Category Archives for Mental Health

The Growing Incidence of Alzheimer’s

Published in Pawtucket Times on April 26, 2016

While Congress and states are nation grappling with how to put the brakes to one of the largest public health crises in recent times, the escalating Alzheimer’s disease (AD) epidemic, the Chicago-based Alzheimer’s Association releases its annual snap shot detailing statistics on the impact of Alzheimer’s and dementia on caregivers and health care costs..

According to the 2016 Alzheimer’s disease Facts and Figures, released on March 30, 2016, this year nearly 16 million Alzheimer’s caregivers will provide 18 billion hours of unpaid care to 5.4 million afflicted with this devastating disorder. That care had an estimated value of $221.3 billion, says the report.

But that’s not all, this recently released report notes that two out of three people believe that Medicare will help them over costly nursing facility costs. Sorry it won’t. AD also has a direct impact on a caregiver’s pocketbook, too, the researchers found. More than one-third of those surveyed say they were forced by caregiving duties to reduce their hours at work or just quit their job entirely. As a result of these actions their income dropped by $15,000 compared to the previous year. Eleven percent of caregivers were forced to cut back on spending for their children’s education in order to provide support.

The 79 page Alzheimer’s Association report notes that both physical, emotional and financial support required by a person with AD may ultimately deprive family and friend care givers basic necessities, such as food, transportation and medical care. The Facts and Figures report reveals that these caregivers were 28 percent more likely to eat less or go hungry while contributing care to someone with AD, and one-fifth even sacrificed their own medical care by cutting back on doctor visits. Overall, nearly half of the caregivers say they cut back on their own expenses to afford dementia-related care for their family member or friend.

“The devastating emotional and physical effects of caring for a person with Alzheimer’s disease has been well-studied,” said Beth Kallmyer, MSW, Vice President of Constituent Services for the Alzheimer’s Association. “However, this new report shows, for the first time, the enormous personal financial sacrifices that millions of care contributors must make every day. These sacrifices jeopardize the financial security of individuals and families, as well as their access to basic needs and health care.”

This year’s Facts and Figures report found that 13 percent of family or friend caregivers sold personal belongings, such as a car, to help pay for costs related to dementia, while nearly half tapped into savings or retirement funds. On average, caregivers, many of whom do not live with the person they’re caring for, spent more than $5,000 a year of their own money to care for someone with AD; however, amounts varied with many spending tens of thousands of dollars per year.
Incidents of AD is Fast Growing

The Facts and Figures report says that out of the 5.4 million (of all ages) afflicted with AD, an estimated 5.2 million are age 65 and over. Yes, one in nine people having the cognitive disorder. Approximately 200,000, having early onset AD, are under age 65.

Also, the recently released Facts and Figures report warns that we are truly in the midst of an AD epidemic as the baby boomers grow older. By 2050, researchers say that someone in the United States will develop AD every 33 seconds. Without a medical breakthroughs to prevent or cure, the age 65 and over population with AD, the incidence is expected to nearly triple, from 5.2 million to a projected 13.8 million. Some say may be even as high as 16 million. It’s the only disease among the top 10 causes of death in America that cannot be prevented, cured or even slowed. .

Additionally, this year’s Facts and Figure report notes that AD is officially listed as the sixth-leading cause of death in this country. It is the fifth-leading cause of death for people age 65 and older. With the graying of America, AD will become a more common cause of death. At age 70, 61 percent of those with AD are expected to die before the age of 80 compared with 30 percent of people without the cognitive disorder — a rate twice as high, says the report.

The Typical Care Giver

The Facts and Figures report puts the face on a typical caregiver. Approximately two-thirds of caregivers are women, and 34 percent are age 65 or older. Forty one percent have a household income of $50,000 or less.

AD takes a devastating toll on the health of caregivers, says the Facts and Figures report. Nearly 60 percent of those taking care of loved ones with Alzheimer’s and dementia report that their emotional stress being high or very high. About 40 percent suffer from depression. One in five care givers cut back on their own physician visits because of their caregiving responsibilities. And, among caregivers, 74 percent report they are “somewhat” to “very” concerned about maintaining their own health since becoming a caregiver.

A Huge Cost on the Health Care System

The report’s researchers warn that the AD epidemic might just bankrupt the nation’s Medicare program. In 2016, total payments for health care, long-term care and hospice are estimated to be $236 billion for people with Alzheimer’s and other dementias, with just under half of the costs paid by Medicare. Nearly one in every five Medicare dollars is spent on people with Alzheimer’s and other dementias. In 2050, it will be one in every three dollars

Medicare and Medicaid are expected to cover $160 billion, or 68 percent, of the total health care and long-term care payments for people with Alzheimer’s disease and other dementias.

Seeing a huge rise in AD over the last two years, federal and state officials are gearing up to strategize a battle to fight the impending epidemic.

A Call to Action

Yes, the AD epidemic is here, right in Rhode Island. Everyone is personally touched by either caring for a family member with the cognitive disorder or knows someone who is a caregiver or afflicted.

Following the efforts of Congress to create a national strategic plan to address the rapidly escalating AD crisis and to coordinate resources across federal agencies, the Rhode Island General Assembly passed a joint resolution enacted into law to direct the Lt. Governor’s Long Term Care Coordinating Council (LTCCC) to be the vehicle to develop a state plan to address this growing public health crisis in the Ocean State. Ultimately, for over a year former Lt. Governor Elizabeth Roberts along with LTCCC members, former Division of Elderly Affairs Director Catherine Taylor, the state Chapter of the Alzheimer’s Association, universities and health care organizations with the public input gleaned from 8 listening events hammered out the 122 page battle plan with over 30 pages of recommendations.

In 2016, Lt. Governor Daniel J. McKee has picked up the ball and convened a meeting of the Executive Board on Alzheimer’s Disease and Related Disorders, consisting of researchers, advocates, clinicians and caregivers, to begin efforts to implement recommendations from the State’s Alzheimer’s Plan. The group will determine which recommendations are outdated.

With a rising population of Rhode Islander’s with AD, state policy makers must act swiftly and lose no more time in addressing this terrible disease and public health issue.

Coping with the holiday blues can be a challenge

Published in the Pawtucket Times on December 14, 2015 

Chestnuts roasting in your fireplace, 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, who now provides one-to-one counseling to clients for the past six years, provides common sense tips as to how to survive stress that can be ignited by holiday family gathering.

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, she says.

“It is okay 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, just reach out to your network of family or friends or contact a professional, she recommends.

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, she says.

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 from your family gathering because of tension, you don’t have to, she says.

“Just keep your visit time-limited,” she recommends, only going for an hour or two rather than spending all day at the event.

The holidays can easily become a source of stress, especially when you’re standing in long lines at the local 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, too, 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 and friends, are unemployed, experiencing painful chronic illnesses, or just feel isolated from others.

If this happens, “feeling low with nowhere to turn,” as noted singer and songwriter Bill Withers says is 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 despairing and lonely throughout the state’s 39 cities and towns.

Since the inception, The Samaritans has received more than 500,000 calls and trained more 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 of 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,” calls for 90 percent listening and 10 percent talking.

Panichas noted The Samaritans of Rhode Island Listening Line is also a much needed resources 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 of Rhode Island 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 or being lonely or just needing to talk, our volunteers are there to listen.”

For persons interested in more information about suicide emergencies, The Samaritans website, http://www.samaritansri.org, has an emergency checklist as well as information by city and town including Blackstone Valley communities from Pawtucket to Woonsocket.

Professional galley and gift shop supports program and 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 one-of-a-kind pieces of art work. The gallery also is a retail site for Rhode Island-based Alex and Ani jewelry and other giftware.

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. Call 401-272-4044 or toll free in RI (1-800) 365-4044.

Comic Robin Williams’ Death Puts Spotlight on Depression, Suicide

Published in Pawtucket Times, August 15, 2014

Last Monday evening, millions of Americans were shocked to hear that 63-year- old Robin Williams died from an apparent suicide. While it was well-known that he had a history of severe depression and years of alcohol and drug addiction, we were stunned by the unexpected tragic news. publically, Williams had it all, fame, fortune, loyal friends, and fans in every corner of the globe. But like millions of Americans he suffered in silence trying to slay his personal demons when he went into substance abuse treatment.

The sudden death of this Oscar-winning actor, recognized as America’s comic genius, squarely puts the spotlight on depression, a mental illness that commonly afflicts tens of millions of Americans.

DDepression Becomes a Public Conversation

Within the first 48 hours of Williams’ suicide The Samaritans of Rhode Island saw an increase in calls from people concerned about loved ones and friends, says Executive Director Denise Panichas, who expects to also see an increase in visits to her Pawtucket-based nonprofit’s website. Last year, its website received more than 50,000 visitors.

Panichas says, “William’s death reinforces the fact that suicide knows no boundaries, it being a relentless demon afflicting both rich or poor, and those having access to therapy or medical care and those not having it.

According to the Woonsocket resident, William’s suicide has raised the awareness of suicide prevention in a way that millions of dollars in public health announcements could never have done. “William’s movies as well as his dedication to community service resonate with multiple generations, says Panichas, stressing that his six plus decades had value “which will live on.”

Williams substance abuse problems also highlights the need for more awareness as to how addictions can be a risk factor for depression and suicide, states Panichas, who observes that throughout the country, in ever city and town, budgets for substance abuse treatment are being decimated, she adds.

“Promoting wellness and preventing addictions will always be a big challenge but we must do more if we want to see a decrease in suicides,” says Panichas.

Panichas expects the death of Williams, an internationally acclaimed movie star, will have an impact on fundraising for suicide prevention or addiction and depression prevention programs. She has seen an increase in donations from Rhode Islanders as well as from around the country. .

“One donor gave a donation in memory of “Mork”. The donations coming in may be small but every one counts toward keeping our programs available to the public,” says Panichas, noting that over the years public funding has “been drying up.” The Samaritans of RI is using more creative fundraising structures, like crowdfunding (www.crowdrise.com/samaritansri2014) and other social venture sites to create new revenue streams for her nonprofit, she adds.

An Illness That Can Affect Anyone

Lisa B. Shea, MD, Medical Director of Providence-based Butler Hospital, Providence, learned of William’s suicide by a CNN alert on her IPhone. To the board- certified psychiatrist who serves as a clinical associate professor at Brown University’s Alpbert Medical School, “it was tragic but preventable.”

Shea, a practicing psychiatrist for 20 years, notes that people who have suicidal thoughts, like Williams, are struggling with mental health disorders. “Their thinking can get very dark and narrow and they believe they have no options,” she says, oftentimes feeling like a burden to others. “It does not matter who you are mental illness can strike any one regardless of their wealth and fame,” she says.

According to Shea, the public’s interest in William’s tragic death sheds light on the fact that people can get help and it begins with taking a positive first step. “People with suicidal thoughts, who feel “intensely tortured and can not see any way out of their situation, can benefit from supportive therapeutic relationships, medications, and getting support from family and friends who can push them into getting professional help,” she says.

Shea calls on Congress and Rhode Island state lawmakers to positively respond to the William’s suicide by providing increased funding to create access to treatment and prevention programs and to support mental health research.

Finally, Shea says that there are a number of tell-tale signs of a person expressing hopelessness who may be thinking of ending their life. They include statements made by someone that others are better off if he or she were not around; excessive use of alcohol and/or drugs; not taking care of yourself; and giving away personal items. When these occur, talk to the person telling them that you care about them and are concerned for their well-being.

Adds Melinda Kulish, Ph.D., a Clinical Psychologist/Clinical Neuropsychologist and Instructor of Psychology at Harvard Medical School, “There are also times when depression is not easily recognizable. Some people who are depressed experience it most acutely when by themselves but can appear fine, even quite happy, when they are with other people.”

Kulish explains that, for various reasons, some people feel the need to make others happy. Cheering others up or making others laugh makes them also feel happy.

“But, if that person is suffering from depression, the happiness is fleeting – the laughter ends and they once again feel empty and sad. The cheering up of others is a fix that is OUTSIDE, not inside of them.

“And drugs and alcohol can make them feel better for a time. The high always ends, and when alone, they feel empty and even more depressed,” says Kulish. “There’s really good research to suggest that talking about traumatic and upsetting events leads to much healthier responses. The old idea, ‘I’m just not going to talk about it so it’ll go away’ doesn’t work.”

“It’s a myth that if you ask a person if they are suicidal you will put that idea in their heads,” says Shea.

Feeling Low, a Place to Call

When this happens, “feeling low with nowhere to turn” as noted singer songwriter Bill Withers once said 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 the state’s 39 cities and towns.

Since the inception, The Samaritans has received more than 500,000 calls and trained more 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 of the world. “Samaritans, can I help you?” is quietly spoken into the phone across the world in a multilingual chorus of voices,” notes its website.

Executive Director Panichas, 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,” calls for 90 percent listening and 10 percent talking. Panichas noted The Samaritans of Rhode Island Listening Line is also a much needed resources 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 2014, The Samaritans of Rhode Island received more than 4,000 calls and hosted more than 50,000 visitors to its website.

The Samaritans of Rhode Island 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 or being lonely or just needing to talk, our volunteers are there to listen.”

For persons interested in more information about suicide emergencies, The Samaritans website,http://www.samaritansri.org, has an emergency checklist as well as information by city and town including Blackstone Valley communities from Pawtucket to Woonsocket.

For those seeking to financially support the programs of The Samaritans of Rhode Island, its Art 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 tohttp://www.samaritansri.org.

Need to Talk? Call a volunteer at The Samaritans. Call 401.272.4044 or toll-free in RI (1-800) 365-4044.

For mental health resources, go to http://www.butler.org.

Herb Weiss, LRI ’12 is a Pawtucket-based freelance writer who covers health care, aging, and medical issues. He can be contacted at hweissri@aol.com.