Month: December 2020

Commit to Connect This Holiday Season

by Lance Robertson: For Complete Post, Click Here…

For many of us, the holidays are a joyful time, filled with opportunities to celebrate with friends and family. For people who are socially isolated, the holidays can bring opportunities to reconnect with loved ones, as families who live far apart and extended family members find ways to celebrate traditions.  

For far too many others, though, the holidays stand as stark reminders of disconnectedness, which can make feelings of loneliness and symptoms of depression worse than ever. 

Social isolation is a long-recognized problem for older Americans, particularly the one in three older people who live alone. Similarly, a recent study published in Disability and Health Journal reported that people with disabilities experience loneliness, low perceived social support, and social isolation at significantly higher rates than people without a disability.

Unfortunately, social isolation seems to be increasing, a trend that began even before the COVID-19 pandemic exacerbated the situation. In the past decade the number of Americans living alone has grown 10 percent. This trend has significant consequences.  We know that social isolation can be as harmful as smoking 15 cigarettes a day, increasing the risk of many illnesses, and even premature death.  Beyond the human cost of social isolation, there are also financial repercussions. For example, an estimated $6.7 billion in annual Medicare spending is attributable to social isolation among older adults.

That’s why addressing social isolation is an important component of many of the programs funded by ACL.  Probably the best-known example is the Older Americans Act congregate meals program, which brings people together for a nutritious meal, but equally important, provides opportunities to socialize.  In fact, many participants report that the program is their only social opportunity. Gathering for a meal also provides an opportunity for people to connect to other programs that can reduce isolation.

Telemedicine reduces the stigma in substance use disorder patients

By JULIE CRAIG, MD: For Complete Post, Click Here…

“The patient is 15 minutes late. Can you still see her?”

“He missed an appointment yesterday because the bus ran late, and he’s out of Suboxone. He’s getting agitated in the waiting room, and other patients are complaining. Could you see him right away?”

“Therapy group has already started. Is the facilitator willing to let one more patient in?”

In the halcyon days before COVID-19, these questions plagued the rural substance use disorder program where I provided medication for opioid use disorder (MOUD) side-by-side with primary care. Unscheduled arrivals from patients with substandard housing and unpredictable transportation were pitted against the need to set expectations for compliance. Compassion for individuals in difficult straights battled against the tendency toward burnout among providers who struggled to accommodate late or otherwise non-compliant patients. Maintaining an orderly clinic opposed the chaotic nature of withdrawal symptoms, early recovery, and behavioral disorders.

The rapid change-over to telemedicine in March of 2020 brought predictable challenges to health care at large and substance use disorder treatment in particular: patients without the skill set to navigate HIPAA-compliant apps, phones with too little smarts to handle video conferencing, lack of connectivity in rural and economically depressed areas. But telemedicine brought unexpected benefits: the no-show rate plummeted. Patients were more empowered by their own motivation to engage in care than limited by bus schedules’ vagaries. Suboptimal face-to-face interactions among individuals in the throes of addiction (otherwise known as “mayhem in the parking lot”) ceased immediately.

Most of all, telemedicine mitigates the stigma associated with substance use treatment. By accessing services from the privacy of their own home (or a convenient Starbucks where the Wi-Fi is always free), patients are relieved of the burden of attending clinics where their very presence might disclose their diagnosis. Widening the geographic area of service (telemedicine providers often work on a state-by-state basis due to licensure) allows patients to participate in group therapy with amicable strangers rather than cousins, neighbors, friends, or even former dealers that might compromise confidentiality or trigger a relapse. The frequency of medical and therapy visits – often weekly or more to start – can be accommodated during lunch breaks at work rather than requiring lengthy absences for travel and waiting room delays. Eliminating transportation helps focus patient investment on therapeutic interventions rather than road time. Ideally, patients can vote with their feet if a telemedicine provider is a poor match or engages in stigmatizing behaviors – an option rarely available for highly impacted in-person services that rely on limited local resources.

Michigan’s Older Adults: Stay Active, Connected & Safe

From Get Set UP!: For Complete Post, Click Here…

Michiganders can now enjoy over 150 small group classes for FREE! This is supported by the Michigan Health Endowment Fund, and in partnership with GetSetUp.

What Would You Like To Learn Today?

Use coupon code MICHIGANHEALTH to waive any fees associated with small group classes.

iPhone Basics – All You Need to Know

Basics of Zoom – Refresher

Using Your Android Smartphone

How Can These Classes Help You

These classes are designed to keep your mind active, allow you to engage with others, increase your ability to live independently and learn new things. And most importantly, have fun!

Learn How To Use Zoom To Connect With Others

Take Fitness Classes To Stay Healthy

Join A Social Hour To Talk About Your Interests

Getting To Know Your Device

Stay Independent By Learning About Apps

View Class Schedule

The Best Parts of Living With Borderline Personality Disorder

By Madelyn Heslet: For Complete Post, Click Here…

It can be difficult to think positive when you have a mental illness, and it’s especially difficult to think positively about your mental illness. Borderline personality disorder (BPD) has affected me for as long as I can remember, and it seems like it’s all been in negative ways. My self-esteem, relationships and moods have all taken hits from my BPD, and sometimes that is all I can think about.

But, on my worst days with BPD, I try to remember the unexpected benefits of my illness, and the best parts of BPD. It’s true that having BPD makes it hard for me to regulate my emotions and control my actions in both positive and negative situations. When having an argument with my partner, I may overreact and threaten to end the relationship without even meaning to. On the flip side, when having a heartfelt conversation with my partner, I may express my intense love for that person. BPD allows me to love harder than most people, and I see that as a definite plus. And though it’s hard to regulate my emotions, I am grateful I am able to experience deeper emotions than most people. Yes, sometimes those emotions are bad. But I choose to accept the bad ones so that I can experience the good ones.

Along with experiencing my own emotions intensely, I am empathetic toward others and am able to feel what they are feeling, too. This allows me to form close bonds with others and offer genuine advice when I’m asked for it. BPD allows me to be passionate about the bonds I have with other people, instead of being a friend only when it is convenient for me. I am also compassionate when it comes to other people and animals, and go out of my way to help them and express my love for them, even when I don’t help or love myself.

Some people may see that as a flaw, but I see it as a benefit of having BPD. 

Is Oregon’s physician-assisted suicide law affecting disabled COVID-19 patients?

BY MERRILL MATTHEWS: For Complete Post, Click Here…

Correlation in not causation. Just because A precedes B doesn’t necessarily mean A caused B, even if lots of people predicted it would. But sometimes it can’t be ruled out. And that may be the case with Oregon’s decades-old physician-assisted suicide (PAS) law and recent efforts to deny life-saving care to COVID-19 patients with disabilities. 

National Public Radio recently ran a story suggesting that some Oregon hospitals and doctors may be withholding health care to COVID-19 patients with significant disabilities.

According NPR investigative reporter Joseph Shapiro, Sarah McSweeney, a lady with multiple disabilities, entered a hospital in a Portland suburb with COVID-19. The doctor wanted to put her on a ventilator. She didn’t get one, even though Oregon had a surplus at that time and was lending its ventilators to other states. She died.

In the story, Jake Cornett of Disability Rights Oregon cites similar cases in which COVID-19 patients with disabilities have been denied care. “For a single state to have multiple cases like this coming up over and over, it should raise the alarm bell. It should convince people that this is a real problem that we need to quickly address at the state and federal level,” Cornett says in the story.

NPR investigated a dozen cases in Oregon. State Sen. Sara Gelser, who has been looking into denial-of-care claims for people with disabilities, told NPR that people think these are “dystopian stories that would never happen, but they do, and they have, and they will.”

The story’s take-away is that some Oregon health care providers have determined that certain people with severe disabilities lack a quality-of-life threshold such that treating them isn’t worth the effort or cost.

When Oregon voters approved a physician-assisted suicide measure in 1994, it became the first state to do so. Many people raised concerns that it might lead to a pattern of devaluing life, especially for certain populations — the very young, very old and for those with severe disabilities.

Vaupel Plan To Improve Mental Health Services Approved By House

By Jessica Mathews: For Complete Post, Click Here…

ngd- This probably sounds like a “technical” problem, but it has a real impact of the day to day lives of people who use behavioral health services…

A local lawmaker’s plan to improve mental health services has passed the state House, marking his final bill passage before the end of his term.

A bill introduced by Republican State Representative Hank Vaupel of Fowlerville creating a uniform Community Mental Health Services credentialing process was approved Wednesday by the Michigan House of Representatives. Credentialing is the process of obtaining, verifying and assessing the qualifications of a practitioner to provide services for a Community Mental Health organization. The need for uniform credentialing was recognized by the bi-partisan House C.A.R.E.S. Task Force, which identified it as a way to improve the process for providers and make it easier to accept Medicaid patients.

Vaupel, who chairs the House Health Policy Committee and co-chaired the Task Force, said his legislation is the first step in overhauling universal credentialing for Medicaid by starting with a smaller subset of mental health services. Vaupel said uniform credentialing is less burdensome on behavioral health Medicaid providers than becoming credentialed through each separate health plan in order to provide Medicaid services. He says if a provider receives credentialing for one behavioral Medicaid health plan, then they should not have to go through a similar process with additional health plans.

The bill marks Vaupel’s last piece of legislation to pass the House, as his final term as state representative comes to a close on December 31st. Vaupel said it has been an honor to serve as an advocate for the people of Livingston County and to help improve the outlook of health care, especially mental health care, in the state of Michigan. He said mental health remains a top priority for the Michigan Legislature and he’s eager to see further improvements in the coming years.

The plan, House Bill 5178, received overwhelming bi-partisan support in both the House and Senate and now moves to the governor for her signature.

AFTER FORT HOOD, THE U.S. ARMY WILL SUCCEED OR FAIL ON TRUST

By CARTER F. HAM: For Complete Post, Click Here…

“The murder of Specialist Vanessa Guillen shocked our conscience and brought attention to deeper problems.” So began Army Secretary Ryan McCarthy’s public statement on Dec. 8 as he, Army Chief of Staff Gen. James McConville, and Sgt. Maj. of the Army Michael Grinston addressed the Report of the Fort Hood Independent Review Committee. While senior Army leaders, including McCarthy, had previously talked about how Guillen’s murder affected them personally and professionally, the report identified failings far deeper than many had foreseen.

I’m an old soldier, one who had the privilege of serving for nearly 38 years, and in some fairly senior positions. A few years ago, I had the honor of chairing the congressionally directed National Commission on the Future of the Army, and I am now the president of the Association of the United States Army, a nonprofit organization that supports soldiers, their families, Army civilians, veterans, retirees, and the businesses that support the Army.

I love the Army, and I think I know it pretty well. Like every soldier I know, past and present, I was disappointed, dismayed, and angry at the failings revealed by the committee. But there was another emotion as well: regret.

As I listened to senior Army leaders and the five members of the committee, then read, reread, and studied the report, I realized that many of the identified failures were failures that I made when I was in uniform. To put it bluntly, as a senior commander, I should have placed increased command-level attention and emphasis on sexual assault prevention and response, more proactively ensured that leaders at every level exercised their rightful responsibilities in instilling the Army’s values, and taken more steps to properly staff and resource sexual harassment/assault response and prevention offices, legal staffs, and investigative staffs. The result, of which I am quite certain, is that soldiers for whom I was responsible did not always receive the protections they deserved, and those who violated the Army’s values, abused their positions, and likely committed crimes against their fellow soldiers were not held fully to account. I suspect that I am not alone in feeling this way.

So, now what? While the Fort Hood report is specific to that installation and addresses a certain timeframe, the findings and recommendations speak to Army-wide problems and have far wider applications. As he mentioned in the initial rollout of the report, McConville has shouldered responsibility for this and charged leaders across the Army to accept the duty to fix the problems identified by the committee. Grinston has similarly made it clear to NCO leaders that they have critical roles in moving the Army forward quickly in addressing many of the identified fundamental leadership failures. The Army also established the People First Task Force, to be led by senior military and civilian officials and supported by a highly experienced, diverse team from both within and outside of the Army. These are necessary first steps to acknowledge and accept that these are deep and underlying problems that require more than superficial actions to remedy.

“But wait,” you say. “We’ve heard this before.” That’s true. I’m one of those who said, “We’ve got this.” But we didn’t. I didn’t. At least not to the extent that our soldiers deserve.

Minds Without Borders

By lifeaspermargo at Wrong Planet: For Complete Post, Click Here…

Autistic behavior is a form of communication. I’m about to take that statement further and show you the significance behind autistic behavior.

For me, autism means that my mind is a vast open space where all my knowledge runs free with my hyper-connected brain. Most people are born with instructions to function on this planet – not me. I can’t think within parameters that I can’t see. It is like being asked to think outside of a box you didn’t know you were inside of. Free-range thinking translates into free-range behavior.

Not seeing borders can manifest itself in difficulties understanding boundaries, and this has been prominent throughout my life beginning at an early age. For instance, I never knew how far to stand from people. To cope, I would stand a little farther away than what I thought was acceptable just to be sure. But not all coping mechanisms and assumed boundaries are perfect – my method failed me once when I was in kindergarten. All of my classmates were sitting in a circle and I happened to be right next to my teacher, who was on a chair reading a book to our class. The top of her foot distracted me; it was flesh-colored, but it appeared to have a textured pattern. I figured she was wearing stockings. I lost my restraint while in some sort of trance and impulsively – but gently – pulled on the top of her foot. It was like my brain had to find out for itself whether my assumption was correct about the stockings. My teacher flinched. She didn’t seem upset, but she was surprised.

My fourth grade teacher was always frustrated that I would never write my assignments within the margins. My print handwriting would spill over the borders of the paper, and my calligraphy was minuscule because I thought it was the only way that I could perfectly align the size and spacing.

My mind’s boundaries followed me outside of school too. One day, I was filing out a form one day and the woman working at the front of the office seemed puzzled. She commented, “You’re the first person ever to start filling out the form at the bottom and working your way up. Why did you do it that way?” I explained that I wanted to get the meatier parts out of the way first so that towards the end of filling out the sheet, my mind can rest as the name/address/date of birth part is a no-brainer.

Assistive Technology to Decrease Social Isolation & Loneliness; Including Celebrating the Holidays at a Distance: Resource Page

From MDRC AT Program: For Complete Post, Click Here…

ngd- There is a lot more on the full page…

Feeling the Animal Love!

Note: live animals can be camera shy sometimes.

Taking action against ableism

From Google Trends: For Complete Post, Click Here…

Ableism, as defined by dictionaries, is discrimination or prejudice against individuals with disabilities, and searches for the phrase in the United States nearly doubled over last year.

Still deeper insights on the topic can be found in the voices of disabled advocates like Alice Wong (pictured), an activist, media maker, and consultant based in San Francisco, and the founder and director of the Disability Visibility Project.

Her book Disability Visibility: First-Person Stories From the Twenty-First Century was released in June 2020, and it shines a light on what ableism means in today’s world.