Grief & The Holidays: A Time of Challenge & Hope

REMEMBERING

Soon it will be holiday time again and reminders of their loss are everywhere for those who are grieving. Traditionally this is a time of joy, sharing of memories, warmth, peace, and coming together in love.

For those who are grieving, the holidays are also a vivid reminder of those that are so dearly missed. Add to this the common expectation that all should be as it was and many grieving families find the holiday season to be the most difficult time of the year. 

The period after the death of a loved one is a journey through grief. We cannot forget and we cannot bury the pain. It is not easy. Our hearts, minds and bodies are grieving and not functioning in their full capacities, as though part of us is missing. 

Yet, we don’t have to hide from our experience of grief. These are natural feelings–they are all a part of the process–we can share them, we can accept them, we can feel them.

WAYS OF COPING

As the holidays approach, start with a blank slate. Accept that you may not have the energy or inclination to accomplish all the things that you or others have come to expect during the holidays. 

Rather than do things automatically, discuss and think about what you really want to do, what you don’t want to do, and what will be difficult but you want to try. We encourage people not to be afraid to make changes in traditions or start new ones.

Equally important is to acknowledge how you feel. It will be a sad time. Many recently bereaved worry they will spoil the holidays for others. According to families Pathways has counseled, the most painful thing is when they try to keep their feelings inside.

If friends or family members take the initiative to talk about the person who has died, it relieves the tension and creates an opportunity for sharing.

MANAGING YOUR GRIEF 

While there are no universal methods for healing and coping, there are some concrete things you can do that may make the holidays easier and provide an opportunity to honor those you love who have died.

  
Acknowledge your grief; accept yourself in whatever mood you find yourself.

• Remember you are not alone. Attend a remembrance event or grief support group.
• Make some personal choices based on your level and what is right for you.
• Give yourself permission to let go of certain traditions–it’s okay to make changes.
• Share your plans with others; let them know how they can help you.
• Reserve time to honor your loved quietly, alone or with others: light a candle, place a photograph on the table, share memories, make a memorial donation.

And finally, as you navigate through your grief this holiday season keep your loved one in your heart and remember to care for yourself.

Helping People with Dementia Cope with Grief and Loss

The death of a loved one is difficult for anyone, but it is a special challenge when someone in the family has dementia.  It’s hard for family members to know how and when to tell the person with dementia about the death.  And what should they do when the person doesn’t remember?

Coping with Losses

People with dementia have had many “little deaths” in the course of their disease—things like losing their independence and the ability to drive, read, cook or enjoy hobbies.  Memories and relationships are huge losses.  These losses are stressful for people with dementia and their families.

How people with dementia cope with loss is affected by many things, including: the stage of their dementia, their relationship to the person who has died, how often they were in contact with that person, and their personal way of grieving.

Grief Process

For people without dementia, recovery from a death usually involves accepting the reality of the loss, learning to live with it, and finding a new “normal.”  For most, the pain of the loss can transform into beloved memories.  For someone with dementia this process is often impossible.

People with dementia who are grieving are often agitated and restless.  They may sense that something is not right, something is missing.  They may confuse one loss with another.  A recent death may stimulate the memory of loss from childhood.  It can be stressful for family members to decide when and how to tell them about the death of a loved one—and even how often to tell them.  Repeatedly telling a person with dementia about a death can make family members’ grief more painful.

Telling About a Death

Here are some hints for telling a person with dementia about a death:

• Tell the news as soon as possible.  They will sense that something is wrong and need information to understand, even if just for that period of time.
• If you are too emotional to talk to them, find someone else—maybe a friend or healthcare professional.
• Choose a time to talk when the person with dementia is well rested.
• Use short, simple sentences.  Don’t give too many details; this may overwhelm them. 
• Answer questions as honestly as possible.
• Use clear words like “died” instead of “passed away” or “at peace now.”
• Try not to protect the person from the truth by suggesting that the person who has died is away and will return later.  This can cause worry and agitation later when the person does not return.
• You can support them with physical touch, such as a hug or holding hands.
• Consider involving the person with dementia in funeral planning, assigning a simple task.  This will help the death be more real for them.  They may recognize the rituals around death and act appropriately.
• Plan for someone to be with the person during services who can also take them out if they become agitated.

Accepting Death

Here are some ideas of ways to help the person with dementia accept the death:

• Speak in the past tense about the person who has died.  For example, “I loved Mom’s holiday cookies.”
• Talk with them about the person who has died and express your sadness.  “I sure miss Dad.  He always made birthdays so fun, didn’t he, Mom?  Remember when he….”  Bring out pictures and tell stories if this helps their grief process.
• Accept how often they want to talk about the person who has died—perhaps frequently, not much, or maybe not at all.

If over time they continue to ask for the person who has died, there are some things you can do.  In the beginning, gently remind them that the person has died. If reminding them becomes upsetting, you can try these ideas:

• Respond to the emotion under their words, feelings like sadness, longing, fear, distress, suspicion, anger, concern or confusion.  You can respond to what you see:
• “You sound really frightened (or lost, or angry, etc.) to me.  Let me help you with that.”
• “You must really be missing her.  Tell me what you miss most.” Share your own feelings: “I miss her, too.”
• Check their mood at the moment.  If the person is unaware and not distressed, you don’t need bring up the reality of what has happened.
• Look for patterns in the times they ask for the person who has died.  Look for an unmet need. For example, if the person who has died usually brought them coffee in the morning, the change in this routine could be distressing and remind them that their loved one is not there. 
• Use distraction only when other ways of dealing with their grief are not working.

Each family has to find what works for them, and then try to be as consistent as possible.  You may want to write out a simple plan for all family members and visitors to follow. 

You can be most supportive to the person with dementia if you also take care of your own needs and get support.  We encourage family members to find support to help them cope with the painful, frustrating, lonely and sad feelings that they may feel.  Supporting the person with dementia takes patience, but family members should remember to be patient with themselves as well during this stressful experience.

References:   http://www.nia.nih.gov/alzheimers;  http://www.alz.co.uk;  http://www.pathwayshealth.org

Minorities See Hydration Differently

Food or Medicine

Culture and ethnicity shape patient’s and families’ view about artificial hydration (AH) at the end of life, with ethnic minorities seeing it as food more often than non-Hispanic European Americans, according to 2012 research.

“Identifying some of the beliefs and barriers regarding the decision-making process in this challenging area may provide preliminary evidence for culturally appropriate end-of-life communication strategies and care that incorporates individual assessments of the pros and cons of hydrating in each particular context,” suggest Isabel Torres-Vigil of the University of Houston, Texas, and co-investigators.

They conducted an interview-based study of 122 terminally ill cancer patients, asking, “Are these fluids more like food or more like medicine?”  The study authors sorted answers as food, medicine, both or other.

Results showed 38% saw AH like food, 34% as medicine, 14% as both, and 14% as other (including vitamins and saline).  Ethnic minorities perceived the AH as food 66% of the time vs. 41% for non-Hispanic European Americans.

The findings were significant enough that the research team suggest when patients with advanced cancer begin to decrease their oral intake of fluids, healthcare professionals should ask what perceptions they or their caregivers have about the role of AH to promote the most patient-oriented approach to end-of-life care.

Source: British Medical Journal: Supportive and Palliative Care, July 2012.

This article was originally published in Pathways Physician & Health Professional Bulletin - Issue 26.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.

Special Diet Improves Mild Alzheimer’s

"Medical Food"

Giving 125 ml of “medical food” once a day to people with mild Alzheimer’s disease appears to improve memory.  These were the findings of a trial done in the Netherlands and presented at the 2012 Alzheimer’s Association International Conference. 

This was the second large study showing that diet with specialized “medical food” can improve memory.  A medical food is specially formulated liquid diet supplement for people with a particular disease or condition and is given under the supervision of a doctor by prescription.

The improvements continued for 48 weeks.  At the end of 24 weeks those who had been assigned to take a placebo drink were switched to the active treatment.  They also experienced significant memory improvement.

The medical food used in this study, Souvenaid, was developed by researchers at the Massachusetts Institute of Technology in Boston.  Lead researcher, Dr. Philip Scheltens, said that the food “is medical nutrition, and we think it may offer a new approach—a dietary management approach, if you like — for people with very early Alzheimer’s disease.”  He added that it is very safe and well tolerated.  No serious adverse events were reported in the participants who complete the trial.

This article was originally published in Pathways & Partners Newsletter - Issue 27.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.

Care Management: When Family Caregivers Need Help

We have an amazing new service at Pathways—Care Management. This service provides a nurse or social worker to oversee the care of an older person when loved ones need help to manage the care or don’t live nearby.  It can also provide one-time assessment and care planning for families.   This is an all-encompassing, privately paid service.

Here are just some of the valuable services care managers provide:

• Scheduling and coordinating medical and dental appointments
• Transporting and accompanying clients to health care appointments
• Helping clients comply with medications and recommendations
• Arranging supportive services such as home care, bill paying, transportation, housekeeping, meal delivery or a handyman
• Overseeing caregivers and other providers
• Arranging for safety devices and medical equipment such as emergency response systems, grab bars, shower chairs and wheelchairs
• Providing crisis intervention and supportive counseling
• Long-term planning for appropriate housing options 

Pathways’ first care manager is social worker Stephne Lencioni, LCSW.  She is a long-time supporter of Pathways, often referring clients to us in her 25 years of care management with other organizations.  We are thrilled to have the experience and expertise of such a respected care manager launching this program for Pathways.

This article was originally published in Pathways Physician & Health Professional Bulletin - Issue 26.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.

Telemonitoring: Catching Heart Failure Problems Early

Fewer Hospitalizations

Telemonitoring puts technology to work improving the lives of Pathways’ heart failure patients.  By catching problems earlier, it reduces hospitalizations.

Home Health nurses don’t visit daily, so telemonitoring gives Pathways a way to assess the patient 7 days a week, from our office.
 
The easy-to-use unit can give us the patient’s:

• Weight
• Blood pressure
• Heart rate
• Oxygen saturation

When a patient touches any button on the small unit, a friendly voice talks them through each step of the health check.  Patients also receive the data, giving feedback.

The information is sent automatically to a nurse via telephone: there is no phone charge to the patient.

Nurses monitor the health information daily, call the patient if necessary, and make home visits when indicated.

Pathways Telemonitoring Program Criteria

• Patient has heart failure
• Patient or caregiver can understand and follow instructions, and are physically able to use the unit 
• Patient or caregiver are open to telemonitoring technology
• Patient does not have an infectious disease (i.e. TB,  MRSA, varicella zoster, herpes zoster)   

This article was originally published in Pathways Physician & Health Professional Bulletin - Issue 26.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.

Depression in Heart Patients

Two of every five patients who experience acute coronary syndrome (ACS) will have depression—a very important psychosocial predictor of poor cardiovascular prognosis.

“A growing body of evidence suggests that mental health problems complicate physical health conditions and that this relationship worsens clinical outcomes, increases hospitalization, and adversely affects quality of life,” Joseph A. Ladapo, MD, PhD, of New York University in New York City.

He and colleagues predicted that treatment of depression after ACS would be cost effective and improve patient outcomes.  They conducted a randomized, controlled study comparing enhanced depression care with usual care in patients with ACS and persistent depression 3 months after discharge.  Ladapo and colleagues defined enhanced depression care as problem-solving psychotherapy, antidepressant use or both.

Their conclusion at the close of the 6-month, prospective trial involving 157 patients was that treatment for depression reduced total per-patient healthcare costs by more than 40% and was cost effective for almost all patients.

An assessment of quality of life showed improved health utility in the intervention group.  Interviews 6 months after discharge showed that in the intervention group 51% were using antidepressants or anxiolytics and 75% had visited a mental health specialist at least once for a total cost of $1,083.  In the control group 30% were using antidepressants or anxiolytics and 35% had seen a mental health professional, for an average of $554.

The extra costs for the intervention group were more than offset by the significant reduction in hospitalization for ACS and heart failure (5% vs. 16%), with a mean cost savings of $1,782 for the intervention group and unmeasured improvement in quality of life.

Total healthcare costs averaged $1,857 in the intervention group and $2,797 for the usual-care arm, resulting in an adjusted difference of $1,229, which did not achieve statistical significance (P=0.09). Because the intervention was cost saving, the investigators could not calculate a cost-effectiveness ratio.

The research was reported in Arch Intern Med 2012; DOI: 10.1001/archinternmed.2012.4448, and was supported by the National Heart, Lung, and Blood Institute; the Health Resources and Services Administration; and the American Heart Association.

This article was originally published in Pathways Physician & Health Professional Bulletin - Issue 26.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.

Integrative Therapy Benefits

Improves Quality of Life

There are more than 600 million visits a year between patients and alternative medicine providers in the US—and the number is growing.

You can call it alternative, complementary or integrated therapy—it is a group of diverse practices and products not considered a part of traditional Western medicine.  But whether you are a skeptic or a proponent, there is no denying that the public is looking for it. 

For those patients who want this kind of treatment, it undeniably works to improve their quality of life.  After all, a hand massage with aromatherapy and soothing music would improve most peoples’ moods and lower their blood pressure and stress.  As simple as that, quality of life is improved.

More and more hospices are adding Integrated Therapies to their armamentarium for achieving comfort and improving quality of life.  As far back as 2004 60% of hospices reported offering complementary treatments (the most popular being music therapy and massage).  The main obstacles to providing these services are lack of adequate funds, knowledge and qualified personnel.  Other Integrated Therapies include animal visits, guided imagery and art therapy.

Pathways has a robust Integrative Therapies Program that provides numerous benefits. Patients report:

• A sense of control when so much control over their lives has been lost
• Improved pain management
• Enhanced emotional wellbeing and decreased anxiety
• Opportunities to experience pleasure
• Better quality sleep and decreased fatigue
• Enrichment in their lives
• Decreased nausea and enhanced appetite

Integrative Therapies often do not lend themselves to randomized, double-blind, controlled clinical trials due to the very subjective nature of the discipline.  However, risk-benefit analyses demonstrate very low risk—won’t hurt, might help.

The holistic nature of hospice is a setting made for Integrative Therapies.  They have repeatedly been shown to provide physical, emotional and spiritual benefits to patients and their families.

One Patient’s Story

Advanced pancreatic cancer was Mr. B’s grim diagnosis.  A resident of a SNF, he had prognosis of a few weeks when referred to Pathways by the distressed facility.  During the admission to hospice, the patient disclosed that he was a Christian Science practitioner and was not open to using any medications to manage his rather severe symptoms.

With this limitation, Pathways quickly initiated several Integrative Therapies and held a stat inservice for the SNF staff and his family.  Hospice volunteers, personal care aides, spiritual care counselors, social workers and nurses all contributed their Integrative Therapy skills.  Mr. B received massages, aromatherapy, guided imagery, Reiki, music therapy and comfort touch.  We also involved the family, asking them to find movies, CDs and other forms of distraction that Mr. B would respond to.

Although his pain was never completely gone, the patient reported it was significantly decreased and that he noticed an improved ability to cope with the pain that remained.  Until he died about three weeks after admission, Mr. B reported that Integrative Therapies had helped manage his symptoms to a level he deemed acceptable. 

This article was originally published in Pathways Physician & Health Professional Bulletin - Issue 26.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.

Addicted to Pain?

Some brains may be wired to become addicted to pain.  In fact, researchers have been able to accurately predict people who will continue to experience back pain more than a year after their initial injuries.

A study done at Northwestern University in Illinois looked at 39 people with recent onset of back pain.  Half still had pain a year later—their original pain had converted into insidious, chronic pain.  All participants had similar pain at the start of their injuries, but the chronic pain cohort had an unusually strong connection between two regions of the brain: the nucleus accumbens and the prefrontal cortex.

The two regions seemed to work in tandem, if one was active the other also “lit up.” A stronger connection correlated with a higher likelihood of developing chronic pain.

“We’re very excited about these results,” observed study coauthor A. Vania Apkarian of Northwestern. “We think they open up a whole new way of looking at chronic pain.” The research was presented in the July 1, 2012 Nature Neuroscience online journal.

Previous studies have examined brain differences in chronic pain sufferers, but researchers had not been able to discern whether these changes were caused by the chronic pain or an effect of living with it.  This study was the first to reveal a predictive signal present in the brain before the pain becomes chronic.

Interestingly, the study may link chronic pain development to the brain’s addiction conduit since both include the nucleus accumbens.  “This is certainly part of the addiction pathway,” Apkarian noted, observing that though the idea hasn’t been tested, chronic pain may stem from the brain essentially becoming addicted to pain and warrants further study.

This article was originally published in Pathways Physician & Health Professional Bulletin - Issue 26.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.

Macular Degeneration

Losing Sight

Age related macular degeneration usually affects older adults and results in a loss of vision in the center of the visual field.  It’s due to damage to the retina. Macular degeneration can make it difficult or impossible to read or recognize faces, although enough peripheral vision remains to allow other activities of daily life.

Causes

• Aging: About 10% of people 66 to 74 years of age will have some evidence of macular degeneration. It’s 30% in patients 75 to 85 years old.
• Family history: For someone who has a relative with it, the risk of developing late-stage macular degeneration is 50%.  It is only 12% for others.
• High blood pressure plays a role in MD.
• High cholesterol, obesity, and high fat intake are associated with an increased risk of MD.
• Smoking increases the risk of MD by two to three times that of someone who has never smoked, and may be the most important modifiable factor in its prevention.

 Management

• Reducing fat intake:  This means cutting down greatly on red meats and high-fat dairy products such as whole milk, cheese, and butter, and eating more cold-water fish (at least twice a week); eating any type of nuts may help.
• Nutritional supplements: Some evidence supports increasing intake of two carotenoids: lutein and zeaxanthin.  Eating foods high in omega-3 fatty acids has been correlated with a reduced progression of early macular degeneration.
• Adaptive devices: These help people read and include everything from magnifying glasses to computer software.
• Audio books: are also helpful.
• Reverse print: Written material with white text on a dark background is easier to read for people with macular degeneration.

This article was originally published in Pathways Residential Care Journal - Issue 5.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.

A Full Life

Setting Priorities

When things in your life seem almost too much to handle, when 24 hours in a day are not enough, remember this story about a jar and two glasses of wine.

A professor stood before his philosophy class with some items in front of him.  When the class began, he picked up a Costco-size jar and filled it with golf balls until he couldn’t cram another one in.  He then said, “I guess the jar is full, huh?” They agreed that it was.

The professor then picked up a box of pebbles and poured them into the jar.  He shook the jar lightly and the pebbles rolled into the open areas between the golf balls.  He said, “Now the jar is really full, right?” And everyone nodded in agreement. 

Next the professor poured a bag of sand into the jar. Of course, the sand filled up everything else.  He asked once more if the jar was full. The students responded with a unanimous, “Yes!”’

The instructor then produced two glasses of wine from under the table and poured them into the jar, effectively filling the empty spaces in the sand. The students laughed.

“Now,” said the professor as the laughter subsided, “I want you to recognize that this jar represents your life. The golf balls are the important things—your family, your children, your health, your friends and your favorite passions—and if everything else was lost and only they remained, your life would still be full.

“The pebbles are the other things that matter like your job, your house and your car. The sand is everything else—the small stuff.

“If you put the sand into the jar first,” he continued, “there is no room for the pebbles or the golf balls. The same goes for life. If you spend all your time and energy on the small stuff you will never have room for the things that are important to you.”

He concluded, “People should pay attention to the things that are critical to their happiness: spend time with your children, and parents and grandparents.  Take time to get medical checkups.  Take your spouse out to dinner. Play games.

“There will always be time to clean the house and fix the disposal.  Take care of the golf balls first—the things that really matter. The rest is just sand.”

One of the students raised her hand and inquired what the wine represented. The professor smiled and said, “I’m glad you asked.  The wine just shows you that no matter how full your life may seem, there’s always room for a glass of wine with a friend.”

This article was originally published in Pathways Residential Care Journal - Issue 5.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.

Shingles Overview

What is Shingles?

After a person has had chicken pox the virus that causes it stays sleeping for decades in nerves near the spine.  The virus is herpes zoster.  About 20% of people who have had chicken pox will later have a shingles outbreak.  Shingles usually affects older people and people with weak immune systems.

Cold sores on the lips and genital herpes are caused by different herpes viruses, herpes simplex viruses.

Symptoms

If the virus wakes up, it travels along nerve fibers to the skin, usually appearing in one area, on one side of the body, and along the line of a nerve.  But shingles can be anywhere on the body.  The rash is painful and has fluid-filled blisters.  The first symptoms start 1 to 5 days before the rash and include:

• Itching
• Tingling
• Burning sensation
• Pain, sometimes worse at night

Less common symptoms are fever, chills, headache and stomach ache.  Shingles near the eye or ear can cause vision or hearing loss and are usually treated aggressively.

The blisters usually scab over in 7 to 10 days and disappear completely in 2 to 4 weeks.  In most people the rash leaves no scars and the pain and itching go away after a few weeks or months.

In some people the pain from shingles stays for months or even years after the rash is gone.  The pain is from damage to the nerves in the skin.  This is called post-herpetic neuralgia. 

Treatment

There is no cure for shingles.  But there are antiviral medications that can make the episode shorter and milder if given early.  They also reduce the risk of pain after the rash is gone.  The antiviral drug should be started at the first sign of symptoms to be most effective.

Over-the-counter pain and itch medicines, such as calamine lotion, work fairly well for many people.  If the pain is severe or the rash is near the eye or ear, the doctor may prescribe steroids to reduce the inflammation.  Using a compress dampened with cool water may help with itching.  Scratching should be avoided to prevent damage to the skin and to prevent breaking the blisters.

Vaccine

A shingles vaccine is available.  It prevents about half of shingles cases and reduces the frequency of post-shingles pain.  The Centers for Disease Control recommend that all adults 60 years and older be vaccinated.  The vaccine does not work well in people over 80 and is generally not recommended for this age group.

Is It Contagious?

Yes, but you can’t get shingles from another person; only chicken pox.  If you have never had chicken pox, or the vaccine for it, and you are then exposed to the fluid in the shingles blisters, you can get chicken pox.

Caregivers can carry the virus from one person to another and if the second person has not had chicken pox, they may get it.  Shingles can only be transmitted when the blisters have burst and are oozing, before they crust over. 

What can you do to prevent spread?

• Prevent blisters from breaking open.
• Keep the rash covered to prevent the blister fluid from contaminating others. 
• Assist the resident with shingles to wash hands often. 
• Only caregivers who have already had chicken pox should be assigned to residents with shingles. 
• No one who is pregnant should be assigned to a resident with shingles.
• Keep surfaces clean and disinfected.
• If the resident has shingles on the buttocks, he or she should not use common toilets.
• All caregivers and housekeepers should wear gloves in the resident’s room until he is no longer contagious.  Hands should be washed after removing gloves.
• Determine if roommates or others the resident socializes with are at risk.
• Use common sense precautions.
• Washing Linens

People handling sheets and towels of a person with shingles should wear gloves.  Sheets and towels should not be shaken or set down on a surface, even the floor.  They should immediately be put into a linen bag.  No special procedures are needed for washing linens.

Staff with Shingles

Staff members who have shingles should not care for vulnerable residents, including people with cancer, residents with compromised immune systems or those who have not had chicken pox. 

This article was originally published in Pathways & Partners Newsletter - Issue 27.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.

Hand Sanitizers vs Norovirus

People in densely populated living situations, like cruise ships and skilled nursing facilities, are reaching for the alcohol-based hand sanitizing gel in hopes of avoiding the norovirus.  But does it prevent infection from the gastrointestinal bug?  It looks like the answer is “No.”

Many studies have shown that alcohol-based sanitizers reduce germ counts on hands and can reduce the spread of some strains of flu.  But the nasty norovirus that causes vomiting and diarrhea is resistant.

Some viruses, including the flu virus, have a coating that the alcohol in the sanitizer can burst open, killing the virus.  But the norovirus doesn’t have a capsule that alcohol can penetrate.  So it lives on even when you believe your hands are disinfected.  Noroviruses are so infectious that as little as 10 missed microscopic particles can cause infection.

Bleach kills the norovirus, and a solution of 10% bleach is great for wiping down counters and surfaces that may have been contaminated.  But since we really can’t wash our hands in bleach, experts say we should wash hands frequently with plain old soap and water.

In 2011 the Centers for Disease Control and Prevention studied records from the winter of 2006-07 in 91 long-term care facilities; they found 23 outbreaks of the norovirus.  Facilities where staff regularly cleaned their hands with alcohol-based sanitizers had six times as many norovirus outbreaks than facilities where the staff used soap and water. 

The CDC says that to prevent the spread of the norovirus, alcohol sanitizers should only be used “in addition” to hand washing, but not as a substitute.

This article was originally published in Pathways & Partners Newsletter - Issue 27.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.

How Not to Catch a Cold

Meditation Works

If there were a way to avoid getting colds and the flu, would you do it?  There is some compelling evidence that there may be just such an antidote!  Meditation and exercise both appear to reduce the frequency of acute respiratory infections—colds and flu.

Researchers at the University of Wisconsin assigned 149 participants, mostly women and all over 50 years old, to one of three groups.  One group took an 8-week training program in mindfulness meditation, the second an 8-week training in moderate intensity sustained exercise and the third served as an observational control group.  They studied the participants for the duration of one cold and flu season.  These results were pretty remarkable.

Acute Respiratory Infections by Group
Meditation - 27   
Exercise - 26   
Control - 40   

Total Days of Illness by Group   
Meditation - 257   
Exercise - 241   
Control - 453   

Days of Work Missed by Group
Meditation - 16
Exercise - 32
Control - 67

The research was funded by the National Institutes of Health and reported in the Annals of Family Medicine in July, 2012.

In addition to washing your hands and getting your flu shot, this cold and flu season you may also want to engage in some mindful meditation techniques or sustained exercise!

This article was originally published in Pathways Residential Care Journal - Issue 5.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.