her years of experience, Bell has created a comprehensive, insightful guide to every aspect of hospice care and the final stages of life.  For people in hospice care, as well as their friends and families, this is an indispensable reference, a trustworthy source of comfort and spiritual healing.



Do you have any thoughts or experience with end of life or palliative feeding?  Please share them in the comments section below.





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Hospital Bed for Home Use

Hospital Bed for Home Use





Should You Consider a Hospital Bed For Home Use?


If you or a loved one has difficulty getting in and out of bed, reaching a standing position, or is bed bound and requires treatments in bed, you may want to consider renting or purchasing a hospital bed for use in your home.







The main purposes of hospital beds at home is that they permit body positioning that is not feasible in a regular home bed and that they permit the attachment of other pieces of equipment that cannot be used on a regular home bed. 


They also make it easier and safer for the patient to get in and out of bed and stand up, and they make it easier for a caregiver to provide bedside care (such as position changes, bathing and assisting with eating). 


In addition, they can be customized with wheels for moving the bed and side rails for patient security. If the patient is at risk of rolling out of bed or has limited mobility, a bed side rail is particularly important.



Let’s talk about five important reasons you may want to look into bringing one into your home:


1. Better positioning for patients


When people spend extended periods of time in bed, the pressure that the bed exerts on their bodies causes skin tissues to become trapped between bone and the bed’s surface, causing pressure sores or bedsores.

For such patients, hospital beds provide an effective solution: they enable users to make adjustments to the positioning of the bed, allowing them to shift the pressure that the bed places from one part of their body to another. Also, patients at risk for bedsores should also take care while choosing mattresses, and select one that will reduce friction


2. Improved Circulation


Hospital beds allow users to alter and adjust the bed to better position their head and feet. These changes allow for movement as well as periodic change to the pressure points on the body, thereby improving the patient’s blood circulation while in bed.


3. Safety


Hospital beds become a requirement for people who suffer from conditions that require a caregiver’s monitoring or occasional restraint. Especially in the case of people who are at risk of falling out of bed – for instance, people living with dementia or other cognitive impairments – the bed rails on hospital beds assist in reducing the risk of fractures due to falls.

While full-length bed rails are a necessity for some patients, many people use rails as an assist while getting in and out of bed, or to re-position themselves in the bed. These patients do not require the restraint of a full-length rail. Most of our hospital beds are available with both full and half-rail options.


4. Transferring


Often, patients experience difficulty getting in and out of beds. Hospital beds make this problem easier because they have the ability to raise the patient higher or lower. Due to this feature, patients can sit up and get out of bed in the position with relative ease.

People experiencing hip and knee problems, for instance, typically look to be seated with those joints at an angle greater than 90 degrees; this helps them comfortably get into a standing position. Hospital beds allow users to do so with safety and ease.


5.  Caregiver Assistance


Caring for a loved one who is bedridden can take a toll on the physical well-being of a caregiver, and a common problem they face is back pain from frequent bending to administer care.

Hospital Beds enable caregivers to elevate their patients to a level at which they can care for them without straining their own bodies in the process.


Types of Hospital Beds



Electric Hospital Bed

The basic modern hospital bed is called an electric bed. They are the beds most often seen in city hospitals or major town hospitals. The options of raising and lowering the bed are chosen through buttons that are set on the side rails.


Invacare Homecare Full Electrical Hospital Bed – Best Seller


This is the bed you would most likely look into, unless the patient has the specific needs outlined in the bed types below.

Bariatric Bed

A Bariatric bed is the heavy-duty full-electric bed frame you would need for bariatric individuals weighing up to 600 pounds. 


Drive Medical Full Electric Bariatric Hospital Bed with Mattress and 1 Set of Rails, Model 1530010BV-PKV
Drive Medical Full Electric Bariatric Hospital Bed with Mattress and 1 Set of T Rails, Model - 15300BV-PKG


Gatch Bed 

The gatch bed has long-standing history of use in hospitals. They are most often seen in nursing homes and older and/or remote areas that are economically-challenged that utilize these beds because of their lack of need for electricity. They have three cranks at the foot of the bed below the mattress. One crank raises and lowers the whole bed, one crank raises and lowers the head of the bed and the last crank raises and lowers the foot of the bed.



The types of beds you see in a hospital emergency room unit are typically stretchers. These beds are designed for mobility. In the event a person must dial 911 from a separate location, these beds can easily transfer from house to ambulance to the operating room to the ER unit, thanks to special features, such as folding legs.


Low Beds

Low beds are specifically designed for those patients who are liable to fall off beds and cause injury, despite the restraint of the side rails. Low beds are set from about 8 inches to less than two feet off the ground at the highest setting. Some designs of the bed have a high/low maneuvering setting, but most beds are just low to the ground with just the option to raise or lower the head and foot of the bed.



Low Air Loss Beds

A low air loss bed is a type of bed which has special cushions and a system designed to blow air into sacs within the mattress. These beds are designed for burn patients and patients with skin grafts by keeping them cool and dry, for patients prone to bed sores and patients with circulatory and/or skin problems by reducing pressure on the skin.



Circo-electric Beds 

A circo-electric bed enables the bed to rotate inside circular bars that look like a giant hamster treadmill. These beds used for patients in traction, severe skin conditions, patients who have severe burns or for patients who spinal injuries that cannot be moved but must be turned every two hours according to standard hospital policy.



Clinitron Beds

A Clinitron bed is similar to both the low air loss bed and the circo-electric bed in that it is .designed for patients with pressure ulcers, flaps, grafts, burns or skin disorders. It reduces pressure on the patient’s skin because it is filled with material that resembles sand. Dry, warm air circulates through the material to maintain a level temperature and to support the body’s weight evenly.


No matter which type of bed you choose, it is important to take some simple precautions in order to use the hospital bed safely. 


Here are some tips for maintaining the safety of the patient using a hospital bed at home:


  • Keep the wheels of the bed locked at all times. Unlock the wheels only if the bed needs to be moved. Once the bed is moved into place, lock the wheels again.


  • Put a bell and a telephone within reach of the bed. These should be available so you can call for help when needed.


  • Keep the side rails up at all times except when you get in and out of bed. You may need a footstool next to the bed. Use a night light if you need to get out of bed at night.


  • Put the hand control pad within easy reach to adjust positions. Learn to use the hand control and practice moving the bed into different positions. Test the bed’s hand and panel controls to be sure the bed is working correctly. You may be able to lock the positions so the bed cannot be adjusted.


  • Follow the specific manufacturer’s instructions for using the bed. Check for cracks and damage to the bed controls. Call the bed manufacturer or another professional if you smell burning or hear unusual sounds coming from the bed. Do not use the bed if there is a burning smell coming from it. Call if the bed controls are not working correctly to change positions of the bed.


  • When you adjust any part of the bed, it should move freely. The bed should extend to its full length and adjust to any position. Do not place the hand control or power cords through the bed rails.


If you think a hospital bed might be helpful in your home, consult with your physician to determine what specific functions you should be looking for. 


Please drop me a comment if you have any thoughts on or experience with having a hospital bed in the home.


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A Hospice Reflection




Modifying Your Bathroom for Critical Illness



As my mom’s liver cirrhosis progressed, she became increasingly weak and unbalanced. 






If she felt well enough to leave her bed, her time was spent on the couch in the family room.  She began to use a walker to avoid falls, and of course my dad was always around to make sure she was moving safely.  When it came time to shower, mom was nervous about losing balance, but wanted to maintain her privacy, so she would bathe with the door unlocked and my dad sitting on the bed just outside the ensuite bathroom.


Eventually, they decided to make some modifications to the bathroom in order for mom to feel safer and maintain her independence with personal grooming.  The company he called helped my Dad decide to make some changes to the shower and add a seat and some grab bars.  While they were at it, my Dad had the bathroom counters and sinks changed to update the whole look. When it was finished, the bathroom was lovely and fresh (not like a hospital, just modern and safe).


Unfortunately, mom spent a lot of time in the hospital after the renovations, so she was not able to make as much use of the upgrades as my dad had anticipated and hoped.  Nevertheless, it was the right thing to do at the time, and it made a difference in my mom’s quality of life when she was home.


In this post, I want to cover some considerations and options for modifying your bathroom to accommodate someone has chronic balance and/or mobility issues.  If you or a loved are feeling unsafe using the bathroom, it is important to assess and minimize your risks.  Sometimes, even something as simple as installing a grab bar can make the difference between a safe shower and falling hazard.


Aspects to Consider


Independence in the bathroom is one of the most challenging tasks for accessibility and safety in the home.  No matter the disability, the bathroom is almost always one of the most challenging rooms to maneuver in. It is difficult to feel at home, let alone safe, if you don’t have secure access to your own bathroom. Achieving safety and independence with bathroom modifications is not only possible, but also customizable and can be attractive.


Modifying a bathroom is, by definition, a very personal project. It includes making alterations to a living space to meet the needs of physical limitations that people may be living with so that they can live a much more independent life.  A customized bathroom space will depend on an individual’s needs, preferences, and space available.  Also, a modified bathroom doesn’t have to look start or institutional; it can be as luxurious as you imagine it to be (and your budget allows).  You can install beautiful tile, stylish sinks and modern fixtures.  The look of your bathroom doesn’t have to suffer in order to accommodate accessibility, independence, and safety.


When modifying the bathroom, keep your focus on altering spaces for safe movement and creating a safe flow.


 Grab Bars



Whether it’s for a person with a disability or the elderly, grab bars are one of the simplest ways to provide support and balance. They can be useful almost anywhere in the bathroom:


  • for getting on and off the toilet
  • for in and out of the tub
  • for stability in the shower or at the sink
  • as handrails for navigation about the space


You can choose from:


  • standard wall mounted grab bars
  • swing up grab bars
  • Super poles
  • handrails


Balance is a tremendous challenge for the seriously ill, disabled and the elderly.  It can be a simple adaptation that can save lives and provide a sense of security when navigating through the bathroom.



Barrier Free Showers


Barrier-free showers are showers without a curb that are designed for easier entrance and exit. The floor of a barrier-free shower is level with the rest of the bathroom floor in order to eliminate the step or climb into the shower that can be difficult to navigate for anyone with a mobility issue.


Selected for its barrier-free design, ease of installation, structural base and integrated wood backing, this roll-in shower is ideal for residential use. The design minimizes the chances of being installed in a non-barrier free manner, having grab bars installed without proper backing, and also reduces installation costs by installing directly on floor joists, sub-flooring and concrete surface.



Doored Bathtubs


Doored bathtubs allow users to enter the bathtub without having to climb in. When the doors are swung open, an entryway a few inches above the floor is created. Once properly seated in the tub, water temperature adjustments are made easy with oversized faucet controls. Doored bathtubs may include hand-held showerheads, stationary showerheads or Jacuzzi water jets.


Doored bathtubs often have a low threshold door to enable easy entry and exit. They can be ordered with or without the upper surround wall. A bather can sit comfortably in a slightly reclined position or shower while standing or sitting. They are carefully designed to accommodate the user without sacrificing installation space and look polished in homes and institutions.  They are also available with a removable lift access cover or full front and side panels that can be installed either against a wall or in a corner.


Bathing can be incredibly challenging for people in wheelchairs or with mobility issues. Doored bathtubs are often designed with contoured seats for a safer transfer from wheelchair to bath and vice versa. Doored bathtub users can take a seated bath or use the seat as leverage and balance.


Water Containment Solutions


Keeping water inside a shower/bath increases the safety factor of the whole bathroom.  You can find many options by contacting a company that specializes in bathroom modifications.


Collapsible Water Dam – Selected as a high quality option to control water spillage in barrier-free and roll-in showers, the collapsible dam is 1” high with strong self-adhesive bottom.


  • Provides for water retention yet collapses when rolled over by a walker or wheelchair
  • Helps reduce maintenance in barrier-free showers



Corner Setting Half Height Bi-fold Shower Door – Half height design allows a caregiver to assist the user in showering, while controlling water and keeping caregiver dry.


Once closed, the doors create a water barrier, ensuring that no water runs out of the shower, and controlling water splash. When opened, the doors allow full access to roll-in showers, walk-in showers and full barrier-free showers. These types of units are available in different sizes.


 Remember that if you or a loved one are unsteady, safety hazards in your bathroom deserve the highest consideration.  The bathroom is the site of many accidents and falls. 


Have you modified your bathroom for safety and accessibility or are you considering doing so?  Please share your thoughts in the comment section below.


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Symptoms of Cirrhosis of the Liver

Symptoms of Cirrhosis of the Liver





Cirrhosis of the Liver, or Chronic Liver Disease, is often asymptomatic until the liver is extensively damaged, and therefore symptoms are not common during the early stages of cirrhosis.  However, as scar tissue accumulates the liver’s ability to function properly is undermined.



How We Discovered That My Mother Had Cirrhosis


My mom’s very first sign of liver cirrhosis was edema – fluid buildup in the ankles, feet and legs.


She mentioned this numerous times to her physician, who prescribed diuretics (water pills) to help flush out the extra water. 


My mother was not a drinker, but she was overweight, sedentary and pre-diabetic with high lipids (sometimes called Metabolic Syndrome or Syndrome ‘X’).


Mom had been diagnosed with fatty liver some years before, but that is quite common, and had not set off any alarms.


At this point though, her doctor should have done a simple liver enzymes blood test, as chronic edema is considered one of the early signs of liver decompensation. 


But he didn’t.


I imagine he assumed the swollen feet and ankles were caused by other, more common, benign factors.


Mom suffered with uncomfortable and unsightly swollen legs for around five years before a much more serious symptom emerged…


ascities – fluid buildup in the stomach.  In her case, the fluid was pushed by her diaphragm up into the lining around her lungs, and she began having a hard time getting a full breath of air.


When she saw the doctor for this, he sent her for a chest x-ray that day.  The x-ray indicated a problem, and mom was told to go to emergency immediately for more testing.  She was admitted briefly to the hospital for a battery of tests, which ultimately confirmed she had cirrhosis of the liver.  At that point, the cirrhosis was considered advanced.


That was only the beginning of a two year nightmare, involving nearly all of the symptoms listed below at some point or another. 


While there were some periods of time when her health would rally somewhat (my sister and I called these ‘reprieves’), the disease was unrelenting in its progression. 


Mom was in an out of the hospital, and eventually had a TIPS procedure to bypass the liver’s portal vein and help with the fluid buildup.  It only helped for a few months.


In the end, mom was admitted to hospice, where she suffered a fatal variceal bleed (internal bleeding caused by increased blood pressure in the portal vein system).


The presence of enlarged veins (varices) usually causes no symptoms.


Until they bleed.


And then it becomes an emergency.


Sometimes a surgeon can tie off or cauterize the bleed.


In my mom’s situation, she was already so weak and ill that her body would not have survived any kind of invasive medical intervention.


So with that said, these are the signs and symptoms may occur in the earlier stages of cirrhosis:


  • Blood capillaries become visible on the skin on the upper abdomen
  • Fatigue
  • Insomnia
  • Itchy skin
  • Loss of appetite
  • Loss of body weight
  • Nausea
  • Pain or tenderness in the area where the liver is located
  • Red or blotchy palms
  • Weakness.


The following signs and symptoms may appear as liver cirrhosis progresses:


  • Abdomen fills up with fluid, giving the patient a large tummy (ascites)
  • Accelerated heartbeat
  • Altered personality (as blood toxins build up and affect the brain)
  • Bleeding gums
  • Body and upper arms lose mass
  • Body finds it harder to process alcohol
  • Body finds it harder to process drugs
  • Confusion
  • Dizziness
  • Fluid buildup on ankles, feet and legs (edema)
  • Hair loss
  • Higher susceptibility to bruising
  • Jaundice (yellowing of the skin, whites of the eyes, and tongue)
  • Loss of libido (sex drive)
  • Memory problems
  • More frequent fevers (susceptibility to infections)
  • Muscle cramps
  • Nosebleeds
  • Pain on the right shoulder
  • Panting (breathlessness)
  • Stools become black and tarry, or very pale
  • Urine becomes darker
  • Vomiting blood
  • Walking problems (staggering).




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Causes of Cirrhosis of the Liver



 If you’re like me, you probably associate Cirrhosis of the Liver with alcoholism.

It was an terrible surprise to learn that my mom, a non drinker, had developed this deadly disease.  In her case, the cirrhosis developed as a result of NASH (nonalcoholic steatohepatitis, or Fatty Liver disease).


In fact, cirrhosis has a variety of causes, and many people with cirrhosis have more than one cause of liver damage.


The list below shows common causes of cirrhosis in the United States. While chronic hepatitis C and alcohol-related liver disease are the most common causes of cirrhosis, the incidence of cirrhosis caused by nonalcoholic fatty liver disease is rising due to increasing rates of obesity.


Chronic hepatitis C. Hepatitis C is due to a viral infection that causes inflammation, or swelling, and damage to the liver. The hepatitis C virus spreads through contact with infected blood, such as from a needlestick accident, injection drug use, or receiving a blood transfusion before 1992. Less commonly, hepatitis C can be spread by sexual contact with an infected person or at the time of childbirth from an infected mother to her newborn.


Hepatitis C often becomes chronic, with long-term persistence of the viral infection. Chronic hepatitis C causes damage to the liver that, over years or decades, can lead to cirrhosis.


Advanced therapies for chronic hepatitis C now exist, and health care providers should treat people with chronic hepatitis C before they develop severe fibrosis or cirrhosis. Unfortunately, many people first realize they have chronic hepatitis C when they develop symptoms of cirrhosis.


Alcohol-related liver disease. Alcoholism is the second most common cause of cirrhosis in the United States. Most people who consume alcohol do not suffer damage to the liver. However, heavy alcohol use over several years makes a person more likely to develop alcohol-related liver disease. The amount of alcohol it takes to damage the liver varies from person to person.,fl_progressive,q_80,w_800/gbigr28lwjypbyz1mmgk.jpg


Research suggests that drinking two or fewer drinks a day for women and three or fewer drinks a day for men may not injure the liver. Drinking more than these amounts leads to fat and inflammation in the liver, which over 10 to 12 years can lead to alcoholic cirrhosis.


Recommended: The Alcohol Free Forever program.


Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). In NAFLD, fat builds up in the liver; however, the fat buildup is not due to alcohol use. When the fat accompanies inflammation and liver cell damage, the condition is called nonalcoholic steatohepatitis, or NASH, with “steato” meaning fat, and “hepatitis” meaning inflammation of the liver. The inflammation and damage can cause fibrosis, which eventually can lead to cirrhosis.



Extra fat in the liver is more common in people who:



  • are overweight or obese.
  • have diabetes—a condition characterized by high blood glucose, also called high blood sugar.
  • have high blood cholesterol and triglycerides, called hyperlipidemia.
  • have high blood pressure.
  • have metabolic syndrome—a group of traits and medical conditions linked to being overweight and obese that makes people more likely to develop both cardiovascular disease and type 2 diabetes. Metabolic syndrome is defined as the presence of any three of the following: large waist size, high triglycerides in the blood, abnormal levels of cholesterol in the blood, high blood pressure, and higher than normal blood glucose levels. NASH may represent the liver component of the metabolic syndrome.


See The Fat Loss Diet I Recommend.


NASH now ranks as the third most common cause of cirrhosis in the United States.


Chronic hepatitis B. Hepatitis B, like hepatitis C, is due to a viral infection that causes inflammation and damage to the liver. Chronic infection can lead to damage and inflammation, fibrosis, and cirrhosis.


The hepatitis B virus spreads through contact with infected blood, such as by needlestick accident, injection drug use, or receiving a blood transfusion before the mid-1980s. Hepatitis B also spreads through sexual contact with an infected person and from an infected mother to child during childbirth.


In the United States, hepatitis B is somewhat uncommon, affecting less than 1 percent of the population, or fewer than one in 100 people.


In many areas of the world, however, hepatitis B is common. In some parts of Africa and in most of Asia and the Pacific Islands, about 5 to 7 percent of the population has chronic hepatitis B. In some parts of Africa, more than 8 percent of the population has chronic hepatitis B. For these reasons, hepatitis B is likely the major cause of cirrhosis worldwide. However, in the United States, hepatitis B ranks well behind hepatitis C, alcohol-related liver disease, and NASH.


Therapies for chronic hepatitis B now exist and health care providers should treat people with chronic hepatitis B before they develop severe fibrosis or cirrhosis. Unfortunately, many people first realize they have chronic hepatitis B when they develop symptoms of cirrhosis.


Hepatitis B is also a preventable disease. Since the 1980s, a hepatitis B vaccine has been available and should be given to newborns and children in the United States. Adults at higher risk of getting hepatitis B should also get the vaccine.


Less Common Causes of Cirrhosis:


Autoimmune hepatitis. In this form of hepatitis, the body’s immune system attacks liver cells and causes inflammation, damage, and eventually cirrhosis. Normally, the immune system protects people from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. In autoimmune diseases, the body’s immune system attacks the body’s own cells and organs.


Researchers believe genetics, or inherited genes, may make some people more likely to develop autoimmune diseases. At least 70 percent of those with autoimmune hepatitis are female.


Diseases that damage, destroy, or block the bile ducts. Several diseases can damage, destroy, or block the ducts that carry bile from the liver to the small intestine, causing bile to back up in the liver and leading to cirrhosis.


In adults, the most common of these diseases is primary biliary cirrhosis, a chronic disease that causes the small bile ducts in the liver to become inflamed and damaged and ultimately disappear. Primary sclerosing cholangitis is a disease that causes irritation, scarring, and narrowing of the larger bile ducts of the liver.


In infants and children, causes of damage to or disappearance of bile ducts that can lead to cirrhosis include:


  • Alagille syndrome, a collection of symptoms that indicates a genetic digestive disorder and leads to a loss of bile ducts in infancy.
  • biliary atresia, a life-threatening condition that affects newborns in which bile ducts are missing. The cause is unknown. Biliary atresia is the most common reason for liver transplantation in children.
  • cystic fibrosis, an inherited disease of the lungs, intestines, pancreas, and bile ducts in which the body does not produce enough fluid and mucus becomes thick and blocks off small bile ducts. This blockage of the bile ducts can lead to cirrhosis.


Long-term blockage of the bile ducts by gallstones can also cause cirrhosis. Cirrhosis may also develop if the bile ducts are mistakenly tied off or injured during surgery on the gallbladder or liver.


Inherited diseases that affect the liver. Inherited diseases that interfere with how the liver produces, processes, and stores enzymes, proteins, metals, and other substances can cause cirrhosis.


These diseases include alpha-1 antitrypsin deficiency, hemochromatosis, Wilson disease, galactosemia, and glycogen storage diseases.


Rare viral infections of the liver. Hepatitis D, or hepatitis delta, and hepatitis E are two rare viral infections of the liver. Hepatitis D infection occurs only in people who have hepatitis B. People infected with chronic hepatitis B and chronic hepatitis D are more likely to develop cirrhosis than people infected with chronic hepatitis B alone.


Hepatitis E is a virus found in domestic and wild animals, particularly pigs, and can cause hepatitis in humans. People with weakened immune systems, including people who are liver or kidney transplant recipients or who have acquired immune deficiency syndrome (AIDS), can develop chronic hepatitis E. Chronic hepatitis E can cause scarring of the liver and cirrhosis. Current treatments for chronic hepatitis D and E are experimental and only partially effective.


Other causes. Other causes of cirrhosis may include:


  • reactions to medications taken over a period of time
  • prolonged exposure to toxic chemicals.
  • parasitic infections.
  • chronic heart failure with liver congestion, a condition in which blood flow out of the liver is slowed. Liver congestion can also occur after surgery to correct a congenital heart problem—a heart problem that is present at birth.


Trauma to the liver or other acute, or short term, causes of damage do not cause cirrhosis. Usually, years of chronic injury are required to cause cirrhosis.


If you believe you may be at risk for liver disease from any of these causes, see your doctor as soon as possible.  A simple blood test of your liver enzymes can alert your physician to liver dysfunction which would warrant further investigation.


Do you have any of the risk factors for Cirrhosis of the Liver?  Or do you or someone you know have liver disease?  Please share your thoughts and experiences in the comment section below.


why you need to stop drinking


If you think you may have a problem with alcohol, please see your doctor as soon as possible to discuss it.  I also recommend that you download this free PDF Report: Why You Need to Stop Drinking … and how to get started TODAY!  I believe you will find it informative and helpful.

Do you have any of the risk factors for Cirrhosis of the Liver?  Or do you or someone you know have liver disease?  Please share your thoughts and experiences in the comment section below.






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Fatty Liver and Cirrhosis

Fatty Liver – This One’s Personal


Dear Reader,

This is a disease that upsets me deeply, as it is the one which took my Mom.  Until the time of her diagnosis, the only thing I “knew” about cirrhosis was that it was a disease which only affected alcoholics and drug abusers.  I was so wrong.


There are, in fact, several paths to liver disease, which I will cover in a separate post.  In my Mom’s case, her cirrhosis developed as a progression from NASH or Nonalcoholic steatohepatitis.  It is also called NAFL (non alcoholic fatty liver), or simply Fatty Liver.


NASH is a common, often “silent” liver disease. It resembles alcoholic liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH is fat in the liver, along with inflammation and damage. Most people with NASH feel well and are not aware that they have a liver problem.


Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly.


Although having fat in the liver is not normal, by itself it probably causes little harm or permanent damage. If fat is suspected based on blood test results or scans of the liver, this problem is called nonalcoholic fatty liver disease (NAFLD). If a liver biopsy is performed in this case, it will show that some people have NASH while others have simple fatty liver.


NASH is usually a silent disease with few or no symptoms. Patients generally feel well in the early stages and only begin to have symptoms—such as fatigue, weight loss, and weakness—once the disease is more advanced or cirrhosis develops.


The progression of NASH can take years, even decades. The process can stop and, in some cases, reverse on its own without specific therapy. Or NASH can slowly worsen, causing scarring or “fibrosis” to appear and accumulate in the liver.


As fibrosis worsens, cirrhosis develops; the liver becomes seriously scarred, hardened, and unable to function normally.


Not every person with NASH develops cirrhosis, but once serious scarring or cirrhosis is present, few treatments can halt the progression. A person with cirrhosis experiences fluid retention, muscle wasting, bleeding from the intestines, and liver failure.


Liver transplantation is the only treatment for advanced cirrhosis with liver failure, and transplantation is increasingly performed in people with NASH.


Although NASH has become more common, its underlying cause is still not clear. It most often occurs in persons who are middle-aged and overweight or obese.


See Alarming New Liver Statistics


Many patients with NASH have elevated blood lipids, such as cholesterol and triglycerides, and many have diabetes or pre-diabetes, but not every obese person or every patient with diabetes has NASH.


Furthermore, some patients with NASH are not obese, do not have diabetes, and have normal blood cholesterol and lipids. NASH can occur without any apparent risk factor and can even occur in children. Thus, NASH is not simply obesity that affects the liver.

My Mom was 73, and had most of the risk factors for NASH, including age, obesity, sedentary lifestyle, insulin resistance and high triglycerides.  Doctors see NASH often, and usually call it “Fatty Liver.” 

Perhaps because it is fairly commonplace, it seems that most physicians don’t adequately impress on the patient the need to make the necessary lifestyle changes to reverse the condition before it potentially progresses to non-reversible cirrhosis of the liver.


Fatty Liver can be potentially reversed by weight reduction (if overweight), activity and healthy diet, and avoiding alcohol and unnecessary medications.  Most importantly, a major attempt should be made to lower body weight into the healthy range. Weight loss can improve liver tests in patients with NASH and may reverse the disease.


These are standard recommendations, but they can absolutely make a difference. They are also helpful for other conditions, such as heart disease, diabetes, and high cholesterol.


People with NASH often have other medical conditions, such as diabetes, high blood pressure, or elevated cholesterol. These conditions should be treated with medication and adequately controlled; having NASH or elevated liver enzymes should not lead people to avoid treating these other conditions.


Experimental approaches under evaluation in patients with NASH include antioxidants, such as vitamin E, selenium, and betaine. These medications act by reducing the oxidative stress that appears to increase inside the liver in patients with NASH. Whether these substances actually help treat the disease is not known, but the results of clinical trials should become available in the next few years.


Over time, more research will help physicians to better understand the liver injury found in this disease. When the pathways that lead to the injury are fully known, safe and effective means can be developed and used along with lifestyle changes to reverse these pathways and help patients with NASH. Recent breakthroughs in mapping the human genome and uncovering the individual steps by which insulin and other hormones regulate blood glucose and fat could provide the necessary clues.


My Mom was told that she had fatty liver by her doctor many years ago, but that information was accompanied by only the advice to lose some weight.  It haunts me to think that the disease could have been reversed if she had been warned of the potentially fatal consequences of ignoring it.  I wish somebody had frightened her into changing her lifestyle when it could have made a difference in her future outcome.

It is a sad thought, indeed, that I lost my Mom to a lifestyle disease which could have been prevented or reversed.



Please share your thoughts or experience with liver issues in the comment section below.



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Coping With Grief (And What I Did)

How I Coped With Grief


Image result for grief


Coping with the loss of a close friend or family member may be one of the hardest challenges that many of us face. When we lose a spouse, sibling or parent our grief can be particularly intense. Loss is understood as a natural part of life, but we can still be overcome by shock and confusion, leading to prolonged periods of sadness or depression.


The sadness typically diminishes in intensity as time passes, but grieving is an important process in order to overcome these feelings and continue to embrace the time you had with your loved one.


Everyone reacts differently to death and employs personal coping mechanisms for grief. Research shows that most people can recover from loss on their own through the passage of time if they have social support and healthy habits. It may take months or a year to come to terms with a loss. There is no “normal” time period for someone to grieve. Don’t expect to pass through phases of grief either, as new research suggests that most people do not go through stages as progressive steps.


If your relationship with the deceased was difficult, this will also add another dimension to the grieving process. It may take some time and thought before you are able to look back on the relationship and adjust to the loss.


Human beings are naturally resilient, considering most of us can endure loss and then continue on with our own lives. But some people may struggle with grief for longer periods of time and feel unable to carry out daily activities. Those with severe grief may be experiencing complicated grief.  These individuals could benefit from the help of a psychologist or another licensed mental health professional with a specialization in grief.



Moving on With Life


Mourning the loss of a close friend or relative takes time, but research tells us that it can also be the catalyst for a renewed sense of meaning that offers purpose and direction to life.


Grieving individuals may find it useful to use some of the following strategies to help come to terms with loss:


Talk about the death of your loved one with friends and colleagues in order to understand what happened and remember your friend or family member.  Denying the death is an easy way to isolate yourself, and will frustrate your support system in the process.


Accept your feelings. People experience all kinds of emotions after the death of someone close. Sadness, anger, frustration and even exhaustion are all normal.


Take care of yourself and your family. Eating well, exercising and getting plenty of rest help us get through each day and move forward.


Reach out and help others dealing with the loss. Helping others has the added benefit of making you feel better as well. Sharing stories of the deceased can help everyone cope.


Remember and celebrate the lives of your loved ones. Possibilities include donating to a favorite charity of the deceased, framing photos of fun times, passing on a family name to a baby or planting a garden in memory. What you choose is up to you, as long as it allows you honor that unique relationship in a way that feels right to you. If you feel stuck or overwhelmed by your emotions, it may be helpful to talk with a licensed psychologist or other mental health professional who can help you cope with your feelings and find ways to get back on track.

(Adapted from a post by Katherine C. Nordal, PhD from the American Psychological Association)




On a personal note … as of this writing, I am one month on from my Mom’s death.  For the first two weeks following her passing, I coped by not coping.  In other words, I forced the issue out of my mind and put all my energy into maintaining control.  I did this so that I could put on a strong front for my Dad, as I was worried about his reaction and did not want to compound the family misery. 


In the last few weeks, I have allowed myself to indulge in sadness, and thankfully, it is not quite as raw as it threatened to be earlier.  I don’t know if that was the “healthy” thing to do, but it felt appropriate to me then.  I’m sure my feelings will evolve over time, and I am open to working through the process, which I will update in future posts.


Things which have helped me cope best are the support of my husband, spending time with my dogs and blogging.   Blogging has been particularly cathartic for me.  I want and need to discuss this topic, but it is not one that I can discuss easily (nor is it a topic which many people enjoy in conversation).




Writing this blog enables me to explore the topic of dying and grief through recounting my experiences with my Mom’s two years of progressive terminal illness and eventual death, as well as through researching what “the experts” say.  I feel it is my new purpose to provide help and guidance for patients and loved ones who have questions they need (but perhaps don’t really want) to ask, or who feel they don’t have the right person to ask.







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