Avocado Salsa, Low on Sodium but High in Flavor!

Pathways is starting a recipe of the month post on our blog to promote a healthy living lifestyle. Each month will feature an original healthy recipe from our employees. To start us off, I am presenting a recipe titled "Señora's Avocado Salsa".

You will need the following ingredients:

1 package (16 oz) frozen corn, thawed
1 can (15 oz) black beans (look for low sodium)
1 medium sweet red pepper, chopped
1 small onion, chopped
1 bunch cilantro, finely chopped
3 fresh tomatoes, chopped
3 garlic cloves, diced
1/4 cup lime juice
3 tablespoons cider or white vinegar
1 teaspoon dried oregano
1/2 teaspoon or less salt
1/2 teaspoon pepper
4 medium ripe avocados

In a large bowl, combine corn, black beans, red pepper, onion, cilantro and tomatoes. In a small bowl, whisk together the garlic, lime juice, vinegar, oregano, salt and pepper.

Mix well. Pour over corn mixture and toss to coat. Cover and refrigerate overnight.

Just before serving, chop avocados and stir into salsa. Serve with low sodium tortilla chips or as a side dish. Yield about 7 cups. Tip - if you place the avocado pit into the salsa, the avocados won't turn brown.

This is delicious. I was hesitant about a salsa with no spicy peppers in it, but this is really tasty. I tried it in tacos and it's great because you also get all the healthy benefits of the tasty veggies in the salsa. Next time I would add a bit less garlic because it was really strong, but that depends on your preference. I also added green onions because I prefer them in my salsa instead of a regular onion.

By Mandi Cacioppo, Sr. Marketing & Communications Coordinator at Pathways Home Health and Hospice. Recipe credit goes to my cousin Lynn Fors.

Living the Low Salt Life as a Heart Failure Patient

When you have heart failure, it is important to decrease the amount of sodium in your diet. Salt acts like a sponge, making your body hold on to extra water.

Eating too much of it can cause weight gain, increased blood pressure, make legs and feet swell and cause water to go to the lungs.  This makes your heart work harder and worsens heart failure systems. 

Check with your doctor to see how much salt you can have in a day. Most doctors recommend less than 2,000 milligrams (mg) or salt each day.

How much salt in a teaspoon?

• 1 teaspoon of salt = 2000 mg of sodium
• 1 teaspoon of baking soda = 821 mg of sodium
• 1 teaspoon of baking powder = 339 mg of sodium

Read food labels to help figure out how much salt is in the food. A good rule of thumb is to choose foods with less than 250 mg of sodium per serving.

Remember, a serving size is not necessarily an entire container of food. If a can contains 3 servings and you eat the whole can, multiply the sodium per serving by 3.

Read the Label - Serving Sizes

•  A can of soup has 300 mg of sodium per serving
• The can has 2 servings.
• You eat the whole can, or 2 servings.
• So you would have 300 mg x 2 or 600 mg of sodium.

Compare salt (sodium) in foods you eat often, especially processed foods like soup, lunch meat, cheese and frozen meals.  Sort the foods into higher or lower sodium groups.

To lower your sodium intake, stop adding salt to food during cooking. Try taking the salt shaker off the table and add other seasonings to add flavor such as lemon juice, onion or garlic power, or herbs.

Avoid high sodium foods like canned foods, hot dogs, cheese and cheese spreads, deli meats, bacon,  ketchup, soy sauce, salad dressings, barbecue sauce, and frozen meals that are high in sodium.

Replace high sodium foods with fresh fruits and vegetables, lean meats, low fat milk, reduced sodium cheese and cereals low in sodium. When you go out to eat, choose food on the menu marked “healthy choice” or “low sodium”. Ask for sauces and salad dressings “on the side” and ask the waiter for low salt recommendations.

Pathways participates in SVGives May 6th Campaign

Pathways Home Health & Hospice is participating in the one-day SVGives campaign. You should start seeing social media promotions from numerous non-profits that serve residents in the San Francisco Bay Area about this event. SVGives is scheduled for May 6^th.   

Here is a brief video that explains what SVGives is and how through the power of coming together, we can bring services and comfort to those who need it the most in our communities.

Learn More about SVGives

Tales of Love and Loss: Sharing the Past with Jeannine

"With calm conviction, and a touch of regret, she looked me in the eye and declared that everyone has a story to tell. She felt that such a significant task as preserving that knowledge should never be delayed until it is too late."

Hospice volunteers often listen to patients and their stories. One Pathways volunteer, Christy Yuen, chronicled the story of Jeannine. 

This week is volunteer appreciation week. Pathways would like to formerly applaud all of our volunteers who help our patient’s tell their stories. Thank you for giving your time and attention to other human beings when they need it the most.

Jeannine, an 89 year-old French lady, knew her days were numbered. More than anything, she wished to put her memories down on paper. I visited her three times before she suddenly passed away. During those special hours as I typed, her accented voice whisked us back into history… 

Like the children in C.S. Lewis’ The Chronicles of Narnia, I found myself in a world of adventure and war, love and loss. Pausing occasionally to clarify the spelling of a French name, Jeannine spoke for hours about her ancestors and their lives in France. She told stories of war, including her time as a resistance fighter in World War II, and of her father, a pilot, crossing over enemy territory on dangerous missions. She told stories of tragedy; stillborn babies, deaths from tuberculosis and pneumonia, and widows and orphans left behind by war. She remembered how elderly folks were forced to sleep on hard wooden floors in the wintertime while invading soldiers occupied their homes.

She also told stories of the human spirit, recalling how her uncle, a chef, made piping hot French fries for hordes of hungry children who waited on the streets for their parents to return home from working late. She described independent wives who rejected their alcoholic, skirt-chasing husbands in favor of raising their children alone and successfully running their own businesses. 

 Humor was frequently woven into her stories, such as the young woman who duped her boyfriend into marrying her, and a village that fooled the occupying enemy soldiers by playing a trick involving a sacrificed pig.

Interspersed throughout her monologues were heartfelt remarks about today’s world. She spoke with ease and fluidity about changing gender roles, the difficulty of learning a foreign language, intolerance towards homosexuals, and the importance of understanding cultural differences. She lambasted the government with characteristic poise and clarity in one breath, while bemoaning the loss of children’s innocence in the next. She remarked on the lack of opportunities for “kids to just be kids.” 

When she spoke about the physical, social, and psychological devastation of ongoing wars, her wise eyes would become rimmed with sadness. “We have not learned the lessons of the past,” she would say, slowly shaking her head.

Unfortunately, Jeannine and I did not get to finish her memoirs. I often remember something she told me at our first visit. With calm conviction, and a touch of regret, she looked me in the eye and declared that everyone has a story to tell. She felt that such a significant task as preserving that knowledge should never be delayed until it is too late.

For the privilege of sharing in her memories, for the insight she dispensed with such wit and character, and for all the reminders of what is truly important in life, I would like to thank Jeannine. Merci Beaucoup.

 

http://bit.ly/1hBYhG2

A Hospice Volunteer Breaks Barriers with Bubbles

by Sherry Rayner, Pathways Hospice Volunteer

The most heart wrenching yet fulfilling cases I’ve had as a Hospice volunteer has been with Pathways KIDS. During this time, I have learned that flexibility is the key and there is always a way to communicate.

My last case was with a Vietnamese family in East San Jose. Their youngest son, Jefferson Vu, was a 4-month-old patient who had a rare genetic disease. My job was to entertain his energetic 3-year-old brother, Truman, so their mother, Tam Vu, could get some much-needed rest and tend to her baby without interruption.

My initial contact by telephone was with the father, Ho Vu, who spoke English fluently. I knew he would be away when I visited each week. My concern was how I would communicate with the patient’s mother and brother, as I knew their English was limited.

As my first visit approached, I felt both anxious and excited. I carried a huge canvas tote bag filled with lots of toys, books and videos. Upon knocking on the front door of their condo, I was greeted by a sweet, smiling young woman and her active and excited 3-year-old son, Truman. Leaving my shoes at the door with families, I was graciously welcomed in.

I was then introduced to their precious baby boy, Jefferson. He was lying very still on a pink satin pillowcase in the middle of their big bed. In direct contrast to the rambunctious Truman, Jefferson was very still, tiny and fragile. He sounded like a wounded baby kitten when he cried. When he opened his eyes you saw big brown eyes looking back at you. His face would light up with the most radiant smile when spoken to softly.

Meanwhile, Truman anxiously eyed my canvas bag to see what I’d brought. Not being able to contain his curiosity any longer, we opened the bag. Out came a small nerf ball and a suction – cupped basketball hoop to put on their closet door. Truman was soon animation in action as he jumped and leaped trying to make a basket. When he made a basket, his Mom and I would clap with joy. During this time, Jefferson, the baby, slept soundly. There were two completely different worlds going on in one small bedroom.

Each week Truman would discover a new item in the canvas bag. Soon, he was helping me carry the bag up the stairs. The biggest hit of all was the “Bubble Machine.” Truman and I would go outside to the porch and play with a battery-operated bubble machine. At the flick of a switch, hundreds of tiny iridescent bubbles filled the air. Soon an excited little boy, ran, jumped, and squealed with joy. The smile on his face was only outdone by the sound of his giggles. He’d race around trying to catch every bubble, breaking it or holding it, letting them crash into him with glee. Needless to say he was hooked on the bubble machine and caught me by surprise when in English he’d ask for bubbles every visit.

One particular week, we were lying looking through his English/Vietnamese Kids Picture Dictionary when he focused on the medical page. He quickly pulled up his pant leg and showed me his scratch. I then showed him a scar I had on my leg. Much to my surprise he leaned over and kissed my “boo boo.” Tears welled up in my eyes as I held him and said, “Thank you, it’s all better now.” I was no longer worried about how we would communicate.

We played together for six months and in January 2007 Jefferson peacefully passed on, at home, in his mother’s loving arms with his brother and Daddy close by. What a cherished journey, never to be forgotten. I’ve learned there are always ways to reach out, but never imagined a bubble machine would be one of them.

About Sherry Rayner

Sherry Rayner has volunteered with Pathways Hospice for over 20 years. With her art teacher education and professional graphic design experience, Sherry is known for the creativity that she brings to her volunteer work. She began volunteering with Pathways after raising a family, care giving for several family members and volunteering with several other organizations. Known for brightening the days of patients of all ages, Sherry has recently specialized in the unique concerns of Pathways KIDS and their families.

Grief & The Holidays: A Time of Challenge & Hope

REMEMBERING

Soon it will be holiday time again and reminders of their loss are everywhere for those who are grieving. Traditionally this is a time of joy, sharing of memories, warmth, peace, and coming together in love.

For those who are grieving, the holidays are also a vivid reminder of those that are so dearly missed. Add to this the common expectation that all should be as it was and many grieving families find the holiday season to be the most difficult time of the year. 

The period after the death of a loved one is a journey through grief. We cannot forget and we cannot bury the pain. It is not easy. Our hearts, minds and bodies are grieving and not functioning in their full capacities, as though part of us is missing. 

Yet, we don’t have to hide from our experience of grief. These are natural feelings–they are all a part of the process–we can share them, we can accept them, we can feel them.

WAYS OF COPING

As the holidays approach, start with a blank slate. Accept that you may not have the energy or inclination to accomplish all the things that you or others have come to expect during the holidays. 

Rather than do things automatically, discuss and think about what you really want to do, what you don’t want to do, and what will be difficult but you want to try. We encourage people not to be afraid to make changes in traditions or start new ones.

Equally important is to acknowledge how you feel. It will be a sad time. Many recently bereaved worry they will spoil the holidays for others. According to families Pathways has counseled, the most painful thing is when they try to keep their feelings inside.

If friends or family members take the initiative to talk about the person who has died, it relieves the tension and creates an opportunity for sharing.

MANAGING YOUR GRIEF 

While there are no universal methods for healing and coping, there are some concrete things you can do that may make the holidays easier and provide an opportunity to honor those you love who have died.

  
Acknowledge your grief; accept yourself in whatever mood you find yourself.

• Remember you are not alone. Attend a remembrance event or grief support group.
• Make some personal choices based on your level and what is right for you.
• Give yourself permission to let go of certain traditions–it’s okay to make changes.
• Share your plans with others; let them know how they can help you.
• Reserve time to honor your loved quietly, alone or with others: light a candle, place a photograph on the table, share memories, make a memorial donation.

And finally, as you navigate through your grief this holiday season keep your loved one in your heart and remember to care for yourself.

Helping People with Dementia Cope with Grief and Loss

The death of a loved one is difficult for anyone, but it is a special challenge when someone in the family has dementia.  It’s hard for family members to know how and when to tell the person with dementia about the death.  And what should they do when the person doesn’t remember?

Coping with Losses

People with dementia have had many “little deaths” in the course of their disease—things like losing their independence and the ability to drive, read, cook or enjoy hobbies.  Memories and relationships are huge losses.  These losses are stressful for people with dementia and their families.

How people with dementia cope with loss is affected by many things, including: the stage of their dementia, their relationship to the person who has died, how often they were in contact with that person, and their personal way of grieving.

Grief Process

For people without dementia, recovery from a death usually involves accepting the reality of the loss, learning to live with it, and finding a new “normal.”  For most, the pain of the loss can transform into beloved memories.  For someone with dementia this process is often impossible.

People with dementia who are grieving are often agitated and restless.  They may sense that something is not right, something is missing.  They may confuse one loss with another.  A recent death may stimulate the memory of loss from childhood.  It can be stressful for family members to decide when and how to tell them about the death of a loved one—and even how often to tell them.  Repeatedly telling a person with dementia about a death can make family members’ grief more painful.

Telling About a Death

Here are some hints for telling a person with dementia about a death:

• Tell the news as soon as possible.  They will sense that something is wrong and need information to understand, even if just for that period of time.
• If you are too emotional to talk to them, find someone else—maybe a friend or healthcare professional.
• Choose a time to talk when the person with dementia is well rested.
• Use short, simple sentences.  Don’t give too many details; this may overwhelm them. 
• Answer questions as honestly as possible.
• Use clear words like “died” instead of “passed away” or “at peace now.”
• Try not to protect the person from the truth by suggesting that the person who has died is away and will return later.  This can cause worry and agitation later when the person does not return.
• You can support them with physical touch, such as a hug or holding hands.
• Consider involving the person with dementia in funeral planning, assigning a simple task.  This will help the death be more real for them.  They may recognize the rituals around death and act appropriately.
• Plan for someone to be with the person during services who can also take them out if they become agitated.

Accepting Death

Here are some ideas of ways to help the person with dementia accept the death:

• Speak in the past tense about the person who has died.  For example, “I loved Mom’s holiday cookies.”
• Talk with them about the person who has died and express your sadness.  “I sure miss Dad.  He always made birthdays so fun, didn’t he, Mom?  Remember when he….”  Bring out pictures and tell stories if this helps their grief process.
• Accept how often they want to talk about the person who has died—perhaps frequently, not much, or maybe not at all.

If over time they continue to ask for the person who has died, there are some things you can do.  In the beginning, gently remind them that the person has died. If reminding them becomes upsetting, you can try these ideas:

• Respond to the emotion under their words, feelings like sadness, longing, fear, distress, suspicion, anger, concern or confusion.  You can respond to what you see:
• “You sound really frightened (or lost, or angry, etc.) to me.  Let me help you with that.”
• “You must really be missing her.  Tell me what you miss most.” Share your own feelings: “I miss her, too.”
• Check their mood at the moment.  If the person is unaware and not distressed, you don’t need bring up the reality of what has happened.
• Look for patterns in the times they ask for the person who has died.  Look for an unmet need. For example, if the person who has died usually brought them coffee in the morning, the change in this routine could be distressing and remind them that their loved one is not there. 
• Use distraction only when other ways of dealing with their grief are not working.

Each family has to find what works for them, and then try to be as consistent as possible.  You may want to write out a simple plan for all family members and visitors to follow. 

You can be most supportive to the person with dementia if you also take care of your own needs and get support.  We encourage family members to find support to help them cope with the painful, frustrating, lonely and sad feelings that they may feel.  Supporting the person with dementia takes patience, but family members should remember to be patient with themselves as well during this stressful experience.

References:   http://www.nia.nih.gov/alzheimers;  http://www.alz.co.uk;  http://www.pathwayshealth.org