MODIFIED DIETS: Dysphagia Part 3 (Liquids)

Wednesday, November 26, 2025

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Image: IDDSI Flow Test Diagram; accessed 30 October 2025 from IDDSI.org

MODIFIED DIETS: DYSPHAGIA PART 3 (LIQUIDS)

By Flora Baker MS, EdM, RD, LDN and Gail K. Kachnycz RN, MSN 24 October 2025

     Dysphagia is the medical term for swallowing difficulties. The inability to swallow liquids correctly may allow fluids to seep into the air passages or lungs. This condition is known as aspiration. The presence of a foreign substance in the lungs can lead to infection and pneumonia. Modifying liquids, usually by thickening them, can promote complete and correct swallowing and reduce the risk of aspiration.

     Since 2019, the standard for the dysphagia diet is the International Dysphagia Diet Standardisation Initiative (IDDSI). There are five levels of liquid thickness, ranging from thin (water) to extremely thick (similar to the consistency of pureed solids). The medical provider may specify the particular level of liquids according to the IDDSI guidelines. The caregiver or client should clarify any questions with the medical provider. The IDDSI website has patient handouts which can be downloaded and instructional videos on how to prepare the liquid and check for appropriate thickness. From the Home Page, click “Resources” along the top of the screen. The drop-down menu includes “Patient Handouts” and “Videos.”

 Here is the link for IDDSI www.IDDSI.org 


     There are products on the market that will thicken thin liquids. A quick online search listed these: Thick-It, Clear DysphagiAide, ThickenUP Clear, and Purathick. These clear powders are unflavored and some can be used in both cold and hot liquids.


     Some people cannot cook for themselves. Stores like Target and Walmart have a selection of pureed meals. Clients and caregivers can check for agencies in their community that provide home delivered meals that accommodate special diets. One such agency is Meals on Wheels.

https://www.mealsonwheelsamerica.org/find-meals-and-services/

Philadelphia Corporation on Aging may help with locating agencies that provide meals.

www.pcacares.org



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MODIFIED DIETS: Dysphagia Part 2 (Solids)

Wednesday, November 19, 2025

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Image: IDDSI Framework Chart, accessed from IDDSI.org 29 October 2025

MODIFIED DIETS: DYSPHAGIA PART 2 (SOLIDS)

By Flora Baker MS, EdM, RD, LDN and Gail K. Kachnycz RN, MSN 24 October 2025

     The goal of making modifications to the diet is to allow a person to safely consume and enjoy their food. If a person is having difficulty swallowing, small amounts of solid foods or liquids may be inhaled into the airways or lungs, a condition known as aspiration. If solid foods are not chewed sufficiently or swallowed completely, there is a risk of choking.

     This post targets general modifications for solid foods. The goal is to eliminate lumps and create a texture that is smooth and pudding-like. Some foods naturally have this consistency, or are easily prepared without special equipment. Examples are:

-Scrambled eggs

-Dairy products like cottage cheese (small curd), yogurt, custard, pudding

-Soft fruits such as mashed bananas, apple sauce, mashed avocado

-Cooked cereals such as oatmeal, grits, Cream of Wheat. Milk (dairy or oat/almond milk) can be added to create desired consistency.

     Some foods may require use of a blender or food processor to soften them. The University of Virginia School of Medicine recommends the following:

-Blended cooked protein (meat, fish, poultry, tofu, nut butters)

-Pureed beans, hummus

-Blended bananas, peaches, pears

-Blended cooked vegetables such as potatoes (white or sweet), peas, carrots, cauliflower, squash (acorn, butternut, spaghetti squash)

Adding sauces, broth, milk or gravy may enhance the flavor as well as help create a smooth, soft texture.

     What are some foods to avoid? In general, foods that are hard, dry, stringy, sticky or chunky. Examples include:

-Vegetables or fruits that have seeds, tough skins, or stringy fibers such as raw celery or mangoes.

-Dried fruit of any kind such as raisins, cranberries, dried apples

-Dried meat such as jerky.

-Fried foods, such as fish or chicken.

-Dry foods such as popcorn, nuts, hard cheeses

-Some bread products, even soft breads, may form a sticky chunk when exposed to saliva

     Since 2019, the standard for the dysphagia diet is the International Dysphagia Diet Standardisation Initiative (IDDSI). There are seven levels of food and liquids, ranging from a regular diet with all textures to liquids as thin as water. The medical provider may specify the particular level of texture for solids or liquids according to the IDDSI guidelines. The IDDSI website identifies and describes the textures and thickness for each level. Instructional videos are also available. These are helpful but the caregiver should clarify any questions with the medical provider.

Here is the link for IDDSI www.IDDSI.org 

From the Home Page, click “Resources” along the top of the screen. The drop-down menu includes “Patient Handouts” which give details of each level in the diet, and foods to avoid. “Videos” show exactly how to prepare and check if the food is the correct consistency.

 


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MODIFIED DIETS: Dysphagia (Swallowing Difficulties) Part 1

Wednesday, November 12, 2025

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Image: Flora Baker 2 April 2023

     This month we welcome a guest blogger. Flora Baker is a Registered Dietician, and a good friend. I asked her to lend her expertise as a resource to A Map Through The Valley blog readers. Our first subject addresses swallowing difficulties, which may become a problem in various types of chronic illness. The topic is divided into three parts. Today is general information about dysphagia. Part 2 addresses solid foods, and Part 3 reviews liquids and community resources. Thank you, Flora!

MODIFIED DIETS: DYSPHAGIA (SWALLOWING DIFFICULTIES) PART 1

By Flora Baker MS, EdM, RD, LDN and Gail K. Kachnycz RN, MSN 24 October 2025


     Nutrition is key to improving health. Mealtimes also provide opportunities for social interaction. Eating healthy foods is so important during chronic illness. However, the progressive nature of some chronic illnesses, or treatment interventions may make eating difficult. Early signs of swallowing difficulties include choking or pain when consuming solids and/or liquids. The medical term for this condition is dysphagia.

      Some causes of dysphagia are due to changes in the mouth or upper part of the digestive tract, such as:

-Missing or decayed teeth

-Oral surgery or ill-fitting dentures

-Injury to the lips or other parts of the mouth

-Cancer of the mouth, esophagus, stomach

-Ulcer of the stomach

Other medical conditions can contribute to dysphagia, including:

-Head or neck injury

-Treatment or chemotherapy for any type of cancer

-Stroke or other injury to the brain

-Degenerative conditions such as dementia, Alzheimer’s disease, Parkinson’s disease

-Inactivity or bedrest weakens all muscles, including the muscles that aid swallowing

     If your loved one has any of these conditions, chewing effectively or swallowing completely and safely may become an issue. Be sure to discuss this with the medical provider, especially if noticing signs such as food residual remaining in the mouth, drooling, a clear runny nose that occurs when eating, or choking/coughing when trying to swallow solids or liquids. The loved one may leave meals unfinished because chewing and swallowing solids may be tiring. 

     The medical provider may recommend a modified diet based on your loved one’s current condition, but changes may be needed over time. In 2019 the International Dysphagia Diet Standardisation Initiative (IDDSI) was introduced globally. The instructions for specific needs may be based on this protocol. Be sure to clarify any questions with the medical provider.  The levels of modification are identified on the IDDSI website and can be used as a reference. 


Here is the link for IDDSI www.IDDSI.org 

From the Home Page, click “Resources” along the top of the screen. The drop-down menu includes “Patient Handouts” which give details of each level in the diet, and foods to avoid. “Videos” show exactly how to prepare and check if the food is the correct consistency.

 

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RECIPE: PUMPKIN SWEETZEL CHEESECAKE

Wednesday, November 5, 2025

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Image: Spice Wafers and Cheesecake 11/22/2024 by Gail K. Kachnycz

RECIPE: PUMPKIN SWEETZEL CHEESECAKE by Gail K. Kachnycz 5 November 2025

     I am not a fan of pumpkin pie, so I went looking for an alternative and found this cheesecake recipe by Sam Merritt. Her recipe has a graham cracker crust, but using spice wafers, with their blend of warm autumn spices, is the perfect compliment. Most of my recipes for caregivers are simple and healthy. This is neither, but it is worth every minute and every calorie as a special treat for Thanksgiving or Christmas.

     NOTE: Spiced Wafers are a treat that is local to the Delaware Valley. We emphasize that they are NOT Ginger Snaps. However, if you live in an area where Spiced Wafers (Sweetzel or Ivan's) are not available, Ginger Snaps may be substituted.

For the original recipes by Sam Merritt, use these links:

Pumpkin Cheesecake by Sam Merritt Graham Cracker Crust by Sam Merritt

Gail Kachnycz put a “Sweetzel Spin” on the recipe (22 November 2024) Make 1 Day Ahead

My recipe is based on her recipe, but modified to use the Sweetzels Spiced Wafers for the crust.

SPECIAL EQUIPMENT: Food processor to make the crumbs. Spring-form pan (9-10 inch), sheet pan with rim to bake on, parchment paper. Microwave. Pyrex or microwave safe container to melt the butter. Stand mixer is best for mixing the batter, it is thick. Hand mixer can be used.

CRUST: original recipe calls for granulated sugar and brown sugar, but I don’t use these since the Sweetzels are already sweetened cookies.

CHEESECAKE: original recipe calls for softened cream cheese and eggs at room temperature. I assemble all the ingredients so they can warm up while I am making the crust.

INGREDIENTS

Crust: 1 sleeve of Spiced Wafers. 7 tablespoons melted butter.

Cheesecake: (whipped cream at serving time; Gail uses canned)

24 oz cream cheese (brick style, not spreadable) 3 eight oz bricks, warmed to room temperature

3/4 cup brown sugar packed

1/2 cup granulated sugar

1/3 cup sour cream

1 ½ teaspoon vanilla extract

1 cup pumpkin puree (check the label, do not buy pumpkin pie filling)

2 ½ teaspoons pumpkin pie spice

3 large eggs lightly beaten, room temperature preferred

INSTRUCTIONS:

1. Plan to make this one day in advance; the dessert needs to chill at least seven hours.

2. Set out all the ingredients so the cream cheese and eggs can warm.

CRUST:

1. Assemble the spring form pan: the circular bottom has a rim, the rim should face DOWN, so the flat edge of the pan allows the serving implement to slide easily under the crust to remove a slice. Cut parchment paper to fit the bottom of the pan, and a panel to cover the inside of the spring-form. Can also try cooking spray to prevent sticking.

2. Seven tablespoons of butter is 1 stick minus 1 tablespoon. Put the seven tablespoons in the Pyrex measuring cup and microwave to melt.

3. Slightly soften half a sleeve of Spiced Wafers by spreading them on a plate, cover with moist paper towel, and microwave on high for 10 seconds. Break each cookie to fit through the chute of the food processor. Pulse until small crumbs form. Remove any larger pieces to re-process with the next batch. Put first batch in a medium mixing bowl. Repeat with the second half of the sleeve. (Any large pieces left in the second batch can be eaten!)

4. Pour the melted butter into the Spiced Wafer crumbs, use a fork to combine until all of the crumbs are moistened.

5. Transfer the mixture into the pie plate or spring-form pan. Use the clean bottom of a measuring cup to firmly pack crumbs into the bottom of the pan. If using a pie pan, use your fingers to pack crumbs tightly into the sides of the pie pan. Refrigerate while making the filling.

CHEESECAKE:

1. Pre-heat oven to 350 degrees F (will bake at least 40 minutes) Line a sheet pan with parchment paper. Gail’s note: The butter from the crust will leak out of the seam where the bottom & side of the spring-form meet. The pan will collect the butter. Do not use aluminum foil, as this slows the heating process and will affect proper baking of the filling.

2. In the stand mixer (or large bowl & hand mixer) beat together softened cream cheese and sugars, scraping down the sides with a spatula occasionally to ensure ingredients are mixed well. Beat on medium-speed about 1-2 minutes, scraping down side occasionally.

3. Add sour cream and stir well, pausing once to scrape down the sides and bottom of the bowl.

4. Add vanilla extract, pumpkin puree, and pumpkin spice and stir until well combined.

5. Break eggs & beat them slightly (Gail uses the Pyrex cup that had the melted butter, so all the egg contents slide out). Add in three portions, beating until just mixed after each addition (and scraping down the sides after each addition).

6. Place the pan with crust on the sheet pan. Spread the cheesecake batter evenly over prepared crust.

7. Transfer to oven and bake on 350 F for 40 minutes or until center of cheesecake is set and bounces back to the touch.

8. Allow pumpkin cheesecake to cool to room temperature and then transfer to refrigerator and chill for 6 hours or overnight.

9. Serving: Release the spring-form. Should be able to insert wide spatula, perhaps 2, under the parchment paper & slide to serving platter. Remove parchment from the sides. Makes 12 slices.

Top with whipped cream (Gail uses canned) just before serving.

Serving: 1 cheesecake yields 12 slices. 520 kcal per slice (original recipe with graham cracker)

Storing: Use an airtight container; can store in refrigerator up to 5 days. Pumpkin cheesecake may also be frozen for several months.

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NPR: A Caregiver's Survival Guide

Wednesday, October 29, 2025

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NPR: A Caregiver's Survival Guide

Accessed 21 October 2025 by Gail K. Kachnycz

     My good friend Donna was introduced to you for Mother's Day 2024. Here is the link:

Mothers Day: Don't Compare

     Donna shared this article with me. "NPR: A caregiver's survival guide: Advice from people who've been there," by Kat McGowan and Connie Hanzhang Jin. It was published October 18, 2025 on NPR. Using the crowd-sourcing ability of public media, these authors compiled information for caregivers divided into several categories: (1) The medical maze: How to help your person through it (2) The new normal: This isn't the life I planned. How do I adjust? (3) Help! How to ask for (and accept) support (4) Self-care: It's essential and it's not what you think (5) Your new relationship: Dealing with a changing dynamic (6) Explore more resources. Each section has the option "Can't see this visual? Click here." By clicking, you will be able to access the details of that particular section.  Although not from a Christian perspective, the information is helpful to anyone in a caregiver role. Here is the link:

NPR A Caregiver's Survival Guide

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SELF CARE: NEW START

Wednesday, October 22, 2025

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Image: Harvest Moon Rises Above Ocean by Gail K. Kachnycz 7 October 2025

SELF CARE: NEW START by Gail K. Kachnycz on 22 October 2025

     You may have noticed there was no new post published last week on A Map Through The Valley. I was taking some time off for self-care, so important for caregivers. I spent two weeks in Ocean City New Jersey with my Elephant Sisters and other friends. If you are not familiar with the term Elephant Sisters, this post explains it:

Elephant Sisters 


     While we were in Ocean City, the full moon, called the Harvest Moon, was due. The name Harvest Moon connotes the timing during the fall, when most crops were harvested. The full moon at that time of year provided extra light to complete the task of harvesting the field. The moon's orbit around the earth is not symmetrical or circular, but rather oval shaped. This harvest moon occurred at the point when the moon is closest to the earth (perigee). After checking for the time and location of moonrise, several of us walked out to the boardwalk and searched the eastern horizon. It seemed like forever, but sure enough, a golden pink edge appeared over the ocean. 


     A cloud bank was hugging the ocean, so for a brief period part of the moon's appearance was obscured. But as the moon continued to ascend, the complete orb was visible.


     The parable here is that God is often closer than we think. But, if we know what signs to look for, we will see His presence in our lives. Even if circumstances obscure our vision, if we continue to look to the Lord and trust Him, He is faithful.

"The heavens declare the glory of God; the skies proclaim the work of His hands." Psalm 19:1

     As noted in the post September 24, this blog has been active for two years now.

Bloggy-versary Two!

 The Lord has provided me the unique opportunity in the next 4-5 months to devote more time to content and expansion of A Map Through The Valley. Please join me in praying for guidance from the Lord with this project. Thank you again to all the subscribers and readers.

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MEDICARE OPEN ENROLLMENT

Wednesday, October 8, 2025

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Image: pexelsleeloothefirst accessed 13 September 2025

MEDICARE OPEN ENROLLMENT  by Gail K. Kachnycz 

     Open Enrollment for Medicare begins October 15, 2025 and ends December 7, 2025. There are quite a few options, and health insurance "Advantage Plans" will be flooding the TV with ads. Of course, they will try to convince you that their plan is the best for you. However, unbiased information and assistance is available through PA MEDI. An appointment is needed, so make contact early to arrange a time to see a counselor.  PA MEDI was introduced on A Map Through the Valley last October, so here is the link to that post which includes more information and the phone number to call.

Post: PA MEDI Explains Plans 

Here is a link to the Medicare website that lists information about Open Enrollment. I find government websites can be "Too Much Information" but it is the official website so no bias to promote an Advantage Plan

Medicare Website: Joining a Plan


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RECIPE: SPAGHETTI SQUASH

Wednesday, October 1, 2025

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Image: Roasted Spaghetti Squash by Gail K. Kachnycz

RECIPE: ROASTED SPAGHETTI SQUASH

     Fall is the time for squash. I like spaghetti squash because it is a veggie alternative to pasta, lower in calories, and gluten free (if that is a concern). The easiest way to cook it to free up the strands inside is to roast it, cut side down. Remember the "4's" that is, 400 degrees F for 40 minutes. I consulted an online cooking site, delish.com, for the particulars. For example, the safest way to cut through the rind, how to season it, and how to check that the squash is cooked but not overdone. Here's the link:

dlish.com cooking spaghetti squash

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Bloggy-versary Two!

Wednesday, September 24, 2025

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Image: Gail and Mike in Cape May, NJ on 23 June 2025

BLOGGY-VERSARY TWO!

     Who-da thunk it? The end of September marks the second year of this blog. It has been a challenge and learning experience for me, and very enjoyable. Thank you to all the readers and subscribers for taking the time to read the posts, comment, and share your insights and resource connections. 

     It is also a personal landmark for Mike and me. We are pictured above on June 23 in Cape May, NJ, where we attended the matinee performance of "Vanities." Our daughter-in-law was one of the three performers in the show. It was also our 35 th wedding anniversary. In 2018, when Mike was admitted to hospice, we didn't think we would celebrate 35 years together. But God had other plans!

"For I know the plans I have for you," declares the Lord, "plans to prosper you and not to harm you, plans to give you a hope and a future." Jeremiah 29:11 NIV

     We are thankful to God for His graciousness to us, and thankful for you as you have joined us in our journey. Happy Bloggy-versary!

                                 Mike & Gail June 23, 1990; God is faithful through all 35 years


 

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Highlight: Dementia Friends PA

Wednesday, September 17, 2025

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Logo: Dementia Friends Pennsylvania accessed 9 September 2025

Highlight: Dementia Friends PA by Gail K. Kachnycz 

     September is World Alzheimer's Month.  I recently learned about a community resource on the "Morning Light" show on Lighthouse TV. Dementia Friends Pennsylvania is part of a global movement that was started in the United Kingdom. Here is the introduction from the website:

"To become a Dementia Friend, you join others in a one-hour Dementia Friends Information Session. The session will cover five key messages about dementia and touch on what it is like to live with dementia. As a Dementia Friend you will turn your understanding into a practical action that can help someone with dementia in your community. The action can be as big or small as you choose, because every action counts!"

Here is the link to Dementia Friends Pennsylvania:

Dementia Friends Pennsylvania

Here is the link to Lighthouse TV. The Morning Light show has featured resources for caregivers.

Lighthouse TV

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SEPTEMBER SPOTLIGHT

Wednesday, September 10, 2025

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Cancer Color Ribbons

SEPTEMBER SPOTLIGHT by Gail K. Kachnycz on 10 September 2025

     September is a busy month: the new school year begins and people return from vacation to settle into the fall routine. September is also a time to draw attention to some health concerns.

     September is Suicide Prevention Month; September 10 is Suicide Prevention Day. Those experiencing a mental health crisis, or concerned family or friends can call the Suicide & Crisis Lifeline by dialing 988. More information about this resource was published on the blog last September. Here is the link:

 Suicide & Crisis Lifeline Information

     September is also Awareness Month for several types of cancer. These are identified by the American Association for Cancer Research (AACR). They are listed here with their ribbon colors:

Childhood Cancer (gold), Leukemia & Lymphoma (orange), Ovarian (teal), Prostate (light blue), Thyroid (teal/pink/blue), Gynecologic (uterine, peach).

The mission of AACR is listed below. To learn more, here is a link:

aacr.org

The mission of the American Association for Cancer Research is to prevent and cure cancer through:

  • Research
  • Education
  • Communication
  • Collaboration
  • Science Policy and Advocacy
  • Funding for Cancer Research


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RECIPE: New Life for Condiments

Wednesday, September 3, 2025

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Image: Condiments from Gail's fridge 8/14/25

RECIPE: New Life for Condiments by Gail K. Kachnycz 3 September 2025

     So, the last summer holiday is over. What to do with those half-used bottles of condiments? As you know, mayonnaise can be substituted for eggs and oil some baked goods. Here are the links to posts that include that information:

Egg Substitutes March 2025 

Banana Baked Oatmeal 2/21/24 

     However, there is a way to use mayonnaise, ketchup, and pickle relish that is genius, in my opinion. Make Thousand Island Dressing! As a kid, I thought the bits of pickle were the "thousand islands," but apparently, this dressing was invented for vacationers in the Thousand Island region on the St. Lawrence River near Lake Ontario. Either connection works for me. Just mix the ketchup and pickle relish into the mayonnaise, and thin down with lemon juice to the consistency of your liking. Sorry, no measured amounts here, just eye-ball it and adjust "to taste." If you're not a fan of pickle relish, just leave it out and you have Russian Dressing. Enjoy! 

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Supports for Grieving Part 2: Children

Wednesday, August 27, 2025

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Image: Helen and Joshua, Christmas Eve 1998

Supports for Grieving Part 2: Children by Gail K. Kachnycz on 27 August 2025

     In the post earlier this month, I shared a composition by my son Joshua. My mother lived with us from the time he was a toddler until he was starting third grade. A retired kindergarten teacher and lover of books, she taught Joshua to read the summer between kindergarten and first grade using phonics. He has been a wordsmith ever since then, and currently makes an income recording audible versions of books. However, since she had been a part of his life on a daily basis, her death was that much more difficult. I, of course, was also dealing with the loss of my mother and I don't know that I had enough emotional strength to help him as well. Today's post shares resources for helping children through their grieving. First, Joshua has given me permission to share this essay he wrote in 6 th grade, three years after her death.

GRANDMA GONE by Joshua Kachnycz November 2002

     One Thursday in third grade was a particularly wonderful day. I did not have a lot of homework, I had handed in all of my work for the day, and I was looking forward to getting home.

     [At dismissal time] I looked around to try to see my mom, but instead saw my dad sitting on the steps to the upper yard. As I approached him, I could see a few tears in his eyes and I asked him what was wrong. He said that he would tell me after we walked to the van. So we walked to the van, I opened the door, and tossed my backpack in the middle seat. I jumped into the van and my dad stood by the door.

     "Grandma...Grandma was in a car accident and she is in the hospital now," my dad said. At hearing that I broke into tears. I cried rivers, no lakes, no oceans of tears for probably the next half-hour. When I finally stopped I felt like I had a coconut lodged in my throat. My eyes were red and I couldn't see very well because of all the tears. After that we drove home.

     When my dad and I arrived home we found out from my mom that grandma had a broken arm, broken ribs, and a damaged lung. My grandma was on a machine that helped her breathe in the hospital for two months.

     On December 7, 1999 the doctors had to pull the plug for my grandmother's machine. Once I found out that my grandmother was gone it felt like my entire world was crumbling around me, like I had a hole in me the size of a tractor. However, not everything was as bad as it seemed. That summer I went to a family reunion in Illinois and moved to Wyndmoor where I made a lot of new friends.

RESOURCES:

In the Philadelphia area: Uplift Center for Grieving Children

Mr. Rogers, an ordained Presbyterian minister, and known for his role in the program "Mr. Rogers' Neighborhood," has said, "I've come to believe that anything human is mentionable, and anything mentionable can be manageable." I'm listing several programs and a book by him.

These materials can be obtained from 

Family Communications, Inc. 4802 Fifth Avenue, Pittsburgh, PA 15213 (412-687-2990)

Booklet and video program: Talking With Young Children About Death by Fred Rogers

Book: When a Pet Dies by Fred Rogers, Program: "Death of a Goldfish" Mr. Rogers Neighborhood

Mr. Rogers speaks on children's grief 


 


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Emergency Preparation: BHG Article

Wednesday, August 20, 2025

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Emergency Preparation: BHG Article

     As this post is being published, the Jersey shore is being pounded with high surf generated by Hurricane Erin. Because Hurricane Season reaches its peak in September, revisiting preparing for emergencies is a good idea. In home care and at school, the nurse always had a "Go Bag" packed with essentials that was ready to take should the client need to evacuate quickly. The bag should be checked on a regular basis, say, on "the 15 th of the month" or, "the second Saturday of the month." Set a reminder on your phone and make it a routine. Here is an article from Better Homes & Gardens on preparing for emergencies.

12 Critical Supplies

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SANDWICH GENERATION

Thursday, August 14, 2025

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Image: Family Christmas Eve 1998

SANDWICH GENERATION by Gail K. Kachnycz on 14 August 2025

     Quite often, someone caring for an elderly parent also has children in the home. Being responsible for the care of both the old and the young can include difficulties, and those in the middle can feel sandwiched, or pressed, in more ways than one. For support and resources, please see these previous posts:

Introducing...A Boomer Hero 

How to Care for Aging Parents 

     Along with the responsibilities and concerns, there are advantages and benefits. Depending on their level of function, the grandparents and grandchildren can enjoy time together and "have an impact." My mother lived with us when my son Joshua was age two to eight years. He has given me permission to share this essay which he wrote in 6 th grade at age 11. Of course I am biased, but I think he was quite articulate. Helen was not his great-grandmother, but she was "great."

GREAT GRANDMOTHER by Joshua Kachnycz, November 2002

     My grandmother was always someone I looked up to, someone who was always there for me-up until December 7, 1999, but that is an entirely different story.

     My grandmother, Helen Kimbleton, has made a very large impact on my life. Here are some examples of ways that my grandmother has impacted me.

     When I was four and five I loved to have her read to me. This gave me my great adoration for reading, which I do every day. Every Thursday during the summer my grandma and I would go to the library and the playground across the street from it.

     The playground was typical with monkey bars, slides, poles, and basketball hoops. I would play there for hours upon hours in that playground. But there was one feature that most other playgrounds did not have that I loved the best. It was a baseball field where I could practice my swing. My grandmother and I might play catch or she would pitch to me and I would swing. This inspired me to spend most of my free time outside.

     My grandmother and I sometimes went on walks and planted some trees. She taught me how to take care of plants and gave me a baby tree which I named "Woody." He is still planted in the backyard of my old house. This motivated me to care more about nature.

     All of these things that my grandmother inspired me to do are things that I still do to this day so that her memory will live on in my heart.

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Cancer Overlap with Chronic Illness

Thursday, August 7, 2025

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Image: Cancer Color Ribbons accessed 7 August 2025

CANCER OVERLAP WITH CHRONIC ILLNESS by Gail K. Kachnycz 7 August 2025

     Thankfully, today a diagnosis of cancer is not always a death sentence. There are many people who are cancer survivors or in remission. However, the treatment may take months or years. While more targeted than in years past, the surgeries, chemotherapy, radiation, and other therapies affect the person in other ways than just eliminating the tumor cells. Cancer treatment has many of the characteristics of chronic illness.

     Fortunately, the network of support for those fighting cancer is strong. Today's post highlights the ribbons/colors for cancer awareness. Certain months of the year are also devoted to increasing knowledge and funding for research for various cancers. During the awareness campaigns, there is often an emphasis on prevention. With new studies, the recommendations for initiating screenings have changed. For example, the age to start screening for colon cancer is now 45 instead of 50. Women of average risk for breast cancer should begin mammograms at age 40.

     Prevention also includes avoiding toxic substances. Recently, several food companies have announced that synthetic food dyes will be phased out in US products, with complete removal targeted for the end of 2027. These dyes may not be linked specifically with cancer, but removing them improves the safety of our foods. You can evaluate ingredients in food & cosmetics using an App called "Yuka." The App can scan products and show what additives are in them. Here is a link to demonstrate the App.

Yuka App

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PECO Medical Certification Waiver

Friday, August 1, 2025

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Image: Logo for PECO Electric Company

PECO Medical Certification Waiver, or DON'T LET THIS HAPPEN TO YOU!

by Gail K. Kachnycz on August 1, 2025

     This past Saturday, during the fourth hottest July on record in Philadelphia, I opened a letter from PECO that said: TEN DAY SHUT OFF NOTICE. Of course, the first thing I did was panic, and there followed a series of unfortunate events which were extremely frustrating. Long story short, our electric service has continued uninterrupted, and we are enjoying air conditioned cool in our house, but I would like to spare you a similar scenario by sharing my experience.

     The initial pebble in the pond that began this downward spiral was a breech in our bank account in early May. Thousands of dollars were transferred out of our account. The bank froze all of our accounts for three weeks while a fraud investigation took place. Thankfully, all funds were restored. A friend at church who works in finance told me, "That doesn't always happen. God had your back!" Indeed. We thank God for His favor and grace to us in this situation. After three weeks, the bank advised us to open new accounts. We transferred all funds to the new accounts. However, our Social Security was still being deposited into the old checking account, so we still had to maintain that account until arrangements could be made to change the deposits (this takes about 2 months).

     We had bank cards for the new accounts within 24 hours. I began making calls to all the services and utilities to catch up on payments that came due while our accounts were frozen. The general number for PECO was answered by "AI Lady," that is, an automated menu. I selected "Billing" and paid using the new bank card. The automated menu offered the option: "Save this card for future payments?" I said "Yes." So, when a statement from PECO came that noted, "Automatic Payment Deducted on 7/17/2025" I thought the new bank card was used. Therefore, it was a shock when the shut-off letter arrived July 26. Apparently, PECO kept trying to take payments from the "old" checking account which was frozen.

      The shut-off letter included a statement that electricity would not be shut off if "you or anyone presently and normally living in your home is seriously ill," but certain requirements had to be fulfilled for this type of waiver. The letter listed steps to take, such as having the doctor call and then send a letter. My friend Donna works in a Cardiology practice, and told me an easier way to do this:

1. Have these ready: the PECO account information, the patient's  information, and the name of the practice, the doctor's name, and fax number

2. Pack your patience. I was on hold for 45 minutes. Fold laundry or do something you can drop as soon as the service rep answers. The business hours are Monday-Friday, 7 AM-7 PM, but recorded message says there is high volume of calls Mondays and 11 AM-2 PM Tuesday to Friday, so long waits then.

3. Call 1-888-480-1533. This connects you directly to the Credit Department, who handles the waivers. This is not the general PECO number.

4. State that you need a "Medical Certification Form" to be faxed to the doctor's office. 

5. They may ask for the patient's name and address. Also give them the doctor's name and fax number. Ask for the PECO fax number in case the doctor's office does not have it on file.

6. Check if there is a confirmation number for your request/conversation.

7. Contact the doctor's office to alert them that the PECO Medical Certification form is being faxed from PECO.

     The Medical Certification gives a window of 30 days. During that time, the electricity will not be shut off. Meanwhile, the reason for the shut-off can be addressed. 

     Finally, I hope your bank account is never hacked. If you do have to stop your automatic payments, don't trust "AI Lady." Be sure to speak with a real person. Stop the deductions from the old account, and then ask about the process to start automatic payments using your new account.

Trying to stop automatic payments

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Re-Post: Christmas in July

Wednesday, July 23, 2025

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RE-POST: CHRISTMAS IN JULY by Gail K. Kachnycz

     Now that we are in the midst of the renovation project, re-posting this idea for de-stressing the holidays is just the ticket. Here is the link:

Christmas in July; Plan Ahead

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Resource: Supports for Grieving Part 1

Thursday, July 17, 2025

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Image: Summer Sky 5/28/2024 by Gail K. Kachnycz

RESOURCE: Supports for Grieving Part 1 by Gail K. Kachnycz 17 July 2025

     Sometimes our role as caregiver ends because the journey of our loved one on earth has ended. Although it is a comfort to know they are "absent from the body and ...present with the Lord" (2 Corinthians 5:8), we miss them and grieve the loss. A daily routine devoted to support and caregiving no longer provides structure to the day, which can intensify loneliness. Grief is different for each person, and can be unpredictable. Today I am posting resources that have been shared with me, either personally or professionally. Some are not specifically Christian, but their aim is to provide support. In two weeks I will share Part 2, listing resources specifically designed for children experiencing loss.

Image: The Verse of the Day 14 July 2025

SUPPORT GROUPS:

Grief Share Not specifically Christian, but provides supports both online and in person

Boomers R Heroes Support groups online and in person for grief, general caregivers, and Alzheimer's

BOOKS:

90 Minutes in Heaven by Don Piper with Cecil Murphey Blog Post Book Review

Glimpses of Heaven; Reflections on Your Eternal Hope by Dave & Jan Dravecky with Amanda Sorenson 

When God Doesn't Make Sense by Dr. James Dobson Blog Post: Deeper Questions 6/4//25





 

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RECIPE: New Life for Left-Overs

Thursday, July 10, 2025

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Image: Condiments by Gail K. Kachnycz 10 July 2025

RECIPE: NEW LIFE FOR LEFT-OVERS by Gail K. Kachnycz 10 July 2025

     In anticipation of relocating while internal repairs are made to the house, I am trying to empty out the fridge and freezer. As you can see from the image for this post, Mike buys in bulk: half gallons of Barbecue Sauce, cases of canned corn and baked beans. There is another full case of beans not even pictured here. My mother grew up during the Depression, so tossing food was unthinkable. I try to find some ways to use things up, but it makes for some interesting combinations. One of my "go-to" recipes is chili made in a slow cooker. It is different every time, depending on what needs to be used up. For example, burgers were sent home from the family July 4 gathering. I cut them up and cooked them in a can of Manwich. That will be the meat for the chili. Left over salsa dip? In it goes. BBQ sauce? About 1/4 cup will add a sweet compliment to the heat of the salsa. I usually use red kidney beans, black beans, and garbanzos (chick peas) for visual variety, but this time around the regular baked beans will go in. I always add a can of corn for eye appeal and sweetness. The last batch I made used up a jar of Bruschetta, adding extra tomatoes to the mix. Here is a very general list of ingredients, check your fridge for other options!

Chili from Left-Overs by Gail K. Kachnycz 10 July 2025

Use slow-cooker on low for 6 hours. Everything is already cooked, just needs to "meld."

MEAT:

1 Can of prepared chili, or cut-up burgers with Manwich, or cooked freezer burnt sausages or meat (the seasonings will overcome the lack of flavor from freezer burn)

VEGGIES:

1 Can each (rinsed) of red kidney beans, black beans, chick peas, corn. Substitute other beans on hand. The baked beans will go in "as is" with their sauce, not rinsed. 

Bell pepper, sauteed. Onions, sauteed. 15 oz can of crushed or diced tomatoes, pasta sauce, etc.

SEASONINGS (adjust to your taste):

1 Tablespoon chili powder or Taco seasoning, 1 teaspoon Cumin, Salsa 1/2 jar, 1/4 cup BBQ Sauce

If you desire: salt, pepper, Hot Sauce 

No corn chips to accompany? I use Corn Chex cereal as a topper. They add  a satisfying crunch.

Future posts will show how to use up ketchup, mustard, mayo and pickle relish.

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Today's Plan

Thursday, July 3, 2025

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Image: Source not known. A good friend sent this image to me this morning.

TODAY'S PLAN by Gail K. Kachnycz on 3 July 2025

     We are now two months into the house project. Exterior repairs are nearing completion. However, as I explained in the post May 28, there have been problems at almost every stage of the project. My sister, who is a Project Manager and works with these situations on a daily basis, said to expect this. It doesn't make it any easier.

     Completing the exterior work means that interior repairs are next. This increases the urgency of purging the items to be donated or disposed of, and packing & storing those that remain. Imagine the Candy Conveyor Belt scene from "I Love Lucy." "Speed it up!" The task seems so overwhelming that at times I am immobilized and resort to avoidance behaviors & procrastination. Sound familiar? Even if it is not a house repair project, we all have responsibilities that can loom before us and we don't know where to begin to pare them down to manageable tasks. Our congregation is reading through the Gospel of John, and in Chapter 8 I discovered a verse that is helpful.

And He who sent Me is with Me. The Father has not left Me alone, for I always do those things that please Him. John 8:29 NKJV

     First, Jesus reminds us that the Father was with Him. The acronym that is the image for this post includes the reminder to "Dedicate your day to God." Remember to draw close to Him immediately as the day begins.

     Second, and this is what really impressed me: Jesus did not do everything there was to do. He did everything He was told to do by the Father. As we dedicate the day to the Lord, ask Him to guide and instruct us, to set the priorities. That way, the time will be used as the Lord desires and directs. He knows our limits and will not overwhelm us. He gives the example of a "yoke" in Matthew 11. The picture is two animals, yoked together and pulling in tandem. Let us join ourselves to the Lord each morning, acknowledging that as He sets the pace and direction, we can meet the challenges of the day.

Come to Me, all you who labor and are heavy laden, and I will give you rest. Take my yoke upon you and learn from Me, for I am gentle and lowly in heart, and you will find rest for your souls. For My yoke is easy and My burden is light. Matthew 11:28-30 NKJV

 

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Emergency Preparation

Wednesday, June 25, 2025

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Image: CBS News Philadelphia 20 June 2025

EMERGENCY PREPARATION by Gail K. Kachnycz 25 June 2025

 

     Last Thursday evening, June 19, strong storms hit the Delaware Valley. Our power went out about 5:30 PM. Electricity was restored in our home about 11:30 AM the next day. However, neighbors only a few miles away had no electricity for 3-4 days. We also had outages for 3 hours Sunday and 30 minutes just last night. Our cell phone service has been spotty. This experience has prompted today's post. 

     Caregivers and those with chronic illness face added difficulties in emergency situations. Medical equipment may have battery back-up, but eventually recharging is needed. Lack of air conditioning, or poor air quality, first affects sensitive groups such as those with heart/lung conditions, children and elderly. Some events can be anticipated, such as hurricanes or severe snowstorms. Others can happen with little or no warning, such as the storm we experienced, or wild fires. Hurricane season on the East Coast & Gulf starts June 1 and continues through November 30. These dates are good reminders to review a plan for emergencies, and update or replace supplies that are nearing their expiration date.

     To be quite honest, I do not have a formal Emergency Plan or stock of supplies. However, I always try to fill the car with gas, since no electricity means the pumps will not work. Making sure my phone is fully charged is important, since that is the portal for news and communication. After our recent experience, I am looking at how I can be better prepared. I am including the links for Ready.gov below. If you have tips, ideas, or information that is helpful for planning for emergencies, please share with me. If appropriate, I will include in future posts. I do plan to have several posts on different topics for emergency planning, such as electronics, food, and medication.

Ready Emergency Supply List

Ready.gov Website

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Juneteenth Flag Symbols

Thursday, June 19, 2025

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JUNETEENTH FLAG SYMBOLS

     Since Juneteenth has been an official Federal Holiday for only a few years, I am still learning the history connected with it. This 2022 article by a CNN reporter explains the symbolism in the Juneteenth flag. Each symbol is positive and forward looking. It is an encouragement to me. Juneteenth is cause for celebration.

Meaning of Juneteenth Flag

The advertisements in the CNN article may not reflect the mission of this blog. I apologize for the advertisements and other links, but wanted to give full credit to the CNN author rather than cut and paste the information.

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CAREGIVERS: Unsung but Not Unseen

Thursday, June 12, 2025

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Image: The Verse of the Day 

CAREGIVERS: UNSUNG BUT NOT UNSEEN by Gail K. Kachnycz 12 June 2025

     The purpose of caregiving is to provide the one cared for the highest quality of life and independence

that can be achieved within the limits of their current chronic illness. By its very nature, caregiving is

an activity that takes place in the background. This affords the loved one dignity and recognition of their value as an individual. However, this means that the caregiver is often overlooked. People

see the challenges and effort of the one living with chronic illness. They ask, “How is your

[spouse/parent/loved one]?” but may fail to ask how the caregiver is dealing with circumstances.


     Caregiving often means isolation, especially if the loved one cannot be left unattended. The caregiver

can feel alone and discouraged. They think no one appreciates what they do. If the loved one is mentally

impaired, he or she may not have the ability to express thanks. No one knows what patience it took to

wait while your loved one searched for words. No one knows how much self control it took to listen to

the same story over and over, or answer the same question again and again, because memory is fading.

But God is aware. He is The God Who Sees.


     El Roi, The God Who Sees is identified in Genesis Chapter 16. God showed Himself this way not to

one of the Patriarchs, but to Hagar, a rebellious Egyptian servant. At the time she was newly pregnant,

and had run away from Abram’s wife Sarai. She was feeling alone and desperate. The Angel of the Lord

met her where she was, and gently redirected her to return to her place with Sarai. God knew all she was

going through. Hagar was overwhelmed that God was interested in her, and she received His blessing. 


     As caregivers, at times we may feel unappreciated, alone, and desperate. God sees our circumstances

and sacrifice. Let the story of Hagar allow us to recognize that God will meet us where we are, and in so

doing, receive His blessing. Caregivers may be unsung, but not unseen.

You number my wanderings; Put my tears in your bottle; Are they not in Your book?

When I cry out to You, Then my enemies will turn back; This I know, because God is for me.

Psalm 56:8-9 NKJV 


Reference: The Names of God, by Dr. William Allan Dean, pages 8-15. Copyright 1963 by

Philadelphia College of Bible (now Cairn University)

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