Our recent weather has gotten me out in the lawn to cut grass, pick flowers, and plan for spring. For me, my lawn is a labor of love, repaying me in dividends of pride and a sense of accomplishment that is contagious in the neighborhood. Last week, I took a few extra minutes to sit out on the deck and admire the fruits of my labor while enjoying the feel of the summer sun warming my skin. The birds were singing as they frolicked in the yard—with the dogwoods budding, the grass a greening, and the wind a blowing—ahhhhhh, spring is in the air.
Spring’s arrival also brings baseball, swimming, fishing, boating, and gardening—to name a few activities we all enjoy. With these fun times in our lives come hot summer days, bathing suits, and lots of sun. As with anything, too much of a good thing can be bad for us, and the sun is no exception. But, there are positive aspects to sun exposure. Because of its warming effects and visible light, the sun has a positive effect on our mental health and feelings of well being. The sun’s UVA rays stimulate the skin’s production of vitamin D, which is necessary for normal composition, growth, and regeneration of bone tissue. One study I read suggests 15 minutes of sun exposure for fair-skinned people and about three times as long for darker skin tones. However, I believe there are risks and benefits, so discuss your individual sun exposure and lifestyle with your healthcare provider.
According to The Centers for Disease Control and Prevention (CDC), the most common form of cancer in the United States is skin cancer. Melanoma is the third most common skin cancer and the most dangerous. Sixty-five to ninety percent of melanomas are caused by ultraviolet (UV) light or sunlight. In 2006, 53,919 people in the United States were diagnosed with melanomas of the skin—30,560 of them were men and 23,359 of them were women. In that same year, 8,441 people in the United States died of melanomas of the skin—5,477 were men and 2,964 were women. One American dies every hour from melanoma.
Slip on a shirt, slop on the sunscreen, slap on a hat, and wrap on sunglasses to protect the eyes and sensitive skin around them from ultraviolet light (American Cancer Society). When out in the sun, it is important to realize that a typical light T-shirt has less protection from the sun’s harmful rays than sunscreen with a sun protection factor (SPF) of 15 or higher. Slop on the sunscreen; remember sunscreens do not give you total protection. If you correctly apply a sunscreen with an SPF of 15, you still get the equivalent of 1 minute of UVB rays for each 15 minutes spent in the sun. Make sure to check the expiration date on your sunscreen, follow the label directions, and apply generously to dry skin at least 20 minutes before going outside to maximize absorption and protection. Apply about 1 ounce of sunscreen (about a palm full) to cover legs, arms, neck, and face for the average adult. Sunscreen should be reapplied at least every 2 hours and even more often if swimming or sweating. Slap on the hat (brim 2 to 3 inches) to protect your neck, ears, eyes, forehead, nose, and scalp. Wrap on UV-blocking sunglasses to help protect your eyes.
So, before you dive into the activities of your life this spring and summer, “Slip, Slop, Slap, and Wrap.” Seek shade, especially when the UV rays are the strongest: 10:00 a.m. – 4:00 p.m. Do these things and you will look better and live longer in the skin you’re in.
Howard Baker, RN BSN
For questions, comments, or suggestions on topics you want to read about please e-mail me at: howard@howardsbaker.com
Tuesday, April 27, 2010
The Golden Years or Years to Fear?
I often reflect back on my childhood memories as my mind plays vivid picture shows—the images tease my senses and take me back to a simpler time and place—like waking up on a cool summer morning on my Aunt Vicky’s farm to the smell of the morning dew rising off the fields and fresh eggs frying under a crackling fire in the old Home Comfort® cooking stove. I remember her laughter and smiles as she told stories of yesteryears and taught me to cook on an open flame. What did I miss later on when those she trusted betrayed her and money was lost? Did I miss something she tried to say or was she silenced by her fear of losing a trust, friendships, and her all important independence?
Daily, it seems I hear news reports depicting outrageous stories of child abuse, battered women, and animal cruelty taking place in every neighborhood and town across our country. Have the elderly faded into the fringes of our communities, or do we simply reassure ourselves that elder abuse cannot happen to us or those we love? The reality of elder abuse paints a grim picture as it is often life altering to the abused and devastating to what should be the golden years of life.
How big is the problem of elder abuse? The National Center on Elder Abuse estimates between one and two million Americans ages 65 and older have been injured, exploited, or otherwise mistreated by someone they depend on for care or protection. Experts estimate that less than one in six seniors who have been abused actually report the abuse and get the help they need.
The Centers for Disease Control and Prevention define six types of elder maltreatment:
• Physical – Abuse occurs when an elder is injured as a result of hitting, kicking, pushing, slapping, burning, or other show of force.
• Sexual – Abuse involves forcing an elder to take part in a sexual act when the elder does not or cannot consent.
• Emotional – Abuse refers to behaviors that harm an elder’s self-worth or emotional well being. Examples include name calling, scaring, embarrassing, destroying property, or not letting the elder see friends and family.
• Neglect – Failure to meet an elder’s basic needs. These needs include food, housing, clothing, and medical care.
• Abandonment – Happens when a caregiver leaves an elder alone and no longer provides care for him or her.
• Financial – Illegally misusing an elder’s money, property, or assets.
Often, simply recognizing the warning signs can help prevent abuse and break the cycle of this tragedy. The National Center on Elder Abuse lists the following warning signs:
• Physical Abuse – Slap marks, unexplained bruises, most pressure marks, and certain types of burns or blisters, such as cigarette burns
• Neglect – Pressure ulcers, filth, malnutrition, dehydration, or lack of medical care
• Emotional Abuse – Withdrawal from normal activities, unexplained changes in alertness, or other unusual behavioral changes
• Sexual Abuse – Bruises around the breasts or genital area and unexplained sexually transmitted diseases
• Financial Abuse/Exploitation – Sudden change in finances and accounts, altered wills and trusts, unusual bank withdrawals, checks written as “loans” or “gifts,” and loss of property
Financial exploitation of the 80+ elderly population is of growing concern for the U.S. Administration on Aging (AOA) as baby boomers in this age group will reach an estimated nine and a half million in 2030. Financial exploitation affects people of all socioeconomic backgrounds—no one is excluded. I believe financial abuse to be especially heinous because it can deprive otherwise financially secure persons of their ability to continue living their lives independently.
I often wonder what happened to Aunt Vicky’s laughter in her final days. Was it her loss of independence or a depression suffered in silence, knowing she had been robbed of her ability to choose by one she trusted? Talk openly to those you love about abuse, recognize the signs, get informed, and advocate for those you love—their happiness and well being may depend on it.
For more information I recommend these resources:
U.S. Administration on Aging National Center on Elder Abuse
Telephone: (202) 619-0724 Web Address: www.ncea.aoa.gov
E-Mail: aoainfo@aoa.hhs.gov
The Preston Medical Library
Telephone: (865) 305-9525
E-mail: library@utmck.edu
Howard Baker, RN BSN
For questions, comments, or suggestions on topics you want to read about please e-mail me at: howard@howardsbaker.com
Daily, it seems I hear news reports depicting outrageous stories of child abuse, battered women, and animal cruelty taking place in every neighborhood and town across our country. Have the elderly faded into the fringes of our communities, or do we simply reassure ourselves that elder abuse cannot happen to us or those we love? The reality of elder abuse paints a grim picture as it is often life altering to the abused and devastating to what should be the golden years of life.
How big is the problem of elder abuse? The National Center on Elder Abuse estimates between one and two million Americans ages 65 and older have been injured, exploited, or otherwise mistreated by someone they depend on for care or protection. Experts estimate that less than one in six seniors who have been abused actually report the abuse and get the help they need.
The Centers for Disease Control and Prevention define six types of elder maltreatment:
• Physical – Abuse occurs when an elder is injured as a result of hitting, kicking, pushing, slapping, burning, or other show of force.
• Sexual – Abuse involves forcing an elder to take part in a sexual act when the elder does not or cannot consent.
• Emotional – Abuse refers to behaviors that harm an elder’s self-worth or emotional well being. Examples include name calling, scaring, embarrassing, destroying property, or not letting the elder see friends and family.
• Neglect – Failure to meet an elder’s basic needs. These needs include food, housing, clothing, and medical care.
• Abandonment – Happens when a caregiver leaves an elder alone and no longer provides care for him or her.
• Financial – Illegally misusing an elder’s money, property, or assets.
Often, simply recognizing the warning signs can help prevent abuse and break the cycle of this tragedy. The National Center on Elder Abuse lists the following warning signs:
• Physical Abuse – Slap marks, unexplained bruises, most pressure marks, and certain types of burns or blisters, such as cigarette burns
• Neglect – Pressure ulcers, filth, malnutrition, dehydration, or lack of medical care
• Emotional Abuse – Withdrawal from normal activities, unexplained changes in alertness, or other unusual behavioral changes
• Sexual Abuse – Bruises around the breasts or genital area and unexplained sexually transmitted diseases
• Financial Abuse/Exploitation – Sudden change in finances and accounts, altered wills and trusts, unusual bank withdrawals, checks written as “loans” or “gifts,” and loss of property
Financial exploitation of the 80+ elderly population is of growing concern for the U.S. Administration on Aging (AOA) as baby boomers in this age group will reach an estimated nine and a half million in 2030. Financial exploitation affects people of all socioeconomic backgrounds—no one is excluded. I believe financial abuse to be especially heinous because it can deprive otherwise financially secure persons of their ability to continue living their lives independently.
I often wonder what happened to Aunt Vicky’s laughter in her final days. Was it her loss of independence or a depression suffered in silence, knowing she had been robbed of her ability to choose by one she trusted? Talk openly to those you love about abuse, recognize the signs, get informed, and advocate for those you love—their happiness and well being may depend on it.
For more information I recommend these resources:
U.S. Administration on Aging National Center on Elder Abuse
Telephone: (202) 619-0724 Web Address: www.ncea.aoa.gov
E-Mail: aoainfo@aoa.hhs.gov
The Preston Medical Library
Telephone: (865) 305-9525
E-mail: library@utmck.edu
Howard Baker, RN BSN
For questions, comments, or suggestions on topics you want to read about please e-mail me at: howard@howardsbaker.com
Tuesday, April 13, 2010
Manners, Etiquette, and Culture
A rental car attendant, a doctor, a nurse, and a patient—what do they have in common? From my perspective, I don’t think the answer is as obvious as I first thought. Last week I had a personal exchange with all of the people listed above, and there were noticeable differences in how I was addressed and treated by each one. I will also concede that my doctor may have addressed and treated me differently because of our relationship and past history.
When I approached a busy rental car counter last week, the clerk greeted me with a smile as he addressed me, “Mr. Baker, how are you today….” During the 10 minutes of exchanging information and signing the rental agreement, he made pleasant conversation as well as informed me of things I needed to know, such as replenishing the fuel, contact numbers for assistance if needed, and so on. When the paper work was all done, he said with a huge smile and handshake, “Here are your keys Mr. Baker—have a great day.”
My doctor always greets me as a friend I haven’t seen in a while; he gives me a big smile, a nice firm handshake, and a pat on the shoulder. We exchange pleasantries and, before getting down to business, he inquires, “How’s the family?” After the office visit I hurried off to get some blood work drawn at a lab where I did not have the good fortune of knowing the nurse or the phlebotomist. Suddenly, I was addressed as “Sweet Pea” and found myself with an internal struggle of how does one respond to “Sweet Pea?” Now, I might be a lot of things—but a “Sweet Pea” I am not.
In these moments of awkwardness when members of the healthcare community refer to us as something other than our names, how are we supposed to respond, or do we? Obviously, I found myself at a disadvantage because the one calling me “Sweet Pea” would soon be in control of a rather long needle used to pierce through my delicate skin and into my arm to draw my blood. With my clothes returned, specimens collected, and the final “Follow me Sweet Pea”—I had to ask—“Why do you call me ‘Sweet Pea’?” She responded, “Because you’re special.”
I have to wonder where our manners have gone, or did we ever have them? In my career I have heard nurses call patients many things: pumpkin, honey, sweetie, baby doll, and sweet pea. To me, it’s like running fingernails down a chalk board, so I can only imagine how some may suffer in silence, feeling helpless to object. Are these terms of endearment part of a culture that, perhaps, I am out of step with? I do believe that hospitals and doctors’ offices have a unique culture all their own, but should we as consumers of healthcare services accept less than the common courtesies that we expect from other service providers?
The New England Journal of Medicine ran an article on Etiquette-Based Medicine, which included a checklist for the first meeting with a hospitalized patient. The list is as follows:
1. Ask permission to enter the room; wait for an answer.
2. Introduce yourself, showing ID badge.
3. Shake hands (wear glove if needed).
4. Sit down. Smile if appropriate.
5. Briefly explain your role on the team.
6. Ask the patient how he or she is feeling about being in the hospital.
I have always used these six steps to some degree when meeting and addressing patients; it’s just good manners. Remember, there is nothing wrong with reminding our healthcare providers that we are more than patients—we are people with feelings, and we expect good manners.
Howard Baker, RN BSN
For questions, comments, or suggestions on topics you want to read about please e-mail me at: howard@howardsbaker.com
When I approached a busy rental car counter last week, the clerk greeted me with a smile as he addressed me, “Mr. Baker, how are you today….” During the 10 minutes of exchanging information and signing the rental agreement, he made pleasant conversation as well as informed me of things I needed to know, such as replenishing the fuel, contact numbers for assistance if needed, and so on. When the paper work was all done, he said with a huge smile and handshake, “Here are your keys Mr. Baker—have a great day.”
My doctor always greets me as a friend I haven’t seen in a while; he gives me a big smile, a nice firm handshake, and a pat on the shoulder. We exchange pleasantries and, before getting down to business, he inquires, “How’s the family?” After the office visit I hurried off to get some blood work drawn at a lab where I did not have the good fortune of knowing the nurse or the phlebotomist. Suddenly, I was addressed as “Sweet Pea” and found myself with an internal struggle of how does one respond to “Sweet Pea?” Now, I might be a lot of things—but a “Sweet Pea” I am not.
In these moments of awkwardness when members of the healthcare community refer to us as something other than our names, how are we supposed to respond, or do we? Obviously, I found myself at a disadvantage because the one calling me “Sweet Pea” would soon be in control of a rather long needle used to pierce through my delicate skin and into my arm to draw my blood. With my clothes returned, specimens collected, and the final “Follow me Sweet Pea”—I had to ask—“Why do you call me ‘Sweet Pea’?” She responded, “Because you’re special.”
I have to wonder where our manners have gone, or did we ever have them? In my career I have heard nurses call patients many things: pumpkin, honey, sweetie, baby doll, and sweet pea. To me, it’s like running fingernails down a chalk board, so I can only imagine how some may suffer in silence, feeling helpless to object. Are these terms of endearment part of a culture that, perhaps, I am out of step with? I do believe that hospitals and doctors’ offices have a unique culture all their own, but should we as consumers of healthcare services accept less than the common courtesies that we expect from other service providers?
The New England Journal of Medicine ran an article on Etiquette-Based Medicine, which included a checklist for the first meeting with a hospitalized patient. The list is as follows:
1. Ask permission to enter the room; wait for an answer.
2. Introduce yourself, showing ID badge.
3. Shake hands (wear glove if needed).
4. Sit down. Smile if appropriate.
5. Briefly explain your role on the team.
6. Ask the patient how he or she is feeling about being in the hospital.
I have always used these six steps to some degree when meeting and addressing patients; it’s just good manners. Remember, there is nothing wrong with reminding our healthcare providers that we are more than patients—we are people with feelings, and we expect good manners.
Howard Baker, RN BSN
For questions, comments, or suggestions on topics you want to read about please e-mail me at: howard@howardsbaker.com
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