Caring for a Person with Arthritis

Transcription

1 Carig for a Perso with Arthritis

2 Arthritis Irelad helps people with arthritis take their lives back. We provide real solutios by empowerig people with arthritis ad those carig for them to take positive actio to maage the effects of their disease o their lives. Our iovative ad life chagig educatio ad support programmes icludig Livig Well With Arthritis ad Breakig the Pai Cycle give people with arthritis the kowledge ad practical skills they eed to live their best possible quality of life. Our helplie provides vital emotioal ad practical support ad, because we kow that kowledge is power ad cetral to livig well with arthritis, we provide a extesive rage of free educatioal iformatio, such as this booklet. Through our work we campaig for icreased levels of fudig i rheumatology services to provide a world class service that will positively chage the outlook ad outcome of patiets lives. We also actively support ad fud research ito arthritis to esure that Irelad is at the forefrot of ew breakthroughs leadig to possible cures ad also fud the traiig of health professioals through medical studets i uiversity to create a direct ad positive improvemet i patiet care. Home Istead Seior Care is Irelad s trusted source of home care for seiors ad is committed to helpig seiors maitai their idepedece ad live at home for loger tha oterhwise possible. There are 18 Home Istead Seior Care offices throughout the coutry that provide a rage of home care services icludig specialist care for people with chroic coditios such as arthritis. For further iformatio o Home Istead Seior log o to or call

3 Itroductio This booklet has bee lauched to mark a ew pioeerig programme, Carig Hads. This programme has bee developed by Arthritis Irelad i partership with Home Istead Seior Care to help people carig for someoe with arthritis lear about the coditio, uderstad more about its symptoms ad realise how they ca support someoe with arthritis to live a full ad idepedet life. By participatig i a free half day workshop, carers will lear about arthritis, what the pai cycle is ad how to break it, the importace of exercise, ad the beefits of relaxatio methods. They will also receive some practical tips o improvig commuicatios betwee the carer ad the perso beig cared for, as well as iformatio o treatmets for arthritis, ad how to idetify medical priorities. Ultimately, ad most importatly they will lear about self maagemet ad how to provide help ad assistace while eablig the perso with arthritis maitai as much mobility, idepedece ad cotrol over their life as possible. 1

4 The iformatio i this booklet has bee kidly supplied by Arthritis Research UK 2

5 Cotets Itroductio 1 How ca a carer help someoe with arthritis? 4 Uderstadig what arthritis meas 5 Commuicatig effectively with the perso who has arthritis 8 Offerig practical help with the treatmet 10 Are they gettig the beefits they are etitled to? 16 Where ca I get support as a carer?

6 HOW CAN A CARER HELP SOMEONE WITH ARTHRITIS? Lookig after ad carig for someoe with arthritis is a challege. You eed to achieve the right balace betwee providig support ad motivatio without beig overprotective. Most people with arthritis will wish to retai as much cotrol over their lives as possible, ad you eed to help them to retai their idepedece. This might mea that i certai circumstaces help may ot be wated. This ca be difficult to judge ad you must be sesitive to sigs, which may ot be verbal, that idicate you should stad back ad ot isist o helpig with a particular task or activity. There Are Four Mai Ways I Which You Ca Help: Uderstad what arthritis meas what causes it, how it develops, ad how it affects people. I the same way that uderstadig their coditio helps people with arthritis to cope with it, the more you uderstad about arthritis the more you will be able to provide successful care ad support. Commuicate effectively. Good commuicatio i both directios is essetial. The perso with arthritis eeds to feel well supported ad may also eed reassurace that you do ot reset the resposibility fallig o you. Offer practical help with the treatmet. This may mea helpig the perso to take their medicatios or assistig with recommeded exercises, activities or therapies that they have foud helpful i reducig the symptoms of their arthritis. Support the perso with arthritis i applyig for ay beefits ad advice they may be etitled to. There are a umber of beefits that they may ot be aware 4

7 of (see Are they gettig the beefits they are etitled to? - page 16). We will look at each of these aspects i more detail i the followig sectios. UNDERSTAND WHAT ARTHRITIS MEANS It is importat that arthritis is diagosed by a doctor (ofte a rheumatologist, but sometimes a geeral practitioer). This is because there are may differet types of arthritis, ad treatmets differ accordig to which type of arthritis a perso has. Doctors ofte divide the differet types of arthritis ito two groups: I thought I kew what arthritis was util I visited problems caused by iflammatio (e.g. rheumatoid arthritis or akylosig spodylitis) mechaical problems or wear ad tear (e.g. osteoarthritis or mechaical back pai). The table o the ext page lists the mai types of arthritis i each group. Read Arthritis Irelad s booklets o Livig with Osteoarthritis ad Livig with Rheumatoid Arthritis for further iformatio or check out for iformatio o psoriatic arthritis, gout, ad akylosig spodylitis. 5

8 Most forms of arthritis ru a very ueve course with dayto-day variatio, ad you eed to be aware of this. The outlook is also very variable ad difficult to predict. The arthritis ca occasioally become very bad, or it ca go away completely, but most people experiece somethig i betwee. A perso who has arthritis eeds to be able to cope with the differet symptoms that arthritis ca cause. Group 1 Iflammatory Rheumatoid arthritis Psoriatic arthritis Gout Akylosig spodylitis Group 2 No-iflammatory Osteoarthritis Back pai I took the time to read up about arthritis ad lear about its effects which has really helped me uderstad what my Mum is goig through. It meat a lot to her too. How ca arthritis be treated? Treatmet is available for all types of arthritis. May of the symptoms of arthritis ca be maaged through the right combiatio of exercise, drugs, lifestyle chages ad learig to cope. 6

9 How does it feel to have arthritis? Arthritis affects differet people i differet ways, ad there are o right or wrog ways to feel. It ca make someoe feel pai, stiffess, tiredess or frustratio. Frequetly they may experiece several of these symptoms at oce. The problem with the pai of arthritis is the fact that it goes o day i, day out. If asked to put up with it for a few hours, most people would cope. Facig it o a regular basis is ot so easy. Most people will get some relief from their pai oce they start treatmet. As arthritis varies i a upredictable way, people eed to fid their ow way of copig. Learig about the disease is a importat factor i copig, ad a specialist rheumatology health professioal will ofte help with this by teachig patiets about the coditio. Iformatio ca also be gaied from booklets like this oe. A perso with arthritis ca also lear more of the skills that will help them deal with arthritis o oe of Arthritis Irelad s self-maagemet programmes or o Whe I fid beig a carer difficult, talkig about it with someoe else really helps me see the positive side agai 7

10 COMMUNICATING EFFECTIVELY WITH THE PERSON WHO HAS ARTHRITIS Good commuicatio is essetial. It is importat that you ad the perso with arthritis discuss how you are both feelig. You eed to agree how to work together so that the perso will feel able to ask if they eed extra help, ad to tur it dow if they do t. Sometimes you may have to stad back ad watch your parter, child, fried or colleague struggle to achieve a goal that is importat to them. Try to respect their wishes, allowig them to maitai their self-esteem. Commuicatio is also ecessary so that you ca judge how they are feelig ad respod sesitively. Carers have suggested the followig practical hits: Lear to recogise the sigs whe the arthritis is bad, as extra support may be eeded at this time. Remember that pai ca make people irritable, agry ad depressed at times. Be patiet if the other perso has to do thigs differetly ad ot as quickly as before. They may fid it difficult to carry out ormal everyday activities such as housework, pickig up a telephoe or usig a kife ad fork. They may fid it embarrassig to talk about the difficulties they face, especially if persoal issues like washig or dressig are ivolved. If you otice chages i the way the perso behaves it may be because they eed help with these activities, ad either you or a health professioal may be able to help by raisig this issue tactfully. Do ot allow yourself to become isolated. Make sure that you still see your family ad frieds ad take part i the activities that are importat to you. Fid time for yourself. Roles may have to chage withi the home ad at work. This eeds to be discussed, ad you may eed the support of a traied health professioal such as a specialist urse, a occupatioal therapist or a professioal caregiver. Be sesitive to the feeligs of the perso who has arthritis it is very difficult, 8

11 for example, to sit ad watch someoe else doig somethig that you saw as your job. Joi i the exercises or other activities so that they become shared activities. Ecourage the perso to fid other activities to replace oes which they ca o loger maage. Doig useful work ca make some people feel better they might, for istace, ivolve themselves i volutary work, or start a educatioal course. Remember that you have eeds as well. Carig ca be hard work. At times you may feel irritable ad depressed. This is ormal ad uderstadable. If it appeals to you, joi a local support group. You ca also get iformatio, support ad advice from The Carers Associatio (tel: or or ifo@carersirelad. com.) Home Istead Seior Care have also published a guide to help caregivers cope with stress. Etitled, Ruig o Empty: Who cares for the caregiver?, the guide offers isights ad iformatio o copig with caregiver stress. You ca dowload a free copy from Alteratively you ca call to order a free copy. 9

12 OFFERING PRACTICAL HELP WITH THE TREATMENT You have a importat part to play i supportig ad helpig the perso to cope with their arthritis. The most commo practical questios we receive from carers are icluded i the followig pages. Be aware of how the differet drugs work ad what is a reasoable expectatio of how effective they will be. If the prescribed paikillers are take oly whe the pai is very bad ad they are ot providig adequate relief, the they may work better by beig take regularly, or they may eed to be reviewed by the doctor. Pai may be eased either by warmig or by coolig the paiful area. Wrap a hot-water bottle or a ice pack (or bag of froze peas) i a towel ad hold it agaist the paiful joit for miutes. Pai makes muscles tese ad more paiful. Relaxatio, massage ad yoga ca help. Joi i you may ejoy it too! Regular movemet is eeded to stop the joits becomig stiff ad paiful. Try ot to be overprotective: ecourage the perso with arthritis to do as much as they ca to keep the joits mobile. Space out daily activities istead of tryig to do everythig i oe go. This ca help reduce pai ad stiffess ad still eable activities to be carried out successfully. Ecourage regular movemet. Sittig i the same positio for too log ca icrease stiffess. Fid o-physical ways of occupyig the mid such as readig, doig a crossword or just talkig. If a particular activity is causig problems, ecourage the perso to fid a differet way of doig it. There usually is oe. For example, carryig shoppig is 10

13 better doe i two small bags tha oe big oe. If that is impractical the a wheeled trolley ca be used. Alteratively, is there somebody who could help with shoppig trips by sharig trasport? Or check whether ay local supermarkets offer a delivery service some schemes allow you to shop as usual at your local store ad have the items you choose delivered to your home later i the day. If there are problems with activities aroud the home the a visit from a occupatioal therapist for advice o aids ad adaptatios ca be very helpful. Ask your GP or hospital rheumatology departmet for more iformatio about this. The worst exercise you ca do for your arthritis is oe 11

14 How does arthritis affect a perso s mood? It is ormal for people with arthritis to experiece a wide rage of feeligs ad emotios. They may be tearful, or agry, or upset amog other emotios. Ecourage them to focus o positive experieces ad thik about what they ca do rather tha thigs they have difficulty with. Arthritis Irelad s booklet Copig with Emotios provides iformatio o the difficult emotios that people livig with arthritis ofte face. Whe Jack s arthritis flares up ad he feels low, sometimes the best support I ca give is ot the practical tasks. It s just to be there to liste ad support. Should a carer ecourage exercise? Yes it is very importat to keep the joits movig to miimise pai ad stiffess. Try to ecourage exercise as a daily habit. Swimmig ad cyclig (it ca be o a static bike) are good exercises. Physiotherapists are the experts i this area, but the perso with arthritis may have their ow prefereces about exercise ad should be ecouraged to express them. If you joi i the exercises the this ca become more of a social activity ad less of a chore. It is importat to start gradually with ay exercise ad icrease the amout over time as the body adjusts to the extra requiremets beig made of it. For more ideas o exercisig whe you have arthritis, check out Arthritis Irelad s Be Active with Arthritis exercise DVD ad booklet specifically desiged for people with arthritis, available to purchase o You could also fid out if there s a local walkig or exercise group ear you such as oe of Arthritis Irelad s walkig groups. 12

15 My husbad used to fid it difficult to get motivated to exercise, so ow we walk dow to the shops for a ewspaper every morig. We ejoy the exercise together, ad I ca really otice the differece i him. Is it atural for the perso to feel tired? Most people with arthritis will fid they get tired more easily, particularly if they have rheumatoid arthritis. For some people the tiredess is more difficult to cope with tha the pai. Tiredess ca be reduced by: spreadig activities throughout the day doig regular exercise establishig a regular sleep patter for example, goig to bed at the same time each ight. Is it ecessary to take drugs? Drugs are oe of the mai treatmets for reducig the effects of arthritis. They are usually divided ito: Fast-actig first-lie drugs, which treat the symptoms of pai ad stiffess ad ca be used for most types of arthritis Slow-actig secod-lie drugs, which are iteded to modify the disease itself (disease-modifyig atirheumatic drugs, or DMARDs, ad biologics) these are used oly i iflammatory types of arthritis. 13

16 See Arthritis Irelad s booklet o Drugs ad Complemetary Therapies for iformatio o the treatmets available i Irelad. As far as treatmet of symptoms is cocered, the perso with arthritis is i the best positio to weigh up the beefits of takig tablets such as paikillers (aalgesics) or o-steroidal ati-iflammatory drugs (NSAIDs). This should always be discussed with a doctor or urse specialist, who will be able to give good advice about the beefits ad possible side-effects of each of these drugs. If the doctor offers these drugs to relieve symptoms, it is usually worth tryig them to see whether they help ad the discussig with the doctor whether to cotiue with them. The drugs give to modify the disease itself must be take as prescribed, or variatios i their use agreed with a doctor. For example, allopuriol for gout has to be take cotiuously or it may make the attacks worse. Predisoloe must ot be reduced too quickly or stopped suddely as this ca be dagerous. Most secod-lie drugs for rheumatoid arthritis (sulfasalazie, lefluomide ad methotrexate are examples) eed to be moitored with blood ad/or urie tests as a precautio agaist side effects. Everyoe is differet, so if oe drug proves to be usuitable there is ofte a satisfactory alterative. Are there ay foods that will help? It is importat for everyoe to eat a balaced diet with plety of fruit ad vegetables for geeral health. People with arthritis should particularly avoid puttig o weight beig overweight will icrease the stress o the joits. Some people with arthritis do seem to beefit from makig chages to their diet, though there is o sigle diet which helps with all types of arthritis. For more iformatio see Arthritis Irelad s booklet o Healthy Eatig ad Arthritis. 14

17 I love shoppig ad cookig for my parets - kowig that followig a healthy balaced diet will help their arthritis Does arthritis affect how people feel about themselves? Havig arthritis ca make some people feel less cofidet i themselves. Your support, if wated, ca icrease their cofidece ad help them to maitai a active social life. This is importat for your well-beig as well as for the perso who has arthritis. 15

18 ARE THEY GETTING THE BENEFITS THEY ARE ENTITLED TO? Here is some iformatio o some of the mai beefits ad etitlemets that might be worth explorig. Equipmet ad Adaptatios to the Home The perso you are carig for may be able to get help with equipmet or adaptatios to their home. The Housig Adaptatio Grat for People with a Disability, the Mobility Aids Grat Scheme ad the Housig Aid for Older People Scheme are admiistered by local authorities. For further iformatio o these schemes ad to see whether the idividual might be eligible for help cotact the Housig Departmet of your local authority. Work ad Educatio If the perso you are carig for has bee out of work as a result of their arthritis, it is worth otig that FÁS offers may schemes, job ad traiig opportuities to help them fid ad retai work. FÁS also has a wide rage of supports available for people with disabilities i employmet; icludig adaptatio grats, disability awareess traiig for employers ad grats to eable a perso stay at work whe they have become disabled while i employmet. You ca access FÁS services by visitig your local FÁS office, by callig the freephoe telephoe service o or by coectig to the FÁS web site If a perso is iterested i goig ito higher educatio, they may be eligible for the Back to Educatio Allowace, paid by the Departmet of Social & Family Affairs. Various other educatio ad traiig schemes exist, AHEAD (Associatio for Higher Educatio Access ad Disability) have published a relevat booklet Accessig Third-level Educatio i Irelad A Guide for Studets with Disabilities. 16

19 Travel People with arthritis ofte fid gettig out ad about difficult. May rely o cars either drivig themselves or gettig lifts or public trasport to get aroud. There are a few thigs that ca be tried to make drivig easier. A automatic gearbox ad power steerig will reduce strai. Mior adjustmets, such as a padded steerig wheel, a headrest, extra side-mirrors or a wide-agled mirror may make drivig easier. There are various meas tested supports available through the HSE icludig grats for adaptig a vehicle, the Disabled Perso s Parkig Card ad tax relief for ecessary adaptatios to vehicles. The Irish Wheelchair Associatio (tel: or ad the Disabled Drivers Associatio (tel: or provide advice ad iformatio o all aspects of motorig. If you would like to lear to drive or have lost cofidece i your drivig skills the Motorig Advice ad Tuitio Service i the Irish Wheelchair Associatio ca provide assistace to you. If relyig o public trasport you ca apply for the Free Travel Pass, which allows you to travel for free o all public trasports ad selected private services. Beefits The Citizes Iformatio Board offer a comprehesive booklet that outlies all etitlemets for people with a disability, icludig rights relatig to work, educatio ad traiig. You ca get this booklet, Etitlemets for People with Disabilities, by visitig your local office or cotactig them o LoCall or A perso may be able to apply for state beefits to help with the extra costs of havig arthritis or if they are uable to work. Some of the mai disability-related paymets are: 17

20 Social Isurace Paymets Illess Beefit: Illess Beefit was previously called Disability Beefit. This is a short-term paymet made to people who are uable to work due to illess. It ca be paid i the log-term. To qualify you must be aged uder 66 ad uable to work because of illess. PRSI cotributios or credits must be up to date. Ivalidity Pesio: Ivalidity Pesio is payable for as log as a perso is uable to work. At the age of 65, the persoal rate of paymet icreases to the same rate as State Pesio (Trasitio). At age 66 a perso trasfers to the State Pesio (Cotributory). Other beefits: Livig Aloe Icrease is payable regardless of age if a perso lives aloe. They may also qualify for free travel ad the Household Beefits Package, which icludes allowaces towards household bills. Rehabilitative work: A perso may be allowed to do rehabilitative or therapeutic work (maximum 20 hours a week) ad retai their Ivalidity Pesio. They must get prior writte approval from the Departmet of Social ad Family Affairs before they start work. The Treatmet Beefit Scheme: A scheme ru by the Departmet of Social Protectio that provides detal, optical ad aural services to people with the required umber of PRSI cotributios. 18

21 Meas-Tested Paymets Disability Allowace: This is a log-term meas-tested paymet made to people with a disability. The disability must be expected to last at least a year. A perso may be etitled to Disability Allowace if they are aged betwee 16 ad 66, satisfy both a meas test ad a habitual residece test, ad have a specified disability which results i them beig substatially restricted i udertakig suitable employmet. The perso s ow meas ad that of their spouse or parter are take ito accout. The perso s parets meas are ot cosidered. The perso may qualify for a Livig Aloe Icrease ad the Household Beefits Package, which icludes allowaces towards household bills. If a perso is awarded Disability Allowace, they get a Free Travel Pass automatically. This allows them to travel for free ad their spouse or parter to travel free i their compay. If they are medically assessed as beig uable to travel aloe they may be etitled to a Compaio Free Travel Pass. Health Service Medical Cards: Most medical cards are grated o the basis of a meas test ad/or medical eed. Each case is decided o its merits but a perso may qualify if their icome is ot much above the guidelie figure ad their medical costs are exceptioally high. It may be possible for oe or more members of a family (who would ot otherwise qualify) to get a medical card i their ow right if they have high medical expeses or eeds. GP Visit Card: The purpose of this card is to help people who are ot eligible for medical cards with the costs of visitig a doctor. The card covers them for GP visits but othig else. The icome guidelies for the GP visit card are 50% higher tha the medical card icome guidelies. Drugs Paymet Scheme: With a Drugs Paymet Scheme (DPS) card, a idividual or family i Irelad oly has to pay a maximum amout mothly for approved prescribed drugs, medicies ad certai 19

22 appliaces. As of Jauary 2009, the maximum amout a family must pay is 100. Everyoe i Irelad who does t have a medical card should apply for the DPS card. Hospital Charges: Everyoe residet i Irelad is etitled to be treated free of charge i a public bed i a public hospital. Some people may have to pay maiteace charges. Out-patiet services, whe you are referred by your GP, are also provided free of charge. Tax relief: A perso may get tax relief o certai health expeses, which they have icurred ad for which they have ot bee reimbursed. The tax relief is at the stadard rate of tax of 20%. So, if you spet 1,000 you would get a refud of 200. This claim should be made o a Med 1 form, available from your local tax office or olie at Tax relief o home care fees: Home Istead Seior Care cliets or their family ca avail of icome tax relief of up to 41% o paymets to Home Istead Seior Care of up to 50,000 per aum. The tax credit ca be adjusted so that the relief will apply o a mothly basis rather tha aually, which may otherwise be the case. We also advise families to avail of home care grats, which ca be applied for through your local health cetre. Please call to discuss i detail how you ca go about claimig tax relief o home care fees. May hospitals have rheumatology health professioals who ca provide support ad iformatio to carers as well as to patiets. Volutary orgaisatios such as The Carers Associatio (tel: or or ifo@carersirelad.com ) ca provide iformatio o what help is available ad how to apply. There may also be a support group i your area where you ca share iformatio with other carers i a similar situatio. Most people feel better for sharig feeligs ad cocers rather tha keepig them bottled up iside. It is atural for you, as a carer, to feel ager ad resetmet at times (because your life has chaged too) ad sharig these feeligs ca make it easier to move forward. 20

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24 WHERE CAN I GET SUPPORT AS A CARER? I called Arthritis Irelad s helplie to get some iformatio about carig for someoe with arthritis. I felt they really did uderstad what I was goig through. There are a variety of beefits that might apply to you, as a carer so it is worth ivestigatig some of the followig: Carer s Allowace: This is a meas-tested paymet to people who are lookig after someoe who is i eed of support because of age, physical or learig disability or illess. It is maily aimed at carers o low icomes who live with ad look after certai people who eed full-time care ad attetio. You will also qualify for the Household Beefits Package ad a Free Travel Pass. Carer s Beefit: This is a paymet made to isured persos i Irelad who leave the workforce to care for a perso i eed of full-time care ad attetio. You ca get Carer s Beefit for a total period of 104 weeks for each perso beig cared for. Carer s Leave: This allows employees to leave their employmet temporarily for a period up to 104 weeks to provide full-time care for people i eed of full-time care ad attetio. The leave will be upaid but those who propose to avail of Carer s Leave will have their jobs kept ope for them for the duratio of the leave. Respite Care Grat: This is a aual paymet made to carers. Carers ca use the grat i whatever 22

25 way they wish. You ca use the grat to pay for respite care if you wish, but it is ot ecessary to do so. The grat is paid automatically to people receivig Carer s Allowace or Carer s Beefit. Iformatio o all of the above is available o Home Care Package: If you eed a professioal home care service you may get help from the HSE uder the Home Care Support Scheme. This may iclude a Home Care Package which you may use to employ caregivers. Home care supports uder this scheme operate differetly i differet parts of the coutry. I some areas, the HSE directly provides care services at home or arrages for their provisio by volutary orgaisatios or by private home care providers such as Home Istead Seior Care. Claimig beefits ca be complicated ad time cosumig, so it s worth gettig expert help ad advice from: a social worker from your local Health Office a housig welfare officer from your local authority your citizes iformatio service: LoCall your local social welfare office the Leaflet Request Lie i the Departmet of Social Protectio: LoCall olie at

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27 to become of Arthritis Irelad just 3 a moth 1 Receive 2 Stay 3 Have 4 Receive 5 Help a year s free subscriptio to Arthritis Life: The oly magazie i Irelad that addresses the iterests of people with arthritis ad provides regular updates o our work ad evets. iformed about Arthritis Irelad courses ad evets: Be the fi rst to receive otifi catios of the educatio courses, semiars ad activities ruig i your area. your say: Have the opportuity to become a member of Arthritis Irelad ad be more actively ivolved if you wish. a free arthritis friedly key turer**: Receive a FREE key turer to give a easier grip ad better leverage whe turig keys. make a real differece for just 3 per moth: For just 3 per moth you will help us provide vital educatio ad support services to empower people with arthritis by givig them the kowledge they eed to take back cotrol of their disease ad their life. Your doatio of 36 will eable us to provide iformatio packs to 10 people like you livig with this chroic coditio. For more details of how your doatio makes a differece to the lives of people livig with arthritis, just log o to

28 Become a fried of Arthritis Irelad today I additio to the fatastic rage of beefits you receive, you are also helpig to make a real differece to the lives of people livig with arthritis. Yes, I would like to become a fried today for just 3 per moth or 36 per year. I would like to make a gift of i support of the 1 i 6 people i Irelad with arthritis. Persoal Details: (please fill i all areas) Name: Address: Telephoe: D.O.B.: Do you have arthritis? If so, what type? Would you like to become a MEMBER of Arthritis Irelad at NO EXTRA COST? Just tick the box ad we will forward you full details.

29 Paymet by Stadig Order: Stadig Order is cost effective, coveiet, ad cofi detial, please fi ll i details below Bak Name: Bak Address: Your curret accout o: Sort Code: Name of accout holder: Address (if differet tha above) Sigature: Date: Please pay to: AIB, 52 Upper Baggot Street, Dubli 4, Sort: , for the credit of Arthritis Irelad. Accout o: Referece: Arthritis Irelad Frieds Paymet by Cheque or Postal Order: Please make payable to Arthritis Irelad Paymet by Credit Card: Please charge my: VISA / MasterCard / Laser (please circle) Credit Card Number: Expiry Date: CVV: (3 digits o reverse) Please retur to: Arthritis Irelad, Freepost, 1 Clawilliam Square, Grad Caal Quay, Dubli 2. Usig a stamp o your retur evelope will help us save costs.

30 Arthritis Irelad 1 Clawilliam Square Grad Caal Quay Dubli 2 Helplie LoCall ifo@arthritisirelad.ie Web I partership with: LoCall: ifo@homeistead.ie Web: