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The Best Option for Your Health Maintenance, by Emily Rowden Fournier

Whether you are young or old, things can happen to make you no longer able to care for yourself. It is a frightening truth. However, home health care is a way to give people who have loss of abilities to participate in a well-lived and meaningful life.

Services that are offered to people depend on the person’s individual need. You are the person that matters; nothing about home care is cookie cutter. As stated in a recent proclamation signed by Governor LePage of Maine on October 15, 2012, “Home care is the most preferred method of health care delivery among disabled, elderly, and chronically ill individuals eager to live independently in their own homes as long as the possibly can.” There is a lot to take in while deciphering what services are best for you, however, most fit within 2 categories: PSS and nursing.

Personal Support Specialist (PSS) services involve helping you participate in Activities of Daily Living as well as some general housekeeping. By providing an all-inclusive service, the worker gives you a better quality of life. Imagine how great it is to not have to worry about exhausting yourself to vacuum and do dishes, especially if it hurts to stand for a long period of time, and also know that someone will help you with bathing and dressing. A PSS works with you to help you in the areas you need help, with both personal care and care of your environment. For a person who is not able to take complete care of himself/herself, whatever the reason, PSS services will give him or her the independence that he/she needs while providing the services they require.

Anyone who has spent a day in a hospital knows that it is an uncomfortable place. Although the beds are made to be welcoming, it is not your bed and you do not have access to your personal possessions should you want them. Having a nurse come to your home to care for either short or long term situations can be a relief. Nurses are able to provide your PCP with information about your medical situations while avoiding weekly office visits. They can help with medical advice or treatment, wound care, medication preparations, and much more. This compassionate care can be provided for both short term and long term medical needs. Many types of in home nursing can be paid for by your health care insurance provider at little or no cost to you.

Living at home is always the best option. It gives us a sense of who we are and the feeling of independence. We have control over our homes, which may not be true of other facilities. Home is where our families gather. “Home care services allow families to stay together, and provide for greater health, dignity and comfort,” Gov. LePage signed. With home care, you can still enjoy the activities that you want to participate in, have the security of your own home, and participate in the decisions of your health care treatment.

Posted in Long Term Care

5 Questions to Ask Before You Start Home Care, by Emily Rowden Fournier

Starting home care can be a scary thing. There is so much to consider when choosing a provider. Some questions always come to mind regarding your safety and the safety of your property, your needs, and even whether or not you REALLY want home care. Many people feel pressured into getting home care from their families. Some people realize the things they are no longer capable of doing on their own but see home care as a failure on their part.

Let us set the record straight: Many people, of all ages and walks of life, receive home care for one reason or another. It should not be an embarrassment to ask for help. You are no less of a person because you need services. In fact, you may find that home care can give you back some of the life you once had, or would like to maintain.

So how does one figure out if home care is right for them, and which home care company they should hire? Here are some questions you should ask before you start home care.

  1. Do I need home care?
    This question may seem simple enough, but is often the most overlooked. Here are some sub-questions of this question. Answer each one and see where you fit in.
  • Have you ever thought of receiving home care?
  • Has your family suggested getting a nurse, housekeeper, or other aid to help you with your daily activities?
  • Are you or your family finding that you are forgetting to take your medications, pick things up from the pharmacy, or other tasks?
  • Do you find driving and shopping to be more difficult lately; or, do you need someone to do these things for you?
  • Are you exhausted or worn out by daily tasks?
  • Are you feeling like you are becoming a difficulty for your family to help care for?

If you answered “Yes” to any of the above questions, you may want to start home care. Having a nurse or personal service specialist come into your home can give you and your family peace of mind while allowing you to do the things you want to do.

  1. What services do I need?
    Many home care agencies offer different services. Some will only provide services for a duration after a hospital visit. Others specialize in certain diseases or stages in life. It is important to find the one that fits you. Home care becomes a relationship between you, the provider(s), and the supervisor(s). You want to find the people that you are most comfortable with. By recognizing what services are most important to you to receive, you will be able to narrow your search to those who will provide those services.
  1. How long will I need services?
    Not all people need services forever. For instance, if you are going into a surgery that requires a long healing process at home, you may need services for that period of time. However, some people will require the agency’s service for the rest of their lives. Knowing how long you will need the services can help you better plan what kind of services and which agency is best fitted for you.
  1. How will I pay?
    Money is an important thing when considering hiring an agency. There are programs and insurance companies that will pay or help pay for home care. However, sometimes people are not eligible for these services. When considering home care, it is important to find out how much the agency will charge you for various services.
  1. What kind of background check do you do on your workers?
    This is not so much a question for you, but for the agency you choose. Think about it: Do you want someone being sent to your home to take care of you without knowing that their background is clean? Do not just assume that the agency you are planning on hiring does a sufficient criminal background check. It is better to be safe than sorry.

Do not be afraid to interview the agency. Remember, you are hiring them. Healthcare providers like to see you take charge of your own care; they will not be upset at all the questions. Impress the agency with showing them that you know what you want, what you can afford, and what you seek out of them. Do not be afraid to let them know if you are looking at other agencies as well. Also, talk to other people, get referrals. Friends and family will be honest about services they have received and who was good and who was not. All in all, be comfortable with the change. It can be a difficult decision, but it is not necessarily a bad one. Home care can be a relief and can give you your life back if you let it.

Posted in Long Term Care

How I Met My Cousin, by Emily Rowden Fournier

We all know the phrase “actions speak louder than words.” In many cases this is true. How would your reaction differ if someone said they would give you a hundred dollars or if someone actually handed you a hundred dollars? However, in some cases this sentiment does not hold true. For 1 out of 110 children, neither actions nor words express their true selves. Although communication is a large struggle with Autism, there is a ray of hope found in technology.

“Hi Cinderella, you wearing your ball gown?” This salutation greets me nearly every time I am on Facebook. It may sound funny to those who don’t know us, but to my cousin, Steve*, and I it is a joke that always makes us giggle. Steve is a dirty blond sophomore in high school with a goofy smile. He is a fan of computer games, a cartoon fanatic, and autistic. The latter is not a characteristic I would normally use in introducing him, not because of shame, but because of the reaction of pity it normally receives. Steve has always been autistic; my family has learned to adjust accordingly. Because of his underdeveloped social skills, associated with his autism, we know that long face-to-face conversations about his life are not going to happen. “How is school going?” Shrugs shoulders. “What are you watching?” Just stares at the television. It isn’t that he is trying to be rude, rather, that he cannot accurately respond.

It is believed that autism affects the way people perceive their surroundings. Unlike most people, autistic people cannot filter their external and internal influences. So, everything that happens around them gets processed on the same level of priority. Because of this they are not able to see the big picture; they do not understand parts of their setting as varying in importance. Although this may improve over time, the things that society consider vital may forever seem insignificant to an autistic person.

Because of their overburdened processors, it is often challenging to communicate with autistic people. They sometimes may not respond, and some of them actually cannot respond. Imagine having a baby crying, a pot of spaghetti boiling over, the dog barking, a cut finger, and the phone ringing all at the same time. Most likely you would ignore the phone, let it go to voicemail, in order to attend to the other situations. Similarly, an overload of external stimulation prevents an autistic person from being able to express him/herself. Some are able to speak, although their speech may be slow or blunt; however, some are unable to communicate verbally altogether. Yet, recent studies have found that this is not a refusal to communicate, but an inability to communicate verbally.

Computers have allowed the silence of autism a loud voice. Carly Fleischmann, an autistic teenager who has found her voice through typing, has been one of the most influential autistic teenagers in the study of the effects of computers and typing and autistic communication. Her website, carlysvoice.com, features her writing, interviews, and even a questions-and-answers section that Carly responds personally to questions about autism. Carly’s answers are some of the first personal experiences of what it is like to be autistic, she is giving scientists and interest groups insight into the silent disorder. Typing one finger at a time, she plugs through pages of text, expressing herself and giving a voice to those, like her, who have been considered unable to communicate. Parents and teachers are now pushing for funding and programs that would allow autistic children to use computers and other electronic devices to communicate. Carly, a very smart girl, says that “things don’t always look like they appear. Just because in your eyes I might not look smart does not mean that’s the case.” Carly could not be more correct.

“You wearing your ball gown?” This was the first time I had ever had a conversation with my cousin, Steve. Why was he calling me Cinderella? I thought that was a strange nickname for me. Perhaps he was confused about who I was or thought it was my favorite movie? The reason was quite clear, I had just overlooked it. He had just looked at my wedding photos on Facebook; he thought I looked like Cinderella and that I should wear a ball gown often as I looked beautiful. Tears swelled to my eyes as I talked with my fifteen year old cousin, who I have known since he was born, because I was meeting him for the first time. Since that fateful day on Facebook chat I have had hundreds of conversations with Steve. I know his favorite shows, his favorite subject in school, what he thinks about from day-in to day-out. He says the things that he cannot when we see each other face to face. Steve even told me things that I never dreamed he thought about.

“I like that you don’t treat me differently. You always talk to me when I see you.” Steve told me over the computer. I felt vindicated; all those years of family get-togethers that I had painstakingly spent asking Steve questions about his life with no answer had paid off. My efforts weren’t in vain; I just wasn’t listening the right way. So often people overlook those with any sort of disability; it is easy to act as though they are invisible. However, when we reach out to them, even if they do not respond immediately, we can affect them.

Because of technology autism and those with it is finally able to speak. For so long the autistic community was looked at with so many questions and no answers. Finally, those who are most familiar with the disorder are able to express its effects. Perhaps in the near future we will see technological advances that will further our depth of communication with people with autism.

*Name changed to protect anonymity.

Posted in General

9 Mental Disorders and How to Spot Them

Mental illnesses can appear over time. Not every person who has a mental illness is born with the signs and symptoms of one. Some appear at certain times in one’s life. Here are 9 mental disorders, when the signs and symptoms are most likely to appear, and how to spot them.

Ages 0-18

Autism: Autism is a neural developmental disorder. It affects the way people socialize and communicate by causing the person to use restrictive and repetitive behavior. People with autism are often withdrawn, do repetitive motions (called stimming), and, in many cases, do not communicate verbally. There is no known cause for autism, but it is believed to be related to nerve cell synapses to the brain. Symptoms usually begin to appear in infancy and develop over the first few years of the person’s life. Symptoms include: impairments in social interaction, impairments in communication, restricted interests and repetitive behavior, atypical eating. Many parents first report a “blank expression” as being the first sign of an autistic child. The child does not react normally to stimulants— such as not laughing at funny faces, staring past people, not focusing on objects or faces, and not mimicking the faces of others. It may take years to properly diagnose autism, as doctors must study the child’s behavior. There is no known cure, but early intervention can help an autistic child succeed.

Attention Deficit Hyperactive Disorder (ADHD): ADHD and ADD (Attention Deficit Disorder) manifest in one’s school years, ages 6-18. Symptoms include trouble focusing on tasks, hyperactivity, unexplainable behaviors (such as creating trouble without knowing why they did it), easily distracted, poor grades on tests, and not completing tasks appropriately. ADHD and ADD are considered behavioral disorders, not neurological. Doctors diagnose this disorder by testing the client on various levels of activity and attention. Treatment includes medications (such as stimulants), behavioral interventions, and therapy. Often symptoms suppress after the child reaches adulthood, although many adults face the challenges of ADD and ADHD.

Tourette Syndrome: Tourette Syndrome (also known as Tourette’s) is an inherited neuropsychiatric disorder. The external signs of this disorder is a combination of physical and verbal tics. A tic is a movement or sound that occurs unpredictably and intermittingly with normal activity. Some tics include: eye blinking, twitching, coughing or throat clearing, and saying certain words randomly. A tic is actually a conscious effort, such as scratching an itch, to relieve whatever sensation the person is feeling. Tourette Syndrome may be diagnosed if a person experiences a motor tic with at least one vocal tic over the course of a year, without a period of more than three months devoid of a tic. These symptoms can be seen in children at an early age. Tics can come and go throughout one’s life; in severe cases, if the symptoms are disruptive to the person’s life, medication may be prescribed.

Ages 18-50

Schizophrenia: Schizophrenia is characterized by a disintegration of thought processes and emotional responsiveness. Early symptoms include auditory hallucinations, paranoid activity, delusions, and disorganized thoughts. As these symptoms progress the person may begin to withdraw from normal social activity and have difficulty working or sustaining a job. Symptoms begin to manifest in early adulthood, usually between the ages of 17 to 30 years old. Despite popular belief, Schizophrenia does not lead to multiple personality disorder, nor do people with Schizophrenia have multiple personalities. Schizophrenia can be caused by genetics, environment, drug abuse, and viral exposure in utero. A doctor can diagnose the disease and may prescribe medications and therapy to help manage it. Life expectancy is approximately 12-15 years after the symptoms manifest, with a high suicide rate because of the troubles noted with the disorder.

Premenstrual Dysphoric Disorder (PMDD): PMDD is a disorder that affects only women. It is similar to PMS, but has more severe, lasting symptoms. The symptoms of PMDD include: feeling deep sadness or depression the week before and throughout your menstrual cycle, suicidal ideation, anxiety, panic attacks, difficulty concentrating, fatigue, insomnia or over sleeping, binge eating, uncontrollable crying or emotions, severe mood swings, the feeling that everyone is against you, and disinterest in relationships. These symptoms coincide with a woman’s menstrual cycle and do not persist more than a few days after the cycle ends. Unlike PMS, PMDD occurs regularly, with similar symptoms and lasts through the cycle. PMDD can be diagnosed by a doctor and medications, such as certain birth control pills, can be prescribed to lessen the severity of the symptoms. Therapy may also help, as well as the knowledge of the regularity of these symptoms as a reminder that they will pass with the menstruation.

Post Traumatic Stress Disorder (PTSD): PTSD was once known as shell-shock and thought to only occur in soldiers returning home from war. Doctors have since realized that similar symptoms occur in people of all backgrounds who experience a serious traumatic event. Although children can get and exhibit PTSD, it is most commonly found in adults. PTSD occurs after exposure to a traumatic event, such as war, rape, and lose of property or someone close. Symptoms include: reliving the experience, depression like symptoms, withdrawal from social activities, persistent numbing of the incident, and persistent arousal not found before the incident (such as not sleeping, overt sexual activity, etc). Symptoms must last over a month in order for PTSD to be the diagnosis. Therapy is used to aid people with PTSD.

Eating Disorders: Eating disorders, such as bulimia nervosa, anorexia nervosa, and binge eating, stem from a mental disorder that causes the person to view themselves as having a different (often larger) body type than he/she actually does. Although some people develop eating disorders over time, many people who suffer from them are genetically predisposed to the disorder. Often people with eating disorders feel a lack of control in their own lives, and so they control what they eat as a way to feel they can manage something. Many people also have body dysmorphic disorder, a mental disorder that alters the way the person views him/herself. Eating disorders are often treated with psychological assistance, such as councilors or group therapy.

Dissociative Identity Disorder: This psychiatric disorder is also known as Multiple Personality Disorder. A person with this disorder has many personalities, or identities, with distinct characteristics and ways of seeing and interacting with the world. Causes include severe stress, insufficient nurturing in childhood, and dissociation of memories from consciousness. Some people experience uncommon memory loss and a fading sensation between two or more personalities. Generally each personality has its own background, name, characteristics, and likes and dislikes. These personalities may not be at all correlated—one may love fish, smoking, and drinking, while the other may despise seafood and vices. In order to diagnose, personalities must exhibit for over a long period of time and include memory lapses. A psychiatrist can diagnose this disorder. Therapy is offered to clients with multiple personalities in order to try to reconnect these identities to the original host.

Ages 50-End of Life

Dementia: Although people of all ages can be struck with dementia, for various reasons, it is commonly seen amongst the elderly. Some causes of elderly dementia include slowing nervous system, loss of brain mass, and degeneration of brain neurons. Symptoms include forgetfulness, an inability to communicate properly, slowed or stumbling steps, falls, repetition of words or phrases, and short term or long term memory loss. People with dementia may believe they are able to do things they cannot do, such as walk even though their leg was amputated, or drive a car. The may lose the ability to recognize family members, or may think that they are younger than they actually are. Dementia can be diagnosed by a doctor and certain medications can help slow the process. Adjustments to surroundings and social settings may be made in order to maintain the safety of a person with dementia. The number one adjustment made when a person is diagnosed with dementia is on the family, which must be counseled to understand the progression of the disease and how to adjust accordingly.

Science is presenting new research on many of these disorders all the time. It is important to remember that early detection is vital in treating all of these disorders. If you think that you or someone you know has a mental disorder, please contact a physician and get help. Many of these disorders are correctable or treatable. It is possible to be diagnosed and continue your quality of life.

Posted in Mental Health

10 Ways to Help Mom Feel Involved With the Holidays, by Emily Rowden Fournier

Mom always made the holidays warm and special. She spent hours baking yummy cookies, trimming the tree, and long nights carefully wrapping each present so you wouldn’t see. She yearned for the excitement in your eyes when you received your first bike, the doll you wanted, and each gift that she had spent months choosing specifically for you.

This is an image of Mom that may be long forgotten. Her soft blonde/brown hair has been replaced with gray curls. That stove she used to stand in front of to prepare dinner each day is dusty from disuse. Her perfect suits have been given to thrift stores and replaced with comfortable stretch clothes. She no longer has the energy to wrap hundreds of presents or address cards to friends and family, and if there are cookies they come from a box.

Although Mom has gotten older, more forgetful, and needs more personal care, it does not mean that she has forgotten the pleasure of the Holiday Season. She may not have the energy for every activity, but here are some ways to help Mom feel involved with the holidays.

  1. Keep things simple. For the aging generation, rushing from party to party is not always a possibility. Health concerns may be an issue, but, for many, this is just exhausting. If the family always gathers at one major party, take her to that one. Stay with her throughout the event, talk with her, let her tell stories. Although Mom’s memory may not be what it used to be, and although she may not even seem highly engaged in the event, she will appreciate that she was not treated like a piece of furniture.
  2. Help her decorate. It may be getting harder for Mom to put out every decoration, and, let’s face it, no one likes the idea of her standing on a chair, alone, trying to put the star on top of the tree. Set up a day to go over to her place and decorate it. A small, tabletop tree may be a better replacement for the 7 foot one you chopped down in the woods behind the house you grew up in. Bring out the favorite ornaments: Our first Christmas, Baby’s first, that strange thing Aunt Mildred made in 1940 (we all know we have one of those, but we love them). Play her favorite music while you decorate and let her tell you where to put everything. Having her favorite things out on display will make her feel closer to those precious memories of holidays past.
  3. Bring dinner to her. If Mom always played hostess, she will love having the chance to take out her fine china and table linens, especially if she does not have to spend the hours cooking the goose with all the trimmings. If you live close enough, do all the preparations ahead of time. Then, giving yourself enough time before dinner is scheduled, bring it over to her house. Let her help you set the table by having her fold the napkins or other small tasks that will not wear her out. She will love seeing her happy family gathered around her table once again.
  4. Make traditional foods. If your family always had a certain food at the holidays, that you have since dropped for a different option, go back to the former. For instance, if your family has always had tourtiere pie (a popular French Canadian meat and potato pie served during the holidays) but you are now a vegetarian, make the pie for those who still desire it. Find alternatives if there is a reason for not using the old family recipe. Replace meat with vegetarian grounds, limit the salt, or use yogurt butter instead of salted cream butter. Most likely no one will notice the difference, and everyone, especially Mom, will love the tradition being restored.
  5. Take her shopping. Anyone who has taken an aging parent to the store knows that this may be a challenge. It takes longer to park and get into the store, they want to look at each item, price it out, etc. We are familiar with the complaints of “$10 for this?! In my day you could buy three of these for a buck!” Despite these remarks, Mom loves to shop. She does not want to burden you constantly to go shopping, but that desire does not disappear after a certain age. She likes seeing things that remind her of certain people, and buying those things for them. Mom likes to personalize her gifts still. Set up a day when the stores may not be overly crowded. Take her to one that has a lot of products at an affordable price, such as a department store. Make sure the store is easily accessible, has carts that she can lean on or an electronic chair that she can drive around in so that she has the energy to spend a lot of time there. Ask the customer service representative if they offer gift wrapping, that way Mom does not still have that task around of her.
  6. Take Mom to see the lights. Everyone loves turning on a radio station that is playing carols and driving around town to look at the lights. This is a fun, low key experience. Even if Mom drives still, she may not like driving at night and may not even be able to pay attention to the beauty of the lights while focusing on the road. Let her sit in the passenger’s seat and stop at each decorated house. This way you and Mom can take in the beauty. Talk about favorite winter experiences, sing along with familiar songs. This will make a memory that you are sure to never forget.
  7. Open presents with her. As previously mentioned, Mom loved to watch you open presents, Mom still loves to watch you open presents. Bring her to your house before anyone starts opening gifts. Sit her in a comfortable chair where she can see everyone. Have each person open their gifts one at a time, so that Mom can really take in their expressions.
  8. Give sensible gifts. Although fine jewelry and collectable knickknacks were once presents Mom adored, she may not have opportunities to wear pearls and her space may be too limited for figurines. Mom will, however, love new clothes, warm bathrobes, slippers that go over her whole foot, and new bedding. If Mom is still living in her own home, she may like housecleaning services, lawn care, or other services that you know she is in need of but cannot afford. Remember the adage: It’s the thought that counts. Mom will feel so good knowing that you thought about her and spent the time to get her a gift.
  9. Take her to concerts. A lot of churches, school groups, and businesses offer free holiday concerts. These are easy activities for Mom to enjoy because all she has to do is sit and listen. If Mom has trouble hearing or seeing, talk to the venue beforehand and reserve a seat near the front where she may have an easier time to hear and see. Nowadays most public concerts are casual so Mom does not have to spend hours prepping. Make sure, however, that the venue takes place indoors, so that Mom does not get too cold.
  10. Spend time with her. Look at photo albums, share stories, give her hugs. Even if Mom does not remember every detail, she will love that you do. It will be a joy for her to see the photographs from your youth. Although her recent memories are not of grand trips to Paris, the new ones you create with her will be just as important as those fond ones from her past.
Posted in General