By: Vinoth Chandar

When you think of someone with Alzheimer’s or dementia how do you see them? In movies or TV shows they are sometimes depicted in an overly dramatized manor; in institutions requiring restraint, with loss of memory and no recall of loved ones, wandering and lost an airport with no pants on. Some of these depictions may be true, a person may exhibit aggressive behaviors, a person will have loss of memory, they can wonder off and get lost. But what if you had the proper education as a caregiver to help someone diagnosed with Alzheimer’s? Maybe these situations could be avoided, maybe institutionalization and wandering can be decreased, maybe function and memory can be preserved when you as the caregiver are provided with proper education and support systems.

HOW MANY PEOPLE ARE AFFECTED BY ALZHEIMER’S AND DEMENTIA

There are more than 55 million people around the world that are diagnosed with Alzheimer’s disease (Alzheimer’s Association, 2022) and there are 15 million unpaid caregivers in the U.S. that assist with care (Verrier, et al, 2017). Typically, there is no advanced preparation or training given to caregivers. Many studies have shown that without proper caregiver education, caregivers are at a higher risk of stress, anxiety and depression and can lead to possible early institutionalization of a person with Alzheimer’s (Verrier, et al, 2017).

Staying in contact with your doctors and care team is essential. Occupational Therapy can be a great educational resource to help assist caregivers and persons with Alzheimer’s setting up a daily routine, provide personal home safety recommendations, exercise routine and provide further education on reducing behaviors within the home.

By: dierk schaefer

WHAT IS ALZHEIMER’S AND DEMENTIA

Alzheimer’s and dementia is a diagnosis that is progressive and through its stages the person will require caregiver assistance. Alzheimer’s is the most common cause of dementia, which can lead to memory loss and other cognitive abilities that effect daily life. Alzheimer’s disease accounts for 60-80% of dementia cases (Alzheimer’s Association, 2022).

Links provided for further in-depth information on Alzheimer’s and dementia diagnosis.

https://www.alz.org/alzheimers-dementia/what-is-alzheimers

https://www.cdc.gov/aging/aginginfo/alzheimers.htm

https://alzfdn.org/caregiving-resources/facts-tips/

COMMON SYMPTOMS OF ALZHEIMER’S AND DEMENTIA 

These are a few common signs and symptoms of Alzheimers and Dementia:

Forgetful: over taking or not taking medications 

Confused: unsure of how to manage day to day tasks 

Moody: easily suspicious or scared 

Physical changes: poor balance, decreased strength or increased risk for falls 

Changes in sleep patterns: up at night or sleeping all day 

Wandering or getting lost: inside or outside the home

Due to the changes in the brain and body maintaining safety becomes an important part not only for the person diagnosed with Alzheimer’s or dementia but for the caregiver as well.
(Jenson & Padilla, 2017).

For further information on signs and symptoms of Alzheimer’s click here: https://www.alz.org/alzheimers-dementia/10_signs

Concerned that you or a loved one may be showing signs of Alzheimer’s contact your doctor.

SIMPLE HOME SAFETY TIPS

Safety modifications that caregivers can implement within their home include:

Keep walk ways and halls well lit and remove tripping hazards like area rugs to reduce falls and potential injury

Place medications in locked drawer and keep all cleaning products out of site and secure to        avoid misuse or poisoning

Use of adaptive equipment in the bathroom to avoid slipping and falling

Installing locks out of sight on doors to reduce wandering and getting lost

Use ambient music to reduce wandering and potential behaviors

As the disease progresses every person presents with different abilities and disabilities, environments and safety recommendations will need to be changed, staying in contact with the care team is essential.

For more personalized home safety tips contact your doctor, ask about an Occupational Therapy consult.

KEEP MOVING 

Continue to encourage participation in daily routines like dressing, bathing, light house hold tasks, hobbies, brain games and physical exercise to delay a functional decline.

By: Nenad Stojkovic

EDUCATION IS KEY 

Staying in contact with your care team is essential. Request an Occupational Therapy referral from your doctors to get specific in home recommendations and education.

Caregiver support groups are available, learn tips and tricks from trained professions and others that are going through a similar experience.  Both in-person and virtual support groups are offered. Click on the link provided to access further information on support groups and helplines in your area:

https://www.alz.org/events/event_search?etid=2&cid=0

https://alzfdn.org/afahelpline/

Great online resources for up-to-date information on Alzheimer’s and Dementia:

The Alzheimer’s Association https://www.alz.org

The CDC website https://www.cdc.gov/aging/aginginfo/alzheimers.htm

The American Alzheimer’s Foundation of America https://alzfdn.org/afahelpline/

References:

Alzheimer’s Association. (2022). Home. Alzheimer’s Disease and Dementia. Retrieved November 15, 2022, from https://www.alz.org/

Jensen, L., & Padilla, R. (2017). Effectiveness of Environment-Based Interventions That Address Behavior, Perception, and Falls in People With       

Alzheimer’s Disease and Related Major Neurocognitive Disorders: A Systematic Review. American Journal of Occupational Therapy, 71(5), 1–10. https://doi.org/10.5014/ajot.2017.027409

Piersol, C. V., Canton, K., Connor, S. E., Giller, I., Lipman, S., & Sager, S. (2017).                                   Effectiveness of Interventions for Caregivers of People With Alzheimer’s Disease and Related Major Neurocognitive Disorders: A Systematic Review. American Journal of Occupational Therapy, 71(5), 1–10. https://doi.org/10.5014/ajot.2017.027581

Smallfield, S. (2017). Supporting Adults With Alzheimer’s Disease and Related Major Neurocognitive Disorders and Their Caregivers: Effective Occupational Therapy Interventions. American Journal of Occupational Therapy, 71(5), 1–4. https://doi.org/10.5014/ajot.2017.715002

Type 2 diabetes is something that can be prevented based on your health and your lifestyle. 

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The CDC (Centers for Disease Control and Prevention) states that about 96 million US adults have prediabetes but more then 80% of those people are not even aware that they are pre diabetic.  In order to prevent patients from becoming a type 2 diabetic, lifestyle changes are required as well as regular doctor visits to stay on top of preventing this disease.

Symptoms for type 2 diabetes develop slowly so knowing what to keep an eye out for can help you catch the disease in its first stages.

These symptoms include:

• frequent urination
• sudden weight loss
• fatigue
• slowly healing cuts and wounds
• blurred vision
• increased thirst

Common causes of type 2 diabetes include: 

• family history
• obesity
• age (people above the age of 45 are at a higher risk)
• prediabetes
• gestational diabetes
• excess abdominal fat
• when your body becomes resistant to insulin, your cells are unable to absorb glucose and turn it into energy and as a result, the body becomes resistant of the insulin.

If you or your doctor are concerned that you may be prediabetic and susceptible to type 2 diabetes, test can be done to help diagnose the issue. Depending on your symptoms will depend on what tests are done to help diagnose the diabetes.

Unfortunately, there are no treatments for type 2 diabetes, that is why taking the right steps to prevent this disease from progressing are crucial. A healthy diet and controlling your blood sugar helps to manage the disease and the condition.

Prevention:

Not only maintaining a healthy lifestyle to help prevent the progression of type 2 diabetes, but plenty have studies have been done over the years to help educate patients on how maintaining a healthy diet can make a huge difference as well.

Plenty of foods have been proven to spike the diabetes such as foods high in fats, red meats, sugary drinks and foods as well as fried foods and high processed foods.

Sources:

Prevent Type 2 Diabetes | Diabetes | CDC

Type 2 diabetes: Symptoms, causes, diagnosis and treatments (msn.com)

Type 2 diabetes – Symptoms and causes – Mayo Clinic

http://Study Suggests Medical Errors Now Third Leading Cause of Death in the U.S. – 05/03/2016 (hopkinsmedicine.org)

A review headline on the Hopkins Medicine website read, “Study Suggests Medical Errors Now Third Leading Cause of Death in the U.S.” (Johns Hopkins Medicine, 2016). The review states that the study published by Johns Hopkins patient safety experts in British Medical Journals (BMJ) calculated that more than 250,000 people die yearly due to medical errors (Johns Hopkins Medicine, 2016). According to the CDC data, the estimated number placed medical errors at three among the leading causes of death. The report states that in the study published on BMJ, the Hopkins medical experts examined four research publications and data sources from 2000 to 2008. The researchers then based their conclusion on the hospital admissions rate in 2013, which recorded 35,416,020 hospitalizations. Of those hospitalizations, 251,454 deaths resulted from a medical error (Makary & Daniel, 2016), placing it behind cancer and heart disease.

Analysis

One of the most frequent medical errors is the myth that medical errors are the third leading cause of death, behind cancer and heart disease. Medical mistakes occur because of errors enabled by a healthcare system that needs improvement; some people have died or suffered severe injuries. However, the overestimation that medical errors are the third most significant cause of death in the United States has detrimental effects on healthcare. This idea originated from a British Medical Journals (BMJ) study. This study has been used to support British Medical Journals (BMJ). It supports academic journals, media reports, and quotes in popular movies and films. These reports have also been a common topic on social media, negatively impacting public trust regarding modern medicine and the healthcare system. Continue Reading⇒

Other Sources Placed The Number Of Deaths At 440,000

https://www.cnbc.com/2018/02/22/medical-errors-third-leading-cause-of-death-in-america.html

Another headline from an article on CNBC reads, “The third-leading cause of death in the United States most doctors do not want you to know about.” The report by Sipherd (2018) quotes the study by Hopkins’s medical experts “more than 250,000 people in the U.S. die every year from medical errors”. It adds that other sources place the number of deaths at 440,000. The author cites the case of Emily, a young girl whose death resulted from medical errors. The article implies that the number of deaths resulting from medical errors could be higher if the framework of collecting data on causes of death were revised. This should include medical error as the cause of death on the death certificate because the healthcare system is responsible for the deaths (Sipherd, 2018). Furthermore, he states that individuals are not to be blamed because, according to Chris Jarry, the hospital pharmacy had a staffing shortage, a malfunctioning pharmacy computer, and a backlog of doctor orders on the day Emily died of the fatal dose of Sodium Chloride.

Analysis

An attempt to disprove the claim that medical errors are the third leading cause of death in the United States can appear insensitive. Especially to the people who have lost their loved ones or have developed life-altering complications due to medical errors. However, such a claim, especially from generalizations and data assumed, is more harmful than beneficial to the healthcare system. According to Jonathan Jarry, a science communicator with the McGill Office for Science and Society, the study published on BMJ is the basis for all the claims that medical errors are the third leading cause of death (Jarry, 2021). However, Jarry argues that the paper published by the medical experts on BMJ was a review of previously published studies on the problem of medical errors. He adds that the experts arrived at their conclusion by using the findings from those studies and using them to conclude the data on hospitalizations in 2013. Therefore, the results derived from the decision cannot be trusted because a back-of-the-envelope calculation supports them. Benjamin L. Mazer, an assistant professor of pathology at Johns Hopkins University and a board-certified anatomic and clinical pathologist, supports the argument. He states that the methodology used to arrive at the conclusions in the study by Makary & Daniel (2016) “falls short of the rigor needed for such an important topic “Mazer (2019). He adds that there is a concern that the estimates presented in that study are inaccurate and absurd, and they encourage unnecessary distrust in the healthcare system. Another error made by Makary and Daniel in their paper is concluding findings from one group of patients to the general population. For example, they took the study’s conclusions by the Office of the Inspector General of the U.S. Department of Health and Human Services, which was carried out on Medicare beneficiaries aged 65 or older. They had disabilities or end-stage renal disease that required dialysis or transplant. Therefore, anticipating findings from this study and applying them to delivering mothers or stage four cancer patients presents inaccurate results. Jarry (2022) describes this as turning oranges into apples. Continue Reading⇒

People Are More Likely To Die While Seeking Treatment And Medicine

https://www.imdb.com/video/vi2400369945/?playlistId=tt7044362&ref_=tt_pr_ov_vi

The idea that medical errors are the third leading cause of death in the U.S. has also been adopted in television shows. In the first episode of “The Resident,” a medical television show. A nurse informs the young leading actor that medical errors are the third most common cause of death in the country after cancer and heart disease. Then she adds, “They don’t want us talking about that” (Holden et al., 2018). This claim implies that people are more likely to die while seeking treatment and medicine.

Analysis

This misinformation in the public discourse affects the public’s trust in the healthcare system. In addition, it provides bullets for supporters of unconventional medicines. Therefore, corrective action is needed to change this idea that has made its way into the public discourse. One of the ways to correct this is for the media to publicize positive information as much as they do negative news. For example, apart from the unreliability of the study by Makary & Daniel (2016). A different survey by Sunshine et al. (2019) showed that the number of deaths attributed to medical errors is lower than estimated attributed to medical errors. Moreover, this number has constantly been dropping. Therefore, approving media action is the way to change the general narrative that medical errors are the leading cause of death in the U.S.

References

Holden, A., Schore, H., & Sethi, R. (2018, January 21). The Resident [Episode 1]. Netflix. https://www.imdb.com/video/vi2400369945/?playlistId=tt7044362&ref_=tt_pr_ov_vi

Jarry, J. (2021, August 27). Medical error is not the third leading cause of death. Mcgill Office for Science and Society. Retrieved October 31, 2022, from https://www.mcgill.ca/oss/article/critical-thinking-health/medical-error-not-third-leading-cause-death

Johns Hopkins Medicine. (2016, May 3). Study suggests medical errors now third leading cause of death in the U.S. – 05/03/2016. Retrieved October 31, 2022, from https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_of_death_in_the_us

Makary, M. A., & Daniel, M. (2016). Medical error—the third leading cause of death in the U.S. BMJ, 353. https://doi.org/10.1136/bmj.i2139

Mazer, B. (2019, September 6). No, medical errors are not the third leading cause of death. Medscape. Retrieved October 31, 2022, from https://www.medscape.com/viewarticle/917696

Sipherd, R. (2018, February 22). The third-leading cause of death in U.S. most doctors don’t want you to know about. CNBC. Retrieved October 31, 2022, from https://www.cnbc.com/2018/02/22/medical-errors-third-leading-cause-of-death-in-america.html

Sunshine, J. E., Meo, N., Kassebaum, N. J., Collison, M. L., Mokdad, A. H., & Naghavi, M. (2019). Association of adverse effects of medical treatment with mortality in the United States. JAMA Network Open, 2(1), e187041. https://doi.org/10.1001/jamanetworkopen.2018.7041

Why is this discussion on obesity important?

Obesity is a public health issue that gets plenty of media attention (Ortega, F. B et al., 2018). From TV shows focused on weight loss (or lack of weight loss) to News clips covering the newest trends in weight loss, it seems everyone has an opinion. Body positivity is talked about often. However, there is not much conversation on how excess weight can or can not affect someone’s health. Being obese puts a person at risk for chronic disease and an early death. Being obese or overweight is a risk factor for:

• cardio-vascular disease (CVD)
• hypertension 
• Hyperlipidemia
• Sleep apnea
• Asthma
• Gastric reflux
• Depression
• Arthritis
• Joint disease
• metabolic syndrome
• diabetes
• cancer
• early death 

Is BMI a good measure of obesity?

A healthy BMI is in the range of 18.5 to 24.9. A BMI of 30 or higher is considered ‘Obese’. There is a belief that having a BMI within the normal range means being healthy. However, health professionals agree that using BMI as a measure of health is not most accurate. Two individuals with the same BMI can have very different body structure and different levels of physiological health (Pizzorno et al., 2017). Using a BMI alone does not distinguish between fat mass and lean mass (muscle mass). It was mentioned that using BMI exclusively could actually mask a normal weight individual with a higher fat mass. Measuring total body fat is the best way to determine obesity. Excess body fat is a more a causes more metabolic changes and is more closely correlated to risk factors. (Pizzorno et al., 2017).  Waist circumference and waist hip ratio are two other measurements that can help to define obesity. (Jin, K., 2022).

In a ‘Good Morning America’ interview, Dr. Jennifer Ashton addresses the Fat but Fit discussion. She agrees that BMI is not a perfect indicator for being in a healthy range. She mentions using waist circumference as a better indicator of health. Woman should be below 32 inches, men under 37. An indicator of good health that she mentions for any weight includes maintaining a high HDL (good cholesterol). Having a low carb diet, exercise, and some medications can help to obtain this.

Is there a difference between being obese and being obese and fit?

There are different classifications of obesity. Those who are metabolically healthy and obese have excess body fat, but are metabolically healthy. Their blood pressure is in a good range, they do not have any inflammation, their lipid levels are in range, and they do not have insulin sensitivity. Those who are metabolically unhealthy and obese are at a higher risk for diseases. They have a higher percentage of adipose and are metabolically unhealthy, including high insulin sensitivity and high blood pressure.  (Pizzorno, J. 2017).

In this ‘ABC News’ special, there are claims made that being obese does not mean you are unhealthy. The man in the interview claims that heavier people who workout, are healthier than a normal weight individual who doesn’t. They made comparisons to linebackers in the NFL. They made claims that a woman who is heavier, may be healthier than a size 2 due to reserve. This was said with the idea that reserve can help to fight a disease. Dr. Besser who spoke on the show, reiterated that increased weight usually means increase risk factors. He also has mentioned that having a low BMI also puts a patient at risk. No matter what weight you are, you should be fit.

‘Normal weight’

 Many believe that being a normal weight means being healthy. However, those with a normal weight who are unfit also have a higher risk for cardiovascular mortality. Several studies shown that normal weight unfit individuals could be at a higher risk than those who are obese and fit (Pizzorno, J., 2017). Many normal weight unfit individuals have higher risk of cardiovascular disease mortality than normal weight fit individuals. In addition, several studies have reported that normal- weight but unfit individuals could be at a higher risk than obese but fit individual. (Ortega, F. B. et al., 2018) Lean but unfit women had the highest risk for major adverse cardiac events compared to all the groups, suggesting normal weight might not be enough for cardiovascular health. Being fit plays an key role (Jin, K., 2022).

The heart of it ❤️

Many studies show that high levels of cardiorespiratory fitness might counteract adverse health consequences of obesity after adjusting some key potential confounders, which is referred as the ‘fat but fit’ phenomenon.(Jin K., 2022) The connection between obesity and cardiovascular disease is eliminated in those who exercise vigorously. Evidence suggests that a moderate to high cardiorespiratory fitness, may counteract the effects of obesity on health, especially in children. Exercise in obese individuals lowers the risk of cardiovascular disease. There is limited studies on the benefit from exercise interventions without weight loss (Ortega, F. B. et al., 2018). Increasing cardiorespiratory fitness, since it may attenuate the adverse effects of obesity on health (Ortega, F. B. et al., 2018). Eating a good ratio of omegas and fatty acids, doing high intensity workouts, and ridding the body of toxins can help lower the risk of disease in obese or unfit individuals (Pizzorno, J., 2017).

Also important to mention, there is a 50% reduction in the risk for developing depression in those who are fat and fit, compared to those who are fat and unfit. Having good physical fitness can counteract adverse effects like psychiatric disorders, cancer, heart rate, hepatic steatosis, brown adipose tissue volume, and brain structure and function (Jin, K. 2022).

A study examined by Jin, K. (2022), looked at the effects of physical fitness and obesity on 899 women with signs and symptoms of heart disease. Obesity was assessed by BMI, waist circumference, and waist–hip ratio. Fitness was measured by Duke Activity Status Index scores. Findings showed overweight-fit and obese-fit women had a lower risk of an adverse event compared to unfit women. Unfit women across all BMI groups were associated with higher risk for an adverse event.

One video goes  on to talk about the fit and fat conversation. He insists that obesity still is an independent risk factor. He claims that an obese and fit person is still more at risk than an average wight and fit person. There actually has not been enough studies to say whether or not this is true. Bottom line is, that if you are physically fit, you are less at risk than if you were not fit.

The take away 

Improving physical fitness and exercising regularly is beneficial to everyone. Improving cardiorespiratory fitness causes-long term health benefits. In regard to public health, healthy lifestyle interventions including a healthy diet and exercise should be considered for those who fall under the obese category. There should be more emphasis on cardiorespiratory fitness rather than weight loss (Ortega, F. B. et al., 2018). Interventions can include cardiovascular exercises such as swimming or a brisk walk. Let’s not forget, those who are in a healthy weight category who are unfit, should consider the same interventions. Cardiorespiratory fitness does in fact lower the risks of developing chronic disease in obese and non-obese individuals. Obese individuals who have good cardiorespiratory fitness, are in fact in better health than those who are normal weight with low cardiorespiratory fitness. You can be obese and fit.

References

 Burkhauser, R. V., & Cawley, J. (2008). Beyond BMI: the value of more accurate measures of fatness and obesity in social science research. Journal of health economics, 27(2), 519-529.

Jin, K. (2022). The fat but fit paradox: what do we know in women with heart disease. European Journal of Preventive Cardiology, 00, 1–3 https://doi.org/10.1093/eurjpc/zwac057

Ortega, F. B., Ruiz, J. R., Labayen, I., Lavie, C. J., & Blair, S. N. (2018). The Fat but Fit paradox: what we know and don’t know about it. British Journal of Sports Medicine, 52(3), 151-153. http://dx.doi.org/10.1136/bjsports-2016-097400

Pizzorno, J. (2017). Is Obesity a Disease?. Integrative medicine, 16(3), 8–11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419783/

By: Dino Olivieri

What is postpartum depression (PPD)?

Postpartum depression occurs after a woman gives childbirth and then experience powerful feelings of sadness, anxiety, and tiredness. PPD may occur within one to three weeks after giving birth. According to Guvenc et. al, the range of postpartum depression (PPD) is 6.9%-12.9% in high-income countries and more than 20% in some low- or middle-income countries (2020).

Recognizing PPD

• Severe mood swings
• Difficulty bonding with newborn
• Withdrawing from loved ones
• Loss of appetite or over consumption of food
• Excessive crying
• Fatigue/loss of energy
• Hopelessness
• Fearing you are not a good mother, feelings of worthlessness, guilty and inadequacy
• Thoughts of death, suicide, or harming yourself or the babyDiagnosis:

  Dr. Tracy Marks on her YouTube channel states that postpartum depression is apparent within the first 72 hours of giving birth. This is not always true. In a peer reviewed journal article written by Kirca & Adibelli, symptoms may appear 2-4 weeks after birth and may last up to 1 year (2021). Julie Lamppa, C.N.M, R.N. discusses how a mother can begin showing symptoms nine months to one year down the road in her lecture at Mayo Clinic. If you begin experiencing symptoms within one year after giving birth, you may have postpartum depression.

Time frame between baby blues vs postpartum depression:

An article published in the New York Times, by Tara Haelle, discusses the difference between baby blues and postpartum depression. Haelle focuses on distinguishing the difference by the time symptoms are experienced. Haelle mentions baby blues only lasts a few days which proves to be fiction. Mayo Clinic family medicine specialist Dr. Summer Allen distinguishes the difference between baby blues and postpartum depression – baby blues can last up to two weeks, therefore causing a misdiagnosis with postpartum depression.

Link to article: https://www.nytimes.com/article/postpartum-depression.html

Postpartum depression is NOT a red flag!!

LAW FM 103.9 posted on twitter that 1.5 million people suffer from postpartum depression in Nigeria, and they should join the discussion to learn about the “red flags” of postpartum depression. Postpartum depression is not a mothers fault, and should not be seen as a “red flag”. In fact, a peer reviewed journal by Mahurin-Smith & Beck indicates that 13% of 3.8 million women in the United States experience postpartum depression at no fault of their own. Postpartum depression is caused by genes, hormone changes, low thyroid levels, physical changes, and emotional issues – there are no “red flags” there!

If you believe you are experiencing postpartum depression – talk to your health care provider. Do not be ashamed, embarrassed, or scared to talk to your physician. Your physician CAN help you!

To reduce symptoms of postpartum depression: make healthy lifestyle choices, set realistic expectations (ask for help!!), make time for yourself, avoid isolation, and remember postpartum depression is NOT YOUR FAULT!

* Skin-to-skin contact (SSC) is an effective method to promote mother-infant bonding and reduce the chances of developing PPD (Kirca et. al, 2021).

*Self-compassion and breastfeeding success may decrease the likelihood a mother develops PPD. Mothers who have a hard time breastfeeding their newborns may judge themselves harshly, contributing to the development of PPD (Mahurin-Smith & Beck, 2022). If you are having a hard time breastfeeding your newborn, you are NOT alone. Reach out to your physician for support.

By: notnef

***Remember: Postpartum depression is NOT your fault! Postpartum depression does NOT make you a bad mother. YOU ARE NOT ALONE.

Help lines:

Postpartum Support International – Call: 800-944-4773 or Text: 800-944-4773

SAMHSA National Helpline – Call: 800-662-4357

References

Guvenc, G., Yesilcinar, İ., Ozkececi, F., Öksüz, E., Ozkececi, C. F., Konukbay, D., Kok, G., & Karasahin, K. E. (2020). Anxiety, depression, and knowledge level in postpartum women during the COVID‐19 pandemic. Perspectives in Psychiatric Care, 57(3), 1449–1458. https://doi.org/10.1111/ppc.12711

Haelle, T. (2020). Postpartum Depression Can Be Dangerous. Here’s How to Recognize It and Seek Treatment. New York Times.

Help for Moms. Postpartum Support International (PSI). (2022, May 20). Retrieved November 15, 2022, from https://www.postpartum.net/get-help/help-for-moms/

Kirca, N., & Adibelli, D. (2021). Effects of mother–infant skin‐to‐skin contact on postpartum depression: A systematic review. Perspectives in Psychiatric Care, 57(4), 2014–2023. https://doi.org/10.1111/ppc.12727

Mahurin-Smith, J., & Beck, A. R. (2022). Self-compassion may protect against postpartum depression and anxiety. Breastfeeding Review, 30(2), 27–35.

Mayo Foundation for Medical Education and Research. (2022, May 24). Postpartum depression. Mayo Clinic. Retrieved November 15, 2022, from https://www.mayoclinic.org/diseases-conditions/postpartum-depression/diagnosis-treatment/drc-20376623

Postpartum depression. March of Dimes. (n.d.). Retrieved November 15, 2022, from https://www.marchofdimes.org/find-support/topics/postpartum/postpartum-depression

Prevent Falls At Home

By: US CPSC

Statistics 

Every year, 1 in 4 adults over the age of 65 experience a fall, and it is estimated that 2.8 million older adults require hospitalization as a result of a fall (Elliott & Leland, 2018). Falls can result in hip fractures, traumatic brain injury, and a limitation in performing daily living tasks (Elliott & Leland, 2018).

Risk Factors

Through univariate analysis, systematic reviews, and meta-analysis evaluation, Bradley (2011) explains that the risk factors for falls in older adults include lower extremity muscle weakness, history of prior falls, vision problems, arthritis, cognitive impairment, impairment in strength, depression, being older than 80 years old, polypharmacy, gait, and balance impairments. Other fall risk factors include using assistive equipment and difficulty performing daily living activities (Lyons, 2005).

What To Do In Order To Prevent Falls In The Home?

By: Jacob Edward

Multicomponent and Multifactorial Interventions That Can Be Used To Prevent Falls 

• There are also multicomponent interventions that older adults can participate in order to prevent falls such as tai chi, taking vitamin D supplements, withdrawing from psychotropic medications, and opting for early cataract surgery (Bradley, 2011).
• Additionally, Bradley (2011) stated that there are multifactorial interventions that older adults can do including assessing medications, addressing vision problems, managing orthostasis, changing the environment, and training in balance, strength, and gait, which will all help prevent falls.

Exercises Designed To Help Improve Fall Prevention 

Fall risk can be decreased by managing medications, making home modifications, and exercising every day. Make small steps each day to create life-changing effects.

References

Bradley, S. M. (2011). Falls in Older Adults. Mount Sinai Journal of Medicine, 78(4), 590–595.
https://doi.org/10.1002/msj.20280

Elliott, S., & Leland, N. E. (2018). Occupational Therapy Fall Prevention Interventions for
Community-Dwelling Older Adults: A Systematic Review. American Journal of
Occupational Therapy, 72(4), 1–11. https://doi.org/10.5014/ajot.2018.030494

Fluid Health and Fitness. (2019, November 11). Fall Prevention – Designed to Move [Video]. YouTube. https://www.youtube.com/watch?v=fyd_WAzCm0o

H2Health. (2022, September 8). Fall Prevention [Video]. YouTube. https://www.youtube.com/watch?v=ZpvCxfFBXCc

Lyons SS. (2005). Evidence-based protocol fall prevention for older adults. Journal of
Gerontological Nursing, 31(11), 9–14. https://doi.org/10.3928/0098-9134-20051101-05

When the conversation about vaccinations comes up, many people have different opinions. Some individuals do not believe in vaccines and believe they cause more harm than good, while others think vaccines are necessary and reduce the risk of disease and illness. There have been many myths regarding vaccines making their way through social media, and it is easy to buy into what others say. Educating all individuals is key to ensuring families have the correct information to make an educated decision.

Myth#1: Vaccinations cause autism

A study done in the 1990s said MMR (measles, mumps, and rubella) vaccine caused autism. This study caused a massive uproar among many parents who refused to vaccinate their children. It was later found that this study was false, and all of the co-authors withdrew their support, and the medical journal that published the study has since retracted the article. Since 2003, Many funded studies by the CDC have been conducted. The CDC has not found any link between autism and vaccines in their studies.

Learn more about the ingredient thought to have caused autism at:  CDC Studies on Thimerosal in Vaccines

Myth# 2: Vaccinations have significant side effects

Vaccinations can have side effects, but these side effects are very mild and only last 1-2 days. Side effects of vaccines include:

• fever
• irritability
• tenderness, and swelling at the injection site.

These side effects are nothing compared to the seriousness of contracting a preventable disease such as polio, tetanus, and Diphtheria.

Myth#3: Vaccinations are full of harmful toxins

Every vaccine ingredient has a purpose

1.Provide Immunity

2. Keep vaccines safe and long-lasting

3. Make vaccines more effective

The FDA (food and drug administration) is responsible for testing and monitoring vaccines and their ingredients to ensure vaccines are safe and effective. Every ingredient has its purpose, and each ingredient is rigorously tested. Once a vaccine is put out into the world (after completing all three clinical trial phases), the vaccine continues to be monitored for adverse events. A Vaccine Adverse Event Reporting System (VAERS) track adverse events. Anyone can use this tool to report any adverse event believed to be caused by a vaccine. The reporting system helps health officials act promptly when a pattern of adverse events occurs (Correll, 2022). The FDA will also routinely inspect plants where vaccines are being made to ensure the facility is up to code and to review batches to verify that they are potent, pure, and safe (Correll, 2022)

For more information about the ingredients in vaccines and what they are used for, click the link below.

Vaccine Ingredients: What you should know | The Vaccine Education Center at The Children’s Hospital of Philadelphia (wyo.gov)

Myth#4: Vaccinations do not work

According to an educational article by Mass General, The Benefits of Childhood Vaccines (2022), nine out of ten children who get vaccinated will not contract the disease the vaccine protects against. As you can see from the picture below, vaccinations have successfully stopped the spread of deadly diseases that once plagued the world. The blue column depicts the number of cases five years before the vaccine was created, and the yellow column depicts the number of current cases. If children stop getting vaccinated, those deadly diseases that once ran ramped will return, causing several children to lose their lives or be left with a lifetime of pain.

Immunizations are the best protection we can give our children against disease.

Vaccinations protect our vulnerable children and the elderly, and other individuals who cannot get vaccinated. Children should be vaccinated to stop the spread of disease and prevent the return of a disease that is no longer common. Parents should be educated on the risks and benefits of vaccinations, so they feel comfortable getting their children vaccinated.

References

CDC. (2021, December 1). Autism and vaccines. Centers for Disease Control and Prevention. Retrieved November 14, 2022, from https://www.cdc.gov/vaccinesafety/concerns/autism.html

CDC. (2022, July 14). What’s in vaccines? ingredients and vaccine safety. Centers for Disease Control and Prevention. Retrieved November 14, 2022, from https://www.cdc.gov/vaccines/vac-gen/additives.htm

Children’s Hospital of Philadelphia. (2022). VACCINE INGREDIENTS: WHAT YOU SHOULD KNOW. Children’s Hospital of Philadelphia, 4. Retrieved November 14, 2022, from https://health.wyo.gov/wp-content/uploads/2020/05/Vaccine-Ingrediants-CHOP.pdf.

Correll, R. (2022, October 7). The safety and science of Vaccine Ingredients. Verywell Health. Retrieved November 14, 2022, from https://www.verywellhealth.com/vaccine-additives-and-preservatives-2633691

Madhavan, V. (2022, November 2). The benefits of childhood vaccines. Massachusetts General Hospital. Retrieved November 6, 2022, from https://www.massgeneral.org/children/primary-care/benefits-of-childhood-vaccines

McMaster University. (2017). Vaccines and Autism: Medical Myth. YouTube. Retrieved November 14, 2022, from https://youtu.be/goRZrmuoMT4.

UChicago Medicine. (2020). How does the Fda approve vaccines? . YouTube. Retrieved November 14, 2022, from https://youtu.be/ZKGn6VqVOmQ.

By: Michael Havens

What is Alzheimer’s Disease?

Alzheimer’s Disease is a disease within the brain that affects memory, behaviors, and one’s ability to make decisions. Alzheimer’s Disease falls under the dementia umbrella, therefore meaning that there are many different subtypes. According to the Alzheimer’s Association, Alzheimer’s Disease is “…the most common cause of dementia…which accounts for 60-80% of dementia cases”. (Alzheimer’s Association, 2022) Unfortunately, Alzheimer’s Disease is progressive and currently there is no cure.

What can you expect from Alzheimer’s Disease? 

According to Agronin (2015), early symptoms of Alzheimer’s Disease include “memory impairment, mild lapses in language (using the wrong word or having trouble finding the right word), recognition (for example, forgetting names or how to get somewhere), organizational skills, and sometimes personality”. (Agronin, 2015). Eventually over time, Alzheimer’s Disease will continue to progress and worsen over the course of years. Agronin (2015) also shares that “by eight to twelve years into the illness, nearly all cognitive skills are so severely impaired that a person is not able to be left alone and becomes totally dependent on caregivers for help” (Agronin, 2015). Individuals who progress in their Alzheimer’s Disease will eventually require a 24/7 level of care, therefore continuing to put a lot of stress on caregivers around the world.

What can we do to prevent caregiver burnout?

Caregivers around the world play a very important role in providing constant care for a loved one when they need it most. Although this role is essential when caring for someone with Alzheimer’s Disease, it is a very difficult one as well. What are some strategies that we can provide caregivers on ways to prevent burnout? 

• • Include the individual in their own decision making. According to Macquarrie (2005), “…people in the early stages of Alzheimer’s Disease demonstrated a variety of ways they acknowledged their disease…” (Macquarrie, 2005). Therefore, we need to include “the Alzheimer’s Disease person in making decisions as appropriate” (Macquarrie, 2005).

• • Take a break! In a study conducted by Mahanta and Sobhana (2021), they found that “the long hours of caregiving can have negative impacts…” (Mahanta and Sobhana, 2021). It is essential that caregivers find time for themselves by “distributing responsibilities among family members” (Mahanta and Sobhana, 2021). 

• • Take care of yourself too! Although you are responsible for someone else, it is important that you remember to take care of yourself too. Pereira et al. (2021), found that “…role strains and stressors” had an impact on caregivers’ overall quality of life. Pereira et al. (2021), also shares that “Primary health care should also include regular medical appointments to assess caregivers’ psychological distress as the patients’ disease progresses and provide training skills to promote caregivers quality of life, over time” Pereira et al. (2021). 

Remember, you play a very important role. It is very important that one takes the necessary steps to prevent caregiver burnout, before it becomes too much to handle. You are not alone!

References

Alzheimer’s Association. (2022) What is Alzheimer’s Disease? https://www.alz.org/alzheimers-dementia/what-is-alzheimers

Agronin, M. E. (2017). The Dementia Caregiver: A Guide to Caring for Someone with Alzheimer’s Disease and Other Neurocognitive Disorders. United Kingdom: Rowman & Littlefield Publishing Group, Incorporated.

Macquarrie, C. R. (2005). Experiences in early stage Alzheimer’s disease: Understanding the paradox of acceptance and denial. Aging & Mental Health, 9(5), 430–441. https://doi.org/10.1080/13607860500142853

Mahanta, S., & Sobhana, H. (2021). Lived experiences of caregivers of persons with Alzheimer’s disease. Indian Journal of Positive Psychology, 12(2), 136–140.

Pereira, M. G., Abreu, A. R., Rego, D., Ferreira, G., & Lima, S. (2021). Contributors and Moderators of Quality of Life in Caregivers of Alzheimer’s Disease Patients. Experimental Aging Research, 47(4), 357–372. https://doi.org/10.1080/0361073X.2021.1895594

by: Reagan Greenwood

WHAT IS DEMENTIA

Dementia is a global health issue and it is an increasingly common health condition among the elderly. Dementia causes a decline in memory, an increase in behavioral problems, loss of initiative,  loss of participation in social activities, and the ability to independently perform daily activities. Further, neuropsychiatric symptoms like agitation and depression coexist in these patient populations, causing more functional difficulties for patients and caregivers. Although medication is available for the treatment of dementia, its potential value is limited, particularly for non-cognitive outcomes. It is especially important during periods of disorganization, distress, and depressed mood frequently experienced due to the diagnosis. Non-pharmacotherapeutic interventions like Music Therapy may be linked to better results.

SYMPTOMS AND TRIGGERS OF DEMENTIA  

-crying                                                                           -fatigue

-pacing                                                                          -hallucinations

–screaming                                                                    -urinary tract infection

-swearing                                                                       -feeling defensive

-getting upset                                                                -feeling misunderstood

-repeating words, phrases, or questions                   -fear

-repetitive movements                                                 -pain

-try to leave the house or room                                  -stress

-aggressiveness                                                              -sudden change in routine

–emotional distress

by: lolivia

Having a creative outlet for expression is crucial for people with dementia. It encompasses a variety of behaviors such as aggressiveness, restlessness, repetitive acts, and wandering. These troubling symptom increases the psychological burden among these patients, and it reduces the chance of positive social connections between society. With incidence rates ranging from 25% to 80%, neuropsychiatric symptoms like agitation, depression, and wandering frequently coexist in individuals with dementia. Helping older adults with these symptoms is a constant problem for nursing facilities. Agitation is one of the most difficult symptoms to manage and affects 20% of nursing home residents. Agitation in dementia has a negative and taxing effect on all people involved with this degenerative disease. The patients themselves, family members/caregivers, and staff are all negatively affected and emotionally drained.

WHAT IS MUSIC THERAPY

Music therapy has been defined as a “controlled use of music and its influences on the human to aid in the physiological, psychological, and emotional integration of the individual during the treatment of illness or disability.” (Monroe and Mount 1978). Music therapy can be divided into active participation (singing, playing an instrument, dancing, and movement) and passive participation (listening). There are several different modalities; songwriting, listening, relaxation exercises, discussing music lyrics, singing, dancing, recording the music or creating a video, and learning or playing an instrument. A variety of exciting, pleasurable activities can enhance the well-being of nursing home patients. Studies have revealed that music therapy improves self-esteem in dementia patients, boosts their sense of independence, and lessens their social isolation. Therefore, it is possible that there is an impact of music therapy that delivers greater engagement than conventional or daily activities. 

“NEGATIVES” OF MUSIC THERAPY

Some studies are unable to pinpoint the special clinical benefit of music therapy in reducing agitation. This could be for a variety of reasons. For example, the tone and mood of music have a direct impact on alleviating symptoms. In one study, during a classical music therapy session,  patients were negatively affected due to overstimulation which resulted in agitated behavior. Therefore the results were recorded as negative. This is an example of data being incorrectly translated. Due to the type of music played for the patients a negative effect was seen. This does not mean that music therapy in itself is negative. It also has been demonstrated that the benefits of the music intervention are transient and disappear shortly after the sessions are over. The absence of meaningful results is hard to prove or disprove because follow-up studies are so rare.

POSITIVE EFFECTS OF MUSIC THERAPY

In the video below, several researchers have found home care residents with Alzheimer’s disease displayed signs of memory recall after letting the patients play the piano. The researchers go on to provide an overview of how music therapy can have therapeutic benefits since it unlocks memories and emotions which can go hand in hand during treatment. Compelling evidence highlights the positive effects of music therapy on the brain. The music and language in songs affect the right hemisphere and limbic system of the brain, which then increases neurological activity. Listening to music stimulates the hypothalamus and prefrontal cortex sections of the brain. Familiar music may also prompt motor activity and memory recall by forming new pathways in the brain.

As dementia worsens, nurses and care professionals must take action to maintain a safe quality of life. Music therapy positively affects patients, families, and caregivers. The intervention is being used more frequently as a drug-free alternative for people with dementia and their families or caretakers. The use of music therapy to treat typical dementia symptoms is becoming more and more common. Music therapy can be effective for treating agitation in moderate to severe dementia patients and is a valid alternative to pharmacological methods. Further research would be beneficial to understand how music therapy can assist people with dementia who are agitated. 

by: Maddie Meyer

ONLINE RESOURCES

Center for Disease and Control: https://www.cdc.gov/aging/dementia/

Alzheimers Association: https://www.alz.org/alzheimers-dementia/

American Music Therapy Association: https://www.musictherapy.org/

References:

Chu, H., Yang, C. Y., Lin, Y., Ou, K. L., Lee, T. Y., O’Brien, A. P., & Chou, K. R. (2013). The Impact of Group Music Therapy on Depression and Cognition in Elderly Persons With Dementia. Biological Research For Nursing, 16(2), 209–217. https://doi.org/10.1177/1099800413485410

Hanne Mette O. Ridder, Brynjulf Stige, Liv Gunnhild Qvale & Christian Gold (2013) Individual music therapy for agitation in dementia: an exploratory randomized controlled trial, Aging & Mental Health, 17:6, 667-678, https://doi.org/10.1080/13607863.2013.790926

Melissa Brotons, Patricia K. Pickett-Cooper. (1996). The Effects of Music Therapy Intervention on Agitation Behaviors of Alzheimer’s Disease Patients, Journal of Music Therapy, 33(3) 2–18. https://doi.org/10.1093/jmt/33.1.2

Sky News. (2022, September 3). Music Therapy May Help Dementia Patients. Youtube. https://youtu.be/Uu8A1d7bX1Q 

Wall, M., & Duffy, A. (2010). The effects of music therapy for older people with dementia. British journal of nursing (Mark Allen Publishing), 19(2), 108-113. http://doi.org/10.12968/bjon.2010.19.2.46295