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Family Health

Dee Staudt

2012-04-19 10:46:53

Q: I drink alcohol almost every day, and occasionally, I drink to the point that I don’t remember things. Do I have a problem with alcohol?

A: Do you know that a few seemingly minor changes in behavior, which you might not recognize as trouble, can signal the start of a drinking problem? Some people may drink occasionally, but can also unwind or enjoy social events without drinking. However, other people may regularly drink above recommended limits (one drink per day for women and older people, two drinks per day for men); or may feel like they need alcohol in order to relax, have a good time, or feel better. If you find yourself needing to drink, you may have a problem with alcohol. Licensed professionals diagnose an alcohol disorder when a person’s drinking causes distress or harm and begins to interfere with everyday living. Do you recognize any of these symptoms in yourself or a family member? In the past year, have you (check all that apply): • Had times when you ended up drinking more, or longer, than you intended? • More than once wanted to cut down or stop drinking, or tried to, but couldn’t? •More than once got into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)? • Had to drink much more than before to get the effect you want? Or found that your usual number of drinks had much less effect than before? • Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having a memory blackout? •Spent a lot of time drinking? Or being sick or getting over the aftereffects? • Continued to drink even though it was causing trouble with your family or friends? • Found that drinking or being sick from drinking often interfered with taking care of your home or family? Or caused problems at work or school? • Given up or cut back on activities that were important or interesting to you or gave you pleasure, in order to drink? • More than once gotten arrested, been held at a police station, or had other legal problems because of your drinking? • Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart or a seizure? Or sensed things that were not there? You may have heard that light to moderate drinking can be good for the heart. With heavy or at-risk drinking, however, any potential benefits are outweighed by greater risks, including injuries. Drinking too much increases your chances of being injured or even killed. Alcohol is a factor, for example, in about 60 percent of fatal burn injuries, drownings, and homicides; 50 percent of severe trauma injuries and sexual assaults; and 40 percent of fatal motor vehicle crashes, suicides, and fatal falls. Heavy drinkers have a greater risk of liver disease, heart disease, sleep disorders, depression, stroke, bleeding from the stomach, sexually transmitted infections from unsafe sex, and several types of cancer. They may have problems managing diabetes, high blood pressure, and other conditions. Drinking during pregnancy can cause brain damage and other serious problems in the baby. Because it is not yet known whether any amount of alcohol is safe for a developing baby, women who are pregnant or may become pregnant should not drink alcohol. Beyond these physical and mental health risks, frequent heavy drinking also is linked with personal problems, including losing privileges, such as driving, and relationship troubles. Most people don’t realize when their drinking becomes a problem. When most people think of someone who has a drinking problem, they think of an individual whose life is falling apart or has hit “rock bottom”, but that only really occurs with the most severe cases of alcoholism. Seek help from your family physician or an addiction professional if you feel you have a problem and want to talk with someone confidentially. Take charge of your health and your life.

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Family Health

Dee Staudt

2012-02-27 12:02:38

Q: I have read a lot of stories about gambling addiction. I go occasionally and really have a good time. What are the chances of people getting addicted?

A: There’s no doubt that gambling addiction exists, but the research out of Stanford Graduate School of Business indicates that casinos are primarily entertainment destinations. The research provided by Sridhar Narayanan and his co-author, Puneet Manchuanda, associate professor of marketing at the University of Michigan’s Ross School of Business built a model based upon how consumers behaved during casino visits by analyzing both their “play decisions” - whether to continue gambling or stop after a win or loss - and the size of the bets they placed. What they found showed some intriguing insights into this gambling-as-entertainment theory. For example, research indicated that people have fairly rigid thresholds for how much they are willing to gamble. People seem to be satisfied with relatively small wins, and will tolerate even smaller losses. “Most of them won’t play after a certain threshold of loss has been reached.” They tend to be conscious that, in the long run, they are more likely to lose than win. “The research results indicate that the casinos are primarily entertainment destinations,” said Narayanan. “After all, a lot happens there other than the gambling - there’s the opulence to look at, the ability to sit and have a drink, or watch a show.” On the other hand, problem gambling is there, affecting millions of Americans of all ages, races, and ethnic backgrounds in all communities that have a significant societal and economic cost. A 1999 National Prevalence Study revealed that .9 percent of the adult populations in Kansas, approximately 18,614 Kansans, are pathological gamblers. Pathological gamblers are five times more likely to be alcohol dependent, four times more likely to abuse drugs, three times more likely to be depressed, and are eight times more likely to have a bi-polar disorder. According to Dr. Rachel A. Volberg, “Suicide attempt rates among pathological gamblers are higher than any other addictive disorder.” Problem gambling is sometimes referred to as the “hidden illness” because there are no obvious physical signs or symptoms, unlike substance use disorders. When gambling is out of control and the game is no longer about winning, but about having enough money to keep playing, it can lead to serious consequences. Problem gambling can result in financial debt, damaged relationships, job loss, loss of self-respect, and involvement in criminal activity. The National Council on Problem Gambling defines problem gambling as: “…gambling behavior which causes disruptions in any major area of life – psychological, physical, social or vocational.” Problem gambling warning signs: •A preoccupation with gambling •Talking only about wins, not losses •Gambling as a way of escaping problems •Hiding losses from family members •Borrowing money in order to gamble •Gambling results in withdrawal from family and friends •Stopping or cutting back seems impossible Problem gambling is treatable and treatment is effective in minimizing the harm to individuals and society as a whole. To help combat the growing gambling problem facing many Kansans, the state of Kansas has allocated funds to reimburse certified gambling counselors in Kansas who provide counseling to individuals with gambling problems and their families. COMCARE’s Addiction Treatment Services employs four Kansas Certified Gambling Counselors and one Kansas Interventionist for Problem Gambling and is credentialed to provide individual, group and family counseling to problem gamblers and/or their concerned family members. This treatment is available at no cost to the individual or his/her family member. March 4-10, 2012, is Annual Problem Gambling Awareness Week. The goal is to educate the general public and health care professionals about the warning signs of problem gambling and raise awareness about help that is available both locally and in Kansas.

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Family Health

Dee Staudt

2011-10-25 10:39:56

Q: I lost my best friend a year ago and still can’t shake these feelings of grief. Is it normal to grieve so long?

A: Grief is a natural response to loss. It’s the emotional suffering you feel when something or someone you love is taken away. You may associate grief with the death of a loved one and this type of loss does often cause the most intense grief. But any loss can cause grief, including the breakup of a relationship, loss of health, losing a job, loss of financial stability, death of a pet, a loved one’s serious illness, loss of a friendship or loss of safety after a trauma. Grief differs based on who you are, who or what you have lost, and how much of your day-to-day life is altered by the loss. Grief, a normal reaction to loss, is unique in its impact, course and meaning to each of us. Feelings of grief vary depending on your personality, past experiences, the length of time that has passed since your loss, and the personal importance of that loss to you. When grieving, it is normal to: • Feel sadness and yearning for the person, object or situation that you have lost. These feelings are central to all grieving. • Feel worry, anxiety, frustration, confusion, anger or guilt. • Be overly sensitive to others’ behavior. • React strongly to seemingly minor losses or changes when they trigger feelings of grief over your loss. • Feel insecure and alone, and want to isolate yourself from others. • Feel depressed or overly anxious. The grieving process takes time. Healing happens gradually; it can’t be forced or hurried and there is no “normal” timetable for grieving. But there are some things you can do to help yourself along the way. Allow yourself time to experience your thoughts and feelings openly to yourself. Acknowledge and accept all of your feelings, both positive and negative. Use a journal to write out your thoughts and feelings. Confide in a friend or family member; tell them about your loss. Crying offers a release. Expect and accept some reduction in your usual ability to be efficient or consistent in your functioning day to day. Try to avoid taking on new responsibilities or making major life decisions for a time. There are also many helpful books or websites related to grief. Sometimes it is helpful to spend time with others who are also grieving. There are self-help support groups available in the community. If grief is understood it is easier to handle. Allow yourself to enjoy a few activities, without guilt; feelings can be intense during these times. Allow yourself quiet time. Whatever your grief experience, it’s important to be patient with yourself and allow the process to naturally unfold. If the healing process becomes too overwhelming, seek professional help. Contact your doctor or a mental health professional.

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Family Health

Tom Pletcher

2011-09-28 14:08:39

Q: I am concerned about my 32-year old sister. She seems depressed. My sister has always been a very active person. About a month ago, I noticed something wasn’t right. She looks and acts extremely fatigued and I have noticed she has trouble thinking clearly when we’re together. She doesn’t go to lunch with her friends at work and she seems to be sleeping more and eating less. Last week, my sister commented that she didn’t feel she “could go on like this much longer” and that she “can barely put one foot in front of the other.” I think it’s time I get involved and help her get help.

A: You have done a good job paying attention to your sister’s behavior. The first step is recognizing that something is just not right. Many people with mental health issues feel like they don’t have anyone to talk to. Be sure to open those lines of communication, and try to make them feel comfortable talking to you. The second step is getting help. These two steps may in fact be the hardest part of the entire healing process. Mental illnesses are thought to be caused by several factors: Biological factors - Mental illnesses are often hereditary, meaning that they tend to run in families like other illnesses. Psychological factors - Various psychological factors, such as trauma suffered as a child or the loss of a close loved one, may contribute to mental illness in some cases. Social factors - Certain social or environmental stressors may also contribute to mental illness. These may include life events such as moving to a new place, a divorce or job loss, or chronic feelings like low self-esteem, loneliness or anger. When people decide they are ready for help, they should contact their medical doctor or a mental health professional. If they are not sure what mental health professional to call, contact the community mental health center and they can assist you. Once you seek help from a qualified health care provider, and the correct diagnosis has been made, proper treatment can be given to help get you back on track. Many safe and effective treatments exist. Depending on symptoms and diagnosis, health care professionals will explain a course of treatment that best fits the person’s needs. Some commonly used treatments include: Medication - Medications work to reduce the symptoms of the mental illnesses. Therapy - During therapy, a person with a mental illness talks to a licensed and trained mental health care professional who helps him or her identify and work through the factors that may be triggering the illness. If you are concerned your loved one is exhibiting harmful behavior or speaking about taking his or her own life, you need to call 9-1-1 or the local suicide prevention hotline. Professionals at these organizations will be able to quickly get help for the person in need. Remember, you are not alone - Mental illness is common; one in four Americans are affected each year. You are not the first to face a mental illness or receive treatment. Also, treatment works. This is possible because many safe and effective treatments exist today, and many people with mental illness can and do recover.

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Family Health

Dawn Easley

2011-04-01 13:55:00

Question: What all comprises long term care? How does one go about paying for it? Does Medicare and Medicaid help?

Answer: That’s a wonderful question and one that I am asked quite often. Let me start with the types of long term care. I will answer your question on paying for these types of care and the role of Medicare and Medicaid once we cover them in a detail. Community Based Services: Many communities provide services and programs to help seniors and people with disabilities with a variety of personal activities. These services include Meals-on-Wheels, transportation services, personal care, chore services, adult day care and a variety of activities in senior centers. These services are usually free or at low cost to individuals who qualify. Local organizations, called Area Agencies on Aging, coordinate these services to promote the independence and dignity of older adults. Your State Medicaid program may pay for home health services including skilled nursing care, home health care, personal care, chore services and medical equipment. You must qualify for Medicaid to receive these services. We will discuss this in detail later. The following community-based services may be available in your community: • Adult day care • Senior centers • Financial management • Transportation • Meals on Wheels • Telephone reassurance • Case management Home Health Care Depending on your needs, you may be able to get help with your personal activities (for example, help with the laundry, bathing, dressing, cooking and cleaning) at home from family members, friends or volunteers. If you think you need home care, talk to your family to see if they can help with care or help arrange for someone to come to your home to help. Some home care can only be given by licensed health workers, such as if you need skilled nursing care and certain other health care services that you get in your home for the treatment of an illness or injury. Skilled nursing care includes services and care that can only be performed safely and correctly by a licensed nurse (either a registered nurse or a licensed practical nurse) or a licensed therapist. You can also hire a home health care agency for care in your home. Home care costs can vary depending on where you live, the type of care you need and how often you need care. Usually, home care is charged by the hour. The following home health services may be available in your community: • Skilled nursing care • Homemaker/Health aides • Personal care aides • Respite care • Medical equipment • Home repair and modification • Hospice In-Law Apartments An in-law apartment is a separate housing arrangement within a single-family home or on your lot. It may also be referred to as a second unit, accessory apartment or accessory dwelling unit. An in-law apartment is a complete living space and includes a private kitchen and bath. An in-law apartment may provide a living space for a caretaker or may be rented to provide additional income to you. Many local or state governments have restrictions about the addition of a second apartment on your property. You should consult your local city or county government about zoning and other restrictions, and for help with an in-law apartment. Housing for Aging and Disabled Adults The Federal Government and most states have programs that help pay for housing for older people with low or moderate incomes, less than $46,000 if single or $53,000 if married. Usually you have to fill out an application, and there may be a waiting list. Some of these housing programs also offer help with meals and other activities like housekeeping, shopping, and doing the laundry. Residents usually live in their own apartments in the complex. Usually a Federal or State agency will review your monthly income and expenses to see if you are eligible for this type of housing. Rent payments are usually a percentage of your income. Board and Care Homes This group living arrangement provides help with activities of daily living such as eating, bathing and using the bathroom for people who cannot live on their own but do not need nursing home services. It is sometimes called a “group home.” In some cases, private long-term care insurance and other types of assistance programs may help pay for this type of living arrangement. Many of these homes do not receive payment from Medicare or Medicaid and are not strictly monitored. The monthly charge is usually a percentage of your income. Assisted Living This group living arrangement provides help with activities of daily living such as eating, bathing and using the bathroom, taking medicine, and getting to appointments as needed. Residents often live in their own room or apartment within a building or group of buildings and have some or all of their meals together. Social and recreational activities are usually provided. Some assisted living facilities have health services on site. Costs for assisted living facilities can vary widely depending on the size of the living areas, services provided, type of help needed, and where the building is located. Residents usually pay a monthly rent and then pay additional fees for the services that they get. Continuing Care Retirement Communities (CCRC) These housing communities have different levels of care based on your needs. Where you live depends on the level of care you need. In the same community, there may be individual homes or apartments for residents who still live on their own, an assisted living facility for people who need some help with daily care and a nursing home for those who require higher levels of care. Residents move from one level of care to another based on their needs but still stay in the CCRC. If you are considering a CCRC, be sure to check the record of its nursing home. Your CCRC contract usually requires you to use the CCRC nursing home if you need this level of care. Many of the questions that you might want to ask about these communities are the same as those to consider when choosing a nursing home. CCRCs generally charge a large payment before you move in (called an entry fee) and then charge monthly fees. Nursing Homes These facilities provide care to people who can’t be cared for at home or in the community. Nursing homes provide a wide range of personal care and health services. For most people, this care generally is to assist people with support services such as dressing, bathing and using the bathroom, for people who can’t take care of themselves due to physical, emotional, or mental problems. Some nursing homes may provide skilled care after an injury or hospital stay. The cost for nursing homes can vary depending on where you live and what type of care you need. Next month we will talk about costs and how they can be paid, as well as the role of Medicare and Medicaid.

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Family Health

Dawn Easley

2011-03-01 14:39:00

Question: What exactly are the rehab therapies available for seniors, and what does each entail?

Answer: Thus far in our series we have discussed physiotherapy and occupational therapy. This month, with the continued assistance from www.healthline.com, we were going to discuss speech therapy. In doing so, we will talk about some common speech and language disorders, their common causes and the therapy itself. The common speech and language disorders include: Aphasia Aphasia is loss of the ability to understand or express spoken or written language. It commonly occurs following strokes or traumatic brain injuries, or in people with brain tumors or degenerative diseases that affect the language areas of the brain. This term does not apply to children who have never developed communication skills. There are many different types of aphasia. In some cases of aphasia, the problem eventually corrects itself, but in others the condition is irreversible. Dysarthria In dysarthria, the person has ongoing difficulty expressing certain sounds or words. They have poorly pronounced speech (such as slurring) and the rhythm or speed of speech is changed. Usually, a nerve or brain disorder has made it difficult to control the larynx and vocal cords, which make speech. Dysarthria, which is a difficulty pronouncing words, is sometimes confused with aphasia, which is a difficulty producing language. They have different causes. People with dysarthria may also have problems swallowing. Voice Disturbances Anything that changes the shape of the vocal cords or the way they work will cause a voice disturbance. Lump-like growths such as nodules, polyps, cysts, papillomas, granulomas and cancers can be to blame. These changes cause the voice to sound different from the way it normally sounds. Dysphonia is another type of speech impairment. The excessive activity of the vocal cord muscles drives the vocal cords either too close or too far apart. This causes a hoarse or grating sounding voice, often with pauses (known as adductor dysphonia) or a whispery, breathy voice (abductor dysphonia), which is less common. Common Causes Some of these disorders develop gradually, but anyone can develop a speech and language impairment suddenly, usually in a trauma. Aphasia • Alzheimer’s disease • Brain tumor (more common in aphasia than dysarthria) • Dementia • Head trauma • Stroke • Transient ischemic attack (TIA) Dysarthria • Alcohol intoxication • Dementia • Diseases that affect nerves and muscles (neuromuscular diseases), such as amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), cerebral palsy, myasthenia gravis, or multiple sclerosis (MS) • Facial trauma • Facial weakness, such as Bell’s palsy or tongue weakness • Head trauma • Head and neck cancer surgery • Nervous system (neurological) disorders that affect the brain, such as Parkinson’s disease or • Huntington’s disease (more common in dysarthria than aphasia) • Poorly fitting dentures • Side effects of medications that act on the central nervous system, such as narcotics, phenytoin, or carbamazepine • Stroke • Transient ischemic attack (TIA) Voice Disturbances • Growths or nodules on the vocal cords • People who use their voice heavily (teachers, coaches, vocal performers) are more likely to develop voice disorders. Speech Therapy Speech therapy helps the patient correct speech disorders or restore speech. Speech therapy may be prescribed to rehabilitate a patient after a brain injury, cancer, neuromuscular diseases, stroke, and other injuries/illnesses. The duration of the speech therapy program varies depending on the injury/illness being treated and the patient’s response to therapy. Performed by a speech pathologist, speech therapy involves regular meetings with the therapist in an individual or group setting and home exercises. To strengthen muscles, the patient might be asked to say words, smile, close his mouth, or stick out his tongue. Picture cards may be used to help the patient remember everyday objects and increase his vocabulary. The patient might use picture boards of everyday activities or objects to communicate with others. Workbooks might be used to help the patient recall the names of objects and practice reading, writing, and listening. Computer programs are available to help sharpen speech, reading, recall, and listening skills.

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Family Health

Tom Pletcher

2011-01-01 10:18:00

Question: Around this time of year, I begin to feel like I’m not getting enough sleep at night. I wake up in the mornings feeling fatigued, in a fog or like I am just going through the motions. Then a few months later when spring rolls back around, I begin to feel better. Is this just the “winter blues” or something more serious?

Answer: During the colder months of fall and winter, when there is less exposure to sunlight during the day, some people suffer from symptoms mentioned above, that can appear gradually or come on all at once. These symptoms often dissipate as spring arrives and stay in remission through the spring and summer months. Those who work long hours inside office buildings with few windows may experience symptoms all year, and some individuals may note changes in mood during long stretches of cloudy weather. This may be a sign of Seasonal Affective Disorder (SAD). Seasonal Affective Disorder has been linked to a biochemical imbalance in the brain prompted by shorter daylight hours and a lack of sunlight in winter. Just as sunlight affects the seasonal activities of animals, SAD may be an effect of this seasonal light variation in humans. As seasons change, people experience a shift in their biological internal clock or circadian rhythm that can cause them to be out of step with their daily schedule. Melatonin, a sleep-related hormone, also has been associated to SAD. This hormone, which has been linked to depression, is produced at increased levels in the dark. When the days are shorter and darker, more melatonin is produced. Researchers have proved that bright light makes a difference to the brain chemistry, although the exact means by which sufferers are affected is not yet known. SAD may begin at any age, but the main age of onset is between 18 and 30 years. And according to the American Academy of Family Physicians, six in one hundred Americans suffer from Seasonal Affective Disorder. Some studies show that Seasonal Affective Disorder is diagnosed more often in women than in men, but that men may have more-severe symptoms. Seasonal Affective Disorder symptoms can include, but are not limited to: fatigue, lack of interest in normal activities, social withdrawal, craving foods high in carbohydrates, weight gain or weight loss, difficulty concentrating and processing information, depression and anxiety. There are some measures you can do on your own that may help, such as: Make your environment sunnier and brighter. Open blinds and curtains and trim tree branches that block sunlight. Sit closer to bright windows while at home or in the office. Get outside. Take a long walk, eat lunch at a nearby park, or simply sit on a bench and soak up the sun. Even on cold or cloudy days, outdoor light can help — especially if you spend some time outside within two hours of getting up in the morning. Exercise regularly. Physical exercise helps relieve stress and anxiety, both of which can increase seasonal affective disorder symptoms. Being more fit can make you feel better about yourself, too, which can lift your mood. If you feel you are suffering from Seasonal Affective Disorder, it is important to seek the help of a trained medical or mental health professional for a proper diagnosis. SAD can sometimes be misdiagnosed as hypothyroidism, hypoglycemia, infectious mononucleosis, or confused with a more serious condition like severe depression or bipolar disorder.

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Family Health

Dawn Easley

2011-01-01 10:18:00

Question: What exactly are the different rehab therapies available for seniors and what does each entail?

Answer: Last month we covered the different types of therapies. This month we will discuss physical therapy. Physiotherapy (also known as physical therapy) is a health profession concerned with the assessment, diagnosis and treatment of disease and disability through physical means. It is based upon principles of medical science, and is generally held to be within the sphere of conventional (rather than alternative) medicine. Physical therapy or physiotherapy, often abbreviated PT, is the attempted remediation to individuals and populations to develop, maintain and restore maximum movement and functional ability throughout the lifespan. This includes providing services in circumstances where movement and function are threatened by aging, injury, disease or environmental factors. Functional movement is central to what it means to be healthy. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, treatment/intervention, habilitation and rehabilitation. This encompasses physical, psychological, emotional, and social well being. Physical therapy involves the interaction between physical therapist, patients/clients, other health professionals, families, care givers and communities in a process where movement potential is assessed and goals are agreed upon, using knowledge and skills unique to physical therapists. Physical therapy is performed by a physical therapist (PT) or physiotherapist (physio), and sometimes services are provided by an assistant (PTA) acting under their direction. It involves the interaction between a PT or physio, patients/clients, other health professionals, families, care givers and communities in a process where movement potential is assessed and goals are agreed upon, using knowledge and skills unique to physical therapists. PTs use an individual’s history and physical examination to arrive at a diagnosis and establish a management plan and, when necessary, incorporate the results of laboratory and imaging studies. Electro diagnostic testing (i.e. electromyograms and nerve conduction velocity testing) may also be of assistance. PT management commonly includes prescription of or assistance with specific exercises, manual therapy, education and other interventions. Physical therapy has many specialties including cardiopulmonary, geriatrics, neurologic, orthopedic and pediatrics, to name some of the more common areas. PTs practice in many settings, such as outpatient clinics or offices, inpatient rehabilitation facilities, skilled nursing facilities, extended care facilities, private homes, education and research centers, schools, hospices, industrial workplaces or other occupational environments, fitness centers and sports training facilities. Physical therapists also practice in non-patient care roles such as health policy, health insurance, health care administration and as health care executives. Physical therapists are involved in the medical-legal field serving as experts, performing peer review and independent medical examinations. Education qualifications vary greatly by country. The span of education ranges from some countries having little formal education to others requiring masters or doctoral degrees. Next month we will discuss occupational therapy.

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Family Health

Dawn Easley

2011-01-01 10:18:00

Question: What exactly are the different rehab therapies available for seniors and what does each entail?

Answer: Last month, we talked about Physiotherapy, or what is otherwise known as Physical Therapy. This month we will talk about Occupational Therapy. Occupational therapists assist clients in performing activities of all types, ranging from using a computer to caring for daily needs such as dressing, cooking and eating. Physical exercises may be used to increase strength and dexterity, while other activities may be chosen to improve visual acuity and the ability to discern patterns. For example, a client with short-term memory loss might be encouraged to make lists to aid recall, and a person with coordination problems might be assigned exercises to improve hand-eye coordination. Occupational therapists also use computer programs to help clients improve decision making, abstract-reasoning, problem-solving, and perceptual skills, as well as memory, sequencing and coordination-all of which are important for independent living. Therapists instruct those with permanent disabilities, such as spinal cord injuries, cerebral palsy, or muscular dystrophy, in the use of adaptive equipment, including wheelchairs, orthotics and aids for eating and dressing. They also design or make special equipment needed at home or at work. Therapists develop computer-aided adaptive equipment and teach clients with severe limitations how to use that equipment in order to communicate better and control various aspects of their environment. Some occupational therapists treat individuals whose ability to function in a work environment has been impaired. These practitioners arrange employment, evaluate the work environment, plan work activities and assess the client’s progress. Therapists may also collaborate with the client and the employer to modify the work environment so that the work can be successfully completed. Occupational therapy is also beneficial to the elderly population. Therapists help the elderly lead more productive, active and independent lives through a variety of methods, including the use of adaptive equipment. Therapists with specialized training in driver rehabilitation assess an individual’s ability to drive using both clinical and on-the-road tests. The evaluations allow the therapist to make recommendations for adaptive equipment, training to prolong driving independence and alternative transportation options. Occupational therapists also work with the client to assess the home for hazards and to identify environmental factors that contribute to falls. Occupational therapists in mental health settings treat individuals who are mentally ill, mentally retarded, or emotionally disturbed. To treat these problems, therapists choose activities that help people learn to engage in and cope with daily life. Activities include time management skills, budgeting, shopping, homemaking and the use of public transportation. Occupational therapists also may work with individuals who are dealing with alcoholism, drug abuse, depression, eating disorders, or stress-related disorders. Assessing and recording a client’s activities and progress is an important part of an occupational therapists job. Accurate records are essential for evaluating clients, for billing and for reporting to physicians and other health care providers.

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Family Health

Dawn Easley

2010-12-01 10:56:00

Question: What exactly are the different rehab therapies available for seniors and what does each entail?

Answer: Thank you for your question. This month we will deal with the main rehab therapies and what they are. In future issues, we talk more in depth about each. While there are other minor therapies depending upon the injury, illness or affliction, the most common rehab therapies are: Type: Physical Therapy Services Description: Physical therapy restores function for individuals who have experienced neuromuscular or skeletal dysfunction. Treatment Can Include: •Training in mobility, gait stability, posture and positioning •Exercise programs to increase muscle function, coordination and endurance •Joint and soft tissue mobilization to increase range-of-motion •Wound care •Pain management Type: Occupational Therapy Services Description: Assists individuals by helping them adapt to their social and physical environment. Treatment Can Include: •Education and training in areas such as dressing, bathing, eating and grooming •Activities for memory, orientation and cognitive integration •Adaptive techniques or equipment to overcome physical disabilities •Strengthening and coordination exercises •Exercises to maintain normal joint movement in order to reduce the effects of arthritis or other conditions Type: Speech and Language Therapy Services Description: Speech and language pathologists address general communication issues and swallowing dysfunction. Treatment Can Include: •Plans designed for individual needs, such as: -Recovery of speech, language and memory skills -Verbal and non-verbal communication, including programs for the hearing impaired -Oral muscle strength and functioning required for speaking and swallowing -Appropriate diet recommendations I will be back next month to talk more about Physical Therapy.

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Family Health

Dee Staudt

2010-12-01 10:56:00

Question: My husband was laid off from his job six months ago. Lately, I have noticed he’s not sleeping well, he seems more irritable and has lost interest in some of life’s simple pleasures. Is this depression?

Answer: Economic turmoil, such as increased unemployment, foreclosures, loss of investments and other financial distress can result in a host of negative health effects. It also can be particularly devastating to your emotional and mental well-being. Although each of us is affected differently by financial downturns, these problems can add tremendous stress, which can increase the risk for developing depression, anxiety and compulsive behaviors, such as over-eating and excessive gambling, spending and substance use. Today’s economic crisis is taking its toll on the mental health of people all over the country. A study by the American Psychological Association revealed that 52 percent of Americans are lying awake at night worrying about finances. The unemployed are four times more likely than those with jobs to report symptoms of depression or anxiety; and four in 10 out-of-work parents have noticed behavioral changes in their children that parents attribute to their own difficulty in finding work. If you have been laid off from your job there are things you can do to help you manage your mental health. Strengthen your connections with family and friends who can provide important emotional support. Engage in activities, such as physical exercise, sports or hobbies that you enjoy, which can help relieve stress and anxiety. Keep your skills sharp or develop new ones and consider volunteering in your community. Any type of stressful event, such as our current economic crisis or a job loss can impact our mental health. Feeling sad for a few days here and there is normal. Stressful situations can increase our risk of depression. Frequently, depression reveals itself in physical symptoms, such as headaches, gastrointestinal distress and sexual dysfunction. When you’re suffering from depression, you and others close to you may notice some of the following changes in your overall demeanor: increased irritability, sleep deprivation, anxiety, physical complaints and lack of motivation to complete tasks. The stress association with debt can also cause muscle tension, back pain, migraines, tension headaches, ulcers, severe anxiety and even heart attacks. Sometimes these problems can seem overwhelming and you may need additional help to get through “rough patches.” Fortunately, there are professionals and services that can provide help. These may include a mental health professional, healthcare provider or spiritual leader. Unemployment and other kinds of financial distress do not “cause” suicide directly, but they can be factors that interact dynamically within individuals and affect their risk for suicide. In fact, thirteen percent of the unemployed population has self-harm thoughts – a rate four times higher than those with full-time jobs. If you or someone you care about is having suicidal thoughts SEEK IMMEDIATE HELP by calling the Suicide Prevention Hotline at 316-660-7500 or 9-1-1.

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Family Health

Dee Staudt

2010-09-01 13:38:00

Answer: Drinking is woven into the fabric of our society—sharing a bottle of wine over a meal, going out for drinks with friends or celebrating a special occasion with champagne. But because alcohol is such a common, popular element in so many activities, it can be hard to see when your drinking has crossed the line from moderate or social use to problem drinking. Alcoholism and alcohol abuse can sneak up on you, so it’s important to be aware of the warning signs of a drinking problem and take steps to cut back if you recognize them. And, if you or a loved one is already in the throes of an alcohol addiction, take heart. Understanding the problem is the first step to overcoming it. Many people drink regularly without experiencing any harmful effects, other than that perhaps a slight hangover on rare occasions. Yet millions of others suffer from alcoholism and alcohol abuse, making even an occasional drink dangerous. How can some people drink responsibly, while others drink to the point of losing their health, their family or their job? There are no simple answers. Drinking problems are due to many interconnected factors, including genetics, how you were raised, your social environment and your emotional health. People who have a family history of alcoholism or who suffer from a mental health problem, such as anxiety, depression or bipolar disorder are particularly at risk, because alcohol may be used to self-medicate these symptoms. Since drinking is so common in our culture and the effects vary so widely from person to person, it’s not always easy to figure out where the line is between social drinking and problem drinking. Taking an honest look at why you drink may help you figure out on which side of the line you fall and remember the bottom line is how alcohol affects you. One thing is clear, if your drinking is causing problems in your life, you have a drinking problem. Substance abuse experts make a distinction between alcohol abuse and alcoholism (also called alcohol dependence). Unlike alcoholics, individuals who abuse alcohol still have at least some ability to set limits on their drinking. However, their alcohol use is still self-destructive and dangerous to themselves or others. Common signs and symptoms of alcohol abuse include: •Repeatedly neglecting your responsibilities at home, work or school because of your drinking. •Using alcohol in situations where it’s physically dangerous, such as driving, operating machinery or mixing with prescription medication. •Experiencing repeated legal problems due to alcohol consumption and continuing to drink even when alcohol use is causing relationship problems. Alcoholism is the most severe form of problem drinking and involves all of the symptoms of alcohol abuse, but it also involves another element: physical dependence on alcohol. There’s a fine line between alcohol abuse and alcoholism, but if you rely on alcohol to function or feel physically compelled to drink, you’ve crossed it. Tolerance is the first major warning sign of alcoholism. Do you have to drink more than you used to in order to get intoxicated? Can you drink more than other people without getting drunk? These are signs of alcohol tolerance – the first warning sign of alcoholism. Tolerance means that, over time, you need more and more alcohol to feel the same effects you used to with smaller amounts. Withdrawal is the second major warning sign of alcoholism. Do you need a drink to steady the shakes in the morning? Drinking to relieve or avoid withdrawal symptoms is a sign of alcoholism and a huge red flag. When you drink heavily, your body gets used to the alcohol and experiences withdrawal symptoms if it’s taken away. Alcohol withdrawal symptoms may include: anxiety, shakiness, sweating, nausea and vomiting, insomnia, depression, irritability, fatigue, loss of appetite and headaches. In severe cases, withdrawal from alcohol also may involve hallucinations, confusion, seizures, fever and agitation. These symptoms can be dangerous. Alcoholism and alcohol abuse can affect all aspects of your life. To start, long-term alcohol use can cause serious health complications, affecting virtually every organ in your body, including your brain. What’s more, problem drinking also may damage your emotional stability, your finances, your mental status, your career and your ability to build and sustain satisfying relationships. Alcoholism and alcohol abuse have an impact on your family, your friends, the people you work with and even the greater community you live in. Denial is one of the biggest obstacles to getting help for alcohol abuse and alcoholism. The desire to drink is so strong that the mind finds many ways to rationalize drinking, even when the consequences are obvious. Unfortunately, denial often increases as drinking gets worse and keeps you from looking honestly at your behavior and its negative effects. Denial also exacerbates alcohol-related problems with work, finances and relationships. It’s a vicious cycle. Those in recovery fight to maintain recovery throughout their lifetime. Ending the use of the drug of choice plays only a small role in staying clean. In our community, there are options for facing a drinking problem. If you do not know where to start, contact COMCARE of Sedgwick County 316-660-7540. COMCARE is a licensed Community Mental Health Center and Certified Drug Treatment program for all Sedgwick County residents.

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Family Health

Tom Pletcher

2010-08-01 13:01:00

Question: I am a wife and mother of two wonderful children. I have a full-time job that can be stressful at times. When I get home in the evenings, there is more to do. My husband and I fix dinner for the family, clean up the kitchen, spend time with the children, get them ready for bed, pick up the house and then we collapse into bed. I am so overwhelmed and sometimes want to cry that my life has turned into this daily routine. It seems I’ve been going 100 mph lately; is there anything a person can do to help with the stress a person deals with on a day-to-day basis?

Answer: Most of us would agree that in our lives today we are challenged by demands, deadlines, hassles and frustrations. And with our busy schedules, stress is pretty common and for some of us a way of life. Stress isn’t always bad, in fact in small doses stress can be a good thing making you more alert, helping you perform under pressure and motivating you to do the best you can. But when you are constantly running in emergency mode, stress can take a toll on your mental and physical health. Stress is caused by both external and internal factors. Some of the more common causes of external stress are major life changes, your job or loss of job, relationship difficulties, financial problems, children and family and just being too busy. Internal causes of stress are our inability to accept uncertainty, pessimism, negative self-talk, unrealistic expectations, and perfectionism. We all respond to stress differently. It is important to recognize when your stress levels are out of control. The dangerous thing about stress is how easily we start to get used to it and that for some, stress begins to feel pretty normal and we don’t notice how much it’s affecting our bodies. Some signs of stress are pretty easy to recognize such as not eating or eating too much, forgetfulness, headaches, lack of energy, lack of focus, trouble getting things done, short temper, trouble sleeping, upset stomach and general aches and pains. These symptoms may also be signs of depression or anxiety, which can be made worse by long-term stress. We are ultimately the ones who will have to take charge of our stress. There are steps you can take to help you manage and handle stress in a positive way. Managing stress is about taking charge. Taking charge of your thoughts, your emotions, your schedule, your environment and the way you deal with problems. Stress management teaches us to change the stressful situation when we can, changing our reaction when we can’t, taking care of our self and making time to relax. Become a problem solver by making a list of things that are causing you stress. Figure out which problems you can solve now and which ones are beyond your control for the moment. Start solving the little ones, calmly look at the problem, think of possible solutions and take action. Being able to solve the small problems gives us confidence to tackle bigger ones. Set limits. When it comes to work and family, figure out what you can really do. There are only so many hours in the day. Set limits for yourself and others. Don’t be afraid to ask for help and to say No to requests for your time and energy when you feel overwhelmed. Get organized. Think ahead about how you’re going to spend your time. Write a to-do list. Figure out what is most important and do those things first. Learn how to relax. Relaxation techniques such as yoga, meditation, and deep breathing activate the body’s relaxation response. When practiced regularly, these activities reduce the level of everyday stress and boost your ability to stay calm and collected under pressure. Take deep breaths and stretch. If you are feeling stressed taking a few deep breaths makes you breathe slower and helps your muscles relax. Stretching can also help relax your muscles and make you feel less tense. Take time to do something for yourself. Do something for yourself regularly, such as listening to music, reading a good book or going to a movie. Take care of your body by getting enough sleep and eating right. Exercise and don’t deal with stress in unhealthy ways such as drinking alcohol or using drugs. If you feel your stress has pushed your mind/body too far and need some help getting your emotions back in balance, call COMCARE of Sedgwick County 316-660-7540. COMCARE is a licensed Community Mental Health Center and serves all Sedgwick County residents regardless of ability to pay. Tom Pletcher, LCP, is Clinical Director of COMCARE and has been involved in community mental health service delivery for 25 years. He is a Diplomate, American Academy of Experts in Traumatic Stress.

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Family Health

Dee Staudt

2010-06-01 10:14:00

My 21 year old daughter recently was told by a nurse at her college campus health clinic that she may have a mental health condition called Bipolar Disorder. She has been referred for further assessment but we don’t know where to start. How can we help our daughter get control of her life?

Answer: Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. These moods are different from the normal ups and downs that everyone goes through from time to time.

Bipolar disorder often develops in a person’s late teens or early adult years. At least half of all cases start before age 25. Some people have their first symptoms during childhood, while others may develop symptoms later in life. Bipolar disorder is not easy to spot when it starts. The symptoms may seem like separate problems, not recognized as parts of a larger problem. Some people suffer for years before they are properly diagnosed and treated. Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout a person’s life. People with bipolar disorder experience unusually intense emotional states that occur in distinct periods called "mood episodes." An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a depressive episode. Sometimes, a mood episode includes symptoms of both mania and depression. People with bipolar disorder also may be explosive and irritable during a mood episode. Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. It is possible for someone with bipolar disorder to experience a long-lasting period of unstable moods rather than discrete episodes of depression or mania. Bipolar disorder symptoms can result in damaged relationships, affect poor job or school performance, and even lead to suicide. But bipolar disorder can be treated, and people with this illness can lead full and productive lives. A bipolar disorder affects not only the person with the disorder but other members of the family. The first and most important thing you can do is help her get the right diagnosis and treatment. You may need to make the appointment and go with her to see a qualified mental health provider. To date, there is no cure for bipolar disorder. Because bipolar disorder is a lifelong and recurrent illness, people with the disorder need long-term treatment to maintain control of bipolar symptoms. An effective maintenance treatment plan includes medication and psychotherapy for preventing relapse and reducing symptom severity. Proper treatment helps most people gain better control of their mood swings and related symptoms. This is also true for people with the most severe forms of the illness. Next, encourage your loved one to stay in treatment. Offer emotional support, understanding, patience, and encouragement. Many families can help by learning the signs unique to each individual that an episode is beginning and develop a plan that may help de-escalate behaviors before they become too overwhelming. Learn about bipolar disorder so you can understand what your daughter is experiencing Listen to feelings your daughter expresses, be understanding about situations that may trigger bipolar symptoms and never ignore comments about her harming herself. Questions about Bipolar Disorder can be directed to the COMCARE Intake and Assessment Center (1st Appointment) 316-660-7540 or for mental health emergencies call 316-660-7500, 24/7. Dee Staudt, LMSW is the Director of Outpatient Services for COMCARE. Dee has been working in the community as an advocate for social services and mental health for 18 years. She is also a member of the Board of Directors for the Kansas Association of Addiction Professionals.