The Journey to Wellness & Balance Counseling Services, Ltd.

Counseling and Mental Health Articles for Your Wellness!

A Broken System – The Elderly and Hospital Care

According to the Chicago Tribune, in 2011, the Illinois Department of Public Health received 560 hospital complaints for inadequate services. Allegations ranged from patient abuse, inadequate infection control to more serious violations such as death. Of those 560 complaints, Illinois officials declined to investigate 85 percent due to a lack of funding. Many of these complaints also failed to reach to a federal level, thus many of these allegations were not further investigated by the U.S. Department of Health and Human Services. So who is ensuring the welfare of hospital patients if hospital staff/administrators and state/federal officials fail to investigate allegations or complaints? When someone is admitted to a hospital, it is expected that they are safe and given quality medical care. It also is expected that nurses, physicians and other staff effectively communicate with one another to ensure adequate care is being provided. Recent events that have occurred with my elderly parents have in part contributed to writing this article. The objective of this article is to increase your awareness of inadequate patient care and encourage you to speak up and not remain silent if something similar were to happen to you.

In December 2013, my father required emergency hospitalization to a hospital in the western suburbs of Chicago. The hospital he was transported to was not our first choice. However, paramedics don’t transport you to the hospital of your choice. Right from the start, I questioned if the ER nurse was adequately trained on how to communicate professionally to patients. This incident though appeared to be the least concerning of the many incidents that occurred during his hospitalization. The one incident in which I am still trying to understand is how my elderly father who happened to be hospitalized for disorientation, fall in an intensive care unit? Is it not common knowledge that the intensive care unit specializes in treating severe and life threatening illness thus requiring the patient to be closely monitored? Unfortunately the poor care did not stop in ICU. Other serious incidents which occurred were the overuse and misuse of a highly potent benzodiazepine. The reasons for the use of this drug were never documented, nor were we informed that the drug was being administered. Despite our numerous requests to nurses and directors to have the drug removed, the drug continued to be administered. We were informed by one nurse that staff administered the drug because my father was agitated and restless. Restless and agitated? Is this enough to administer a highly potent benzodiazapine to an elderly patient with a history of dementia, pulmonary disease, heart and kidney failure? If restlessness and agitation were sufficient reasons to administer this drug, then the entire world’s population would be on it at some point. At one point we were told that he may become dangerous, thus they administered the drug for everyone’s safety. The humor with this is that my father is a 5 foot tall, frail, 87 year old man, weighing 120 pounds when wearing his dentures. How dangerous can he be? If there was concern about his safety maybe they should have been proactive and used the bed alarms which commonly are used with dementia patients who wander. Better yet, maybe they should not have administered as many doses of benzodiazepines as they did. In a healthy individual, the half-life of the drug used (the amount of time it takes for the body to excrete at least half the drug) is 12 to 15 hours. For my father, that number is substantially higher due to end stage renal failure. The number of times in which this drug continued to be administered despite communicating with directors and nurses was quite alarming. Even more alarming is that they used this drug despite it being contraindicated in individuals with a history of pulmonary disease and kidney failure. Could the known side effects of this drug i.e. strong sedation/hypnosis, dizziness, drowsiness have contributed to his fall? Despite speaking to the patient liaison department, 3 different nurses and 3 nursing directors; the drug continued to be administered without consent. It is quite alarming that my fathers records failed to specify our requests nor did anyone bring our concern to the doctor. No matter whose attention our concerns went to, no one seemed to take the matter seriously. I cannot count the number of times I was told someone was looking into the incidents. While we were trying to manage all of the above and get some answers from doctors, we were concurrently dealing with my mother having been transferred to hospice. Well, hospice is what they called it but obtaining the services appeared to require an act of God. We waited three days to transfer my mother to hospice and only were given a room when we went up the chain of command. The time we waited for the room was alarming however, what was disturbing was that we were told by one of the nurse administrators that they did us a favor by placing both of my parents on the same floor. How compassionate of her! What about addressing your staffs failure to communicate with not only the family but also with the physician and other hospital staff?Unfortunately, many people receive below average standards of care while hospitalized. Millions of people worldwide are harmed by poor hospital care each year. Despite one’s deep involvement with a family members care, significant negligence and inadequate care continue to occur. I can’t imagine what happens to those who don’t have advocates or family members involved in their care. Is it worth it to pursue a concern about quality? For many of us, it’s not easy to act on a concern about the quality of care we or loved ones receive. The process can be stressful, frustrating and quite honestly emotional exhausting. And in the end, it’s possible that others may not agree with the way we see the situation. Is it worth the time and energy to take action on concerns about the quality of hospital care? Only you or your loved one can decide. In making the decision, think about the continued harm that might take place if you do nothing. And think about how the actions you take might lead to better care for future patients.

Marijuana and Teens

As the number of states legalize the medical use of marijuana and decriminalize recreational use of marijuana, it has become more and more common for marijuana to be viewed simply as a harmless substance.

One of the unintended consequences of the changes in the law is that teens who use marijuana on a regular basis use the changes in marijuana laws as proof that they will not experience any ill effects from their regular use of marijuana. They reason “if adults feel the use of marijuana is safe, it must also be safe for us to use.”

There is, clearly, not enough information being distributed to parents of teens about the problems associated with teens’ regular use of marijuana. And parents of teens often are not aware that the marijuana teens use today is much stronger than the marijuana teens were using 20 years ago.

According to Susan Weiss, Associate Director for Scientific Affairs at the National Institute for Drug Abuse, pot seized in raids now is 15 percent THC as compared to pot seized in earlier times that was 3 or 4 percent THC.
THC, tetrahydrocannabinol, is the main mind altering ingredient in marijuana.

One of the most serious problems associated with teens who regularly use marijuana that is rarely discussed is amotivational syndrome. The mellow feeling that adults enjoy while using marijuana is what makes teenagers lose interest in studies and productive activities they formerly enjoyed and found stimulating. Teenagers who are chronic users of marijuana just check out of life during their developmental years when it is most important for them to be involved in life.

Chronic teenage users begin over the long term to feel all activities are better enjoyed while under the influence. Some lose the ability to enjoy the many small pleasures of life that non users enjoy and take for granted.

Chronic teenage users don’t set career goals. They spend their time discussing the funny things their friends did while under the influence, who can provide the best marijuana at the best possible price, and who has the best weekend parties.

Chronic teenage users don’t learn problem solving skills because they turn to marijuana when they encounter problems.

Chronic teenage users, who are socially awkward, don’t develop healthy social interacting skills because most of their socializing is done under the influence of marijuana. And, some chronic teenage users , as adults, may still interact socially as 13 and 14 year olds because that is the age they stopped developing social skills.

Depressed teenagers who use marijuana to self medicate their depression will over time become more depressed.

Chronic teenage users’ school grades typically fall over time because the THC stored in their brain negatively impacts their short term memory and their ability to focus in class.

Chronic teenage users party their way through high school doing the bare minimum needed to graduate and don’t realize until after high school graduation how ill equipped they are to succeed in the adult world.

Only too late, as their classmates who made better choices move forward with their lives, do the chronic users realize that the road they took during the critical high school years has lead them to a dead end.

It is important that parents of teenagers never take too lightly their teenagers use of marijuana.

Disciplining Teens – A Skill That Takes Practice and Refining

Teens need rules and they need the rules to be enforced. Sounds simple doesn’t it? But giving teens rules and enforcing those rules is one of the more difficult parenting tasks parents face.
     First off, teens resent rules and they can argue endlessly for a life with no parental controls. Often, parents’ first mistake is to engage in the argument about the need for rules. A better approach is to explain that having rules is a given. What can be negotiable are the kinds of rules and the consequences for rules not followed.
     Many parents readily dismiss the idea of involving their child in the process of making rules and setting consequences without even trying that method. When a child is fairly emotionally healthy and the parent/child relationship is, for the most part, stable and friendly, the rule/consequence negotiation meeting can be a a valuable starting point.
     Surprisingly, teens on their own often come up with consequences more harsh than the parents are considering. The critical piece when planning the consequence is that enforcing the consequence isn’t going to make life more difficult for the parents than the teen. Inconsistent enforcing of the consequences is what usually weakens the whole system.
     Grounding the teen seems to be the most ineffective method of discipline because parents usually set up a grounding consequences right after an unexpected misbehavior. The parents are at the height of their anger at the teen and suggest grounding for a period of time that requires they, themselves having to stay at home much longer that is feasible. The teen learns very little from this process other than their parent usually doesn’t follow through on the month or six weeks of grounding.
     The most effective response when an unexpected misbehavior occurs is for the parent to tell the teen, ” I am so angry with you that I don’t know what I want the consequence to be. I will tell you in a few hours. ”  This approach allows the parent come up with an appropriate consequence that the parent will enforce. Allowing the teen to worry about the consequence for a few hours is a plus. But the parent MUST follow as quickly as possible. The closer the consequence is set up following the misbehavior the better.  
     Also important in the disciplining process is the parents’ view of the reason for setting up the consequences. The reason is not punishment. The reason is to teach teens that, for the most part, making poor choices results in unwanted consequences. The other reason for disciplining is to help the teen learn self- control.
     When done right, when the teen accuses the parent of being mean, the parent doesn’t crumble but reminds him/herself that setting reasonable consequences is being a good parent. Not setting consequences is poor parenting.  
     Parents often report that their teen says, “I don’t care” when the parent removes a privilege.  Usually, THEY DO CARE. That’s why they are telling you they don’t care. But it doesn’t help for the parent to say, ” I know that you really do care. ”  
     There are times when a teen really doesn’t care. When that happens it can be that the teen is depressed. And sometimes when a teen is depressed it is because the parent has taken away all of the teen’s privileges without providing any plan for earning them back.
     Parents also often say “giving my teens consequences for misbehavior doesn’t work; I’ve tried it.” This usually means the parent thinks that letting the teen know in advance what the consequence is will automatically stop the behavior. When the unwanted consequence for misbehavior is first established, the teen will test it at least three times to see if the parent is truly going to follow through with the enforcement of the consequence. Once the teen sees the parent is being consistent in enforcing consequences the unwanted behavior usually stops.  
     Occasionally, the teen may weigh the benefits to him/herself of the misbehavior and then choose the misbehavior. Parents may then have to find a new consequence.  
      Another important tip is to start small with consequences so you can add or intensify as needed. For instance, take away the cell phone for one night in response to one instance of a minor unwanted behavior.  Then when a more serious misbehavior occurs you have the option of taking the phone away for a week or more.  
     Food, shelter, clothing and health care are some of the basics parents are expected to give their child. Most of the other things parents are currently providing for their children are privileges that can be taken away for short periods of time as consequences for misbehavior. It helps when both parents and teens start with this premise in mind.  

So Just What is Normal Adolescent Behavior?

   “I just want my sweet, kind, respectful kid back.  I don’t even know the person she has become.”  Counselors hear countless parents complain about their pre-adolescent or adolescent child in that manner.

     The good news is that the child you knew before WILL return but the bad news is that it may not be for several years.  The other good news is that I could give you some tips to help you, survive your child’s teen years.   Generally, if followed, things could get better in a reasonable amount of time.

     The first step in making your life with your adolescent less turbulent is defining what is normal adolescent behavior.  Most parent’s have been warned about the ” terrible two’s, so when your child goes through this stage you may easily recognize that the behaviors are normal and come to an end.

     What many parent’s often forget is that all of the changes that are taking place with their adolescence are an essential part of healthy human development.  All the pulling away, oppositional, critical behaviors is what a child must do to better survive in the real world.  Just as little birds are programmed to leave the nest, so are adolescent humans, programmed to begin to separate from their parents at a certain stage of their development.

     So when teens don’t want to be seen walking with their parents in the mall that is NORMAL.  Parents’ of course, are hurt by this  because they don’t remember that this has less to do with being embarrassed by the parent but more about that the child worrying that a friend or classmate will view them as being a “baby” and not being allowed to shop on their own.

     When a parents’ own self-confidence is not solid, their teen’s changing interactions with them are a constant source of pain. Nature plays a dirty trick on many parents’ because they are experiencing their own “mid life crisis” at the same time their children are going through adolescence.  Often, parents’ are asking ask themselves the same questions that their teens are asking themselves–Who am I? What do I believe in? What do I do with the rest of my life?

     Teens question their parents’ values because they want their parents’  to convince them to accept the parents’ values.  This whole process is NORMAL but many times can be very threatening to parents’. 

     At the very same time, the teens begin to make fun of the music their parents’ listen to, the TV shows they watch, the movies they enjoy, the clothes they wear and even the way their parents’ talk. Of course, it’s no surprise that some parents’ may begin to wonder if it was such a good idea to have children. Yes, all of the aforementioned behaviors are NORMAL but for the most part temporary behaviors.

     Many parents’ worst fear is that their adolescent has turned into a selfish, self-centered and self absorbed person. This total self- focus is NORMAL.  It is what the adolescent must do to achieve the final formation of their personality to help them become self- confident enough to leave the comfort of their parents’ home. 

     One of the hardest struggles parents’ also have is watching their adolescent experiment with radical hair, piercings and clothing styles as they put the finishing touches on the image they want to present to the world.  Parents don’t have like the external changes.  They just need to tolerate them, remember that what they are seeing is NOT the finished product.  It is helpful if you can avoid power struggles and try to convince your adolescent to modify their new look.

     What most parents’ don’t realize is that the way they respond to their teens temporary unpleasant behavior often factors greatly in their future parent/child relationship.  Sadly, many adults do not remember all the wonderful things their parents’ did for them when they were one through six years of age.  What adults often remember most vividly is either their parents’ tolerance of them as they passed through the difficult teen years or the terrible battles or hurtful things their parents said to them.  Some simple rules for you’ to follow and try to remember as you walk with their teens through adolescence is:  


1.  Pick Your Battles.

2.  Replace Lectures With Consequences for Unwanted Behaviors ( The teens already know all of your      lectures, word for word.)

3.  Set Reasonable Limits.

4.  Expect Grumbling and Testing of Those Limits. 

5.  Be Flexible, Give Freedom Gradually to See What Your Child Can Handle.

Healthy Strategies for Stress Management

If you’re feeling stressed, you’re not alone.  Try a few of these simple techniques to make life’s challenges a bit more manageable.

1)    Learn to say “no” – know your limits and stick to them.

2)    Reframe your problems, look at the big picture.

3)    Improve your time management skills.

4)    Don’t try to control the uncontrollable.

5)    Exercise for 30 minutes at least three times per week.

6)    Reduce your caffeine and sugar intake.

7)    Get enough sleep.  Turn off your smart phone!

8)    Spend time with fun, supportive people.

9)    Light scented candles and take a long bath

10)   Begin and end your day with 15 minutes of meditation.

 

Mindfulness and Attention

Mindfulness and Attention

Tips to Help Your ADHD Child Manage Their Homework

Written by Laura Piuca Hinkes LCSW

One of the biggest challenges parents of ADHD children face is the homework dilemma. As a therapist I have often heard parents complain about their child’s disorganization with their schoolwork and the constant battle they face in just getting them to do the work. Here are some tips to insure you’ll have more productive homework sessions.

  • If your child is on medication make sure to schedule homework time before their meds run out. It will be difficult for them to focus and attend once their medication has worn off.
  • Look to see if you can get an extra set of schoolbooks to have at home. Essential if your child has a tendency to forget to bring books home. Also have extra folders that are colored to match the classroom system.
  • Pull together a phone list of classmates that your child can call if he/she didn’t get the assignments. Also some schools have an online system that will show assignments.
  • Use a large calendar to keep track of projects and homework. Color code for each subject. For bigger projects break the work down into smaller tasks and indicate what will be done each day on the calendar.
  • ADHD children need structure. They most likely will not voluntarily sit down to do homework. Establish routine and expectations such as no video games or TV till after homework is done. This way they will be motivated to complete homework to get the reward.
  • Your child should have a neat and uncluttered area to do their homework. A parent should be close by to supervise and keep them on task.
  •  Use a timer to help them with time management. Allowing them to take brief frequent breaks rewards them for their efforts so far and helps them to not get overwhelmed with the amount of work they have.
  • Some ADHD children can focus better when they can be active or fidget. Try letting them stand at the table or sit on an exercise ball. Chewing gum or squeezing a stress ball may also be helpful.
  • Once homework is done have your child put it away in the appropriate folders or notebooks and pack their backpack right away. You don’t want to be scrabbling in the morning to find everything your child needs to bring to school.
  • If the amount of homework your child has is overwhelming talk with the school about making accommodations that will decrease the amount of homework. Schools will do this especially if your child has an IEP or 504 Plan.

Omega 3 and Learning

http://psychcentral.com/news/2013/09/14/omega-3-strongly-linked-to-behavior-learning-in-children/59556.html

How Fido and Fluffy Can Change Your Life: Benefits of Pet Ownership

“Until one has loved an animal, a part of one’s soul remains unawakened.” – Anatole France

A pet is certainly a great friend that provides unconditional love during difficult times. Whether you’ve had a difficult day at work or home, pet owners immediately feel love from their pets and experience an improved mood.

There are many benefits from pet ownership. Whether it’s a fluffy kitty or cute puppy, they help satisfy basic human needs to have contact, touch and allow us to interact with other beings. Whether you’re at the pet store or park, having a pet can provide you an opportunity to engage socially with others reduce anxiety and build confidence.  By nature, people crave attention and love; animals mutually share these feelings and want to share their affections back without any expectations. Unlike human interaction, where you may feel that the other person wants something, an animal wants nothing more than to see you happy and feel loved. Based on statistics released in 2011 from the American Humane Association, “80% of dog and cat owners surveyed claimed that their pets could sense their moods…three in four believed their dogs tried to make them feel better when they were unhappy.”

There are physical benefits to having pets also; it has been found that pets increase your ability and desire to exercise. This is not limited to taking a pet for a walk, but includes chasing a pet around the house, or all those funny faces and actions we perform to get our pets attention. Playing with an animal can actually help calm and relax you as it elevates your dopamine and serotonin levels dramatically; you are also less likely to suffer from depression. Pets have been shown to reduce blood pressure and stress which is part of the reason many doctors’ offices keep aquariums in their waiting rooms.

Animals can also bring stability into an individual’s life because a majority of them require structure. They require and depend on you to feed them, even if it’s filling a bowl throughout the week or taking them outside throughout the day for a walk. These simple routines can help you take control of your life; it forces you to get out of bed and holds you accountable for your actions. This is also extremely beneficial for the elderly and senior citizens as it can give them a sense of purpose and help them want to focus on the ‘now.’

Granted pets are not for everyone or every lifestyle however adding a companion certainly has its advantages to your mental health. Simply having someone depend on you can help make your existence feel more important and confident in yourself. Though pets are not a replacement for medication or therapy they certainly can improve your mental wellbeing.

An Epidemic of Domestic Violence

Domestic violence are behaviors in an intimate relationship in which one partner uses physical, sexual, emotional, psychological or economic threats or actions to gain or maintain power and control over their significant other. It is a social problem which does not discriminate against age, sex, race, culture, education, religion, sexuality, marital status, social class, or employment status.

It is estimated that 1 in 4 women will experience some form of domestic violence in her lifetime; approximately 4 million women a year. Although the vast majority of recorded incidents of domestic violence are women, men also suffer from domestic violence.  According to a national study conducted by the Centers for Disease Control and the U.S. Department of Justice released in December, 2011, an estimated 5.4 million men were victims of intimate partner violence. Approximately 2.3 million were victims of serious physical violence.

What are some signs of being abused or in an abusive relationship?

  • Physical abuse is any unwanted aggressive physical behavior such as hitting, biting, choking, kicking or restraining you.
  • Emotional abuse is name-calling, insults, threatens to hurt you or loved ones, humiliation or criticism.
  • Sexual abuse includes, but is not limited to, sexual assault, rape, pressured sexual situations, forced prostitution and being hurt during sex.
  • Psychological abuse is when someone threatens you or someone you care about, stalking, destroying personal property and use of fear.
  • Economic abuse is controlling the finances, refusing to share money, interfering with education or financial obligations. 

Traumatic experiences such as domestic violence can lead to a variety of emotional and psychological symptoms. Many survivors suffer from post-traumatic stress disorder, depression, trust issues, substance abuse and anxiety.  If you or someone you have recently left an abusive relationship, counseling and/or support groups can help you heal, feel empowered and regain control. If you or someone you know is a victim of domestic violence call the National Domestic Violence Hotline at 1−800−799−SAFE(7233) or TTY 1−800−787−3224.

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