Sunday, June 22, 2008

Warrior One

OK, I don't want to give anyone the impression I actually practice yoga. So not the case, alas. But seeing how long it's been since I felt like saying anything on the blog, I thought I'd take a suggestion from a book I reading right now Downward Dogs and Warriors, to give the blog a little boost. (Also, JMax delivered the beer last night, so I have to give him the blog address and I figure I ought to post something, y'know, current.)

OK, so here's a suggestion for journaling related to the Warrior poses that Zo Newell writes in the book:

Reflect and journal on a time that you came to the defense of a righteous cause or an innocent person. Invite the emotional qualities of that experience into your practice of the warrior poses. Keep the experience in mind while practicing with softness in the eyes and openness in the heart.

Where, for you, is the line between laziness and intelligent inaction? Where is the line between intelligent action and thoughtless rage?

This is harder than it looks! (the journaling, I mean, not the pose) What I come up against is the difficulty of finding recent examples of coming to someone's defense, which is quite disheartening, really. When I was younger, I was quite the crusader, but of late, I've sidelined myself, and I definitely do not seek opportunities to be righteous. Apart from taking the dog to task for snapping at the cat (or the cat for taking a swat at the dog), I just don't do a lot of this on a routine basis.

I'm ambivalent about whether it would be good to develop this more or not. I suppose if it were always done with soft eyes and an open heart, I'd be more trusting of it, but look at the media folks who are making a living from "righteousness." [I'll spare y'all my "Lou Dobbs is an idiot" rant for the time being, but be warned that from time to time I find myself in a waiting room or lobby or someplace where he's on the TV, and you're likely to hear about it then.] And don't we TV-addicts get our righteousness-fixes from watching programs like Medium or Heroes or Bones or even CSI? (TMI, again, this time about my TV habits, but, hey, it's a blog ferpetesakes.) Dedicated professionals investigating wrongs in pursuit of justice, that's our defense of the weak.

And reality just isn't so simple. I have yet to think of a single thing I can do or say to "defend" Rachel (or her mom). And the best example of my coming to someone's defense I can think of just wasn't this sort of thing. Here it is anyway:

I'm "in charge" (ha) of an assisted living with a kindv lame actitivies program and to try to kick a little life into it and lead by example (not that the activities director was going to see it that way, but whatever), I set up a trip to Montgomery College to see Maryland Youth Ballet's Nutcracker. The Son of one of my very elderly and disabled residents calls me and asks if it would be OK or if I think his mom would even be able to enjoy it if he went with her to this event. The lady requires 24/7 one-to-one care and he'll have the caregiver come, too, but he'd like for her to be able to go unless I think it's a bad idea. I said I think it's a wonderful idea and that even if she can't really see the dancers all that well, she'll hear the music, and she'll be out to the ballet with her son and the time spent with him doing something special will mean a lot to her.

This lady doesn't have a lot of energy left to expend interacting with people in the ways they're most used to, but she's still sharp enough, and she loves to be around other people and experience what's going on. It's one of the unfairnesses of the assisted living world that such people tend to be excluded from things by staff who think they don't contribute enough to the milieu and "aren't really getting anything out of it anyway", supported by marketing people who want to make sure potential residents' families don't see "too many wheelchairs." This was the kind of treatment this lady and her family had come to expect. Coming to her "defense" just consisted of affirming the rightness of her being supported and encouraged in participating in an activity in her community.

Writing about that does give me that strong feeling to work with in the pose, but interestingly, it also gives me a feeling of needing to be cautious. I'm aware of some pretty strong negative feelings toward individuals who disregarded what this lady may have wanted, as well as toward the industry (for lack of a better word) and how for-profit so often in practice turns into against-resident, but we're all supposed to just play along with the way it is, because it's how we make our own livings, after all, and if we don't market, market, market, we could wind up unemployed waiting for Westat to get that hospital's IT department's clearance for remote access to their medical records system. (sigh)

It's not really journal material, I guess, but the two questions about laziness vs intelligent inaction and intelligent action vs. thoughtless rage are valuable considerations when faced with a decision about rising to someone's defense.

I'm less keen on rising to the defense of a righteous cause or ideal, but culture change needs to happen. Bob invited me to a meeting on July 14th, but I'm hoping to be coming back from Bethelehem, PA that evening. More on that later....

Saturday, June 14, 2008

The President's Fitness Challenge

I remember in public school that periodically, typically years apart, a gym class or so would be devoted to assessing the students for the Presidential Physical Fitness Award. We had to do push-ups and pull-ups and sit-ups and run a little ways, and then in high school there was drama over the "body-fat percentage rating" where they took calipers to our arms. I recall being terrified of the calipers test, and then mystified to learn that my body fat percentage was a not-too-bad 17%, whereas a short athletic girl (I remember her name but won't mention it here) was measured as 24%. I think the cut-off at the time for OK vs not-OK was identified as 18%. So every time they did it, maybe 5% of the girls would actually qualify, be congratulated with a certificate, and then it would be forgotten for another few years.

Well, it's back, and this time it's for adults, too. And since there are no calipers involved and I've just resolved (again) to try to improve my health and fitness, I've registered (even thought the challenge officially ended in mid-May). Being quite sedentary, I've enrolled in the Active Lifestyle Program, in which I can track daily online whether I did my 30 minutes of exercise, and get a star :) for every week in which I do so 5 or more days in the week. There is also an Adult Fitness Test, and when I'm good and ready I can also enter my scores online and get comparisons between my own fitness and some vaguely comparable percentile-ranking scale.

The President's Fitness Challenge gives me a page of my own to track my progress, but don't worry, y'all won't see it. The link in the sidebar is just the main page, in case any of my imaginary readers wants to try it out.

Friday, June 13, 2008

Taking the blog way personal

WARNING: The following post is TMI

My dosha is very kapha, so I've tendencies for both laziness and being overweight, although on the plus-side, when properly nourished, excercised, and rested, I'm quite strong. How fat I am has always been a good indicator of how stressed and/or unhappy I am. For example, over the past few years, I started my nursing home social worker job at a high degree of fatness, having come off of several months of unemployment and a year of uncertain job security before that. Over the course of 2 years at the nursing home, I lost about 30 pounds, although toward the end we had an administrator who was a demented nightmare (may all beings benefit) and I regained about 10 pounds prior to my promotion to executive director of an assisted living, a job I had really wanted and had worked for years to get. Over the next 14 months in that position I gained an additional 35 pounds, a sure-fire indicator that it was not the job for me after all. My subsequent release from the fat-making job has not helped matters, and for the past few months of unemployment, I have remained fatter than I've been since 2001, when I lost 60 pounds of stress-weight to return to a close-to-healthy BMI.

Well, I start a part-time job Monday, and I'm encouraged to see that the folks there are normal-weight, since obesity is at least somewhat contagious. (At the fat-making job, my boss and all but one of my 7 peers were overweight-to-obese, whereas at the nursing home all but one of my peers was normal-weight. Hmmm.) To leverage this opportunity of a fresh start, I have signed up for a fitness journal, in which I can enter everything I eat and whatever exercise I get, and track my weight loss.

I took this step after reading this article on WebMD, which is disappointingly not linked to the study on which the claim is based, but what can you expect from Good Housekeeping after all, right? It seemed reasonable, so I decided to give it a try. (I wasn't vegetarian when I lost the weight in 2001, I did it by going high-protein and low-carb, which meant eating meat daily, not just a couple times a week which was my more natural tendency, so it's not an option this time, I have to come up with something else workable.)

Mostly for my own convenience, I'm making the fitness journal "public" so that I can link to it form here for ease of access. This will have the unfortunate side effect of inflicting on my imaginary readers way more infomation about the eating and non-exercising habits of a middle-aged suburban mom than anyone wants, and for this I apologize in advance.

Wednesday, June 11, 2008

Another Good "Duh" Study

I can't get the JAMA article without a subscription, but there's a good summary at bright lights have (again) been shown to reduce symptoms of dementia, such as agitation, depression, and poor sleep. (I call these "duh" studies because the results should be fairly obvious, but it's good that these studies are being done to confirm and quantify the benefits of health interventions, to encourage investment in implementation.) I saw a good presentation on the importance of lighting design in senior care settings at the Pioneer Network conference in April, too.

I'm pretty passionate about the lighting issue, since managing a 27-bed dementia unit in an assisted living in 2001-2003 and gathering data from our QA meetings that over the course of a year -- in which the building (general AL and Special Care) switched over from yellow incandescent lighting to white lighting in our hallways and common areas -- demonstrated a decline in falls throughout the building. Then when we were bought by Another Assisted Living Company, their regional management team came in and the first thing they wanted to do was go back to yellow lighting because they thought the white lighting looked "institutional". I tried to show them the data and explained that the next project was to paint the dining room for more contrast so the residents weren't lost in a beige blur when we sat them down to eat (so they'd be better oriented and eat more), but I was just a peon manager who had issues with their Vision, so I was moved on.

I wonder how long it's going to take the senior living industry to catch up...

Wednesday, June 4, 2008

Dream Snake

So I'm watching TV in the living room, sitting on the sofa by the window, only I'm not really watching TV because Britney Spears is posing semi-nude, a la Marilyn in a white sheet, in the open window for someone taking photos from next door, which strikes me as odd and silly, but hey, it's Britney, right? The photographer calls a warning to her and she scurries off into the house and a corn snake follows her inside. Well that won't do, and I'm the household Wildlife Removal Specialist (usually just spiders and the random squirrel), so I grab the poor thing just below the head and halfway down its body and take it out front under the trees. He's a little miffed with me, since it's wet out and he meant to be in the house, but I manage to let him go without being bitten, and then I answer my cellphone standing there in the front yard next to the snake, which doesn't move off, but waits for me to finish the conversation. I don't remember who I was talking to or why. Then I go back into the house, but he dashes after me, and I'm only barely able to shoo him back to close the storm door and keep him from getting back into the house. I tell the Fam about it so they know to be careful that the snakes want in because it's really wet out, but no one's interested, so we just have breakfast.

It rained good last night, but it's sunny-ish this morning. The road and the deck are starting to dry. My head hurts this morning and I'm sinus-y, so there must still be something going on with the air pressure. Doppler radar suggests there will be more rain, and there's a flash flood watch through this afternoon. No swim practice for Angelina anyway, since we missed the orthodontist last week and she has to go today.

No snakes in sight when I went to get the paper. I haven't seen a corn snake since Summerville (2004). I wonder where that came from....

Tuesday, June 3, 2008

Policies and Options

OK, here's something to think about. Apparently this is CPR/AED Awareness Week (the very first one!), so the newspapers have an incentive (?) to publish stories about how unprepared we as a community are to help people in a cardiac emergency. According to Google, there seem to be plenty of Red Cross press releases, and some papers are carrying stories, like the AJC article above or this one in Frederick, but there are crickets chirping at the Washington Post, and my own Red Cross chapter -- you know, where I teach CPR and so forth to try to raise the community's preparedness? -- didn't think to mention it when scheduling classes this month or last month or list it on their training calendar. I know I should try harder not to be cynical, but looking at the Red Cross NCA page, it occurs to me that the Golf Tournament has top billing and there's no mention of the First Annual National CPR/AED Awareness Week because the Red Cross is pretty desperate for funds at this point and the Golf Tournament's a fund-raiser and the CPR classes, well, aren't. It might not have been a bad idea to advertise ahead of CPR/AED awareness week that CPR/AED classes this week or this month even would be free, to really kick-off and give people a little extra incentive to get involved, but hey, what do I know, I didn't even know we had a National CPR/AED Awareness Week, I just teach the stuff in exchange for t-shirts and such.

Here's where the policy and options part comes in. The AJC article mentions how many people don't even recognize an AED and how many fewer people are trained to use an AED than are trained in just CPR, and I know this is because the AED portion is optional. Every time I show up to teach a class, I have to check which version I'm teaching. Adult CPR? Adult CPR with AED? Adult, Infant and Child CPR? Adult, Infant, and Child CPR with AED? In a way all these distinctions make things easier. I know if I'm teaching Adult, Infant, and Child CPR, I've likely got a class full of camp counselors or in-home day care providers. If it's with AED, it's likely to be corporate-ish daycare or schools. Adult CPR with AED is probably fitness instructors and/or Nursing Assistants, although I get Nursing Assistants in the CPR without AED classes, too, because there's no consistency across their work-settings about whether the AED portion is a requirement. The policies where people are required to know CPR for their jobs all (or mostly, it'd just be wrong to generalize too much) require CPR without the additional specification of AED. The Red Cross could address this by just making it policy to teach AED whenever CPR is taught, but inexplicably that is not the case. Somehow it made more sense just to lobby for a CPR/AED awareness week during which it could be pointed out that most people wouldn't know an AED if it fell out of the wall at their feet. Is it the American Way that continuing to have obsolete options just for the sake of having options is preferable to phasing out the old options when better ones arise? (Looking at the heathcare system as a whole, I'm gonna have to say um, yeah.)

OK, so for the AED-uninitiated, I found a couple of links to introduce what is an AED? HowStuffWorks disappointed me by having a section on CPR that did not mention AED's at all, although they do mention defribrillators as part of the crash cart in and Emergency Room. (sigh) does have an article describing use of an AED. As noted, reading stuff on the internet is no substitute for getting training, so get trained. I'm teaching CPR/AED on the 24th in Silver Spring. I'm also teaching just CPR on the 10th, but it's full. It costs more to get AED with it. Policies and options...