September Springfield Healthy Cells 2011 by Healthy Cells Magazine

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Promoting Healthier Living in Your Community • Physical • Emotional • Nutritional

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HealthyCells September 2011

www.healthycellsmagazine.com

M A G A Z I N E

Advanced Healthcare Services Hospital Care Comes Home

page 14

Win at Weight Loss page 12

Fight the Bite

page 17

SIU Physician Treats Bladder Control Problems page 22

When illness or injury affects a person’s ability to function independently, difficult choices must be made. For those who wish to remain in the comfort of their home, ADVANCED HEALTHCARE SERVICES, LLC can provide the necessary services and support in your home. Advanced Healthcare Services, LLC serves Central Illinois which includes 13 counties. • MEDICARE Certified • Illinois Department of Public Health Licensed

Services • Visiting Nurse, RN, Registered Nurse, LPN, Licensed Practical Nurse • Certified wound-ostomy nurse • Physical Therapy • Occupational Therapy • Speech Therapy • Home Health Aide • Medical Licensed Social Worker • Medical Equipment • Podiatry

Payment Options • Medicare • Private Insurance • Workman’s Comp • Medicaid Care will begin within 48 hours after a physician order is received. Our staff is available to answers questions 24 hours a day. Contact Shannon Lionberger at 217-726-6956 with any questions you may have.

Celebrate Therapists! Caring people changing lives Happy Rehabilitation Awareness Week September 18-21, 2011 3900 Pintail Drive, Suite A, Springfield, IL, 62711 Phone: 217-726-6956 or Fax: 217-726-7082 advancedhealthcareservices.org September 2011 — Springfield / Decatur — Healthy Cells Magazine — Page 3

S E PTEMBER

2011 Volume 2, Issue 9

Mental Health: Melancholy in the Elderly

Emotional: The ‘A’ Word

Nutritional: The basics for better health

Physical: Arthritis of the Foot and Ankle

Healthy Balance: Win at Weight Loss

Prevention: Fight the Bite!

Family Health: Trendy Technology and Our Children

Senior Care: The Silent Epidemic

Future Planning: Life Insurance

Women’s Health: SIU Physician Treats Bladder Control Problems

23 24

Safety: Home Safety is Serious Business

Grief Recovery: “Are There Actual Stages Of Grieving?”

This Month’s Cover Story:

Advanced Healthcare Services Hospital Care Comes Home page 14

For information about this publication, contact Becky Ar ndt, owner at 217-413-1884, Becky@healthycellsmagazine.com Healthy Cells Magazine is a division of: 1711 W. Detweiller Dr., Peoria, IL 61615 Ph: 309-681-4418 Fax: 309-691-2187 info@limelightlink.com • www.healthycellsmagazine.com

Healthy Cells Magazine is intended to heighten awareness of health and fitness information and does not suggest diagnosis or treatment. This information is not a substitute for medical attention. See your healthcare professional for medical advice and treatment. The opinions, statements, and claims expressed by the columnists, advertisers, and contributors to Healthy Cells Magazine are not necessarily those of the editors or publisher. Healthy Cells Magazine is available FREE in high traffic locations throughout the Greater Springfield and Decatur area, including major grocery stores, hospitals, physicians’ offices, and health clubs. Healthy Cells Magazine is published monthly and welcomes contributions pertaining to healthier living. Limelight Communications, Inc. assumes no responsibility for their publication or return. Solicitations for articles shall pertain to physical, emotional, and nutritional health only. Mission: The objective of Healthy Cells Magazine is to promote a stronger health-conscious community by means of offering education and support through the cooperative efforts among esteemed health and fitness professionals in the Springfield/Decatur Illinois area.

I wish to thank all the advertisers for their support of Healthy Cells Magazine’s mission to bring positive health related information to our readers. Because of their generosity we are able to provide this publication FREE to you. – Becky Arndt

mental health

Melancholy in the Elderly:

Normal or Not? By Dr. Bev Matthews, Central IL Neuropsychological Services

any people believe that because a person is older than 60, the person is slower, sad and not as active. This is a mistaken belief. Visit a Senior Center. Take a vacation. Visit your local theatre. Seniors are volunteering, working out, employed and taking classes. They remain active, leading a full life well into their 70’s and 80’s. Depression in the elderly does go undetected. Many people prefer not to talk about their sadness. They will report physical symptoms instead of sadness. Recognizing and treating medical illnesses along with psychological symptoms improves longevity in an elderly person. One study cites as much as 40 to 50 percent of nursing home and geropsychiatric hospital residents are depressed. Depression in the nursing home in cognitively intact residents is estimated to be as high as 25% with depression in the cognitively impaired estimated at 10%. Clinicians will want to watch for the following symptoms of depression in an elderly person; insomnia, chronic aches and pains, frequent headaches, lack of interest in sex, a bad taste in the mouth, constipation, over concern about bodily functions, irritability, agitation, weight loss and multiple physical complaints. Older people may be unable to put their feelings into words. The technical term for that phenomenon is alexithymia or “no word for feelings”. Emotions are actually generated in the right hemisphere of the brain and transferred through the corpus callosum to the left hemisphere and put into words. It is believed that this functioning does not work as well in the elderly. Elderly people who are depressed may display persistent anger with themselves or others. They may make negative statements or express unrealistic fears. They may express repetitive health complaints. They may require more attention regarding their meals, schedules, laundry, clothing and in relationships. A change in sleep pattern may be noticed. Their facial expression may be sad, pained, or worried. They may cry more than usual. Constant calling out for help is another sign of depression. Isolation or withdrawal from activities once interested in may manifest itself in an elderly person who is depressed. Loneliness and hopelessness as well as feelings of worthlessness may be exhibited. Expressions of a lack of pleasure in life are another symptom of depression. There is also research that supports the fact that vascular disease in the elderly contributes to depression. Depression interferes with a

person’s ability to think, reason, and remember. Focusing on internal events such as loss contributes to depressive thoughts. Depression actually slows down the level of brain activity in the person who experiences it. This interferes with a person’s ability to generate and process thoughts contributing to hopelessness and helplessness. Decreased levels of neurotransmitters contribute to depression in an elderly person including noradrenaline, serotonin, melatonin, dopamine and adrenaline. Antidepressants are sometimes effective in increasing the levels of the neurotransmitters. Psychotherapy, physical exercise and medication as a combined form of treatment is generally the best treatment. Other causes of depression may include nutritional deficiencies, mismanagement or excessive prescription medication use, illegal drugs, alcohol, caffeine, nicotine, hypoglycemia and hormonal imbalances. A distinction between grief and depression will need to be addressed in an elderly person who presents with a change in personality. Sadness is a transitory state. Grief may last for months or years. Family members of an elderly person who experiences a loss will want to watch for normal grief versus depression. The person who endured depression and/or anxiety prior to a loss may exhibit grief differently and to a different level that someone who did not have a mood disorder. We cannot forget that heredity, biology, psychology, social structures and cultural factors contribute to a person’s mental health status. We also want to consider medical diagnosis that could contribute to depressive symptoms. Ruling out dementia, delirium, or other illnesses that could change personality is recommended. What to do if you suspect that you are depressed or someone you know is depressed? An evaluation by a qualified mental health professional such as a licensed clinical psychologist will assist in determining the exact diagnosis and initiate a course of treatment that is tailored to the person’s special needs. Treatment should include a medical checkup, medication evaluation and psychological evaluation. In Decatur and Macon County, residents may call Dr. Bev Matthews, Licensed Clinical Psychologist, Licensed Clinical Professional Counselor, Certificate in Clinical Neuropsychology at Central Illinois Neuropsychological Services (217-876-7929). September 2011 — Springfield / Decatur — Healthy Cells Magazine — Page 5

emotional

The ‘A’ Word By Heather Mulder, Alzheimer’s Association- Greater Illinois Chapter

orgot what you ate for lunch, or even if you ate lunch? Having trouble keeping up with conversations? Not being able to play your favorite game, because you can’t remember the rules anymore, or difficulty preparing your world famous specialty? Sounds pretty scary, right? For 5.4 million American’s, this is how it started- the ‘A’ word. Alzheimer’s disease. Remembering back to the not-so-distant past, cancer was known as the ‘C’ word and was uttered in necessity only. Over the past couple of decades, cancer has become a common term to hear, and the advances in research give the millions of people, affected by one form or another, hope. Various groups are working to spread awareness of risk factors, lifestyle choices to shed a light on cancer, and dispel some of the myths out there. The ‘A’ word, on the other hand, is still shrouded in stigma, and despite the fact that talking about it can help- for all the same reasons as it did with cancer, Alzheimer’s disease is not a topic that people speak of readily. Page 6 — Healthy Cells Magazine — Springfield / Decatur — September 2011

However, when we are aware of the facts, it can help us to make informed decisions, and give a feeling of control and understanding. The first part of being aware of Alzheimer’s is understanding the disease. We used to think that memory loss was a normal part of aging. We gave it names like ‘hardening of the arteries’ or ‘senility.’ Now we know this is simply not the case. Alzheimer’s is a form of dementia, which is memory loss severe enough to affect daily life. Alzheimer’s is the most prevalent form of dementia, accounting for nearly 70% of the cases. Scientists believe that it starts forming in someone’s brain ten, or even twenty years before outward symptoms start to show. When signs do become apparent, the first thing people notice is problems with short term memory, which is why symptoms such as forgetting something that happened recently, or asking the same question over and over are commonly associated with Alzheimer’s. It progressively moves through a person’s brain destroying brain cells responsible for things such as memory, thinking and behavior. Eventually,

Alzheimer’s moves to the part of the brain that is responsible for our most basic bodily functions such as breathing and swallowing. The greatest risk factor for Alzheimer’s disease is age. At age 65, people have about a one in eight chance of developing this disease. That risk double every five years until at age 85, nearly one in two people will have it. With the facts as they stand, we are looking at a population explosion in the number of people with Alzheimer’s disease. The reason? The baby boomers have started turning 65 at a rate of nearly 10,000 per day for the next nineteen years. Without the development of a treatment, prevention, or cure, by the year 2050, the number of people living with Alzheimer’s is estimated to be between 11 and 16 million. Coined ‘the defining disease of the Baby Boomers,’ many of this generation will spend their retirement years with Alzheimer’s, or caring for someone who has it. According to the report ‘Generation Alzheimer’s’ from the Alzheimer’s Association, “death rates for other major diseases- HIV, stroke, heart disease, prostate cancer, breast cancer- are declining.” This is a testament to the fantastic amounts of research, money, and awareness that have been poured into these conditions. Death rates for Alzheiemer’s, on the other hand are skyrocketing. It remains the only one of the top ten causes of death in the United States without a way to prevent, cure, or slow its progression. So, what can we do? First and foremost, talk about it. Spread awareness to your friends and family. Only by talking about it can we destroy the stigma associated with Alzheimer’s. Consider, as well, joining the Walk to End Alzheimer’s. This is an incredibly touching event where people can come together to remem-

“Spread awareness to your friends and family. Only by talking about it can we destroy the stigma associated with Alzheimer’s.” ber loved ones, and pay tribute to them, and feel the camaraderie and support of people who have been through the journey of Alzheimer’s. Funds are raised to help advance research- that will find the treatment, or cure, to help spread awareness of this disease, and to help people who are affected right now. Walks are being held on Saturday, September 24th in Springfield and Saturday, October 15th in Decatur. To start a team, or sign up to join us, contact Rachel.redd@alz.org or visit www.alz.org/illinois If you have concerns or questions, you can contact the Alzheimer’s Association Helpline at 800.272.3900 for information, referrals and for support. You can email any questions to Heather.mulder@alz.org.

September 2011 — Springfield / Decatur — Healthy Cells Magazine — Page 7

nutritional

Photo courtesy of Getty Images

f you’ve ever struggled with trying to figure out what you need to do to take to maintain a healthier lifestyle, you’re not alone. The 2011 Food and Health Survey, commissioned by the International Food Information Council Foundation (IFICF), found that among the 69 percent of Americans currently trying to lose or maintain their weight: n 70 percent believe that both physical activity and monitoring food and beverage consumption are equally important in weight management. Page 8 — Healthy Cells Magazine — Springfield / Decatur — September 2011

n However, only 54 percent report actually implementing both strate-

gies in an effort to manage their weight. While the survey showed that approximately half of Americans perceive their overall diet as at least “somewhat healthful,” the World Health Organization ranks the United States as 18th (out of 153 countries) in the world for obesity and 28th in the world for cases of diabetes.

Why Is It So Hard? There’s a lot of information available about nutrition and fitness, and it can be tricky to sort through it all and put it into practice. Confusion over nutrition, conflicting reports over what’s healthy and what’s not, busy lifestyles that leave no time for exercise — all of these can be roadblocks to better health. Nutrition Made Easier You are what you eat. And how you eat. And when you eat. In the latest edition of her book, “Nutrition For Dummies,” (Wiley, May 2011), Carol Ann Rinzler says that nutrition is simply the science of how the body uses food — and in order to take care of yourself, you need to know a little bit about how that science works. “Nutrition is about why

becoming fit, how to get started and how to stay motivated. “We want to help make fitness a permanent and enjoyable part of your lifestyle.” The 5 Key Areas Schlosberg and Neporent say that it doesn’t take much effort to get a basic level of physical fitness in the five key areas: cardio, strength, flexibility, balance and nutrition. Why are these so important? n Cardio fitness. Workouts that get your heart pumping and continuously work a lot of large muscles improve your heart, lungs, blood vessels and stamina. They also burn a lot of calories, helping you lose weight. Think walking, cycling and using an elliptical machine. n Strength training. People who don’t exercise lose 30 to 40 percent of their strength by age 65, say the authors. By age 74, more than

Smart Ways to Eat Out If you go out to restaurants at all, you know that most menus don’t have a long list of healthy foods. In the book “Restaurant Calorie Counter For Dummies, 2nd Edition” (Wiley, May 2011), you can find helpful information for making smart choices. Here are a few tips from the book: n Drink your whole glass of water (or more), but limit other beverages to just one glass. n Physically split a meal in half when it arrives at your table and ask for the to go box right away. n Choose fresh toppings, such as onion, tomato and lettuce, rather than pickled items such as jarred pepper strips or pickles. n Aim to get some lean protein with your meal. At salad bars, choose beans or cottage cheese. For the entrée, choose grilled chicken or fish. The guide also provides calorie counts for menu items at 150 popular restaurants.

you eat what you eat and how the food you get affects your body and health,” she said. Hunger vs. Appetite Rinzler says that hunger and appetite are two very different things: n Hunger is the need for food. It’s a physical reaction that includes chemical changes in your body. It’s an instinctive, protective mechanism to make sure your body gets what it needs to function. n Appetite is the desire for food. It’s a sensory or psychological reaction (This looks good! That smells good!) which creates an involuntary response like salivation or stomach contractions. It’s also a conditioned response to food — think Pavlov’s dogs. Understanding the difference is the first step toward more healthful eating. Making Wise Food Choices In her book, Rinzler walks readers through things like the facts on fat and cholesterol, carbohydrates and proteins, building a healthful diet, food labeling, and what happens when food is cooked at home or processed in a plant — all to help make sense of nutrition so that making good choices that please your palate as well as your body, is easy. The Facts on Fitness Fitness can actually mean a number of things. You can be fit to run 5 miles or do yoga. You can look fit — that is, lean — and not have much stamina, strength, flexibility or balance. Suzanne Schlosberg and Liz Neporent, authors of “Fitness For Dummies, 4th Edition” (Wiley, December 2010), want to help people understand what’s involved in

one quarter of men and two-thirds of women can’t lift an object heavier than 10 pounds. Lifting weights means strengthening your muscles for the long term. It also means strengthening your bones and speeding up metabolism. n Flexibility. Maintaining flexibility helps keep your joints mobile, minimizing risk of injury and allowing you to move with agility and good posture even as you age. n Balance. Balance is important when you’re young, and essential when you’re not. A good sense of balance helps you move more fluidly and prevents unnecessary falls. n Nutrition. When you make wise food choices, you have more energy to exercise and you recover more quickly from your workouts. The “Fitness” authors say it’s important to keep things interesting. Boredom can be the enemy of any workout. Listen to music, mix up your workouts — running on Monday, yoga on Tuesday, hiking on Wednesday, etc. Vary your pace or terrain, or try different exercise equipment. And remember to stay realistic. “Trying to do too much or setting expectations too high can lead to frustration. Pace yourself and cut yourself some slack. Everyone improves at a different pace. Fitness is something personal and unique to you.” For more about these books, visit www.dummies.com. To celebrate its 20th anniversary, For Dummies is hosting special book promotions, sweepstakes, exclusive giveaways on their Facebook and Twitter pages, as well as other special events. To find out more and to download a free minibook, visit www.dummies.com.

September 2011 — Springfield / Decatur — Healthy Cells Magazine — Page 9

physical

Arthritis of the Foot and Ankle By John M. Sigle, D.P.M., F.A.C.F.A.S., Foot & Ankle Center Of Illinois

ain caused by arthritis of the foot and ankle is one of the most common complaints that I get from patients in my office. Most patients live with it for years before seeking treatment by a physician. That is unfortunate because early detection and treatment can help to slow its progression. If you are suffering from this condition, you are not alone. In fact, over forty million Americans suffer from some form of arthritis. The first part of this article will help you understand what arthritis is and what causes osteoarthritis. The second part of the article will explain what arthritis feels like, how it is diagnosed, and how it is treated. WHAT IS ARTHRITIS Arthritis is a condition that affects and causes pain in joints of the human body. Arthritis causes inflammation of the joint lining and loss of the cartilage covering on the bone. Cartilage functions to cushion and protect bone during movements. Loss of this protective covering can cause bone-on-bone contact, limited motion and pain. It can affect any one joint or multiple joints at the same time. Arthritis can present itself at any age. There are over one hundred different disorders that can manifest in painful arthritis. The most common type is osteoarthritis. Osteoarthritis, also known as degenerative arthritis, is a “wear and tear” form of arthritis. It usually presents in patients over the age of 45 and often is a part of the aging process. When cartilage loss is significant, its symptoms can be painful enough to prevent one from performing even routine daily activities. In some cases it can be crippling. The foot and ankle can be particularly vulnerable to this type of arthritis. There are thirty-three joints in each foot and ankle that can be afflicted. What a complex structure it is! The first x-ray is a top view of great toe joint osteoarthritis. The Page 10 — Healthy Cells Magazine — Springfield / Decatur — September 2011

second x-ray is a side view of great toe joint osteoarthritis. Notice the free floating bone fragment at the top of the joint. WHAT CAUSES OSTEOARTHRITIS One common cause of this type of arthritis is overuse and repetitive stress in the affected joint. Athletes and industrial workers commonly overuse and stress the joints of the foot and ankle. The third x-ray is an example of ankle joint arthritis. Weight is a big factor. The United States, in particular, has a large population of overweight people. What most people do not realize is that each step we take, with gravity figured in, our foot joints take on four times our body weight! Naturally, our feet will break down with time and added weight. The ligament structures surrounding the joints eventually fail and give way to gravity. This causes the joint alignment to change and cartilage breakdown ensues. So, being overweight is another significant cause of this disease. Other factors that can cause joints to become arthritic are abnormal foot structures such as flat feet or excessively high arches. Flat feet tend to have unstable or hyper mobile joints that lead to erosion of the cartilage. High arches often are rigid and do not have enough motion and result in constant jamming of the joints. Both can be very painful. Injuries can also lead to arthritic joints, especially if they are ignored. Fractures that enter joints often leave incongruent cartilage that will lead to joint breakdown. Sprains or ligament tears can also leave joints unstable and cause gradual erosion of the cartilage. Next month, part 2 of this article will explain what arthritis feels like, how it is diagnosed, how it is treated, and surgical intervention. Dr. Sigle is the owner of the Foot & Ankle Center Of Illinois located at 2921 Montvale Drive, Springfield, Illinois. Dr. Sigle received a Bachelor of Science degree in Liberal Arts and Sciences from the University of Illinois Urbana-Champaign, graduated from Dr. William M. Scholl College of Podiatric Medicine in Chicago, and completed his Podiatric Medicine and Surgical Residency at Botsford General Hospital in Farmington Hills, Michigan. He went on to complete Advanced Reconstructive Ankle and Foot Surgery/ Trauma at Kaiser Hospital in San Francisco. Dr. Sigle is board certified through the American Board of Foot Surgery and in Reconstructive Rearfoot and Ankle Surgery. He is currently on the physicians’ panel for Memorial Medical Center’s Wound Healing Center. For more information, Dr. Sigle may be reached at (217)787-2700.

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September 2011 — Springfield / Decatur — Healthy Cells Magazine — Page 11

healthy balance

Win at Weight Loss - Long Term Weight Management Success By Dr. Tom Rohde, Renew Total Body Wellness Center

his is truly not a mistype – overweight and obesity really are dangerous conditions that will require constant vigilance, management, and a daily decision to “do the right thing” every time a thought about food pops into our head or we walk past a tasty treat. A recent report out in early July on obesity showed that we now have 12 states with obesity rates over 30%! This keeps growing (couldn’t help myself) as 20 years ago no state had an obesity rate over 15%! Worse, our kids are really in trouble – more than a third of our 10-17 year olds are obese or overweight. They are headed for serious trouble and significantly shortened life spans with the increase in diabetes and the subsequent increase in heart disease that the inflammatory burden of the excess weight guarantees them. Our excess body fat is literally a health damaging inflammation factory. We will have an even more significant crisis in healthcare costs we haven’t even yet imagined to fund! What to do? Many opportunities are advertised daily to help with weight loss –

Page 12 — Healthy Cells Magazine — Springfield / Decatur — September 2011

hospitals, doctors, and private companies all offer programs and we do manage to lose weight while we are enrolled BUT then the weight comes back over a short period of time and often a bit more than the original starting weight. Why? We have always been told that weight is a result of calories eaten versus calories utilized or burned. Sounds simple, yet I daily see patients who have catalogued their diets and their exercise regimens and they should be able to lose weight and even keep it off. But they don’t. Why? More to the story – hormones and biochemistry specifically are the unseen larger base of the iceberg our excess weight represents. Our hormonal biochemistry controls many metabolic processes in our bodies and I want to briefly detail these and what I think will make or break a weight management program’s long term success. Let’s start with the Thyroid. Most weight programs do lab work, but often they only do a TSH as a screening test for thyroid function and if it’s in the normal range (which is a pretty wide range in most laboratories) then it is assumed that the thyroid is normal, even if you feel poorly. There’s more to the story – TSH, from the front part of your pituitary in your brain controls release of T4 and T3 from the thyroid. T4 is mostly inactive and must be converted to T3, which is your active thyroid hormone. TSH alone doesn’t really give us any idea of how your body is converting your hormones from inactive T4 to active T3. Further, it also doesn’t tell us how your thyroid hormone is affecting your peripheral tissues and organs – i.e. does it produce an effect as it should. There are other metabolic conditions that interfere with the conversion process from T4 to T3. T4 conversion not only produces an active T3, but in certain situations also an inactive “mirror image” reverse T3 (rT3). rT3 also fits into the hormone receptor but is inactive. When rT3 binds it blocks the active T3 from binding and producing its active thyroid effect. If you have more rT3 produced than active T3, then you will feel hypothyroid (lousy) when the T3 test looks like you have an adequate amount of activeT3 if the rT3 value wasn’t specifically tested. If you’re not testing – you’re guessing! Finally, do you have some peripheral tissue resistance to the hormone action which would also keep you feeling hypothyroid when the numbers look OK? Do you have symptoms like cold hands and feet or a lower than normal body temperature? These are signs of tissue thyroid resistance and can only be corrected with thyroid hormone replacement despite normal thyroid values. This must be adjusted clinically to correct your symptoms or the numbers can lead you astray and keep you feeling lousy clinically when you look great on paper in the doctor’s office! This is labeled euthyroid sick syndrome and is frequently seen with stress leading to adrenal gland dysfunction. What about your Adrenal glands? These vital organs look like a small stocking cap on your kidneys and produce cortisol among a few other

hormones. Cortisol is vital for life and a number of bodily functions. It can cause problems with weight if you have too much or too little. Your body is always about BALANCE – and if your adrenal balance is off due to stress, you’ll feel that way as well - unbalanced. Lots of life’s events affect your cortisol – STRESS being the major one, and we all struggle with stress in our fast paced society. We don’t shut down and relax enough, we don’t sleep enough, we have cell phones and music on all the time – and our adrenal glands weren’t meant to keep up with this hurried pace for any length of time. The glands first crank out too much cortisol to deal with the chronic stress - this builds the central tummy fat weight, and then when they fatigue or “burn out” we have too little cortisol and our metabolism tanks along with our energy and we can’t burn off the calories like we used to – the weight gets stuck! Sound familiar? How can you figure out your adrenal function? If you’re not testing – you’re guessing! Saliva testing is the most accurate and most easily performed way to get a cortisol level measured in the morning, at noon, at dinner, and at bedtime to see your total daily output. Measuring your adrenal function and working to restore balance to your cortisol is vital for success with weight loss and long term weight maintenance. Look for part 2 of this story in next month’s issue of Healthy Cells. For more information on weight management, thyroid function, hormone evaluation and management, or anti-aging medicine please see Dr. Rohde’s web site: www.DrRohde.com or call 217-864-2700 to schedule a consultation for the next step to a healthier life.

September 2011 — Springfield / Decatur — Healthy Cells Magazine — Page 13

feature story

Advanced Healthcare Services

Hospital Care Comes Home By Alan Scherer

Front row: Andrea Woolard (CNA), Shirley Lotz (RN), Joannalyn Reserva (Oasis Coordinator), Kimberly Ginder (CNA), Annette Castleberry (LPN), Angela Simpson (RN), Vivian Sales (RN, Director of Nursing), Nina Kpangni (CNA), and back row: Amy Riva (RN), JR Lauer (community liaison), Amber Green (RN), Juanita Jones (RN, Administrator), Dr. Eli Goodman, and Joy Gresham (RN).

he patient is in stable condition, resting in his hospital room. The doctor is satisfied that recovery will go well, with little risk of setback. The patient will now be released, but it is too early to expect him to be able right away to do everything he was doing before hospitalization. The doctor writes the order, and the patient becomes the client of a home health care service, a group of professionals licensed to go into the home to do a wide array of medical services. A home health care service provides professional medical care to individuals in their homes. It liberates the patient from the hospital, and it is less expensive than hospitalization. Advanced Healthcare Services, LLC, of Springfield, Illinois, is a home healthcare provider operating in central Illinois. They send nurses and other care givers, including doctors, to clients suffering from a wide range of post-hospitalization and other post-treatment conditions. Reasons for Home Health Care With over one sixth of our national income being spent on healthcare, it is imperative that we find the most economically efficient ways Page 14 — Healthy Cells Magazine — Springfield / Decatur — September 2011

to get well. Keeping a patient in a hospital room beyond the point when she needs access to doctors, labs, constant monitoring, etc., is indefensibly expensive, if all she needs is to have a wound cleaned once or twice a day, or to be shown how to do rehabilitative exercises; or if what he needs is not 24-hour care but rather some physical therapy or a single rented piece of durable medical equipment. Here, home health care is far less expensive to the client, to the insurance company, or to whoever is paying the bill. But even if it were just as expensive, home health care would still present an advantage: Most patients would just rather be at home than in the hospital, sitting in their favorite chair, holding the remote, with family around. Advanced Healthcare Services, LLC Advanced Healthcare shares the vision of the patient to be well caredfor at home. Advanced is a family-owned and operated company that began with state licensure and Medicare certification in 2006 in New Berlin, Illinois. In 2009, the offices were moved to Springfield, Illinois.

Advanced started with nursing, physical therapy (PT), and certified nursing assistant (CNA) services. The company now also provides occupational therapy (OT), speech therapy (ST), medical social workers (MSW), and podiatry—in fact, an actual foot doctor, the only one making home care calls in downstate Illinois. Nursing Services Advanced Healthcare’s staff features registered nurses (RNs), licensed practical nurses (LPNs), and certified nursing assistants (CNAs). Staff do not stay overnight in clients homes, but there is a nurse on call 24 hours a day. There is also a certified wound and ostomy nurse, a special advanced-practice nurse with skills beyond those of the typCarl Booth (Hickory Glen resident) and J.R. Laver (community liaison) at a blood pressure screening. ical nurse. Nurses help the patient with the ordering and in order for the client to speak effectively. A speech articulation disoracquisition of durable medical equipment and wound supplies. They der, as in the case of a recovering stroke patient, arises when muscles help with medication management and urinary catheter care. Nurses of the mouth and/or the tongue need training and practice to regain teach patients about medications, the disease process, home safety, coordination. wound care—whatever will help to empower the individual or family For clients who have lost a measure of muscle control for swallowmembers to assist, or to take over when Advanced leaves off. ing, Advanced performs a “swallowing evaluation.” Unless sufficient swallowing proficiency is demonstrated, the patient may need more Physical Therapy comprehensive care. This is important because incorrect or deficient Physical therapists (PTs) take a restorative approach. Gait training swallowing can allow food to go into the lungs, with pneumonia and is learning how to walk again or to walk better after a physical disabilother complications resulting. ity. In transfer training a patient learns to transfer himself from chair In the very common case of a stroke patient, the ST can assess to bed, or to wherever he is to go, and to adopt the correct position. cognition (mental processing). Oft-detected conditions include exTherapists develop and offer a personalized in-home exercise program, pressive aphasia, in which the wrong word comes out; and receptive designed for the unique needs of the client. Ultra sound treatment is aphasia, in which others’ words are jumbled by the listener’s brain. The a home-care option, often used to enhance healing of scar tissue. In assessment will indicate the proper intervention. order to offer aqua therapy, the physical therapist may meet the client at the exercise pool. Certified Nursing Assistant (CNA) Advanced sends CNAs who perform a variety of functions. The Occupational Therapy highest priorities include bathing and dressing the client if needed. The occupational therapist (OT) works to re-teach the recovering Sometimes skin care, such as the application of lotions, is required. client to perform the activities of daily living. This may involve “muscle Transfer and ambulation may arise, such as walking the client to bathre-education.” The stroke patient is a typical example. Adaptive equiproom safely, or helping her to achieve a more comfortable position in a ment is also introduced by the therapist, who can show the recovering bed or chair. Functions which may or may not be assigned to the CNA client how to use an adaptive fork, so the client can feed himself. For include light meal preparation, or helping the client to switch seasonal buttoning one’s shirt, a “self-buttoning” tool can be introduced, which clothes into the closet from storage. Housekeeping is a less frequent goes through hole and pulls the button through. But this is often only expectation. transitional, as the therapist goes on to teach the client how to button the shirt without any tool. This is an example of retraining for fine motor Medical Social Worker coordination. Under Advanced Healthcare, sometimes the PT and the Advanced may send a medical social worker (MSW) to the client’s OT will both be assigned to the same client, and they may both actually home around the time of the transfer to home-care status in order work with the client at the same time, often concerning the same need. to assure that any factors relating to the home that might affect the smoothness of the recovery are ideal. The MSW assesses family dySpeech Therapy namics, exploring the questions, “Is this family currently equipped to Advanced features speech therapists (STs) who can treat a client deal with the recovering member?” “Does the household include a with a voice disorder. An example of this is in the case of an advanced member capable of aiding and protecting the client who will also be Parkinson’s Disease patient. Here, the vocal chords may need training September 2011 — Springfield / Decatur — Healthy Cells Magazine — Page 15

feature story

(continued)

Angela Simpson, RN with a patient

present enough of the time?” Some issues could even preclude home care, but most issues are resolvable. The MSW can also serve to connect clients to community resources, such as to insurance for medications, or to a local pantry for food. The MSW can also offer short-term counseling to depressed patients. With cuts to public health clinic budgets, this has become particularly important. The MSW can counsel in the transition from hospital release to the client’s beginning with a regular mental health provider. Podiatrist An actual doctor of podiatric medicine (DPM) may be sent to the home. Advanced has the only home-visiting podiatrist in downstate Illinois. The podiatrist is a licensed foot and ankle surgeon. He can actually perform some minor foot surgeries in the home including the removal of toenails, calluses, and corns; and the DPM may inject steroid. Some clients are unable to reach far enough or lack the necessary eyesight to trim their own nails, or lack hand strength. This is extra critical for diabetics, for whom a wound can lead to infection, and even the loss of a toe. Qualifications for Home Health All services offered by Advanced are 100% covered by Medicare— no deductibles or co-pays—as long as the client is considered home bound. The home bound status is determined by two criteria: 1) The beneficiary’s medical condition must restrict the ability to leave home without the assistance of another individual or without the assistance of a supportive device; 2) The beneficiary leaves home only to receive medical treatment that generally cannot be provided in the home or leaves the home infrequently for short periods of non-medical purposes (i.e. religious services, funerals, graduations, etc.) Community Involvement Consistent with Advanced Healthcare’s concern for the client is its concern for the community, shown in free physical therapy and free Page 16 — Healthy Cells Magazine — Springfield / Decatur — September 2011

blood pressure or health screenings (conducted at senior centers, assisted living facilities, retirement homes, and public housing high-rises). Since music and art are known to stimulate the brain in helpful ways, Advanced community liaison and craft person Shannon Lionberger conducts a free craft hour at local retirement facilities. Advanced actively participates in many local charities. At Contact Ministries, a Springfield residential program for homeless and jobless moms, they conduct a game night two to three times per year. They provide Christmas gifts at Capitol Care Nursing Home. Some employees adopt a family for Christmas, using the family’s own list to buy them gifts. Others have given time to a local pantry. Hands-on charity seems to be the preference. Some People to Know at Advanced Healthcare Services: • Cristina Agno, CEO of Advanced Healthcare Services, is a member of the family that founded the company. • Dr. Eli Goodman is the Director of the Disease Management Program at Advanced. His department’s goal and purpose is to prevent rehospitalization (which is really the goal of all the staff). • Juanita Jones, RN, is an administrator, but she also works as an on-call nurse. • Christie Chevalier, MSW, is a medical social worker. • J.R. Lauer is a community liaison. • Vivian Sales is the Director of Nursing. • Dr. Jim LaPlant, DPM, is a Podiatrist. These and some fifty other Advanced staff members support the mission of home healthcare in central Illinois, a bridge from the hospital to final recovery.

For more information about Advanced Healthcare, please contact Shannon Lionberger at 217-726-6956.

prevention

Fight the Bite! Avoid Mosquito Bites to Avoid Infection

hen dealing with West Nile virus, prevention is your best bet. Fighting mosquito bites reduces your risk of getting this disease, along with others that mosquitoes can carry. Take the commonsense steps below to reduce your risk: • avoid bites and illness; • clean out the mosquitoes from the places where you work and play; • help your community control the disease. Something to remember: the chance that any one person is going to become ill from a single mosquito bite remains low. The risk of severe illness and death is highest for people over 50 years old, although people of all ages can become ill.

Install or Repair Screens Some mosquitoes like to come indoors. Keep them outside by having well-fitting screens on both windows and doors. Offer to help neighbors whose screens might be in bad shape.

Avoid Mosquito Bites

Help Your Community

Use Insect Repellent On exposed skin when you go outdoors, use an EPA-registered insect repellent such as those with DEET, picaridin or oil of lemon eucalyptus. Even a short time being outdoors can be long enough to get a mosquito bite. Get double protection: wear long sleeves during peak mosquito biting hours, and spray repellent directly onto your clothes.

Report Dead Birds to Local Authorities Dead birds may be a sign that West Nile virus is circulating between birds and the mosquitoes in an area. Over 130 species of birds are known to have been infected with West Nile virus, though not all infected birds will die. It’s important to remember that birds die from many other causes besides West Nile virus. By reporting dead birds to state and local health departments, you can play an important role in monitoring West Nile virus. Mosquito Control Programs Check with local health authorities to see if there is an organized mosquito control program in your area. If no program exists, work with your local government officials to establish a program. The American Mosquito Control Association can provide advice, and their book Organization for Mosquito Control is a useful reference.

Clothing Can Help Reduce Mosquito Bites When weather permits, wear long-sleeves, long pants and socks when outdoors. Mosquitoes may bite through thin clothing, so spraying clothes with repellent containing permethrin or another EPA-registered repellent will give extra protection. Don’t apply repellents containing permethrin directly to skin. Do not spray repellent on the skin under your clothing. Be Aware of Peak Mosquito Hours The hours from dusk to dawn are peak biting times for many species of mosquitoes. Take extra care to use repellent and protective clothing during evening and early morning — or consider avoiding outdoor activities during these times.

Mosquito-Proof Your Home Drain Standing Water Mosquitoes lay their eggs in standing water. Limit the number of places around your home for mosquitoes to breed by getting rid of items that hold water.

Clean Up Mosquito breeding sites can be anywhere. Neighborhood clean up days can be organized by civic or youth organizations to pick up containers from vacant lots and parks, and to encourage people to keep their yards free of standing water. Mosquitoes don’t care about fences, so it’s important to control breeding sites throughout the neighborhood. www.cdc.gov/ncidod/dvbid/westnile/prevention_info.htm

September 2011 — Springfield / Decatur — Healthy Cells Magazine — Page 17

family health

Trendy Technology and Our Children By Aimee Ladd, Ph.D., Psychology Specialists, Ltd.

oday’s world is full of amazing technology, allowing us to engage with the world in a way that was unheard of just a decade ago. However, technology is being developed so quickly that it is nearly impossible to keep up with the current trends our children are bombarded with. In fact, whole new words have become part of the English language. There is texting, tweeting, chatting, blogging, and facebooking, just to name a few. Between the internet, cellular phones, I-phones, etc., it has become difficult for the average parent to become adequately educated on each new device to safely monitor their children’s use of technology. Because of the vast array of devices, it may be best for parents to take a generalist approach to safety. It is important for parents to become aware of the possible dangers of technology use as it pertains to their children as well as to develop strategies to limit these dangers. The Dangers • Cyberbullying • Online Pornography • Internet Addiction • Online Scams • Online Gaming sites and Online Gambling • Hacking • Unsafe Social Communities • Becoming Socially isolated from “real, face to face” interactions • Access to inappropriate material online • Posting of inappropriate material online • Cellular Phone use while Driving • Sexting • Sleep deprivation due to interrupted sleep or all night use of cell phones, computers, etc. A Generalist Approach to Safety We can’t be with our children every second of every day. So how do we keep them safe? General Technology Safety Guidelines for all ages include: Limiting computer use to a public location in the home, discussing values and standards regarding technology use, setting up computer security systems and virus protection, and establishing rules for internet usage when adults are not present. Children of all ages should be given age-appropriate education on technology use. In addition, Children and Teens’ technology usage should be monitored at varying degrees according to their age and level of responsibility. Children and Tweens • Carefully monitor online activity • Children should visit pre-approved sites only • Begin teaching older children why some sites are inappropriate • Engage Tweens in determining appropriate sites and frequently discuss what makes a site appropriate versus inappropriate Page 18 — Healthy Cells Magazine — Springfield / Decatur — September 2011

• Engage in electronic communication with known friends only • Teach children and Tweens not to share personal information online • Teach children and Tweens to leave the site or get an adult if they encounter something that makes them uncomfortable or that they know is “not ok” • It is not advisable for children or Tweens to participate in social networking sites designed for Teens and Adults • Begin teaching Tweens about the risks during internet use and the protective strategies to deal with these risks Teens • Consistently monitor online behavior • Discuss risks and protective strategies often • Require that they make you a “friend” if they engage in social networking sites • Set social networking profiles to “private”, while teaching that nothing online or by text is really private • Limit friendship links to known friends and friends of friends • Regularly review your Teen’s profile and friends • Remove any inappropriate material posted on their profile and discuss why you have done so with your Teen. • Periodically review text messages on your Teen’s cellular devices, if safety has been a concern in the past, you may discuss receiving print outs of all out-going and in-coming text messages from your cellular phone provider. • Set a technology use curfew. For instance: no cell phone, computer, etc. use after 10:30 on week nights and 12:00 on weekends.

• Have Teens “check in” their phones and other devices to the parent at curfew, store these devices in parent’s room for night. • Limit time spent using technological devices • Make a household rule of turning off cellular devices during mealtime, during religious services, and during family time • Do not allow Teens to use cellular devices while driving and enforce strict consequences (i.e. loss of cellular device privileges) if this rule is broken • Allow internet access on cellular devices only to older Teens with a history of responsible online behavior and a willingness to discuss online activities Balance is Best for Everyone It is important for the entire family, parents included, to learn to balance their use of technology. Children learn by modeling the behavior of the adults around them. So, parents must also manage the time they spend online and using other technology such as cell phones. Be sure to schedule plenty of technology-free family time. Plan family events such as hikes, trips to the beach, picnics, game nights, etc. and only use your phone for emergencies during those times. In addition, try to frequently be the “Host House” that your children and their friends hang out at. This allows you to supervise their behavior and generally results in closer parent-child relationships. Psychology Specialists is a group of doctors and counselors with a broad range of specialties who help people with all types of physical and emotional pain. For more information, you may contact Psychology Specialists at 217-520-1047 or visit www.psychologyspecialists.com.

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September 2011 — Springfield / Decatur — Healthy Cells Magazine — Page 19

senior care

The Silent Epidemic Protecting Aging Americans From Elder Abuse

very year, millions of aging Americans experience physical, financial and emotional abuse. It is estimated that up to 10 percent of people aged 65 years or older have experienced some form of abuse. However, experts suggest that only one out of every 14 incidents ever comes to the attention of authorities. May is Older Americans Month —an opportunity to honor our elders by mobilizing the community to report abuse and ultimately prevent it. “We need to educate ourselves to recognize the warning signs of elder abuse so that we can better protect our loved ones from abuse or exploitation,” said Rhonda Randall, D.O., executive vice president and chief medical officer at UnitedHealthcare Medicare & Retirement. “Seniors should feel empowered to talk with their caregivers, family members, physicians or other health care providers anytime they feel threatened, or when they suspect someone is trying to exploit them. In order to stop elder abuse, we must talk about it openly.” An area that is sometimes overlooked when discussing elder abuse is financial exploitation, the most common form of elder abuse. Medicare fraud—one aspect of financial abuse—costs U.S. taxpayers $60 billion to $90 billion each year. According to Randall, aging Americans, caregivers and others can work together to prevent elder abuse by doing the following: • Know the warning signs of physical and emotional abuse: Clues to the presence of abuse include unexplainable bruises or injury, unreasonable fearfulness or suspicion, and changes in personality, attitude or behavior. • Take precautions to prevent Medicare fraud: Never give out Medicare, Social Security or credit card information to anyone without proper identification. If a Medicare card is lost or stolen, report it immediately by calling (800) 772-1213. Never sign your name to a form you do not fully understand. Ask questions of Medicare and health care providers in order to clarify any questionable charges or claims.

• Take advantage of resources that can assist you. Look to your community for support—seek help from family members, friends and neighbors, senior organizations and physicians. • The most important thing is to speak up. Elder abuse thrives on silence. By educating ourselves to recognize the signs and through taking smart, preventive measures, we are working together to ensure aging Americans are no longer abused or exploited. To learn more about elder abuse, including information on recognizing and reporting abuse, visit the National Center on Elder Abuse at www. ncea.aoa.gov. Older Americans and the people who care about them can protect them from elder abuse of all kinds.

Beverly J. Matthews Licensed Clinical Psychologist Tel Cell Fax

217-876-7929 217-825-9010 217-876-7950

bmatthewspsyd@att.net www.bmatthewsneuropsych.com

Central Illinois Neuropsychological

5130 Hickory Pt Frontage Rd Suite 260 Decatur, Illinois 62526

Page 20 — Healthy Cells Magazine — Springfield / Decatur — September 2011

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future planning

Life Insurance Too Valuable To Ignore Submitted By Julie Hale Miller, Country Financial

he need for life insurance can be a difficult topic to discuss. But if someone depends on you financially, it’s a topic you need to address. According to a survey commissioned by COUNTRY Financial, about four out of ten Americans say their families would not be able to live comfortably if they died.1 Who needs life insurance? Everyone needs life insurance, especially if family members depend on you financially. If you are single and provide financial support for aging parents or siblings, or if you have significant debt you wouldn’t want passed on to your family, you should consider life insurance. Even if you already have life insurance, you may need to update your coverage, especially when you experience any of these life-changing events: • Getting married • Becoming a parent • Buying a home • Changing jobs • Planning for retirement

• Typically, employers provide a modest amount of coverage that protects you while you are an employee. Make your decision today Most people need help deciding how much life insurance to purchase and what type of policy best fits their needs. That’s why they usually turn to a financial representative who knows the right questions to ask. Your family is worth the financial security and peace of mind life insurance offers. Don’t leave their financial future to chance. Contact a COUNTRY Financial representative for an insurance and financial review to discuss what type of life insurance coverage is best for your family. 1 COUNTRY Financial Security Index, October 2009 Policies issued by COUNTRY Life Insurance Company® and COUNTRY Investors Life Assurance Company®, Bloomington, IL.

Types of life insurance There are two basic types of life insurance: term insurance and permanent insurance. Term insurance provides protection for a specific period of time (the “term”) and is designed to fill a temporary need, such as covering a mortgage or sending a child to college. Typically, term insurance offers the greatest amount of coverage for the lowest initial premium and is a good choice for young families on a tight budget. Permanent insurance offers lifelong protection and allows you to accumulate cash value on a tax-deferred basis. This type of coverage is designed to fill long term needs, such as income replacement. According to a 2008 study by the American Council of Life Insurers, 57 percent of life insurance policies purchased were permanent life insurance coverage. Misconceptions About Life Insurance There are many reasons people don’t purchase life insurance. But don’t let these common misconceptions keep you from getting the valuable coverage you need: Misconception • “It’s too expensive.” • “I don’t have time to talk with my financial representative.” • “I don’t want to make the wrong decision.” • “I already have coverage with my employer.” Truth • Not having life insurance could be more costly to your family. • Don’t procrastinate – there are no guarantees in life. • A qualified insurance professional can guide you through the buying decision. September 2011 — Springfield / Decatur — Healthy Cells Magazine — Page 21

women’s health

SIU Physician Treats Bladder Control Problems in Women

rinary incontinence or loss of bladder control is an embarrassing medical condition that affects millions of women in the U.S. It is very treatable but should be addressed early says Dr. Sohail Siddique, assistant professor of obstetrics and gynecology at Southern Illinois University School of Medicine in Springfield and a member of SIU HealthCare, the medical school’s practice group. “About half of adult women have urinary leakage at one time or another. Although it is more common in older women, it also can affect younger women,” says Siddique. “Some avoid social activities because of incontinence or map out bathrooms when away from home.” Symptoms of urinary incontinence can range from mild leaking to uncontrollable wetting. Many people are embarrassed to discuss their urinary incontinence with their physician, even though it is a common problem. “It often exists for years before a woman seeks help from a physician, and by that time it may be more advanced and difficult to control,” explains Siddique, who is chief of the urogynecology division in the department. Two of the most common types are stress incontinence and urge incontinence. Stress incontinence occurs when urine leaks as pressure is put on the bladder with coughing, laughing, sneezing and other types of physical activity. Urge incontinence happens when individuals have a sudden need to urinate and aren’t able to hold it long enough to get to the restroom in time. The primary risk factors for incontinence in women include older age, weight gain and number of pregnancies. The problem also can be brought on by urinary tract infections. Some medications can cause short-term bladder control problems. “For treatment, we recommend women start with conservative steps such as pelvic exercises (known as Kegel exercises), physical therapy or biofeedback and weight loss,” says Siddique. Kegel exercises help strengthen Page 22 — Healthy Cells Magazine — Springfield / Decatur — September 2011

the pelvic floor muscles. Siddique advises individuals to consult with their physician to learn how to do the exercises correctly, because they are effective only if done properly. Only half of women do them properly. Lifestyle changes that might help include quitting smoking, avoiding alcohol, caffeine, and other bladder irritants, treating constipation and avoiding lifting heavy objects. “Every treatment plan is geared for the specific type of incontinence that an individual may be experiencing. Some drugs can help the bladder empty more fully during urination, while other drugs tighten muscles and can lessen leakage,” says Siddique. Another type of treatment is a pessary, which is a device placed into the vagina to help prevent leakage. Surgery such as a sling procedure or bladder neck suspension to repair faulty structures can be helpful. Prolonged incontinence may put individuals at risk for getting rashes, sores, and skin infections. Siddique urges women who have the problem to seek treatment from their primary care physician or a urogynecologist or urologist early in the condition, so that treatment options can be considered and one’s quality of life can be improved. For more information about urinary incontinence visit the American Urogynecology www.augs.org or American Urological Association www.auanet.org websites. Siddique joined the SIU faculty in 2009. He completed a threeyear fellowship in female pelvic medicine and reconstructive surgery at Johns Hopkins Medical Institutions in Baltimore (2005) and his obstetrics and gynecology residency at the Naval Medical Center in San Diego (2000). Siddique earned his medical degree at the University of Illinois College of Medicine (1994). He is board certified in obstetrics and gynecology and board eligible in female urology.

safety

Home Safety is Serious Business S

afety becomes more important with age. Poor eyesight and hearing can decrease awareness of hazards. Impaired coordination and balance can result in trips and falls. But simple, inexpensive steps can prevent accidents. Here are just a few safety tips to help avoid the most common accidents. In-home trips and falls—the most common cause of serious injury in the aged, cause 6,700 deaths each year. Simple ways to reduce the likelihood of falling include: • Illuminating all stairways, and place light switches at both the bottom and top of stairs. • Using night lights for trips to the bathroom or kitchen. • Having handrails on both sides of the stairway. • Use only carpet which is tacked down, get rid of throw rugs! • Arrange furniture so there are no obstacles. • Do not use your hallways or stairwells for storage. • Use grab bars on bathroom walls and non-skid mats or strips in the bathtub. • Wear good shoes with nonskid soles. • Allow yourself time to do what you must. Don’t hurry or run. • Keep outdoor steps and walkways in good repair. • Spread sand on icy walkways. Electrical & Fire Safety • Lamp, extension and telephone cords should be out of the flow of traffic, and out from beneath furniture, rugs and carpeting. • Electrical cords should be kept in good condition, no fraying or cracking. • Make sure all outlets and switches are at room temperature, not warm or hot to the touch. • All outlets and switches should have cover plates, with no wiring exposed. • Light bulbs should be the appropriate size and type for the fixture. • Make sure towels, curtains and other flammable items are located away from the range. • Wear clothes with short or close fitting sleeves when cooking. • Make sure kitchen ventilation systems or range exhausts are functioning properly and use them while cooking. • Unplug small appliances such as hair dryers, shavers, curling irons, etc. when not in use. • Move ash trays, smoking materials and other fire sources (heathers, hot plates, teapots, etc.) away from beds and bedding. • Keep chimneys clear from accumulations of leaves, and other debris that can clog them. • Smoke detectors should be properly located on each level of the home, including kitchen and sleeping areas. • Change batteries annually and check smoke detectors regularly to make sure they are in proper working order. • Have an emergency exit plan and an alternative emergency exit plan.

General Safety • Post emergency numbers on or near the telephone. • Keep good, even lighting over the stove, sink and counter top work areas, especially where food is sliced or cut. • Step stools should be stable and in good repair. • Hallways, passages and heavy traffic areas should be well lit. Keep exits and passageways clear. • Keep water temperature 120 degrees or lower. • Medicines should be stored in the containers they came in. • Keep a telephone close to your bed, and have lamps and light switches within reach. Provided by HCR ManorCare, a leading provider of short-and longterm health care. For more information, contact Heartland of Decatur at 217-877-7333.

September 2011 — Springfield / Decatur — Healthy Cells Magazine — Page 23

grief recovery

“Are There Actual Stages Of Grieving?” Healthy Cells magazine is pleased to present another in a series of feature articles on the subject of Grief Recovery®. The articles are written by Russell P. Friedman, Executive Director, and John W. James, Founder, of The Grief Recovery Institute. Russell and John are co-authors of WHEN CHILDREN GRIEVE - For Adults to Help Children Deal with Death, Divorce, Pet Loss, Moving, and Other Losses - Harper Collins, June, 2001 - & THE GRIEF RECOVERY HANDBOOK - The Action Program For Moving Beyond Death, Divorce, and Other Losses [Harper Perrenial, 1998]. The articles combine educational information with answers to commonly asked questions.

any years ago Elizabeth Kubler-Ross wrote a book entitled On Death and Dying. The book identified five stages that a dying person goes through when they are told that they have a terminal illness. Those stages are: denial, anger, bargaining, depression, and acceptance. For many years, in the absence of any other helpful material, well-meaning people incorrectly assigned those same stages to the grief that follows a death or loss. Although a griever might experience some or all of those feeling stages, it is not a correct or helpful basis for dealing with the conflicting feelings caused by loss. We hesitate to name stages for grief. It is our experience that given ideas on how to respond, grievers will cater their feelings to the ideas Page 24 — Healthy Cells Magazine — Springfield / Decatur — September 2011

presented to them. After all, a griever is often in a very suggestible condition; dazed, numb, walking in quicksand. It is often suggested to grievers that they are in denial. In all of our years of experience, working with tens of thousands of grievers, we have rarely met anyone in denial that a loss has occurred. They say since my mom died, I have had a hard time. There is no denial in that comment. There is a very clear acknowledgment that there has been a death. If we start with an incorrect premise, we are probably going to wind up very far away from the truth. What about anger? Often when a death has occurred there is no anger at all. For example, my aged grandmother with whom I had a

wonderful relationship got ill and died. Blessedly, it happened pretty quickly, so she did not suffer very much. I am pleased about that. Fortunately, I had just spent some time with her and we had reminisced and had told each other how much we cared about each other. I am very happy about that. There was a funeral ceremony that created a truly accurate memory picture of her, and many people came and talked about her. I loved that. At the funeral a helpful friend reminded me to say any last things to her and then say goodbye, and I did, and I’m glad. I notice from time to time that I am sad when I think of her or when I am reminded of her. And I notice, particularly around the holidays, that I miss her. And I am aware that I have this wonderful memory of my relationship with this incredible woman who was my grandma, and I miss her. And, I am not angry. Although that is a true story about grandma, it could be a different story and create different feelings. If I had not been able to get to see her and talk to her before she died, I might have been angry at the circumstances that prevented that. If she and I had not gotten along so well, I might have been angry that she died before we had a chance to repair any damage. If those things were true, I would definitely need to include the sense of anger that would attend the communication of any unfinished emotional business, so I could say goodbye. Unresolved grief is almost always about undelivered communications of an emotional nature. There is a whole host of feelings that may be attached to those unsaid things. Happiness, sadness, love, fear, anger, relief, compassion, are just some of the feelings that a griever might experience. We do not need to categorize, analyze, or explain those feelings. We do need to learn how to communicate them and then say goodbye to the relationship that has ended. It is most important to understand that there are no absolutes. There are no definitive stages or time zones for grieving. It is usually helpful to attach feeling value to the undelivered communications that keep you incomplete. Attaching feelings does not have to be histrionic or dramatic. It does not even require tears. It merely needs to be heartfelt, sincere and honest. Grief is the normal and natural reaction to loss. Grief is emotional, not intellectual. Rather than defining stages of grief which could easily confuse a griever, we prefer to help each griever find their own truthful expression of the thoughts and feelings that may be keeping them from participating in their own lives. We all bring different and varying beliefs to the losses that occur in our lives. Therefore, we will each perceive and feel differently about each loss. Question: I have heard it said that anger is a key component of grief. Is this true? And how does it relate to the actions of Grief Recovery®? Answer: A primary emotional response to loss of any kind is fear, for example, “How will I get along without him/her?” Anger is one of the most common ways we INDIRECTLY express our fear. Our society taught us to be afraid of our sad feelings. It also taught us to be afraid of being afraid. We are willing to say “I am angry,” but we don’t say “it was scary.” It is possible to create an illusion of completion by focusing on the expression of anger. Usually anger is not the only undelivered feeling relating to unresolved grief. Next Month: “Am I Paranoid, Or Are People Avoiding Me?” For information about programs and services, write to The Grief Recovery Institute, P.O. Box 6061-382 Sherman Oaks, CA. 91413. Call [818] 907-9600 or Fax: [818] 907-9329. Please visit our website at: www.grief-recovery.com.

September 2011 — Springfield / Decatur — Healthy Cells Magazine — Page 25

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