Why we need to do better with Mental Health. We need to listen to John Oliver.

@LastWeekTonight

Why we need to do better with Mental Health. We need to listen to John Oliver.

I believe this. I believe that every day we wake up and we do the best we can. I don’t think any sane person wakes up and says “Hey I’m going to be a terrible person today.”

People with mental illness do not have a choice. Most of them do not get the care they need. Even when they get care they don’t get the care they need most of the time. They get medications that could be helping or not.

At our local mental health center when you finally get in you get 15 minutes with a person whose only job it is to write you a prescription.

A few years ago for weeks I faxed someone there with no answer. For weeks. Every week I sent this person an FYI fax. The day she was leaving she called me. As it turned out we knew each other and she worked as a psych nurse in the program I ran years ago down in Boca. She said this to me. “Let me give you a little advice! No one will ever call you back. Even if you have releases. The practitioner’s only job is to write prescriptions every fifteen minutes. They are not allowed to call you back.”

So here I am out in field and I can’t communicate with the person who write the prescriptions. There is no continuum of care.

There is no care.

Last June a friend of mine contacted me. She had terrible anxiety and depression. She had tried an antidepressant before and didn’t do well. I suggested to her there are all kinds of antidepressants. To call her PCP and talk to him. She called and could not get an appointment until the next September. She finally got a prescription from another one of her doctors and is doing great.

I have a friend who has a son. A really good kid. As a teen he was experimenting and just like any parents nightmare he took one of those designer drugs. I can’t remember the name. They are all awful.

This stuff fried his brain. He ended up at the local (same one!) community mental health center. He was diagnosed with schizophrenia. Placed on a bunch of antipsychotics.  He was zombie. He couldn’t work really. He went to work with him mom but couldn’t even last the day.

I met them at our local Reiki Circle. This is a really good kid. A bright light under all that mess. A good soul. I spent some time with him and his mom. He loved Reiki. I  asked some questions. Is there a family history of schizophrenia? No Was there any signs of mental illness before he took this drug? No. He was a normal kid.

Now granted it can happen and this kind of event can bring it out.

I just felt like the 15 minute old doctor was wrong and I encouraged her to bring him to the University of Florida. She did. They did a bunch of tests. Like me. They said he’s not schizophrenic. They put him on one antidepressant. He still has anxiety. They put him on another antidepressant. I pray someday he’ll be ok. That his brain will be unfried.

I encouraged the mom to continue to bring him to Reiki which they both enjoyed and if she could afford to take him to our marvelous community acupuncture program that we are so lucky to have.

I see him in our neighborhood. He has dog walking business. He always gives me a hug and says “thank you.” I leave in a puddle of tears.

I always encourage him. He is a great kid.

He has a great mom. She really believed in him. Som

Last week there was another shooting. Another mentally ill person. The same thing. The pro gun people come and drown out the people who want more mental health services and nothing is done.

It will happen again.

I don’t want to have this conversation anymore. About guns. About how the GOP is trying to take my free speech away and tell me I can’t ask a patient if they have gun. Who does that?

I’m not even going off on that rant. You cannot talk to people who apparently having difficulty processing information. These people are destroying us with their BS rhetoric.

You want people to work. You help them get well. Because they want to work. Because no one wakes up in the morning and says “I want to be disabled. I want to collect SSDI. I want to worry about where my next meal is coming from. I want to be alone. I want to isolated. I want to be mentally ill.” No one.

Let’s start here.

Let’s watch this fabulous piece by John Oliver together and talk about that. Because John is saying everything I’ve said to all of you.

“In 2013, an estimated 43.8 million adults in the US had any mental illness.
10 million people suffer from serious mental illness.

John talks about how JFK mandated the state mental Hospitals get shut down and he is right when he says we never followed thru with the funding for community mental health.

Many are being place in nursing homes. They send people on a “greyhound” to someplace else so far away they can be admitted to that facility again.”

I want to thank John Oliver from the bottom of my heart. Just yesterday for some reason Dr Phil was on my tv. He was berating this person that was delusional. So now America will think that people can talk themselves out of delusions. I didn’t see the beginning so I have no idea what the background is. I don’t know if this kid is on medications. All I know is this baffoon is standing in my tv giving this kid advice. Maybe it good and maybe it’s not. But what is the take away? The take is people can talk themselves out of their delusions which is not true unless your Dr Phil.

Now lets take this situation and think about this. Your mentally ill loved one ended up in a jail in Florida where he has a broomstick stuck up his butt.  Imagine that is your child.

It’s unimaginable.

Unfortunately its true.

I’m going to go even further and say there are a lot of people out there that are mentally ill that could be a lot better.  With the proper diagnostic care , some creatively, and  community followup they could go beyond the community home they live in (If they are lucky enough to live in a place like this.) and function in the world. Have jobs. Relationships. Like every one.

Because they are like everyone except they have chemistry issues.

They could have a life.

I hope you take the time to read this blog. If you live someplace with cool mental health solutions I would love to hear about it.

Here are some other posts I’ve written on the subject.

https://cyndi-lenz.com/2015/06/04/jail-is-the-new-state-mental-hospital-where-are-the-diversion-programs/

https://cyndi-lenz.com/2015/06/02/june-is-educate-your-legislators-in-mental-illness-month-i-said-so/

https://cyndi-lenz.com/2015/05/11/the-asylum-life-house-on-the-hill/

https://cyndi-lenz.com/2015/05/07/dorothea-dix-psych-nurse-and-social-reformer/

How to Love an Addict

How to Love an Addict

by Darcy Flierl

Addiction. We’ve made progress over the last decade. The stigma is decreasing and we are openly discussing it. Once upon a time, if your parent, spouse, or child suffered from alcohol or drug abuse, it was the family secret. Now, I talk to people every day who are open about how addiction has afflicted their lives. Perhaps it’s because loved ones are dying due to this disease? Perhaps it’s because as individuals we are becoming more aware of our own dependencies? The fact is, it’s everywhere, and the proof is in the increase in substance abuse providers popping up daily. The proof in in the number of Alcoholics Anonymous meetings one can find on any given day. The proof is in our county jails and the proof is in the ache of our own hearts, especially if you’ve ever loved an addict.

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As a an addictions professional and expert in prevention, I’m often asked, “How do I help my child….my friend….myself?”. There is no shortage on research, books and articles on this subject. Resources from support groups and treatment centers are plentiful, yet lovers of addicts are always left feeling hopeless and frustrated. I wish there a was Wiki- How to Love and Addict Guide and one could just follow the prescribed 10 steps on Voilà your loved one is healed and the family is on the road to recovery!

The truth is there is not one thing any one of us can do to help our loved one stop using alcohol and drugs but there are many things we can do to help our loved ones not use alcohol and drugs. Confusing? Contradictive? Yes! Just like addiction.

Here are my- 3 steps to helping your loved one suffering from the Disease of Addiction:

  1. Set up boundaries- this is an individual process and a mental health professional can assist you in establishing these boundaries that are unique to your situation. Boundaries might include limiting assistance: house, food, money, transportation and even termination of the relationship.
  2. Only give what you have to give-Many families will invest countless hours and thousands and thousands of dollars in services for their loved ones. If you have the resources and the individual is open to treatment, than by all means provide the help. If providing these resources is a detriment to your physical or emotional well being, than it’s not a healthy decision. Remember that helping isn’t always helping. Sometimes it’s called “enabling”. Enabling is a term every addict lover needs to understand. In addictions, enabling is the act of making excuses, stopping the bottom of falling out for the addict and leads to an obsession surrounding the addicts behaviors.
  3. Get a therapist- For yourself! Loving an addict is a long, difficult and painful road and sometimes doesn’t have a happy ending. Guilt, shame and desperation are often many of the “rest stops” along this journey. A Therapist can provide ongoing education and empowerment to you as you come to terms with the fact that in the end, everyone makes their own decisions in life and ultimately we are all powerless. If you don’t have the financial resources for a therapist, there are many helpful on line support groups.

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Managing caregiver stress and preventing burnout.

Managing caregiver stress and preventing burnout.

Why is managing stress so important?

http://www.webmd.com/balance/stress-management/effects-of-stress-on-your-body

Stress that continues without relief can lead to a condition called distress — a negative stress reaction. Distress can lead to physical symptoms including headaches, upset stomach, elevated blood pressure, chest pain, and problems sleeping. Research suggests that stress also can bring on or worsen certain symptoms or diseases.

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How does stress affect the immune system?

Stress can make up ill as it affects out immune system.

http://www.apa.org/research/action/immune.aspx

“For stress of any significant duration – from a few days to a few months or years, as happens in real life – all aspects of immunity went downhill. Thus long-term or chronic stress, through too much wear and tear, can ravage the immune system.

The meta-analysis also revealed that people who are older or already sick are more prone to stress-related immune changes. For example, a 2002 study by Lyanne McGuire, PhD, of John Hopkins School of Medicine with Kiecolt-Glaser and Glaser reported that even chronic, sub-clinical mild depression may suppress an older person’s immune system. Participants in the study were in their early 70s and caring for someone with Alzheimer’s disease. Those with chronic mild depression had weaker lymphocyte-T cell responses to two mitogens, which model how the body responds to viruses and bacteria. The immune response was down even 18 months later, and immunity declined with age. In line with the 2004 meta-analysis, it appeared that the key immune factor was duration, not severity, of depression. And in the case of the older caregivers, their depression and age meant a double-whammy for immunity.

Emerging evidence is tracing the pathways of the mind-body interaction. For example, as seen with the college students, chronic feelings of loneliness can help to predict health status — perhaps because lonely people have more psychological stress or experience it more intensely and that stress in turn tamps down immunity. It’s also no surprise that depression hurts immunity; it’s also linked to other physical problems such as heart disease. At the same time, depression may both reflect a lack of social support and/or cause someone to withdraw from social ties. Both can be stressful and hurt the body’s ability to fight infection.

Managing stress, especially chronic or long-term stress (even if it’s not intense), may help people to fight germs. When burdened with long-term stressors, such as caring for an elderly parent or spouse with dementia, health can benefit from conscientious stress management.

Finally, the newest findings on social stress underscore the value of good friends; even just a few close friends can help someone feel connected and stay strong. Social ties may indirectly strengthen immunity because friends – at least health-minded friends — can encourage good health behaviors such as eating, sleeping and exercising well. Good friends also help to buffer the stress of negative events.”

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Preventing and dealing  with caregiver stress.

I first want to clarify what I mean when I say “caregiver.” I’m talking about the main person who is doing the hands on care. The wife, husband, mother, father, daughter, son or other people who is the number one person caring for someone.

Lot’s of people interface with caregivers. We do as nurses. You do as friends, family and neighbors. We get to go to the house, spend an hour, do our assessment, say what we think and then leave the person behind to deal with this on their own.

My general attitude is everyone is different, every one has different coping skills and styles. It’s our job as nurses, friends, families and neighbors to be accepting and to be helpful. Everyone copes with this differently but the needs still remains the same.

The one point I always try to make is this: This will end and at the end of the day when you have to make peace with yourself and move on in your life will you being to look back and say “I did everything I could and I am at peace.” I think the best way to get to that place is not getting burnt out.

The most important thing that a caregiver can do for themselves is to make sure they leave time for themselves and do something, even if its the littlest thing, every day. Being a martyr is a sure road to burnout and feeling like your stuck in a situation.

I know it hard. Sometimes there is no one around to relieve you and you feel like this is on your shoulders. Some places have great resources and some places have next to none.

In this day and age unless you can afford it there’s not a lot of help out there and if there is the older person living by themselves they get addressed first before the person with a caregiver. (Unless the person is under Hospice)

I thought instead of just googling I’d ask my friends first what they thought. So here goes. Some of these folks are in the medical field and some are or have been the main caregivers for a family member.

This is what they had to say:

Carol said “Get help!”

I know that’s a tall order sometimes. Many people can’t afford help. The first thing you should do is call your Elder Hotline. Our number around here is 866-684-5884. There is a process and it takes a while  to this so don’t wait until you need something. Do it now so by the time you need it the information is there.

Call the local chapter of the appropriate disease and see if someone can come out and talk to you about the disease and what is available to you. Often they have respite set up and know everyone who is available.

Call your church or temple and ask if there is anyone available to help. Many times they will mention this at services and people will volunteer.

Lisa Ray said

“#1 Take care of yourself first and foremost … it may sound selfish but it is not. If you are not emotionally and physically healthy then you can’t help the other person. #2 Ask or pay for help. Don’t turn away help … accept the gift. You are not the only one that can care for your loved one. Let other family members become involved in the care. Or pay someone to help. #3 Don’t take the mean things they say and do personally. They are sick and realize they have lost much of their independence, this is an expression of that frustration #4 Join a support group… you will learn things from others & help others with your experiences. #5 This also goes along with #2 Get out of the house and have fun, stay in contact with your friends, don’t become isolated.”

Aimee Said:

For sure don’t become isolated. I broke free finally in June and took a long weekend to myself and went to Missouri and met up with some other ladies. It didn’t go over well but he survived it. Never had been away without him. I never let him play that card. He tries often but when there is something he wants to do he finds a way. Take time for yourself and do whatever it is you love to do. Meet up with friends, take that trip and take care of yourself. And try not to stress (easier said than done) about that next scan or blood test. It is what it will be and I can’t change that.”

Susan said:

“Take time for yourself. While helping with my father’s cancer and death I would get their local paper (very small town) and circle garage and estate sales.  Then I would steal away for a few hours every Friday to treasure hunt. Try to keep some of your own little routines and hobbies going during this time. It was fun to share my finds and create memories with my parents while giving me something else to focus on.”

Irene said:

You must have someone to come in to give the caretaker a break from the emotional roller coaster

Eileen said: Have a network of friends or support group to support you the caregiver.

What is caregiver burn out?

http://www.webmd.com/heart-disease/heart-disease-recognizing-caregiver-burnout

“Caregiver burnout is a state of physical, emotional, and mental exhaustion that may be accompanied by a change in attitude — from positive and caring to negative and unconcerned. Burnout can occur when caregivers don’t get the help they need, or if they try to do more than they are able — either physically or financially. Caregivers who are “burned out” may experience fatigue, stress, anxiety, and depression. Many caregivers also feel guilty if they spend time on themselves rather than on their ill or elderly loved ones.”

What Are the Symptoms of Caregiver Burnout?

“The symptoms of caregiver burnout are similar to the symptoms of stress and depression. They include:

  • Withdrawal from friends, family, and other loved ones
  • Loss of interest in activities previously enjoyed
  • Feeling blue, irritable, hopeless, and helpless
  • Changes in appetite, weight, or both
  • Changes in sleep patterns
  • Getting sick more often
  • Feelings of wanting to hurt yourself or the person for whom you are caring
  • Emotional and physical exhaustion
  • Irritability

What Causes Caregiver Burnout?

Caregivers often are so busy caring for others that they tend to neglect their own emotional, physical, and spiritual health. The demands on a caregiver’s body, mind, and emotions can easily seem overwhelming, leading to fatigue and hopelessness — and, ultimately, burnout. Other factors that can lead to caregiver burnout include:

  • Role confusion: Many people are confused when thrust into the role of caregiver. It can be difficult for a person to separate her role as caregiver from her role as spouse, lover, child, friend, etc.
  • Unrealistic expectations: Many caregivers expect their involvement to have a positive effect on the health and happiness of their loved one. This may not always be realistic.
  • Lack of control: Many caregivers become frustrated by a lack of money, resources, and skills to effectively plan, manage, and organize their loved one’s care.
  • Unreasonable demands: Some caregivers place unreasonable burdens upon themselves, in part because they see providing care as their exclusive responsibility.
  • Other factors: Many caregivers cannot recognize when they are suffering burnout and eventually get to the point where they cannot function effectively. They may even become sick themselves.

I’ve heard many people say to me “She was the mother and I was the child now i’m the mother and she is the child.’ It may feel that way but it not. Your still the child taking care of your mother.

More Ways to Prevent Burnout.

  1. Find someone to talk to. There is always someone to talk to and sometimes just saying things out loud can make you feel better.  If you have a computer there are many Facebook groups that you can join and speaks to others. In this day and age if you join a local support group online you can also benefit from the other member’s knowledge of resources.
  2. Be realistic about your loved one’s disease.

http://www.helpguide.org/articles/stress/caregiving-stress-and-burnout.htm

A list much like the the one my friends made above.

  1. Ask for help.
  2. Give yourself a break
  3. Practice Acceptance: Focus on the things you can control,find the silver lining,avoid tunnel vision.
  4. Take care of your own health: Exercise, meditate, do yoga, eat well and don’t skimp on sleep.

Cyndi Lenz is a psychiatric home health nurse in the Treasure Coast.

Stuart City Hall 5 PM monday. Support our local music.

To the Stuart CIty Commission:

I thought it was to be a nice quiet afternoon in the hood and I could do something like read a book, finish watching my movie, clean the closet. Around here it just never ends. Now we have people threatening to sue over noise and the City Commission is caving.

We have toxic discharges. We have trains with loud horns. We can’t go swimming.  The new train when it comes through is going to destroy our downtown Stuart which is a very beloved place.

We need great music and great places to go. Music is therapy is good for our mental health. We  have very little in mental heath services around here so when I see lots of my friends going to listen to music I know they will leave feeling better.

I could write an entire blog post on music as therapy but I don’t want to bore everyone. I will say this Music lights a part of people brains, the nucleus accumbens, and makes them happy. It’s true. I have a friend, Dr Ed Long,who does this research down at FAU.

What I’m going to write about is decibels and noise ordinances This is a really bad idea.  First of all will you insist the train turn down its horn because it not at 60 decibels I can tell you that. Secondly, if this  how your going utilize your police force? This is more important that catching criminals and keeping us safe?  Are the fire engines and police going to turn off their sirens?  Are not going to be allow to have traffic? Are you to close the airport down?  Are we banning hair driers and food processors?  Lawn Mowers and Blowers? How far are you willing to go to have us live at 65 decibels. Or are we just picking on one person?

Now here in Jensen Beach sometimes on Sunday we have a very loud church service. What would you do if that was in Stuart? Would you arrest them or fine them? It’s very loud way more than 60 decibels. Wakes me up early on a Sunday morning. Would you be willing to go to a church and shut them down?

Also keep in mind that that what they proposing is worse than the Lake worth ordinance and that was called Draconian. You can’t have things both ways. You can’t have people claiming to be conservatives being draconian. Well you can but they won’t be around long. Not around here.

Sticky wickets.

When you deal with decibels it gets very sticky.

I would take it personally if this was something police would have to deal with 24 hours a day 7 days a week instead of protecting us. I would say it’s a misuse of the police department.

Here are some examples of decibels

Painful

150 dB = fireworks at 3 feet

140 dB = firearms, jet engine

130 dB = jackhammer

120 dB = jet plane takeoff, siren

Extremely Loud

110 dB = maximum output of some MP3 players, model airplane, chain saw

106 dB = gas lawn mower, snowblower

100 dB = hand drill, pneumatic drill

90 dB = subway, passing motorcycle

Very Loud

80–90 dB = blow-dryer, kitchen blender, food processor

70 dB = busy traffic, vacuum cleaner, alarm clock

Moderate

60 dB = typical conversation, dishwasher, clothes dryer

50 dB = moderate rainfall

40 dB = quiet room

Faint

30 dB = whisper, quiet library

http://home.earthlink.net/~dnitzer/4HaasEaton/Decibel.html

An aircraft takeoff is 180 decibels. Are we shutting the airport down?

Passing truck, home lawn mower, car horn @ 5 meters, wood saw, boiler factory is 100 decibels.

Average radio, normal street noise is 70 decibels.

This is cat purring at around 60 decibels.

Here is someone eating a sandwich at 50-60 decibels

They’ll have close down every out restaurant in town.

How to help. We all need to go to Stuart City Hall on Monday at 5 pm.

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The fact that this was added at the last minute is total BS and total disrespect from the City.

This about people threatening to sue the city so instead of the people we elected standing up they are giving in and we are being punished.

We are done being punished. Just having filthy dirty dangerous water  and trains all hours of the day and night.

Please come and help us all keep our music!

Here is the facebook page please go there.

https://www.facebook.com/events/1653563341589572/

Alzheimer’s and “Still Alice” : Caring for those who can’t care for themselves.

@Gayle_Harrell

@FLGovScott

@joenegronfl

I’m sending this blog post to my state rep, rick scott and my state senator. None of these people actually care about anyone especially older people who are ill. They are under some kind of delusion that these people can have help. In the case of Ms Harrell she thinks people can go to a free clinic if they have no health insurance.

Right now if you call the Elder Hotline they are wonderful about getting assessments done but they have one problem. There are no funds to help. People are put on a list by need and usually people with dementia are on top of the list. I have no issues with these folks. They are doing the best they can. But no money is no money. It’s could be months before people get services.

And thats for people over 65.

What happens to the younger person who is not on Medicare that get’s diagnosed with

Alzheimer’s Disease or dementia?

Where do they go and how do they manage? What about the people who live by themselves?

This past weekend I watched “Still Alice.”

http://www.bustle.com/articles/66764-is-still-alice-based-on-a-true-story-the-tale-resonates-powerfully-with-its-audience

Still Alice, directed by Ricard Glatzer and Wash Westmoreland, was adapted by the pair from a novel of the same name by Lisa Genova.

Who is Lisa Genova?

Lisa Genova graduated valedictorian, summa cum laude from Bates College with a degree in Biopsychology and has a Ph.D. in Neuroscience from Harvard University. She is the author of the New York Times bestselling novels Still Alice, Left Neglected, Love Anthony, and Inside the O’Briens.

“Dr. Alice Howland (Julianne Moore), a linguistics professor at Columbia University, celebrates her fiftieth birthday with her physician husband John (Alec Baldwin) and three adult children. During a lecture, Alice forgets the word “lexicon”, and during a jog becomes lost on campus. Her doctor diagnoses her with early onset familial Alzheimer’s disease.”

Julianne Moore won a well deserved “Oscar” for her performance.

“Alzheimer’s is a pretty brutal disease — and as Moore pointed out in her acceptance speech for Best Actress at the 2015 Oscars:

I’m very happy — thrilled, actually — that we were able to hopefully shine a light on Alzheimer’s disease. So many people with this disease feel isolated and marginalized, and one of the wonderful things about movies is that it makes us feel seen and not alone. And people with Alzheimer’s deserve to be seen, so that we can find a cure. “

http://www.alz.org/facts/overview.asp

2015 Alzheimer’s Disease Facts and Figures

Learn. Share. Act.

quickfacts-img

https://www.youtube.com/watch?t=23&v=kcI5UVwFyN0

“An estimated 5.3 million Americans of all ages have Alzheimer’s disease in 2015.

  • Of the 5.3 million Americans with Alzheimer’s, an estimated 5.1 million people are age 65 and older, and approximately 200,000 individuals are under age 65 (younger-onset Alzheimer’s).
  • Almost two-thirds of Americans with Alzheimer’s are women. Of the 5.1 million people age 65 and older with Alzheimer’s in the United States, 3.2 million are women and 1.9 million are men.
  • Although there are more non-Hispanic whites living with Alzheimer’s and other dementias than people of any other racial or ethnic group in the United States, older African-Americans and Hispanics are more likely than older whites to have Alzheimer’s disease and other dementias.”

Why is there an issue disclosing the diagnosis?

“disclosing a diagnosis

Most people living with Alzheimer’s are not aware of their diagnosis.

Despite widespread recognition of the benefits of clear and accurate disclosure, less than half (45 percent) of seniors diagnosed with Alzheimer’s disease or their caregivers report being told the diagnosis by a health care provider, compared with 90 percent or more of those diagnosed with cancer and cardiovascular disease.”

I’d like to remind everyone that Alzheimer’s is a bipartisan disease. It doesn’t really care if your rich or poor, Democrat or Republican.

Let’s bring it home.

http://www.alzcare.org/statistics

In Palm Beach County there are more than 55,000 people affected by Alzheimer’s disease. In Martin County there are more than 6,400 people and close to 9,000 people in St. Lucie County affected by Alzheimer’s disease.

http://www.alzcare.org/specialized-adult-day-service-centers

Alzheimer’s Community Care operates nine Specialized Alzheimer’s Care and Service Centers with locations throughout Palm Beach, Martin and St. Lucie Counties. All are licensed in accordance with the higher standards of Florida’s Specialized Alzheimer’s Day Care Act of 2012. The cost for a full-day, up to 10 hours, is $65, while half-day care plans begin at $40. The organization provides dementia-specific care for the patient and his or her caregivers.

This is great if you have 40 Bucks a day.

I’m not in any way criticizing the wonderful people from any of the organizations that do this work. I applaud them. I am however criticizing our representatives for not even having this on their radar and telling people if they have no health insurance they can go to a free clinic which btw was line item vetoed by Rick Scott.

Please watch ” Still Alice.” It’s an amazing movie. You all know someone just like Alice. My heart breaks for these people and for the people who love them who bravely take care of them the best they can every day. You are the unsung heros.

The Florida Legislature Gags Health Care Workers. How not to save a life.

 The Florida Legislature Gags Health Care Workers. How not to save a life.

Just file this  under “Kick me in the head.”

As well as others, like people who don’t want their houses to float away in Miami, or their drinking water to be all salty, or just us folks here in Stuart/Jensen Beach that don’t want to have to worry about pollution, trains with bombs,  and getting flesh eating bacteria when we go to the beach only to be eaten by horny sharks.

When does this endless intrusion end?

Honestly. I’d rather be some sharks dinner than have to figure out how to deal with this garbage.

The people who couldn’t even pass half the credentialing that’s needed to work in the health care field passed a terrible law again to punish all of us that are trying to do our jobs.

https://cyndi-lenz.com/2015/05/31/do-our-legislators-need-to-be-credentialed/

This whole mess started when a woman took her child to the pediatrician in Ocala. Pediatricians go to meetings with other pediatricians.  and in those meeting  they come up with a list of things to “educate” their clients. Just like us nurses do. Especially now that everything is computerized we can’t upload our admission unless all the questions are answered. Many of our safety questions are mandated.  That’s just for regular medical people. I’m not even talking about psych.

Let me repeat that one more time. WE CAN’T UPLOAD OUR PAPERWORK UNLESS THE ALL THE QUESTIONS ARE ANSWERED.

At any rate, the pediatrician is doing his job and this girl totally goes off on him and she gets in touch with her state rep who lives in Sanford. The Florida NRA gets a hold of all this and they just run with it. I’d have to go back and look it up but I think the pediatrician refused to see the patient not because of the gun. Because she went off. Doctor’s have the right to tell patients they don’t want to come back. It happens all the time.

Guess what. One of those questions is “Do you have a gun?” or “Do you have any weapons?” or “Do you have any fire arms? ” We ask this question, honestly ,with the same tone in our voices as did you poop today? It’s just one more question in a zillion questions when you are doing an assessment of a patient. It’s just one little bit of education. We talk about all kinds of things: scatter rugs, seat belts, steps.  Anything that is about the safety of patient is OUR business.  Because that’s our job. Our first priority is to make sure our patients are safe and if they are not we have a legal/moral/ethical responsibility to make sure we fixed the situation so the patient is safe.

I’ve have never in all my years as a nurse had anyone who was upset about this question. I’ve had some great discussions about safety especially when children are involved.

I’m not antigun. We had Dad’s army guns in the house and we had guns in Maine at our camp. I was a sharpshooter at summer  camp in New Hampshire and I carried a rifle on my back in the field of the kibbutz I lived on in Israel. I was taught to be responsible.

There are some cases that I do need to know if someone has gun. Because if I don’t ask and the person hurts them self  or someone else its malpractice. It beyond malpractice. It’s immoral. It’s beyond reason. Just the thought that I could after all my hard work be responsible for the death of someone because my legislators are idiots just slays me.

http://thinkprogress.org/justice/2014/07/29/3464945/court-upholds-florida-law-that-punishes-doctors-for-talking-about-guns/

“Several years ago, the American Medical Association advised doctors to ask their patients about firearms and “educate patients to the dangers of firearms to children” in the name of public health. But doctors in Florida may be suppressed from giving this medical advice, now that a federal appeals court upheld a Florida law that became known as the “physician gag rule” because it punishes doctors for talking about guns.”

Except it not just about physicians. It’s about all health care workers. We are all gagged and we are all open to disciplinary action.

http://www.theatlantic.com/health/archive/2014/08/doctors-cant-ask-about-guns/375566/

“The American Academy of Pediatrics likens counseling on gun safety to counseling on lead paint avoidance or seat belt use. Pediatricians, the group’s recent policy statement reads, are “urged to counsel parents about the dangers of allowing children and adolescents to have access to guns inside and outside the home.” Doctors are encouraged to promote trigger locks, lock boxes, and gun safes. Some distribute cable locks. The American College of Physicians is similarly proactive, calling gun violence a public health issue “requiring immediate attention.” The group, of which most practicing internal-medicine doctors are members, declared in its recent position statement: “Physicians must become more active in counseling patients about firearm safety.” The college implores doctors to open that conversation by asking patients (with and without children in their homes) about gun ownership.”

http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String+&URL=0700-0799/0790/Sections/0790.338.html

790.338 Medical privacy concerning firearms; prohibitions; penalties; exceptions.

(1) A health care practitioner licensed under chapter 456 or a health care facility licensed under chapter 395 may not intentionally enter any disclosed information concerning firearm ownership into the patient’s medical record if the practitioner knows that such information is not relevant to the patient’s medical care or safety, or the safety of others.
(2) A health care practitioner licensed under chapter 456 or a health care facility licensed under chapter 395 shall respect a patient’s right to privacy and should refrain from making a written inquiry or asking questions concerning the ownership of a firearm or ammunition by the patient or by a family member of the patient, or the presence of a firearm in a private home or other domicile of the patient or a family member of the patient. Notwithstanding this provision, a health care practitioner or health care facility that in good faith believes that this information is relevant to the patient’s medical care or safety, or the safety of others, may make such a verbal or written inquiry.
(3) Any emergency medical technician or paramedic acting under the supervision of an emergency medical services medical director under chapter 401 may make an inquiry concerning the possession or presence of a firearm if he or she, in good faith, believes that information regarding the possession of a firearm by the patient or the presence of a firearm in the home or domicile of a patient or a patient’s family member is necessary to treat a patient during the course and scope of a medical emergency or that the presence or possession of a firearm would pose an imminent danger or threat to the patient or others.
(Because EMT’s have nothing better to do while they are saving the life of your family member.)
(4) A patient may decline to answer or provide any information regarding ownership of a firearm by the patient or a family member of the patient, or the presence of a firearm in the domicile of the patient or a family member of the patient. A patient’s decision not to answer a question relating to the presence or ownership of a firearm does not alter existing law regarding a physician’s authorization to choose his or her patients.
(5) A health care practitioner licensed under chapter 456 or a health care facility licensed under chapter 395 may not discriminate against a patient based solely upon the patient’s exercise of the constitutional right to own and possess firearms or ammunition.
(Who does this anyway? How do you people come up with this garbage? We’re health care workers. It’s our job NOT to judge anyone. Just because your judgmental doesn’t mean we are. A case of pure projection.)
(6) A health care practitioner licensed under chapter 456 or a health care facility licensed under chapter 395 shall respect a patient’s legal right to own or possess a firearm and should refrain from unnecessarily harassing a patient about firearm ownership during an examination.
(7) An insurer issuing any type of insurance policy pursuant to chapter 627 may not deny coverage, increase any premium, or otherwise discriminate against any insured or applicant for insurance on the basis of or upon reliance upon the lawful ownership or possession of a firearm or ammunition or the lawful use or storage of a firearm or ammunition. Nothing herein shall prevent an insurer from considering the fair market value of firearms or ammunition in the setting of premiums for scheduled personal property coverage.
Another care of guilty until proven innocent.
(8) Violations of the provisions of subsections (1)-(4) constitute grounds for disciplinary action under ss. 456.072(2) and 395.1055.
History.s. 1, ch. 2011-112.
If violated we get to go in front of disciplinary board.
How would you suggest we not ask this question since it required? I’m pretty sure we all similar computer programs which ask basically the same question.

Almost 20,000 people committed suicide in the United States with firearms in 2011. More than 11,000 were killed by firearms that year, and more than 200 were killed in accidents with guns. In 2009, almost 7,400 children were hospitalized because of injuries related to guns.

Doctors who ask about guns aren’t doing so because they’re nosy. They’re doing so because the vast majority of those deaths and injuries are preventable.

It’s entirely possible to keep a gun in your home safely. But studies show that the majority of people who keep guns in their homes do so in an unlocked space. Few have any kind of trigger locks. More than 10 percent report keeping their guns loaded or near ammunition, in an unlocked area.

That’s often how children get hurt. Few people argue that young children should have access to guns or ammunition. But that’s what’s happening in far too many homes in the United States. Research shows that guns kept in the home are more likely to be involved in accidents, crimes, or suicides than in self-defense.

http://www.slate.com/articles/health_and_science/medical_examiner/2014/07/docs_vs_glocks_upheld_florida_pediatricians_forbidden_from_asking_patients.html

ut this kind of stuff does happen in Florida—far more often than you’d think. In 2013 alone, at least 17 children in the state were killed by guns, and myriad more were wounded. These tragedies are part of a spiraling, nationwide epidemic of gun violence toward children, which includes a horrifyingly high number of absolutely preventable accidental shootings.

The gag law, nicknamed the Docs vs. Glocks law by its detractors, was passed by an overwhelmingly Republican Legislature brimming over with money from NRA lobbyists. It would seem to be an obvious First Amendment violation: For asking a patient a question that could save his child’s life, a doctor in Florida could lose her medical license or be fined $10,000. The state has no rational—let alone compelling—interest in censoring doctors from asking this basic question, much less preventing doctors from making evidence-based recommendations about public health and safety. And the law is so broad and vague that even an indirect inquiry could potentially qualify as illegal “harassment of a patient regarding firearm ownership.”

I can’t wait for next year! I bet we won’t be able to ask people if they pooped.
I pooped today

Jail is the new state mental hospital. Where are the diversion programs?

@joenegronfl

@MaryLynnMagar

Jail is the new state mental hospital.

and Florida is one of the worst places.

If its “our money” we’d like to keep it and not waste it on housing people. We need a real solution. Stop wasting our money on a solution that doesn’t work and hurts people.

P1-BN290_JAIL_j_G_20130925183605 state of denial

Here is a TC Palm Editorial I found from Feb 2013

http://www.tcpalm.com/opinion/editorial-county-jails-expensive-and-ineffective

“During the 1960s, there were well-intentioned public policies to close most mental health institutions, some of them dens of abuse and neglect, and replace them with community mental health centers, which could dispense medication to people who needed it. But states failed to follow through with either sufficient community mental health centers or funding for treatment.

As a result, many states, including Florida, shifted the burden of dealing with the mentally ill to counties, which lacked appropriate treatment options. Ultimately, jails became the first resort for people whose mental illness contributed to their commission of crimes.

As a result, county jails have become de facto mental institutions at massive costs to taxpayers without resolving long-term problems of the ill, Treasure Coast sheriff’s spokesmen agreed.

Nationally, about one in five inmates suffers from a diagnosed mental illness. Those numbers are even higher on the Treasure Coast, local officials said. And, the numbers have been climbing, in part because of the economic downtown as well as the rise in pain killer addictions.

mentalilljail

The St. Lucie County Jail is the largest mental health institution in the county, housing about 240 mentally ill inmates daily. Over the past year, the jail housed 9,452 inmates with mental health issues, compared to 5,431 five years ago.

St. Lucie contracts for health, mental health and dental services at an annual cost to county taxpayers of about $4 million. Meantime, the mentally ill stay five times longer and cost six times more than other inmates, he said.”

And, while those with mental problems may stabilize with medication in jail, many cannot afford to medicate when they are released and find no other place for treatment.

“This causes havoc with the judicial system,” Tighe said. “The courts have no place to send them. It’s just a vicious cycle.”

http://www.npr.org/2014/01/20/263461940/mentally-ill-inmates-often-locked-up-in-jails-that-cant-help

Officials acknowledge that what’s happening in these wards is reminiscent of the mental asylums of the last century. But they say the only other option is to lock the mentally ill in solitary confinement for weeks on end.

This is, after all, a jail. And this is one of the few in the country with doctors and nurses, psychologists and correctional officers trained in how to handle psychotic episodes. And there are rules: Inmates can only be forcibly medicated with a doctor’s orders. Leather restraints and padded rooms have time limits.

mental_illness_photo_img

“Sometimes I would even commit a crime just to make sure I would get my meds,” says inmate Joseph DeRiggi. “Here, there’s a little more understanding because they know us: ‘OK, DeRiggi, we know what you’re on. You’re good.’ That’s just the way it is.”

But jail is an expensive place to get medication. It costs almost $200 a night to house a mentally ill person here; health clinics cost a fraction of that.

Plus, their cases clog the courts with largely minor offenses. That lengthens jail time for everyone. The average stay is now eight days longer than it was a few years ago. Adding eight days costs county taxpayers $10 million more every year.

http://en.wikipedia.org/wiki/Community_Mental_Health_Act

The Community Mental Health Act of 1963 (CMHA) (also known as the Community Mental Health Centers Construction Act, Mental Retardation Facilities and Construction Act, Public Law 88-164, or the Mental Retardation and Community Mental Health Centers Construction Act of 1963) was an act to provide federal funding for community mental health centers in the United States.

The CMHA provided grants to states for the establishment of local mental health centers, under the overview of the National Institute of Mental Health. The NIH also conducted a study involving adequacy in mental health issues. The purpose of the CMHA was to build mental health centers to provide for community-based care, as an alternative to institutionalization. At the centers, patients could be treated while working and living at home.

Only half of the proposed centers were ever built; none were fully funded, and the act didn’t provide money to operate them long-term. Some states saw an opportunity to close expensive state hospitals without spending some of the money on community-based care. Deinstitutionalization accelerated after the adoption of Medicaid in 1965. During the Reagan administration, the remaining funding for the act was converted into a mental-health block grant for states. Since the CHMA was enacted, 90 percent of beds have been cut at state hospitals.

The CMHA proved to be a mixed success. Many patients, formerly warehoused in institutions, were released into the community. However, not all communities had the facilities or expertise to deal with them. In many cases, patients wound up in adult homes or with their families, or homeless in large cities,but without the mental health care they needed.

Essentially we are spending a lot of money to house people when we could spend smarter money to treat people. In this day and age with all the good medications we have these folks could get jobs, have a life, be a part of the world. Instead they are ignored and live in a world which is really no better than the state hospitals that closed down. Another example of our legislators wasting our time and money and not advocating the people who must be advocated for.

http://www.treatmentadvocacycenter.org/storage/documents/final_jails_v_hospitals_study.pdf

“Florida
In the Broward County Jail in 2007,
23 percent of the prisoners were
taking psychotropic medication. Polk County
Sheriff Grady Judd said: “Our jails and
prisons collectively are the biggest mental-health
facilities in the state. . . . Jails have
become asylums for thousands of inmates with
mental illnesses whose problems and needs
far exceed what jails can provide.”

Food for thought when we are all binge watching “Orange is the New Black.’

Excellent video about CIT (Crisis Intervention Team Training)

Which is great but we have to have a place where people are bought that not jails.

“Diversion programs work better than incarceration – for everyone. In cities like Seattle, San Antonio, and Salt Lake City, we see that successful solutions are a viable option to help end serious social problems. These services alter the course of people’s lives in a positive way and save taxpayers huge amounts of money. We cannot continue to isolate and imprison people who suffer from mental illness, substance abuse, or homelessness. We must treat them with compassion and care to better serve our communities and our pocketbooks.”