By Robin Williams Adams Your Health correspondent

LAKELAND Sitting back in a wheelchair designed to support his small frame, Parker McAdoos eyes sometimes moved from side to side as his parents talked about a local hospices role in his medical care.

At other times, he looked straight ahead, his lips open slightly, making an occasional humming sound as he held two soft stuffed animals. When a visitor stood beside him to say goodbye, he moved one hand slightly toward her but he couldnt speak.

Parker's parents, Jennifer and Colin McAdoo, must interpret what he wants.

The McAdoos learned Parker has a rare neurological condition, called Alexander disease, when he had a seizure weeks after his first birthday. Its part of a group of disorders, leukodystrophies, that lead to the destruction of insulation covering nerve fibers in the brain.

Parker, now 10, and his family have gotten services through Good Shepherd Hospice since he was 2.

The help theyve received includes nurses staying with Parker at home when he was ill, rather than putting him in a hospital, and arranging other assistance to cover medical equipment his parents insurance didnt.

A social worker spends time with his 8-year-old sister to make sure she copes with the impact of his illness on the family and doesnt feel neglected. When his condition grew worse in the past year, preventing him from returning to elementary school, a home health nurse began staying with Parker while his parents work.

His mother is a nurse at Tampa General Hospital. His father does painting, pressure washing and other home improvements.

In addition to work and Parker, the Lakeland couple need to look after their other three children: Peyton, 8; Paxton, 2; and Piper, 6 months.

Eight years isnt a length of time people typically associate with hospice organizations. Hospice is for people expected to live six months or less.

Since the 1990s, however, the concept of palliative care for patients whose illnesses arent so immediately life threatening has gained momentum.

Hospitals, doctors, hospices and others recognize that patients with chronic, severely limiting illnesses often need services beyond traditional hospital and doctor care before their illness is so advanced they meet time guidelines for traditional hospice.

What we really want to do ultimately is keep people out of the hospital, said Judith Skretny, director of palliative care for the National Hospice and Palliative Care Organization in Alexandria, Va.

Chronic obstructive lung disease or congestive heart failure are examples often cited by supporters of expanded adult palliative care.

Large hospitals, among them Lakeland Regional Health, have created in-hospice palliative care units.

Hospices interested in doing expanded palliative care, beyond their usual constraints, sometimes partner with hospitals palliative care or create their own community-based palliative care.

Compassionate Care Hospice of Central Florida has that type of program, which it calls Advanced Care Connections, in Sebring, said Rana McClelland, executive director for Polk, Highlands and Hardee counties.

It helps patients with chronic illnesses who are expected to live longer than six months.

She expects the palliative program to become available in Polk County sometime this year. Its also in Lake, Sumter and Miami-Dade counties.

A lot of patients out there are in that gap where there arent a lot of services in the community, McClelland said.

Compassionate Care already has hospice services in Polk County.

Understanding the difference between traditional hospice care and community based palliative care can be difficult.

Partly thats because hospices give palliative care to their traditional patients; services like pain control, symptom management, counseling, emotional and spiritual support and other comfort aimed at enhancing quality of life.

A community-based or purely palliative care for people with longer than six months to live does a lot of the same.

All hospice is palliative care but not all palliative care is hospice, Skretny said.

One key difference:To access palliative care, you dont need that diagnosis (of six months or less.) And you can be getting curative treatment.

She estimates about half of her national organizations members have some form of palliative care program.

In another change from times past, some hospices are more receptive than others to letting traditional hospice patients get more aggressive treatments like radiation to alleviate their symptoms, said Dr. Ron Schonwetter, chief medical officer for Chapters Health System, parent company of Good Shepherd.

Children with ongoing conditions that arent likely to let them live into adulthood, but that will continue longer than six months, are another group needing palliative care.

Parker and about 50 other Polk County children with severe, chronic, disabling illnesses get care from Good Shepherd through its participation in Partners in Care: Together for Kids. Partners in Care is a program allowing palliative comfort care along with therapies to cure childrens illnesses or prolong their lives.

We focus on the whole family, trying to provide support and services, Schonwetter said.

Thats definitely true for their family, the McAdoos said.

The Lakeland couple discovered the wheelchair Parker needed consumed all the yearly amount their insurance would pay for durable medical equipment. Yet Parker, on a feeding tube for eight years now, needed other expensive medical supplies.

Jennifer McAdoo, not yet a nurse, went online to look for medical items at a cheaper price. She and Colin also were concerned with whether they were doing everything he needed, so they contacted Good Shepherd in September 2009.

We needed some help in making sure his quality of life was being considered and maximized, she said. We were having a difficult time.

Parkers frequent medical crises put a strain on his family, but equipment Good Shepherd provides allows him to recover at home now from illnesses that once sent him to the hospital.

Florida has some quality community palliative care programs, Skretny said. In Polk County, however, getting them has been slow.

Cornerstone Hospice and Palliative Care and Good Shepherd Hospice, two large nonprofits, have provided hospice care in Polk for years. Neither has a purely palliative program here for adults with serious illnesses who arent ready for hospice.

Cornerstone does outpatient and inpatient palliative care with oncology patients at Orlando Health. They also provide consultations in Lake County and look forward to expanding to Sumter County in the near future, said Dr. Michael Shapiro, its chief medical officer.

They work collaboratively with Lakeland Regional Healths palliative care unit in providing services to their hospice patients, such as bereavement and counseling, he said.

Chapters Health partners with some pediatric palliative care programs in the Tampa Bay area.

Both medical officers said they support the idea of having greater access to community based palliative care programs if finances and staffing would allow it.

Medicare has an established hospice benefit package, but expanding palliative care to a wider group means more complicated billing and reimbursement, Skretny said. Programs often need to raise community funds for services Medicare wont cover.

Her organization is working with the federal government in an effort to get established funding for more open access to palliative care. The growing number of baby boomers with chronic conditions is likely to give the movement more leverage.

Robin Williams Adams can be reached at robinwadams99@yahoo.com.

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Some hospices want to expand traditional boundaries - The Ledger

BURNSVILLE, Minn., July 11, 2017 /PRNewswire/ --Titus Contracting, a residential remodeling company serving St Paul, Minneapolis and the entire Twin Cities area, recently completed a home remodeling project in Prior Lake. The log home remodelpresented some unique challenges, but the experienced crew was able to work with space and create a functional design.

The homeowners came to Titus Contracting with three specific needs. First, they wanted a total remake of their master bath. Second, they wanted an additional powder room on the main level. Third, they wanted to update their kitchen and the rooms surrounding it.

Titus Contracting started by looking at the existing master bathroom and the space around it. Having access to plumbing in this location already made it an ideal location for an additional bath. However, complications arose from this being a log home with tongue and groove ceilings, and getting plumbing, venting and electrical in existing locations can be difficult.

Not swayed by the challenge, the professionals at Titus came up with a plan and design to work with the space. They decided the separate shower area off the master bathroom could be used for a portion of the new half bath, along with a large entry closet. The remodeling crew re-worked the existing master bath space to incorporate a large shower and free-standing tub with tub filler (a huge trend in bathrooms now).

The old shower and commode room was turned into just its own water closet connected to the master bath. The master bath was updated with white cabinets, granite countertops, natural stone tile, LED recessed lighting, in-floor heat on a programmable thermostat, a beautiful free-standing tub, a shower surrounded by heavy glass with a barn-style sliding glass door, and a shower head/handheld with multiple controls.

The half bath was completed with hardwood floors to match the adjoining rooms. A classy painted vanity with stone countertops was added, and the exposed tongue and groove ceilings were painted white.

The kitchen required the remodelers to stay within the existing footprint. Titus re-worked the cabinets to make them more user and storage friendly. Rollouts, soft-close hinges, full extension guides and specialty storage cabinets were all integrated into the new package. New LED under cabinet lights were installed on LED dimmer switches to create either utility lighting or mood lighting. Stone countertops and tile backsplash polished up the space.

In addition, new hardwood was installed to tie into the existing floor and keep the flow smooth throughout the home. Pop-up stainless outlets were added to the floor and the living room fireplace was resurfaced with an updated stone.

The finished project met all the homeowner's needs and gave them a fresh, updated look that they can enjoy for years to come.

Titus Contracting is a home remodeling company serving the Twin Cities area. They specialize in home additions, kitchen renovations, lower level finishing, bathroom remodeling and home theater rooms. Titus Contracting has a reputation for good communication, timely work, and quality construction. The company also has a commercial remodeling division.

For additional information, contact Scott Rajavuori, sales and design manager for Titus Contracting, at scott@tituscontracting.com.

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Titus Contracting Completes Home Remodeling Project in Prior Lake - PR Newswire (press release)

Folks are moving less and fixing up their homes more.

And 1-in-7 California homeowners plan to begin a home renovation in the upcoming year, according to a new survey.

Research by GetHearth.com, a startup remodeling advice website, found 15 percent of Californians have plans to fix up their home in the next year. Thats just behind the 16 percent of U.S. owners who have similar plans, according to a survey of 2,000 Americans.

The national hot spot for remodeling was Hawaii, where 33 percent of homes were sprucing up their home, followed by Kansas (32 percent), Montana and Rhode Island (29 percent), and New Hampshire and Utah (24 percent).

Remodelers are probably not happy in the states with the lowest makeover plans from the survey: North Dakota (4 percent) and Wyoming, Alaska and New Mexico (5 percent.) All of these states have seen their economies hurt by the energy slump.

Still, remodeling is a hot business that touches a wide spectrum of the broad economy with projects including money spent on workers, building suppliers, home fixtures, accessories and furniture.

Market tracker Metrostudy said remodeling activity that required professional help has risen for 20 straight quarters through the start of 2017. Its remodeling index is up 4.5 percent since the start of 2016 and 7.3 percent above the previous peak in 2007.

There were roughly 11.4 million pro-worthy remodeling and replacement projects nationwide last year worth $170.6 billion, Metrostudy estimates. This year, it predicts the number will rise to 11.9 million jobs worth $180 billion.

The current strength of the remodeling market can be attributed primarily to economics low mortgage rates, strong existing home sales, the bull stock market run, good job gains, and now more recently, wage gains, Mark Boud, Metrostudys chief economist, said in a news release.

The Joint Center for Housing Studies of Harvard University which tracks a broader definition of remodeling that includes home repairs expects some cooling from a 7.3 percent annual growth rate to start 2017 to 6.1 percent in 2018s first quarter. Thats better the 5 percent historical norm and adds up to a $320 billion-a-year business.

The National Association of Home Builders index of the remodeling industrys optimism rose in 2017s first quarter to its highest level since 2015. Helping to boost the industry wereincreases in calls for bids, work committed and a backlog of jobs.

Oh, by the way, what did the GetHearth survey find as the dream remodeling project?

When asked If money was no object, which room would you renovate next in your home? Kitchen was No. 1, according to 38 percent of those polled, followed by thebathroom (15 percent), living room (12 percent), basement (10 percent) and bedroom (10 percent).

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1-in-7 California homeowners plan to remodel, but what states have more? - OCRegister

OKLAHOMA CITY -- Starting Wednesday, the Homeland at NW 18th and Classen Blvd, will undergo major remodeling, sprucing up what many in the neighborhood said was an out-dated and neglected grocery store.

In February, Homeland announced it was preparing to put $2 million in upgrades to the exterior and interior of the existing building, which was built in 1972.

As reported earlier by Red Dirt Reports Louis Fowler, The bakery and deli will be renovated with items such as fresh sushi and artisan breads to be featured, as well as a much-needed expansion of their produce section with an added emphasis on organic goods. Additionally, the meat department will have a service counter offering a broader selection of beef, fish and poultry.

Dennis Maxwell, director of marketing for Homeland grocery stores, said the company was very excited to make the proposed improvements to this store, and said the anticipated completion date for the renovation would be late fall.

Construction will include an updated storefront and added LED parking lots, new landscaping, a new vestibule entry, new paint and decor and mostly replaced floors.

The store will also have a new check-out and customer service counters, an updated break room for employee owners and new LED lighting throughout the store, Maxwell said.

The deli section of the store will offer enhanced hot and cold deli offerings like flat bread pizza, sushi made on site, heat-and- eat entrees and gourmet cheeses. The bakery will also be updated to offer artisan bread, cakes and other cookies and pastries.

Maxwell said the produce and meat sections will also be updated, offering exclusive Red River Ranch certified Angus beef and a new service case with marinated meats, store-made sausage, custom cuts, kebabs and fresh seafood.

The store will also have an increased variety of organic items like fruit and vegetables, gluten- free items, Asian offerings and Hispanic items.

Homeland is an employee-owned grocery chain in Oklahoma.

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Remodeling of 45-year old Homeland store to begin on Wednesday - Red Dirt Report

How does a professional remodeler renovate his own home after a damaging house fire?

"My heart goes out to anyone who has to go through a fire or disaster or anyone who is displaced and has to rebuild their homes," Peninsula remodeler and native Robert Criner said. "You work very hard to get back to where you were. I had no idea how much it wore you down and how emotionally drained you become just going through the process."

Criner, 61, said he will never forget the day of the house fire two years ago on Jan. 26 his birthday. He had just achieved one of the highest milestones of his career a couple days prior when he was sworn in as chairman of the National Association of Home Builders Remodelers for 2015.

The fire started as an electrical fire in a second-story exercise room where a treadmill malfunctioned, Criner and wife Aggie said. By the time fire crews were finished extinguishing the flames, the three-story house suffered significant smoke and water damage, too.

Criner said he spent about half a year negotiating with the insurance company and documenting the home's contents. His firm, Newport News-based Criner Remodeling, stripped the house down to its wood frame and worked torebuild the home while the Criners stayed in an apartment for less than two years.

The Criners, married nearly 34 years, had remodeled their Criner Lane home at the end of Elliott Road in Tabb in the '90s after buying the property in 1985. One silver lining to the fire was that they could customize the home to their needs now that their four sons have grown and left the four-bedroom, three-and-a-half-bathroom house.

"It's great," Aggie Criner said. "It's everything I wanted."

The exercise room was converted to give space to the master bedroom while adding a large master bathroom with soaking tub, a digitally controlled toilet with automatic lid opener and a digitally controlled shower with body sprays, rain and standard shower heads and a steam option.

Aggie Criner finally has two kitchen doors that allow easier access to the back patio and provide more lighting. The downstairs family room with the TV was darkened by trading windows for built-in backlit bookcases and the staircase was opened up. Aggie Criner said her new favorite area is the expanded front porch's gazebo-like lounge area with a large ceiling fan.

For energy efficiency, the Criners put three separate heating and air systems on each of the three floors with the ability to set different temperatures in different zones on the upper floors. They also installed a large heat pump water heater.

The custom kitchen has plenty of space for entertaining the couple's family with a large granite-topped island with a farm sink, touch-activation faucet, two dishwashers, a six-burner gas range and standard and advantium wall ovens.

What makes the house a comfortable home for Robert Criner is the "little things," such as hidden outlets under the kitchen counters or the USB plugs for charging mobile devices. A major convenience in the master bathroom is the motion-controlled LED lights under the cabinetry to help users see at night, supplemented by the toilet's night light.

The large, deep storage drawers in the kitchen pull all the way out so people don't have to reach for anything, he said. Bumping the handle for the kitchen trash cabinet opens it hands-free. A lot of the home was designed with "aging in place" features in mind, such as easy-close doors or in-shower benches.

While insurance didn't pay for the extra upgrades in the more than $500,000 remodel, Robert Criner said he wanted a place to take clients to show them various home features with the ability to give real feedback on which ones are most useful.

"It is a mini showroom," he said. "It gives me the advantage of being able to describe to people how these things work."

Criner has received plenty of accolades since founding Criner Remodeling in 1977, including being named the "Remodeler of the Year" by the National Association of Home Builders in 2012. When lifelong friend Mike Mannen of Hampton hired Criner Remodeling for his kitchen remodel, he said he knew the work was going to be done right the first time.

His attention to detail also shows in his own home renovation, Mannen said, adding he loves the front porch area with the octagonal cathedral ceiling.

"He's meticulous," Mannen said.

Anyone wanting to attend a future open house for the Criner Lane home can sign up at crinerremodeling.com.

Bozick can be reached by phone at 757-247-4741. Sign up for a free weekday business news email at TidewaterBiz.com.

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Peninsula remodeler renovates home after fire - Daily Press

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Patio Enclosures - Sunrooms | Pergolas - Patio Covers

British Dictionary definitions for plumber Expand

a person who installs and repairs pipes, fixtures, etc, for water, drainage, and gas

Word Origin

C14: from Old French plommier worker in lead, from Late Latin plumbrius, from Latin plumbum lead

a weight, usually of lead, suspended at the end of a line and used to determine water depth or verticality

the perpendicular position of a freely suspended plumb line (esp in the phrases out of plumb, off plumb)

(prenominal) (informal, mainly US) (intensifier): a plumb nuisance

in a vertical or perpendicular line

(informal, mainly US) (intensifier): plumb stupid

(informal) exactly; precisely (also in the phrase plumb on)

(transitive) often foll by up. to test the alignment of or adjust to the vertical with a plumb line

(transitive) to undergo or experience (the worst extremes of misery, sadness, etc): to plumb the depths of despair

(transitive) to understand or master (something obscure): to plumb a mystery

to connect or join (a device such as a tap) to a water pipe or drainage system

Word Origin

C13: from Old French plomb (unattested) lead line, from Old French plon lead, from Latin plumbum lead

Word Origin and History for plumber Expand

late 14c. (from c.1100 as a surname), "a worker in any sort of lead" (roofs, gutters, pipes), from Old French plomier "lead-smelter" (Modern French plombier) and directly from Latin plumbarius "worker in lead," noun use of adjective meaning "pertaining to lead," from plumbum "lead" (see plumb (n.)). Meaning focused 19c. on "workman who installs pipes and fittings" as lead water pipes became the principal concern of the trade. In U.S. Nixon administration (1969-74), the name of a special unit for investigation of "leaks" of government secrets.

"lead hung on a string to show the vertical line," early 14c., from Old French *plombe, plomee "sounding lead," and directly from Late Latin *plumba, originally plural of Latin plumbum "lead (the metal), lead ball; pipe; pencil," a word of unknown origin, related to Greek molybdos "lead" (dialectal bolimos) and perhaps from an extinct Mediterranean language, perhaps Iberian.

early 15c., "to sink" (like lead), from plumb (n.). Meaning "take soundings with a plumb" is first recorded 1560s; figurative sense of "to get to the bottom of" is from 1590s. Related: Plumbed; plumbing.

"perpendicular, vertical," mid-15c., from plumb (n.). The notion of "exact measurement" led to extended sense of "completely, downright" (1748), sometimes spelled plump, plum, or plunk.

early 15c., "to sink" (like lead), from plumb (n.). Meaning "take soundings with a plumb" is first recorded 1560s; figurative sense of "to get to the bottom of" is from 1590s. Related: Plumbed; plumbing.

"perpendicular, vertical," mid-15c., from plumb (n.). The notion of "exact measurement" led to extended sense of "completely, downright" (1748), sometimes spelled plump, plum, or plunk.

Slang definitions & phrases for plumber Expand

noun

verb

To botch; ruin: I tho't I plumbered it (1930s+)

adverb

Completely; entirely; stone: What he said was plumb silly

[1748+; fr notions of exact extent and precision associated with the plumb bob or sailor's plumb line (for measuring depth of water), ultimately fr Latin plumbum, ''lead'']

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Plumber | Define Plumber at Dictionary.com

Patch.com

Plumber's Tool Ignites Annandale Two-Alarm Fire - Annandale, VA ... Patch.com Annandale, VA - Two people were displaced after a plumbing torch ignited the wall of their Annandale home. and more »

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Plumber's Tool Ignites Annandale Two-Alarm Fire - Annandale, VA ... - Patch.com

WATCH LIVE

The driver of a plumbing truck joined a chase involving another pickup Thursday morning on narrow and winding streets northeast of downtown Los Angeles.

The chase began in the Altadena area after officers responded to a man who called authorities from several locations saying that he needed some type of medical assistance. The driver sped away when officers first found him on the 210 Freeway in the San Gabriel Valley.

Officer continued following the driver on the 210 Freeway before he exited onto streets in the Eagle Rock and Glassell Park areas northeast of downtown Los Angeles. The driver came to stop with officers behind him outside a house at about 8:30 a.m., refused to get out, then took off again.

He encountered an unoccupied green and logo-emblazoned pickup belonging to the Right Price Rooter service parked in the middle of the street, but squeezed between the truck and another vehicle to continue into the hillside neighborhood. The plumbing pickup driver could be seen running from a nearby property to the pickup before chasing the driver for several blocks.

NBC4 has reached out to the plumbing service for comment.

The chase eventually came to a stop in the 3100 block of Weldon Avenue and a standoff ensued when the driver entered a house. At least four people were escorted by law enforcement officers from the house. The man's brother told NBC4 he was recently hospitalized and planned to turn himself in, which he did early Thursday afternoon.

"We were there to determine whether he was a danger to himself or others," said LAPD Officer Liliana Preciado.

The driver was arrested on suspicion of felony evading.

Published at 8:46 AM PDT on Jul 6, 2017 | Updated at 2:50 AM PDT on Jul 7, 2017

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Plumber Joins Police Chase on SoCal Streets | NBC Bay Area - NBC Bay Area

The Sun

Girlfriend tests plumber boyfriend with scantily-clad model whose taps don't work but will he be tempted to cheat? The Sun The footage of his encounter with the honeytrap girl starts when he is sent to a house as part of his plumbing job, believing he is meeting with a customer. When he arrives he is greeted by Alison, a model wearing nothing but underwear and a skimpy robe.

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Girlfriend tests plumber boyfriend with scantily-clad model whose taps don't work but will he be tempted to cheat? - The Sun