From Maesk Counseling in Fort Lauderdale - Loneliness

Nov. 19, 2018, 3:42 PM EST

By Dr. Olimpia Paun, geropsychiatric clinical nurse specialist and researcher

At the 1976 Democratic National Convention, Hubert H. Humphrey said, “The ultimate moral test of any government is the way it treats three groups of its citizens."

"First, those in the dawn of life — our children, " he added. "Second, those in shadows of life — our needy, our sick, our handicapped. Third, those in the twilight of life — our elderly."

At the time, he said that Republicans had "failed this basic test of political morality." But as a former psychiatric visiting nurse and now as a researcher working with family caregivers of persons with dementia, it's a test that many of us are failing.

That is because loneliness is a broad societal problem that affects not only Americans, but everyone on the globe, as social isolation becomes widespread with an aging population.

Six million Americans 65 and older live alone in their communities, are homebound because of medical or emotional conditions or lack access to transportation. Many of these adults become physically isolated and emotionally lonely, contributing to what many call the loneliness epidemic.

Recent research indicates that loneliness and social isolation are risk factors for depression, impaired cognitive performance, dementia progression, compromised immune system, cardiovascular disease, hypertension, stroke and an overall increased mortality risk.

Take my elderly neighbor, Mary: we first crossed paths when she was walking her dog, and we smiled at each other, nodded and went about our business.

Soon after that, on a weekend evening, I noticed she had not picked up her newspaper that day, so I knocked on her front door. She was surprised but grateful that someone cared enough to check on her; few other people ever had. We remained friends for a decade, until she passed away.

Her circumstances are far too common. As a psychiatric visiting nurse in the mid-90s, I had the privilege to work with many older adults confined to their homes or apartments because of physical and/or mental health limitations. In many cases, apart from the occasional Meals-on-Wheels volunteers, I was the only other human being they interacted with over the course of each week.

My presence ensured that they maintained a degree of safety, medication adherence and, if necessary, that they would be connected with further medical care before a crisis ensued.

But not every elderly person living along can count on having a nurse used to working with older adults living on her block or coming by the house. And, according to recent U.S. Census Bureau data, the population of adults 65 and over will grow from 49.2 million in 2016 to 78 million by 2035. As the number of older adults increases at such a fast pace, so will the needs for addressing their health care needs, including those created by loneliness and isolation.

According to recent reports, a few major health care providers across the U.S. are already defining loneliness and isolation as social determinants of health. These providers are taking measures to connect their clients through basic measures such as home visits, phone contacts and providing transportation. The hope is that preventing and combating loneliness and isolation in older adults may prove cost effective.

Many of the connecting strategies to combat loneliness, though, rely on technology. While online messaging, voice and video chatting and social networking are effective ways to connect, not all older adults in the U.S. and globally can afford or have access to the Internet. In 2017, a Pew Research Center Survey found that only four in 10 seniors in the US owned a smartphone, only about half of them subscribed to high speed internet services and only one-third accessed social networking platforms such as Facebook or Twitter.

Low tech programs are out there, but they're mostly volunteer-based — like The Little Brothers-Friends of the Elderly, a non-profit volunteer agency with eight chapters across the United States. Volunteers visit those who are homebound, organize holiday and birthday celebrations, and even plan mini-vacations.

Many organizations are just beginning to launch self-assessment and awareness campaigns to bring attention to the problem of social isolation in older populations. The AARP Foundation, launchedConnect2Affect in 2016, collaboration with organizations such as the Gerontological Society of America, United Healthcare, Give an Hour and the National Association of Area Agencies on Aging. The goal was to increase understanding of the complexities of loneliness and isolation in older adults, raise awareness of the public health implications, and rally resources to create evidence-based interventions.

Other nations are addressing the loneliness epidemic directly through policy initiatives.

In 2017, The Australian Coalition to End Loneliness enlisted the combined efforts of academic, not-for-profit, national, local and community-based resources to raise awareness, advocate and create evidence-based interventions to eradicate loneliness.

And in the United Kingdom, a recent report by The Jo Cox Commission inspired the Prime Minister Theresa May to pledge the equivalence of $23 million to tackle loneliness that afflicts an estimated 4 million British older adults. Earlier this year, May charged the Minister for Sport and Civil Society to include loneliness under its auspices, naming Tracy Crouch its Minister of Loneliness.

Medicare spends a reported additional $6.7 billion per year to treat the health problems of persons with limited social connections.

In the absence of a national plan endorsing the older adult loneliness epidemic in the U.S., millions simply rely on volunteer-based, charitable organizations to address a serious problem with severe public health implications. Or they will have neighbors, like Mary did, who are able and willing to visit them and check on their well-being.

Relying on individuals to be their neighbor’s keeper may indeed be a moral test for the individual but, as Humphrey opined four decades earlier, it is also a moral imperative of government and policy makers to create policies, standards and frameworks to care for those who have paved the paths before us.

I am willing to check on people I understand may need my help; I see it is not only as a kindness, but as my social responsibility. In the broader picture, how we as a nation address the needs of our elderly is a reflection of our humanity. This is difficult political test as well, and one that must be passed and passed on, not passed over.

Dr. Olimpia Paun

Dr. Olimpia Paun is an associate professor in the College of Nursing at Rush University and a geropsychiatric clinical nurse specialist and researcher. She is a Public Voices Fellow through The OpEd Project.

From Maesk Counseling in Fort Lauderdale - Therapy

Individual, couples or family therapy - we are here for you!

From Maesk Counseling in Fort Lauderdale - Trauma in Our Public and Private Lives

NOTE: This is NOT a political post. I am posting this because it is a very insightful, personal and much needed commentary on trauma, the treatment of which is the new great frontier of psychotherapy. I hope it will get you thinking, and that it will help. Posted with permission of the author, Mr. Matthew Dowd, to whom I am very grateful.

With bitter division, America needs a president who can heal in 2020

By
MATTHEW DOWD
Jul 1, 2019, 4:02 PM ET

In January 2017, I said on ABC News that America had not been this divided since the Civil War, and the last two plus years has confirmed this conclusion numerous times. We are divided in so many different ways today – by sex, party, age, race, religion and region.

While we have not taken up arms against each other as happened in the battle to save the Union, words of hate and contempt proliferate, and we are again in a different kind of fight to save the Union.

The presidential election of 2020 is going to be a poignant and historic moment to see if we can begin to heal these divides and breathe new vigor into this great experiment of democracy and to see if we can rebuild the bonds of our American family. Thus one of the characteristics I am looking for as we all peruse whom to vote for is who can best bring a healing vision to our country.

I have read much about the effects of trauma on individuals, and have experienced some of this trauma myself -- through divorce, the loss of two children, the loss of a younger sister to drug addiction, the jettisoning of a political career when I publicly broke with President George W. Bush, and in watching how our politics has caused rifts in my own family.

One thing I have come to believe is that trauma can occur privately and personally to each of us, and it can occur publicly and in a more broad way to us as a community. Wounds we carry with us affect not only our own daily lives; we are also impacted as a group when leaders bully, divide, push hate and inspire not love, but fear.

From a public sense, these wounds are real. And just as we have a choice to heal our own private wounds and come through it all as more compassionate and empathetic and less judgmental, seeking to enlarge our hearts through love and kindness, so too politically do we have a choice to try and heal wounds writ large. And those are the leaders America needs at this point in our history.

Who are the leaders who will push for love instead of hate? Who are the leaders who seek consensus and the common good -- and not division and what is best for only a small group of Americans? Who understands that we need to retain the values of antiquity like integrity and compassion while understanding that we are in a transformative moment where the current problems can't be solved with old solutions?

Let us look for leaders who have developed a language of union and peace rooted in their own growth from trauma and wounding. Those leaders who have overcome loss, who grew up with little financially or know they were blessed by the accident of birth and want to share, who have overcome racism or sexism or ageism or any form of discrimination along their journeys. And by overcoming these hurdles, they are less concerned with defeating enemies, but more concerned with bringing us together as a country.

Those leaders that can heal publicly are very likely those leaders who have healed privately through hardship or hate. Seek those leaders who didn't become bitter and whose hearts shrunk, but whose hearts have grown larger and become softer.

I know that everyone might see their own indication of this in many different candidates -- and that is a wonderful thing -- but if one is making a list of criteria of the leaders America needs in this moment, let us put at the top of that list those candidates who reach out beyond boundaries and walls, and who see that we all share a common humanity that includes loss.

Yes, we each have experienced our own distinct traumas -- that is the nature of our humanness and a cruel world at times. But we each also have suffered public trauma in the midst of hate and the terrible divisions which have gripped these United States today.

Let us look for leaders whose purpose they see not as punishing opponents, but as pursuing a path of respect, compassion, and justice for all. This is why Mandela and Lincoln were such important leaders, because they spoke to their countries in an attempt to heal, rather than to ride the existing wave of hate battering the land we all love.

Matthew Dowd is an ABC News analyst and special correspondent. Opinions expressed in this column do not necessarily reflect the views of ABC News.

From Maesk Counseling in Fort Lauderdale- For Those Who’ve Lost a Pet

From Maesk Counseling Fort Lauderdale - Emotional Support Animals (ESA)

Maesk Group Counseling provides Emotional Support Animal (ESA) evaluations.  It is well documented through research that pets provide benefit to people suffering from anxiety, depression, PTSD, insomnia and many other conditions.  Having an ESA prescription letter allows you to have your pet in no-pets housing, and allows you to travel with your pet in the cabin of airlines at no additional cost.

There are other details/benefits.  Feel free to contact the office to schedule your consultation.

***THE LAWS IN FLORIDA WILL BE CHANGING SOON! IT IS IMPORTANT TO GET YOUR ESA EVALUATION NOW!***

From Maesk Counseling in Fort Lauderdale - Therapy Timetable?

Lots of people ask: How long will I be in therapy? The short answer is, well, it depends.

There are many factors that determine length of treatment, including the severity of presenting problems, how well someone responds to treatment and various other factors. As a general guideline however, I would say that the average person is in therapy for 3 - 6 months. That’s usually enough time to resolve most immediate concerns and getting you to “feel like you” again. At the beginning of our work together, I will provide you with my best professional estimate of how long to expect to be in treatment. And of course, the treatment plan will be developed in collaboration with you.

Therapy works. There is plenty of clinical evidence to back that up. If you are feeling that therapy might help, then you should probably make that call or send that email to get help. As the Dalai Lama said, “The purpose of life is Happiness.” I agree!

From Maesk Counseling in Fort Lauderdale - Emotional Support Animals

Maesk Group Counseling provides Emotional Support Animal (ESA) evaluations.  It is well documented through research that pets provide benefit to people suffering from anxiety, depression, PTSD, insomnia and many other conditions.  Having an ESA prescription letter allows you to have your pet in no-pets housing, and allows you to travel with your pet in the cabin on airlines at no additional cost.

There are other details/benefits.  Feel free to contact the office to schedule your consultation.

From Maesk Counseling in Fort Lauderdale - Emotional Support Animals (ESA)

Maesk Group Counseling provides Emotional Support Animal (ESA) evaluations.  It is well documented through research that pets provide benefit to people suffering from anxiety, depression, PTSD, insomnia and many other conditions.  Having an ESA prescription letter allows you to have your pet in no-pets housing, and allows you to travel with your pet in the cabin of airlines at no additional cost.

There are other details/benefits.  Feel free to contact the office to schedule your consultation.

From Maesk Counseling in Fort Lauderdale - Following Your Plan of Care

Many times, patients quit their treatment prematurely because the immediate crisis is over. This is equivalent to quitting a two week antibiotic prescription after the second day’s dose; the SYMPTOMS are eased, but what about the root cause? It will surely return later because it hasn’t been thoroughly addressed. Momentum toward recovery will be lost as well.

Depression, anxiety, relationship issues, panic attacks, teen and children’s behavior issues, anger management, divorce recovery—these all take time to change, to heal. You didn’t GET this way in a month or two, and it will take longer than that to heal completely. Often, we’ve carried problems of poor self- esteem, drug or alcohol addiction, and other counseling issues for most of our lives.

Periodic check ins, where we go over your progress and look again at your goals in the Plan of Care, help us understand where we have been together in therapy, what we have accomplished, and what still needs to be addressed. This is also a great time for you to “dream” and set new goals for a better life! When these goals have been met and all issues addressed, you are ready to go on to “maintenance care,” where you come in to see me every few months or so for checkups. These checkup visits can go a long way toward maintaining the growth and rational thinking you worked so hard to achieve in our sessions.

When I give you a Plan of Care, I’ve carefully considered your issues, your hopes and dreams, and your goals, using all of my education and experience to help you toward as happy a life as possible. It can be painful to go deeper at first, but the rewards you can experience can be very gratifying and life changing!

From Maesk Counseling in Fort Lauderdale - Do I Need Counseling?

Every day many people in Fort Lauderdale and Broward county search online for help with their problems, wondering if it’s finally time to reach out for direction and support to handle sadness, depression, anxiety, stress, fights with their partner or spouse, and family issues, among others. Here are some of the questions and mistaken beliefs we encounter as therapists every day.

Can’t I just talk to my friends about my problems?

Talking to a friend about mental health or personal issues may bring you temporary relief, but will make the problem more deep seated in the long run because you become more identified with the issue the longer you complain without intervention. Remember, you get what you pay for, and zero-cost advice is pretty much worth zero!

Nobody can change my situation, so why pay to see a professional about it?

There is a saying that “your world changes when YOU change.”  A professional, licensed therapist is trained in ways to help you respond to your world differently. We have at least two college degrees and extensive supervised training thereafter. There are thinking patterns, usually formed in childhood, of which you are completely unaware. I can show you how you are holding yourself back and perhaps help you find insight and freedom. It’s often a cage of your own making!

I’ve felt this way so long…

If you had a persistent fever, would you just say “oh well” and live with it? Or would you go to a health care specialist who could evaluate, diagnose, and treat it? The average person doesn’t realize how common mood and relationship problems are to the human condition, and that they can be (and are) identified and studied. Whole systems of therapy are developed for common issues, much as drugs are developed for physical ailments. 

What will people think?

The people intelligent and mature enough to seek therapy realize that it doesn’t matter what people think! It matters how you live every day of your limited, precious life, and whether you can enjoy that to a higher degree and love more fully. Besides, you would be surprised how many of those “imaginary people” you think are judging you are actually patients themselves.

Is it time for YOU to feel better? It’s time!  Get started NOW.