Guiding Patients and Families through the Health System

By Diane Drago, PFCC Advisor

Have you ever been lost or overwhelmed when visiting a large city that is new to you?  Or tried to navigate a road in thick fog?  If so, just imagine what our patients and families are feeling when they first enter the health system—or even for a return visit. They aren’t just entering a new, large place, they’re often doing so while frightened, confused and concerned about their health or that of a loved one.

Having easy access to basic health system information is imperative for our patients and families to navigate UMHS and is integral to us being able to provide the best patient- and family-centered care possible. While there is a fair amount of information online, not every patient and family member is able to access it and often times, doesn’t even think to do it prior to their first visit.  Therefore, UMHS’ Department of Patient and Family Centered Care (PFCC) embarked on project to design a new and improved guidebook for our patients and families.

The goal?  To provide a new, simplified and easy-to-use guidebook which can be used throughout the hospital on the adult side. (C.S. Mott is revising its own materials as well.)  Past versions were too long and confusing, essentially defeating its purpose.

The process?  PFCC’s intern, Anna Solomon, took responsibility for the enormous and painstaking research required to create a user-friendly version of the guidebook.  A group of PFCC advisers was also convened to review materials and offer feedback on what is most important to patients and families.  Anna spent most of her internship interviewing all known UMHS departments, to determine the critical information needed from their area.  This included departments such as social work, interpreter services, food service, complementary therapy and Gifts of Art, among others.

The result?  Anna completed her internship by providing a thorough outline of and the materials for the new guidebook.  It will include system-wide information such as maps, food service options, local hotels, hospital amenities, parking, financial services and tips for medical stays.  Important phone numbers for major clinics will be included, along with the ability for individual clinics to add their own, specialized information.  The guidebook is now being finalized by the PFCC office and is expected to be completed next year. It will also be hosted online.

Communication.  Information.  Education. As always, these are the themes which comprise quality patient- and family-centered care, and is the foundation of the new UMHS guidebook.

 

UMHS reimagines how pathologists interact with patients, families

By Dale Parry, PFCC Advisor

Reinventing the relationship between pathologists and patients is one of the concepts being explored by the Department of Pathology’s new Patient Family Advisory Council (PFAC). The group, which has 36 regular members and seven patient/family advisers, began its work in July with Jeffrey Myers, M.D., (Vice Chair for Clinical Affairs and Quality) as facilitator.

“Patients and families may be unaware of the substantial role that pathology plays in their healthcare journeys,” Dr. Myers says. “Those who work in pathology, in turn, struggle to stand in our patients’ shoes to more deeply understand opportunities to improve the value of the services that we provide.  I believe that learning to partner with, rather than simply doing things to and for, patients and their families will transform our discipline and significantly improve the quality, safety and value of our contributions to an increasingly complex health care ecosystem.”

Dr. Myers believes that when pathologists are not so removed from patients and their families, they can drive safer, higher quality, and more effective pathology care for less cost.

The group’s initial areas of concentration:

• Reimagining how pathologists share information with patients and families.
• Making pathology more transparent and accessible.
• Understanding how pathology can create new value in patients’ experience.

In November, 24 members of the Pathology PFAC – including three patient/family advisers – participated in the Institute for Patient- and Family-Centered Care’s intensive training seminar in San Antonio.

In 2017, the Pathology PFAC will be digging deeper with patients and families to determine how and where they as a department can turn from what is more system centered services to those that can embrace a patient and family centered care model. Working with the Institute’s faculty, they created an action plan to structure the PFAC’s next steps.

PFCC Partners to help cultivate a culture of advance care planning

By Diane Drago, PFCC Advisor

PFCC and partners “talk turkey” about ACP during Thanksgiving week, staffing a table in the cafe.

Advance care planning (ACP) and end-of-life decisions—topics that few people can escape, yet we rarely want to discuss it until we’re forced to in a crisis. Research and anecdotal evidence demonstrate the tremendous benefits of quality ACP.  For patients and families, ACP can provide a higher quality of end-of-life care, higher health care satisfaction, lower anxiety levels, and less depression among caregivers.  For healthcare professionals and health systems, it enables better quality of care and decision making, fewer end-of-life hospitalizations and readmissions, and much higher patient satisfaction.

Having the difficult conversations about quality ACP is a keystone of Patient and Family Centered Care. Despite the enormous benefits and importance of ACP, what is the reality at UMHS?

• Completion of all UMHS faculty and staff’s own ACPs still remains a work in progress.
• In the most recent survey (October 2016) of patients aged 65+ being served at UMHS clinics, only three clinics had more than 40% of their patients’ ACP on file—Dexter Family Medicine (the highest at 43%), East Ann Arbor Geriatrics at 41% and West Ann Arbor General Medicine at 40.3%. The other clinics had results ranging from 15.4% to 38.2% completion rate.  While these figures show an increase since the beginning of 2016, they still fall short of UMHS’ goals.

Research studies across the spectrum demonstrate that these completion rates are the norm across the U.S.  The “gold standard” in ACP remains Gunderson Health System’s “Respecting Choices” program.  Since its inception, this program in LaCrosse County, Wisconsin, data consistently shows that they have achieved nearly a 100% completion rate across all adult residents in the county, along with 99% of the ACPs available in the patient’s medical records and treatment consistent with the patients’ wishes.

The UMHS Initiative

Efforts are being undertaken at UMHS to improve ACP completion rates and enhance communication around this issue.  In late 2015, an ACP Steering Committee was established. Members include 13 physicians and nurse managers, administrators from Ambulatory Care Services, Medical Benefits, and Social Work, and PFCC Advisors.

The committee is charged with cultivating “a culture of advance care planning” at UMHS.  It serves as the internal panel of experts in ACP and patient-centered end-of-life care. Responsibilities include: (1) developing and implementing a strategic plan to embed ACP into clinical practice, (2) ensuring patients and clinicians have earnest conversations on ACP, and (3) working to see that ACP documentation flows seamlessly throughout the institution and community.

Committee Objectives

The objectives of the ACP Steering Committee are:

• Improve the quality of ACP conversations across care settings.
• Increase the rates of advance directives completion and documentation for patients aged 65+ with a UM primary care physician.
• Increase rates of code status documentation for UMHS patients.
• Increase the percentage of times healthcare providers use documented end-of-life wishes to make care decisions.
• Improve transparency and coordination of ACP documentation with local health care partners.

The Work to Date

The Steering Committee identified two priority areas: Patient/Caregiver Education and Engagement and Patient-Provider Communication and Documentation.  To achieve the committee’s objectives, it is critical to ensure that patients and caregivers fully understand the status of their health/illness and to enable them to engage in robust ACP conversations and shared decision making.  Therefore, the majority of the work done in 2016 has focused on the burning issue of revising UMHS’ ACP booklet available to patients and families.

The information currently used at UMHS was developed in 2011, based largely on the State of Michigan’s information.  The committee discovered that patients, caregivers and front line workers found the 2011 materials confusing and not user-friendly (patients thought that three forms had to be completed), did not meet plain language standards, is costly to print, and had been developed without any patient or caregiver input.  Further, the committee learned that the materials were disconnected and found in at least three different “homes” within UMHS.

The committee embarked on an exhaustive study of best practices in ACP materials, including the previously mentioned Gunderson method, as well as other Michigan-based initiatives and materials, such as the work done by the Washtenaw Health Initiative, St. Joseph Mercy Hospital-Ann Arbor, and the Henry Ford Health System.  Within several months, a new, patient-centered, user-friendly booklet was created, incorporating plain language principles and patient and caregiver input.  It includes clear and straightforward information on advance directives and DPAs for health care; the forms themselves with instructions; and referral to the Patient Education Clearinghouse for FAQs and the DNR form.

Work is also continuing on the development and improvement of the culture and processes to support patient-provider communications. The November “Talk Turkey” initiative was one of those endeavors.

Next Steps

Watch for these next steps in the months ahead:

• UMHS is currently reviewing the new materials.
• The new materials will be piloted with UMHS primary care patients.
• Creation of a new ACP page on the Patient Education Clearinghouse.
• Development of more patient-centered educational materials. 

For more information on the ACP Steering Committee

Contact Kathryn Shindeldecker (kajab@med.umich.edu)

UMHS Windows Covered in Memorials, Well Wishes

Health care professionals, like patients and families, can be overtaken by the pain and suffering they witness day in and day out. Tremendous grief can impede one’s ability to care for themselves or others. Unrecognized effects of cumulative grief can lead to burn-out and stress.

Social Worker Lisbeth Harcourt, Program Manager Office of Decedent Affairs, is committed to recognizing a need for grief support and education among our health care workers who are often in an environment of loss and suffering. One way to offer support is through this December’s Grief Wall. The windows in the hospitals have transformed this week into a resource for faculty, staff, patients and families to express their grief and well wishes to patients. Using paint markers on the windows, our community will have an opportunity to share thoughts, messages, poems and coping strategies related to their personal loss and grief stories. This is an interactive way to display personal expression of grief and coping, and connect us all to this universal human experience.

For more information about past Grief Awareness Week activities and resources about grief and loss, click here.

PFCC, Child & Family Life Connects Patients, Families with Nature

Many family members of UMHS patients spend countless hours at their loved one’s bedside. Parents stay at Mott Hospital with their children for days on end. They are exposed to trauma, stress, and heartbreak and, often, caregivers do not take time for themselves. Julie Piazza, Project Manager for PFCC and Child & Family Life, has witnessed this many times. Her concern led to a study and new initiative to try to get caregivers out of the hospital, even for a short while.

“We know that parents and loved ones often don’t want to leave their child or family member, yet it’s critical to take breaks and have moments away for replenishment to help reduce compassion fatigue,” Piazza said. “Parents and caregivers need to take breaks, but how are we communicating the importance of self-care and well-being?”

Piazza worked with unit hosts throughout Mott and partnered with the Mott Patient Family Advisory Committee to create a survey to build awareness about the various amenities available to our patients and families. Then Child & Family Life Community Intern Kailyn Wiersma, along with PFCC interns Katlyn Carlin and Heidi Droste administered the survey on all pediatric, post-partum and anti-partum inpatient units.

They asked about the challenges caregivers face in leaving the bedside and taking a break. Do they know about Nichols Arboretum, a natural resource opportunity, right across from the hospital? From those responses, they then created a flyer with QR Codes linking to virtual videos and to the Arb’s website.

“We’re trying to build upon our hospitals’ connection and close proximity to the Arb,” said Piazza. “Once our families know that it’s so accessible, right across the street, they think it’s really great. It gives them hope.” Studies have shown that “simple and brief interactions with nature can produce marked increases in cognitive control.” (Berman et al, 2008, The Cognitive Benefits of Interacting with Nature, Psychological Science). In another recent study, participants who took a 15-minute walk in woods had a 16 percent decrease in the stress hormone cortisol, a 2 percent drop in blood pressure, and a 4 percent drop in heart rate. (Bowler et al, 2010).

Another way Child & Family Life Program connects patients and families with nature is through the Butterfly Explorers Program. Some caterpillars arrive special delivery to Mott and others are raised in area school classrooms. Mott hosts butterfly releases twice each year, once in June and once in September.

“Patients come in wheelchairs from all over UMHS to watch the Monarchs come out of their chrysalis and take part in the butterfly releases,” said Piazza. “The Monarchs are tagged and our families and patients can track them as they migrate to Mexico.”

There were over 200 butterflies released at each celebration this year. Staff from Leslie Science and Nature Center and the “Wild About Nature” Arboretum volunteers attend the releases to provide hands-on nature activities and engage participants in their butterfly related programs.

“We’re continuing to look for new ways to encourage patients, families and staff to care for themselves body, mind and spirit utilizing the tools we have available to us in our health system and Ann Arbor,” said Piazza, who also mentioned that they are recruiting more gardeners to volunteer in the Mott Healing Garden beginning again in May, 2017.

For more information about these or other PFCC/Child and Family Life programs, contact Julie Piazza at 734-232-5629. If you would like to donate to the Healing Butterfly Program and Garden, please go to www.giving.umich.edu/give/med-butterfly.

FCVC’s Innovation Challenge 1st Winner Awarded $100,000

By Diane Drago, PFCC Advisor, Member of  FCVC Clinical Innovation Challenge Committee

Nearly a year in the making, the first annual Frankel Cardiovascular Center (FCVC) Clinical Innovation Challenge, celebrated its Selection Event on Thursday, Dec. 8. The purpose of the Challenge was to give every person, regardless of their affiliation, an opportunity to submit ideas to make improvements within the FCVC. This initiative received strong support from the virtual Clinical Value Innovation community, which grew to an impressive 638 members.  Thirty-six unique ideas and proposals were submitted, resulting in 107 comments and 568 votes cast.

Five proposals were selected as finalists and the teams presented their proposals to a packed audience in Danto Auditorium.  The audience, along with a panel of four distinguished judges from Michigan, Chicago and Pittsburgh, selected the first recipient of the Innovation Challenge—a dedicated group of CVC’s ICU nurses and technicians, along with members of the physical therapy department (pictured above).  Erika Koerner, one of the CVC’s ICU nurses, presented her team’s vision of helping to facilitate increased mobility for patients in the CVC’s ICU.  Team members included:

• Regi Freeman, RN, CNS – CVICU Clinical Nurse Specialist
• Alice Ferguson, RN, ENC – CVICU Educational Nurse Coordinator
• Courtney Clark, NP – CVICU Nurse Practitioner
• Erika Koerner, RN – CVICU Nurse
• Shelly Green – CVICU Technician
• Jessica Miller, PT, DPT – Physical Therapist
• Lisa Haggitt, PT, DPT – Physical Therapist
• Jessica Russell, PT, DPT – Physical Therapist

An award of $100,000 will be used to purchase at least 12 Livengood Mobility Aides.  These mobility aides will consolidate the equipment required to mobilize a patient (such as a wheelchair or a walker) and would provide a method to mobilize patients on a portable monitor, intravenous poles, hooks for drainage devices and securement of oxygen tanks.  The award will also incorporate tracking and data by the team to demonstrate the success of the project.

Two other smaller projects won the “Just Do It” awards–Utilizing Technology…Empowering FCVC Patients through the Use of the Patient Portal and the Little Free Libraries Project. For information on these, all of the finalists and the Challenge, click here or view the event slideshow here. The FCVC plans to continue the Challenge in 2017, so watch for information next year.

PFCC Announcements

Dr. Kathy Wade leaving patient-centered legacy, helped form UMHS PFCC

Dr. Kathleen Wade is retiring from the University of Michigan Health System. She has faithfully served as Associate Hospital Administrator and Director of Social Work, Assistant Dean for Hospital Social Work. Kathy has also been the administrative lead for the Patient & Family Centered Care Program, and was one of the leaders that helped promote the program and its many successful initiatives into what PFCC is today.

Kathy’s dedication to programs that support patients and her recognition that health care teams need support in order to provide the best care to patients and families will be greatly missed. She is warm, kind, wise, and cares deeply for our patients and communities. Kathy is also known for her fantastic sense of humor.

When asked what PFCC meant to her, she shared, “PFCC needs to be more than a change in culture; it must be a way of life.” Kathy has helped ensure that patient and family centered care is a way of life at UMHS. The PFCC Program continuously partners with patients and families to increase the quality, safety and experience of care. Kathy has made a difference. We wish Kathy Wade a wonderful and fulfilling retirement, and hope to continue the great work that was championed by all the leaders working to shape the ideal patient care experience.

Sounds of Change – How U Respond To Language and Its Impact on Health Disparities

How does language we are not familiar and comfortable with and our response affect the quality of care African American patients and families receive?  Come participate in a panel discussion hosted by the Division of Public Safety and Security.  We will explore how a fear for safety can be escalated by a misunderstanding created by cultural differences in communication.  Experience thought provoking role playing and a facilitated panel discussion.

Panel discussion moderated by Marlanna Landeros Division of Public Safety and Security Program Manager for Diversity, Equity and Inclusion. Panelists:  Nichole Burnside, PFCC Family Advisor, Officer Maureen Burke from the University of Michigan Police Department, Sgt. Darric Terry Health System Security,  and Nada Farhat, PGY2 Ambulatory Care Pharmacy Resident, Department of Pharmacy Services and Adjunct Clinical Instructor at the College of Pharmacy. Light refreshments to be served immediately after where the conversation can continue. This talk is presented by the University of Michigan Division of Public Safety and Security.

February 8, 2016, 9:00 AM-11:00 AM at Kuhn Auditorium, Alfred A. Taubman Biomedical Science Research Building, 109 Zina Pitcher Place, Ann Arbor, Michigan 48109

New Hour Tracking Capability will help Measure Volunteers’ Hourly Contributions

 Starting in 2017, PFCC will be able to track volunteer hours in our database in bulk. With more than 200 volunteers each, it would be incredibly helpful if you could keep track of your number of volunteer hours for 2016 and send them to us at the end of the year. Thanks so much! Shelly & Melissa

PFCC Learning Forum

The next PFCC Learning Forum is “Breaking Bad News: Patient & Family Panel” to be held Thursday, Jan. 26 from 1/26 from 1-2:30p.m. in the CVC Danto Auditorium.

Special Memorial

 It is with deep sadness that we share the news that PFCC Advisor Norm Bash passed away October 12^th. We will miss his genuine passion for helping others. He was always willing to try new things and had recently joined the PFCC Editorial Board as a reporter. Our condolences go out to his wife, Leslie, and their family.

We also lost PFCC Advisor Gail Kimball on May 1 of this year. Gail started volunteering for PFCC in November, 2012 and was a member of the I-MPACT E-Advisory Board and the Volk/Ed Committee, a participant in the Afib Collaborative Conversation, and volunteer with the former Family Centered Experience Program. Gail was an extremely thoughtful and delightful person and we will miss her greatly. Our sympathies go out to her daughter, Vicki Kimball, and family.

 

Are you the captain of your soul?

By Gary Evans, PFCC Advisor

Gary Evans, PFCC Advisor

In a parable that I have always turned to when facing life concerns, an old man and his granddaughter were sitting on a bench in the heart of town. As they sat, a car pulled up and a well-dressed man got out of his car and walked over to them.

He explained that he would be moving into the town with his family in the next week or two and he was interested in the town and the kind of people who lived there.

“What were the people like in the town from which you are moving?” asked the grandpa.

“I am so glad to be moving,” the man said, “those people were always gossiping and being rude and not at all nice.” The grandpa looked at the man for a moment and then said, “Unfortunately, you are going to find the same kind of people here.”

Later that same day, another car stopped and again a man got out and said he was being transferred and would be moving to the town. He asked the old man what kind of people lived in the town. Again, the grandpa asked the same question, “What were the people like in the town from which you are moving?”

“Oh my whole family is so saddened that my job makes this move necessary. The town we are leaving is such a wonderful place to be. The neighbors are so kind and caring and they are all sad that we are moving”.  The grandpa looked at the man for a moment and then said, “Fortunately you are going to find the same kind of people here.”

After the man had gone, the granddaughter was puzzled and wanted to know why her grandpa had such different answers for the two men.

He answered, “ If you expect people to be hard to get along with, they likely will be, and if you expect people to be kind and caring, there is a good chance they will be.”

It is a wise and thought provoking answer. As the old saying goes, “That which I expected has come to pass.” Our attitudes and expectations for others often create the realities with which we live and ways we interact with them. It is most important to remember the wisdom of the saying, “We see the world not as it is but as we are.”

Wise people know that personal judgments can very much affect what we see. Through personal experiences and academic training, nurses and doctors are trained to look for certain symptoms as they assess the health of a patient.

It is no less important to consider the person simply as a human being that needs as much personal attention as professional attention.

One of the Detroit newspapers used to run a column of short statements attributed to an Ashley Brilliant and one I remember so well was, ‘I believe my dear there is no such thing as a cold person. There are only frightened people and cold is the temperature of fear.”

Abraham Lincoln was making the same observation about our attitudes and the reality with which we live. Said Lincoln, “Most people are about as happy as they make up their minds to be.”

Likewise, In his poem Invictus, William Ernest Henley wrote, “I am the master of my fate, I am the captain of my soul.” Our expectations and our will power create the realities with which we live.

I have heard people say, “You made me angry” or “You made me feel badly.” They chose to blame other people for their behavior rather than recognizing that the decision regarding how respond was theirs to make.

I find it helpful to think to myself, “I choose to be angry,” or “I choose to feel badly. “ Such a self-admission reminds me that I am the one responsible for my reactions to what other people are saying and doing.

We are all capable of becoming the masters of our fate and the captains of our souls. We can choose how we relate to others. We are capable of being caring and kind to the grouchy or angry person. We can choose to behave consistent with the person we are becoming and the person we want to be. It never hurts to set daily goals for how we want to live each day and work at our goals. Even when we are not successful, it only means we have to practice the next day and the next day and the next. It is exciting to be the person we are constantly working to become!

As Mahatma Gandhi so wisely said, “ You must be the change you wish to see in the world.”

 

 

 

Deidre Todd, Doug George and Courtney Alexander

Faces of Cardiovascular Disease Featured PFCC Advisors

The UMHS/CVC launched its Washtenaw County Heart Walk campaign on Monday, February 15 with its Faces of Cardiovascular Disease event. The event featured patients Courtney Alexander and PFCC Advisor Doug George and was facilitated by UMHS staff member and PFCC Advisor Deidre Todd. The three cardiovascular patients visited the Danto Auditorium to share their personal journeys of living with cardiovascular disease with Frankel CVC staff. Attendees heard moving stories from our panel on what it’s like to be a cardiovascular patient, how it affected their lives, and why it is important to support the Heart Walk Campaign.  We thank our panel for sharing their experiences with the group!

More about the speakers…

• Courtney Alexander is a University of Michigan graduate and former U-M field hockey player. At 33, Courtney went into cardiac arrest and had a heart attack; she was saved by her husband who began CPR and quick-acting police officers who had an AED in the back of their patrol car. Courtney was in great shape and had no family history of heart disease. She is a strong advocate for AEDs, and has raised money to put AEDs in all on-duty police cars in her town.
• Doug George had his first heart attack at age 36, and had five bypasses. He experienced several more heart attacks and angioplasties over the years to open up the blockage. In the fall of 2007, Doug had another heart attack, and was told by his cardiologist that there was nothing they could do. He requested a transfer to the UMHS, where he received a heart transplant in February 2008.
• Deidre C. Todd has been a UMHS employee for over 25 years. She was diagnosed with post-partum cardiomyopathy in 2010, five months after giving birth to her son Alex. Deidre strives to educate others, especially women on recognizing symptoms not typically associated with heart conditions. She currently serves as co-chair of the UMHS/CVC Heart Walk Committees and on the event’s logistics committee.

• 

  Doug George and son, Jacob

PFCC Advisors take inspiring paths coping with grief, loss

Most of us have our own experiences with grieving. What we don’t and will never have is someone else’s experience with grief and loss. Even so, we can often learn from each other’s coping mechanisms, finding a way to apply a version of them in our own lives.

Two members of the Patient and Family Advisory Board at the Comprehensive Cancer Center, Kristin Meekhof and Michele Mitchell, and PFCC Advisor Nancy Maxwell James, found different yet individually fulfilling ways to continue on.

Nancy became part of the PFCC family after suffering a devastating stroke in 2014 and losing the use of her right arm. An artist, Nancy began working in mixed media in 2006, using pieces of antique lace, old photos, buttons and other items in her artwork. She started Sugar Lump Studios while grieving the loss of her dad; “Sugar Lump” was a nickname her mom gave her. Soon, her work was being published.

After the stroke, Nancy longed to get back to her art work and, though physical therapy at UMHS, was able to slowly recover. Below is the text from one of her pieces titled, “Faith Altered Journal.” This work chronicles her path to recovery and faith. It was published in the winter, 2016 issue of Somerset Studio Gallery Magazine. You can read more about Nancy’s artwork and journey at her blog: sugarlumpstudios.com.

Kristin is pictured at the 2016 United Nation’s Conference on the Status of Women, where her work was featured.

Kristin, who experienced the loss of her husband from advanced adrenal cancer in 2007, says she found that moving forward in a healthy and meaningful manner requires finding a purpose that is as interesting and intense as the wound one has suffered.

One of the ways she accomplished that was to write a book, “A Widow’s Guide to Healing: Gentle Support and Advice for the First 5 Years”. Meekhof says the book about what she and others experienced, and the lessons that resulted, doesn’t fill the void, but “rests alongside it.”

In the course of writing the book, Meekhof, who holds a master’s degree in social work from the University of Michigan, interviewed more than 100 widows. She also spoke with Dr. Gary Hammer, the director of the Endocrine Oncology Program at the UMCCC.

Next year will mark a decade since the loss of her husband, yet Meekhof says she continues to learn, both from her own experiences and those of others. “I traveled to Kenya and learned from widows about how they live on less than a dollar a day. At the United Nations I learned about 17 sustainable developmental goals, including health and well-being,that can transform the world,” she said.

An in-demand speaker on the topic of grief/loss, she also writes about ways individuals can help in the achievement of these goals. You can visit Kristin’s website and blog here: www.kristinmeekhof.com.

(l-r) Jennifer Coryell, Tricia Kachin, and Michele Mitchell

Michele and her family found a different way to travel through the grieving process as well as honoring the memory of her stepdaughter, Tricia Kachin. In 2010, at just 20 years of age, Tricia was diagnosed with Stage 4 Hodgkin’s Lymphoma, ironically, from x-rays taken following a car accident. She had been treated for asthma for some time and in retrospect, had all the symptoms of Hodgkin’s, but it had never been diagnosed.

This began a three-year journey on which the entire family travelled. It included a variety of difficult and sometimes, experimental treatments—stem cell extraction, chemotherapy and biopsies—in Houston, New York City, St. Louis and then the University of Michigan. During this time, Trish continued to study cosmetology and to plan her wedding. She had planned one more round of chemo before her wedding. However, during the last chemo treatment, she suffered heart failure, had to go on a ventilator and 10 days later, on July 12, 2014, Tricia’s journey ended.

The family was devastated after such a long struggle, but it was Tricia’s sister, Jennifer Coryell, who came to Michele with an idea to honor Tricia and hopefully, help others. In just a few months, the Kachin Strong Foundation was established.

Jennifer and Michele at the Kachin Strong Wine Event Fundraiser

The first fundraising event was held in the fall of 2013—a wine tasting. Other events have been held and to date, more than $7,000 has been raised. The Foundation was established to honor Tricia’s memory and create awareness about this disease. The family feels that had Tricia received more of her treatment at UMCCC, she would have had a better chance of survival. Michele and Jennifer, also a PFCC Advisor, are exploring ideas with the CCC to use the funding to honor Tricia’s interest in cosmetology by supporting the wig bank for cancer patients, developing a salon and/or in-room salon services and perhaps someday, an endowment for a medical student scholarship.

Michele said that establishing the foundation has helped the family through their grieving process, by giving them purpose and helping Trisha’s memory live on. She encourages others to keep the stories of their loved ones alive. While the grieving process truly never ends, you do learn to create a “new normal.”

Not everyone wants to write a book – but starting a blog or writing in journal or even on scrap paper might be helpful for some. Starting a foundation won’t appeal to everyone, but finding a way to support a charitable effort in honor of a loved one may bring comfort. For others, it may be setting aside a few minutes a day to read a book or take a walk. The only thing that matters is that it be something that’s important to that individual. Whatever path is chosen won’t begin to fill the void, but it may begin the healing and coping process.

ENTRY FROM “FAITH ALTERED JOURNAL”

By Nancy Maxwell James

On July 24, 2014, my world changed forever. On a lovely summer afternoon, my motor skills and speech began to falter, an ambulance was called, and I was rushed to the University of Michigan Hospital. I was suffering from an Ischemic stroke. The next three weeks were spent living on the acute rehabilitation floor at the hospital.

Since the stroke had occurred on the left side of my brain, it took my functions on my right side. My right arm was completely useless that first week, but my team of occupational therapists were able to get me moving. I told them that I did not care if I could walk again — I just wanted my right arm and hand back so I could make art.

I did not know until returning home that I was looking at a minimum two-year recovery. I had no clue that I would be re-learning how to use my right side. When I was discharged from the main hospital, I was sent to an outpatient program at a local hospital. Twice a week, the ladies there worked their magic, teaching my body how to do things again, and relieving the pain that comes with a stroke.

While my right side is still affected greatly, I am so happy to be able to grasp things with my hand, write a few words at a time (without tiring), and even wash my hair. There was a time I could not even do these simple things. I am hopeful that my recovery and strength continue to grow.

Creating this journal took a few months, but it gave me faith again! All I wanted was to have my art back.

I separated a Kraft chipboard book, and applied paint in layers using bubble wrap and pouncing-brush techniques. I added white paper doilies and cookbook ephemera with matte gel medium. I stamped numbers on page tabs. I printed various photos in a sepia tone on double matte photo paper, cut them out, and inked the edges. I computer generated text to a size compatible with the book size. I then cut out the text, and inked edges. I adhered photos and text to the book pages, and added photo tabs. I adhered buttons, word charms, paper flowers, and other embellishments to the pages. I bound the book with binder rings, and tied assorted ribbons to the rings.