A Gentle Approach to Dementia for Care Providers

dementia-patient

When I first became a hospice social worker, I was stunned to realize more than half of my patients were diagnosed with advanced dementia. I had been under the assumption that I would be working with mostly people with cancer or other chronic illnesses such as Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure (CHF). While many of my patients have suffered from those maladies in the latter category, the prevalence of dementia is rather high. After seven years as a social worker “in the trenches,” I would have to learn a whole new skill set if I was to survive and thrive in hospice.

Most of these patients eventually end up in nursing facilities as the burden of their care becomes too great for family members to keep them at home. In visiting such facilities, I have came to find that many more people than just those in hospice were in various stages of dementia. It is a fascinating phenomenon with several different causes, but I have developed my own way of working with these individuals based on their current level of capability to engage interpersonally. As a result, I have identify several areas of concern regarding the treatment elderly patients receive from care providers and other medical professionals.

Aside from the ways dementia affects different people on a physical level which can include the ability to ambulate, muscle contraction, etc., the mental symptoms can range from extreme forgetfulness to devastating interpersonal impairment. Some of the most pleasant conversations of my day are sincerely answering the same three questions over and over again for an hour with the same patients, but they have little to no short term memory.

I have also spent a lot of time in constant redirection and assurance with people that can no longer recognize relatives with whom they have spent the last eighty years. I have seen these individuals coddling realistic looking baby dolls as part of their care and have played music for people that are nearly catatonic, only to watch their bodies come alive with movement at the faint and automatic memory of their favorite songs, something that blessedly seems to remain long after their ability to speak has faded. I have heard ninety year old patients insist that their mother had just been to visit them or that their young children were running around the facility.

The common thread with which I approach these wounded patients is a measured gentleness that preserves their dignity and, to the greatest possible degree, facilitates their comfort in the immediate moment. For most of these people the present moment is all they have. Thus my preferred method is to redirect them in conversation and to by no means challenge their obviously factually incorrect assertions with harsh reality.

If an elderly woman whose mother has obviously passed insists that she must know when (her mother) will be visiting, I will respond that she’ll probably be around later. I have witnessed facility nurses and aides confronting such patients with the fact that their mother will not be visiting because “she’s dead,” repeating this every time the person asks. I will just as gently take such workers aside and explain that they are effectively breaking the news of the death of a patient’s loved one several times a day, each instance with its own accompanying trauma.

Another of my concerns is when I see people with dementia being treated like children because “they don’t know any better.” Almost every culture in the East has, currently or at some time in their history, had a practice of revering their elders simply for the fact they have lived longer and accrued more life experience than most.

Watching people with little wisdom earned through the kind of adversity their patients have faced treat said individuals as mere nuisances to be quieted makes me sad to say the least. I labor under the belief that my patients are people, whether they be completely lucid and able to participate in conversation or if they are unresponsive. As such, I also believe that each of these persons have the right to my full presence and attention and that, while their minds may have been rendered functionally impaired, their spirits are perfectly intact and engaging with mine. In short, I am no better than these people just because my mind is still functional.

Lastly, watching the pain endured by the family members of such patients is nearly unbearable. They faithfully and dutifully make their regular visits in the vain hope that they will see even the briefest signs of recognition in the eyes of their loved ones, only to inevitably leave disappointed and heartbroken. They deserve to know that their family members are being treated with the highest level of respect and dignity and with a kindliness and gentleness reserved for the most vulnerable amongst us.

Please keep these concerns in mind the next time you encounter a person with dementia. They are locked in a special kind of hell that I hope you and I will never have to experience.

North Carolina Legislators Heading Towards Adjournment, Week 6 Recap

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Legislators are still going back and forth on an adjournment date, but our latest predictions are that legislators will go home by the second week of July if they are not done the week of July 4th. With a lot of controversial bills still on the table and not having reached an agreement on the budget yet, legislators have a lot more work to do before adjourning for the year. It is possible for legislators to leave with the current budget in place that was passed in the 2013 long session and only make a few adjustments to cover the shortfalls in Medicaid and the Department of Revenue.

Week 6 of the short session started off with a new regulatory reform bill that created controversy for many House members that did not see the bill until shortly before it was presented. Legislators commented that their uneasiness with the bill stemmed from the bill being more than just regulatory reform and included other provisions. This uneasiness slowed down the bill and it was sent back to the Regulatory Reform Committee before going to the floor. Additionally, on Wednesday night, House Health and Human Services Committee members introduced a new Medicaid Reform plan that makes big changes for provider payment and certain I/DD clients in Cardinal Behavioral Health’s catchment area. More information about these two bills is below.

Relevant bills with action:

  • HB 712 Clarifying Changes/Special Ed Scholarships: This bill allows $3,000 for eligible students with disabilities per semester to attend private schools and exempts certain private schools from child care licensure requirements. The exemption is extended to private schools that provide more than 6.5 hours of child care as long as they are not funded by childcare subsidies or NC Pre-K. This may open the door for more private schools to offer after school care knowing they do not have to be licensed and meet certain state requirements for health and safety. The bill passed the Senate and was sent back to the House.
  • HB 1181 Partnership for a Healthy North Carolina: This bill addresses a new Medicaid Reform plan. The plan would set provider capitation rates over the next 5 years instead of fee for service. This would make providers responsible for overspending but also allows them to absorb any savings. Section 10 of the bill directs Cardinal Behavioral Health to pilot integrated care, physical and mental health care, with certain I/DD clients living in group settings. This bill is supported by the Governor. It was discussed in committee this week and referred to Appropriations. Read more about this plan and House and Senate differences on Medicaid.
  • HB 1220 Hope 4 Haley and Friends: This bill establishes standards for the use of hemp oil extract from marijuana plants to be used for people suffering from intractable seizure disorders when no other medicines have worked. The bill sets up a registry of neurologists who prescribe the extract, caregivers, and patients. The bill also encourages UNC Chapel Hill, Duke University and Wake Forest University to further study the use of hemp oil extract. The bill passed the House and was sent to the Senate.
  • HJR 1262 Suicide Prevention Resolution: This bill directs the Legislative Research Commission to examine ways to prevent suicide among minors and veterans in NC as suicide in these populations more prevalent. The bill directs the commission to study evidenced-based treatment and prevention strategies and ways to engage and train professionals who work with minors and veterans. It was assigned to the Committee on Rules, Calendar, and Operations of the House.
  • SB 493 2014 Regulatory Reform Act: This bill makes several changes but the biggest for social workers is that it would direct insurance companies to cover autism services and allows for reimbursement of licensed clinical social workers to provide therapeutic care. This is the language from House Bill 498, supported by NASW-NC, that passed the House in the 2013 long session. The bill also establishes a board for Behavioral Analysts in NC (there is currently no state level licensing board for behavioral analysts). Additionally, the bill prohibits tanning bed use for minors under the age of 18. The bill is going through House committees at this time.
  • SB 761 Credit for Military Training: This bill enhances the effectiveness of military members and veterans obtaining occupational licenses and directs the Board of Governors for the University System and the State Board for Community Colleges to submit a plan that would grant college credit for students with military training. The bill passed the Senate and will be sent to the House.

Budget Conferees:

The Senate voted not to concur with House budget changes last week and a conference committee was established. The 41 member appointed committee is compromised mostly of appropriation chairs that will work to flush out the details and other influential legislators. Only one Democrat was appointed to the committee that will work to combine the House, Senate and Governor’s budgets. No persons of color were appointed. Legislative staff released a Comparison Report of the differences in the House and Senate budgets.

Another Harm Reduction Perspective: An Interview with Walter Cavalieri from the Canadian Harm Reduction Network

The Canadian Harm Reduction Network is a virtual meeting place for individuals and organizations committed to reducing the social, health and economic harms associated with drugs and drug policies. The network was established in 1999 by a group of activists committed to improving the lives of people struggling with drug use, and Walter Cavalieri is the director of the organization.

The Canadian Harm Reduction Network is a virtual meeting place for people to exchange ideas and information. The network has been engaged in recent research, presentations and the media. Essentially the Canadian Harm Reduction Network wants to change the world to make it better, kinder, and a more evidence-based place.

The Canadian Harm Reduction Network has a Facebook page and a Twitter account. The Canadian Harm Reduction Network has also taken part in media studies looking at what harm reduction looks like internationally, rather than only what it looks like in Vancouver, Toronto and Montreal.

Photo-Podcast-16-Walter-Cavalieri
Walter Cavalieri

Walter worked in professional and academic theatre for over 20 years. However, he eventually began to become more in touch with his pursuit to improve individuals’ lives and make the world a better place. Therefore, he began to volunteer at the LGBTTQA counseling centre at the time and his work with the counseling centre became more interesting than any area of theatre work that he engaged in. Walter then went back to school and obtained his Bachelor of Social Work degree and resided in Toronto. During his initial involvement in Toronto, he began to work with children living on the street, that were surviving through drug use.

His initial response to children using drugs was telling them to stop using drugs; however, he began to explore alternatives to this view on drug use. He began to work with the children and discovered the drugs were often used as a coping mechanism for trauma. Walter also began to work with adults and opportunities for a needle exchange were established. He then attended a harm reduction conference in Toronto and realized that harm reduction should be very important in reducing the harm of drug use in Toronto. Thus, Walter helped to establish the Canadian Harm Reduction Network in 1999.

SWH: What does harm reduction mean to you?

Harm reduction means very simply “ending suffering and saving lives”, which is a slogan from Chicago Recovery Alliance. Therefore, whatever harm reduction does, it helps individuals who may be engaging in harmful behaviour move forward and make small incremental changes and improvements in their lives. The client is considered to be the expert and the service provider learns just as much from the client as the client learns from the service provider in order to facilitate less harm in the client’s life.

SWH: How easy is it to get funding for research in harm reduction?

Funding for drug research is very hard to come by. Harm reduction has a very close relationship with AIDS, but drug research needs to be expanded. Much of the funding comes from pharmaceutical companies, as those companies are often interested in drug research. However, it is very difficult to get funding for the health of people on the street or the harm that is coming from injecting. It is also difficult to obtain funding for this research because the government is not interested in harm reduction’s effects on drug use. The government does not like people who take drugs because it isn’t fashionable and does not play to their base.

SWH: Why are harm reduction approaches so controversial?

Harm reduction is done naturally to protect society, children, loved ones, families and communities. For example, children are taught to look both ways before crossing the street. Harm reduction is very intuitive, but keeps humanity’s best interest at heart. The stigma against people who use illicit or licit drugs (ie. prescription or over-the-counter medication) is huge and it’s fostered in official propaganda. Drugs are a dangerous substance to use badly. Instead of raising awareness and educating people to reduce the harm of drug use, the world is trying to induce fear on drug users and potential drug users. However, fear doesn’t always work.

SWH: What is the difference between a harm reduction based program and a 12-step program?

Harm reduction is more than individual treatment. As Dr. Gabor Mate would say, ‘everyone who is addicted to drugs has a history of early trauma’, then we need to address early trauma. However, individuals who have been experiencing life on the street for two to three years are continually being re-traumatized on the street. Many people who live on the street for many years have a limited chance of leading a drug free life because the drugs work for them in hiding the physical and emotional pain and trauma that they must cope with in their lives. What right do we have to say to a person that they cannot take away a painkiller and leave them to suffer, we are not sure that we have that right.

There are many ethical dilemmas in working with people who are struggling with drug and alcohol use that are insoluble. Thus, harm reduction is different than an abstinence-based or 12-step program because there is not one way to reduce harm (ie. remaining abstinent) but many ways. Harm reduction is very much based on an individual’s needs, temperament and goals; therefore, it can include abstinence; however, abstinence does not work for everyone. Harm reduction may not witness the solution as quick; however, the solution will most likely become apparent over time. However, since substances are illegal, it is very difficult to receive support for harm reduction practices. Thus, it is much easier to gain support for moderation management with alcohol and/ or cocaine.

SWH: What stage is Canada at for receiving government support for harm reduction?

The federal government still opposes harm reduction. However, on a province-to-province basis, there is some hope. However, funding is always difficult even for the provinces, but at least the provinces are discussing and brainstorming ideas regarding how harm reduction can be implemented. However, it has become increasingly more difficult to get support for harm reduction at the provincial level as grant funding for harm reduction has become more difficult to acquire. Many organizations have relied on city grants to fund harm reduction outreach programs, which is an integral aspect of harm reduction.

SWH: Do you think Canada is further ahead than the United States in harm reduction?

Canada is ahead of the United States in terms of harm reduction; however, Canada should be much further ahead than it appears to be. If you take a close look at harm reduction in the United States, there are at least 17 states that have Good Samaritan laws. Therefore, in some ways Canada is further behind the United States. Canada has led needle exchange programs and crack kit distribution; however, these programs and resources need to be further administered in both Canada and the United States. In addition, the United States has very solid activist groups that are dedicated to making a difference and advocating for harm reduction, which do not exist in Canada.

For more information please visit the Canadian Harm Reduction Network’s website at .

Harm Reduction Defined

Harm reduction seeks to maintain people’s safety and minimize death, disease and injury from high-risk behaviour. The reduction of harmful consequences can be associated with drug use or other risky health behaviours. Thus, harm reduction can be used to decrease harmful illicit drug use or prostitution. The main goals of harm reduction are supported by social justice and empowerment theory, as harm reduction allows people to make autonomous decisions, but it also addresses the inequalities and stigma that individuals who take part in risky behaviours experience in the community.

Harm reduction functions on a continuum with prevention and education on one side and enforcement on the other. The criminal justice apparatus cannot fix many health issues that result in risky behaviour; thus, harm reduction advocates for prevention, treatment and other healthcare services. However, critics of harm reduction often believe that tolerating these behaviours can represent an acceptance of these behaviours as acceptable in the community.

Drug Use

hr saves livesHarm reduction respects that people who use drugs will not always abstain from using drugs. Thus harm reduction strategies include needle and crack pipe distribution programs, supervised injection facilities, methadone replacement therapy, heroin maintenance programs and naloxone distribution. The primary function of needle and crack pipe distribution programs and supervised injection facilities is to provide clean needles to decrease the risk of abscesses, damage of veins, syringe sharing, HIV/HCV infections and fatal overdoses.

Methadone replacement therapy reduces harmful effects of opiates by substituting an opiate drug with an oral prescription, which eliminates the need to inject. In addition, if administered properly, individuals will not experience withdrawal symptoms and cravings. In heroin maintenance programs, people are provided with medical prescriptions for pharmaceutical heroin so that heroin-dependent individuals can use heroin in controlled environments.

Evidence has suggested that these programs can improve the health and social circumstances of participants, while also reducing costs incurred by criminalization, incarceration and health interventions. Naloxone distribution is used to counter overdose effects of opioids such as heroin or morphine overdose. The World Health Organization indicates that naloxone is one the most “essential medicines” and recommends its availability and usage. Harm reduction programs and practices help drug users develop awareness and education regarding safer drug use practices. Harm reduction programs also provide easy access to addiction counselling as drug addicts are often in contact with drug programs, social workers and healthcare staff, which can evidently lead to discontinuation of drug use as well.

Alcohol-Related Programs

The HAMS harm reduction network encourages goals for safer drinking, reduced drinking, moderate drinking and abstinence. Thus, harm reduction provides education to individuals on alcohol consumption, but allows individuals to make their own choices. In addition, the dangers of drinking and driving have also been analyzed and designated drivers or free taxi programs are used to reduce the occurrences of drunk driving accidents.

Tobacco

Harm reduction to reduce tobacco consumption takes action to lower the health risks associated with using tobacco, without engaging in abstinence from tobacco and nicotine. Such methods may include switching to lower tar cigarettes or using a non-tobacco nicotine delivery system. In addition, although discontinuing the usage of all tobacco products is encouraged, many individuals are unable or unwilling to be abstinent; thus, harm reduction can provide many benefits to these individuals.

Sex

Safe Sex
Many schools have committed to pre-teen and teen students who may be sexually active. Since teenagers may have sex, a harm reduction approach seeks to provide adolescents with the education to have safe sex such as use of birth control and condoms to prevent sexually transmitted diseases and unwanted pregnancy. These programs differ from abstinence-only education, which assumes that educating teenagers about sex will encourage them to engage in it.

Prostitution
Harm reduction provides education and advocacy for the human rights of both voluntary and coerced prostitution. Harm reduction strives to end the marginalization, isolation, powerlessness and oppression of sex works by promoting development of a critical and social consciousness. Since much disapproved behaviour from sex workers is often criminalized (ie. sex trafficking), the disproportionate amount of violence that they endure makes them increasingly vulnerable. Thus, sex workers are considered to be addicts, incompetent, diseased and desperate despite their likely circumstances of not having any other income options. Thus, instead of victimizing and infantilizing sex workers, harm reduction promotes the health, rights, and dignity of individuals impacted by sexual exchange and provides respectful and non-judgmental affirmation of power and control in society.

Photo Credit: Courtesy of Youth Rising

References

BC Centre for Disease Control. (2013). Harm Reduction. Retrieved March 24, 2014,from BC Centre for Disease Control :

Canadian Harm Reduction Network. (2014). What is harm reduction? Retrieved March 24, 2014, from Canadian Harm Reduction :

Canadian Paediatric Society. (2014, Feb 1). Harm reduction: An approach to reducing risky health behaviours in adolescents. Retrieved March 24, 2014, from Canadian Paediatric Society: health-behaviours

Harm Reduction Coalition. (2014). Sex workers without boarders. Retrieved March 24, 2014, from

OHRDP. (2014). Harm Reduction. Retrieved March 24, 2014, from Ontario Harm Reduction Distribution Program : http://www.ohrdp.ca/about-us/harm-reduction/

Rhodes, T., Kimber, J., Small, W., Fitzgerald, J.,Kerr, T. et al. (2006). Public injecting and the need for ‘safer environment interventions’ in the reduction of drug-related harm. Society of the Study of Addiction, 1384-1393.

Wikepedia Encyclopedia. (2014). Harm reduction. Retrieved March 24, 2014 from

Reducing the Risk of Developing Dementia: Is Freedom 55 Really Attainable?

Dementia is a debilitating illness that is characterized by degeneration of memory, cognition, behaviour and the ability to perform activities of daily living. Approximately 35.6 million people worldwide have dementia and there are 7.7 million new cases every year, given the projected increase of the aging population. In addition, although dementia mainly affects older adults, it is not a normal component of aging because it has led to much disability and lack of independence among older adults throughout the world.

Elderly Woman Smiling Wearing a Swimming Cap in a Swimming PoolAlthough incidences of dementia, the most common being Alzheimer’s disease, have been rapidly increasing, no treatment has been developed to cure the disease or reverse its deterioration of the brain and individuals’ functioning capacity. Therefore, research needs to take place to establish inexpensive ways to help individuals reduce their risk of dementia and maintain cognitive function.

Recent studies suggest that people who delay retirement have a decreased risk of developing Alzheimer’s disease or a related dementia. However, researchers believe that the age of onset of Alzheimer’s disease and dementia is affected by many more complex risk factors and protective factors that extend beyond simply delaying retirement, which makes this topic relevant to the future health of older adults.

Although, many individuals enter into a pursuit of attaining Freedom 55, this may not be the healthiest option for older adults. A recent study lead by Carole Dufouil concluded that every additional year of work could reduce the risk of developing dementia by 3.2 percent, decreasing the risk of developing Alzheimer’s disease or a related dementia. However, the findings of the study are reliant on many more complex protective factors than only retirement such factors include education, occupation and retirement age.

Firstly, education produces health and well-being, which thus lowers an individual’s risk of developing dementia. In addition, each year of education may decreased the risk of developing dementia by 12 percent. Secondly, employment can be both mentally and socially stimulating, thus helping an individual maintain cognitive abilities. Thirdly, level of occupation, retirement age and education may have greater cognitive reserve capacity that may delay onset of dementia. Other protective factors may include a healthy diet, exercise and continued cognitive stimulation activities later in life.

Therefore, since the amount of people with dementia is expected to double by 2040, it is evident that a means to reduce the risk of dementia needs to be developed. However, older adults must decide what activities will be the most effective in helping them maintain cognitive and mental health throughout old age. For some this may be continuing to work or retirement, depending on their current occupation and job satisfaction. It does not make sense for an individual to continue working if they hate their job; therefore, an older adult must choose unique ways of exercising their brains that will work for them. Freedom 55 may be attainable for some; however, not for all.

References

Basu, R. (2013). Education and dementia risk: results from the aging demographics memory study. Research on Aging, 35, 7-31.

Lupton, M.K., Stahl, D., Artcher, N., Foy, C., Poppe, M., Lovestone, S. et al. (2009). Education, occupation and retirement age effects on age of onset of Alzheimer’s disease. International Journal of Geriatric Psychiatry, 25, 30-36.

Marchione, M. (2013, July 15). Delaying retirement can delay dementia, large study finds. The Associated Press. Retrieved from .

World Health Organization (2012).Dementia Retrieved November 15, 2013 from .

Photo Credit:

Passing the Social Work Exam: “Don’t Overdo It!”

Passing the social work exam not only gets you a nice new set of letters after your name, it can also open up all sorts of unanticipated avenues in your career. It helps to get licensed. But…easier said than done. First, you’ve got to get past the exam. A good way to figure out how to structure your exam prep time is to talk to people who’ve successfully navigated the exam process, to hear their stories, to get their words of wisdom.

overdoHere’s one such social work exam narrative with a simple take-home message: “Don’t overdo it!”

“I was really freaked out by having to take the social work licensing exam. I wanted that license! What if I didn’t pass? I’d probably have to stay in the same job, at the same salary, with the same responsibilities. After getting all those hours for licensure, I was ready for a change and passing the exam was the way to get it.

So I took it seriously. Probably, in retrospect, too seriously. I studied books and books full of social work facts. I listened to CDs and podcasts as I drove to work. I stole time at work to take every practice question I could get my hands on. I worried a lot.

Wasn’t necessary. I’m pretty sure that some basic review and a practice exam or two would’ve done the trick.  This was driven home when a friend from my MSW program asked me for some advice about how to pass. He was taking the exam in a couple of days and thought he should study a little bit first. Study a little bit first?! Two days before the exam?! Yep. He studied a little bit, taking a couple of practice exams, and sure enough, two days later, he passed

I’d overdone it. I’d overstudied. My friend may have been a little bolder than I could have imagined being, but it worked. Somewhere in between his two casual days of preparation and my months of overstudying would’ve been better.

Of course, everyone has their own studying style, their own way of learning. But please, don’t overdo it. This exam is based primarily on common sense. It’s designed to protect the profession and the public. That means, whatever answer would do the least harm is almost always the right one. Whatever answer closely reflects the Code of Ethics is the right one. Whatever people encounter in real social work situations–at a community mental health office, say–is what vignettes will cover. So, more than likely, when you were getting your hours, you were getting your social work exam preparation done at the same time…just by doing your job.

I hope this helps!”

 

Photo Courtesy of Time Magazine

Interview with Sherry Gaba from Celebrity Rehab and Sober House

Social Work Helper caught up with acclaimed author, life coach,  and host of CBS radio A Moment of Change, Sherry Gaba from Celebrity Rehab and Sober House. Sherry Gaba is wanting to help other therapists learn how to become a media expert, and she shares her contact information later on in the interview in case anyone is interested in learning more about using media to elevate your practice.

sherry-pose-2[1] SWH: Tell us a bit about your background, and your work as a therapist and life coach? Could you explain the difference between the two?

Sherry: I am a Licensed Clinical Social Worker and a Life Coach. I added life coaching to my business because I have always been a goal oriented, solution focused psychotherapist, therefore, life coaching was a natural fit for me. A Psychotherapist looks at family of origin issues, mental health issues such as depression, anxiety, and trauma and life coaching works on helping individuals move forward in their lives.  For example, if someone is feeling stuck at a job and has always wanted to start his or her own business, my role as a life coach is to help him/her create goals towards starting his/her own business and be accountable to those goals.  If my client is stuck because of trauma from the past, he might benefit from psychotherapy and we might start there working on deep seated early trauma issues.  I either see clients as a psychotherapist or a life coach, never both.

SWH: What was it like working on Celebrity Rehab, Sober House, and Celebrity Sex Addiction as the go-to expert?

Sherry: Working with Dr. Drew on VH1’s Celebrity Rehab, Sober House, and Sex Addiction was an amazing experience that I will always be grateful for.  It launched my media career and since then I have published a book, The Law of Sobriety: Attracting Positive Energy for a Positive Recovery and have hosted a radio show on CBS, as well as been a media expert on CNN, Showbiz Tonight, HLN News, Jane Velez Mitchell on HLN, Inside Edition, The Bio Channel, E!News, and many more media appearances.  I have coached therapists worldwide create their own celebrity expert careers, as well, from my own experiences in the media.

SWH: Currently, you have a radio show with CBS and a new book out. What kind of topics do you discuss on A Moment of Change, and  what do you want readers to know about your award winning book, The Law of Sobriety?  

Sherry: The radio show is a show about positive transformation with celebrities, experts and authors that share their own moments of change with insightful, enlightening, and healing conversations along with my co-host, Cathleen O’Connor who has a doctorate in Metaphysics.  The Law of Sobriety is the first addiction and recovery book that looks at recovery from a law of attraction perspective.  It takes the approach that we are creators of our own realities. In other words, our thoughts, actions, beliefs, and emotions attract back to us what we bring into our lives. If we are vibrating on a positive frequency, we are going to attract positivism into our lives. If we are putting out to the universe negativity or self deprecating thoughts, emotions, beliefs, and behaviors, that is exactly what we will attract back into our lives, as well.  The book also takes the reader through a process of meditations, journaling, and affirmations that will help him/her unearth his/her , highest potential, therefore, discovering  what his/her life purpose is.  Everyone has a calling and once an addict or alcoholic gets sober,  it is helpful to their recovery process  to replace their addiction with something that brings them joy and passion so that they don’t go back to using or drinking.

SWH: Clients and potential clients have the ability to schedule skype appointments with you. What’s your thoughts and experience with using technologies such as skype for conducting sessions?

Sherry: We are living in a new world and clients are demanding new ways of getting the help they need so it is important as social workers we keep up with the trends. What I don’t approve of is individuals out there calling themselves energy healers, coaches, shamans, and other types of spiritual healers working with clients on very serious issues such as trauma or with clients that are severely depressed or  suicidal and needing a licensed social worker or other mental health professional.  I believe this is dangerous and as social workers, we need to find ways to make sure these “snake oil salespersons”  are kept away from clients that need real mental health services.  This is a pet peeve of mine and with the internet, there of zillions of these fraudulent so called healers taking advantage of many individuals and it must be stopped!!!!

SWH: What are your aspirations and what new adventure(s) would you like to pursue in your career?

Sherry: Presently, I am creating telseminars workshops for therapists and online meetings based on techniques from my book, the Law of Sobriety and coaching therapists to become media experts.  For more information go to www.sherrygaba.com or email me at sherry@sgabatherapy.com or 818-756-3338.

Scoop.It! Have Other Search Engines Do The Work For You

Scoop.it! is a great resource to accumulate information about resources collected by search engines. You can create an account and have the search engines bring content across the Web to your site. An e-mail will be generated each day with the news accumulated. If you don’t want to go through the work of perusing a daily e-mail on your subject matter just look for other people who have similar interests and they will Scoop.it! for you! This is not limited to technology. Social workers can scoop advocacy issues, research, areas of practice, or show clients how to access information.

Mashable.com put together a great article to help non-technical folks better understand how to use tools like Scoop.It. They go in detail about Scoop.it, Storify, Curated.by, and Pearltrees.  Here is an excerpt from the article 4 Promising Curation Tools to Help Make Sense of the Web: 

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As the volume of content swirling around the web continues to grow, we’re finding ourselves drowning in a deluge of data. Where is the relevant material? Where are the best columns and content offerings? How can we balance the need for timely, relevant information with reasonable limits of our ability to find, sort, fact check and validate information?

The solution on the horizon is curation. You can either choose to be a curator — offering your filtered world view to followers — or you can choose curators to follow. As curation moves to center stage, a new category of software is emerging to provide curation solutions.  Read More

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Below are examples of how the resource is used…

Link for Latest research on BiPolar Disorder Scoop.it!
Link for Teaching with Tablets Scoop.it!

You can visit Ellen Belluomini LCSW at her blog Bridging the Digital Divide in Social Work Practice.

Advice for the Family Caregiver

If you are a family caregiver, then you’ve probably had a moment or two where you said or did something to your loved one that you later regretted. Whether you were frustrated because your loved one “pushed all of your buttons” or you were having a bad day, your outburst may have caused you to later feel like the “worse daughter or son in the world” or made you think, “How could I have said that?” If any of this sounds familiar, then you should know it is familiar to many other adult children who are caring for a parent, especially those whose parents live with them. Aside from knowing you are not alone, you should also know there are steps you can take to reduce your level of frustration and prevent future outbursts.

Understand Where Your Parent is Coming From

As we age, the reality that we will need assistance to do things we were once able to do on our own becomes more prevalent. Between our body becoming more frail, our vision and hearing becoming impaired or our memory not being what it once was, at some point needing assistance seems inevitable. For most older adults, this need for assistance is synonymous with losing other freedoms like driving, living alone plus many others. And while there are definitely some situations that warrant taking away such liberties, the truth is that it’s never easy to accept. Understanding how your parent accepts this change and how it can affect his/her’s well-being may give you a better sense of the motive behind your parent’s actions.

Remind Yourself of What Their Day Looks Like 

For the most part, older adults are not as active as they used to be. Whether they are retired, recovering from a medical condition or just staying out of the hot/cold weather, chances are their level of socialization has declined. As a result, it is not uncommon to be bombarded with all of their thoughts, complaints or critiques upon your arrival home and for you to become frustrated as a result. One way you can try to minimize this type of frustration is to encourage your parent to increase his/her social interaction by going to a Senior center, attending family and friend outings or engaging in his/her hobbies. By doing so, it can allow your parent to regain his/her sense of purpose and potentially reduce the amount of friction in your interactions.

Recognize Your Limitations

When you find yourself in a heated discussion with your parent, being aware of what sets you off or gets your “blood boiling” is the first step in being able to reduce your chances of saying something negative. The next step is to walk away, meditate or simply ask your loved one to give you some time alone. Depending on your situation, any one of these techniques can help to give you a few minutes to remind yourself about the previous pointers and to calm down. Overall, the goal should be to mentally or emotionally get to a place where you will not do or say something you will later regret.

Seek Professional Help

While the above tips can work for some, they don’t work for all. Factors like personality issues, past family conflict or resentment towards your parent can serve as barriers to remaining calm. Seeking the assistance of a professional like a social worker or mediator can help you get to the bottom of the problem and assist with developing a plan of action to prevent future outbursts.

If any of the above tips have worked for  you, I would love to hear your input. Do you have other tips or recommendations you would like to share about “keeping your cool”, please share them below.

Planning Ahead for Life Altering Events

When planning ahead for the future, most people willingly envision and plan for positive events like marriage, parenthood, retirement, etc. Events that are not often planned for, however, are the life-altering events that affect a person’s ability to make decisions for him/herself. And while it is understandable why such issues are not willingly discussed, it is important to know that it could lead to days, weeks or months of emotional distress, financial strain and/or family conflict. In order to avoid the potential of such distress, it important to at least be aware of the term advanced directives and what legal documents exist in order to reduce the potential for conflict.

Courtesy of http://www.themcdonnellfirm.com/practice-areas/wrongful-deathAdvanced directives are documents created for the purpose of planning ahead and ensuring you and your family’s needs are properly arranged for. Basic documents like a Health care proxy, a Living Will and Power of Attorney are documents that can ensure you and your loved one’s wishes are honored.

Health Care Proxy also referred to as Medical Power of Attorney is a legal document whereby a person is appointed to make medical decisions for another individual. For example, if your loved one suffers a stroke and becomes disoriented, a health care proxy would give you the legal ability to make medical decisions about his/her care.

Living Will is ideal for individuals who want to have their wishes in writing either because they do not have anyone to designate as proxy or because they hold strong convictions about the level of care they do/do not want.

Power of Attorney gives an appointed person the ability to handle another person’s finances. A durable power of attorney, specifically, will allow the chosen individual to handle a person’s finances even after the individual is no longer competent. Simple tasks like getting a new bank card for Mom or using Dad’s money to pay for his own medical care, are more easily accomplished when a person is appointed power of attorney.

HOW TO GET THESE FORMS – depending on the state you live in, getting the above forms can be as simple as speaking with your physician or with a social worker. The Power of Attorney forms can generally be obtained from an attorney. While there are versions available online, it is important to verify the document you have is the most current version as laws can change.

For information on Advanced Directives in New Jersey, click here; for New York, click here. For other states, visit www.lawhelp.org. Aside from getting over the hurdle of addressing this issue with your loved one and/or family, educating yourself about what is available can be a great way to start the process of planning ahead.

Have you already planned ahead and obtained any one of these documents? Have you tried but were unsuccessful? Feel free to ask questions or share your experience below.

How to Convince Your Relative to Accept Help

For many family members, getting an older adult to accept help can be met with many barriers. Whether trying to assist with managing finances, implementing home safety measures or arranging for home care, chances are your relative will resist; This especially holds true if your loved one has great pride in being independent.

Below are a few recommendations you may want to consider to increase the chances your loved one will accept the services you know they need: 

Pull at the Heart Strings

Courtesy of Hallmark.comOne technique I often suggest to family members, especially adult children, is  to “pull at the heart strings” of your relative.  Many older adults will refuse assistance for a variety of reasons but in some cases upon hearing how stressed and worried you are about them, they generally concede so as to not be burden to you. Often a conversation about how stressed you are with trying to manage everything, along with suggestions of services that can ease your troubles, may allow your relative to see things from a different perspective and hopefully agree to the assistance you are suggesting.

Make it About You

One of the worse things you can do is to tell an older adult how THEY are no longer capable of taking care of themselves. Besides being confronted by denial, you may also be accused of being “dramatic”, “interfering”, or “crazy.” Focus instead on how you are arranging for “x” service in order to alleviate some of YOUR own responsibilities. Explaining how some of the physical chores you are doing is straining on your “bad back” or that the amount of time you are taking off from work for doctor’s visits is causing trouble with your boss may lead to your relative to agree with your proposal.

Offer a Trial Period

Much like with anything, most of us like the idea of being able to try something first before we fully commit to it. Explain to your loved one how the service you are proposing is something that can easily be cancelled should they not like it. By doing so, they will know they have the final say, which can make the idea of accepting help easier to swallow. It has been my experience that once a good service is in place older adults will see the benefit and stick with it.

Lastly, remember that many older adults despise the thought of receiving assistance because it basically is a blow to the ego and also signifies the inability to tend to their own needs. Understanding where they are coming from, what makes them feel useful and their past history at gaining independence can provide you with additional insight about how best to implement the above recommendations.

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