By: Mike Licht

An advance directive. What is it? Why do we need it? Isn’t it SO morbid? Why do I need to make a plan for something that may never happen especially since I am healthy? In our society, we like to live life in the here and now, but sometimes, we need to plan for the “what-if”. Advance directives do just that. How do we broach this topic? It’s simple, just ask your closest loved ones. Although they may be caught off guard as this is not the typical nor quintessential dinnertime conversation, having an idea about what they would or would not want for medical treatment should they become unable to make healthcare choices for themselves, could not only decrease suffering but lead to decreased levels of stress at an already difficult time. 

To get an idea of what an Advance Directive is, take a peek at this clip that explains how it works.

…..After watching this video, did you realize that an advance directive isn’t just a morbid plan about a loved ones death even though they are healthy now? For most, this is a common misconception which is what leads to barriers regarding the  creation of an advance directive plan. Creating a plan is simple, and starts with a conversation with your famly regarding whether or not you would like certain life-sustaning measures such as: CPR, artificial nutrition, organ donation, and/or respiratory support as well as appointing someone to be your voice should you be unable to advocate your wishes personally. These wishes then get discussed with your doctor and placed into a document and legalized by a notary and/or lawyer. As one grows older and/or their health status changes, adjustments may be necessary. So, why is this so important and what are the benefits? Merlane & Armstrong (2020) discuss the benefits that include patient and family confidence/empowerment, reduces uncertainty, determines clear wishes and desires leaving nothing to be decided by family members, and ensures/prevents unwanted treatment to be performed.

To further clarrify, listen to this fun poem to put these concepts into context.

With so many benefits of an advance directive, why don’t more people have them? Well, because of all of the myths that lie around understanding what they truly are that we have “debunked”. As clarrified above, an advance directive plan lays out clear wishes and desires of each person well before it may ever be needed and an appointed spokesperson is chosen to ensure that these wishes are carried through. Family members, if not given some sort of guidance, may act out of emotion or fear, which could lead to decisions made that would contradict or disrespect what the person might have truly wanted.  Above all, Banerjee & Novelli (2015) discuss how advance care planning provide the utmost dignity and respect for both the patient and family members. To understand some real-life perspectives and stories, view the two TED Talks below. Additionally, links are listed to help guide your planning today, to be prepared for tomorrow.

Additonal Sites for Information:

(National Institute on Aging: US Department of Health)

https://www.nia.nih.gov/health/advance-care-planning-healthcare-directives

AARP: Forms to Fill Out, State by State

https://www.aarp.org/caregiving/financial-legal/free-printable-advance-directives/

Mayo Clinic: What is an Advance Directive? What is included?

https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/living-wills/art-20046303

References:

Banerjee, R., & Novelli, B. (2015). Advanced Illness Care: We Can Do Better. Journal of the American Society on Aging, 39(2), 106–111. 

Merlane , H., & Armstrong , L. (2020). Advance care planning. British Journal of Nursing, 29(2), 96–97.

In areas of the world with poor access to clean water, the spread of infection happens quickly and can have devastating effects. The World Health Organization (WHO) reported that prior to the introduction of revised infection prevention and control practices, such as hand washing protocols, to healthcare facilities in Ghana, as many as 19% of infants born in hospitals were afflicted with sepsis, a serious and life-threatening form of infection. 

As patients, we trust that the healthcare professionals caring for us are compassionate competent in their practice. We also expect that their practices are safe, follow current regulations and  best practice recommendations, as well as aim to do no harm. However, the Centers for Disease Control and Prevention (CDC), report that a staggering number of healthcare professionals fail to complete proper hand hygiene at key moments of care for optimal infection control practice. Knowing the facts about hand washing and asking your healthcare provider to complete proper hand hygiene can help to keep you and your loved ones in good health. One study found that fifty percent of the public surveyed was uncomfortable with requesting that their healthcare provider wash their hands, but only five percent of healthcare providers reported actually being uncomfortable in these situations (Flannigan, 2015). So, as a patient, how do we approach healthcare professionals about hand washing to advocate for ourselves? First, we need to understand proper hand hygiene. Hamilton Health Sciences explains the powerful effects properly washing your hands has on reducing the spread of illness. Continue reading →

Dyslexia vs Dysgraphia

Dyslexia and Dysgraphia both can go undiagnosed for years. To the average individual looking on the outside in, an individual appears to be very intelligent with no learning disabilities. Both diagnoses can co-exist with ADHD which makes it difficult to treat or recognize.

Dyslexia is a reading disability that involves difficulty with decoding and identifying speech sounds. People with dyslexia appear to be of normal intelligence and have normal vision. Dyslexia can be treated, but not cured with early intervention and assessment. Tutoring , OT services and IEP’s can help children with dyslexia succeed in school.

Dysgraphia is a learning disability, where the individual has difficulty handwriting. Dysgraphia is more difficult to recognize than dyslexia. Dysgraphia affects the individuals fine motor skills needed to write. The main symptoms of dysgraphia include poor spelling, poor utensil grasp, wrist and body positioning while writing. It may also include improper letter and word spacing. Treatment for dysgraphia may also include, tutoring, OT services, and individualized education programs in school.

https://www.youtube.com/watch?v=WMfl5kqSWmk

By: Injurymap

Over 200,000 cases of Congestive Heart Failure (CHF) are diagnoses annually in the U.S. The term “heart failure” can definitely sound scary however there are some misconceptions about what it actually is. Contrary to the term “failure”, CHF does not mean the heart has completely failed to work, it means the heart isn’t pumping as great as it should be (American Heart Association, 2020).

CHF can often present itself with respiratory systems including difficulty breathing, shortness of breath, and wheezing. This is due to the fact that the heart muscle is unable to pump enough blood through the body therefore, not meeting the oxygen requirement needs of the body. Without the heart pumping efficiently, fluid can buildup in the body in places such as the legs and arms. This fluid buildup presents itself as swelling, also known as edema. With the fluid buildup, some people experience a significant weight gain. Monitoring daily weight is an important part of managing this disease process (U.S. Department of Health and Human Services, 2019). The video below demonstrates some of these CHF warning signs.

A common misconception is that CHF is presented as appearing similar to a myocardial infarction AKA a heart attack. This is not the case and there are quite a few significant differences in the symptoms. As you read above, the primary symptom of Congestive Heart Failure is related to the respiratory system. In terms of a heart attack, this usually presents with chest pain, pressure, jaw pain, and arm pain.

Another myth is that heart failure cannot be treated or improved. In fact, there are many ways that people can reduce their congestive heart failure presentation and symptoms and get their body functioning healthier. Managing a low sodium diet, restricting fluid intake, trending daily weights, and exercise can all help to improve CHF. According to Bartlo (2007), an evidence-based research study showed that aerobic exercises such as running, walking, swimming, cycling, etc. improves the pumping function of the heart thus accumulating less fluid build up in the body and reducing shortness of breath and other respiratory symptoms. Just walking for 30 minutes a day a few times a week can improve CHF.

With social media in today’s society it can be difficult to figure out what is fact or fiction when it comes to health. Everyone has a different opinion and some people like to think their opinion is the right one. When it comes to health and medical sources, evidence-based and peer reviewed medical journals are trusted sources of information. Also, going to your physician to seek more information is always a legitimate way to learn more about your health and ways to improve it.

The video below is about a man who was able to reverse his heart failure symptoms and lead a healthier lifestyle through exercise.

References

American Heart Association. (2019). Congestive Heart Failure. Retrieved from: www.heart.org/en/health-topics/heart-failure/warning-signs-of-heart-failure.

Bartlo, P. (2007). Evidence-based application of aerobic resistance training in patients with  congestive heart failure. Journal of Cardiopulmonary Rehabilitation and Prevention, 27(6), 368-375.

U.S. Department of Health and Human Services. (2019). Subtle and dangerous: Symptoms of heart disease in women. National Institute of Health, 1-12.

Autism spectrum disorder (ASD) is a developmental disorder that often affects communication and behavior. Severity and symptoms on the spectrum can vary greatly. This contributes to ASD being difficult to represent in media and to teach others about. However, there are commonalities in people with ASD. There are television shows and public service announcements that are trying to educate the public and encourage inclusiveness for people with ASD.

Below is a public service announcement from the organization Autism Speaks called The World of Autism. It touches on some of the primary characteristics of ASD. It is animated and from the viewpoint of a young boy with ASD. He talks about having difficulty communicating and always liking things to be the same. He states that change and the unknown makes him feel scared and upset. Research shows that risk-aversion behavior is a core feature of ASD (Gosling & Moutier, 2018). This public service announcement helps us to understand why a routine is so important for people with ASD. Making difficult or risky decisions can lead to a major crisis and they will need support and encouragement when dealing with change.

The children’s television show Sesame Street has included a 4-year-old character named Julia who has ASD. Julia displays some of the core characteristics of ASD which includes difficulty speaking and communicating. The show does an excellent job at explaining her condition and talking about interventions that help Julia, such as a communication device. It is great to encourage education and inclusiveness at this young age because early intervention and diagnosis can lead to better outcomes. A research study states that assessing communication issues by the preschool age and implementing services have positive impacts (Ellis Weismer & Kover, 2015). It is not only beneficial for children to observe a character on the show with ASD. Parents may not know the signs of ASD or be in denial about things they may suspect. Julia’s character on the show may lead to parents seeking early intervention for their child which will benefit them in the long run.

Netflix has a show called Atypical who’s main character is an 18-year-old boy with ASD. He is high functioning but still faces daily struggles. Throughout the series, it shows how beneficial interactions with his typically developing best friend, teenage sister, girlfriend, and peer support group are to him. He takes a lot of questionable advice from his best friend. Even though it may not always be the best advice, it puts him in situations where he is constantly learning what is socially acceptable. Research shows that adolescent males with ASD will display prosocial behavior if they are around peers that are also displaying those behaviors as well (Van Hoorn, Van Dijk, Crone, Stockmann, & Rieffe, 2017). Prosocial behaviors include sharing, volunteering, cooperating, and following rules. There is often the misconception that people with ASD are not affected by the behaviors of the people around them, but this is not the case. Atypical does a good job in portraying the main features associated with ASD and helps to get the message out there that positive peer support and acceptance can be very beneficial to people on the spectrum.

Autism spectrum disorder is a great thing to incorporate into our mainstream media. It is hard for the media to please everyone when trying to depict the struggles of ASD because the spectrum is so varied, however, inclusion and education on any scale is better than none. The media seems to be on the right track with incorporating the core features of ASD and I imagine this will get even better over time.

References

Ellis Weismer, S., & Kover, S. T. (2015). Preschool language variation, growth, and predictors in children on the autism spectrum. Journal of Child Psychology & Psychiatry, 56(12), 1327–1337. https://doi.org/10.1111/jcpp.12406

Gosling, C. J., & Moutier, S. (2018). Brief report: Risk-aversion and rationality in autism spectrum disorders. Journal of Autism & Developmental Disorders, 48(10), 3623–3628. https://doi.org/10.1007/s10803-018-3616-8

Van Hoorn, J., Van Dijk, E., Crone, E., Stockmann, L., & Rieffe, C. (2017). Peers influence prosocial behavior in adolescent males with autism spectrum disorders. Journal of Autism & Developmental Disorders, 47(7), 2225–2237. https://doi.org/10.1007/s10803-           017-3143-z

We spend our entire lives using our brains. What happens when our brain starts to fail us as we grow older? Dementia is a generalized term for a  group of progressive diseases that effects the brain of some individuals as they get older. Most people do not understand dementia until it directly effects their live in some way, usually it is a grandparent,  parent, aunt or uncle. With advances in healthcare and the average life span being extended related to these advantages, basically we are living longer. It is noted that currently 5 million individuals have a  diagnosis of Dementia, this number will  triple in the next 40 years. These numbers also effects healthcare dollars spent on dementia care currently estimated at 2 billion dollars a year these costs will triple over the next 40 years as well.

Although there is no cure for Dementia,  doctors discuss early diagnosis so that interventions can be put into place. These measures can prepare individuals and families for the future care of individuals with  this progress illness.  This can be an overwhelming process, for both the individual and their family. Once there are noted issues with memory , speak with you doctor. Your doctor will want medical tests to rule out other factors it can be. Next, there will be testing from a doctor that specializes with the brain. There is not one set of  tests  that will give a diagnosis, but a series of memory testing along with a image of the brain that will lead a doctor to make a dementia diagnosis.

Life after diagnosis,  can be stressful for the individual and the family. The future is really unknown. There is no time stamp on how fast or slow this disease will progress. Quality of life  should remain the focus for the individual diagnosed with dementia. Prepare for the future. Work closely with your doctors, they can provide education to what interventions can go into place. Get involved in support groups, these can be found at  https://alzfdn.org/?gclid=EAIaIQobChMIts3DzaPX5wIVAovICh1V4AUmEAAYASAAEgJrnPD_BwE. Also  for more information, on dementia you can visit https://www.cdc.gov/aging/dementia/