Finding Support – Mental Illness & Caregivers

Looking for support and resources to help care for a loved one with mental health concerns? A great first step is contacting your local NAMI chapter — the National Alliance on Mental Illness (NAMI) is a supportive and strong network with chapters all over the country. They have been where you are, and can help you start getting the support and resources you need – for yourself, and your loved one.

NAMI Programs

Education Classes

NAMI Basics
NAMI Basics is a class for parents and other family caregivers of children and adolescents who have either been diagnosed with a mental health condition or who are experiencing symptoms but have not yet been diagnosed. This course is also available in Spanish, Bases y Fundamentos de NAMI.

NAMI Family-To-Family
NAMI Family-to-Family is a class for families, partners and friends of individuals with mental illness. The course is designed to facilitate a better understanding of mental illness, increase coping skills and empower participants to become advocates for their family members. This program was designated as an evidence-based program by SAMHSA. The course is also available in Spanish, De Familia a Familia de NAMI.

NAMI Homefront
NAMI Homefront is a class for families, partners and friends of military service members and veterans experiencing a mental health challenge. The course is designed specifically to help these families understand those challenges and improve the ability of participants to support their service member or veteran.

NAMI Peer-To-Peer
NAMI Peer-to-Peer is a recovery education course open to anyone experiencing a mental health challenge. The course is designed to encourage growth, healing and recovery among participants. This program is also available in Spanish, De Persona a Persona de NAMI.

NAMI Provider Education
NAMI Provider Education is a class for line staff at facilities providing mental health treatment services. The NAMI Provider Education class is designed to expand the participants’ compassion for the individuals and their families and to promote a collaborative model of care.

Presentations

NAMI Ending The Silence
NAMI Ending the Silence is an in-school presentation designed to teach middle and high school students about the signs and symptoms of mental illness, how to recognize the early warning signs and the importance of acknowledging those warning signs.

NAMI In Our Own Voice
NAMI In Our Own Voice is a presentation for the general public to promote awareness of mental illness and the possibility of recovery. This program is also available in Spanish, En Nuestra Propia Voz de NAMI.

NAMI Parents & Teachers As Allies
NAMI Parents & Teachers as Allies is a presentation for teachers and other school personnel to raise their awareness about mental illness and help them recognize the early warning signs and the importance of early intervention.

NAMI Compartiendo Esperanza
NAMI Compartiendo Esperanza is a bilingual presentation for Latino communities designed to promote mental health awareness, explore signs and symptoms of mental health conditions and highlight how and where to find help.

NAMI Sharing Hope
NAMI Sharing Hope is a presentation for African American communities designed to promote mental health awareness, explore signs and symptoms of mental health conditions and highlight how and where to find help.

Support Groups

NAMI Connection
NAMI Connection is a weekly or monthly support group for people living with a mental health condition. This program is also available in Spanish, NAMI Conexión.

NAMI Family Support Group
NAMI Family Support Group is a weekly or monthly support group for family members, partners and friends of individuals living with a mental illness.

http://www.nami.org/Find-Support/NAMI-Programs

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Meditation – the Scientific Benefits

The Mental Health Benefits Of Meditation: It’ll Alter Your Brain’s Grey Matter, And Improve Memory, Sense Of Self

By Lecia Bushak

It appears that scientific evidence of meditation’s powers continues to add up. Meditation, in a way, is like exercise for our brains: it’s been shown to assist in mental health maintenance, improve our memory, empathy, and sense of self — similar to how exercise boosts our resilience, muscle strength, cardiovascular health, and blood pressure/cholesterol.

Perhaps one of the most fascinating studies published on meditation is one from several years ago — but one that is good to keep in mind if you’re interested in mental health and brain plasticity. The study, led by Harvard researchers at Massachusetts General Hospital (MGH), found that meditating for only 8 weeks actually significantly changed the brain’s grey matter — a major part of the central nervous system that is associated with processing information, as well as providing nutrients and energy to neurons. This is why, the authors believe, that meditation has shown evidence in improving memory, empathy, sense of self, and stress relief.

“Although the practice of meditation is associated with a sense of peacefulness and physical relaxation, practitioners have long claimed that meditation also provides cognitive and psychological benefits that persist throughout the day,” Dr. Sara Lazar, a Harvard Medical School instructor in psychology, said in the news release. “This study demonstrates that changes in brain structure may underlie some of these reported improvements and that people are not just feeling better because they are spending time relaxing.”
The idea that mindfulness and meditation can bring you compassion, focus, and joy is thousands of years old, but it’s only recently that science has begun to back it.

In the study, 16 participants took a Mindfulness-Based Stress Reduction program for 8 weeks. Before and after the program, the researchers took MRIs of their brains. After spending an average of about 27 minutes per day practicing mindfulness exercise, the participants showed an increased amount of grey matter in the hippocampus, which helps with self-awareness, compassion, and introspection. In addition, participants with lower stress levels showed decreased grey matter density in the amygdala, which helps manage anxiety and stress.

“It is fascinating to see the brain’s plasticity and that, by practicing meditation, we can play an active role in changing the brain and can increase our well-being and quality of life,” Dr. Britta Holzel, an author of the study, said in the press release.

Another recent study examining the health benefits of positive thinking found that mindfulness exercises like meditation or yoga actually changed the length of telomeres in breast cancer patients — which works to prevent chromosomes from declining. And in the past, researchers have found that people who practiced meditation actually had different brain structures than people who didn’t.

Indeed, the notion that meditation can foster improved sense of self, compassion, happiness, and focus is thousands of years old, but it’s only now that science has begun backing it.

(www.medicaldaily.com)

Caring for Elders

A Conversation with Dr. Saadia Husain

We speak with Dr. Saadia Ishaq Husain on caring for elders – how to be aware of the subtle signs of illness in seniors, attending to their emotional and physical needs, along with caregiver support issues and resources.

What are some of the unique medical issues you find caring for elders?

Geriatric syndromes like fraility, polypharmacy , mood disorders, fall risk are common in this population.

How about family issues in elder care – what have you seen are common struggles?

There are different kinds of struggles when it comes to family. Some families are very close and wish to take care of their loved ones at home but lack resources. Other times, they have resources but prefer for their relative to move to a long term care setting for closer medical monitoring.

As our parents age, many of us wonder about the early signs and detection of dementia/Alzheimer’s – what are some early warning signs and what are the first steps we should take if we see those?

Early signs in functional elderly are subtle. They are able to, until some point, cover their forgetfulness by other activities that they can still do. We may see them sometimes writing an incorrect check, leaving the stove on, forgetting names, numbers, forgetting or driving directions to a familiar place.

Do seniors have different sleep/wake patterns, and how much sleep should those over the age of 65 get, on average?

Normal aging as well as dementia are associated with major physiologic changes in sleep. Changes can be seen in total sleep time as well as time spent awake after falling asleep. Difficulty with sleep initiation and sleep continuity are most commonchanges . Total sleep time decreases by average of 30 minutes per decade starting in midlife.

Grandmother's Success

What options / resources are there for assistance with caring for elders at home, given our busy lives? Can you also speak to the financial aspects of what insurance may provide coverage for, and what families may have to finance themselves?

It depends on their needs. If they are skilled needs like home IV, wound care, dressing change ,therapy, they are paid by Medicare for nurse or therapist visits at home. However, if we need assistance with Activities of Daily Living like bathing, dressing, toileting, grooming, feeding and transferring, there are home care agencies that provide Home Health Aids who are privately paid on an hourly basis in a common scenario. Typically this is not paid for by Medicare.  Social workers work closely with Home Health Agencies to provide families with the aid they need.

Nursing homes have traditionally been a cultural contradiction in our immigrant community. Is that changing, and have you seen more culturally sensitive centers for those who lack the ability to care for their elder family member at home? What questions should one ask about a nursing facility or home when searching?

With ongoing CMS regulations and changes for improvement, I think overall Nursing Home quality is moving in the positive and right direction. However, for immigrant communities, it can still be a cultural shock. The language barrier is first. At this age we prefer people to communicate in our mother tongue. Activities like going out for dinner, playing bingo, going out for movies, music night,  etc. may not be something elderly from a different cultural background look forward to.

This area is something that needs a lot of work. I would ask about the daily schedule and flexibility in the schedule, food options, visiting hours, availability of a translator on phone or otherwise, if patient needs one. Also one should inquire about accommodation of patient’s cultural needs, religious activities like praying and celebrating their special occasions etc.

I’ve heard that illness in elderly patients can present in subtle ways, different than younger patients. What are a few “warning symptoms” for families to be tuned in to for early detection of serious health concerns?

Anything different than their normal routine. Missing meals, feeling tired, not hungry, falling or gait changes, low moods , low grade temperature (not necessarily having fevers)… Patients with severe UTI or sepsis may present with generalized weakness as the only symptom. Patient with pneumonia may present with loss of appetite and low grade temperatures and no cough. Stroke can present with acute confusion or a fall.

Vintage white roses in clear glass vase with purple background, shallow DOF

What do you advise families to help care for the emotional needs of elders? Many seniors seem to fall into a bit of depression or agitation following the loss of spouse or friends, or as their ability to function independently decreases, for example.

I tell them that the presence of loved ones around the elderly is the most effective medication. Families can take turns to be there for them or visit them. Assist them with their meals and basic needs. Identify early if extra help is needed.

How about advice for children caring for aging parents – certain legal considerations they should look into, and also how to manage the stress of the caregiver role?

Again taking turns and getting extra help is important. Caregivers should not feel exhausted on a day to day basis. If a caregiver is always tired, something is not right and needs to change. Caregivers should not feel guilty or bad expressing their concern of work load to social workers, other family or PCP.

How important is establishing a daily routine/pattern for elders? How about exercise?

Daily routine is important in all ages but crucial in the geriatric population. At the same time we cannot be very rigid if a person is not up to it on a certain day. It is important to do some exercise as a routine for mental, psychological as well as physical wellbeing. Some nursing homes have exercise routines for elderly based on their capacity.

How would you advise helping seniors balance a sense of independence while also maintaining safety? (For example, when it may not be safe to drive alone, etc.)

There is no easy answer to that. Taking away your driving license is taking away all your independence. That is how they feel. It needs a lot of education and reinforcement and replacing that activity with something enjoyable is important. It is a team effort and the decision should be made in collaboration with families and a plan of care should include alternatives.

What is the most rewarding aspect of your job caring for elders, and what would you advise others in regard to this special generation?

I lost both my parents. I have a special place in my heart for elderly patients. Every parent, every elderly person, has the right to be cared for and loved in this time of their lives more than ever before. It is very rewarding when they hug me and feel loved and cared for. Sitting by their bed and holding their hands and listening to them makes my day and theirs too. My advice is that if we get the opportunity to take care of elders, be mindful of their needs as they may not express them like other people. They need company and should not feel lonely. They should be taken care of as a whole person rather than as a list of medical problems.

* Dr. Saadia Ishaq Husain is medical director and attending physician, geriatrician at Crescent Cities Center, a skilled nursing and long term care facility in Maryland. This facility is part of Genesis Physician Services.   Dr. Husain has been in practice for several years and has clinical experience in the assessment and management of geriatric syndromes.

 

Women’s Health – A Conversation with Dr. Mahnaz Ali

A Conversation with Dr. Mahnaz Ali

Can you tell us a bit about your clinical practice?

I work at a federally qualified health center called PCC Wellness Community Center in the Chicagoland area. I did my Family Medicine training from MacNeal Hospital and the University of Arizona with a fellowship in Maternal-Child Health at West Suburban Hospital. I practice full spectrum family medicine including OB.

What are some of the leading health concerns you see in women?

Many of women’s office visits are related to: STDs, depression, diabetes, hypertension, heart disease, abnormal menses, hot flashes and obesity.

What are three important screening tests for women?

Pap smears for cervical cancer screening starting at age 21

STD screen once sexually active

Diabetes screen for any age woman with risk factors

I will also say mammograms for breast cancer screening starting at the age of 40.

How important is heart disease as a concern for women?

Very important. Heart disease is the leading cause of death in women.

My daughter’s periods are very irregular, and I was told the pill can help. But I’ve also heard that the pill may not be safe, or may cause problems with fertility later – is that true?

The pill can help with regulating periods. Like any medications, pros and cons have to be weighed with the treatment benefit and the medication’s side effect profile, but the pill does NOT cause issues with fertility.

If my mother or aunt had breast cancer, does that increase my risk, and should I be screened earlier?

It may increase your risk and screening can start early at age 30-35.

At what point should a couple think about fertility testing if they are struggling to have a child?

I recommend patients to try to conceive naturally for 1 year. For women 35 or older, they can seek earlier intervention after 6 months of trying on their own.

What are some dietary recommendations for nursing and post-partum mothers?

I recommend moms to continue to take prenatal vitamins and eat a well balanced meal with iron and calcium.

How often do you see issues of emotional stress, domestic violence or other abuse in the community? What resources are available for women to start seeking help?

We screen all of out patients for domestic violence and most of our patients for anxiety/depression because they are very common. We are lucky to have a behavioral health specialist in each of out clinic sites or access to one in the system. We also have pamphlets and help lines.

Achieving balance always seems a top concern for many women – what advice do you have for women struggling to “balance it all”?

This is a tricky question because I don’t think its possible to “balance it all.” What really helps in trying to “do it all” is a great support system with friends and family. Don’t sweat it if you can’t do things perfectly or exactly the way you want it, things will fall into place.

What are a few positive health habits or routines you would recommend for women (e.g exercise, sleep, meditation/yoga or other habits)?

We all want to have healthy habits, but I think getting a restful sleep and exercising tops the list. Other forms of relaxation that are helping are yoga, meditation and massages.

What is the most rewarding aspect of your job caring for women?

Getting to know women at a more personal level and helping them find a happier place in themselves. I love to see women gain confidence and take charge of their lives.