Wednesday, October 30, 2013

Take a Break: Celebrate the Eerie-It’s all about the skull

With Halloween tomorrow and Dia de los Muertos (Day of the Dead) starting on Friday, what better time to learn some easy ways to draw a skeleton and to celebrate all things skeleton.

• Skull cake: While there are skull molds you can use, this is a good way to make one.  Also check out lots of ways to turn tops of cakes into various types of skulls. 

To celebrate Dia de los Muertos (Day of the Dead) check out the following previous posts:

And finally, for some eerie treats, try Our Bestbites Halloween. 

Saturday, October 26, 2013

The Difference Between Helping and Enabling

This week I had an interesting conversation with a good friend and colleague who I worked with for many years in AIDS. We touched on a very familiar topic-the fine line between being helping and enabling.

 Working in AIDS, and more recently during the Irene response, I saw a lot of well meaning people whose enabling-and not the good kind-kick into high gear.  Stuff happens to all of us. Feeling sorry for them or viewing them as a “victim” is not helpful. Everybody has something at sometime to deal with. A continuing string of hand outs and enabling creates a sense of powerlessness, entitlement and ends up de-motivating the person to take charge of their life.

As more and more is learned about how the brain functions, and its incredible ability to heal and protect us, we need to pay close attention to this research. There are good indications that we can “rewire” the brain to be dependent or independent.

In our effort to keep people from failing, we weaken them.  As Diana Nyad has stated in the weeks following her incredible swim-“failure is not a bad thing.” Basically, you can learn as much, if not more, by a bad experience than a good one. 

So when is it enabling? Consider how you answer the questions below to determine if you are helping or enabling someone – be they children, spouse, partner, colleague, parent, friend, client etc.:

• Has the person’s circumstances stayed the same, gotten worse or improved? For those in a caregiver role, keep in mind that people get worse because of disease progression no matter what’s been tried. Yet, you do need to assess whether they are doing what they need to do to take care of themselves as best as they can.

If you are dealing with a person who is abusing drugs or alcohol, while acknowledging that addiction is a sickness, if they have not changed their behavior or gotten worse, take note. Take the Quiz: Are You an Enabler for insight into what you might be doing.

• Is the person doing everything in their power to change the situation?

• Why are you doing this? Is your need to be needed part of the picture? Are fear, pity or guilt motivating factors? We all need a sense of purpose and we do need to be needed. However, if your need is keeping them from being as independent as they possibly can be, rethink what you are doing.

• Are you emotionally and/or physically drained from the experience? If you answer yes to this question you’ve given too much and chances are good you’ve crossed over the helpful line. For caregivers, this is tiring and demanding work. If you feel totally rung out by it, pay attention. You may not be enabling the person who needs the care, but you may be enabling siblings or other family who need to be stepping up to the plate to help in this situation. 

For those who work in human services, burnout can be, and often is, very high. When you start thinking things like, “I just paid their electric bill and they are showing off their new tattoo,” or “I’m working everyday plus overtime, and all they do is come in here and complain that we haven’t done enough for them” -enabling is at play and your clients have learned or are learning to be dependent on others to solve their problems, and or ways to get what they want, not necessarily what they need.

When I was running an HIV/AIDS program, we had a group of  HIV+ women that acted as peer counselors-offering advocacy,  healthcare navigation, support etc. One of our slogans was “if you do, they don’t,” meaning if the peer makes decisions, offers constant advise, remedies and solutions before long the person feels powerless to solve their own problems. They can become more needy. In fact, it becomes a viscous cycle, with people attracting more negative situations and staying stuck.

It was interesting to watch the peers as they learned first hand the line between enabling and helping. Certainly blurry at times, some of the sickest women were the ones to ask for empowerment training and made incredible peer counselors. They were often very direct saying things like ,“It’s not my job to be stressin’ because of the stupid shit your doing.” “Get off the pity-pot,” and the line that they could only say, “It sucks to be you,” meaning “you created the problem, you fix it.”

The best peers quickly understood that it wouldn’t help them or the person they were working with if they didn’t set boundaries, not become intimidated by threats, or live in fear “that they might do something.” Not everyone made a good peer and there were plenty of heated discussions about what was helpful and what was enabling.

Enabling can feel like the right thing at the time since it may make you feel needed, loving and kind. It’s also an easy way to avoid conflict and negative consequences. It can make you feel less guilty. It may make life easier for the moment,  as well as give you a sense of importance. The bottom line is if your behavior is keeping them from doing what they can and should be doing for themselves, or keeping them from getting the professional help they need, you become part of the problem.

Enabling doesn’t just pertain to individuals. It also extends to communities, organizations, friends, co-workers, religious groups etc. Because it is a basic need for humans to want to help one another, most communities have a wide array of social support agencies, self help groups, community based organizations, churches, families etc. that provide help. Thanks to HIPAA, and funding streams, there isn’t a lot of discussion among these groups. Consequently it is very easy for certain people to become very enabled by the very organizations that are designed to help.

In truth, if you have an ounce of compassion, chances are good you’ve probably enabled somebody and have been enabled (co-dependent) yourself. Now and again okay, but when it goes on where it is interrupting lives and causing problems, change is needed.

How to stop enabling:

• Accurately assess and accept what you are doing. Completing Am I an enabler for someone else witha problem can help you clarify a bit better what exactly you might be doing that is no longer helpful 

• Draw clear and concise boundaries. Be prepared to follow through with consequences-don’t make idle threats. Stop cleaning up after them. Learn to say “no” and let them be responsible for the choices they make.

• Accept the responsibility for your behavior and no one else’s.

• Get support so you don’t waiver. 

Wednesday, October 23, 2013

Take a Break: Candy Corn isn’t just for eating

The famous yellow, orange and white layer candy corn is a harbinger of Halloween and autumn. My preference is for the “Indian corn” because it has a tootsie roll type base and it’s marginally less sweet than the original. Candy corn appears to have been started in 1880 by the Goelitz Confectionary Company in Philadelphia, which today is called Jelly Belly Candy Co. The ingredients remain the same -sugar, fondant, corn syrup, vanilla flavor and marshmallow crème.

This year, instead of eating these candies, craft them into fun Halloween items.

• Stick a bunch of candy corns in a bowl or clear vase and insert a pillar candle

• String candy corn like you would popcorn for a Christmas Tree. Use monofilament (fishing line), attach a needle and start stringing. Put it through the solid points, basically avoiding where colors meet as these are more likely to break. Another option is to just glue the candy corn to ribbon.

Wreath, tree and centerpiece from Sweet &Crunchy. The wreath and tree use a Styrofoam wreath, which you can pick up at any Dollar Store.

 Candy Corn Star Burst/Topiary: This is the same idea as the wreath. Use a ball of Styrofoam, paint it yellow, orange or black and glue the candy corn. Insert a wooden dowel, tie some seasonal ribbon around it and place in a container-small flower pot with straw would be great.  

Candy Corn on the Cob: These directions push candy corn into cookie dough and it does result in an ear of corn. Wonder if it would work with a marshmallow. 

Candy Corn Halloween Crafts (making items that look like candy corn) 

Saturday, October 19, 2013

Multitasking in the Health Care Setting: How to protect yourself

Do you think you can multi task? Most women, and particularly mothers of young kids, think they can. When talking about the difference between men and women, it’s not uncommon for women to say “guys just don’t know how to multitask.” Guess what? Neither do women. The human brain is not wired for multitasking.

The mother, with the two year old tugging at their leg, while they are making dinner and talking on their cell phone, is not an uncommon image. Fact is, no one wins in this scenario. The two year old can’t get Mommy’s attention to use the potty and so wets their “big kid pants.” The meal is undercooked, “yuck” and no one eats much of it.  The person she’s on the phone with-say its work-makes a mistake because our multitasking Mom gave incorrect information. Basically, no one had their needs met, including “super Mom.”

As Dr John Medina, author of “Brain Rules,” describes it “The brain is a sequential processor and large fractions of a second are consumed every time the brain switches tasks.” It’s easy to see that a half second slower to put on the brakes causes an accident. A half second distraction from the child on Mom’s leg causes a misstep and fall, injuring Mom and child.

Multitasking can increase errors by 50%. According to the authors of Organize Your Mind, Organize Your Life, multitasking is also associated with missing important cues and making it harder to retain information in working memory. These are very important functions for anyone working in healthcare. Being distracted by a text message has literally resulted in people getting the wrong medication and dying.

The new technologies are here to stay, so how do we adapt? How can we interact with our medical providers to keep them on task when there are so many distractions?

Consider the following:

• Use an advocate for medical appointments and have people stay with you in the hospital. Patients and providers alike agree that medical visits are better when an advocate is present. 

• Write down your concerns prior to your appointment and provide a copy to the provider at the start of the visit.

• Take notes. If the provider is interrupted by a phone call, text message etc., write down what you were discussing and refer back to it when the visit resumes. Keep in mind that the provider’s working memory may no longer hold information you’ve already provided. Suggest a recap and repeat information that you think is important.

• Just because the provider is distracted, don’t allow yourself to be. Stay focused on the visit. Refer to your list of concerns and make sure they are being addressed.

• It is appropriate to ask your provider not to take calls while you are meeting.

• Turn off your cell phone when you are meeting with your provider.

• Check your medical records to make sure the information they contain is correct and that important information is included.

• If you are going to have a medical procedure, and have special requirements-such as a pain protocol-ask to see it prior to having the procedure.

At the same time we’re trying to reign in our provider, we need to be looking at our own multitasking behavior, and do what we can to switch from multitasking to set shifting.  

Margaret Moore, co-author s of Organize Your Mind, Organize Your Life,  writes I don't know anyone whose mind isn't frenzied, distracted or divided by multitasking a good deal of the time.... Whether or not you have an organized mind depends upon your ability to "drive" your attention and keep it focused when you're under pressure or faced with challenging conditions. Just like driving a racecar, a lot of skills are required. Fortunately, these skills are built into the brain's normal wiring. So how do you start to tap into your innate ability to be organized?

Moore identifies six rules to help in shifting from one thing to the next and avoiding the pitfalls of multitasking. These rules are as follows:

Tame your Frenzy: Sleep well, exercise, practice mindfulness and reduce the negative emotional frenzy of worry, anger, irritation, sadness etc. I’ve recently read some interesting observations about  knitting as therapy and how it helps to slow things down similar to mindfulness training. No worries if you aren’t a knitter, having a craft or something of that sort that absorbs you is very healthful.

Sustain Your Focus: Focus on one thing. Shut the door, turn off your phone, set a timer, turn off the phone.

Apply the Brakes: No matter how focused you are, distractions happen, since our brain is wired to constantly be on the look out for things that could harm us. When distracted, practice STOP (stop, take a breath, observe, proceed). Is there something you need to take note of and move to a new task? For example, hunger pains remind you that you haven’t eaten for the last six hours because you’ve been so absorbed in a project. However, if it’s just the wind ruffling your papers, go back to your original task.

Access your Working Memory (short-term memory): The same activities that help to quiet the mind (listed in #1) increases your ability to tap into your short-term memory. This helps with problem solving, creativity etc.

Shift sets: This brain skill, called "set-shifting," allows you to leave behind one task and leap to a new one with a fresh and productive focus. A fit and flexible mind and body are equally important.

Connect the Dots: Put the rules above into play to increase productivity and reduce frustration. 

Wednesday, October 16, 2013

Take a Break: Chunk a Punkin (virtually)

This is just too much fun. In honor of the World Championship Punkin Chunkin Contest, you can now try your skills virtually at the Discovery Channel. The contest takes place in Delaware each year at the beginning of November. Sponsored by the WCPCA,  the contest helps to raise money for scholarships, as well as various organizations that benefit youth and the local community. So Chunk your Punkin and see if you can be “Lord of the Gourd.”

Saturday, October 12, 2013

The Shutdown Impacting Your Health- What to Do.

With the government shutdown continuing into its second week and most likely will extend for another week or more, what’s the impact, or potential impact, on health care for people with chronic conditions and what can you do?

 While Medicaid and Medicare are still operational, the following have been impacted:
• Government health agencies such as the NIH (National Institutes of Health) and the CDC (Centers for Disease Control and Prevention) have furloughed 52% of their staff. Websites, such as Pub Med, Medline Plus, are not being updated or are receiving minimal attention. The CDC has significantly less capacity to deal with outbreaks such as flu. As CDC Director, Dr. Tom Frieden noted, "I usually don't lose sleep despite the threats that we face, but I am losing sleep because we don't know if we'll be able to find and stop things that might kill people.” The NIH is not taking new patients or taking action on grant applications. The FDA (Food and Drug Administration) is unable to support the majority of its food safety, nutrition and cosmetics activities.

• Social security and Medicare continue to pay, but there can be delays in processing new disability applications.

• Many state human services agencies-including programs such as WIC (Women, Infant, Children), heating/fuel assistance, housing etc. receive a significant portion of their funding from the federal government. The longer the shutdown, the more likely it is that state programs, as well as community based organizations,  will no longer be able to remain functional and significant cuts will be made. Since many with chronic conditions are in need of these types of services, this will most likely be the area of biggest impact.

What You Can Do
1.  If you count on services like WIC, heating assistance, housing etc., the first thing is to find out what the impact could be the longer the shutdown lasts. Is your state going to use their own money to keep some of the these programs going? If you don’t know who to call in your state,  dial 2 1 1, the information number. They may already have information that can help you, or they can refer you to someone who knows more.

2. Once you know what might happened and when, start preparing. What is it that you absolutely must have? Make a list and eliminate anything that isn’t essential. Need ways to cut back? Read Consider Ways to Save Money on Monthlies (Bills).

3. Assess what is available in your community that is not tied to federal funds. Be sure to consider:
-                churches
-                civic organizations (e.g. Rotary, Lions Club)
-                condition specific organizations (e.g. American Cancer Society)
-                schools
-                support groups: not only condition specific ones, but places like AA
-                family and friends
-                thrift stores and food shelves
-                food coop
-                charitable funds of major businesses

4. Reach out to those listed in item 3. What can you do to help them? If you are scratching your head and thinking, “but I’m the one that needs help,” consider this- One of the most important things any of us can do, shutdown or not, is develop “social capital.” If you are not familiar with that term, it basically means investing in your community so that you can be of help to them, and they can help you when you need it. The website “Better Together” offers 150 ways , and counting, to help you develop social capital. Bottom line is that if you are already involved in helping, you will be in a better position to benefit should you need it.

5. If you thinking, “but I’m very limited in what I can do,” you’d be surprised at what you can offer that will help. Consider things like:
- Organizing a support group
- Offering to telephone or e-mail members of an organization
- Stuff envelopes
- Write a newsletter, or write an article for a newsletter
- Be an advocate for others, even if it’s just talking to them by phone or e-mail
- Donate items or services for fundraising events: This can include making a dish for a pot luck supper; knitting something; giving gently used items that can be resold etc.
- Helping to staff an office.
- Become a member and/or board member
- If you have computer skills, offer to run a website, Facebook, blog or a Lotsa Helping Hands website

To learn more ways to help, call or send an e-mail to a group in your community where you’d like to volunteer.

6. Since we’re now heading into Flu season, and the CDC has been heavily impacted by the shutdown,  follow the guidelines in Don’t have time for the flu. Take Time to Prevent it. 

 7. Let people know what you need. If you don’t know, they can’t help you.