Wednesday, February 27, 2013

Take a Break: Celebrate the Oscars/Animated Short Films

I’ve been a fan of the animated short film (a.k.a cartoons) since I was a little kid.  What could be better than spending a hot summer afternoon watching Merry Melodies cartoons in my friend’s basement?

Take a break today and watch a variety of Oscar winner (or nominated) cartoons:

And of course, to give tribute to both past Oscar winners and my childhood memories, What’s Opera Doc? 

Saturday, February 23, 2013

Help Yourself Heal: Do What You Love Now!

This post is dedicated to my good friend and colleague Michelle.

I drink the expensive wine now, says Dr. Susan Love, the well known surgeon and cancer researcher, after being treated for leukemia. Besides being a nationally recognized breast cancer researcher, Dr. Love, wrote the book  Live a Little!: Breaking the Rules Won’t Break Your Health . 

In discussing her book, co authored with Alice Domar, a Harvard Professor and senior staff psychologist at Beth Israel Deaconess Medical Center, Love notes Is the goal to live forever? I would contend it’s not. It’s really to live as long as you can with the best quality of life you can. “ Her recommendation Relax, take a breather, and give up trying to follow the narrowly prescribed health “rules” that are constant sources of unhealthy stress and guilt. The key to being in good health in the absence of good data is to use your common sense, eat good food, move your body regularly, laugh, and love!

While Love wrote this book before her diagnosis, her message remains consistent. …none of us are going to get out of here alive, and we don’t know how much time we have. I say this to my daughter, whether it’s changing the world or having a good time, that we should do what we want to do. Susan Love’s Illness Gives New Focus to Her Cause 

There are lots of pop expressions around the idea of doing what you love-“Do What You Love the Money Will Follow,” “Follow Your Bliss,”  and “Leap and the net will appear.”  However, this post isn’t about bumper sticker expressions. Instead it’s thinking about the choices we make every day and picking the ones that bring us the most joy.

All too often our decisions-be it about jobs, food, health care choices and even who we socialize with and date/marry,  are made on what we think “we should be doing,” rather than actually what we want to do. According to Aristotle, “We are what we repeatedly do.”  So if you aren’t doing what you love, or you can’t find the love in what you do, what’s the message you are sending to yourself? Do you think that’s a healing force? Most likely not.

In July, I wrote a post called Super Better,  which described a game that can increases life expectancy by as much as ten years. Doing what you love was right up at the top of the “to-do” list.

I like to periodically talk things over with my friend Michelle, which is why I’m dedicating this post to her. When a decision seems pretty obvious to both of us, and yet I’m still a bit hesitant, she’ll say, “so what, do you need permission? If so, I’m giving you permission.”   With that thought in mind, if you need it, you have permission to do the things you love that bring joy to your life and the best opportunities for healing.

Wednesday, February 20, 2013

Take a Break: Re Purpose Pill and Vitamin Bottles

So how many empty pill and vitamin bottles do you have lying around? Instead of throwing them away,  recycle them or consider crafting them into something new.

 Before you begin, remove the label. Someone suggested pouring boiling water into the bottle, wait a minute and the label would fall right off. I tried that with a vitamin bottle and yes the label came right off, but the bottle collapsed. So removable techniques are going to very by bottle type. In general, I find that the labels on the brown bottles peel off pretty easily. Soaking in hot water helps and the remaining residue can easily be scrubbed off with soap and water or alcohol. Make sure you clean them well inside and out, particularly if you are going to put food or seed items in them.

The basics of decorating are simple-paint with acrylics, cover with contact paper or duct tape, glue on fabric, paper, glitter, old jewelry, ribbons or whatever strikes your fancy. Oasis  has some beautiful examples of decorated pill bottles.

You can use the decorated containers to create:
• Your Own “Prescription:” Use M & M’s or other small candy as the pills. Decorate with fun colors, and make a new label with directions such as “Feeling blue-take two.” Use a large vitamin bottle filled with Jellybeans and label it “Happy Pills.” The Graphics Fairy has a variety of labels you can print for free to make your prescriptions look authentic. 

•  Mini kits: A few needles, a little thread,  safety pins, tiny scissors and even a few tiny buttons makes a quick sewing kit. Can also use as mini eyeglass repair kits. A few Band-Aids, ointments, aspirin etc. will make a nice first aid kit. Just the essential lure or two will make some fisherman happy.

• Coin Purses, Coin Holders: Since the brown pill bottles can hold quarters, this is the perfect gift for anyone who has to use the Laundromat.
• Puppy treat container: For a new puppy owner,  decorate the container with tiny paw prints using a Qtip and paint. Fill with small puppy treats. Write words like “Sit,” Roll Over” “Stay.”

• Rattles: Fill with different beads or beans so that you have a nice rattle effect when you shake it. Seal shut with super glue. Undecorated use them in stuff toys so they’ll rattle when shaken. The cat will enjoy it as a fun toy to chase, so it doesn’t matter whether you decorate it or not. Use as percussion instruments for young kids.

• Container to Soak/Store reeds for musical instruments

• Container to store items that never seem to have a home-paper clips, tacks, odd buttons, beads. Vitamin bottles, with their flip lids, are great for paper clips.

• Seed container: Store seeds from one season to the next. Just be sure to label them.

• Pill container: Always good to have some ibuprofen or allergy pills handy. Take it up a notch by using a vitamin container where you can glue a medicine cup to the inside of the vitamin bottle cap. This way you can have a small cup for water to make it easier to swallow pills. Be sure to dry it carefully before you reseal though.
Other ideas for bottles

Saturday, February 16, 2013

Care giving and Family-Mediators Can Make a Difference

Recently, I’ve been talking to a number of caregivers who are being worn out by the activity. Sometimes it’s a matter of caregiver fatigue, so putting appropriate respite services and supports in place makes a big difference. However, there are times when a family or marriage is on the brink of being destroyed because of the care giving responsibility. There are also very difficult decisions that need to be made, such as how much money each sibling can provide to help towards Mom’s care or when is it time to stop advanced life support, that all parties need to weigh in on.

 One of the things I hear over and over again in these situations is the disappointment and anger that primary caregivers express about other family members not being willing to help out. As the stress of care giving mounts, along with all the day to day issues families deal with, it’s not surprising that tempers flare, marriages fall apart, siblings end up not talking for years, the person who needs the care giving is caught in the middle, and legal action can even result.

What to do? Organize a family meeting, but with a third person.

Some families do an excellent job of organizing the care giving responsibilities, and other families, “well not so much,” as the expression goes. However, even in the best of situations, there can be times that the problems are so overwhelming and no one seems to know which way to turn. In such situations, it’s not surprising that communication breaks down, or as one colleague put it, “they eat their own.”

Before things spiral out of control, get a third party involved who can help guide the family meeting so that no one feels like they are getting beat up and the ultimate goals of providing care giving are met.

There are a variety of professionals that can serve as the third person in a family meeting-social worker; case manager; an advocate from a condition specific organization;  a pastor or rabbi; or a mediator. As good as the local minister or social worker might be, many times it’s better to have someone neutral that doesn’t have ties to any of the participating members.

Family caregiving mediation, like general mediation, provides a cooperative, non- adversarial setting for families to discuss their concerns in privacy and with confidentiality. The mediator serves as a neutral facilitator who has no connection to the case or situation The mediator does not decide the outcome or determine who is right or wrong; and there is no force on the disputing parties to reach agreement – it is a consensual process in which all parties must agree in order to have an agreement. The mediator listens to the concerns of all the parties and their ideas on how the matter might be resolved, facilitates the conversation, and helps the parties develop and agree upon a workable solution themselves.

Mediators can help with the following types of issues: daily care giving;  communication; health/medical/end of life decisions; safety/risk-taking; financial decisions; family relationships; and guardianships.

So where to find a mediator? Elder Locator can help to identify resources in your community including mediators.. Call 1-800-677-1116 weekdays, 9:00 am-8:00 pm.  Other places to try:
-       Ask the person’s medical provider, case manager,  social worker, nurse or hospice coordinator for a referral.
-       Every state has a 211 number, an information and referral service helpline available 24 hours a day. Dial 211 for assistance, or go to the 211 directory for more information in your state. 
-       Independent Living Centers will generally have a list of mediators. Call 713-520-0232 
-       The local chapter of a condition specific organization, such as the Diabetes Association, Cancer Society maybe able to refer you to a mediator or may have someone on their staff that can help you. 

Note: If finances are an issue, look for volunteer mediators or ones who provide service on a sliding scale fee.

Further Reading
Can Family Mediation Solve Disputes During Hospice? 

Wednesday, February 13, 2013

Take a Break: Try a mantra/Music and Valentines

Mantras can be a word, such as Om, a phrase, sound or syllable, which can be silently said, sung-George Harrison’s The Hare Krishna Mantra, or recited. According to the dictionary, the mantra is used as an object of concentration and embodying some aspect of spiritual power. A Sanskrit word, “mantrana” means advice or suggestion.

Mantras are sounds, and like any other sound, they impact how we think and feel. Used for thousands of years, they can help regulate thinking. They can be things we say for a variety of reasons: to help us cope, remind us to change how we’re thinking at a particular time, disrupt negative thoughts, get the day off to a good start or help to relax for a deep sleep at night.

Research studies indicate that using mantras can improve well being among stressed healthcare workers. The Journal of Continuing Education in Nursing (2006; 37 [5], 218-24) and Vedic Mantras have been found to reduce stress and increase effectiveness in the workplace.  The Sa Ta Na Ma mantra appears to help in preventing memory loss.

Below are several mantras to consider:

Om mani padme hum (ohm mah nee pahd may hum): In Buddhism this is the most common mantra. According to Gen Rinproche, in his book Heart Treasure of the Enlightened Ones: "The mantra Om Mani Pädme Hum is easy to say yet quite powerful, because it contains the essence of the entire teaching. When you say the first syllable Om it is blessed to help you achieve perfection in the practice of generosity, Ma helps perfect the practice of pure ethics, and Ni helps achieve perfection in the practice of tolerance and patience. Päd, the fourth syllable, helps to achieve perfection of perseverance, Me helps achieve perfection in the practice of concentration, and the final sixth syllable Hum helps achieve perfection in the practice of wisdom.

Sa Ta Na Ma: This chant/meditation was studied in 15 people aged 52 to 77 who had memory problems. The participants learned the Kirtan Kriya technique. It involves the repetition of four sounds -- SA, TA, NA, MA. While saying the sounds, the person meditating also touches their thumb to their index finger, and middle, fourth, and fifth fingers. They perform it out loud for two minutes, in a whisper for two minutes, in silence for four minutes, a whisper for two more minutes, and out loud for two minutes. When compared to controls, who listened to two Mozart violin concertos each day for 12 minutes, the study found that  cerebral blood flow was increased in the meditating group in the frontal lobe and parietal lobes, both areas involved in retrieving memories.

Make up your own mantras, such as I am healthy, or try other Mantras by going Mantrapedia: List of mantras from A to z. 

Since Valentine’s Day is tomorrow, enjoy watching Great Performances Paul McCartney’s Live Kisses, which is the PBS documentary about his Grammy winning album “Kisses on the Album.” 

Finally, there are lots of Valentine’s activities in previous “Take a breaks.”
-       Valentine’s Day Activities Paper and Scissors (chains, cobweb, German Paper cutting) 

A very Happy Valentine’s Day tomorrow!

Saturday, February 9, 2013

Valentines Gifts for Hospital Patients

Because Valentine’s Day is associated with chocolates, flowers, luscious meals and cards, this can offer some challenges as well as opportunities when visiting a person in the hospital. In addition to the suggestions from Unique Gifts for Hospital Patients, consider some of the following ways to celebrate the “love” holiday.

•  Bring a meal from the person’s favorite eatery (could be your kitchen) that the two of you can share. Check for dietary restrictions before you order/cook. Create the ambiance by including such things as: flameless candles; a small tablecloth-a yard of fabric works-to cover the table; special napkins and a Valentine’s Day glass. Wine glasses work for water too. A quick trip to your local Dollar Store may inspire other items for the romantic dinner.

• Check with the staff, and if it’s okay, arrange for a special massage, or bring some special oils and give them a nice foot rub.

• Dark chocolate is actually good for you, so bring a box-provided there aren’t dietary restrictions.

• Flowers always cheer up a room. However, as many hospitals have live plant and flower restrictions, consider some other options for the vase including: origami flowers; a fan; button and felt flowers;  seashells

• Since spending time with someone is the best gift of all, consider bringing a romantic movie to watch together. Many will have their favorite and so need no help here. However, if you are looking for a good suggestion, you might want to consider some of the following:
-       I Hate Valentine’s Day
-       Valentine’s Day
-       Mr. & Mrs. Smith
-       Titanic
-       When Harry Met Sally
-       The black and white films: Casablanca; The Philadelphia Story; Notorious; Some Like it Hot; Roman Holiday

• Creating something is relaxing, so consider some of these fun and easy Valentine projects

• There are lots of fun clothing items for Valentine’s Day, such as socks with hearts on them, pajamas, T-shirts etc. Places like Old Navy will have them on sale before Valentine’s Day.

And of course, don't forget the card. 

Wednesday, February 6, 2013

Take a Break: Make a Mardi Gras Mask

Mardi Gras, or Fat Tuesday, is Feb. 12. With the following day being Ash Wednesday, and the beginning of Lent it’s the last day to eat, drink and be merry until Easter. Since I’m going to several Mardi Gras parties, I’ve been making different types of masks. I’ve made one out of felt, including felt feathers. However, since I’ve been asked for ideas for masks to make at the last minute, here are some ideas to consider:

• Pick up cheap eye (bandit) masks at the Dollar Store, along with ribbons, feathers, jewels and start gluing. Keep in mind the traditional colors of Mardi Gras are purple, green and gold.

• Draw on a bandit style mask with make up.

• Foil Mask: It’s best to use the heavy foil and fold it several times, but if all you have on hand is aluminum foil, that’ll work. Be sure to use about 8-10 sheets to get the thickness you need. I tried it with four and found it wasn’t as thick as I wanted it.

Decide whether you want a full-face mask or just a partial one. Press the foil over your face and shape it. Carefully cut out the eyeholes so you can see what you’re doing, as it’s easier to “tape” the mask while it’s on your face. Cutting small pieces of masking tape (you can use Duct Tape) cover the mask front and back.  Before you start to tape, punch holes in the side so you can slip a ribbon threw it.
Once you’ve taped it, you can either put a layer of paper mache on it or just start painting and decorating. Good instructions, with pictures, are available at How to Make a Mask out of Tin Foil and Tape

Other suggestions for Mardi Gras
• Make a King Cake

Saturday, February 2, 2013

Do What You can, With What You have, Where you are

This quote from Theodore Roosevelt sums up the four part series on Creating Positive Outcomes for Patients, which I started on January 5. My desire to write this series came about because I was fed up from watching another week of screwy situations where patients didn’t get the care they needed.

When I asked colleagues and friends alike about what they would recommend to improve patient outcomes, some had excellent suggestions. However, most just identified more issues with our health care system and pretty much said it was just “too big,” or “that’s the way its always been.”

However, everyone can do something to improve patient outcomes, regardless of income level, or whether you are a medical provider, friend, patient or community. As I wrote on Jan. 5, My goal is to identify straight forward approaches that have minimal or no costs associated with them, are effective based on research and/or from those with extensive experience working in the field, and can be easily implemented in a variety of settings. For the most part, the recommendations in this four part series do not require that much money relatively speaking.

Note that at the end of this post are the links to the four part series Creating Positive Outcomes for Patients. Each part identifies Five Things a piece that Community, Patients, Family/friends and Hospitals can do. Please go to these posts for detailed information.

As I wrote these posts, there were certain suggestions that were relevant for all four groups, with the leading one being advocacy. Whether it’s self -advocacy, being “a friend with a pen,” or helping to organize volunteer advocates for those most in need, some type of advocacy was recommended across the board.

Due to our mobile, as well as aging society, an increasing number of people are finding themselves in positions were they don’t have a family/friend that can speak for them in the event of an emergency, and/or are not close by to help them if the need arises for hospitalization, recovery or end of life care. Consequently, regardless of the position we are in today, we continually need to assess our situations, be clear about what we want and form agreements to help one another.

“Responding” was recommended across the board. Family, friends and community members want to be helpful when someone is sick or injured, but they aren’t always sure how to go about it. The clearer patients can be about what they need the better the response. Hospitals and community groups can make a big difference by training and using volunteers to provide an array of programs that meet patient need. 

Organizing was another element for all groups. It could be organizing support, such as creating a Lotsa Helping Hands for a patient or community group, organizing information so patients know what resources exist in their community and have a good understanding of their medical situation, or the patient organizes their thoughts about what they want for care.

Information gathering, distribution and presentation-be it community resources, condition specific materials or who offers what at the hospital-are very important. All groups need to be aware of the following:
• The internet is the way many people get their information. Act accordingly by providing information that is on-line and includes local resource information and links to appropriate condition specific sites, e.g. the American Heart Association. Keep the site current, updating on a monthly basis. While hospitals by and large have done this, many community groups have not. Considering that 99% of the time a person with a chronic condition is in community and not in a health setting, community groups without a website or social networking (e.g. Facebook, Twitter, Blogs) need to reconsider how they are reaching people. Further, many hospital sites are written well above the literacy level of patients so they aren’t being used the way they should be. Finally, the social networking aspects of the web are rapidly becoming the ways many communicate. For many, a picture, or cartoon, along with a line or two is all they are looking for. Think about this when you do your outreach.

• Fraud and scams abound on the internet. Simply put, if it sounds to good to be true it probably is.

• Whenever possible offer several types of information in print format. Keep in mind literacy level. While the general rule is the simpler the better, there are those that do not care for the “dummied down” version. Also offer materials in different languages.

We all do best if we take care of selves. This can be: appropriate staffing levels at hospitals; family and friends participating in care giver support programs; and patients taking the responsibility seriously of managing their health and well being. The more mindful we are, the better we will be in caring for others and ourselves.

The recommendations I’ve made are not earth shattering. You’ll find no overhauling of patient records, implementing new billing systems, adding new equipment or sweeping reforms. Instead these are fairly straightforward ideas to try within our existing communities.   If this sounds too simplistic, think of the “The Butterfly Effect” in Chaos Theory-something that seems very small can make a substantial change to a large complex system. 

We have to start somewhere, so the change begins with you and me.