Category Archives for Mental Health

National Report Grapples with Impending Alzheimer’s Epidemic

Published in the Pawtucket Times, July 25, 2013

.This 56 page report must not sit on a bureaucrat’s dusty shelf.

With the graying of the nation’s population and a skyrocketing incident rate of persons afflicted with Alzheimer’s disease, the Chicago-based Alzheimer’s Association and the U.S. Centers for Disease Control (CDC) and Prevention release a report last week to address a major public health issue, an impending Alzheimer’s disease epidemic on the horizon.

Researchers say that in 2013, an estimated 5 million Americans age 65 and older have Alzheimer’s disease. Unless more effective ways are identified and implemented to prevent or treat this devastating cognitive disorder the prevalence may triple, skyrocketing to almost 14 million people.  Simply put, Alzheimer’s disease is now the 6th leading cause of death and 5th among those 65 to 85 years of age.

A Call to Arms

A July 15, 2013, CDC, the federal agency charged with protecting public health and safety through the control and prevention of disease, injury, and disability, and the Alzheimer’s Association, the world’s leading voluntary health organization in Alzheimer’s care, support and research, unveiled The Healthy Brain Initiative: The Public Health Road Map for State and National Partnerships, 2013-2018 at the 2013 Alzheimer’s Association International Conference in Boston.

The released report calls for public health officials to quickly act to stem the growing Alzheimer’s crisis and is a follow-up to the 2007 The Healthy Brain Initiative: a National Public Health Road Map to Maintaining Cognitive Health.

“The public health community is now paying greater attention to the Alzheimer’s epidemic that millions of families have been facing for decades and that is poised to drastically increase,” said Robert Egged, Vice President of Public Policy at the Alzheimer’s Association. “On the heels of the 2012 release of the country’s first-ever National Alzheimer’s Plan, the Alzheimer’s Association and CDC have partnered again to create a tool for public health officials to improve the quality of life for those families and advance cognitive health as a integral component of public health,” says Egged.

Released five years ago, the original Road Map addressed cognitive health and functioning from a public health perspective and provided a framework for the public health community to engage cognitive health, cognitive impairment, and Alzheimer’s disease and other dementias. More than 280 experts in the field contributed to this new Road Map report that outlines specific actions steps that state and local public health officials can take to promote cognitive functioning, address cognitive impairment for individuals living in the community and help meet the needs of caregivers.

While federal agencies play a critical role in leading and funding efforts to address Alzheimer’s disease, state and local health departments organize and provide public health services at the community level.

“The goal of the Healthy Brain Initiative is to enhance understanding of the public health burden of cognitive impairment, help build evidence-based communications and programs, and translate that foundation into effective public health practices in states and communities. This Road Map provides guidance to states, communities, and national partners to plan for and respond to this major public health issue,” said Lynda Anderson, PhD, Director of the Healthy Aging Program at CDC.

A former Assistant Secretary at the U.S. Administration on Aging, Bill Benson, now a managing partner of Silver Spring, Maryland-based, Health Benefits ABC, notes that the cost of providing care to people with Alzheimer’s disease will have a drastic impact on the nation’s economy due to the cost of lost productivity, and the care costs for those no longer able to care from themselves. “This does not include the profound personal impact and consequences to those who suffer from Alzheimer’s and to their loved ones,” he says.

“The scope, cost and the extraordinary burden both to individuals and to society make it a true health crisis,” says Benson, stressing that public health officials need to know more about the disease and those who have it, better ways to diagnosis it.  There must also be a better understanding of the economic impact and programs and services that are proven to ease the burden of those who suffer from it and their caregivers, he adds.

Action Steps for Local Communities to Follow

The Road Map report includes more than 30 action steps that the public health community can take at the federal, state and local levels over the next five years to address cognitive health and cognitive impairment from a public health perspective. The actions are intended as a guide for what state and local public health officials could do – on their own or with other national, state and local partners. Agencies are encouraged to select those actions that best fit state and local needs and customize them to match priorities, capabilities and resources.

As to specifics, the Road Map report calls for improved monitoring and evaluation of persons with dementia including Alzheimer’s disease and younger onset as they relate to employment and employers, and defining the needs of these individuals and their caregivers.  Also, increased support should be given to state and local needs assessments to identify racial/ethnic; lesbian, gay, bisexual, and transgender; socioeconomic; and geographic disparities related to cognitive health and impairment.

Public health officials must educate and empower the nation in confronting the epidemic of Alzheimer’s disease by promoting advance care planning and financial planning to care partners, families, and individuals with dementia in the early stages before function declines.  They can and promote early diagnosis.

The Road Map report urges that sound public health policies be developed and partnerships created to collaborate in the development, implementation, and maintenance of state Alzheimer’s disease plans. It also recommends that state and local government integrate cognitive health and impairment into state and local government plans (e.g. aging, coordinated chronic disease, preparedness, falls, and transportation plans).

Finally, the Road Map report also recommends that strategies be developed to help ensure that state public health departments have expertise in cognitive health and impairment related to research and best practices.  Support must also be provided to continuing education efforts that improve healthcare providers’ ability to recognize early signs of dementia, including Alzheimer’s disease, and to offer counseling to individuals and their care partners.

A Local View

Maureen Maigret, policy consultant for the Senior Agenda Coalition of RI coordinator of the Rhode Island Older Women’s Policy Group, agrees with the assessment of theRoad Map report, especially with the Ocean State having the “highest percent of persons age 85 and over in the 2010 Census and this is the population that is growing fast and most likely to have dementia.”

Maigret notes the economic impact will have significant impact across our economy for the state budget and for individual families. “It is imperative for our public officials to promote programs to identify those with early cognitive problems and implement policies to strengthen community and caregiver supports that will help persons to safely remain in home and community settings as long as possible, she says.

The Rhode Island General Assembly passed legislation this year that requires caregiver assessments in the state Medicaid long term care system.  “It’s a good first step in helping caregivers. But we must do so much more to inform the public about available resources, to adequately fund assistance programs such as RIde, Meals on Wheels and respite services and to promote cognitive screening as part of annual wellness visits funded by Medicare,” she says.

“Having a clear active mind at any age is important but as we get older it can mean the difference between dependence and independent living,” says Executive Director, Donna McGowan, of the Alzheimer’s Association-Rhode Island Chapter. “We are excited that the CDC has partnered again with the Alzheimer’s Association to create a tool for public health officials to improve the quality of life for those families afflicted by the disease,” she says.

For more information on The Healthy Brain Initiative: The Public Health Road Map for State and National Partnerships, 2013-2018, visit alz.org/publichealth. For more information on Alzheimer’s disease and the Alzheimer’s Association, call 1-800-272-3900 or visit alz.org®.

 

The ABC’s of coping with the holiday blues – Local Commentary

Published in the Pawtucket Times on December 14, 2012

Chestnuts roasting on an open fire, along with green wreaths with red ribbons and brightly colored lights on decorated evergreen trees may elicit pleasant thoughts about the upcoming holidays; however, these thoughts might just tear open old wounds and bring to the surface bad memories, triggering stress, tension, and even depression.

Not every family gathering with your parents, siblings, children, or grandchildren will be as serene as a Norman Rockwell painting. Of course, everyone has heard horror stories involving holiday family gatherings.

Surviving the stress of Family Visits Allison Bernier, LICSW, associate director of Wellness Employment and Network Services, at the Providence Center, notes that while the holiday season can be a time of family celebration, joy, and companionship for many people, it can also be a very stressful time.

“High expectations, disrupted routines, dealing with loss or separation from loved ones, financial strain, and time constraints can all exacerbate anxiety and depression,” she says.

Bernier, who has 15 years under her belt employed as a social worker, and who, for the past six years, has provided one-to-one counseling to clients, offers common sense tips on how to survive stress that can be ignited by family gatherings.

Fighting holiday blues can be as simple as being prepared for family conflicts and having a specific plan to handle the uncomfortable emotions that may arise, notes Bernier. Creating a list of “potential issues” and “role playing how you will react with people you trust” can be effective ways to survive difficulties that might occur.

“It is OK to know that you don’t have to be happy during the holidays,” states Bernier, stressing “just accept your feelings and the place where you are at.” If needed, she said, just reach out to your network of family or friends or contact a professional.

According to Bernier, when expectations are unrealistic, we almost always will fail to meet them. Scale back on your plans, or ask for help. Just keep your expectations low and when you visit family or friends, just go and enjoy the social interactions.

If seeing family causes you great amounts of stress each year, it is alright to say no sometimes and celebrate with friends, Bernier recommends. If you don’t want to withdraw altogether from your family gathering because of tension, you don’t have to, she says. Just keep your visit time-limited. She recommends going for an hour or two rather than spending all day there.

The holidays can easily become a source of stress, especially when you’re standing in long lines at the mall waiting to buy the last available iPad while trying to remember how much money you have left to use on your credit cards. Writing out a gift list along with creating a budget for holiday spending can help decrease anxiety, though, Bernier notes. By setting spending limits, you will also reduce the anxiety that comes with reviewing your post-holiday credit card bills.

Maintaining healthy habits can also take the blues out of your holiday, predicts Bernier. Enjoy some eggnog, cheese cake or pastries at a holiday party, but keep the balance by eating healthy foods (smaller portions), drinking alcohol in moderation, continuing to exercise and getting enough rest.

Coping with Holiday Depression Besides family stress, other factors may well play into bringing on the holiday blues.

During this time of the year, some Rhode Islanders may even feel a little depressed or have suicidal thoughts with the approaching upcoming festive holidays, especially if they have lost a spouse or other loved one/friend. Or perhaps they are unemployed, experiencing painful chronic illnesses, or just feel isolated from others.

If this happens, “feeling low with nowhere to turn,” as noted singer songwriter Bill Withers says in a public service announcement, there is a place to call – The Samaritans of Rhode Island – where trained volunteers “are there to listen.” Incorporated in 1977, the Pawtucket-based nonprofit program is dedicated to reducing the occurrence of suicide by befriending the desperate and lonely throughout RI’s 39 cities and towns.

Since its inception, The Samaritans has received more than 500, 000 calls and trained 1, 380 volunteers to answer its confidential and anonymous Hotline/Listening Lines.

With the first Samaritan branch started in England in 1953, chapters can now be found in more than 40 countries around the world. “Samaritans, can I help you?” is quietly spoken into the phone across the world in a multilingual chorus of voices, notes its web site.

Executive Director Denise Panichas, of the Rhode Island branch, notes that the communication-based program teaches volunteers to effectively listen to people who are in crisis. Conversations are free, confidential and, most importantly, anonymous.

A rigorous 21-hour training program teaches volunteers to listen to callers without expressing personal judgments or opinions. Panichas said that the listening techniques called “befriending” call for 90 percent listening and 10 percent talking.

Panichas noted that the Samaritans of Rhode Island’s Listening Line is also a much needed resource for caregivers and older Rhode Islanders.

Other services include a peer-to peer grief Safe Place Support Group for those left behind by suicide as well as community education programs.

In 2011, the Samaritans of Rhode Island received more than 7, 000 calls and hosted more than 50, 000 visitors to its website.

The Samaritans can be the gateway to care or a “compassionate nonjudgmental voice on the other end of the line,” Panichas notes. “It doesn’t matter what your problem is – be it depression, suicidal thoughts, seeking resources for mental health services in the community, being lonely or just needing to talk – our volunteers are there to listen.”

For persons interested in more information, visit the Samaritans website at http://www.samaritansri.org. There is an emergency checklist as well as information by city and town including Blackstone Valley communities from Pawtucket to Woonsocket.

Gallery and Gift Shop Supports the Program and its Services In December 2011, The Samaritans began a social venture by relocating to the city of Pawtucket’s Arts & Entertainment District, and opening the Forget-Me-Not Gallery and Community Education Center. Through partnerships with Rhode Island’s fine arts and crafts community, “we hope to foster hope, inspiration and commemoration of the lives of our loved ones who have fallen victim to suicide,” stated Panichas.

At the Forget-Me-Not gallery, no sales taxes are charged on oneof-a-kind pieces of artwork. The gallery also is a retail site for Rhode Island-based Alex and Ani jewelry and other gift ware.

For those seeking to financially support the programs of the Samaritans of Rhode Island, its Gallery and Education Center is available to rent for special events, meetings and other types of occasions. For information on gallery rental, call the Samaritans business line at 401-721-5220; or go to http://www.samaritansri.org.

Need to Talk? Call a volunteer at the Samaritans – 401-272-4044 or toll free in RI (1-800) 365-4044.

AARP Research Study Explores Why People Are Happy

Published September 14, 2012, Pawtucket Times

           “Good conversation, meeting new people while traveling, and being in good health” brings much happiness to long-time Pawtucket resident Jean Babiec.  The former Providence school teacher, in her eighth decade, added she would be ‘extremely happy’ if the Rhode Island General Assembly passed legislation, signed by Governor Lincoln Chafee, to create a Pawtucket Red Sox vanity license plate.

           At-Large Pawtucket City Councilor, Lorenzo C. Tetreault, 65, is “the happiest when he can help others.”  The retired Pawtucket teacher is also happy when he holds his one-year old twin grandsons from Narragansett, Samuel and Benjamin, in his arms.

           Former Pawtucket Tax Assessor, Dave Quinn, 64, who now oversees the Tax Office in the City of Providence, finds happiness “knowing that his family is healthy and his children are doing well.”  The Seekonk resident also feels happy by being intellectually challenged by his job.

           Babiec, Tetreault and Quinn’s statements on what makes them happy are reflected by others documented in a recently released AARP study on what happiness means to aging baby boomers.  The findings of this report indicate that relationships and being in control of your health and life are key factors in bringing happiness into your life.  

Defining Happiness

            The new AARP study, titled “Beyond Happiness: Thriving,” found that most Americans age 35 and over are happy, but compared to historical General Social Survey (GSS) data, levels of happiness are on the decline and at their lowest levels (due in part to the nation’s economic downturn).  In an effort to explore what happiness means to aging baby boomers and what it takes to thrive as they age, over 4,000 adults age 35 and over were surveyed to determine what makes them happy.   

             “We’re always looking to get a more robust understanding of the contributors and barriers to happiness in people’s lives,” said Steve Cone, Executive Vice President of Integrated Value Strategy, AARP. “Building on previous AARP research, which shows the importance of happiness and peace of mind to aging baby boomers, these new results affirm that we are on the right track—advocating to ensure basic health and financial security and making available everyday discounts that let people enjoy time with family and friends.”  

             According to researchers, the findings of this study reveal the existence of a U-shape curve of happiness by age. The early 50s is the lowest point from which happiness builds. Thus, if you missed happiness in your 30’s, there is still another chance to achieve it in your 60’s.

             The Researchers note that as people age and eventually retire, they can devote more time to building relationships and just enjoying simple everyday pleasures.  Younger people are still working hard to solidify their accomplishments.

           The AARP study’s results also provide four key insights around the drivers of happiness.

The Happiness Spectrum

            Overall, the strong majority (68%) of respondents say they are happy, although intensity of happiness is somewhat tempered as the largest percent report being somewhat happy (49%) versus very happy (19%). Almost half of those surveyed feel they are just as happy as others (49%) and the rest tend to believe that they are happier than others (31%) as opposed to less happy than others (13%). Part of this may be attributed to the perceptions of people being the masters of their own happiness destiny.

            More interesting, the respondents were concern for the happiness of the next generation. Less than half feel they will be as happy or more (45%). Most are either not sure (19%) or believe they will be less happy (35%).

Relationships Key to Happiness 

           The AARP survey findings also indicate that regardless of your age, good relationships with friends, family, and even pets, were found to be universally important. Activities associated with those relationships contributed most to a person’s happiness. The most significant activity was kissing or hugging someone you love.  Other activities included: watching your children grandchildren or close relative succeed; being told you are a person who can be trusted or relied upon; spending time with your family or friends such as a meal or social gathering; and finally, experiencing a special moment with a child. 

            Researchers say that relationships with family pets were especially important to women, singles and older individuals.  However, relationships did have to be real: “connecting with friends or family on a social media site like Facebook” came in 37th out of 38 activities in contributing to happiness. Importantly, none of the top contributors require a lot of money to achieve; they are “simple pleasures” that can be had by all.

 Good Health Linked to Happiness 

          Without good health, it is far more difficult to achieve happiness: people in “good or excellent” health are three times more likely to report being “very” happy, the researchers say.  However, one’s health may be more a state of mind than objective reality.  The findings noted that the percentage of those reporting good health is relatively stable over the ages 35 to 80, varying only seven percentage points, even as reported chronic or serious medical conditions increase 400% in the same age range. 

Calling the Shots, Brings Happiness

          The majority of those surveyed feel they have control over their personal level of happiness. Interestingly, this sense of control increases with age. Moreover, people who feel in control are clearly happier—reporting that they are 2.5 times happier than those who believe happiness is out of their control. The study’s findings indicate that a sense of control is linked to higher income, higher education, good health and the lack of having experienced a major life event in the past year.

Money Does Not Always Guarantee Happiness

            While many will say having money can bring happiness, this research study showed that it seems that how one spends it seems to matter more.  Happiness increases with income and conversely, lack of financial resources was tied to unhappiness. While less than a third of participants said money contributed to happiness, when asked how they would spend $100 on something to increase happiness, most respondents said they would spend it on their family or going out to dinner. Money is only a resource, that when applied to meaningful areas of one’s life, can provide experiences that can increase happiness.

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