Saturday, June 8, 2013

Nursing Discipline - How the Bureaucracy Hurts You


The Healthcare Integrity and Protection Data Bank is a federal database that keeps track of nurses and other healthcare professionals who have been disciplined for a variety of reasons. According the website at the Department of Health and Human Services, the HIPDB was created in 1996, "to combat fraud and abuse in health insurance and health care delivery." These are very noble and lofty goals, and work to instill confidence of the general public into the hands of nurses nationwide. Certainly most nurses don't want to have to work around people who are negligent and unsafe. They also want patients to trust them. Any breech of that trust reflects poorly on the profession as a whole.

The unfortunate part of the issue is that at this time, the federal government will not provide you access to the information contained in your particular file. Suppose you were accused of something and written up in absentia. Through the court system and throughout all of labor law, you would be entitled to some course of action against the offending party. As the situation exists, you are not even privy to the knowledge that your file contains.

Under Section 1128E of the Social Security Act, "the Secretary [of HHS] will...provide for...disclosure of the information, upon request, to the health care provider, supplier, or licensed practitioner." The problem, like many things in the federal system, is that bureaucracy makes this information gathering almost completely unavailable. According to NPR, not even the hiring agencies that employ nurses, such as hospitals and nursing homes can access the database. A recent feature story says that Dr. Sidney Wolfe, CEO of the Public Citizen's Health Research Group, "notes that there are more than 102,000 nurses, nurse aides, pharmacists and pharmacy assistants who've been disciplined and included in the registry, but that hospitals and nursing homes can't check the data bank." This useful tool to protect the profession is just something else to be thrown in the trash bin of bureaucracy.

What Is Elder Abuse?


Everyone knows that it can be difficult to deal with and take care of an aging family member. Dealing with senior citizens is never easy and takes a lot of patience and compassion. Unfortunately, some people at this task and wind up mistreating the elderly. This happens all of the time in home environments, nursing home, and care facilities. In order to understand elder abuse better, let's take a look at the different types of elder abuse that exist.

What is Elder Abuse?

Elder abuse is when an older person is harmed or taken advantage of by another individual. This can be a family member, friend or stranger. There are many different types of elder abuse. The most common types are physical, mental, neglect, and financial.

Physical Abuse

Physical abuse occurs when any appropriate physical contact takes place with elders. This includes punching, slapping, and hitting of a senior citizen. Even restraining or confining a senior citizen qualifies as elder abuse. An elderly person cannot be restricted in order to make it easier to take care of them. Signs of elderly abuse are bruises, markings, cuts, and swelling.

Emotional Abuse

Emotional abuse is just as harmful and traumatic as physical abuse. Subjecting an elderly person to situations that cause them to be frightened or humiliated is elder abuse. This includes swearing, yelling, and using insulting terms. An elderly individual should not be subjected to cruel treatments that can weaken their mental state. Emotional abuse can be spotted in individuals that are either afraid, timid, or are in a constant frightened state.

Neglect

Sometimes doing absolutely nothing at all is a sign of elder abuse. Depriving an elderly person of necessary care is abuse. Elderly people should not be deprived of food, clothing, and adequate home care. They should be kept in an adequately heated environment with all of the items that they need. They should be comfortable in their environment and have all of the medication that they require.

Financial Abuse

Financial abuse is a valid form of elder abuse. Taking advantage of the weakened physical or mental state of the elderly is illegal. This includes taking items from them or using up all of their financial resources for personal gain. Taking the power of attorney from an elderly person and not using it to take care of their best interest is a form of financial abuse. The elderly are often the victims of financial scams from family members and strangers whose goal is to wipe them out. Trying to profit from the misfortunes of an elderly person is a clear cut sign of elderly abuse.

All of the forms of abuse listed above are types of elder abuse. You need to be watchful to make sure that your family members, neighbors, and friends do not become victims of elder abuse. Pay attention to all of the signs and check up on your loved one regularly. Be sure to only hire qualified trained personnel whom have an outstanding reputation for dealing with the elderly.

Can I Make My Mom Happy?


I had an email once from a Jewish family whose elderly mother had moved from Brooklyn to Florida.

"Our mother doesn't seem to be enjoying Florida. Her former friends ignore her and won't spend time with her. She's very upset. We're thinking of bringing her to Israel to live in an assisted living home near us. Do you think she'll be happy here?"

The question of a parent's happiness is one that troubles good children. When they think about what would work for their mother or father in old age, they wonder about the happiness factor. That's because they're considerate adults who want happiness for that parent.

My answer to that email was to ask what capacity had their mother shown for happiness so far in her life. Being happy, or not, is only partially to do with circumstances. It tends also to be deeply connected with each person's generosity of spirit, lack of resentment and general willingness to deal with the difficulties of life.

If your elderly parent has shown a general tendency in life to embrace happiness, contentment, warm relationships with others and a non-blaming attitude, the chances are good that your good choices in care will help restore temporarily-disrupted happiness.

If your parent has tended not to be particularly happy in general throughout your life, this is likely to continue. In fact, perhaps unfairly, I tend to assume that when someone asks me if an action would make their parent happy, the answer is almost bound to be "No."

That's because asking that question suggests to me their parent habitually is not happy. So how do we choose a good setting for our parent's old age? Consider the following.

Five Home Possibilities:
1. Living with you;
2. Living next door to you;
3. Living in independent-yet-sheltered housing;
4. Living elsewhere, with a care-manager or friend overseeing;
5. Living in assisted living.

Never feel guilty about not taking a parent home with you. Let's face it, you know how they are. So you know whether their presence helps your happiness, let alone theirs.

Don't make the mistake of taking a parent into your house but continuing to live a largely absent uninvolved lifestyle. That almost guarantees unhappiness, because they'll be lonely.

Besides which, frankly, you flatter yourself if you think your presence will be enough to keep your parents happy. No, they want a life like the life they want. It's probably slower. It involves a different culture, music, food, activities. Even if they like their grandchildren, they may not do well with their lifestyle all around them.

I'm not saying old people should live apart. Not at all. Over my years as a caregiver to elders, however, I have learned the comfort they get from their way of living. I was always pretty much against generational separation. Now I do see that there is a generational comfort level going on when people have shared similar times and similar history.

If you make the move to bring your parents into your own home, be sure they can mix with other elders and that you are clear about maintaining your own lifestyle. If that prospect doesn't lift your heart to think about, then don't even think about doing it.

Consider possibilities 3, 4 and 5 instead. Don't make your parents' happiness your goal. Make their safety, health and welfare your target.

Leave happiness to them to sort out. That is, after all, their responsibility.

Nursing Home Abuse and Neglect is Physical and Emotional


Nursing homes are places that are meant to be an area of comfort, rest, and relaxation for the elderly. A lot of people nowadays would opt to bring their parents or grandparents to a nursing home believing that they would be taken cared of better. However, there have been so many reports that a lot of elderly are being abused by the caregivers in nursing homes. These abuses are either physical or emotional.

Physical abuse, as the term denotes, means bodily harm inflicted on an elderly. This can be direct physical abuse such as hitting or slapping, and can also be an indirect abuse which consists of food deprivation and not receiving the right kind of medication as prescribed by a physician. These abuses often lead to a lifetime trauma that could render an elderly utterly dysfunctional.

One of the most obvious signs that an elderly is being physically abused is a bruise. This may appear on any part of the body such as at the arms or legs. You may also need to look out for scars and welts. You cannot simply imagine what pains the elderly goes through whenever caregivers give them this kind of treatment. A small bruise usually hurt younger aged-people but an elderly who has a frail body, weak bones, and thin skin will surely be hurting all the more.

Other signs that an elderly is physically abused are broken bones, dislocations, as well as sprains. Bones in the hip area usually get dislocated due to shoving and pushing from a caregiver, which often results to a fall on the floor. Shoulder injuries are also results from rough handling of caregivers and other nursing home personnel. At times, a resident may have broken eyeglasses, which often results from a force applied on the face directly, causing the eyeglasses to fall. Some signs of restraint such as rope marks on the wrists can also be a determinant of physical abuse. The suspicious behavior of the caregiver, when he does not want you to see your mom or dad alone, is also a sure giveaway.

The other classification of nursing home abuse is the emotional abuse. This usually involves the language that is used by the caregiver in communicating with the elderly. Foul language may be hurled at the elderly, which may bring about a low self-esteem. Emotional abuse is also done through threats and intimidation. These would often leave elders with skittish behavior and they are usually afraid and wary about their surroundings. You can always notice fear from the way they move and from the look on their faces. They are also most likely to exhibit behavior that is prevalent with persons suffering from dementia such as sucking or rocking. Any of these symptoms are warning signs of elderly abuses.

How Using Simplicity And Efficiency In Senior Living Marketing Is Essential For Success


There are many challenges when advertising senior housing in today's environment. Not only do you face increasing competition, overcoming obstacles and finding out if the potential resident is a good fit for your community, but you're dealing with an aging audience whose senses and mind are not as sharp as they once were. Every communication your community has with seniors needs to keep this in mind.

Imagine this scenario. A 70 year old widowed woman living at home who is starting to have trouble taking care of their daily tasks. She stubborn and thinks she can take care of herself forever, but her family is worried about what her future holds.

She is starting to find that daily living is getting harder. Tasks like laundry, cooking, cleaning, yard work, and bathing. She is slowing down, but home life is not. Plus her vision and is going, and her mind is starting to slip a little.

Now imagine she opens her mail and sees a brochure that reads like the one described below: Headline: Experience Life In Abundance. Subhead [in small print]: Experience healthy living. Picture: An elderly woman smiling in a garden.

What is this woman supposed to think when she sees the outside of this brochure? Is she going to become more abundant? Will she become healthier? If she sits in her garden will she then enjoy abundance?

The ad can cause confusion amongst readers. If your senior living ad is ambiguous in anyway, you're reducing response before you even mail or place the ad.

It is crucial to use simple and easy to comprehend messages in your senior housing advertisements. When you do this, your ad becomes more efficient, and efficiency allows the greatest amount of seniors and caregivers to comprehend the ad.

Eight ways to increase power with seniors in your advertising: 1. Use Short Paragraphs

Big bulky paragraphs can overwhelm seniors and divert them away from reading. When you breakup the paragraphs the copy becomes more inviting to seniors and is easier on their eyes. You also separate thoughts and have the content flow more natural.

2. Use Short Sentences

Short sentences allow for the greatest understanding in an advertisement. Having long sentences confuses seniors and forces them to over think just to understand your message.

3. Use Short Words

Using short words is another way to cast the net as far as possible. The advertising legend John Caple's writes of a story about a publisher wanting to know the secret to a popular children's history book. The publisher questioned the author and the author said he had given the book to a ten year old to cross out words he did not understand.

4. Use A Large Readable Font

Most seniors have trouble reading and require glasses. Use a readable font and make it large. Do not force extra effort upon your readers. Comprehension and understanding is only possible when seniors and their adult children can see your ad.

5. Give A Good Call To Action

Once you have a senior's attention, then give them an action to take. Is it to call for an appointment, discover more online, return a reply card, etc…

6. Read Aloud

Read you senior housing ad aloud and make sure it sounds conversational. If your ad sounds funny and notice a pause or stumble at certain areas then these are areas you can improve upon. You can take this a step further by recording yourself reading the ad. When you play it back you'll be able to give it a further analysis.

7. Give To A Senior To Read

You can give your ad to a senior at your community and get great feedback. Do they understand the ad? Do they know what action to take after reading it? Do they find anything confusing, uninteresting, or boring in the ad? If they find something, then you know you need to work on it.

8. Multiple Ways To Contact

Give seniors and their adult children every way to contact you as possible. Phone, email, reply card, website address. People have their reasons for not wanting to use one way over the other. Maybe they just want to learn more and want to see the website, or maybe they want to speak to someone right away. Giving options gets a greater response.

A great way to test if you have an easy to comprehend ad is to keep your reading level low. In Microsoft word there is a function to check the Flesch-Kincaid Grade Level of your ad. This is when you do a spelling and grammar check. If you keep the reading level below a 7.5 then you ad will be understood by a wide range of people and increase response.

Your ad is not a dissertation and it isn't a place for beautiful poetry. The main purpose is to get a response and have someone take a next step. Not everyone out there is at the same intelligence, reading comprehension level, and can perceive things differently than they were intended. Making your senior living marketing easy to understand allows the most readers to comprehend your message.

When you place an ad or direct mail piece your ad is going to get seen by a specific number of seniors and caregivers. Your goal is to cast the widest net possible and connect with those who would be a great fit for your community or service. Having an ad that is simple and efficient ensures that when you cast the net you bring in the biggest catch possible.

Friday, June 7, 2013

Protect Your Parents' Golden Years With Help From Elder Law Lawyers


Americans are living longer than ever which is putting more and more adult children in the position of having to care for or make decisions on behalf of their aging parents. This is where attorneys who specialize in elder law become invaluable. These attorneys assist seniors and their families manage and protect their homes and assets during their golden years.

Areas Of Focus

Elder law is an area of legal practice that encompasses issues affecting aging adults and seniors. It has become a fast-growing specialty as Baby Boomers have reached retirement age, and as medical advances keep us alive longer than ever. There are three major areas of this specialty.

1. Estate Planning and Administration

2. Medicaid, Disability and Long-term Care Issues

3. Guardianship, Conservatorship and Fiduciary Administration

This is a wide-ranging field. Legal issues that fall under the umbrella of these categories include: wills; trusts; protection against elder abuse, neglect, and fraud; end-of-life planning; all levels of disability and medical care; retirement planning; Social Security benefits; Medicare and Medicaid coverage; Medicaid planning; consumer protection; nursing homes and in-home care; physicians' or medical care directives, declarations and powers of attorney; landlord/tenant needs; real estate and mortgage assistance; various levels of advice, counseling and advocacy of rights; tax issues; and discrimination.

Elder law lawyers may practice in all of these areas or specialize in just one or two. An elder law firm will likely have a staff of attorneys who cover all of these areas among them.

Getting Help From Elder Law Lawyers

These attorneys can help seniors plan for their future with or without the assistance of their children or heirs. Seniors may want to have their wills reviewed, create an estate plan or get assistance making a Social Security or Medicare claim. Qualified attorneys can help pre-retirement age individuals address issues such as retirement planning, and benefits and age discrimination in employment. For seniors of minor or adult children with special needs, they can help create a guardianship and estate plan to take care of their child after they die.

For children of seniors, elder law lawyers can help make sense of government regulations relating to Medicare and Medicaid, assist them in managing their parent's finances, taxes or real estate, obtaining power of attorney and determining their parents insurance needs.

In addition to these longer-term issues, these specialists can help in day-to-day matters in issues affecting senior care such as assisted living and nursing home rights and care. Because of their specialization, elder law attorneys are well-equipped to understand the needs of seniors and the challenges they face. They are also very well-versed on current laws affecting seniors, particularly government entitlement programs. These lawyers can help locate nursing homes, assisted living or long-term care facilities and advocate for their clients' rights.

For anyone faced with making decisions for aging or infirm parents, attorneys who specialize in these issues can be a dependable resource. They offer services far beyond wills and estate planning and can help you make informed decisions that will work best for your particular situation.

4 Reasons to Consider an In-Home Caregiver


If you have an elderly loved one, you probably have many concerns about his or her well-being. There are various reasons to consider hiring an in-home caregiver to look after a relative, especially if he or she needs extensive care. In many cases, a caregiver is fully licensed and bonded or underwent proper training, leaving a relative in good hands.Agencies often provide a full list of qualified professionals, who can assist your family in a time of need.

Here are a few reasons to consider a caregiver.

You work full-time.

Being able to provide an elderly relative with continuous care can feel like a full-time or second job in itself, and can also get expensive. By hiring in-home assistance, you allow protection and peace of mind. An agency or individual may charge by the hour; with the former, the going rate may be a little higher, to cover insurance and taxes.

You live further away.

If your relative is in a distant city or state, but needs constant care, you may want to consider someone who can tend to him or her daily, or stay for an extended period. If you do not know anyone who lives nearby, consider an agency, which usually performs a background check of any potential applicants. This can help allay any fears or paranoia you may have.

Round the clock care.

Some family members may require extensive medical attention, whether it is in the middle of the night or during the afternoon. You and your family may need someone who can handle emergencies at all hours, which is where a live-in or at-home caregiver becomes a factor.

Professional assistance for relatives.

Caregivers are licensed and trained in cardiopulmonary resuscitation (CPR) and first aid. In the event of a medical emergency or more severe illness, you will want someone familiar with treating someone who is sick. A caregiver provides that efficiently.

When choosing a caregiver, be sure to provide detailed information. Nothing should be too specific when it comes to the health of your loved one. Include personal preferences or allergies to certain medications or food. Ask if the potential provider is qualified and comfortable handling extra tasks, and treat the process as you would a job interview. Be sure to also explain what may be required, such as extra chores or laundry. However, remember to also mention that he or she is also a companion for a relative, a friend. If your loved one likes to go outside, be sure to say so, but remind the applicant of any time constraints that may limit how much time can be spent outdoors, or how much exercise is too much.

Malnutrition in Nursing Homes


For many people, it can be difficult to turn over the health care of loved ones to a nursing home. Due to the fragile nature of an elderly individual, the care they receive is going to be essential to their health. Unfortunately, this care can not always be trusted. The number of nursing home malpractice cases is growing. One of the many ways that we are seeing negligent care in the nursing homes is in the failure of these homes to feed their residents the essential nutrients they need to remain healthy.

The following are vitamins that must be included in an elder's diet. The medical professionals have this knowledge, and therefore there is no reason why they should be ignoring these essential foods.

  • Iron

  • Calcium

  • B Vitamins

  • K Vitamins

These vitamins should be included in every person's diet. However, due to a weakening immune system, it is essential that elder's consume these vitamins regularly to prevent sickness that could become life threatening.

Malnutrition is a common cause of illness in nursing homes. Recognizing the signs of malnutrition will probably fall into the hands of the victim's family. They will know the normal mental and physical habits of their loved ones. Therefore if there is a drastic change in their health, they will most likely be the first to notice a change in their health. The symptoms of elder malnutrition include weakness, fatigue, abnormal skin color, and a changed mental state. If these are recognized, it is important to look through what vitamins and foods the victim may be missing.

How Can You Pay for Assisted Living Care?


Assisted living can potentially be a positive lifestyle transition for seniors as they go through the aging process. Moving into these communities can be a relief from the stress of living alone and the responsibility of maintaining a home as you age. Additionally, it can be an opportunity to enjoy social activities in a community designed for people of the same age group who often share similar interests.

However, a major concern for people who are considering making this transition is how they will pay for the comforts of senior living such as apartments and retirement communities. And especially in today's tough economy, these are important money questions that every family should be considering. Here are a few ways people are finding ways to pay for senior care:

Option #1: Self Funded

Self funding means simply paying out of pocket, as many people are able to rely on their own resources to cover the costs of these communities. Options include savings accounts and investments, insurance, and even reverse mortgages. For seniors with significant savings and investments, these funds can be easily directed toward the costs of assisted living.

Option #2: Public Funding

Public funding is a second option, depending on the restrictions and limitations in your state and the type of care you are seeking. While Medicaid often covers nursing care for elderly individuals with certain conditions, the program is more limited in its coverage for assisted living communities. Additionally, Medicaid is only available for those who have lower incomes and fewer assets. This means that not everyone is eligible even if your state does offer some coverage.

Option #3: Long Term Care Insurance

Not every person is in the position to either self fund their senior care or take advantage of public programs, which is why some choose to invest in long-term care insurance. This type of insurance is specifically for the costs of care as you age, and depending on the policy, can be used for both nursing homes and assisted living. These policies are generally cheaper for younger individuals and more difficult to obtain as you age or develop certain conditions. It is important to read the fine print carefully on these policies, as they are highly specific about what they will cover. Some only cover medically necessary assisted living while others will only fund certain facilities. Depending on whether or not you agree with their choice of facility, this insurance may not be the best choice for your future.

Option #4: Reverse Mortgages

Lastly, for seniors who own their homes, reverse mortgages are a viable source of funding for assisted living. The Home Equity Conversion Mortgage program allows you to tap the equity in your home hat way you can use the cash for other things.

What am I paying for?

One other important question to ask when determining how you will pay for your long-term care or assisted living is to determine what, exactly, you are paying for. In some cases, assisted living facilities charge a flat rate that includes all of the available services. Other facilities charge a base rate that covers the most basic services and costs for the room. Additional services are then charged on an "a la carte" basis, which can add up quickly if you or your loved one needs a great deal of attention each day.

Picking the Scab


This article is about picking at the past, memories of that unwanted experience, and at any undesirable present condition. We all have this propensity to pick at the unwanted memory, experience or condition. Like the scab on your body from a previous experience. We don't like that it's there and are uncomfortable with it, we don't like how it looks and feels and know that doesn't reveal who we really are; divine, beautiful and perfect. We want the scab gone, like the past unwanted experience and the feelings that accompany them, so we pick at the scab. But picking at a scab, an old wound, only irritates it, reopens it and brings it back into our present experience.

It reminds me of a funny thing that happened a couple of years ago. I went to the doctor, here in Germany before I learned any German. I had injured my knee slipping on an icy sidewalk and I went to the doctor because the swelling was not going down. First of before I continue, all over the same leg I have a birthmark and it looks like someone beat me.

Well the doctor, a sweet woman, didn't speak a lot of English. I didn't speak any German. She took a look at my leg, after we tried to discuss the problem with an English/German dictionary, and said, "Uh, um, you have angered your knee" I understood that she was saying that I have irritated my knee, but got a giggle out of it non-the-less. From then on my husband and I referred to irritation of any body part as angering it.

This is what we do to scabs, to memories and conditions, we anger them. We rile them; reopen them to harm us again. It is the same thing as resentment.

Resentment can be triggered by an emotionally disturbing experience that is being felt again or relived in the mind. When the person feeling resentment is directing the emotion at their self it appears as remorse.

Resentment is reliving the same experience over and over and over again. And of course it's always reliving something undesirable and painful; picking at the scab reviving it to its original pain and condition; often to a worse state getting infected. In this action we are reigniting the thoughts and emotions, previously experienced and in turn keeping it active until it manifests something similar to the original experience. The wounds from the past, like a scab, left alone or put out of your mind heals and falls away.

Often the scab we are picking at is the wound that we carry about something someone else said about us. We carry the wounds of abandonment, criticism, guilt and rejection like a sack of rocks; carried heavy upon our back and it doesn't occur to us to just drop the bag of rocks and move on. Some might call it our baggage.

Put the sack of rocks down. Replace the thoughts of the past with new and better thoughts. It is almost impossible to make yourself stop thinking about something in order to rid yourself of the thoughts. It's much easier to just decide on something else better and grand to think about; and eventually, like the scab, the old thoughts fall away and are replaced with the new and better thoughts.

Why do we pick at the past, the scab of previous wounds or the unwanted memories; usually because the person that inflicted said wound had been deemed as an authority. We had given that person a lot of power. We had decided long ago that we should care about what others think and gave them the authority on us our lives. We considered what others thought of us as true. So each time we come upon a thought or experience, that reminded us of that past experience, we brought to mind the scenario of the past experience, relive it and continue to conduct our lives in the same way; because we believed the person we gave the authority to; be it a lover who decided we were not enough, the parent who decided we were inadequate, or the so called friend who criticized.

It's time to lay the past to rest, "the you called" authority figures to their own business and let the scab heal. That Resentment, according to popular belief, hurts the other person is not true. Resentment only hurts you.

I am reminded of a scab/resentment I picked at for a long time, keeping it alive and active; my mother's life long romance with being a victim and self hatred. Her constant manifestation of illness and constant attempted suicide's preyed on my mind as often as she felt sorry for herself. I was consistently angry over the calls to rescue her, her threats of abandonment (suicide) even when I was a child, and the guilt I allowed myself to feel through it all. When my anger culminated into a rage, speaking and thinking of her behavior often I realized that I was reopening the scab and keeping it alive. I realized that in my expectation of her behavior I was co-creating, with her, the same experience over and over. I was participating and perpetuating her behavior. I was really just afraid. In my fear I drew her experience into mine. I expected she delivered. I so often worried that at any moment I would get another call, about her negative manifestations, that I did.

She, in her believed inability to create a happy life, thrived on the attention she got when ill in a hospital or recovering from a suicide attempt. She could only feel good about herself when others ran to her side, which to her meant they cared. She didn't know how to feel good any other way. So when she felt bad she recalled how she was able to feel good, siting the past as proof, and re-created the situation. Don't believe for a minute that I didn't, almost every day since I was able to reach the kitchen cabinets that I did not try to help her. It encouraged, cared for her and was her cheerleader for as long as I could remember. Ultimately it stole my childhood and much of my adulthood.

I finally made a decision to no longer entertain her negative possibilities. I made a decision to focus on my life and think of only that which I desired. I also visualized my mother healthy and happy. I did not talk to my mother for a period of time in order that I not focus on her unhappiness and get re-centered. I told her that I would no longer take care of her, I would no longer RSVP to her shows of illness or attempted suicides and until she made the decision to enter a hospital and get help I would not talk to her. It was difficult and I received much disdain from family members. One family member passed onto me from another family member who actually said, "That's blackmail" I told the messenger, "You bet it is"

Within months, my mom who had landed herself in a nursing home at age sixty after an attempted suicide took charge. She decided she would not die in a nursing home and made calls from her hospital room until she found a government assisted apartment complex that welcomed her. She arranged to enter a psychiatric hospital and received help. She recovered physically, started her mental recovery and moved into her own apartment, after years of being taken care of by her family, and is moving towards, little by little, a new way of thinking and living. She still struggles with her long ago physical illness that she manifested, but is ever moving closer and closer to becoming happy, healthy and self-reliant. She practices often thinking only of that which she desires and with all her might avoids picking the scab.

We talk now all the time. She appreciates that I insisted she stand on her own two feet. We talk all of the time about Law of Attraction and manifesting, she embraces the concepts, and is manifesting a life experience she desires. And she absolutely loves and watches the video I produced for her. Her Fantastic Life Video where she can see herself doing, being and having all that she desires.

And I am focusing on that which I desire for my experience. I no longer pick at the scab of my mother's previous behavior. Truly until this moment that I translate to you the story of my mother I had not given thought or attention to the way it was for many years now.

In conclusion; pay attention to, only give thought to the now. Decide on what you will think about, how you want to feel and what you prefer as your life experience. Leave the scab alone and it will heal. Replace previous negative thoughts with new and exciting thoughts. Dwell in the possibilities, the visions of a beautiful joyful healthy abundant life.

The possibilities are unlimited, the experiences boundless and the joy is yours. You are divine energy in physical form. You are full of astounding ideas, magical inventions, and craftiness creations.

Plumbing and Drain Cleaning For Nursing Home Owners


If you are the owner of a nursing home or assisted living facility, no matter what the size, then you know that you have a very serious responsibility to provide the best services and conditions possible to the seniors in your facility. Making sure that the plumbing and drains are properly serviced in your nursing home is one important part of providing sanitary conditions, which will add to the comfort and peace of mind of your residents and their families. Cutting corners or settling for poor workmanship when it comes to plumbing and drain cleaning in nursing homes is simply not an option.

There are two types of plumbing services you will probably end up needing in a nursing home or assisted living facility. The first is regularly-scheduled maintenance calls, which include testing backflow devices in your facility and yearly high-pressure water jetting for sewer drains on the property. Just like any large, professional facility that houses large numbers of people, it's the responsibility of the management to make sure this maintenance is performed regularly to prevent any expensive problems in the future.

Regularly scheduled maintenance calls such as these should be done by a company you know and trust to charge you a fair price for repeat business. Spend some time researching local drain cleaning companies and getting price lists before settling on anyone. And make sure that you specifically ask if they offer any kind of discounts if you sign a long-term contract for regularly scheduled drain cleaning services at your nursing home.

The second kind of nursing home plumbing problems you will run into are classified as unexpected emergencies, such as clogged or broken drains, or even flooding and water damage on your property. In this case, you simply won't have the leisure to do extensive research on many local companies. It's best to get a reference from other people in your industry, or to call a plumbing company you have had experience with in the past.

Above all, you should only go with a plumbing and drain cleaning company that you are certain will treat your nursing home residents with respect and kindness. Your responsibility to your residents also extends to making sure every worker who comes on the premise is trustworthy and professional. There are many different plumbing companies in metropolitan areas to choose from, so take some extra time to ensure you make the best decision possible. By doing so, you will gain not just the respect and appreciation of your residents, but also will be likely to save significant time and money.

Eric Hoffer - The Obstacles We Face Daily Present Our Greatest Opportunities


As a young, struggling college student in the 1960's I became entranced with the life, philosophy and writings of the great American thinker Eric Hoffer. Hoffer's life story was almost mystical, his thinking so lucid and the concepts he presented were so fresh that I could not get enough of this great mans ideas. Only now do I fully realize how my adherence, to the thoughts of Mr. Hoffer have positively affected my professional life to this very day.

Eric Hoffer was born in Germany. His family immigrated to America when he was a toddler. He could read English and German fluently by the age of five. His earliest years were spent in poverty, living in tenements in New York City. He lost his sight at the age of seven after a fall that ultimately took the life of his mother. Inexplicably, at the age of 15 his sight returned.

This gift of the return of his eyesight stoked a voracious desire in Hoffer to read everything he could lay his hands on. He was completely without formal education and yet he was one of the most studied, learned men of the 20th century.

Hoffer spent most of his life living in farm camps in California, working as a longshoreman and finally in a one room flat in the Tenderloin neighborhood of San Francisco. His first book, "The True Believer", was an immediate classic and stamped him as a most original thinker. "The True Believer" is Hoffer's observations on mass movements and fanaticism. Nazism, Communism, socialism, and early religious movements were topics that this classic book examined and critiqued with scrupulous research and poignant observations.

Owing to a life lived mostly in poverty; Hoffer's comments on the human condition are particularly astute. Hoffer's life was full of obstacles: blindness, loss of his parents at an early age, growing up in a new country without access to education, a lifetime of manual labor and subsistence wages. And yet, this self-educated man has left an indelible mark on all that have read his writings and consider his brilliant thoughts on a wide range of cultural, philosophical and political topics.

As a student reading "The True Believer", I did not realize the lasting effect it would have on my life. Hoffer observed that the struggle to survive, at its most elemental, offered the best promise of a lifetime of fulfillment. The man who must work, must harvest, must create is most satisfied. Man with plenty has too much time to reflect, regret and criticize.

I have been a serial entrepreneur all of my working life. Currently I work with small businesses, inventors, and entrepreneur's to commercialize new product ideas. Each of these individuals and company's possess an unintended compliance with one of Eric Hoffer's most prescient observations: "It still holds true that man is most uniquely human when he turns obstacles into opportunities".

Every time a new technology, product or service is commercially successful an opportunity has overcome an obstacle that the inventor has identified, analyzed and conquered. The world becomes a bit more comfortable, more beautiful, healthier, or a bit safer as a result. It is hard wired into all successful entrepreneur's that there are answers to problems that others can not identify or address.

For the last 40 years, I have read and re-read "The True Believer" more times than I can count. I don't think there is another book that I have ever fully re-read. Each time I pick up this amazing work I learn something new, fresh perspectives and concepts that I can apply to my personal and professional life.

Obstacles represent opportunity. Identifying problems and needs is the first step necessary to providing answers that commercially benefit consumers. As Eric Hoffer so correctly observed, we are "most uniquely human when we turn obstacles into opportunities".

Thursday, June 6, 2013

A New Beginning: A Training Book on Home Based Care for Children With HIV/AIDS by Dr P Manorama MD


1. Introduction:

The stigma attached to the HIV epidemic is more dangerous than the epidemic itself. Especially, innocent women who inherit the pandemic from their husbands and the innocent children who inherit from parents are condemned by the society for no fault of theirs. They are not allowed to live a normal life like others. Children with HIV infection are not given admission in schools. In India there are about 84,000 children less than 15 years of age living with HIV. There are a few N.G.Os who have taken up their cause and help them in leading a normal life.

Dr P.Manorama is a well qualified and experienced social worker who is a pioneer in the field of HIV intervention. She established Community Health Education Society (C H E S) in Chennai and has adopted more than 500 children who have inherited HIV from their parents. (some of them are no more now). She is training several medicos and non-medicos on how to provide community and home based care to Children. For this purpose, she has written and released the book "A New Beginning" which is first of its kind in Tamilnadu. This book has helped many individuals and agencies alike in broadening their understanding to plan and also to execute with perfection comprehensive programmes for intervention with children affected and infected with HIV/AIDS.

The author of this article got a formal training with famous Christian Medical College, Vellore in this field and later was guided by Dr P.Manorama to get his PhD in alternative medicines (Psychological Counselling) and he is glad to submit the following article for information of readers. It is hoped that readers will get first hand information of this pandemic and ways and means to treat the children with HIV/AIDS.

2. Essentials of Home-based Care:

WHO defines home based care as a provision of health services by formal and informal caregivers in the home in order to promote, restore and maintain a person's maximum level of comfort, function and health including care towards a dignified death. It can be classified into preventive, promotive, therapeutic, rehabilitative, long term maintained and palliative care categories.

The goal of Community Home Based Care is to provide hope through comprehensive care, helping patients and families maintain their interdependence and have the best quality of life.

It should also reduce the stigma and discrimination associated with the disease by providing emotional, physical and nursing care. It will also be the most cost effective model.

3. What are the formalities to be observed by the health/social workers while visiting homes of HIV/AIDS affected/infected children?

'Infected' means the children who are infected with HIV whereas 'affected' means people around them say, parents are infected, by virtue of which, lives of children are affected. Likewise, HIV children means only infected with HIV whereas AIDS means somewhat advanced stage of infection wherein other opportunistic infections have spread over the child.

The things to be done by Health workers while visiting home:

1. General enquiry about the health of the family is to be made and relevant medical records are to be organised.
2. Specific enquiry about health of children to be made, look for any possible weight loss. The nutrition should be taken care of by giving needed tablets and simple food.
3. To verify whether any ART (Anti Retro Viral Treatment) treatment is given to the children with visit to ART centres.
4. Environmental issues are to be attended. Stigma issues are to be discussed freely.
5. CD4 counts are to be verified at regular intervals.
6. Education should be taken care of.
7. They should reach children by freely mixing and playing with them.

Thus the primary need of health workers attending to the children is empathy and understanding of issues related to children.

Medical Care Taken to Homes:

HIV/AIDS is a chronic disease and needs prolonged lifelong care. Many a time, children with HIV may fall sick and need hospitalization. Also it may need continued treatment at home.

Children with HIV live for long years, when they receive good nutrition, care and treatment. It is very unfortunate that some children develop AIDS and have premature death for want of proper care and treatment. Hence, social workers visiting children at home need to understand the growth and development and possible basic care is to be given at home setting. Hence the basic need for a social worker in this field is identification and management of opportunistic infections (OI) and ART and also the terminal care. The pathetic aspect in this field is that the worker should be aware of even cremation arrangements when an AIDS affected children dies because people may refuse to undertake that work also because of the stigma.

5. Certain Common Infections and methods to handle them:

Common fever: The child should inhale fresh air. The skin is to be wiped with wet cloths all over the body till the temperature reduces to normal. If the child has high fever above 38.5 C paracetomol tablet is to be given.

Diarrhoea: Lot of fluids like rice water with salt, tender coconut water, butter milk, dhal water, rice kanji, soup, tea and fresh fruit juice are to be given. Older children may be given easily digestible food like idly, banana etc.

Common respiratory disorders like sinusitis and pneumonia:

Caregiver should clear the congested nose using a cotton cloth moistened in clean salt water. They should be given warm water at regular intervals. The head position should be raised with more pillows to help avoiding breathing problems. For babies who need feeding, it is better to give frequent feeding in small quantities.

Oral Thrush:

This is a symptom of fungal infection and a hallmark of HIV/AIDS. Children cannot eat and drink properly. They will have difficulty in swallowing. Oral cavity will show the plaques if white semi solid materials.

Gargling with salt water will help easing the throat. Clean mouths four times a day with soft cotton swabs. Cold food and drinks may be given. Spicy foods and citrus fruits are to be avoided. Soups and yogurt are good. Gentian violet solution may be given 3 or 4 times a day. If there is no improvement, a qualified doctor is to be consulted immediately.

Skin problems:

Skin problems arise because of bacterial, viral and fungal infections and scabies. The symptoms are itching, pustules and rash. The following basic treatments are recommended:
Daily bathing, the skin is to be smoothened using calamine lotion, coconut oil, soaps and lotions will reduce itching. Baby's bottom is to be exposed to free air (as against using nappies). Potassium permanganate solution is a good antiseptic for soaking infected soars.

Bed Soars:

Bed sours are caused when children are bed ridden. Caregivers should encourage getting out of bed often. Their position is to be changed once in two hours. Bed also is to be changed at regular intervals. Medical guidance should be taken before giving local anaesthetics for pain relief.

6. A R T (Anti Retro Viral Treatment)

(History of ART and other details about the treatment are reserved for a future article. In this article, we shall deal with only the topic of ART to paediatric patients by the caretakers and its follow up)

1. Parents are to be counselled before starting ART to their child. Medicines, once started cannot be stopped unless the child develops enough resistance. Parents are to be counselled about the cost involved (in case of private hospitals) and the results of ART, that it is no permanent cure for AIDS but improves the immune system helping the children to lead a dignified life and improve the life expectancy.

2.Paediatric syrups and Fixed Dose Combination are available free of cost at ART centres of Government hospitals.

3. CD4 is the best measurement for assessing immune deficiency and should be used in conjunction with clinical assessment. It helps to decide when ART should be started. Children up to 6 years of age have high CD4 count because of high lymphocytes. CD4 automatically drops to normal values when the reach the age of 6.

4.The persons registered for care and treatment at ART centres should have their clinical stage of HIV. The initiation of ART is based on the clinical stage and the CD4 count. The lack of CD 4 count should not delay the initiation of ART if the patient is clinically eligible. But, however the result of CD4 should be obtained as early as possible. That is why CD4 count testing is also free all over the country.

5. Finally, drug adherence should be evaluated with utmost care.
Involvement of children in treatment preparation is to be ascertained.
Half-hearted attempts to initiate therapy should be avoided.

CONCLUSION:

We had been seeing certain important aspects of paediatric HIV/AIDS care by caretakers as instructed by Dr P.Manorama in her book on this subject. AIDS pandemic is no more a dreaded disease or the caretakers are to worry about possible infection. The stigma and discrimination is much reduced because of the tireless workers like Dr P.Manorama and her volunteers.

This article is a humble attempt as a tribute to the great work rendered by them.

If the readers get clarifications about paediatric AIDS and they offer to volunteer their services to the innocent children who suffer for no fault of theirs, the aim of this article is fulfilled.

Let me complete this article by paying respects to thousands of social workers and caretakers who work in this field as volunteers against odds.

Assisted Living Options in Orange County


Orange County California is a favorite retirement destination. Due to the number of seniors who decide to spend their retirement years in this popular location, there's a large demand for assisted living accommodations for seniors who need help with day-to-day living.

Orange County Assisted Living

Orange County residents in need of assisted living can choose from in-home services that provide help for daily living activities including personal care, housekeeping, or in-home help for people with health concerns. Other options include board and care homes and assisted living communities. The number of options is huge, so it's important to start your research early and to figure out what option is the best for your situation financially, emotionally and physically. This list can get you started.


  • Arbor View Residential Assisted Living (Mission Viejo)

  • Atria Golden Creek (Irvine)

  • Atria Woodbridge (Irvine)

  • Cranbrook Senior Living of Tustin (Tustin)

  • Crown Cove (Corona del Mar)

  • Emeritus at Brookhurst (Westminster)

  • Emeritus at Garden Manor (Garden Grove)

  • Emeritus at Orange (Orange)

  • Karlton Residential (Anaheim)

  • Inn at the Park (Irvine)

  • Laguna Woods Village (Laguna Woods)

  • Newport Beach Plaza (Newport Beach)

  • Nohl Ranch Inn (Anaheim Hills)

  • Park Plaza (Orange)

  • Sunnycrest Senior Living (Fullerton)

  • Sunrise at Tustin (Tustin)

  • Sunrise of Huntington Beach (Huntington Beach)

  • Westminster Terrace (Westminster)

Things to Consider When Choosing a Facility

Whether you're looking for yourself or a loved one, when you're ready to make a move to a facility or community there are a number of things to consider to guarantee that you choose a living environment that will make you happy.


  • Proximity: With so many facilities and communities in Orange County one of the things to take into consideration is the proximity of the facility to family, church, and doctors. Making the right choice helps keep you connected to your social network and medical team.

  • Finances: Assisted living can be costly so finances are a big consideration. Facilities offer different payment options. Some accept a one-lump-sum payment to cover housing and care for as long as a resident lives there, but this option comes with risk. If the facility happens to become insolvent and goes under, the money is gone and so is the care and housing you need. If you are dependent on SSI or Medicaid to pay for your care, you need to choose from facilities that are Medicaid certified. How you plan to pay for care should be determined before you make the move.

  • Level of Care: The term "assisted living" is an umbrella that covers many aspects of assistance. For those with a progressive illness, these needs will change. When looking for an assisted living facility in Orange County, ask what levels of care they offer. If mobility will become an issue, can they accommodate those needs? For those with dementia or Alzheimer's does the facility offer a wing or unit where you can be transferred when the time comes?

  • Get Your Name on the Waiting List: Start your research early. It is not unusual for popular assisted living communities to have a waiting list. Even if you're not quite ready to make the move, get your name on the list because, if you don't, when you actually need the room, it may not be available.

  • Surprise Visits: Make a couple of surprise visits to the facility. This will give you a glimpse of what life is really like for residents. It's a good idea to make at least one daytime visit and another at night. Talk to residents and see what they have to say. Observe the staff and how well they meet the needs of residents.

  • Pets: Some facilities allow residents to bring their pets. If this is an important factor for you, look for a community or facility that is pet-friendly.

Assisted Living Can Be a Positive Thing

Change is never easy, and when the time comes to make the move it is important to focus on the positive. The main positive is that it provides needed help and care, but beyond that it is an opportunity to enjoy companionship with other seniors and to still maintain a measure of independence.

Water Aerobics - The Perfect Exercise for Seniors


Many activities become increasingly difficult for seniors as they age and exercise is another one of them. It is reported than many seniors become less active, not just because of ailments, but because of the fear of falling as well. Yet exercise can help seniors stay fit enough to prevent many falls and other injuries.

Seniors can greatly benefit from water aerobics. The water, and a skilled instructor, can help the elderly exercise their full bodies, with effective low impact workouts. Participants can work out at their own comfort and ability levels, improving over time. Most muscle groups are worked thoroughly and without any added strain to the joints, which is a common complaint of regular exercise. Because these exercises are conducted in the water, there is very little chance of falling, or any injury.

Instructors design workouts with music that can vary the tempo, keep the momentum and energy levels up and vary the intensity of certain workouts. Working out in the aerobics class with friends is an added social bonus as the elderly are more likely to continue to participate when they have the camaraderie of people they know. The more fun they have the more often they will return and make exercise a regular routine.

The health benefits of water aerobics for seniors can be incalculable as muscles are strengthened, circulation is improved, brain function is improved, stress levels are reduced, blood pressure is reduced and the body benefits overall from the activity. Even those in varying stages of recovery from ailments can experience improved health and faster healing.

Water aerobics for the elderly are offered at many community swimming pools and YMCA's across North America. Nursing homes, and assisted living facilities also offer some of these forms of activities and exercise classes.

Nursing Homes Can Better Use Admissions Process to Minimize Discharge Anxiety


Families face major anxiety when the phone rings and it is either the business office or social work in a nursing home urging more family involvement in transitioning a patient out of a facility. Often there is a need for a person to complete the Medicaid application process and transition to a long-term bed in a different facility.

The very process scares a family and the nursing home is panicky about rendering weeks of uncompensated care. Families are understandable nervous as most have no clue about how the long-term care apparatus works in America. The nursing home is concerned about tons of uncompensated care which hits its bottom line hard. The question is how can we routinely improve this effort? One way is by making better use of the admissions process.

The right questions asked in the beginning can save lots of grief but in order to enact such a routine we have to move our minds beyond the Medicare billing and the profits accorded during this rehabilitative period. The admission period is an opportunity to gather lots of information which can be crucial at discharge. What is this patient's current financial condition? Is there a long-term insurance policy in place? Does the patient have an open and active no-fault auto claim? Has the family demonstrated a sincere interest in this person's long-term well-being? Do we need to recommend an independent case manager early on to help the patient and designated representatives explore post nursing home options?

Knowing some of this well in advance of the discharge date tells the nursing home if this is a likely assisted living placement, Medicaid applicant, etc. Further the grief associated with so many discharges can be eliminated, including hundreds of active lawsuits against nursing homes in America right now accusing the facility of prompting, arranging and in many cases forcing an unsafe discharge. Much of this grief can be avoided. In one recent settlement the award was over ten million dollars, ($10,000,000.00) after a patient was discharged to their private residence, de-compensated, fell and died.

Documentation from the nursing home proved they were well aware of this person's medical and cognitive state. The award will likely be reduced on appeal but the financial bite will still be hefty and the loss credibility enormously costly.

So let's minimize the anxiety; "use the beginning to plot a successful end".

Thanks for allowing me to share.

Residential and Nursing Home Care


Sometimes, people find it difficult to look after themselves. This can happen slowly or as a result of an illness or accident. In most cases, this happens once they have stayed for sometime in a hospital.

Many people may be able to stay home with the help and assistance of their families or friends as well as with the help and support from social care services like the NHS or home care visits from the district nurse. However, for some people, a move to a sheltered housing or some other type of accommodation would help meet their needs.

A few other may still find it difficult that they cannot cope and considers taking the step into moving to a home care. This could be a residential care home providing meals and personal care or even a nursing home having qualified nurses on the area. Sometimes people needing to move into a care home are able to arrange the transfer themselves and cover the costs. For those who cannot, the local authorities can help them in the transition.

Selecting a nursing home
The first move to make when considering a move to a nursing home is to contact your local social care team. These people will be able to give you information about the different local homes and help you decide which care homes will suit your needs, including the content of the inspection reports of homes you are considering.

Your social care team will also organize an assessment of your needs to see what level of care you really require.

Residential care homes inspections
The Commission for Social Care Inspection conducts registration and inspection of residential care homes twice a year.

All resident in that certain care home are given the opportunity to share their views about the home to the Commission during an inspection and may also address their complaints to the Commission for Social Care Inspection if they cannot derive satisfactory responses on their complaints from the home.

If you are interested in converting your home into a registered care home, you need to get in touch with the Commission for Social Care Inspection and they will assist you through the registration process

Resolving problems with your care home or service
If you are having problems with a care home or service it is best to try resolving the problem with your care provider first. You may do this by making them aware of your concerns. Only if you feel that the matter is not being handled to your satisfaction, should you contact your care manager if the care is being paid for either full or in part by the county council or the local authorities. If you are not able to contact your care manager directly, you should directly call your local social care team.

However, if you are paying for the care services of home care services fully, you may contact the Commission for Social Care Inspection to voice out your concerns, dissatisfactions or complaints.

Reflexology and the Elderly


It seems to me that reflexology and working with the elderly is a match made in heaven. Alternatives to medications are always of interest because they are often safer and with fewer side effects.

People usually seem rejuvenated after a reflexology session (and if not, it's because the body needed to rest a bit more). Reflexology definitely shows results and it's proven all the way back to ancient times.

Not only have nursing homes accepted reflexology as a powerful complementary and alternative therapy, reflexology has also found its place in eldercare and hospice.

Reflexology from a well trained reflexologist can do a lot to ensure better health or faster recovery.

Here are some facts that define why reflexology is so essential in hospice and nursing homes:

• Reflexology helps to relieve pain and of course, this makes a person feel good and relaxed. It might reduce the necessity of pain reliever medicines which can have certain side effects, but this will have to be determined by a medical professional only.

• It can really help someone feel rejuvenated with less stiffness and they can carry that into day to day activities with more ease and comfort.

• Blood circulation is increased with reflexology. Increase in circulation ensures speedier recovery. It can also help to improve the lymph, nerve function, muscle function, etc.

• The client can be sitting up or lying down and there's no need to roll over or to disrobe in order to receive and feel the benefits.

• Reflexology helps increase body awareness and is stimulating to the nervous system. Better nerve function can help maintain faster responses and thus able to deal with day to day activities in a better way.

• And, reflexology is safe and compassionate touch, without being too invasive.

The elderly are a large segment of the population and can feel isolated and be lonely, even when they are in facilities like nursing homes. The touch they receive in institutions is mostly for practical purposes and is often mechanical making reflexology a greatly appreciated experience especially because of its attentive and non-invasive qualities.

There are things you need to remember when working with the elderly:

Since the elderly tend to suffer from more illnesses and have more complications from these, always check with a medical professional before beginning to work with anyone who has health issues. This is so much easier to do when the client is in a nursing home or hospice because medical professionals are right there on staff.

Use less pressure when starting to work with an elderly client because their organ systems are older and may be slower than someone who is younger. There's no need to move too deeply or too quickly, certainly not until you have established what the tolerance to the reflexology is, and maybe never if you're working in a hospice setting.

Make the session shorter - there's no need to tax the body. The therapeutic benefits are still there and with a shorter session, you won't be overdoing what they might need or appreciate.

Of course there are always exceptions. I've been working with a client for almost 10 years. She's 94 years young and has been doing yoga for over 50 years. She has the physicality of a 60 year old (one who would be in excellent shape). For longer than I've known her, she's had a massage session and a reflexology session on alternating weeks. She eats well and has never indulged in sweets or desserts.

This is my one exception to the above mentioned rules and also a road map on how to stay healthy and live well.

Wednesday, June 5, 2013

Registered Nuts - A Night in the Life of an ER Nurse


I've ceased with the pre-shift ritual of meditating in my parked truck along with a soothing piece of music. No more prayers to God en route to work asking for more patience, more humanity, more understanding. I have accepted the fact that it will be no different than any other night in the Emergency Department, no matter if I blare Yanni's rancid piano etudes or make a promise to God to pass out my own body parts to the discharged patients as they leave. Nothing will change. I use to look forward to making a difference in someone's life, helping a poor soul whose body has given out. Those moments are few and far between now. Instead, I resign myself to the fact that the next 12 hours will be spent pasting a fake smile on a tired body, going through the motions of caring, repeating ready-made lines of false concern and giving out medical advice that fall on deaf ears. I use to feel important in my role as Charge Nurse at a major ER of an inner-city charity hospital. Now, as I sit in my truck at 6:45 in the evening, gangster rap blaring, I send out a quick impromptu message to God..... "Please God, allow me the opportunity to be gainfully employed 12 hours from now."

7:02 PM-

I receive a quick report of the clingons and leftovers who haven't made it out of the department by change of shift and to no surprise to myself and the night crew, a few names are all too familiar and the reports of their latest "illness" easily recitable from memory. The usual apologies from the day crew for not getting them out before we arrived go unnoticed. A shrill screech from one of the psych beds startles no one. We all just look up from within the "safe" confines of the nursing station, confirm that our overweight security force is camped out beside the room, shake our heads briefly and go on about our business. We go through the ritual of taking our own baseline vital signs, popping a few Xanax and removing sharp objects from our pockets. Patient safety is important and we wouldn't want to accidentally stab one of them repeatedly in the chest.

7:17 PM-

My primary job aside from direct patient care is triage. Initial interview, vital signs, brief medical history, current medical problem, current medications, height, weight etc etc. My first of 35 or so fits the typical profile of this or any other ER in the country. 40 year old, female, morbidly obese, diabetic, hypertensive, multiple psych meds, very little English, less common sense, no means to pay. She complains of the usual nausea, vomiting, diarrhea and generalized abdominal pain. She's already spent thousands of dollars of other people's money last week for the same complaint. She didn't fill her scripts, didn't follow up with her Gastroenterologist as requested and by no means was this 300 + lb, truffle hunting leech going to alter her diet one iota in order to prevent another attack of diverticulitis. Her idea of a "Clear Liquid Diet" was a bucket of chicken and bowl of menudo an hour prior to her arrival. So here she is, totally oblivious as to why she is still sick. Non-compliant with her meds, non-compliant with the discharge instructions, follow up or diet instructions, which included a bland, low-fat, liquid diet for a few days until she was able to tolerate semi-solid/or solid food.

She bitches profusely when she is not brought straight back and put into a bed, instead she is sent back out to the waiting area for a lengthy wait. We are full and busy with the truly "emergent" patients but she can't seem to fathom this. She barrels through the exit door, into the waiting area calling me every name in the book (in Spanish) and swearing to never come back again. "PENDEJO!", she mutters. Oh, she'll be back.

"NEXT"!

7:31 PM-

My 3rd patient is a 23-year-old mother of 3, the oldest being 10. She has somehow mistaken our "EMERGENCY DEPARTMENT" for a pediatric clinic and wants her brood "checked out" because they feel "hot." No temperature ever taken at home, no Tylenol or Motrin given before the decision was made to spend $1500.00 of other people's money and to waste our time babysitting 3 snot-nosed, unkempt ankle-biters who are no more sicker than the man in the moon. I usher them one at a time onto a scale for weights and am not surprised that each is twice the size they should be at their particular ages. One, I have to pry finger foods and a "Big Gulp" from their obstinate little mitts prior to the weight so as not to inadvertently add 5 lbs to his already triple digit reading. The electronic scale beeps incessantly and reads, "ONE AT A TIME, PLEASE."(Ok, not really) With all their vitals being normal they are ushered out into the waiting area where they eagerly pounce on the furniture and run around like the defensive line for the Attention Deficits.

I am verbally attacked by my obese belly pain lady, who has "been waiting for hours" (uh, how about 20 minutes). I instantly notice the "positive Cheetos sign" on her fingers and around her lips and remind her that the sickest are seen first and to have a seat. She tosses me a "Pincha Pendejo" and rumbles back to her seat. I sneak in a quick call to God asking that he makes sure she looks before she plops back down in her chair(s). I can hear the intercom announcer now, "CODE BLUE TRAUMA, ER WAITING ROOM." I mentally picture the scenario of the code team spending the next hour removing baby Julio from the rectum of a 300-lb verbally abusive Hispanic woman.
"NEXT"!!

9:21 PM-

I've survived the dinner crowd with my job intact and make my way back to the treatment area to assist the rest of my team in the treatment of the patients who were lucky enough to make it back ahead of the non-emergent riff-raff. I make my way to the EMS radio station when I hear....."Unit 842 code 2 patient report"....we have a 102 year old nursing home patient,....found unresponsive on the floor....no IV....she's now awake, combative, confused, covered in stool, incontinent of urine, blah, blah, blah..." The report from the nursing home prior to her EMS transport reveals that this patient had a tendency to "dig out stool from her rectum when constipated." "Oh, that's just friggin lovely"

9:25 PM-

The waiting room intercom a buzz......"I beeen waiting for 10 hours, you pendejo...you piece of...." Click!

9:33 PM

Our lovely elderly finger painter arrives, covered in poop from head to toe. EMS personnel smirk as they wheel her by, updating us as to any changes en route. Nope, no changes, except that now she's given up the fight and is again unresponsive and her breathing more shallow. In an instant her breathing stops and is immediately rushed to trauma 1 where CPR is initiated. "CODE BLUE ER-1, CODE BLUE ER-1."

9:57 PM-

"Time of death, 9:55" is belted out by the code team leader. "She never stood a chance." "It was her time." "She had a long and good life." Blah Blah Blah Blah. She had a horrendous death. Born covered in amniotic fluid, but certainly a proud moment for her parents one can be sure. She died, however, covered in shit, piss and bedsores. The nursing home where she spent her remaining days in agony and perpetual loneliness should be burned to the ground. No family, no attention, nowhere near as prominent and proud as she once was. Left to waste while the understaffed workers at Our Lady of the Perpetual Petri Dish took their extended breaks and pillaged through her personal belongings. A courtesy call to the nursing home is placed telling them that Mrs. Mullins will not be coming back and has been transferred to the ECU (Eternal Care Unit). I hear, "Whew, thank God.....CLICK."

10:22 PM-

Our usually bevy of drug-seeking, bipolar, depressed, suicidal, Xanax, Vicodin, Demerol hounds arrive as scheduled with multiple and varied complaints of, migraine headaches, chronic back pain, stress, anxiety, fibromyalgia, blah, blah, blah....!
They are easy to spot, almost always familiar, with the same ole' story. Most we know on a first name basis. They are all, coincidentally, allergic to the same medications; Tylenol, Motrin, Vistaril, Toradol, Aspirin or any other non narcotic or harmless placebo we've attempted to quell their "pain" with in the past. The only thing that works is "Demerol" and they must have a large supply of Vicodin in the form of a prescription when they leave. (Vicodin has Tylenol in it but apparently doesn't cause a severe allergic reaction when mixed with euphoria,....go figure!)

Security is usually called, for to tell them "no drugs tonight" is just asking for a fight. $1000.00 later of other peoples money and they usually leave with their buzz on and their script for Vicodin. But usually not before asking for a "shot for the road" or additional scripts for anxiety (preferably Xanax) or sleep aids. 30 pills are often the number of pills given, depending on the frequency of the prescribed dose. This usually last a few days for the typical drug seeker and then they'll usually return with more "pain" and a hungry monkey.

In the age when Doctors are sued for both under treating pain OR for prescribing too many narcotics and "getting them addicted", we medical personal are caught up in the proverbial "catch 22". More often than not I have been written up and on several occasions was at a point where my job was in jeopardy because I challenged their pathetic lies whenever these low-life drug addicts invaded our ER's. Now I just shut up, shake my head and pray for an overdose.

11:12 PM

Waiting Room intercom is ringing off the wall. "...how long will I.......can you tell me where I am on the list......Donde esta su Doctor.......I can't find my child........the dingo ate my baby.....PINCHE PEDEJO, I BEEN HEER FER TWO DAYS AND MY ASS FEELS LIKE SOMEONE POURED SALSA RIGHT UP MY..........click.

Midnight in the garden of good (for nothings) and the evil (doers)-

After a flurry of non emergent triages, (sore toe, "the shakes", anal abscess, foreign bodies in the nose, ears and stomach of a 2 year old, blah blah, blah) I call in an astute, well dressed, middle aged white male, who is walking quite gingerly and refusing to sit. Differential diagnoses race through my head, back pain, abdominal pain, rectal abscess,. or perhaps....no!....NO!......NOOOOOOOOOOO!

Yes!

The story goes (and it is a common one) that he and the Mrs. were "experimenting" in bed (against his wishes, no doubt) when a vibrator was jammed in his keester and is now painfully out of reach. Given the nature of the "injury" he is whisked back to a private room, placed on his side, lubed up like a 57 Chevy, and a valiant effort is made to retrieve the 12 inch "perpetrator with ribs" from his large bowel. All to no avail. At one point we had a hold of the foreign body (actually, it was made in the US) but the colon wouldn't let go of it's new found cylindrical friend. We tugged, twisted, yanked, pulled, all efforts proving futile. Finally the physician stopped, exhausted from the tug-o-war match, with the forceps, commonly used to removed big headed babies, protruding from the prominent lawyers butt, he made the decision to call in the surgical team. All efforts to remain professional, however, fell by the wayside when, during a moment of silence, a low buzz was detected in the room. Had the blood pressure cuff inflated? Were the incandescent lights buzzing? Was the TV on?

No, no and no. We looked at the forceps and noticed they were vibrating uncontrollably, instantly realizing at that point that this thing was STILL ON. A mad rush by the scant crew to the exit door of the private room was attempted as to not embarrass this local professional with our boisterous laughter. No dice.

We will all eventually be written up and apologies made for our "unprofessionalism and disregard for the patient's privacy and mental well being".
That's ok. We needed that to preserve our own mental well being. Still proving that laughter is still the best medicine.

1:02 AM

Ten triages later and its dinner time for this mentally worn crew. We retrieve our food, locate it to the middle of the nursing station and we eat. Not all at once, mind you but usually a bite at a time. Eat a French fry, go wipe an ass in ER-1, a bite of a Big Mac, go clean up cherry cool-aid flavored vomit in ER-4, a sip of Dr Pepper, then physically restrain a combative Scitzo-effective patient. By 2:15 we have polished off the last bite of a hardened burger, ate our last stale French fry and sucked down the last gulp of our watered-down soda. A soda that is now as warm as fresh urine and food that is as cold as Mrs. Mullins in ER13.

2:30 AM-

Ahhh, my favorite time during the entire shift is upon us. The "Last Call at the local bar crowd" (LCLBC) start to pour in to the front entrance, while EMS brings the ones who got the shit kicked out of them through the back ambulance entrance. "Santa Rosa, this is unit 842....we are coming code 2 trauma with a 19 year old male.....closed head injury....intoxicated...combative....soiled....bloody.....no insurance.....blah, blah,blah.

The same ole song and dance spews from this patients bloodied spout as he is wheeled into Trauma-2......"I was just minding my own business"......"I only had two beers"....."I don't do drugs"..... "Can I get something to eat?" "RAALLLLLLPHHH!" "Housekeeping to ER Trauma-2, Housekeeping...."

2:31 AM-

"Dear Lord, If ANYONE can make time travel possible, it's you, God." "Pleeeese, send me forward to 7 AM.

3:03 AM-

Patient waiting room intercom is screaming..........."CLICK"......."BANG, BANG, BANG".

3:15 AM-

I am ushered into the staff break room for a "time out" and reminded by the night supervisor that the cost of the intercom will be deducted from my paycheck.

4:18 AM-

Our portly female beast of a woman is finally ushered back to a room but not before mumbling under her breath as she brushes past me, "Pendejo"! A major "abdominal work-up" is ordered. 40 lab tests, urine tests, stool cultures, abdominal x-rays, Cat Scans, blah, blah, blah......She's placed in a gown that looks like curtains stolen from the Grand Ole Opry, and given the reminder "Opening to the back, please," tossed in for good measure. ("Lord, give me the strength to...........Oh forget it, never mind")

She's given a URINE cup as she bounces her way to the bathroom. She fills it with STOOL. "Housekeeping to ER, STAT."

Can't find a blood pressure cuff large enough so we must take a chance at an erroneous reading by placing it around her calf or forearm. The hydraulic bed grunts and groans with ever twitch and shift from this woman of substances. She continues to bitch and moan and will eventually file a complaint with (in) human resources, I am sure. Multiple attempts at IV access finally yields a vein that hasn't been choked off by the mass of arm fat and IV fluids are initiated. After a quick assessment by the ER physician she is off to radiology, with a little 120 lb tech pushing 600 lbs of patient and bed up to the 3rd floor for a series of $3000.00 radiologic exams. X-rays that were done just last week and that she has no intention or means to pay for. It would have been easier (and cheaper) had she driven to Sea World instead. Certainly more accommodating for a woman of her stature.

5:57 AM-

Multiple early morning stragglers are triaged and sent to wait. The foul odor of urine, poop, BO, booze, vomit, etc, permeates the air. "One Hour Left", I thought. We get all the results of the voluptuous Ms. Hinojosa's tests back and surprise, surprise...."Diverticulitis." Perhaps this time she will be compliant with her meds, compliant with her diet, compliant with her follow up, compliant with life. "Fat chance,"I thought. (Pun intended).

Her IV is removed and a half gallon of fat globules ooze from the harpoon hole. She is hoisted off the bed with the help of several departments within the hospital; half of who will call in sick tomorrow with severe back spasms. The battered stretcher which now resembles a low-rider after a major accident is towed to the back for repair. Ms Hinojosa is discharged but not before requesting a breakfast tray. Request denied.

Off she goes to the local "Taco Cabana" for a flurry of assorted breakfast tacos and a bowl of menudo. "She you in a few days, Ms Hinojosa."

"Pinche Pendejo!"

6:47 AM-

The dismal faces of the morning crew are evident as they reluctantly make there way in, some still in mid-prayer, the newer nurses with walkman's on, listening to ocean waves or cricket noises saturated with Muzac. A quick report is given to the mentally exhausted night crew and apologies made for the missing bed in ER 3 and the dead body in ER-12.

7:07 AM-

Each member of the night crew, each with a phone in hand, are awaiting the instant the clock strikes 7:08 where, with lightning speed, a flurry of buttons will be punched to clock out, ending another horrendous but typical night in the ER.

7:47 AM-

I pull up to my apartment and sit quietly in my truck. I recall the night's events and wonder if I had made any critical errors in care or judgment. I mentally prepare for the answers to the complaints made the night before by this unique ER culture of ignorant, non-compliant, abusive, poor, helpless, drugged-up, psychotic, dregs of society.

I say a prayer for Mrs. Mullins and her family and curse all those who've abused the system in the last 12 hours, spending thousands upon thousands of dollars of other people's money but contributing nothing to society what-so-ever. Once I deem that I will have a job come 6:45 that evening, I ease my tired body and shattered mind out of my vehicle, meander up to my apartment and into bed, hungry, frustrated, angry. Where I will fight the demons for an hour or so until I am able to fall asleep. I don't. I am woken by a dream whereby the ER staff are all patients in the waiting room on a busy night. I am called into the back where a 500-lb female nurse is ripping my clothes off with one hand and swinging a 6 foot rectal scope in the other like a pair of numchucks in a Bruce Lee movie. The alarm clock sounds and I immediately spring up and grab my ass, praying that a 6-foot proctoscope isn't dangling precariously from it. It's not. I breathe a sigh of relief and make my way to the shower and into another fateful night of chaos and mayhem.

6:43 PM-

I pull up to the ER, park my truck and sit. I clip on my name badge, giggle as I read our "Mission statement" tattooed on the back. "To extend the healing ministry of Christ," it reads, and I take a minute to ponder that statement. I smile, acknowledge it's powerful and profound meaning and bow my head to pray.
"Lord, today, give me your divine power to accept my responsibilities within this ministry. I pray that..."

Just then a beat up delta 88 rolls by on two wheels, with a definite lean to one side. I watch as they take up two parking spaces in the "staff" lot and out pops Ms Hinojosa. I cringe. She leaves a trail of urped-up fajita and menudo through the patient parking lot, into the physicians parking area, towards the ER entrance. Anger churns inside me and I hang my head, looking down at my badge and the mission statement on the back. I try desperately to find the peace and pride I felt just 2 minutes earlier and I resume my prayer......"Lord,....I just.......If you could only find it in your heart to............OH FORGET IT!!!!!....... NEVER MIND."

Emotional Abuse in Nursing Homes


Despite what the brochures and pamphlets say, nursing homes are not all about sipping lemonade and playing shuffleboard. In fact, there are a lot of serious issues to contend with to make a nursing home run.

Nurses and administrators of homes need to be mindful at all times of the unique needs of all of their patients. They need to do their best to make sure everyone is happy, properly medicated, and satisfied with the facility. As you might imagine, this can be difficult with sometimes ornery patients and even more ornery families.

Therein lies one of the more subtle causes of nursing home abuse - the emotional mistreatment of patients. It's can become evident when a nurse or practitioner falls out of line and starts hitting or abusing a patient. But what about emotional abuse? How can we tell if our elderly loved ones are actually being abused or just deciding to be (for lack of a better term) "grouchy"?

The truth is there is no exact line. Emotional abuse works in nuance and it is the duty of the family to pay close attention to changes in their loved ones. It also helps to be properly educated regarding what kinds of emotional abuse can happen and what the symptoms can be. Finally, it's critical that the family know when and how to pursue legal recourse should they think it necessary.

Types of Emotional Abuse:

It's tough to understand emotional abuse without giving some categories and descriptions. The following are not prescriptive or all inclusive, but mainly to help you in identifying potential problems.



  • Verbal Harassment. This constitutes a stream of insults, put downs, and slights. The patient is made to feel like a lesser person and can be made hyper-aware of their age and illnesses.


  • Threat of Punishment. Sometimes physical abuse is never reported because it is never needed. The nurse or practitioner could simply threaten, yell, and scare the patient into compliance.


  • Humiliation. Humiliation comes in many varieties, both public and private.


  • Deprivation. Deprivation blurs the line between physical and emotional abuse. Much less physically obvious, deprivation can be  withholding of medication, food, water, or even attention.


  • Abandonment. Successful living in a retirement home is more than just satisfying base needs. Mature adults require interaction and a feeling of fulfillment. Abandonment is an utter lack for these concerns.


  • Intimidation. Much like verbal harassment, intimidation is the use of coercion and threats to gain compliance.


Signs of Emotional Abuse:

Part of figuring out if abuse is occurring is paying attention to certain signs and symptoms. Consider the following:



  • Direct Reports of Abuse. First, and most obviously, is direct reports of abuse from your loved one. Whether they make the complaint to the home administrators or directly you, this is the best way to get a sense of what's happening. Unfortunately, due to physical/mental handicaps or just 'not wanting to make a fuss', direct reports or much less prevalent than one might think.


  • Emotional Withdrawal/Non-communicative. If your loved one is normally openly communicative and you see a sharp drop in that, it could be because they are having problems they don't want to burden you with.


  • Self Abuse or Deprecation. Some individuals begin to internalize the abuse and believe it. Watch for drastic  changes in levels of self confidence.


  • Emotional Sensitivity. When abuse is occurring, there is often an increase in agitation and suspicion. Be especially aware of this if your loved one has a naturally positive demeanor.


  • Unusual Changes in Personality. Adjusting to different surroundings can be difficult, but they shouldn't result in drastic personality changes.


Legal Recourse
It's important for people to know that criminal statutes exist for nursing home abuse. Often there are particular regulations in place regarding emotional abuse specifically. You should never feel like emotional abuse is simply something 'made up' or without precedent.

To figure out if you have legal recourse for emotional abuse in a nursing home, first do your best to assess the situation. Don't jump to unsubstantiated conclusions and understand the complexities of home living. But if you believe there is definite trouble, find and contact a specialist attorney in your area. With intangible factors such as emotion and mental state, it's critical to have representation who knows how to handle those factors.

Long Distance Elder Care - Will Senior Citizens Embrace Elderly Monitoring Services?


Providing long distance elder care has always been a challenge for adult children who are scattered across the globe, but now there is help. A cottage industry of elderly monitoring services is hoping to cash in on an explosive need: to provide peace of mind to elder people's children and extend autonomy/independent living to their aging parent(s).

This challenge is being addressed by placing sensors in an elderly person's home, allowing the senior citizen to live independently while providing loved ones who live far away access to data gathered by the sensors. Data collection involves tracking when and where the elderly person has been in the house and even what parts of the rooms have been accessed, such as the refrigerator, medicine cabinet, and kitchen cabinets. General health information, such as weight and blood pressure, can also be monitored.

Although this is a well-intended solution, there can be some problems due to the reversal of roles between parent and child as well as the aging parent's perception of his/her privacy being invaded. There is a delicate balance, a trade-off; giving up some privacy in exchange for being able to stay and live at home. Some elders resist, thinking that this is too intrusive.

Broaching this subject in a sensitive and compassionate way is key. Additionally, it is wise to put this type of long distance elder care in place when the senior is healthy and has no medical issues. It is easier to get an elderly person on board with the technology when they have no health issues and are able to carry out all activities of daily living. A child could say to his/her parent, "Hey Dad, we're so glad you are doing well on your own at home; let's talk about how we can make sure you continue to stay safe." Talking about this need for monitoring long before it is needed will allow the senior citizen to process the information and get used to the idea.

This health monitoring solution for the elderly is not cheap; it can cost many thousands of dollars to install the monitoring equipment, and then there is usually a monthly monitoring fee. However, when one considers the cost of nursing home care, assisted-living care, and in-home health aide costs, it is a solution that, although not perfect, can be a compromise that all parties can live with.

Long distance elder care will continue to challenge thousands of families across the United States as the Graying of America continues to push numbers of seniors to unprecedented heights. Thanks to technology, many elderly people will be able to stay in their homes longer and live happier, more productive lives, and their children will have the peace of mind that Mom and/or Dad are doing fine.

Renaissance Science, Registered 21st Century Rebirth Document


This essay is the birth certificate of the 21st Century Renaissance. It shows how the life-science of the Classical Greek era's Humanities has been upgraded in order to bring balance into Western technological culture. Many philosophers have warned that the fate of human civilisation depends upon achieving that goal.

The ancient Greek Parthenon represented a Greek life-science culture, symbolising concepts of political government long lost to modern Western science. The Ottoman military once stored gunpowder in the Parthenon and in1687 a Venetian mortar round blew the building into ruin. Recent restoration techniques using computers revealed that strange illusionary optical engineering principles had been used in the building's construction. We know that they were associated with the mathematics of the Music of the Spheres that Pythagoras had brought back from the Egyptian Mystery Schools. We also know that Plato considered that any engineer who did not understand about spiritual optical engineering principles was a barbarian.

Harvard University's Novartis Chair Professor, Amy Edmondson, in her online biography of Buckminster Fuller, The Fuller Explanation, wrote about how Fuller had plagiarised Plato's spiritual engineering discoveries and used them to derive his life-science synergistic theories. Those theories, which completely challenged the basis of the 20th Century Einsteinian world-view are now the basis of a new medical science instigated by the three 1996 Nobel Laureates in Chemistry. During the 21st Century the complex Fullerene geometrical reasoning has brought about the rebirth of the lost ancient Greek optical science of life. This is now rewriting Western technological culture, so there is a need to know why Buckminster Fuller wrote that this reunification provides a choice between Utopia or Oblivion.

After presenting complex geometrical reasoning, Professor Edmondson wrote, "By now familiar with Fuller's underlying assumptions, we shall take time out to introduce some background material. The origins of humanity's fascination with geometry can be traced back four thousand years, to the Babylonian and Egyptian civilisations; two millennia later, geometry flourished in ancient Greece, and its development continues today. Yet most of us know almost nothing about the accumulated findings of this long search. Familiarity with some of these geometric shapes and transformations will ease the rest of the journey into the intricacies of synergetics."

Human survival now depends upon a more general understanding that ethics is not about how science is used but about what is the ethical form of the spiritual, or holographic structure of science itself. There is no need for the reader to become conversant with the complex geometrical equations suggested by Professor Amy Edmondson, in order to follow the journey of ethical logic from ancient Egypt to the 21st Century Renaissance. However, before undertaking that journey we need to realise the nightmare scenario that the unbalanced 20th Century understanding of science has forced global humanity to endure and which Buckminster Fuller warned about.

In 1903, Lord Bertrand Russell's book A Freeman's Worship was published, containing his vision of A Universe in Thermodynamic Ruin. This nightmare mathematical assessment of reality stated that all the most ennobling thoughts of humankind amounted to nothing at all and all life in the universe must be destroyed. Lord Russell wrote that humans must endure, with total despair, the hopelessness of living within a reality that was totally governed by a lifeless energy law that Einstein was to call The Premier law of all science.

The name of the law governing 20th Century technological culture is the Second Law of Thermodynamics. It is also known as the Universal heat death law or, the Law of Universal chaos.

That law demands the total extinction of all life in the universe when all heat is dissipated into cold space. As a result of that law, all life sciences, including global economic rationalism, can only be about species moving toward this imaginary heat death extinction.

Buckminster Fuller's life-science energy does not obey the heat death law. It is based instead upon fractal logic, which exists forever. Einstein's governing death-science law is the correct basis of modern chemistry, but that chemistry is balanced by Plato's spiritual engineering principles, or the functioning of Fullerene holographic 'chemistry'. While mainstream science does indeed accept that fractal logic extends to infinity, no life science within the Western technological culture can possibly be part of its workings. That mindset can be a serious distraction to biologists who seek to associate rain cloud fractal logic with the effects of climate change upon human evolution.

In 1996 within an Open Letter to the Secretariat of the United Nations on behalf of the Science-Art Research Centre of Australia, Australian National Library Canberra Australian Citation RECORD 2645463, a complaint was made that the Australian Government was unintentionally committing a major crime against humanity for endorsing a totally entropic educational system governed by the second law of thermodynamics. At the United Nations University in Washington the complaint was handed to the United Nations University Millennium, Project-Australasian Node, for investigation. Seven years of peer reviewed research ensued, concluding that the complaint was justified. In 2006 a formal Decree of Recognition was issued by the Australasian Division of the United Nations University Millennium Project, attesting to the urgent global importance of this issue.

Having contrasted the 21st Century rebirth of Classical Greek fractal logic life-science - the New Renaissance, with the 20th Century nightmare, we can follow Professor Amy Edmondson's advice to begin our journey of ethical understanding from ancient Egypt. (George Sarton's, A History of Science argues that ancient Kemetic theories of Egypt were scientific and established the foundations of later Hellenistic science).

The ability of the ancient Egyptian Old Kingdom to reason that two geometries existed to balance the workings of the universe was praised by the Greek philosopher Plato, whose fundamental idea was that "All is Geometry". Old Kingdom wall paintings depicted that evil thoughts prevented evolutionary access to a spiritual reality. The geometry used to survey farm boundaries lost each year when the River Nile flooded was quite different from the sacred geometries basic to Egyptian religious ceremonies.

The BBC television program about the collapse of the Egyptian Old Kingdom by Professor Fekri Hassan of the Institute of Archaeology, University College, London, explained that some 4000 years ago, a prolonged drought collapsed the First Kingdom, soon after the death of King Pepy II. Professor Hassan explains that 100 years after the collapse, hieroglyphs record that Egyptian government was restored when the people insisted that the ethics of social justice, mercy and compassion were fused into the fabric of political law. It is rather important to realise that at that point of time in history, ethics associated with fractal geometrical logic had been fused into a political structure.

During the 6th Century BCE the Greek scholar Thales went to Egypt to study the ethics of life-science at the Egyptian Mystery schools and he advised Pythagoras to do the same. Pythagoras learned that evolutionary wisdom was generated by the movement of celestial bodies, which the Greeks called The music of the Spheres. It was thought that this harmonic music could transfer its wisdom to the atomic movement of the soul through the forces of harmonic resonance, such as when a high note shatters a wine glass.

The Platonic tradition of Greek philosophy was to fuse ethics into a model of reality called the Nous, postulated by the scientific thinker Anaxagoras. The Nous was a whirling force that acted upon primordial particles in space to form the worlds and to evolve intelligence. The ancient Greeks decided to invent science by fusing further ethics into the fractal logic structure of the Nous. The harmonic movement of the moon could be thought to influence the female fertility cycle and this science could explain a mother's love and compassion for children. The Classical Greek science was about how humans might establish an ethical life-science to guide ennobling political government. The idea was, that by existing for the health of the universe, human civilisation would avoid extinction.

The Classical Greek life-science was constructed upon the concept of good and evil. Good was For the Health of the Universe. A very precise definition of evil is found in Plato's book, The Timaeus. Evil was classified as a destructive property of unformed matter within the physical atom.

The ancient Greek atom was considered to be physically indivisible and it can be considered that the anti-life properties of nuclear radiation had been classified as evil. Modern chemistry is constructed upon the logic of universal atomic decay, which is governed by the second law of thermodynamics. The Egyptian concept of evil thought processes leading to oblivion echoes Plato's and Buckminster Fuller's concepts of an oblivion brought about through an obsession with an unbalanced geometrical world-view.

The Max Plank Astrophysicist, Professor Peter Kafka, in his six essays entitled The Principle of Creation and the Global Acceleration Crisis, written over a period from 1976 to 1994, predicted the current global financial collapse being brought about by "scientists, technologists and politicians" who had an unbalanced understanding of the second law of thermodynamics. Kafka wrote in chapter four, entitled Ethics from Physics, that the second law of thermodynamics had been known for centuries. Kafka realised that it had various other names throughout history such as Diabolos, the Destroyer of Worlds, the evil god of Plato's Physics of Chaos, now the god of modern Chaos Physics.

The science to explain a mother's love for children involving both celestial and atomic movement became associated with the Science of Universal Love taught in Greece during the 3rd Century BCE.

Julius Caesar's colleague, the Historian Cicero, recorded during the 1st Century BCE, that this science was being taught throughout Italy and across to Turkey by teachers called 'saviours'. He considered that such teaching challenged Roman political stability. During the 5th Century some 1000 years of fractal logic scrolls held in the Great Library of Alexandria were burned. The custodian of the library, the mathematician Hypatia, was brutally murdered by a Christain mob during the rule of Pope Cyril. Hypatia's fractal logic life-science was condemned by St Augustine as the work of the Devil. In his The Decline and Fall of the Roman Empire, Edward Gibbon marked Hypatia's murder as the beginning of the Dark Ages.

Encyclopaedia Britannica lists St Augustine as the mind which mostly completely fused the Platonic tradition of Greek philosophy with the religion of the New Testament, influencing both Protestant and Catholic religious belief in modern times. His translation of Plato's atomic evil as female sexuality, influenced the 13th Century Angel Physics of St Thomas Aquinas, known as History's Doctor of Science. During the mid 14th Century until the mid 17th Century, Angel Physics was used to legalise the imprisonment, ritualistic torture and burning alive of countless women and children. The argument that Augustine's banishment of fractal life-science logic in the 5th Century was responsible for Western life-science becoming obsessed with the second law of thermodynamics can be validated.

The Reverend Thomas Malthus derived his famous Principles of Population essay from the writings of St Thomas Aquinas and used it to establish the economic and political policies of the East India Company. Charles Darwin, employed by that company, cited Malthus' essay as the basis of his survival of the fittest life-science. Darwin, in the 18th Century, held the essay as synonymous with the second law of thermodynamics.

Plato's Academy had been closed for being a pagan institution in 529 by the Christian Emperor Justinian, Banished Greek scholars fled to Islamic Spain where their theories were tolerated. The Golden Age of Islamic science, from which Western science emerged, included the Translation School in Toledo. Islamic, Christian and Jewish scholars worked together to translate the lost Greek ideas into Latin. The Franciscan monk, Roger Bacon, during the 13th Century studied work from Jewish scholars familiar with the research undertaken at the Toledo school. Pope Clement IV encouraged Bacon to write his pagan ideas in secret, but after the death of Clement IV, Roger Bacon was imprisoned by the Franciscans.

Roger Bacon developed ideas about flying machines, horseless carriages,submarines and self propelling ships from the same Islamic source that later inspired Leonardo da Vinci. Roger Bacon studied the optics of Plato and the upgrading of Plato's optics by Islamic scholars. Unlike Leonardo, Roger Bacon agreed with Al Haytham, History's Father of Optics, that the eye could not be the source of all knowledge, an erroneous idea of reality that Descartes and Sir Francis Bacon, the Renaissance author and father of inductive reasoning, used to usher in the age of industrial entropic materialism. Thomas Jefferson, inspired by Francis Bacon's vision of a great Empire for All Men based upon all knowledge from the eye, depicted the concept onto the Great Seal Of America.

Cosimo Medici, with the help of Sultan Memhed II, re-established Plato's Academy in Florence during the 15th Century. Cosimo appointed Marcilio Ficino as its manager. Ficino wrote about the Platonic love associated with the Music of the Spheres influencing the atoms of the soul. He carefully avoided serious charges of heresy by placing eminent Christian figures into his writings and paintings associated with the new Platonic Academy. Two famous paintings commissioned by the Medici that survived the Great Burning, instigated by the Christian Monk Savarola, illustrated Ficino's cunning.

In 1480 Botticelli was commissioned to paint a portrait of St Augustine in His Study, in which a book is depicted opened at a page displaying Pythagorean mathematics. Alongside the written formulae is an instrument for observing celestial movement. Augustine is gazing directly at an armillary sphere, an instrument used to calculate data relevant to Pythagoras' Music of the Spheres. The Saint's halo, accepted at that time as representing the consciousness of the soul, upon close examination, has a spherical book-stud within its orbit, depicting Ficino's atom of the soul responding to the Music of the Spheres.

At the same time that Botticelli was commissioned to paint Augustine's portrait, Ghirlandhiao was commissioned to paint a portrait of Augustine's close colleague, St Jerome in His Study. Again, with careful examination, Jerome's halo can be seen to have a spherical bookstud placed into its orbit, demonstrating that Botticelli's depiction of the atom of the soul associated with the Music of the Spheres was not coincidental. Both Botticell and Ghirlandaio were mentors to Leonardo da Vinci.

By realising that Roger Bacon's knowledge of Platonic optics was generally superior to Leonardo's, the Science-Art Research Centre of Australia, in collaboration with a cancer research team at the University of Sydney, during 1986, was able to successfully modify the optical key to Leonardo's da Vinci's Theory of Knowledge. This discovery also corrected the optics understanding of Descates, Sir Francis Bacon, Lord Russell, Emmanuel Kant, Albert Einstein and other scientists who considered Al Haitham's optics as being industrially impractical.

The Science-Art Research Centre's correction to the crucial optics key was published in a Science-Art book launched in Los Angeles in 1989 under the auspices of the Hollywood Thalian Mental Health Organisation. In 1991 the Nobel Prize in Physics was awarded to Peirre de Genes for his theories about liquid crystal optics. In the following year the vast new science and technology, predicted by the Science-Art Centre's correction of da Vinci's work, was discovered The principal discoverer, Professor Barry Ninham of the Australian National University, later to become the Italy's National Chair of Chemistry, wrote that the Centre's work encompassed a revolution of thought, as important to science and society as the Copernican and Newtonian revolutions.

Leonardo da Vinci was certainly a great genius, but he was not really the Man of the Renaissance at all, because he was unable to comprehend the life-energy basis of Plato's spiritual optical engineering principles. He had attempted to develop the relevant optics for several years then reverted back to what Plato had referred to as the engineering practices of a barbarian. On the other hand, Sir Isaac Newton, was a genuine Man of the Renaissance, as his unpublished papers, discovered last century revealed. His certain conviction that "a more profound natural philosophy existed to balance the mechanical description of the universe," was based upon the same physics principles that upheld the lost Classical Greek Era's science of life and they are now at the cutting edge of fractal logic quantum biology.

The 20th Century began with the aforesaid Lord Bertrand Russell's horrific acquiescence to enslavement by the second law of thermodynamics in 1903, followed in 1905 by Einstein's unbalanced E=Mc2. TIME Magazine's Century of Science lists Maria Montessori as the greatest scientist of 1907. Her association with President Woodrow Wilson, Alexander Graham Bell, Thomas Jefferson and Teildard de Chardin demonstrated how the entropy law embraces Plato's definition of evil. Montessorri called the second law of thermodynamics the energy greed law. Montessori and de Chardin's electromagnetic life-science key to open their Golden Gates of the future were derived from concepts based upon the spiritualisation of matter and humanity evolving with the cosmos. That was in direct contrast to the electromagnetic understanding of Alexander Graham Bell.

President Wilson was genuinely troubled by the loss of life during World War I. He and Alexander Bell chose Darwin's entropic life-science as the electromagnetic key to the future of America rather that Montessori's. After World War II, High Command Nazi prisoners at the Nuremberg War Crimes Tribunal protested that Adolph Hitler had based the policies of the Third Reich upon the the Darwinian Eugenics of which Present Wilson and Alexander Bell had been involved with.

The scientist, Matti Pitkanen, can be considered to have upgraded de Chardin's ethical electromagnetic key to open Montessori's Golden Gates to the future. De Chardin insisted that the gates would only open for all people at the same time and not for any chosen race nor privileged few. Pitkanen noted that the earth's regular deflection of potentially lethal radiation from the sun fulfilled the criteria of an act of consciousness, protecting all life on earth at the same time.

The 1937 Nobel Prize Winner for Medicine, Szent-Gyoergyi, wrote a book about scientists who did not recognise that their understanding of the second law of thermodynamics was balanced by the evolution of consciousness. The title of the book was The Crazy Apes. In his 1959 Rede Lecture at the University of Cambridge in 1959, the Molecular Biologist, Sir C P Snow, argued that the inadequate understanding about the nature and functioning of the second law of thermodynamics by his fellow scientists was scientifically irresponsible. He referred to their thinking as belonging to their neolithic cave dwelling ancestors. The title of Snow's lecture was The Two Cultures and the Scientific Revolution. This book was listed by The Times Literary Supplement as one of 100 books most influencing Western public thinking since World War II and has been systematically denounced ever since.

During the past 15 years, science has developed so rapidly that it has given the Humanities no time to grasp the significance of the social ramifications of the rebirth of Fuller's Platonic spiritual, or holographic, engineering principles from ancient Greece. Organised religious opposition to criticism of the understanding of the second law of thermodynamics from Christian schools, Colleges and Universities has been extremely thorough throughout the world. For example Professor F M Cornford, educated at St Paul's School and Trinity College, Cambridge, was made a Fellow in 1899, becoming the Laurence Professor of Ancient Philosophy in 1932, and was elected a Fellow of the British Academy in 1937. His grasp of the ancient Greek fractal science of life can be shown to be completely illogical, yet it is the foundation for well organised international academic study courses at the present time.

Since 1932 Cambridge University has produced ten editions of Cornford's book Before and after Socrates. Cornford states in this book that Plato can be considered as one of the greatest fathers of the Christian religion. Encyclopaedia Britannica advises that St Augustine was the mind which mostly completely fused the Platonic tradition of Greek philosophy with the religion of the New Testament. Such pious academic reasoning flies in the face of Plato's spiritual engineering principles being observed functioning within the DNA as a function of a fractal life-science evolutionary function, and is therefore ludicrous.Plato defined that reasoning as being ignorant and barbaric and the language of engineers not fit to be considered philosophers. The Harvard Smithsonian/NASA High Energy Astrophysics Division Library has published papers by the Science Advisor to the Belgrade Institute of Physics, Professor Petar Grujic, arguing that the Classical Greek life-science was based upon fractal logic, a totally incomprehensible concept within the much lauded ancient Greek study courses currently set for post graduate studies.

Having arrived at the destination of Professor Amy Edmondson's journey from ancient Egypt to modern times, in order to be educated about the importance of Buckminster Fuller's geometrical understanding, we are able to grasp the stark reality of the title of his book Utopia or Oblivion. The objective of this essay, to construct the foundations of the Social Cradle to nurture the Florentine New Measurement of Humanity Renaissance, was derived from that book. The following explains the Science-Art Research Centre of Australia's long and arduous struggle to help contribute towards the vital human survival research now being carried out under the auspices of the New Florentine Renaissance.

In 1979 the Science Unit of Australian National Television documented the work of the Science-Art Research Centre into its eight part series The Scientists-Profiles of Discovery. During that year, at the International Centre for Theoretical Physics in Trieste, China's most highly awarded physicist, Kun Huang, proposed a research plan that was put into operation by the Centre. Professor Huang was angry that Einstein and the framers of the 20th Century world-view were unable to discuss the Classical Greek life sciences in infinite biological energy terms. He proposed that by observing the evolutionary patterning changes to species designed upon ancient Greek Golden Mean geometry, it should be possible to deduce the nature of the life-force governing their evolution through space-time.

Huang suggested that the world's seashell fossil record would provide the necessary patterning-change information. The research was assisted by the communities of the six towns comprising the Riverland Region of South Australia. During the 1980s the Centre's several seashell life-energy papers, written by the Centre's mathematician, Chris Illert, were published by Italy's leading scientific journal, il Nuovo Cimento. In 1990 two of the papers were selected as important discoveries of the 20th Century and were reprinted by the world's leading technological research institute, the Institute of Electrical and Electronic Engineers in Washington.

By deriving an Art-master optics formula from the Italian Renaissance, which can be considered to be associated with fractal logic, a simulation of a living seashell creature was generated. By lowering the musical harmonics a simulation of the creature's fossil ancestor was obtained. By lowering the musical order by a different amount, the simulation of a strange, grotesque creature was generated. The Smithsonian Institute identified the fossil as being the famous Nipponites Mirabilis that drifted along the coast of Japan 20 million years ago. It was designed to drift along upright in water in order to ensnare its prey. Chris Illert became the first scientist to link its evolution to a living seashell.

In 1995 the discovery won an internationally peer reviewed Biology Prize from the Institute for Basic Research in America. China's most eminent physicist, Kun Huang, was greatly honoured. The work was acclaimed for the discovery of new physics laws governing optimum biological growth and development through space-time. The Research Institute's President, Professor Ruggero Santilli, in collaboration with the Centre's mathematician, made a most important observation. He observed that the accepted scientific world-view could not be used to generate such futuristic simulations. Instead it generated cancer-like biological distortions through space-time.

The Centre's Bio-Aesthetics Researcher, the late Dr George Robert Cockburn, Royal Fellow of Medicine (London), who had worked with the centre's mathematician, became concerned by the scientific community's refusal to challenge its obsolete understanding of the second law of thermodynamics. He published several books about creative consciousness based upon the ancient Greek fractal logic life-science. His correction to Emmanuel Kant's Aesthetics was later found to be validated by the 19th Century's mathematician Bernard Bolzano's Theory of Science. Bolzano's own correction to Emmanuel Kant's ethics had been assessed by Edmund Husserl in his Logical Investigations- vol. I - Prolegomena to a pure logic 61 (Appendix) (1900), as being the work of one of the greatest logicians of all time.

We know that Bolzano corrected the ethical logic of Immanuel Kant by using aspects of fractal logic, as the famous Bolzano-Weierstrass theorem of 1817 is now synonymous with the pioneering of modern fractal logic. The Aesthetics associated with Emmanuel Kant belonging to the destructive entropic world-view are hailed as being of global importance during the 21st Century, when, in fact, they are known to be obsolete. J Alberto Coffa's book The semantic tradition from Kant to Carnap: to the Vienna station, edited by Linda Wessels - Cambridge, Cambridge University Press 1991 contains the statement "Kant had not even seen these problems; Bolzano solved them. And his solutions were made possible by, and were the source of, a new approach to the content and character of a priori knowledge." The famous Bolzano-Weierstrass theorem was based upon fractal logic concepts.

In the book The Beauty of Fractals- Images of Complex Dynamical Systems is a chapter entitled Freedom, Science and Aesthetics by Professor Gert Eilenberger, who also corrected an aspect of Kantian Aesthetics in order to upgrade quantum mechanics into quantum biology. Professor Eilenberger wrote about the excitement surrounding pictures of fractal computer art, as demonstrating that "out of research an inner connection, a bridge, can be made between rational scientific insight and emotional aesthetic appeal; these two modes of cognition of the human species are now beginning to concur in their estimation of what constitutes nature".

The Science-Art Centre had discovered that by using special 3-D optical glasses, holographic images emerge from within fractal computer generated artwork. The excitement within the art-work itself extends to the realisation that, over the centuries, certain paintings reveal the same phenomenon, created unconsciously by the artist, indicating the existence of an aspect of evolving creative consciousness associated with Plato's spiritual optical engineering principles now linked to the new Fullerene life-science chemistry.

The electromagnetic evolutionary information properties generated into existence by the liquid crystal optical functioning of the fertilised ovum are transmitted to the first bone created within the human embryo. From the Humanoid fossil record, each time that bone changes its Golden Mean patterning design, a new humanoid species emerges. It is currently altering its shape under the influence of the same physics forces responsible for seashell evolution, as was discovered by the Science-Art Research Centre of Australia during the 1980s. The sphenoid bone is in vibrational contact with the seashell design of the human cochlea.The design of Nipponites Mirabilis was to keep its owner upright in water, the cochlea design is to enable humans to balance so as to keep them upright on land.

The cerebral electromagnetic functioning of creative human consciousness as a Grand Music of the Spheres Composition has been adequately charted by Texas University's Dr Richard Merrick in his book Interference. The Fullerene life-science of the three 1996 Nobel Laureates in Chemistry has found expression within the medical company, C Sixty Inc. The Science-Art Research Centre in Australia considers that Buckminster Fuller's crucial Social Cradle within the Arts, under the auspices of the Florentine New Renassaince Project might be able to bring to the public an understanding for the global betterment of the human condition.

China's most eminent physicist, Hun Huang's research program can now be upgraded to generate healthy sustainable futuristic human simulations through millions of space-time years, and from those human survival blueprints the technologies needed for overpopulated earth to ethically utilise the universal holographic environment are becoming obvious. The 20th Century adage that ethics is how one uses science is as barbaric as Plato's Spiritual engineering classified it. Ethical consciousness has quantum biological properties beyond Einstein's world-view as has been proven by medical research conducted under the auspices of the Florentine New Measurement of Humanity Renaissance.

Dr Candace Pert's Molecule of Emotion, discovered in 1972, referred to in the films What the Bleep, do we know? and Down the Rabbit Hole, has been experimentally extended into further realms of holographic life-science reality. Dr Pert's Molecule of Emotion is the same in humans as in a primitive cell, but has evolved by increasing the speed of its molecular movement. Associated with this emotional evolution is the functioning of endocrine fluids necessary to maintain cellular health. The Florentine life-energy research has established that endocrine fluids evolve within the earth's holographic electromagnetic environment, affecting health in a manner beyond the understanding of an unbalanced 20th Century world-view.

On the 24th of September 2010, on behalf of the President of the Italian Republic, Dr. Giovanna Ferri, awarded the "Giorgio Napolitano Medal" to Professor Massimo Pregnolato, who shared it with Prof. Paolo Manzelli for research conducted in Quantumbionet/Egocreanet by their Florentine New `Renaissance Project.

This essay has explained the primary obstacle that has prevented Sir Isaac Newton's 'more profound natural philosophy to balance the mechanical description of the universe' from being brought about. The knowledge of how to correct this situation has become central to the objectives of the Florentine New Measurement of Humanity Renaissance of the 21st Century. This essay is the Birth Registration Certificate of the New Renaissance.

Copyright Robert Pope 2010.