Resources for Mental Health

https://www.mentalhealth.gov/basics/mental-health-myths-facts

Gay Pride Month-Why is it Necessary to Have a Pride Parade?

Over the years, I have heard many friends and acquaintances ask “Why isn’t there a straight pride?” I am sure many of you have thought this but have remained silent.  Some might say this is a fair and reasonable question. Others may say that is an example of how many cis heterosexuals (a term used to describe a person’s gender identity, matching the sex that they were assigned at birth) fail to understand how the LGBT+ community has struggled to exist without prosecution and why it’s necessary to have a movement that has continued for decades.   To help you understand, I am taking you back a few decades. Hopefully this will help you better understand why it is necessary to have a Pride Parade and why the LGBT+ community continues to have this movement each year.Throughout history, the LGBT+ community has been looked at with disgust, disdain and fear thus they were required to go underground to avoid being viewed in this way. An overwhelming number of people in the medical community viewed the LGBT + community as having psychopathology (mental illness and sexual deviance).  The LGBT+ community was constantly under attack just as other marginalized groups were. The civil rights movement for African Americans was in the early infancy stages and slowly advancing with some constitutional amendments. However, homosexual acts were not protected by the law or the constitution. Homosexuality and Masquerading (drag queens) was still illegal in all states except for Illinois. Neither the law nor the constitution protected the LGBT+ community.  Educators, doctors, lawyers or any profession with a professional license could have the license revoked. Public service announcements were televised in the 1960s by CBS specifying that “homosexuals were promiscuous and are not interested or capable of a lasting relationship like a heterosexual marriage.” A prominent psychologist further went on to say that “No man was born homosexual and homosexuality was formed in the first 3 years of life.” The “mental illness of homosexuality” was viewed as reaching epidemiological proportions. In addition to the aforementioned, police departments used lectures as a way to scare juveniles from being homosexual, mental institutions were using castration, sterilization, aversive conditioning (shock therapy), lobotomies and psycho stimulants that simulated drowning similar to water boarding to “cure sexual diseases like homosexuality. Through bar raids, The LGBT+ community were hunted and beaten by police arrested for loitering, solicitation and crimes against nature. If you were arrested you were not only subjected to embarrassment, harassment but listed in the newspaper as a sexual deviant. Repeated bar raids occurred in the 1960s however due to an increase in active social/political movements, the LGBT+ community stood up and said no more. After repeated raids, the final straw came In June 1969 where a mob owned, small dive bar in Greenwich Village, named the Stonewall Inn, was raided by the NYC Police Department. This began the violent demonstrations by the members of the LGBT+ community that are called the Stonewall Riots.   On the 1^st year anniversary of the Stonewall Riots, June 1970, the LGBT+ community marched 51 blocks to central park for the first pride march in U.S History. So now you know the events that led up to the Stonewall Riots. So why do they still need a parade you ask? They have equal rights! They want special rights! Well, this is where we discuss the last 2 decades, so that you better understand why this is still as important as it was in 1969. In 2004, same sex marriage was granted in Massachusetts.  After several failed attempts of states attempting to amend their constitution to define marriage between a man and a woman, the US Supreme Court found that nationwide federal anti-same sex marriage laws were found to be unconstitutional. In June 2012, Marriage equality was granted in all fifty states.  They finally have equality right? No, sorry, not even close.  Just like other social/political movements, we take two steps forward and take three steps back. The following list reflects only a few policy changes that have occurred in the last 3 years. There are several others that have not been listed.  1.) A federal policy indicating transgender workers were protected from discrimination under Title VII of the Civil Rights Act of 1964 was reversed. This new rule is conflicting to the Equal Employment Opportunity Commission (another federal agency).  Several federal courts have ruled that Title VII does protect transgender workers.  2.) The Justice Department argued in a federal lawsuit that the Civil Rights Act of 1964 doesn’t protect gay workers from discrimination. Despite the court having ruled in favor of LGBT + rights, the current administration has not reversed its stance that it’s legal under federal law to fire employees for being gay. 3.) The Bureau of Prisons reversed an earlier position that had allowed transgender inmates to use cellblocks and bathrooms, which match their gender identity. Federal officials now “will use biological sex” to determine the type of housing transgender inmates are given, resulting in conditions that increase the likelihood of rape for transgender women. The administration will not explain how they will determine who is transgender and who is not. 4) A Christian bakery owner in Colorado and the Justice Department argued in the Supreme Court that the baker's religious views allow him to by-pass Colorado law, which bans businesses from anti-LGBT+ discrimination. 5.) Protections for transgender students were withdrawn that said Title IX of the Education Amendments of 1972 must be treated in accordance with their gender identity in classes, sports, and school facilities. 6) The Department of Education is refusing to investigate anti- transgender discrimination complaints in public schools filed by transgender students banned from using restrooms that match their gender identity. 7)  Four Courts have overturned a transgender military ban however the Justice department is still trying to enact the ban. 8) Federal agencies were provided a vague and broad memo stating officials should interpret the Constitution and existing federal law in favor of religious rights. No answer has been provided by the Justice department if this allows federal employees and federal contractors to discriminate against LGBT people. 9) Currently there is no LGBT+ liaison at the White House, a position that previously served as a channel between the executive branch, organizations, and individuals when decision where made on LGBT+ policies. 10) A proposal to collect demographic information on LGBT+ people in the 2020 Census was retracted. Not asking citizens about their sexual orientation and gender identity — like other characteristics — undermines the government’s ability to develop policies that serve LGBT+ people’s health, safety, and other needs. The Department of Health and Human Services, has also said that surveys would no longer collect information on LGBT people. So as the anonymous quote states “  Gay pride was not born out of need to celebrate being gay, but instead our right to exist without prosecution. So maybe instead of wondering why there isn’t a straight pride month or movement, straight people should be thankful they don’t need one”

Dealing with Winter Blues: Seasonal Affective Disorder

Seasonal Affective disorder (SAD) is commonly referred to as winter depression or winter blues. It is a depressive disorder that tends to occur in the fall or winter months when temperatures start to fall and the days get shorter. Those suffering with SAD are more likely to sleep and eat more. Common symptoms associated with other forms of depression may also occur such as lethargy, sadness, hopelessness, anxiety, trouble with concentration and social withdrawal. Symptoms may become severe enough that the person will have thoughts of death and suicide.The exact cause of seasonal affective disorder is not known but there are some factors that may be involved. It is thought that the reduced amounts of sunlight in the fall and winter months can disrupt our body’s internal clock (circadian rhythm) and lead to depressed mood. Less sunlight can cause a drop-in serotonin levels and thus trigger depression. Also, seasonal changes may alter melatonin levels which can affect sleep patterns and subsequently our mood.Women are more at risk for SAD than men. Those who already have clinical depression or bipolar disorder may see symptoms worsening in the fall and winter months. The incidence of SAD is greater among populations that live farther north.Treatments for seasonal affective disorder can include light therapy, medications and psychotherapy. For those with Bipolar disorder it is important that their doctor is aware of this diagnosis as light therapy and ant-depressants can trigger a manic episode.

Light therapy involves sitting a few feet in front of a special light therapy box to give you exposure to bright light. The light therapy acts to replace the amount of sunshine that is lost in the fall and winter months.  Antidepressants known as Selective Serotonin Reuptake Inhibitors (SSRIs) are used to treat SAD. Talk therapies such as cognitive behavioral therapy (CBT) are known to be effective in the treatment of depressive symptoms.

Those with mild cases of winter blues would benefit from getting more sunlight by either getting outside more or sitting in a south facing winter. Getting regular exercise and keeping a regular sleep schedule can also be helpful.Consult your physician or a mental health professional if you believe you may be dealing with seasonal affective disorder. 

Steps You Should Take If Your Child Is Being Bullied

You do all you can as a parent to keep your child safe but how helpless might you feel to protect your child when you realize they are being bullied. There are steps you can take to support your child and intervene in productive ways.

• Listen carefully to your child when they report the bullying. Be supportive and thank them for sharing this.

• Don’t direct the child to ignore the behavior. This undermines the seriousness of the situation and ignoring is not an effective method for handling bullying.

• Don’t assume your child has done something to provoke the bullying.

• Find out as much as you can about the bullying. When and where did it happen? Who was involved and did any adults witness it?

• Don’t encourage physical retaliation. It could make matters worse and your child could get suspended or expelled.

• Keep your emotions in check. You don’t want to react in an emotional way but instead come up with a plan that is smart and rational.

• Report bullying to school officials as it is not likely to stop without their involvement.

•  Let school staff know that you want to work with them on a solution. If you feel their plan is not appropriate or adequate work with them to develop a plan of action that you are satisfied with. Ask for changes in your child’s schedule to reduce contact with the bully.

• If the bullying does not stop, contact school staff again. Be prepared to go to higher ups in the school district if necessary.

• Do not contact the parents of the bully(s). It can make matters worse. School administrators should contact those parents.

• Seek support from other parents. Consider working in the community to shed light on this issue. Perhaps an expert on bullying can speak at the school or the school can get involved in an anti-bullying program.

• Encourage your child to make contact with friendly students in their class. Help facilitate those friendships by inviting these positive friends to your home.

• Boost your child’s confidence by helping them develop their talents or positive attributes through music, art or athletic programs. These activities are good places for your child to meet like-minded peers.

• Talk to your child about seeking help from adults when bullying behavior occurs. Let them know that reporting bullying is not the same as tattling.

• If your child is being targeted because of a learning disability or lack of social skills, consider getting help through counseling and social skills groups so they can improve their interaction with peer groups. The bullying is still wrong in these cases but helping the child develop social skills can help them feel less set apart from peers.

•  Make sure that your child always feels safe and protected at home and keep lines of communication open.

Binge Eating Disorder

Binge Eating Disorder (BED) is the most common eating disorder. It affects 3.5% of women and 2% of men. Binge eating disorder (BED) is characterized by recurrent episodes of eating large amounts of food, quickly and to a point of feeling uncomfortably full. The person has a sense of loss of control during the binge. Afterwards they experience shame, guilt and disgust with themselves. Purging is not a part of the disorder. Those who suffer from BED may be secretive about their eating. They may not practice normal eating behaviors and instead skip meals or only eat small portions at a meal and may engage in sporadic fasting and repetitive dieting. There are health consequences associated with binge eating disorder. Many of these consequences are related to unwanted weight gain due to binge eating. These can include Type II diabetes, high cholesterol levels and heart disease as a result of elevated triglyceride levels. Binge eating disorder is strongly associated with depression, anxiety, guilt and shame. Possible risk factors include genetics, mood disorders, trauma, abuse and neglect and problems with family or other significant relationships. Effective treatments available for binge eating disorder include cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), dialectical behavioral therapy (DBT) and psychotropic medications. A nutritionist can help those suffering with BED help regain normal eating patterns and learn about proper nutrition and having a balanced diet.

For more information on BED visit the following: 

BEDA Binge Eating Disorder Association www.bedaonline.com

ANAD (Anorexia Nervosa and Associated Disorders) www.anad.org 

National Eating Disorder Association www.nationaleatingdisorder.org. 

Traits of a Healthy Marriage

We have all heard that “Fifty percent of marriages end in divorce.” Arguments over the divorce rate continue to be an ongoing debate. Some studies suggest that the divorce rate in the U.S. is declining and that the rates are somewhere between 40-50%. Regardless of the statistics, there clearly are many people struggling to find a way to make marriage work. It may seem that the odds for a successful marriage are not in our favor however with resolve and commitment it is possible to have a long and healthy marriage.

Here are 6 traits of a good marriage

• Accept your partner as they are.  Entering a marriage expecting you can change your spouse is a recipe for disaster.

•  Put your relationship first.  When making big decisions consider how it will affect your partner. You are part of a team now. Don’t make choices that will put undue stress on the relationship.

• Be kind and respectful in your relationship. You won’t always agree with your spouse and at times you will get angry but you can still remain considerate of the other’s feelings. You can focus on criticizing and hurting your partner or you can be kind in expressing your hurt and anger. Kindness is always a quicker path to resolution.

• Don’t keep secrets. You can’t build trust with a partner when secrets are being kept and once trust is lost it’s hard to rebuild.

•  Consider “divorce” a dirty word. Couples who frequently refer to divorce are more focused on their exit strategy and lack the commitment they need to heal and strengthen their marriage.

• Live in the present. You can’t change anything that has happened in the past. It’s important to be forgiving and accepting in order to move forward. Couples who continually dredge up old hurts get stuck in their anger and resentment.

Forming Healthy Habits

It happens every new year. We feel the need to make those resolutions for ourselves because it’s a new year. What better time to make those changes that we did not accomplish last year. We resolve to lose those 20 pounds; we will exercise 5 times a week; we will finally organize that out of control closet. There seems to be messages everywhere to push us in that direction. Tips and guidelines in magazines and news programs. Not to mention all the sales and deals on exercise equipment, gym memberships and storage containers you see every January. What could go wrong?

The reality is that for many of us we start our resolutions with the best intentions but our efforts tend to fizzle out by February. There are different reasons why we struggle to establish these new habits.

•       We make too many resolutions at one time. Trying to make too many changes at once will become too difficult and overwhelming.

• We set goals that are not realistic. Are you really going to be able to go to the gym 6 days a week when you work full time and have a family?

• We adopt someone else’s resolution instead of our own. Are you resolving to lose weight because your spouse is pressuring you? Are you using ultra- thin models as your standard?

• We depend on outside solutions like a gym membership without doing anything to prepare our inside- our brain. 

•  We don’t consider how we will psychologically handle the stress and discomfort that comes with change.

• Focus on small changes. Tasks are always easier when you break them down. Replacing a daily snack with something healthy is not as hard as revamping your entire diet. You can then move on to other small changes.

• Consider your timing. Do not try to make changes during times of stress and disorder in your life. The day you get fired is not a good time to quit smoking.

• Focus on the behavior not the result. Often we give up when we haven’t lost the pounds we expected to but if we continue with these healthier behaviors we will see results in time. It’s a matter of making lifestyle changes not looking for a quick fix.

• Find a partner. It can help to work with someone who can be your cheerleader and help keep you accountable.

• Change your environment. It will be harder to eat well with a pantry full of junk food. Turn off your devices or put them away if they are interfering with your efforts. Surround yourself with positive people.

• Set realistic goals. You may never be able to wear a size 4 or run a marathon but that doesn’t mean you can’t improve your health or lifestyle in significant ways.

• Give yourself time. We hear that it takes 21 days for a habit to form but that might not be true for everyone. Accept that things will get easier but we have to be willing to give it time.

Here are some steps that may make your journey to healthier habits a little easier.

If you take small steps and keep your expectations realistic you are on the right path to form healthy habits.

May is National Mental Health Awareness Month

In this year approximately one in five adults in the U.S. will experience a mental health condition like depression, anxiety, bipolar disorder, schizophrenia or post- traumatic stress disorder. To bring awareness and reduce the shame and stigma that surrounds these illnesses, President Obama has proclaimed May 2015 to be National Mental Health Awareness Month, 2015.

What are the Early Warning Signs of Mental Illness? Having a combination of symptoms (not just one symptom) indicates that someone might be showing signs of a mental health condition. Pay attention to these symptoms when they last longer than a few weeks.

• Problems with concentration, memory or ability to think clearly.

• Feeling overly worried.

• Changes in eating such as loss of appetite or overeating.

• Unable to complete school or work tasks.

• Feeling sad, hopeless or worthless.

• Loss of interest in activities that were previously enjoyable.

• Social withdrawal.

• Irritability and/or restlessness.

• Changes in energy levels or sleep patterns.

• Sex drive changes.

• Extreme mood changes.

Many mental health illnesses can be effectively treated with one or a combination of medication and psychotherapy. There are day programs or partial hospital programs and in more serious cases inpatient hospital programs. There are a variety of professionals that can provide psychotherapy or counseling services. These include psychologists, licensed clinical social workers (LCSW) and licensed clinical professional counselor (LCPC). These professionals must adhere to strict rules of confidentiality to protect client’s privacy.

Many gain support and valuable information from support groups. For more information on support groups visit National Alliance on Mental Health www.nami.org  or Depression and Bipolar Support Alliance www.dbsalliance.org

Talk with your doctor or mental health professional about your mental health concerns.

If you or someone close to you has thoughts or a plan of killing one’s self or someone else seek immediate attention by calling 911 or going to your nearest emergency room.

New Potential for Alzheimer's Treatment

http://www.sciencealert.com/new-alzheimer-s-treatment-fully-restores-memory-function

Video on the Impact of Cyberbulling

http://www.psypost.org/2014/11/video-explains-real-effects-cyberbullying-29158

Screening for Mental Health :: Depression Statistics

Screening for Mental Health :: Depression Statistics

Survival Strategies with Parenting Children with ADHD

• Be Available During Homework Time. Be present and talk through what assignments need to be completed. Once your child begins to work on his assignments, you then can complete the tasks you may have to complete. If your child asks you to leave, consider going to another part of the home, as long as he or she is working on their assignments.

• Increase Physical Activity. Studies suggest a connection between physical activity and increased levels of alertness, mental function and learning. Physical activity increases blood flow to the brain, allowing for increased levels of glucose (brain food) to the brain, while releasing endorphin's, which are shown to improve mood. Encourage your child to bounce a ball or walk around the house while reading aloud from a book. Your child will eventually settle down and be able to focus on their work more easily.

• Use medication. Most children with ADHD are mentally exhausted upon returning home from school. This often poses significant challenge for completing homework. Discuss with your doctor additional options such as, prescribing a medication that is short acting/ quickly absorbed. Children are able to remain focused, complete assignments and recall the material they studied when prescribed medication.

• Arrange the environment. Although the end of the day may be approaching, homework still has to be completed. Getting your child comfortable and reducing interruptions/distractions improves his or her ability to complete homework. Create an inviting work-space free of the TV and cellphone. Have your child sit away from anything that could distract him from completing homework.

• Make it more fun and it will get done. Homework can be difficult and exhausting. The idea of coming home from a long day of school, only to begin the process all over again can be dreadful. Develop a reward system for homework assignments. You can reward your child with additional privileges such as increased television time or a later bedtime on weekends after homework is completed. If your child is studying for a test, turn it into a game of jeopardy or allow him to also ask you questions. Math, Science and English are some of the subjects that tend to tedious for children. Spice it up a bit.

• Periodically take a break. Allow your child a few minutes to rest in between subjects. Don’t expect your child to complete each assignment one right after the other. Consider also working for 20 minutes then allowing for a short break before moving to the next 20 minute segment.    

• Find a tutor. Depending on your schedule, you may find it hard to help your child with assignments. Consider hiring a tutor or locate an after school program where your child has a teacher available for assistance.

• Organize assignments in their appropriate folders.  Have your child place their homework in the designated folder and place it in his schoolbag the night prior. Develop a system with his teacher to ensure that his assignments are being turned in daily. 

To Praise or Not to Praise Your Chilldren

In the past several years there has been some discussion among parenting experts and researchers regarding the value of parents praising their children.  Some researchers  have even reported that inflated praise can harm children with low self esteem. One article in New York Magazine carried the following, alarming headline “The Self Esteem Movement Backfires—When Praise is Dangerous.” Another headline in a Psychology Today article read, “Praising Children With Low Self Esteem Can Backfire.”The headlines appeared to be more attention seeking than informative. The actual research projects provided some interesting and helpful information for parents about the best ways to praise their children.

Some researchers  looked at the effect of praising a child’s intelligence vs. praising a child’s effort.  Other researchers  looked at the effect that  inflated or exaggerated  praise has on a child with low self esteem Dr. Carol Dweck, along with a Columbia University team, for ten years studied the effect of praise on students in 20 New York schools.  Researchers would take a single child out of the classroom for a non-verbal IQ test..  When the researcher told the student his score,  he would be  given a single line of praise.  Randomly divided into groups,  some were praised for their intelligence. They were told “you must be smart at this.” Other students were praised for their effort.  They were told, “you must have worked really hard.”

In follow up research, students were given the choice of taking a  more difficult   second test  or an easy test just like the first test.  The students were also  told that they would learn a lot if they took the more difficult test.  Of those praised for their efforts,90 % chose the harder test.  Of those praised  for their intelligence, a majority chose the easy test.  Other subsequent  tests,  so  hard that all of the students failed,  looked at the two groups of  students’ response to failure. Those praised for their effort on the first test, assumed that they hadn’t focused hard enough on the difficult  test.  Those praised for their intelligence assumed that their failure was evidence that they really weren't smart at all.”

At the end of her 10 years of studying the effects of praising students for their intelligence vs praising students for their effort, Dr.  Dweck  concluded”Emphazizing effort gives a child a variable that they can control.  They come to see themselves as in control of their success.  Emphasizing natural intelligence takes it out of the child’s control and it provides no good recipe for responding to a failure” .

Dr. Dweck, based on  some of the findings from   her ten year study ,  went on to develop a   theory of two different  mindsets that she believes  shape our lives and our brains.  LS Blackwell,  a member  of Dr. Dweck’s team, took the study one step further. Acting  on the findings of the previous tests , Blackwell took a group of students who had a history of decreasing math grades. A total of 50 minutes were spent  teaching the students a single idea: that the brain is a muscle, giving it a harder workout makes you smarter.  That alone improved the students’ math scores.  

In another university, research was done looking at the effect that inflated or exaggerated praise has on children with low self esteem.  Eddie Brummelman and Brad Bushman conducted research at Ohio State University in which they found that adults seem to naturally give more inflated praise to children with low self esteem.

For the research, inflated praise included one additional adverb such as “ incredibly” or an  additional adjective “ perfect.”  An example of simple praise would be, “you’re good at this”  while “ you’re incredibly good at this” was considered inflated praise. The findings of this study showed that children with high self esteem seemed to thrive with inflated praise,while  those with low self esteem, who had been given inflated praise  actually avoided attempting any new challenging work. Brummelman said their findings suggested that the inflated praise may put too much pressure on those with low self esteem. “ They may think that they always need to do incredibly well.”  Bushman in an article for Psychology Today when providing a conclusion regarding the Ohio research says it is important when praising a child to focus on behavior or the process of the behavior  vs praising the good qualities of the child.   

The overall message for parents seems to be  that  praise for children needs to be sincere, specific, contain no exaggerations, and the focus of the praise should be on effort vs. the achievement or intelligence of the child. 

10 Effective Tips to Manage Your Anger

Take deep breaths while lying down or sitting. Breathe in filling your lungs for 5 seconds. 

Hold your breath for 5 seconds and then exhale for 5 seconds.

Visual Imagery- Imagine a peaceful and relaxing scene. Maybe imagine a place you went to on vacation such as the beach. Imagine the sounds, smells, and sights.

Walk away from the situation contributing to your anger. 
Count to ten. Slowly count and think about how you want to respond to the situation.

Find humor in the situation. Try to make light of the upsetting event.

Listen to soothing and calming music.

Meditate. Concentrate on breathing and clearing your mind of the negative event.  

Journal your thoughts and feelings to diffuse your anger. 

Express your anger in a healthy fashion by using "I" statements. Assertively communicate your thoughts, feelings and needs. 

Get some exercise. Channel your negative feelings into a healthy physical activity such as yoga, bike riding or walking. 

Replace the negative thoughts with inspiring words or thoughts.  

Improving Family Dynamics - Traits of a Healthy Family

1.  Family members communicate openly with each other

     and also feel listened to.

2.  Family members support and affirm each other.

3.  Family members respect and trust each other.

4.  Family members make the time to do things

     together as a family.

5.  Family members have positive, optimistic attitudes.

6.  Family members work together to develop effective

     problem solving skills and coping strategies.

7.  Family members have a good sense of humor

     and have fun with one another.

8.  Family members have a strong commitment to

     the family and have a sense of belonging.

9.  Family members don’t take each other for granted—they show

     appreciation to each other.

10.  Family members have shared spiritual values.

11.   Family members share responsibilities. 

12.  Family members respect privacy. 

Complete a family assessment to determine if your family has these traits.   Each member of the family should look at the traits mentioned above and give your family a score of 1 to 10 for each of the traits.  Share the scores with one another to identify weak areas and encourage a discussion that can help you improve these areas.

A Broken System – The Elderly and Hospital Care

   According to the Chicago Tribune, in 2011, the Illinois Department of Public Health received 560 hospital complaints for inadequate services. Allegations ranged from patient abuse, inadequate infection control to more serious violations such as death. Of those 560 complaints, Illinois officials declined to investigate 85 percent due to a lack of funding. Many of these complaints also failed to reach to a federal level, thus many of these allegations were not further  investigated by the U.S. Department of Health and Human Services. So who is ensuring the welfare of hospital patients if hospital staff/administrators and state/federal officials fail to investigate allegations or complaints?  When someone is admitted to a hospital, it is expected that they are safe and given quality medical care.  It also is expected that nurses, physicians and other staff effectively communicate with one another to ensure adequate care is being provided. Recent events that have occurred with my elderly parents have in part contributed to writing this article. The objective of this article is to increase your awareness of inadequate patient care and encourage you to speak up and not remain silent if something similar were to happen to you.

   In December 2013, my father required emergency hospitalization to a hospital in the western suburbs of Chicago. The hospital he was transported to was not our first choice. However, paramedics don’t transport you to the hospital of your choice. Right from the start, I questioned if the ER nurse was adequately trained on how to communicate professionally to patients. This incident though appeared to be the least concerning of the many incidents that occurred during his hospitalization.  The one incident in which I am still trying to understand is how my elderly father who happened to be hospitalized for disorientation, fall in an intensive care unit? Is it not common knowledge that the intensive care unit specializes in treating severe and life threatening illness thus requiring the patient to be closely monitored? Unfortunately the poor care did not stop in ICU. Other serious incidents which occurred were the overuse and misuse of a highly potent benzodiazepine. The reasons for the use of this drug were never documented, nor were we informed that the drug was being administered. Despite our numerous requests to nurses and directors to have the drug removed, the drug continued to be administered. We were informed by one nurse that  staff administered the drug because my father was agitated and restless. Restless and agitated?  Is this enough to administer a highly potent benzodiazapine to an elderly patient with a history of dementia, pulmonary disease, heart and kidney failure?  If restlessness and agitation were sufficient reasons to administer this drug, then the entire world’s population would be on it at some point. At one point we were told that he may become dangerous, thus they administered the drug for everyone's safety.  The humor with this is that my father is a 5 foot tall, frail, 87 year old man, weighing 120 pounds when wearing his dentures.  How dangerous can he be? If there was concern about his safety maybe they should have been proactive and used the bed alarms which commonly are used with dementia patients who wander. Better yet, maybe they should not have administered as many doses of benzodiazepines as they did. 

   In a healthy individual, the half-life of the drug used (the amount of time it takes for the body to excrete at least half the drug) is 12 to 15 hours. For my father, that number is substantially higher due to end stage renal failure. The number of times in which this drug continued to be administered despite communicating with directors and nurses was quite alarming. Even more alarming is that they used this drug despite it being contraindicated in individuals with a history of pulmonary disease and kidney failure. Could the known side effects of this drug i.e. strong sedation/hypnosis, dizziness, drowsiness have contributed to his fall? Despite speaking to the patient liaison department, 3 different nurses and 3 nursing directors; the drug continued to be administered without consent.  It is quite alarming that my fathers records failed to specify our requests nor did anyone bring our concern to the doctor. No matter whose attention our concerns went to, no one seemed to take the matter seriously. I cannot count the number of times I was told someone was looking into the incidents. While we were trying to manage all of the above and get some answers from doctors, we were concurrently dealing with my mother having been transferred to hospice. Well, hospice is what they called it but obtaining the services appeared to require an  act of God.  We waited three days to transfer my mother to hospice and only were given a room when we went up the chain of command. The time we waited for the room was alarming however, what was disturbing was that we were told by one of the nurse administrators that they did us a favor by placing both of my parents on the same floor.  How compassionate of her!  What about addressing your staffs failure to communicate with not only the family but also with the physician and other hospital staff?  Unfortunately,  many people receive below average standards of care while hospitalized. Millions of people worldwide are harmed by poor hospital care each year. Despite one’s deep involvement with a family members care, significant negligence and inadequate care continue to occur. I can’t imagine what happens to those who don’t have advocates or family members involved in their care. Is it worth it to pursue a concern about quality? For many of us, it's not easy to act on a concern about the quality of care we or loved ones receive. The process can be stressful, frustrating and quite honestly emotional exhausting. And in the end, it's possible that others may not agree with the way we see the situation. Is it worth the time and energy to take action on concerns about the quality of hospital care?  Only you or your loved one can decide. In making the decision, think about the continued harm that might take place if you do nothing.  And think about how the actions you take might lead to better care for future patients.