Navigating Depression After Retirement

For low-income Collier County residents who are working but uninsured, access to the medications they need is not as easy as going to a regular chain pharmacy to pick them up. Thats where the Neighborhood Health Clinics expanded non-narcotic medication room comes in, giving patients managing chronic conditions including hypertension and diabetes timely access to medications at no cost. The 1,850-square-foot medication room, located at the clinic on Goodlette-Frank Road near Central Avenue, was built at a cost of $500,000 and is named for the late Stacy Forman, a Naples philanthropist who donated funding for the expansion.Keith Maples, CEO of Neighborhood Health Clinic, said the expanded medications facility enhances the clinics ability to serve patients faster and more efficiently. On a typical day, a patient can walk in and when they walk out, theyre walking out with thousands of dollars worth of medication that, if it were outside of the Clinic, they would not be able to fill those prescriptions because it would be outside of what they could afford, Maples said. He said the expanded space, equipped with updated technology and increased storage capacity, allows for a larger inventory of non-narcotic medications that enables the Clinic to fill prescriptions immediately to minimize delays in treatment. In 2024, the Clinic distributed $6.5 million in retail value of medications thanks to partnerships with Americares, Direct Relief, Dispensary of Hope and other pharmaceutical companies. The expansion allows us to work even more with our pharmaceutical partners to basically procure all of the medications necessary for our patients, Maples said. He said that many patients arriving at the Clinic for the first time have not previously received medical care for the condition needing treatment and may have vastly elevated blood pressure or blood sugar levels, for example.  When they walk through the doors, theyre at such a heightened level that were trying to bring it back to a controlled number to where its manageable for them, Maples said. If their A1Cs are through the roof, their [blood] sugars are through the roof, were trying to get them back to an established number that helps them feel better. Well never cure them of all those illnesses, but well maintain that health for them, so they feel better and have a better quality of life.Clinic grows to meet patient demand The nonprofit Neighborhood Health Clinic was established in 1999 by Dr. Bill and Nancy Lascheid to provide medical care to low-income, working but uninsured Collier County adults. Their daughter, Leslie Lascheid, now serves as president of the organization. In 2024 the clinic saw more than 12,000 patient visits and delivered more than 30,000 patient procedures, Maples said, with all medications, primary care, specialty care, surgeries and outpatient procedures provided free of charge to patients.All funding is through philanthropy, as the Clinic does not receive any city, county, state or federal funding including Medicaid or Medicare. Over the years the clinic has expanded as the patient load has increased. The original 11,000-square-foot facility more than doubled in size with the completion of the Armstrong Medical Specialties Building in 2021, which expanded the campus to 23,000 square feet.  The addition of the Van Domelen Education and Wellness Building, also in 2021, took the total to its current 32,000 square feet, and when the Bill and Candy Raveis Pathology Building is completed this summer, the total campus will be at 43,000 square feet, according to Marcie Berland, the Clinics director of development. Maples said the Clinic has expanded strategically over the years to meet the medical needs of patients many of whom work in hospitality, service or construction industries in Collier County and the growing volume of patient visits. When weve expanded, we didnt do it just to do it, he said. We based it on what were the patient needs and what do we need in-house on a daily basis to deliver the care, providing the opportunity for a patient to walk in the door, get all the care they need and not have to go to another location somewhere else, or come for another appointment. Because when our patients miss days of work, thats food on the table and the roof over their heads. Its not like if I call in sick: I get a sick day and still get paid.  He said the campus expansions allow most procedures including lab work to be done in-house, creating opportunities for sustainable, uninterrupted patient care. When that patient walks through the doors, I never want them to wonder where theyre going to get their care or how theyre getting to their next appointment, Maples said. Many of our patients get rides here, or they walk or ride their bikes, because very few own cars that they can drive in.  And while the Clinic does have a full-time paid staff of 14 and five part-time staff, no medical professionals are paid to deliver care, Maples said. More than 250 physicians, 50 dentists, 100 nurses and 300 non-medical personnel deliver care and provide patient education on a volunteer basis. 

Beyond the Surface: Naples Cancer Advisors Spotlight Melanoma During Awareness MonthMay 1, 20256 Min ReadBy Jillian Hunt, CNP Executive Director of Clinical Operations at Naples Cancer AdvisorsMay is Melanoma Awareness Month, and in sun-drenched Collier and Lee Counties, its more than a calendar observance. Its a call to action. The sunny environment increases exposure to ultraviolet (UV) rays, which are a significant risk factor for skin cancer, including melanoma. Understanding the risks and adopting preventive measures can help residents enjoy the sun safely while minimizing their skin cancer risk.At NCA, we specialize in delivering second opinions and expert oncology guidance at no cost to patients. Our team, including nationally recognized oncologist Dr. Philip Leming, believes that no one should face a cancer diagnosis alone. This month, we want to shine a light on reshaping melanoma prevention, detection, and awarenessso you can stay protected and proactive.Prevention: A Daily Practice, Not Just a Summer ChecklistMost people know the basics: use sunscreen, avoid tanning beds, cover up when outside. But melanoma doesnt just show up where the sun shines. It can develop under your fingernails, between your toes, even on your scalp or eyes. We educate patients to look everywhere, not just the obvious spots.One powerful (and often overlooked) fact: a single blistering sunburn in childhood doubles your lifetime risk of melanoma. Thats why prevention is a family affair. We urge parents to build sun safety habits early and keep them consistent all year.Detection: A Watchful Eye is The Best ToolThe front line of defense against skin cancer is early detection. Identifying skin changes especially changes in moles is the easiest way to catch skin cancer earlier.What is a mole?A mole is a benign (non-cancerous) growth on the skin that develops when melanocytes, the cells responsible for producing pigment, cluster together instead of being evenly distributed. Moles can be present from birth or develop later in life.ABCDEs of Moles and Melanoma Detection Asymmetry: One half of the mole doesnt match the other. Border irregularity: The edges of the mole are uneven, ragged, or notched. Color variation: The mole has multiple shades of brown, black, or other colors like red, white, or blue. Diameter: The mole is larger than 6 millimeters (about the size of a pencil eraser). Evolving: The mole has changed in size, shape, or color, or has new symptoms like itching, bleeding, or crusting.The ABCDEs are a helpful tool for self-examination and can prompt individuals to seek professional medical advice if any of these signs are present.Dermatologists remain the front line in detection and diagnosis. However, emerging technologies are offering exciting backup. Artificial intelligence skin scanners and total body imaging are improving the speed and accuracy of diagnosis.Whether its through advanced tools or a trained eye, one truth remains: catching melanoma early saves lives.The NCA Difference: Compassionate, Cost-Free Cancer GuidanceNaples Cancer Advisors was founded to be a bridge for patients who feel lost, overwhelmed, or unsure where to turn after a cancer diagnosis. We offer a second set of expert eyes, help explain treatment options, connect people to top-tier providers, and support them throughout their journey.Melanoma may be aggressive, but its also highly preventable and treatable when caught early. This May, we urge everyone in our community to schedule a skin check, learn your ABCDEs (Asymmetry, Border, Color, Diameter, Evolving), and take sun safety seriously.And if you ever need clarity or support after a diagnosis, Naples Cancer Advisors is herefree, local, and fully focused on you.Jillian Hunt, CNP BioJillian has been caring for cancer patients since 2004. In that time, she has set the benchmark for her patient-centric approach in Cincinnati, Southwest Florida, and beyond.Her professional journey began at Cincinnati Childrens Hospital Medical Center in 1999 on the hematology/oncology/bone marrow transplant unit and later the emergency department.After spending five years caring for children, Jillian found her passion in caring for the adult oncology patient. Starting as a chemotherapy infusion nurse in private practice with Dr. Philip Leming at Cincinnati Hematology Oncology, she then pursued an advanced degree to offer a higher level of care to her cancer patients.Jillian has been an oncology nurse practitioner since 2011 and is passionate about patient care, education and staying current on research opportunities available for the patients she cares for.Jillian is a national speaker traveling to educate clinicians on the use and management of toxicities of medications that are used in cancer treatments. She has spoken at national nursing conferences and sits on several advisory boards. Jillian feels strongly about staying on the front lines to improve patient care and expert advice on cancer.Jillian was born and raised in Cincinnati and graduated from Lakota High School. She and her husband have five children. Outside of her love and passion for oncology, Jillian and her husband are licensed foster parents and have participated in global mission trips to serve orphaned children around the world.Naples Cancer Advisors239-846-2273 (CARE)3201 Tamiami Trail N, Suite 112, Naples, FL 34103

Alzheimers is the most common type of dementia and occurs when plaques and bundles of proteins build up between nerve cells in the brain, ultimately causing brain cell death. Individuals often experience confusion, memory loss and inability to care for themselves. The disease is physically degenerative and is often mentally and emotionally draining on both the individual with the disease, as well as family members around them. If you or a loved one has been diagnosed with Alzheimers, you likely have a lot of questions. At BrightStar Care, our team has experience in working with clients and families dealing with Alzheimers and want to help you better understand the road ahead.Causes & Diagnosis of AlzheimersWhen caring for a loved one with dementia, knowledge and understanding of their condition can be invaluable. Although every case of Alzheimers disease is unique, there are some commonalities in terms of causes, symptoms and general prognoses.What causes Alzheimers?For people diagnosed with Alzheimers, the exact timeline, symptoms and primary causes will vary. There are many possible causes of Alzheimers disease that include genetic, environmental and/or lifestyle factors. Diet, sleep patterns and a lack of both cognitive and physical exercise may all play a role in the causes of Alzheimers.What is the difference between Alzheimer's and dementia?Dementia is not a disease itself, but rather a group of symptoms that impact brain functionality caused by various diseases and conditions. Alzheimers disease is the most common form of dementia, accounting for 60-80% of dementia cases.What is the 12-question test for Alzheimers? The 12-question test for dementia, also known as the Mini-Mental State Examination (MMSE), is a clinical tool used to evaluate cognitive impairment. It assesses several cognitive functions including memory, orientation to time and place, language abilities, and calculation skills. By asking a series of 12 questions, healthcare providers can gauge a person's cognitive status and help determine the likelihood of dementia.Alzheimers Symptoms & PrognosisThe earliest detectable signs of Alzheimers include memory trouble, apathy and depression. People in the early stages of Alzheimers might have problems completing familiar tasks or misplace things and be unable to retrace their steps. As the disease progresses, more severe symptomsincluding impaired communication, poor judgment and disorientationmay emerge. Each individuals experience with Alzheimers is unique. Your doctor and medical team can help you better understand your condition, symptoms and any treatment options as they relate to you. What are the symptoms of Alzheimers?Alzheimers is most commonly characterized by mental confusion and forgetfulness. Some common tell-tale behaviors are forgetting familiar names, getting lost in familiar places, and an inability to complete routine tasks.How can I tell the difference between Alzheimers and typical signs of aging?While forgetfulness and confusion are associated with Alzheimers, these symptoms also accompany normal aging. So, how can you tell the difference? The Alzheimers Association lists memory loss as a challenge that disrupts daily life, challenges in planning or solving problems, and difficulty completing familiar tasks. They also differentiate these symptoms from the milder signs of normal cognitive decline. For instance, while a normal older adult might occasionally struggle to balance their checkbook or forget an important name or date and then remember it later, these difficulties are more persistent or extreme for an Alzheimers sufferer.For example, occasionally losing your keys or forgetting what you had for breakfast that morning is common among older adults. However, a person with Alzheimers may show even more pronounced lapses in memory. For instance, they may not only lose their keys, but also completely forget what keys are for, showing a stark decline in cognitive connections. Whats the typical Alzheimers prognosis? For people diagnosed with Alzheimers, the exact timeline, symptoms, and severity of their disease can vary. However, the trajectory of the disease tends to flow through seven distinct phases, originally outlined by Dr. Barry Reisberg of New York University.The arc generally begins with symptoms similar to those of normal aging, proceeds through gradually worsening stages that can include difficulty with simple arithmetic and forgetting personal details, and ends with severe decline typified by the inability to swallow.Early stages: Early-stage Alzheimers typically includes mild decline, such as difficulty in finding the right word during conversation, losing personal possessions and having trouble remembering familiar names. At this stage, family members can typically manage care for their afflicted loved one.  Middle stages: This period is marked by moderate decline in mental faculties, including poor short-term memory, inability to manage personal finances, difficulty dressing or grooming and significant confusion. In these stages, a person with Alzheimers may need occasional in-home care or nursing services.Late stages: In the final stages, severe decline is present, including inability to recognize familiar faces, inability to remember personal details, loss of bladder control and major personality changes. Individuals at this stage either relocate to a residential facility or have a full-time in-home caregiver.Is there a cure for Alzheimers? Theres no known cure for Alzheimers, only treatments that can ease symptoms. The FDA has approved two types of medications (cholinesterase inhibitors, such as Aricept, Exelon, and Razadyne, and memantine, found in Namenda) that diminish mental confusion, memory loss, and other cognitive symptoms, but these do not reverse the underlying causes.Recent research and clinical trials have made potential breakthroughs with immunotherapy treatments and monoclonal antibodies. Many also suggest herbal supplements like gingko biloba and coenzyme Q10, but these lack confirmation through clinical trials. Additionally, non-drug interventions such as cognitive behavioral therapy as well as caregiver support programs can improve quality of life, especially in early stages. Alzheimers Prevention and Management Understanding the nature of Alzheimers and how to manage it can positively impact families affected by this disease. Having accurate information about risk factors, early warning signs and how to manage each stage of Alzheimers can help support family caregivers throughout the progression of the disease. How can I prevent Alzheimers? There are no proven ways to completely prevent Alzheimers. As with many degenerative illnesses, a healthy lifestyle, including regular exercise, balanced diet, and effective sleep habits, may help lower the risk of developing Alzheimers. Research has shown a correlation between high blood pressure and high cholesterol and the incidence of the disease. Doctors recommend getting these numbers to a healthy level, not only for Alzheimers prevention but for general good health.There are a variety of ways to maintain good brain health that can also work toward a lower likelihood of Alzheimers disease. Regular social interaction, brain stimulating activities such as puzzles and learning new skills, and managing stress levels can help maintain cognitive health. Certain forms of physical exercise can also support brain health such as walking, swimming and strength training. Is Alzheimer's hereditary?There are rare familial forms of dementia caused by genetic mutations such as familial Alzheimers disease, frontotemporal dementia and familial vascular dementia, which are more likely to occur in people under the age of 65. However, research shows that most cases of Alzheimers are not linked to genetics.How prevalent is Alzheimer's?Before the age of 65, only 1 out of every 1,000 people develop dementia. The chance of having the condition rises sharply with age to 1 person in 20 over the age of 65. Over the age of 80, this figure increases to 1 person in 5.How does Alzheimer's disease progress over time?Alzheimers is a degenerative disease that progresses in stages from mild to moderate to severe. The disease usually starts with mild symptoms such as increasing forgetfulness, then progresses to general confusion and disorientation. Finally, Alzheimers patients end up with severe symptoms, such as an inability to communicate or care for themselves.Caregiver Support for Alzheimers Disease Caring for a loved one with Alzheimers disease can be difficult from both a physical and emotional perspective. Family caregivers can benefit from trusted resources to help them more effectively communicate with their loved one with Alzheimers. Having the right resources and information can help them learn to manage difficult behaviors like agitation and wandering and ensure safety and fall prevention in the home. At BrightStar Care, we can help connect you with resources to support family caregivers, including support groups, education and training. For those with family members in the early stages of Alzheimers, we offer respite care to help give you a much-needed break. And as their condition progresses, our team can match you with compassionate, qualified memory care professionals. Reach out today and let us know how we can help.To learn more please contact us at 303-300-6666.