Dear Linda:
I'm worried about my dad who is a 78-year-old widow. Though he's always been jovial and outgoing, lately he's cranky and totally withdrawn. The last time I visited he was shaking, covered in bruises, and unwilling to discuss why. I fear I found the answer in empty alcohol bottles in the trash.
Dear Fearing Alcoholism:
Alcoholism among seniors is considered a "hidden epidemic". The very symptoms that would suggest a problem are ignored or misdiagnosed because they are also associated with aging--dizziness and falls, incontinence and poor hygiene, confusion and impaired memory, depression and excessive napping, disinterest in food and isolation.
The typical consequences of alcohol abuse (family and financial problems, job loss and arrest) are not really a deterrent for an older person. Seniors who are retired, drive less, and live away from family and friends are able to drink alone for a long time before the problem is detected. It finally becomes obvious to the family when the aging alcoholic can no longer function independently.
The Center for Substance Abuse Treatment reported that: 15% of male alcoholics and 24% of female alcoholics began abusing between the ages of 60-69, and 14% of males and 28% of females began abusing between the ages of 70-79. Social isolation, loss and grief, housing and financial concerns, and physical and mental health problems are some of the reasons for late-life drinking.
Because of physiological changes due to aging and the pharmacological impact of mixing medications with alcohol, seniors 65 and older are even more vulnerable to the adverse effects of abuse. Their immune system is compromised and ability to resist disease greatly diminished.
Education is key before intervention can be successful. Read Aging and Addiction: Helping Older Adults Overcome Alcohol or Medication Dependence by Carol Colleran and Debra Jay (Hazelden). Visit the National Institutes of Health at www.niaaa.nih.gov. Call Focus on Recovery at 866-255-5029 for program referrals or Alcoholics Anonymous at 212-870-3400.
Confront with love, compassion and understanding. Visit a physician for proper diagnosis, and take heart. Generally, the elderly stay in recovery programs and respond well to treatment.
Saturday, October 27, 2012
Friday, October 19, 2012
Parents Need to Get a Grip
I am a firm believer in raising well-disciplined children who are respectful, responsible, and motivated to excel, and those goals should be accomplished primarily by the time children begin elementary school. Though refinement of those characteristics continues until adulthood, if children are well-mannered, well-behaved and hard working at the start of school, they will experience encouragement and positive reinforcement, and their self-esteem will be nurtured based on merit.
As a result of a lot of effort on my part and a clear value system in our family, I raised two very successful children; both are college-educated and philanthropic, highly responsible with thriving careers, and well-liked and respected by others, and I didn’t have to beat them to accomplish those goals.
I am more and more distressed over what seems to be a trend in this generation. Many parents are proponents of the theory that “sparing the rod spoils the child” and wielding that rod is generally the first course of action rather than the last. My worry is that it has more to do with the parents, rather than the children, being out of control.
A horrendous example of that is the Texas woman who beat her two year old into a coma over a potty training issue and super glued her hands to the bathroom wall, and though this is obviously extreme, abuse like this has become more and more common. I recently had a repairman in my home bragging about beating his four year old with his belt. He truly believed it was the only way to make his son behave. What a terrible mistake and a particularly crazy philosophy when trying to teach a child not to hit others. Don’t these parents see the absurdity of hitting a child for hitting? Where do they think the child learned the behavior?
What is necessary for raising well-disciplined children?
Being Committed
Parents need to have a well-thought out philosophy that both agree to enforce, and they need to have a well-considered plan in place to handle situations before they present themselves. Then they need to follow through. That way they are prepared, empowered and in control of themselves.
Taking Time
Parents must devote time and energy to the JOB of parenting well. Problems are not solved with shortcuts, and hectic schedules or being tired are never good excuses for not following through. It takes time to explain to children why certain behaviors are unacceptable and why the desired behavior is required. Teaching the child to behave appropriately is the parent’s JOB. Learning to behave appropriately is a process that takes time.
Being Realistic
Parents, particularly with the first born, often have unrealistic expectations for their children. If they have set the bar too high and the child repeatedly fails, they become frustrated and ultimately lose belief in themselves. If a child is punished for something that they are not capable of doing yet, a trust is broken and a defeated child is the consequence. The parent risks killing the child’s spirit. The other consequence can be high performing children without self-confidence driving their behaviors.
Explaining Your Expectations
Explain your values in terms your child can understand. Take the time to explain the reasons behind why you are asking he/she to behave in certain ways. If your child understands the types of behavior you'd like them to avoid, they're more likely to apply that reasoning to different situations, instead of learning to stop one behavior at a time.
Assessing the Environment
If your child is acting out of sorts, be sensitive to what is going on. Have you gotten them off schedule? Is your child sick or tired or hungry? Is it a new place or situation? Are they afraid or intrigued or embarrassed? Perhaps there is good reason for a change in behavior. Make an assessment of the situation before reacting. New situations offer teaching opportunities but the parent must be patient and even forgiving if there are lapses.
Avoiding a Power Struggle
If you don’t want your child to say no to you, don’t give them the opportunity. For example, if I wanted my children to have cereal in the morning, I would say, do you want oatmeal or Wheaties. They felt empowered because they had been given a choice, but I was really in control. If I had asked instead, “Do you want cereal?” I might have gotten a no answer instead and then the battle begins.
Being predictable
It is critical that your child knows that you're going to do what you say you will. If you explain what a punishment will be, and then don't act on it, you will have less credibility the next time.
Being Consistent
It is crucial for your child to understand that if they choose a certain behavior; they will always get the same consequence. If he/she can count on the rules staying the same, they're more likely to abide by them. This also allows the child to feel as if they have control over their life.
Being Reasonable
Consequences for unacceptable behavior should be logical. For example, one time, my three year old sprinkled baby powder all over the stair case. I could have spanked her but what would that have taught. Instead, I made her clean up the mess. Because I consistently required that she clean up her messes, she made fewer and fewer of them. The punishment should always fit the crime.
Withholding rewards
Determine what your child values — it could be a toy, an activity, or even a privilege like getting to stay up. That becomes leverage when the child misbehaves. Those positive things can be withdrawn for a certain period of time. You could also introduce a negative consequence like a time-out or being sent to their room to consider what they’ve done.
Giving Positive Reinforcement
If you want your child to behave well, you have to reward those behaviors at every opportunity. Look for the moments to give praise and be effusive. Discuss the accomplishment with pride to others—Daddy or grandparents. They say it takes 20 positive comments to compensate for one criticism, and we are so quick to point out and punish the negative. Create opportunities for your child to be successful and then reward them not with things but with compliments and hugs and more of what they really want—generally your time and attention.
As a result of a lot of effort on my part and a clear value system in our family, I raised two very successful children; both are college-educated and philanthropic, highly responsible with thriving careers, and well-liked and respected by others, and I didn’t have to beat them to accomplish those goals.
I am more and more distressed over what seems to be a trend in this generation. Many parents are proponents of the theory that “sparing the rod spoils the child” and wielding that rod is generally the first course of action rather than the last. My worry is that it has more to do with the parents, rather than the children, being out of control.
A horrendous example of that is the Texas woman who beat her two year old into a coma over a potty training issue and super glued her hands to the bathroom wall, and though this is obviously extreme, abuse like this has become more and more common. I recently had a repairman in my home bragging about beating his four year old with his belt. He truly believed it was the only way to make his son behave. What a terrible mistake and a particularly crazy philosophy when trying to teach a child not to hit others. Don’t these parents see the absurdity of hitting a child for hitting? Where do they think the child learned the behavior?
What is necessary for raising well-disciplined children?
Being Committed
Parents need to have a well-thought out philosophy that both agree to enforce, and they need to have a well-considered plan in place to handle situations before they present themselves. Then they need to follow through. That way they are prepared, empowered and in control of themselves.
Taking Time
Parents must devote time and energy to the JOB of parenting well. Problems are not solved with shortcuts, and hectic schedules or being tired are never good excuses for not following through. It takes time to explain to children why certain behaviors are unacceptable and why the desired behavior is required. Teaching the child to behave appropriately is the parent’s JOB. Learning to behave appropriately is a process that takes time.
Being Realistic
Parents, particularly with the first born, often have unrealistic expectations for their children. If they have set the bar too high and the child repeatedly fails, they become frustrated and ultimately lose belief in themselves. If a child is punished for something that they are not capable of doing yet, a trust is broken and a defeated child is the consequence. The parent risks killing the child’s spirit. The other consequence can be high performing children without self-confidence driving their behaviors.
Explaining Your Expectations
Explain your values in terms your child can understand. Take the time to explain the reasons behind why you are asking he/she to behave in certain ways. If your child understands the types of behavior you'd like them to avoid, they're more likely to apply that reasoning to different situations, instead of learning to stop one behavior at a time.
Assessing the Environment
If your child is acting out of sorts, be sensitive to what is going on. Have you gotten them off schedule? Is your child sick or tired or hungry? Is it a new place or situation? Are they afraid or intrigued or embarrassed? Perhaps there is good reason for a change in behavior. Make an assessment of the situation before reacting. New situations offer teaching opportunities but the parent must be patient and even forgiving if there are lapses.
Avoiding a Power Struggle
If you don’t want your child to say no to you, don’t give them the opportunity. For example, if I wanted my children to have cereal in the morning, I would say, do you want oatmeal or Wheaties. They felt empowered because they had been given a choice, but I was really in control. If I had asked instead, “Do you want cereal?” I might have gotten a no answer instead and then the battle begins.
Being predictable
It is critical that your child knows that you're going to do what you say you will. If you explain what a punishment will be, and then don't act on it, you will have less credibility the next time.
Being Consistent
It is crucial for your child to understand that if they choose a certain behavior; they will always get the same consequence. If he/she can count on the rules staying the same, they're more likely to abide by them. This also allows the child to feel as if they have control over their life.
Being Reasonable
Consequences for unacceptable behavior should be logical. For example, one time, my three year old sprinkled baby powder all over the stair case. I could have spanked her but what would that have taught. Instead, I made her clean up the mess. Because I consistently required that she clean up her messes, she made fewer and fewer of them. The punishment should always fit the crime.
Withholding rewards
Determine what your child values — it could be a toy, an activity, or even a privilege like getting to stay up. That becomes leverage when the child misbehaves. Those positive things can be withdrawn for a certain period of time. You could also introduce a negative consequence like a time-out or being sent to their room to consider what they’ve done.
Giving Positive Reinforcement
If you want your child to behave well, you have to reward those behaviors at every opportunity. Look for the moments to give praise and be effusive. Discuss the accomplishment with pride to others—Daddy or grandparents. They say it takes 20 positive comments to compensate for one criticism, and we are so quick to point out and punish the negative. Create opportunities for your child to be successful and then reward them not with things but with compliments and hugs and more of what they really want—generally your time and attention.
Saturday, October 13, 2012
Dental Nightmares
I have a friend who just had the most horrible experience at the dentist. She went in to correct imperfections in her smile that had come with aging, but came out frowning instead about both the process and the outcome.
Finding the right dentist is critical for successful procedures that will impact for years the appearance and function of your mouth and teeth.
According to Dr. Susan Hollar (who is one of fewer than 250 accredited cosmetic dentists worldwide), “Most dental schools don’t teach adequate courses in cosmetic dentistry. To perform restorative and cosmetic procedures with the greatest artistic eye and highest technical skill, a dentist must study cosmetic dentistry in a post-graduate program like the American Academy of Cosmetic Dentistry (AACD) with an accreditation process similar to board certification. The dentist you select should have substantial experience in complex cases, extensive hands-on training, an expert approach to your particular case, and a gentle chair side manner to ensure comfort and easy questioning.”
Visit www.AACD.com for a list of accredited dentists in your area and for information about procedures, techniques and materials. Educate yourself about the procedures you’re considering, interview several cosmetic dentists before deciding, and tour their offices and in-house labs. You’ll be able to assess who’s given an honest evaluation of your needs and who has the highest standards for execution. You want the dentist who’s a perfectionist—the one who wants to meet your expectations for excellence but needs to exceed his/her own.
Look at before-and-after photos of the restorations you want. Beware that commercially produced photos can be acquired, so confirm who’s done the work. Ask how long the restorations last and if they’re warranted against breaking, chipping and staining.
See if the dentist uses a procedure known as the “Trial Smile”, a simulation of your new smile that adheres to your teeth. Not only do you get the look and feel of the future, but also an accurate assessment of procedural time and fees.
Great cosmetic dentistry is really an art. Take the time to do your research and find the best qualified in the field.
Finding the right dentist is critical for successful procedures that will impact for years the appearance and function of your mouth and teeth.
According to Dr. Susan Hollar (who is one of fewer than 250 accredited cosmetic dentists worldwide), “Most dental schools don’t teach adequate courses in cosmetic dentistry. To perform restorative and cosmetic procedures with the greatest artistic eye and highest technical skill, a dentist must study cosmetic dentistry in a post-graduate program like the American Academy of Cosmetic Dentistry (AACD) with an accreditation process similar to board certification. The dentist you select should have substantial experience in complex cases, extensive hands-on training, an expert approach to your particular case, and a gentle chair side manner to ensure comfort and easy questioning.”
Visit www.AACD.com for a list of accredited dentists in your area and for information about procedures, techniques and materials. Educate yourself about the procedures you’re considering, interview several cosmetic dentists before deciding, and tour their offices and in-house labs. You’ll be able to assess who’s given an honest evaluation of your needs and who has the highest standards for execution. You want the dentist who’s a perfectionist—the one who wants to meet your expectations for excellence but needs to exceed his/her own.
Look at before-and-after photos of the restorations you want. Beware that commercially produced photos can be acquired, so confirm who’s done the work. Ask how long the restorations last and if they’re warranted against breaking, chipping and staining.
See if the dentist uses a procedure known as the “Trial Smile”, a simulation of your new smile that adheres to your teeth. Not only do you get the look and feel of the future, but also an accurate assessment of procedural time and fees.
Great cosmetic dentistry is really an art. Take the time to do your research and find the best qualified in the field.
Saturday, October 6, 2012
Surviving A Shingle Shot
Well, I finally bit the bullet yesterday and got a shingles vaccination. We have a commercial running currently that was effective in terrifying me about the extent of associated pain. It reminded me about the pain my father suffered with an outbreak both on his leg and surrounding his EYE. He described the patch on his leg as if somone had laid an iron on his skin, and the doctors were forced to call in a specialist for the eye.
I actually got my vaccination at the pharmacy. The pharmacist spent some time warning me about the possible but not probable side effects--swelling and reddness at the injection site and/or light rash reminicient of chicken pox but not nearly as severe. None of that happened, though I needed to be aware that the rash could happen during the coming two weeks, when I am also slightly contagious to the very young or old who have not been vaccinated.
The pharmacist also suggested getting my flu shot at the same time. That worried me, but she said that if I had them done at the same time, there would be no problem, but if I didn't have them done (one in each arm) together, I would have to wait 3-4 weeks before getting the flu shot. I decided to get both done, and so far so good.
Shingles is a viral response to chicken pox. Chickenpox (varicella zoster) is a common virus among children that causes mild illness and lifetime immunity. The varicella virus remains dormant in the body, however, and if the body’s immune system is weakened (by aging, stress or other infections), the virus can reactivate and cause shingles, a far more serious illness than chickenpox.
Most common in adults 65 and older, the shingles (herpes zoster) virus spreads down the nerves and causes a painful, blistering rash that patients can’t bear having touched, even by clothes. Though more common on the trunk of the body, the excruciating rash may break out on the limbs, head and in the eye (causing blindness), an emergency reason for the involvement of an ophthalmologist as well as a physician, who can treat the disease most effectively at onset. The rash pattern, blister fluid and blood samples can confirm the diagnosis. Despite the size of the rash (sometimes a small patch that seems out of proportion to the extent of the pain), the patient may feel very ill—feverish, exhausted, achy, and often depressed.
Medication can be particularly helpful within 72 hours of first symptoms. Usually within two weeks, blisters burst and crust over, sometimes leaving scars. The pain may subside as the rash recedes, but not always. Some are left with pain in that area for months and even years (called post herpetic neuralgia).
In addition to antiviral medications (which lessen disease severity and duration), steroids for inflammation, pain killers, antidepressants and anticonvulsants, topical agents may be prescribed. Shingles isn’t contagious, but the virus particles are in the blister fluid. Someone who hasn’t had chickenpox could become infected.
To learn more about shingles, contact the National Immunization Hotline at 800-232-2522 or visit www.cdc.gov. Call the National Chronic Pain Outreach Association at 540-862-9437 or visit www.chronicpain.org for information about chronic pain management.
I actually got my vaccination at the pharmacy. The pharmacist spent some time warning me about the possible but not probable side effects--swelling and reddness at the injection site and/or light rash reminicient of chicken pox but not nearly as severe. None of that happened, though I needed to be aware that the rash could happen during the coming two weeks, when I am also slightly contagious to the very young or old who have not been vaccinated.
The pharmacist also suggested getting my flu shot at the same time. That worried me, but she said that if I had them done at the same time, there would be no problem, but if I didn't have them done (one in each arm) together, I would have to wait 3-4 weeks before getting the flu shot. I decided to get both done, and so far so good.
Shingles is a viral response to chicken pox. Chickenpox (varicella zoster) is a common virus among children that causes mild illness and lifetime immunity. The varicella virus remains dormant in the body, however, and if the body’s immune system is weakened (by aging, stress or other infections), the virus can reactivate and cause shingles, a far more serious illness than chickenpox.
Most common in adults 65 and older, the shingles (herpes zoster) virus spreads down the nerves and causes a painful, blistering rash that patients can’t bear having touched, even by clothes. Though more common on the trunk of the body, the excruciating rash may break out on the limbs, head and in the eye (causing blindness), an emergency reason for the involvement of an ophthalmologist as well as a physician, who can treat the disease most effectively at onset. The rash pattern, blister fluid and blood samples can confirm the diagnosis. Despite the size of the rash (sometimes a small patch that seems out of proportion to the extent of the pain), the patient may feel very ill—feverish, exhausted, achy, and often depressed.
Medication can be particularly helpful within 72 hours of first symptoms. Usually within two weeks, blisters burst and crust over, sometimes leaving scars. The pain may subside as the rash recedes, but not always. Some are left with pain in that area for months and even years (called post herpetic neuralgia).
In addition to antiviral medications (which lessen disease severity and duration), steroids for inflammation, pain killers, antidepressants and anticonvulsants, topical agents may be prescribed. Shingles isn’t contagious, but the virus particles are in the blister fluid. Someone who hasn’t had chickenpox could become infected.
To learn more about shingles, contact the National Immunization Hotline at 800-232-2522 or visit www.cdc.gov. Call the National Chronic Pain Outreach Association at 540-862-9437 or visit www.chronicpain.org for information about chronic pain management.
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