A Day in the Life

Health Awareness for Women

Sandra McTernan, MSN — Mon, 20 May 2013 18:23:37 +0000

Caring for children and family can often be more than a full time job. It pays to be organized. But are you as organized about your own healthcare needs. The number one killer of women today is heart disease and few women know their risks. Do you know the signs of a heart attack in men or women? Symptoms vary but having baseline EKG at your well visit will help pick up on abnormalities early-and maybe save your life. Only 30% of women survive their first heart attack. Often there are no symptoms prior to this life threatening event… So how do you get organized about your heart? Easy as: 1-Schedule an appointment/annual check up , be thorough in your health history.2- Listen to your body and don’t ignore any of these warning signs (Shortness of breathe,Fatigue, sweating, pain radiating in jaw &/or down left arm, GI upset, upper or lower back pain.3-Prepare- learn CPR, encourage your friends to also- make it a mom’s nite out and be AWARE-heart disease does not discriminate- young or old….we are all at risk.

Good Day Sunshine!

Sandra McTernan, MSN — Mon, 13 May 2013 20:28:20 +0000

As we flock from indoors to outdoors, we enjoy not only the change of scene but also the change in air. Spring cleaning was historically a way to purge your home of ‘bad bugs (viruses)’ and replace with healthy air. All should be good except if you suffer from allergies. Then those ‘Bad Bugs’ (pollen) will come in and reside in your home causing chaos. probably in the middle of the night. What are we to do? Stay in? NO! Fresh air is clarifying for your body and soul and we need to awake in spring to more outdoor time. Protecting yourself is ley from allergy flare ups but also purging your home of bad air. Recommendations for indoor air quality report that damp mop and damp dusting contains airborne irritants and helps keep respiratory triggers at bay. Also wearing something that can cover your nose and mouth when you are outside prevents you from breathing in potential irritants. Opportunity for air exchange in your home is good, but don’t do it on windy days when you are more likely to have distribution of airborn irritants come into your home. Enjoy the sunshine, and the fresh air.

What Lurks in the Lawn?

Sandra McTernan, MSN — Mon, 06 May 2013 18:39:11 +0000

Spring has given us some warm, sunny weather. It is nice to have sunny days and more opportunities to be outside. Even if it is just laying on a park lawn, the fresh air helps rejuvenate after a long winter. Maybe hiking, biking, climbing, running and outdoor sports are on your weekend agenda. Getting active it is great. But take precautions, too. Now that we have had weather over 60/62 degrees for many days, the bugs will come. With the flies and mosquitos, there will also be ticks. Just walking through a lawn unprotected (without repellents and wearing long covered sleeves and pants), they will climb on to you. You are a food source and these tiny painless bites carry great risk for Lyme disease among other tick-borne diseases. Ticks travel on you to find a warm dark place to bite, such as underarms, groin, inside shorts/shirts, and maybe even between toes. You won’t feel it but you will see it later if a rash develops. As more people become infected, treatment is evolving. Antibiotics alone was the mainstay of treatment in the past BUT now treat-

Photo by Simon Howden / FreeDigitalPhotos.net

ment is multifaceted. Which means it can be lengthy, involves many blood tests and medications and maybe even altered lifestyle to get it in control. Report any rashes to your MD, note fevers and tiredness and any other symptoms you may have (headache, joint pain, memory issues). And protect yourself–wear insect repellents and long sleeves and pants.

Why Caregiving Can Lead to Depression

Judy Santamaria, MSPH — Wed, 01 May 2013 18:37:16 +0000

Family caregivers face a higher risk of depression than do non-caregivers. In fact, estimates show that between 40 to 70% of caregivers have clinically significant symptoms of depression.[i] And rates of depression increase as the health status of the care recipient decreases[ii] — higher levels of depression are seen in people caring for someone with a disorder that requires a great deal of hands-on care, such as dementia. According to the Family Caregiver Alliance, 30 to 40% of dementia caregivers suffer from depression and emotional stress.

What are some of the reasons family caregivers feel depressed? To name a few, family caregivers often:

Feel confined to the home and isolated from friends and their former life;
Face continual demands on them from caregiving;
Have financial worries from the many out-of-pocket expenses related to caregiving; and
Have to deal with difficult behaviors and changes in their relationship with their loved one.

Compounding the problem for depressed family caregivers is that they are often so busy, they don’t seek help for themselves. Or they choose to “grin and bear it” rather than get professional help. Many aging baby boomers and Korean War veterans, for example, stigmatize mental health problems, and believe they should “tough it out” themselves. But untreated depression can lead to worse depression, a host of physical illnesses, thoughts of suicide, and earlier death. A recent study has even shown that depression is the factor most strongly linked to long-term mortality after liver transplantation,[iii] emphasizing the important link between mental and physical health.

Depression can be treated. Larry Jacobsberg, MD, PhD, a psychiatrist in VNSNY’s Behavioral Health program, stated in a VNSNY Twitter Chat that depression can be treated with medication and cognitive behavioral therapy (CBT). CBT is psychotherapy that helps a person become aware of inaccurate or negative thinking and respond to it in a more effective way. “CBT is a proven self-management tool that involves structured exercises and ‘homework’ to be done between therapy sessions. The combination of both medication and CBT is the most successful way to treat depression — medication helps therapy to be more effective; therapy helps optimize the effects of medication.”

If you or someone you know is a caregiver, be aware of the higher risk for depression. Signs that you or someone else might be depressed and need help include:

Loss of interest or pleasure in usual activities
Change in weight or appetite
Inattention to grooming
Change in sleep patterns or extreme fatigue
Thoughts of suicide

If you are experiencing these symptoms, it’s important to tell a friend, your doctor, or a counselor how you’re feeling and to remember that effective remedies exist. Treating depression will enable you to remain at your best psychologically, and therefore in the best position to provide ongoing care for your loved one.

[i] Zarit, S. (2006). Assessment of Family Caregivers: A Research Perspective. In Family Caregiver Alliance (Eds.), Caregiver Assessment: Voices and Views from the Field. Report from a National Consensus Development Conference (Vol. II) (pp. 12 – 37). San Francisco: Family Caregiver Alliance.

[ii] Grunfeld, E. (2004). Family caregiver burden: Results from a longitudinal study of breast cancer patients and their principal caregivers. Canadian Medical Association Journal, 170(12): 1795-1801.

[iii] http://alert.psychiatricnews.org/2013/03/untreated-depression-can-lead-to.html

Preventive POWER of Movement

Sandra McTernan, MSN — Mon, 29 Apr 2013 18:03:25 +0000

From the day we are born, we age. It is inevitable. But did you know that the more sedentary you are, the less efficient all your organs become? And as we age, our ability to make up for this sedentary lifestyle decreases dramatically. As more children are diagnosed with what I refer to as ‘TOO MUCH Sitting Syndrome.’ From urinary incontinence, skin rashes on their laps from laptop computers, lack of normal sleep and chronic backpain and eyestrain, where will our children be at 30? 40? 50? Probably not well. Aerobic exercise is more beneficial than many want to admit but we do think and feel better when we move. The physical challenges of running, swimming, walking and lifting weights add to improved muscle memory, neurological function and brain activity. Four to five times per week has the most benefit. So how to get your kid to move may be challenging, but if they are motivated by computer use, use computer time as the reward. One hour of computer time for every one hour of movement. Now, if only I could invent the bike that powers the computer–even better!

Spring and Allergies

Sandra McTernan, MSN — Mon, 22 Apr 2013 17:19:41 +0000

As warm weather approaches, some are struggling with allergies. If you and your family are “blessed” with environmental allergies (alleries to things like pollen and mold), then you are likely dreading this time of year. Praying for rain (to clean the air) may be one of your strategies. And seeing there has been little rain, it is time for a new strategy. First and formost, do you know what you are allergic to? If not, basic allergy testing could be extremely helpful in determining the culprit of your symptoms. Then you can avoid what makes symptoms worse, keeping them in check. However, it is estimated that as many as 65% of allergy sufferers do not know their trigger. They associate it with the time of year, there may be years whem their symptoms have been mild and other years when their symptoms are severe. It is impossible to plan for better health if this is your only strategy. Our goal is always optimal health, so how can we do that?

First, update your allergy testing if you have never had it or it has been many years since you were tested. Second, home air purifiers and keeping windows closed is important prevention. Third, taking your medication as prescribed and informing your MD if there are any problems with your medications is a smart step. And finally, avoid those who are ill, as colds and flu can exacerbate your allergy symptoms, making recovery harder and convalesence longer. Stay healthy, breathe healthy!

An Adventure in ANXIETY

Sandra McTernan, MSN — Mon, 15 Apr 2013 20:00:08 +0000

Remember when you were a teenager and you had some big test, activity or responsibility coming up, how you tried but just could not sleep? Does it still happen today? Our ability to adjust to stressful events is often also reflected in our children. Yes, does our son or daughter react as you did? How difficult it was for you then and how difficult it is to watch your child going through that anxiety now. What is a parent to do? First, a certian level of anxiety is normal and good as a motivator. BUT, when this anxiety drives your child to avoid school and activities that they enjoyed, intervention is necessary. Is there a pattern? As children get older they need to adapt and develop the skill to deal with everyday decisions and possibly things just not going their way. Mastering the worry that comes along with that is dependent upon maturity. As a parent, offering reassurance and a nonjudgmental ear is always the best place to start. You may not approve of some decisions/actions but ultimately your child will learn from them. Second, help your child identify and develop healthy coping skills. These skills will evolve over time and help them adjust to the challenges of adult life.

Sexuality and Aging

Debbie Stricoff — Mon, 15 Apr 2013 12:56:37 +0000

An important component of the VNSNY CHOICE Adult Day Center is offering health education to our seniors. We want to provide our members with information to help them live safe and healthy lives at home, as long as possible.

Last week, we had a terrific speaker from the Jamaica Service Program for Older Adults (JSPOA) present on Sexuality and Aging. The speaker, who’s an RN and a senior herself, helped our members get comfortable with the topic while educating them. She spoke about living a healthy, sexually active life regardless of age. She also educated us on a surprising statistic – “almost one-fourth of all people with HIV/AIDS in this country are age 50 and older.” (National Institute on Aging – http://www.nia.nih.gov/health/publication/hiv-aids-and-older-people).

It’s interesting that no matter how old the audience, this topic makes people giggle. Our seniors started off quiet, then giggled, then full on expressed their opinions and thoughts. I’m so glad we helped them get comfortable with the topic so they could ask some very important questions and really learn how to protect themselves and stay healthy. Here are some of their comments:

I didn’t think seniors could get HIV/AIDS.
I didn’t know if someone was pregnant, they could pass diseases onto the baby.
We are never too old to learn something new.
I may not be active anymore, but I’m sure going to pass this information on to my grandchildren.
I haven’t been sexually active in many years, but I should I still get tested.

To learn more about this important topic, see the Administration on Aging’s Toolkit of information at http://www.aoa.gov/AoARoot/AoA_Programs/HPW/HIV_AIDS/toolkit.aspx

Five Ways to REALLY Help a Family Caregiver

Judy Santamaria, MSPH — Fri, 12 Apr 2013 21:37:37 +0000

Almost all of us know someone who is a family caregiver—someone who provides frequent or even daily assistance to a family member, friend of neighbor. We know this is a hard job, which often leads to feelings of stress, fatigue and isolation. We want to help that person, and many of us even offer. We say, “Please know that I’m here for you. Call me if there’s anything I can do.” But they don’t call. Are they so in control of the situation that they don’t need help?

Chances are the answer to that question is a resounding no. There aren’t many long-term caregivers who couldn’t use a hand now and then. The problem is, like many of us, they don’t like to, and don’t know how to, ask for help. They know you’d be there for them if they asked, but they don’t want to burden you. So they muddle on alone.

They are brave souls, these independent family caregivers. But a little help from you could go a long way in easing their burden and helping them feel supported. So really, what can you do? Here are some ways to help a family caregiver, without waiting for them to ask:

Invite them to lunch, for a walk, or a quick pedicure. If they can leave their family member for a short time, a change of scenery is a great way to re-energize.
If they can’t leave the house, stop by for a cup of tea. Don’t stay long, just long enough to show them you care. Don’t be offended if they have to cut the visit short, or if your timing is not right and they can’t see you at all. Just the fact that you cared enough to show up will mean a lot to them.
Send a meal. Very few caregivers will ask someone to make them or their loved one food, but almost everyone appreciates it. Make it a simple dish that is palatable to most people and will freeze well in case they can’t eat it right away.
Call them when you’re IN the grocery store or pharmacy and ask if you can pick up anything for them. If they know you’re not making a separate trip, they may admit there are a few things they need.
Give gift certificates for services that will help them – such as restaurants, laundry services and grocery stores that deliver. They may not splurge on these services themselves, but will appreciate them if given as a gift.

You’ll probably find that family caregivers are more likely to take these specific offers for help than general offers such as “Call me if you need anything.” Either way, when a family caregiver does accept your help, they may act embarrassed. Assure them that you know they’re doing a herculean task, and that you’re just trying to ease the burden they face in caring for another.

When Your Loved One Resists Treating Hearing Loss

Judy Santamaria, MSPH — Mon, 01 Apr 2013 19:16:07 +0000

As a family caregiver, your goal is to help your family member hear as well as possible so they can remain vibrant members of their community and connected to the life around them. While there have been many improvements in hearing assistive technology, and many people report that a hearing aid has greatly improved their quality of life, the reality is that many elderly people still resist any mention of their hearing loss, never mind getting treatment for it. And to be honest, many users of hearing aids report that “they’re not perfect.” Often, a person finds that more than one device is necessary to maximize their ability to hear, leading to a higher cost and time commitment. It’s no wonder that so many family caregivers face resistance when suggesting hearing aids for their loved ones.

If this happens in your family, know that you are not alone, and it is not a result of your inability to give a convincing argument. Many people will eventually seek help for their hearing difficulties. In the meantime, there are things you can do to help your family member hear to the best of their ability and remain connected to the world around them:

Talk openly with your loved one about their hearing loss. Explain how common it is among people their age, and encourage them to talk about their concerns and fears.
If they mention a fear of becoming dependent on others, explain that certain devices may prevent that. Additionally, the sooner they deal with their hearing, the better, because reduced stimulation to the ears and brain can actually impair the brain’s ability to recognize speech later, even with a hearing aid in place. ^[i]
When talking with your loved one, face them directly so they can see your lips move and your face react.
Speak loudly and clearly, but do not shout. You don’t have to talk slowly, just more clearly.
Try to control background noise. At home, turn off the TV or the radio if it does not have to be on. In a restaurant, do not sit near the kitchen, under a speaker, or near a band playing music.
Continually re-assess your family member’s hearing options, and encourage them to talk with a professional if they are not satisfied with how they are hearing. Very often, improvements can be made, and you never know when they may suddenly be open to the idea of exploring options to hear better. ^[ii]

For more tips on caregiving for a loved with communication difficulties, please go to: When Your Loved One Can’t Communicate.

^{[i] http://www.americanhearingbenefits.com/hearing_loss_signs.jsp}
^{[ii] http://www.nidcd.nih.gov/health/hearing/pages/older.aspx}