When Army veteran Shawn Burchett spotted a puppy abandoned on the side of a highway in 2022, it changed the course of his life. Burchett and his wife Tricia rescued the pit bull mix, named him Beacon and brought him on their road trip.
Quinton and his service dog MolyBurchett suffers from post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) from his time in the military, so Tricia looked into nonprofit organizations that help veterans train their pets to become service dogs.
They happened to be driving through Santa Fe, New Mexico, where the nonprofit Assistance Dogs of the West offers such a program. Burchett enrolled in a six-month training course to teach his dog skills like interrupting night terrors, applying deep pressure during heightened anxiety and retrieving medication.
Partner and Protector
It proved so helpful that after only a month, the couple decided to make Santa Fe their permanent home. Burchett credits Beacon with increasing his confidence to enter public places; if he becomes anxious, Beacon will lead him to a quieter space and calm him.
"When I first started training, I never really left my house much," Burchett said. "I definitely would not go to stores unless it was the quietest time of the day or right when they opened or closed.
A service dog graduate bonding with a vet"Now I can actually go out and feel confident that if I'm going to have an issue, Beacon is there to help me through that issue."
Due to TBI, Burchett's heart rate can fluctuate suddenly, and Beacon learned to recognize when his handler's heart rate starts to get too high or low. That way, Burchett can sit down before he passes out.
"The other thing Beacon does is seizure response, which includes taking my hand and rolling me over by pulling with his mouth," he said. "Or he will lick my face trying to wake me up."
Service Dogs Save Lives
Service dogs like Beacon make significant improvements in lives of military veterans across America, but many more could benefit. According to the U.S. Department of Veterans Affairs (VA), America is home to nearly 20 million veterans, and 9.4% will have PTSD at some point in their lifetime.
"Participants living with a service dog . . . exhibited significantly less PTSD severity as well as less anger, anxiety, sleep disturbance and alcohol abuse symptoms."
The VA's 2023 National Veteran Suicide Prevention Annual Report found 6,392 veterans died by suicide in 2021 (the last year for which the agency has data).
"It will take all of us — working together — to end veteran suicide, and we will not rest until that goal becomes a reality," VA press secretary Terrence Hayes said.
He added that people with PTSD often have additional disorders such as depression, substance abuse, difficulty functioning in social and occupational roles and reduced quality of life.
There's hope. A 2018 pilot study found veterans with a psychiatric service dog experienced clinically significant reductions in PTSD symptoms, including lower depression, higher quality of life and improved social functioning, according to Steven Feldman, president of the nonprofit Human Animal Bond Research Institute (HABRI) in Washington, D.C.
"An additional paper resulting from this pilot study measured salivary cortisol awakening response in the participants, concluding that participants living with a service dog also exhibited significantly less PTSD severity as well as less anger, anxiety, sleep disturbance and alcohol abuse symptoms than those on the waitlist to receive a service dog," he added.
Feldman noted veterans often wait years to receive a service dog — something volunteers can help change.
Puppy Raisers Needed
One of the biggest needs at service dog nonprofits across the country is puppy raisers. These volunteers bring 8-week-old puppies into their homes and expose them to as many positive experiences as possible for around 16 months before they head to advanced training.
Joybound rescue dogs turned service dogsPuppy raisers are always needed at America's VetDogs, a New York-based nonprofit that provides service dogs at no cost to veterans, active-duty service members and first responders with physical injuries, PTSD, seizures and vision and hearing loss, according to Lorin Bruzzese, puppy program manager at America's VetDogs (and its sister organization, Guide Dog Foundation).
Bruzzese has personally raised five puppies and said it is fun to bring service-dogs-in-training to grocery stores, movie theaters and sporting events. Plus, the organization offers guidance and pays for all veterinary care and supplies, except for dog food.
"What motivates me is seeing both the dog and the veteran blossom. To serve our veterans is a nice way to give back to them for the sacrifices they've made for the rest of us."
"Our goal is to have a puppy who's just at ease anywhere and everywhere," she said.
There are many volunteer roles beyond puppy raising, according to Barrie Madasu, volunteer services manager at America's VetDogs. For instance, volunteers can join the "Taxi Team" to transport puppies from puppy raiser homes around the country to the nonprofit's New York headquarters, or to veterinary appointments. The nonprofit provides a vehicle and covers gas, tolls and other travel expenses.
Volunteers can also hang flyers recruiting puppy raisers, host fundraising bake sales and toy drives, or join the "Sewing Club" and work from home to stitch mats for puppy crates.
"The volunteers really take pride in making the mats look good," she said. "Especially when quilters donate, they have so many beautiful fabrics."
Stephanie Vogt at K9s For Warriors, a nonprofit that rescues dogs from animal shelters and trains them as service dogs for veterans with PTSD, TBI or sexual trauma at no cost, agreed that the need for volunteers is endless.
Large Support Crew 
For instance, volunteers who live within driving distance of the nonprofit's training campuses in Ponte Vedra, Florida, and Helotes, Texas (near San Antonio), can join the "Cooking for Warriors" program to prepare and drop off dinners for veterans staying in "Warrior housing" while they spend three weeks learning to partner with service dogs.
"The Warriors love it because they get a home-cooked meal," she said. "It shows them how the community really cares."
A Joybound service dog with a vetFreedom Service Dogs, a Denver nonprofit, has a dog-breeding program that provides service dogs to veterans and active-duty members of the military at no cost, so it is always looking for volunteers to work in the nursery to observe new mothers and their puppies in overnight shifts, Karen Perez, community engagement coordinator, said.
Volunteers also help socialize the Labrador and golden retriever puppies in the nursery by playing different sounds, turning on special lights, dressing the pups and wearing masks.
"Our volunteers help us get them used to different (stimuli) and build their confidence," Perez said. "From the day after they're born all the way to about eight weeks, we have something new for them every day."
Plenty of Work to Do
Susan Lee Vick, CEO of the animal welfare nonprofit Joybound People & Pets in Walnut Creek, California, said the group's "Shelter to Service Veteran Support" program — which trains shelter dogs to be service dogs for veterans with PTSD at no cost — always needs fosters and other volunteers.
Volunteers can exercise dogs, wash laundry, work on behavior training and serve as "matchmakers" for veterans looking to adopt a pet. (Pet adoptions are free to veterans; research found simply living with a pet dog can alleviate symptoms of PTSD.)
"We expect to nationalize this program and partner with local shelters to help place dogs into becoming 'Shelter to Service' dogs or veteran emotional support animals or pet dogs," she said.
Joybound's 2023 Volunteer of the Year, Sue Andrews, 63, is a retired teacher who donates her labor in several ways, from walking dogs once a week to photographing the relationship between veterans and their service dogs.
"When you see a dog is actually making a difference in that person's life, it just makes you feel so good."
One veteran told Andrews that since partnering with a service dog who can detect oncoming seizures, he's been able to get a full night's sleep, start a job and get engaged.
"What motivates me is seeing both the dog and the veteran blossom," Andrews said. "To serve our veterans is a nice way to give back to them for the sacrifices they've made for the rest of us."
Some service dog programs, such as Assistance Dogs of the West, offer ways for veterans to support other veterans. After training his own dog, Burchett joined that nonprofit's program, in which veterans train service dogs for other veterans with PTSD and people with disabilities. In addition to the therapeutic value of working with dogs, the veterans develop camaraderie and support one another.
The experience provides Burchett with "so much joy and happiness that I thought I'd lost forever."
"We're all veterans. It doesn't matter what branch of service — we've all gone through something and had similar experiences," he said. "And when you see a dog is actually making a difference in that person's life, it just makes you feel so good."
Further Information
If you or someone you know are contemplating suicide, call the free, confidential 988 Suicide & Crisis Lifeline by dialing 988, or visit: 988lifeline.org.
To learn about PTSD treatments from the VA's National Center for PTSD, visit: www.ptsd.va.gov. Veterans at risk for suicide can also download the Safety Plan app by searching "VA Safety Plan" from the Mac App Store or Google Play.
Veterans interested in partnering with a service dog can contact the nonprofit Association of Service Dog Providers for Military Veterans for help connecting with local providers by visiting: servicedogs4vets.org.


Help Vets with PTSD Get Life-Saving Service Dogs

Jen Reeder

My phone dinged — it was a text notification from my son, Travis, to me and his two sisters in our group chat. "Should I do it?" he asked.
It was August 2022, and he sent us a screenshot of the ticket he wanted to purchase for "WrestleMania 39" — the Super Bowl of professional wrestling. He needed to decide immediately and I didn't hesitate to respond.
Travis Brinkley doing the traditional 'point to the stage' move at Wrestlemania 39."Yes!" I texted back. "Bud, this has been your dream since you were little. Go!"
I have watched professional wrestling since my brothers introduced it when I was seven. It was the days of the legendary Bruno Sammartino, Bob Backlund, Andre the Giant, Chief Jay Strongbow and my favorite, Dusty Rhodes. 
I had a bout with breast cancer, the pandemic hit, and their grandmother passed away last year. It was time to do something special.
My then-husband Jeff, who was also a big fan, and I introduced it to our children when they were little. Travis has dreamed of going to WrestleMania since, but the biggest wrestling event of the year is different from the other WWE events. It can come with a Super Bowl price tag, too.
Our Family Tradition 
We had hoped going would be a family event, but his sisters had work obligations. However, Nicole and Sami encouraged his purchase. It had been a hard couple of years for our family. I had a bout with breast cancer, the pandemic hit, and their grandmother passed away last year. It was time to do something special.
Travis didn't know that once he texted us, I jumped online and immediately started searching for my ticket as close to him as possible.
I thought, '"I want to share this with him. I want to see his face when he gets there. I want to watch it, too."
Since the kids were little, we watched professional wrestling as often as possible. After Jeff died in 1999, we made it our way of connecting. No matter how busy we were, we came together for the show. Special pay-per-view events became our special traditions of hot chocolate and baked chocolate chip cookies, and, on many occasions, the kids invited friends over to watch and have fun with us. 
We also saw many events live, bought a lot of merchandise and attended several meet-and-greets. The memories we created will last forever. The kids are grown and out of the house now, but we do our best to continue watching and texting during the shows. We also Skype during the PPVs (Pay-Per-Views) and keep track of our predictions in a spreadsheet.
No sooner did I pay for the ticket than I started panicking.
"What if I join you, bud?" I replied.
I attached a screenshot of my ticket.
The excitement emojis poured in. This was happening.
WrestleMania 39 would be held at SoFi Stadium in Los Angeles in April. Travis lives in Arizona, a short flight away. I live in New York. No sooner did I pay for the ticket than I started panicking. I love to travel and have dreamed of living on the road and driving across the country, but the pandemic changed me. I hadn't flown since the shutdown, and the idea of driving from New York to California suddenly paralyzed me. 
Worried About Traveling Again 
I didn't want to let Travis down but was buying the ticket a mistake?
Months ticked by. Christmas came, and I still hadn't decided how, or if, I would go.
The journey of a thousand miles begins with a single step.
 I knew if I didn't do this road trip now, it would be harder to get behind the wheel later.
"Mom, you can do this," the kids told me. They are my biggest cheerleaders, and this was the best reason to travel again. I have to do this, I thought. I knew if I didn't do this road trip now, it would be harder to get behind the wheel later. Book one hotel room, that's all.
I planned a three-week road trip from New York to Phoenix for me and my significant other. From there, we would fly to California, where Travis and I would attend WrestleMania and then tour Hollywood for a few days. We would then fly back to Phoenix, and I would drive home.
It took months of planning and budgeting. Travis and I regularly discussed our plans for WrestleMania and our time in Los Angeles. As each month passed, our excitement built.
I overcame my nerves and thoroughly enjoyed driving again. We visited the Pro Football Hall of Fame in Ohio and stopped to see America's kitschy attractions like the "Big Things Small Town" Casey, Illinois. 
I took an emotional tour of the Oklahoma City National Memorial and saw a few national parks where we got our souvenir passports stamped. I drove a large part of Route 66. We slept in an RV and a WigWam, stood on the corner of Winslow, Arizona (famous courtesy of "Take It Easy" by the Eagles) and witnessed someone complete a 72-ounce steak challenge (with all the fixings) at the Big Texan Steak Ranch. I also indulged my love of "Breaking Bad" while visiting Albuquerque, New Mexico.
Taking In the Moment 
I was feeling more alive than I had in years.
After arriving in LA, Travis and I took a SONY Pictures Tour and checked out The Hollywood Museum, The Broad and the Getty Museums before the spectacular two-night event.
Lisa Iannucci and her son Travis Brinkley"Mom, do you want to look at it for the first time together?" Travis asked as we finally stood inside SoFi Stadium. We were about to see the stage and the ring and do what we've waited years to do – point at the WrestleMania sign, a WWE superstar tradition. We took that moment in, and I watched my now 28-year-old son's face light up as his dream came true.
My seat was only one row behind Travis, and we were fortunate to be close to the action. We screamed, cheered and booed with over 80,000 WWE universe fans. To see our current faves in person including Roman Reigns, Sami Zayn, Rhea Ripley and Bianca Belair, was electric, and we still had another night! We didn't want this to end. I teared up several times, just remembering how excited Travis was.
On the drive back to New York, my significant other and I saw more of Route 66, where we stayed at a historic motel. We also stopped at more national parks, and at The Sophia M. Sachs Butterfly House in Missouri, I released a butterfly (her favorite) in my mother's memory, who I knew would be proud of what we did.
It was one text from my son that not only made his dream come true but was the catalyst I needed to find myself again on a three-week, 5,600-mile cross-country road trip. We are already talking about doing it again.  


A Mother and Son's Journey to  'Wrestlemania 39'

Lisa Iannucci

I'll never forget the first time I heard about Cape May, New Jersey.
It was more than a couple of decades ago, and I was in a local writers' group, which met at different members' homes. One night, when I was getting ready to leave, I happened to look on the refrigerator of the writer who was hosting.
The Emlen Physick EstateI loved what I saw: tons of magnets of everything Victorian — from houses to lamps to fancy shoes.
"Wow! I love Victorian homes, too," I said to her.
"So, you must have been to Cape May," she replied.
Cape May? I hadn't even heard of it.
The writer then proceeded to tell me all about the many Victorian homes, the beautiful beaches, the tours, the shops …
I had to go.
Our First Visit to Cape May 
My husband and I were going to be celebrating our fifth wedding anniversary that June. We decided that Cape May would be our special destination. Another writer in our group had just stayed at a great B&B. We took his advice and made our reservations.
The Twin Gables would be the only B&B we would ever stay in while visiting Cape May. (The B&B was sold during COVID and now is rented out as an entire home.)
When we arrived that first time 23 years ago, we initially got lost, ended up at the Wildwood Boardwalk, and had to stop once we turned around because a local fraternal organization was having a parade. (Remember the days before GPS? Yeah. Good times.)
Once we arrived at Cape May proper, we decided to drive around the town before settling into our B&B. I couldn't believe what I saw.
Victorian houses — hundreds of them. All with more foo-foo, rickrack, and gingerbread than I had ever seen in my life! The colors were gorgeous and ranged from earthtones — which Victorians used on homes back in the day — to bright purples, pinks, blues, green and more. Some were more fancy, some less. But that first day, I think I loved them all.
Cape May became my happy place.
Trolley tours offer a glimpse of history The History of Cape May 
Cape May's history dates back to 1609 when it was first sighted by Sir Henry Hudson. In 1621, Cornelius Jacobsen Mey explored the area, which was originally inhabited by the Kechemeche Indians of the Lenni-Lenape tribe, who were known to hunt there — and had likely been living there for centuries.
Victorian houses — hundreds of them. All with more foo-foo, rickrack, and gingerbread than I had ever seen in my life!
Mey then did what most explorers did back then: he named the place after himself. Though somehow over the years, the spelling changed to Cape May (which is the Dutch spelling) instead of Mey.
By the 19th century, Cape May had become a seaside town as well as a big draw for tourists from Maryland, Philadelphia, New York and Washington, D.C. Homes, boarding houses and hotels were constructed. The area became known as the Queen of the Seaside Resorts.
But it was not without its problems. In November of 1878, a fire broke out, and in less than 12 hours, it had burned more than 40 acres — including hotels, houses, and other buildings.
Undeterred, Cape May rebuilt.
Over the years, there were hurricanes that caused destruction. In "Great Storms of the Jersey Shore," authors Larry Savadove and Margaret Thomas Buchholz document many hurricanes that hit the area, including a devastating one in 1962.
During that hurricane, out of the county's sixteen municipalities, fourteen of them flooded. Again, houses, hotels and other buildings were destroyed. And once again, the people rebuilt.
Cape May of Today 
During my most recent visit to Cape May, which was my first since COVID, my husband and I decided to take the combination trolley tour and tour of the Emlen Physick Estate to see if anything was new.
A lighthouse on Cape MayGiven by docents from Cape May MAC, the trolley tours provide a relaxing ride. There are many different kinds of tours including Victorian Homes, Ghost Stories and other topics related to Victorian times and Cape May. 
The tour guides give you really cool information as you ride. Throughout the tours, the trolley driver will occasionally stop, or slow down, so that tourists can get a good look at the houses, buildings or areas, while the guides give interesting historical information about each.
If you're planning a visit, make sure to take in this tour: The Emlen Physick Estate is named after its first owner Dr. Emlen Physick, who had the mansion and carriage house built in 1876 by renowned architect Frank Furness. When Physick died in 1916, the house went through many owners, and fell into disrepair. In the 1970s, a developer was set to buy the house and land — then called the Haunted House of Cape May because it was falling apart — and build a number of homes.
But a group of Cape May residents vowed to stop it. They had it declared a historical site and formed Cape May MAC in the process.
To see the beautiful mansion now, it's hard to believe it was once an eyesore. Cape May MAC restored it to its former glory.
Today, Cape May MAC also runs the Cape May Lighthouse as well as the World War II Lookout Tower, both near Sunset Beach. The organization offers walking and golf cart tours, boat and nature tours, and, depending on the time of year, a Gardens of Cape May tour.
Sunsets on the Beach 
While Cape May is mostly a walking town, be sure to get in your car and take a ride to Sunset Beach. There's so much to see on Sunset Beach. In the water lies the remains of the SS Atlantus Concrete Ship. Yes, there were actually a dozen concrete ships built in WWI. The wreck of this one was decommissioned in 1926. While the new owner was moving it, the ship ran aground and got stuck. It's been there ever since. And in the last 23 years, I've seen more and more of it disappear into the surrounding waters.
Be sure to get in your car and take a ride to Sunset Beach. 
Between Memorial Day and Labor Day, every night there is an evening flag ceremony. Flags from the caskets of deceased military are given by family members to be flown during the day. Each day at sunset, the flag is lowered as part of a ceremony. It's so moving. Get there early if you can.
Before the sunset, take some time and search for "Cape May Diamonds." These little stones are pieces of quartz but when polished up, they look like diamonds.
There are so many other things to see and do in Cape May: the Cape May Zoo, the Colonial House Museum, dolphin tours, birdwatching tours, butterfly tours, antique stores, water sports, the Nature Center of Cape May, the Harriet Tubman Museum, or even just lying on the beach and reading a book.
No matter what you decide to do on your trip to Cape May, be sure to take time to stop and look at the Painted Ladies. Like I was 23 years ago when I gazed at my first Victorian homes, I'm positive that you'll be astounded.


Get Your Victorian On! Visiting Cape May

Michele Wojciechowski

The Medicare Advantage and Prescription Drug Plan (PDP) annual election period (AEP) runs from Oct. 15 to Dec. 7, making now a good time to take inventory of your health and prioritize your wellness. Whether you're enrolling for the first time in Medicare, or signing up again, it's important to understand that not all plans include prescription drug coverage — this includes Original Medicare (Parts A and B) and some Medicare Advantage plans.
When comparing your PDP options, also referred to as Part D, check to see if your medications are covered and what copays or co-insurance you'll be charged, in addition to the monthly premium costs. Plans can also differ in terms of your pharmacy choices, and some include the option to use a home delivery pharmacy, like CenterWell Pharmacy, which can provide convenience and potential cost savings. Consider the following advantages of home delivery pharmacy when selecting and using your PDP.
Convenient and Easy Online Access: A home delivery pharmacy is a fast and easy way to manage your prescriptions whenever and wherever you want. Look for a pharmacy with online tools that allow you to transfer prescriptions, request refills, view real-time order status and chat live with pharmacists to answer your medication questions. To get started, check to see if a home delivery pharmacy has a mobile app available in the app store or visit their website to learn how to activate your account.
Real-time Order Status Updates: Getting your medication on time is very important for managing your health. With online tools, you can quickly track your order status so you can take comfort in knowing where your prescription is and when it will arrive.
90-day and Auto Refills: Since most medications from home delivery pharmacies are available as a 90-day supply, there are fewer refills required, and in some cases, switching from 30-day to 90-day refills may save you money. You can also use online tools to quickly set up auto-refills to automatically deliver your next order. In addition to the benefits of using a home delivery pharmacy, many prescription drug plans, including Humana's, have a "switch and save" option available on a mobile app or the plan's website providing suggestions for generic and lower-cost medication options.

Other good news for those enrolling in a PDP for 2024: new prescription drug laws are expected to save beneficiaries an average of 15% on their out-of-pocket drug costs this coming year, covered Part D insulin costs will not exceed $35 a month and many vaccines will be free to PDP members. Additionally, more low-income Americans will qualify and pay less for Part D coverage through Medicare's Low-Income Subsidy program.
For more information about prescription drug home delivery pharmacies, you can call 1-800-MEDICARE (800-633-4227) 24 hours a day, 7 days a week (except on some federal holidays) or go to Medicare.gov. To learn about Humana's Medicare Advantage, PDP and/or Medicare Supplement plans, visit www.Humana.com/Medicare or call 1-800-213-5286 (TTY: 711) to speak with a licensed sales agent from 8 a.m. to 8 p.m. local time, seven days a week.
About Humana
Humana Inc. is committed to putting health first — for our teammates, our customers and our company. Through our Humana insurance services, and our CenterWell health care services, we strive to make it easier for the millions of people we serve to achieve their best health — delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
Additional Information
Humana is a Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organization and a stand-alone prescription drug plan with a Medicare contract.  Enrollment in any Humana plan depends on contract renewal. Other pharmacies are available in the Humana network.
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The Benefits of Home Delivery Pharmacies For Your Prescription Drug Plan

TJ Gibb, Vice President and Leader of Medicare Prescription Drug Plans at Humana

"How is caregiving different for members of the LGBTQ+ community?" That's a question I've asked audiences over the years at national conferences where I've had the opportunity to speak on this subject. Many people aren't sure how to answer this question, or if there are differences. As you speak with members of the LGBTQ+ community and consider historical events during their lifetime, these differences become more apparent.  
June is Pride Month, also called Gay Pride, celebrated in the United States and elsewhere around the world. Pride Month commemorates years of struggle for civil rights, and the ongoing pursuit of equal justice under the law, as well as the accomplishments of lesbian, gay, bisexual, transgender and queer (LGBTQ+) individuals. For gay couples in the United States, the option to marry only became legal on a federal level in 2015. Marriage has significant implications for caregivers in terms of benefits like Family Medical Leave Act (FMLA) to take time off from work to care for a loved one, and spousal benefits through Social Security. Many couples who have been together for decades, unmarried, may not have considered how marriage can affect caregiving and financial survivorship as we age. 
The U.S. census has never measured how many LGBTQ+ people live in America, but some reports estimate there will be roughly 7 million LGBTQ+ adults over age 50 by 2030. LGBTQ+ seniors and caregivers face unique obstacles and issues because they are twice as likely to age alone and four times less likely to have children. As a result, LGBTQ+ elders are more likely to need long-term care. 
Yet according to a recent AARP survey, over 60% of older LGBTQ+ adults are concerned about mistreatment in long-term care settings because of their sexuality. Since the pandemic, staffing shortages have been widespread across long-term care facilities, which have furthered concerns about finding facilities welcoming to LGBTQ+ seniors.

Many people don't realize that LGBTQ+ seniors become caregivers more often than their heterosexual counterparts, including LGBTQ+ seniors themselves. Since LGBTQ+ adults are less likely to have children, they more often assume caregiving responsibilities for aging parents and for other "chosen family." Yet, for some members of the LGBTQ+ community, caregiving can feel especially isolating. In our society, the act of providing care is still very much considered a gendered responsibility. 
Many caregiver programs target women, who take on the majority of caregiving responsibilities as we age according to the National Alliance for Caregiving (NAC) and AARP report "Caregiving in the U.S." A Google Image search using the term "caregiver" reflects this notion, with very few men represented. Even fewer images reflect same-sex couples when it comes to caregiving. If you think about the advertising images used for health care and long-term care, it is rare to see the LGBTQ+ community represented, which underscores a feeling of being invisible for many LGBTQ+ caregivers. 
Each June, the WellMed Charitable Foundation provides its annual Pride of Caring series for LGBTQ+ caregivers and professionals serving them through its Caregiver Teleconnection. Now in its fifth year, the Pride of Caring is a unique program focused on a range of issues affecting LGBTQ+ caregivers, from care planning to end-of-life issues. Other organizations serving LGBTQ+ seniors and caregivers from across the country have participated in sharing their experiences, resources and strategies. 
Bruce, a past participant, shared: "For the first time, I wasn't the only man in a caregiver support group, and the only gay person. At my community support group, I felt like if I shared what I was going through with my husband, I wasn't sure how people would react or respond. People don't realize that you're not only sharing what you're going through, but coming out to a bunch of strangers." 
This is exactly why the Pride of Caring series was created – to give caregivers a supportive environment to discuss their lived experiences. Sharing and learning from others can make all the difference.   
To register for upcoming sessions or to listen to recordings, visit www.caregiverteleconnection.org


How is Caregiving Different for Members of the LGBTQ+ Community?

Elliot Montgomery Sklar, PhD, MS

In the United States, approximately 6.7 million people aged 65 and older are living with Alzheimer's dementia, and nearly half or more of those individuals experience something called agitation. Watching a loved one endure a battle with a condition such as agitation that may happen with dementia due to Alzheimer's disease can be very difficult for everyone involved. However, it is important to understand that while this diagnosis can be overwhelming, there are resources available for those who are taking on the role of a caregiver.  
The symptoms of agitation that may happen with dementia due to Alzheimer's disease, of which the behaviors and characteristics vary widely and can manifest as verbal aggression, physical aggression and/or restlessness, can cause emotional distress for both the person living with this disease and their caregivers. Due to the nature of the condition, caregivers may mistake the symptoms as those of Alzheimer's disease and think that nothing can be done to help manage them. These behaviors may include yelling, repetitive sentences and questions or wandering. Caregivers also may be reluctant to bring these symptoms to their loved one's doctor. However, it is important for caregivers to recognize changes in behavior and continue to monitor symptoms — flagging concerns and being open with their loved one's healthcare team.
The Need to Support Caregivers
Caring for a loved one can be an important step to take when navigating a person's treatment plan, but it may exacerbate caregivers' existing stress levels. This in turn could then impact their personal emotional, financial and physical well-being — which can further amplify the challenges that caregivers may face when trying to care for their loved one. Caregivers should know that they are not alone and find relief in knowing that they have support and resources available to them.
Tips for Caregivers 
While it may feel overwhelming to care for someone with agitation that may happen with dementia due to Alzheimer's disease, there is still hope, as there are a variety of ways to help manage the symptoms. These include but aren't limited to several non-pharmacological approaches: identifying triggers, loud noises, unfamiliar people or unpleasant physical sensations. Creating a simple daily routine; maintaining a calm environment; and including sources of comfort in the individual's environment can also help. Caregivers should also maintain a list of specific symptoms and detailed notes to share with their loved one's doctor to report changes in behavior so that the best management plan can be implemented. It is particularly important for caregivers to establish an open, ongoing dialogue with their loved one's healthcare team to formulate a path forward that is right for them. Even if behaviors don't seem significant, there are treatment plans that may help alleviate the symptoms in those with this condition. If non-pharmacological approaches do not provide relief from the symptoms, there are other treatment options available that may help alleviate the symptoms of agitation that may happen with dementia due to Alzheimer's disease.
Helping a person living with this condition manage their symptoms can lead to high rates of caregiver stress. It is important that caregivers have access to educational resources that may help them feel empowered to continue conversations with a healthcare professional to seek the best treatment plan for the individual they care for.
For more information and a questionnaire to see if your loved one may be experiencing agitation that may happen with dementia due to Alzheimer's disease, visit www.ManagingAgitationInAlz.com.
About Otsuka 
Otsuka Pharmaceutical Co., Ltd. is a global healthcare company with the corporate philosophy: Otsuka–people creating new products for better health worldwide. Otsuka researches, develops, manufactures and markets innovative products, with a focus on pharmaceutical products to meet unmet medical needs and nutraceutical products for the maintenance of everyday health. In pharmaceuticals, Otsuka is a leader in the challenging areas of mental, renal and cardiovascular health and has additional research programs in oncology and on several under-addressed diseases including tuberculosis, a significant global public health issue. Learn more about Otsuka in the U.S. at www.otsuka-us.com and connect with us on LinkedIn and X at @OtsukaUS. Otsuka Pharmaceutical Co., Ltd.'s global website is accessible at https://www.otsuka.co.jp/en/. 
About Lundbeck 
Lundbeck LLC is a wholly owned subsidiary of H. Lundbeck A/S (HLUNa / HLUNb, HLUNA DC / HLUNB DC), a global pharmaceutical company specialized in brain diseases. For more than 70 years, we have been at the forefront of neuroscience research. We are tirelessly dedicated to restoring brain health, so every person can be their best. Our research programs tackle some of the most complex challenges in neuroscience, and our pipeline is focused on bringing forward transformative treatments for brain diseases for which there are few, if any therapeutic options. With a special commitment to the lives of patients, families and caregivers, Lundbeck US actively engages in a broad range of initiatives each year that support patient communities. For additional information, we encourage you to visit us at lundbeck.com/us and connect with us on LinkedIn and X at @LundbeckUS. 
© 2023 Otsuka America Pharmaceutical, Inc. All Rights Reserved August 11US23EUC0059


Agitation That May Happen with Dementia Due to Alzheimer’s Disease

This content is sponsored by Incyte Corporation. During the third week of February, the cholangiocarcinoma community rallies together for World Cholangiocarcinoma Week to raise awareness of cholangiocarcinoma (CCA) around the globe. 
CCA is a rare and often overlooked cancer that forms in bile ducts, which are tubes that connect the gallbladder and liver to the small intestine.(i) These ducts carry bile, a fluid made in the liver that helps with digestion. 
Only about 8,000 people are diagnosed with CCA in the U.S. each year, although there may be more cases that go undiagnosed. Because of its non-specific symptoms – which may include abdominal pain, fatigue, and weight loss – CCA is difficult to diagnose and often happens at an advanced stage, when the prognosis is poor.(iii,iv)
Partnering with a healthcare team to determine individualized management plan 
It's important for those with CCA to have proactive conversations with their healthcare team about an individualized management approach and the best care plan based on their goals and needs.   
Jackie, a physician assistant in Houston, works alongside CCA patients and caregivers to ensure they have the latest resources and information available to help them understand their options and make informed decisions.   
"Cholangiocarcinoma is a very difficult diagnosis, but as a care team member, we are here every step of the way to help navigate treatment decisions and shape your journey," said Jackie.
Biomarker (short for "biological marker") testing allows healthcare providers to examine tissue from a patient's body to determine specific cancer biological molecules and further assess the exact type of cancer a patient has – which can open the door to more individualized disease management plans.(v)
"Early biomarker testing is a major advancement in helping to individualize cancer treatment. Each patient is different, so I advocate for all patients to get biomarker testing as soon as possible, so they know what their options are," stated Jackie.    
In addition to advocating for an individualized management approach, patients and caregivers should also find a healthcare team they feel comfortable with.  
"Every person has distinct goals for their health and cancer journey, making it critical to have proactive conversations with their care team from the start and throughout the entire process," added Jackie. "Having a close relationship with your care team is essential, as it gives you more confidence in their recommendations and allows you to better advocate for yourself." 
"I always encourage patients and caregivers to be proactive and speak up for themselves. For example, when you come across new research or treatment options, don't be afraid to share with your team." 
Embracing the CCA community as a resource  
When confronted with a health challenge, lack of information, or the need for additional support, the CCA patient community can be a valuable resource. Advocacy groups like the Cholangiocarcinoma Foundation (the CCF) leverage experiences and knowledge from the broader CCA community that can help patients and caregivers as they navigate their diagnosis.  
In 2009, Melinda Bachini, director of patient services at the CCF, was diagnosed with stage 4 cholangiocarcinoma after experiencing a series of symptoms that she attributed to her grueling job as a paramedic and suspected it could be gallstones.  
After a series of failed treatments, Melinda eventually came across an experimental clinical trial that was evaluating a new therapy for individuals with cancer that had spread throughout their body. It was this trial that kickstarted Melinda's recovery and saved her life. With this second chance, Melinda wanted to do more for the cancer community that had given her so much in her time of need.  
"A strong support system is essential to managing your diagnosis. It's important to realize that you're not alone in this journey and to utilize the cholangiocarcinoma community as a resource," said Melinda. "At the CCF, we realize how critical that sense of community is, so we support a variety of online support groups that allow patients and caregivers the ability to share personal experiences, resources and other tools to help manage this condition."  
In Jackie's profession, she recognizes the significance of being a positive resource for her patients. 
"While being diagnosed with CCA can be extremely overwhelming, it's important to encourage patients to stay positive and to remember that others are going through similar experiences," said Jackie. "The CCA community is incredibly tight-knit and inspiring, from the patients and caregivers to the advocates and researchers. Connecting with the community through support groups and social media can not only provide comfort, but also offer new learnings, and even friendships."  
While everyone's journey with CCA may be different, Melinda often reflects on how her cancer journey has impacted her outlook on life.  
"Every day is a gift, that's why when I was given a second chance, I decided to use my knowledge to support the cholangiocarcinoma community," said Melinda. "Through my team at CCF, we're able to advocate on behalf of patients as well as support research for potentially curative therapies that could help the thousands of individuals living with this disease. My hope is that the work we continue to progress at the CCF helps other patients, like myself, live long and fulfilling lives." 
For additional information and resources on CCA, visit TestMyCholangio.com and cholangiocarcinoma.org. 
The content presented in this article is not medical advice and should not replace a conversation with your Healthcare Professional, who is the best source of medical information about your individual diagnosis and management plan.  
### 
© 2023, Incyte. MAT-ONC-00196  02/23 
(i) "Cholangiocarcinoma: Definition." National Institutes of Health. https://ghr.nlm.nih.gov/condition/cholangiocarcinoma#definition. Accessed 1/12/23.
(ii) "Key Statistics for Bile Duct Cancer." American Cancer Society. https://www.cancer.org/cancer/bile-duct-cancer/about/key-statistics.html. Accessed 1/12/23.
(iii) Uhlig J, et al. Ann Surg Oncol. 2019;26:1993–2000.
(iv) Banales JM, et al. Nat Rev Gastroenterol Hepatol. 2016; 13:261-280.
(v) "How are biomarkers used to treat cancer?" The University of Texas MD Anderson Cancer Center. https://www.mdanderson.org/cancerwise/how-are-biomarkers-used-in-cancer-treatment.h00-159460056.html. Updated April 5, 2021. Accessed 1/13/23.


Finding Support and Information After a Rare Cancer Diagnosis

This content is sponsored by IncyteThroughout his childhood, Pedro – an attorney, husband, and father of two – suffered from various autoimmune-related conditions. Following a successful liver transplant in 2020, Pedro's hopes for a healthy future took an unexpected turn – he was diagnosed with cholangiocarcinoma (CCA), an aggressive and rare cancer formed in the bile duct. Within two years, Pedro's life was upended as the disease metastasized to his lungs and peritoneal area. The diagnosis left the family with many questions and led them on a journey from their home in Puerto Rico to Houston, Texas, as they fought for the answers, support and care they so desperately needed.
Many people living with rare cancers like CCA and their caregivers will understand this experience all too well, spending years making sense of unpredictable and nonspecific symptoms before receiving a diagnosis. But for Pedro and his wife Ángela, the resources and support found along the way were invaluable.
To honor the dedication of caregivers like Ángela during November – National Family Caregivers Month – the family shares their story, as well as raises awareness of the issues many families face when living with rare cancers.
What is cholangiocarcinoma?
CCA is a rare and often overlooked cancer that forms in the bile ducts, tubes that connect the gallbladder and liver to the small intestine. These ducts carry bile, a fluid made in the liver that helps with digestion.
This rare condition accounts for only 3% of all gastrointestinal cancers, appearing mostly in people over 60 years of age, and occurring slightly more often in men than women. Only about 8,000 people are diagnosed with CCA in the U.S. each year, although there may be more cases that go undiagnosed. Because of its non-specific symptoms – which may include abdominal pain, fatigue, and weight loss – receiving a CCA diagnosis can be difficult and often happens at an advanced stage, when the prognosis is poor. Most patients visit their doctor to address initial, non-specific symptoms, only to undergo extensive testing to eventually discover they may be living with CCA.
For both people living with CCA and their caregivers, this process of receiving a diagnosis and educating oneself about the disease can be extremely difficult. "There's a lot of work that we do for our loved ones living with this condition, there's also a lot of education that we need as caregivers," Ángela shares. "The emotional toll can be a lot for Pedro and our family, so it's my role to be present, to gather as much information as I can during medical appointments, then go back home and research and try to clarify the information we received. The education that caregivers carry with them is a way of surviving this process."  
Partnering with a healthcare team to determine an individualized management plan 
As part of this education, it's important for both those living with CCA and their caregivers to have proactive conversations with their care team to create the best management plan based on their individual goals and needs. Through diagnostic methods such as molecular profiling (also called "biomarker" testing), healthcare professionals (HCPs) are able to examine tissue from a patient's body to gain more information about their cancer. By understanding CCA at a molecular level, HCPs can better understand the condition, risk factors, morbidity factors, and characteristics found in the cancer cells. This information can help HCPs to build a tailored care plan. It's important to speak to the care team about biomarker testing early in one's diagnosis, as this information can help inform treatment options best suited for one's condition and current health.
Biomarker testing informed Pedro's management plan. For Pedro these results were ultimately what helped advance his care in Houston. "When my care team evaluated my biomarker results, they spotted right away five or six markers that were targetable. That changed my whole outlook because it provided us with hope and that something could be done," Pedro shares.
Ángela elaborates, "Biomarker testing was a total game changer for us. We felt hopeful. We felt like we had options, and now when we meet other patients with cholangiocarcinoma, the first thing we ask them is, 'Have you done biomarker testing?' Because we know what a difference that can make in the treatment plan."
Embracing the CCA community as a resource
When confronted with a lack of information and the need for additional support, Ángela and Pedro have turned to the CCA community as a valuable resource for their family. Patient advocacy groups like the Cholangiocarcinoma Foundation (CCF) leverage experiences and knowledge from the broader CCA community that can help patients and caregivers as they navigate their diagnosis.
"There are a lot of people going through the same situation, feeling totally isolated and alone in the process. So, it's important to tell our story and invite people to tell theirs, to find ways as a community to support patients and caregivers that are going through this situation," Ángela explains. "There are many ways to make this happen through the CCF – being part of their support groups, offering yourself as a resource for others who are facing this diagnosis for the first time, advocating within your community. It's important to let others know what you're facing and share how they can help."
Advice for Others in the CCA Community
Today, through the support of Ángela and the CCF, Pedro is able to spend his days with his family, enjoying their favorite hobbies together – reading books, watching TV and building toy structures. "It's important to know that cholangiocarcinoma does not need to be your entire life," he shares. "I've learned to deal with it by being present for my loved ones and finding time to do the activities I love with the people I love."
"It has been a huge learning curve and humbling experience to learn how to relax and trust the process. We don't know what's going to happen in two months, three months, so let's just deal with what's happening now," Ángela adds.
According to Pedro, "Ángela is my hero – she's the hero of our whole family. I let her know every chance that I get, that her role in this journey is vital, it's critical and I really appreciate it."
For more about Pedro and Ángela's story, visit  www.facebook.com/testmycholangio.
For additional information and resources on CCA, visit TestMyCholangio.com and cholangiocarcinoma.org.
The content presented in this article is not medical advice and should not replace a conversation with your Healthcare Professional, who is the best source of medical information about your individual diagnosis and management plan.
### 
© 2023, Incyte. MAT-ONC-00223 10/23


Celebrating the Power of Caregiving During National Family Caregivers Month

In December 2022, Jane's mother-in-law had a medical event that resulted in a hospital stay. A week later, she was discharged to a rehabilitation facility. All was going well, or so they thought. During the second week of her stay, the family was informed by the doctor that Mom would not be able to live on her own any longer. All that could be done at the rehab facility had been done. They were stunned by this news.  
Then, the discharge planner informed them Mom was scheduled to be discharged in three days. They needed to make and agree on a plan – and fast. It was a desperate, stressful time for their family. Jane experienced a definite before and after feeling. She equated this feeling with a few other times, like when you find out you're having a baby or you have cancer. Life-changing words. 
Family caregivers often hear life-changing words without any real support. If we are lucky, we may be given a few sheets of paper with lists of phone numbers and websites for various services that may or may not be needed. Jane was given very little guidance. During that time, she did not know what she did not know. It is in this moment family caregivers are born.  
Unfortunately, Jane's experience is not unique. Most of us, or someone we know, have been jolted by the news that a family member or friend now needs 24/7 care as a result of an accident or hospitalization.  
In this moment, we need to get as much information as possible regarding the health and required care of our family member or loved one. In this moment, when a caregiver is born, we need to ask ourselves some critical questions before initiating a plan of action.  
What are we willing to do? What are we able to do?  
Some people are not willing to be involved with wound care, injections or issues related to incontinence. Understandably, a son might not be comfortable assisting his mother with a shower. There are also things we are not able to do. We might be physically unable to transfer a larger person from a bed to the toilet. We may live too far away or have our own health challenges.
Who is going to support us? Are we the right person? Do we need to say no?  
Building a circle of care with family members, friends, church or club members and paid caregivers, with each providing their unique talents and abilities, prevents the burden of care from falling upon one person. We can't be afraid to ask for help; we have to start building that circle from the start. Maintaining support over the long run will impact our ability to continue to be a caregiver.  
Relationships create other implications. If we had a volatile or toxic relationship with the person needing care, becoming their caregiver is not suddenly going to fix the broken relationship. A wife who divorced her husband years ago might not be the right person to care for her ex-spouse. Broken families have unrealistic expectations if they decide an estranged relative should be the caregiver. The impact on other important relationships in our lives can also be a factor in our decision. It can hinge on something as simple as not being able to give up our job to provide 24/7 care without jeopardizing our own families. "No" is a valid response and might be the right answer.  
Do we know the resources available to us? Do we need a geriatric care manager?  
A discharge planner at the hospital or a hospital social worker can assist in identifying available resources. Contacting the health plan of the person needing care can also help identify available services. Finally, the Eldercare Locator (www.eldercare.acl.gov, 800-677-1116) can connect us to the area agency on aging that serves our community and can identify available community resources.  
We may want to get personalized assistance with setting up a plan of care. A private geriatric care manager is a professional, often a paid social worker or nurse, who can help create a plan of care. The impartial geriatric care manager can help navigate family dynamics and deliver uncomfortable news in a professional manner. They know of local resources, state and federal laws and key services such as elder law attorneys and financial/estate planners.  
Do we agree the discharge plan is safe?  
Sometimes, we do not agree with the discharge plan or feel it is safe. Caregivers have the right to appeal or ask for another review of the situation. Next Step in Care has an excellent guide to rehabilitation services at www.nextstepincare.org/uploads/File/Guides/Rehabilitation/Guide/Complete_Rehab.pdf 
The publication states, by law, the rehab program must let us know how to appeal and explain what will happen. They recommend we request contact information for the Beneficiary and Family-Centered Care Quality Improvement Organization (BFC-QIO) that reviews appeals in our area. An appeal may only take one or two days. It's important to know that if the appeal is denied, the patient is responsible for paying for the additional days and will have to leave the facility immediately. 
Have we considered palliative or hospice care?  
Palliative and hospice care are not the same thing, but both might be good alternatives to tailor the care to the needs of the person. Palliative care is specialized care for persons with serious illness – such as cancer or heart failure. Treatments for a cure are still an option, but the patient decides their health goals and how they wish to spend their energy — which may mean less aggressive medical treatments or hospital stays. Hospice means the person needing care is not going to be cured and probably has six months or less to live. Pain and symptom management, along with emotional support, are the goals. Palliative and hospice care can impact the care and support received, which impacts the caregiving situation.  
Caregivers are often born in that moment of a fall or accident, a diagnosis or a dramatic change in health status. We also can become caregivers over time — taking on more and more tasks to support the person needing care. It is worthwhile to pause and ask ourselves why we are willing to take on this challenge and meet this opportunity. If we move forward with this journey, we may need to pause along the way to see if the "why" is still valid and the "how" is still working. As a wise nonagenarian once said, "Now, things will be different."


The Place Where Family Caregivers Are Born

Carol Zernial

Jane Paccione

Boston resident Veronica Fernandez considers her dog CeeCee a member of the family. She adopted the little mixed-breed dog 10 years ago to help one of her young daughters cope with anxiety brought on by the Boston Marathon bombing. The playful dog delights in cuddles, toys and belly rubs. She sleeps in bed with Fernandez and her husband every night.
Veronica Fernandez and CeeCeeSo earlier this summer when CeeCee stopped eating and playing, Fernandez, 52, immediately brought her dog to a veterinary emergency room. Bloodwork revealed CeeCee's kidneys were in trouble. The little dog would need to be hospitalized at least one night — to the tune of $3,000, which Fernandez couldn't afford.
"What do you do? That's your family. That's like telling your kid, 'You can't go to the doctor,'" she recalled. "People are like, 'It's just a dog. It's just a cat.' But she's my baby."
"I'm getting teary eyed thinking back at it. She's very special to the family."
Fortunately, the hospital had a special fund for such cases provided by the nonprofit KodiakCare, which provides emergency funds to eight major nonprofit animal hospitals in the U.S.
After two nights, CeeCee pulled through and is now back to her cuddly, playful self. Fernandez is incredibly grateful to the team that saved her dog and the nonprofit that covered over $3,000 in medical bills.
"I'm getting teary eyed thinking back at it," she said. "She's very special to the family."
The economic turmoil of the past few years has left many families — like CeeCee's — struggling financially to give their pets the care they need, from veterinary treatments to pet food and other supplies. So animal hospitals, shelters, animal welfare organizations and other nonprofits are increasingly offering support to help keep pets with the families who love them.
Take KodiakCare. Retired Connecticut residents Glenn and Nancy Shapiro founded the nonprofit in 2020 in memory of their beloved dog, Kodiak, a Bernese mountain dog who let foster kittens crawl all over him.
The couple felt lucky to have enough money to pay for Kodiak's extensive veterinary bills over the years, and realized not everyone is so fortunate. Then they heard about a person crying in the lobby of an animal hospital because they couldn't afford surgery for their dog and were faced with euthanizing their pet – until a "Good Samaritan" who happened to be in the lobby stepped in and paid for the dog's treatment.
"Nancy and I were saying, 'What if we could virtually stand in the lobby and do that every time somebody was maybe having to lose their dog just because they don't make enough money?'" Glenn Shapiro, 57, said. "That made sense to us because we're huge animal lovers and we know how impactful they can be on people's lives."
By working with animal hospitals, their nonprofit has helped save 440 dogs.
The Benefits Pets Bring 
While they've had some pushback about helping animals instead of a people-based cause, the Shapiros feel strongly that helping pets helps people.
"All these benefits that show the positive influence of pets on healthy aging point to the importance of programs and policies that keep older adults and their pets together."
They're right. Scientific research demonstrates that pets are beneficial at all stages in life – especially as we age, according to Steven Feldman, president of the nonprofit Human Animal Bond Research Institute (HABRI) in Washington, D.C.
"Studies show that dog and cat ownership can provide important forms of social and emotional support for older adults that instill an important sense of meaning and purpose, reduce loneliness, improve cognitive function, maintain physical function and overall quality of life," he noted.
Feldman added that by serving as a soothing presence and a source of motivation for activity and routine, pets can also facilitate behaviors that improve cognition, enhance coping with pain and reduce depression. "All these benefits that show the positive influence of pets on healthy aging point to the importance of programs and policies that keep older adults and their pets together," he said.
Providing Compassionate Care 
"Compassion always" is the motto at the nonprofit Dumb Friends League, a Denver animal shelter founded in 1910. To help increase access to veterinary care for people who can't afford it, the nonprofit partnered with Colorado State University to open the Dumb Friends League Veterinary Hospital at CSU Spur in January of 2022.
Spur offers deeply discounted care for sick and injured dogs and cats, as well as low-cost spay/neuter, according to Jodi Buckman, CAWA (Certified Animal Welfare Administrator) and vice president of Community Services at the League.
A vet gives vaccines at the Dumb Friends League clinic in Colorado."We appreciate that it's been a really hard time for families through the pandemic and the economic impact of the increased cost of everything, including veterinary care," she said. "We're deeply committed to helping provide care for pets who otherwise wouldn't get care."
For the hospital to be sustainable, it depends on pet owners to pay what they can. But when families need an even deeper discount, the team has a "conversation" with them to see if they qualify for an additional "compassion plan."
There's no paperwork involved because the nonprofit doesn't want it to be a barrier to care, Buckman noted.
The League also offers discounted vaccine clinics — both where people can drive up with their pets, as well as hosted in subsidized senior housing facilities, and offers free rideshare transportation if clients need a ride to Spur for services.
Last year, the nonprofit served 24,000 pets between the hospital, spay/neuter program and vaccine clinics.
Some groups serve distinct demographics. That's the case with Georgia-based nonprofit Ahimsa House, which supports people with pets escaping domestic violence.
"The top barrier to care is financial." 
"Abusers use pets as a way to control victims and to keep them from leaving," said Executive Director Myra Rasnick. "No one wants to have to leave and make that choice between their safety and that of a pet."
Because less than 20% of domestic violence shelters can accommodate pets, Ahimsa House offers fostering and boarding for pets, and pays for vaccines, veterinary exams and any medical care pets need due to neglect or abuse.
The nonprofit also pays for rideshare trips from the home to the animal hospital and then a shelter or other temporary boarding, as well as pet deposits for clients moving into housing, and pet supplies like food, bowls, crates, leashes and collars.
Searching for Assistance 
Across the country, nonprofits are working to offer help with pet care. Support can also come from churches that host pet food banks, animal hospitals that offer "pay over time" options without a hard credit check, or temporary boarding for pets of active members of the military, or people who are hospitalized.
Daisy receives careIt can be overwhelming to know where to start looking, so early in 2023 – after two years of development – the nonprofit Open Door Veterinary Collective launched the free online tool Pet Help Finder. Anyone can enter their zip code to search for over 5,000 providers offering "financially friendly pet services" in North America, including veterinary care, pet food and supplies, transportation and crisis housing.
The site is available in English and Spanish and is designed to support people with disabilities.
Heather Cammisa, CAWA, chief enterprise officer at Open Door Veterinary Collective, which works to remove barriers to veterinary care, said there is "absolutely" a growing push among veterinary professionals, animal shelters and animal welfare organizations to help keep pets in their homes.
She developed the Pet Help Finder tool after conducting research with Meals on Wheels during the pandemic that found 96.6% of homebound clients with pets agreed that having pets in their life made them feel less lonely, and nearly 1 in 3 reported going without necessities for themselves such as paying bills to try to provide for their pets.
"The top barrier to care is financial," Cammisa said. "That's why it's so important for us all to work together with social services to tap everyone's expertise to bring together great, efficient programs that stretch scarce dollars and help as many people as possible."
For More Information 
To search for financially friendly pet services in your zip code (or to add one for free), visit: www.pethelpfinder.org
If you or someone you love is in danger, please contact the National Domestic Violence Hotline at 1-800-799-7233 or visit: TheHotline.org.


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