Monthly Archives for December 2001

The Best of…Call the Samaritans for a Shoulder to Lean On

Published on December 24, 2001, Pawtucket Times

             Chestnuts roasting on the fire.  Green wreaths with red ribbons. Soothing Christmas music coming from speakers in shopping malls.  Houses decorated with long strands of brightly colored lights.  Decorated evergreen trees.

            Got the Christmas spirit?  Many do, but many don’t, especially if they are seniors.

           With Christmas tomorrow, not everyone is feeling the holiday spirit.  The  holidays may be a very difficult time for seniors, particularly the elderly who have lost spouses and friends, have painful chronic illnesses or feel isolated or powerless, says Cynthia Barry, M.S.W, executive director of the Mental Health Association of Rhode Island.  At this time “some may feel depressed and even suicidal.”

            Even drinking during the holidays can put seniors at a higher risk of experiencing depression and thinking about suicide, Barry adds.

            Even drinking during the holidays can put seniors at a higher risk of experiencing depression and thinking about suicide, Barry adds.

            But the stigma of mental illness will keep older persons from seeking out needed treatment for their depression or suicidal thoughts, Barry says.  Those who feel that they have a problem with depression should visit their local mental health care, neighborhood health canter, the family physician or even private practitioners re commended by their health plan, she says.

            Carolyn Pellegrino, deputy director of Self Help, Inc., a nonprofit community action agency in the East Bay that provides senior case management to all upper East Bay communities and both Pawtucket and Central Falls, , notes that 60 percent of her older clients usually involve  persons who just worry to those experiencing severe clinical depression.

           “There’s a lot of depression out there,” Pellegrino says, adding that today’s seniors, who grew up in a different era, were told not to dal with their feelings of depression, “just get on with your life.”

          Although depression, like heart diseased, is an illness, seniors will get treated for their heart disease, but not their depression, Pellegrino says.  Oftentimes, a combination of medication and therapy can do wonders about a person’s depression, she states.

          A newly released Public Service Announcement (PSA) tells seniors to seek out another resource to fight the holiday blues.  Last week, WHJJ and B101 played a PSA featuring well-know songwriter Bill Withers who, after singing a few lines of his popular song, “Lean on Me,” urges his radio listeners “feeling low with nowhere to turn to contact The Samaritans.”

        Directed to the lonely, the depressed and suicidal, the PSA is intended to raise the awareness of the existence of The Samaritans of Rhode Island, a nonprofit program dedicated to reducing the  occurrence of suicide by reaching out to the despairing and lonely.

          Denise Panichas, serving as The Samaritans’ interim executive director states the communication-based program, established in Providence in 1979, teaches volunteers to effectively listen to people who are in crisis.  Conversations are free, confidential, most important anonymous.

         A rigorous training program teachers volunteers to feel and think without expressing personal judgements or opinions, Panichas says, noting that the listening technique, called “befriending,” calls for 90 percent listening and 10 percent talking.

          Last year, more than 20,o00 Rhode Islanders called The Samaritans, Panichas said.  The Samaritans, Panichas said.  “It doesn’t matter what the problem is, be it depression, suicidal thoughts, seeking resources for mental health services in the community or being  lonely and just needing to talk,” she said.

          Panichas notes that The Samaritans also offers other needed resources to caregivers and older Rhode Islanders. “We do community education programs and also have our peer-to-peer Safe Place Support Group for those left behind by suicide.

          For seniors who are looking for something to do with their time, the art of “befriending” is something that anybody can do.  Becoming a compassionate listener to someone in need.

         Herb Weiss is a Pawtucket-freelance writer who covers health care, aging and medical issues.  He can be reached at hweissri@aol.com.

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The Best of…Research Confronts Nursing Homes’ Pain-Management Problems

Published December 10, 2001, Pawtucket Times

         Nobody says that old age is easy, especially for those who ultimately end up being admitted into a nursing  facility.  And for those residing in facilities, there is a very high probability of being in pain, Brown University researchers say.  One of the first nationwide research studies reported in the Journal of the American Medical Association last April that pain is “prevalent, persistent and poorly treated in nursing facilities.”    

         According to the JAMA study, nursing facilities across the country provided “woe-fully inadequate pain management” with a large majority of the residents ultimately experiencing excruciating severe pain just months after admission.  Furthermore, the researchers acknowledged that the study results may even “underestimate the actual pain burden.

        The study noted that for those able to report on their pain, the rate of persistent pain in Rhode Island facilities was 46.4 percent. Nationally, the rate is 46.7 percent.  For those in pain, persistent pain left untreated experience impaired mobility, depression, and a reduced quality of life, the researchers say.
 
        The Rhode Island Quality Partners, Inc., Brown University Researchers and 18 Rhode  Island nursing facilities came together last year to confront this issue by improving  how nursing facility residents are assessed for pain and how pain is managed.   At a press conference held last month, it was reported that all facilities participating had put into place pain policies and procedures, which included both the use of medication management and non-drug interventions like massage, music and aroma therapies and heating packs.

        During the 15 month study, the participating nursing facilities attended two-hour educational seminars each month.   The seminars were conducted by the project partners and, with the assistance of nurse facilitators, each facility began to develop pain policies and procedures, and worked with the project partners to implement the treatment protocols.

       Preliminary findings show a nearly 10-fold increase in the rate of comprehensive assessment of pain among the 18 nursing facilities, as well as a five-fold increase in the use of pain intensity scales to monitor the resident’s pain.  Translation.  Nursing facility residents benefited from the facility’s efforts to confront this care issue.

       “Some Rhode Island facilities watch previously inactive residents begin to participate in a variety of activities.  Others found that residents could cut back on some of their medications once their pain was well controlled,” stated Dr. David R. Gifford, principal clinical coordinator with Rhode Island Quality Partners.

       “Nursing facilities were able to get together, share and work closely with each other to try to improve pain management, despite the staffing shortages, inadequate Medicaid reimbursement despite all the other regulations they are trying to comply,” Gifford told All About Seniors.  “The participating facilities deserve credit for putting the time and resources into the project to improve an area of care that every one is concerned about, that is inadequate pain management.”

       “Both scientific and professional literature clearly tell us that pain management has been an area that can be controlled but it has not been,” states Wayne Farrington, Chief, Facilities Regulation, at the State’s Health Department.  “Sadly nursing facility residents have been living with unnecessary pain and implementing the best practices that were determined by this research project will greatly enhance the quality of life in 103 Rhode Island facilities.” 

        Hopefully, the states nursing home industry will disseminate the methods and practices identified as being successful by this research project to every facility in the state.  At least in Rhode Island, nursing facility residents should not be suffering from unnecessary pain.

        Herb Weiss is a Pawtucket, Rhode Island-based writer covering aging, health care and medical issues.  This article appeared in December 10, 2001 in the Pawtucket Times. He can be reached at hweissri@aol.com.