Whether home care work ever amounted just to a spot of dusting, and making a cup of tea for the elderly householder, is a moot point. But there is no doubt that the job has changed out of all recognition in recent years. And the strain is starting to tell.
According to a new survey by Unison, the public services union, 73% of today's home care workers frequently help their clients with medication, 56% at least occasionally do dressings and as many as 83% have assisted with catheters. In 1995, in a previous survey, 43% said most or nearly all of their work was still domestic, as opposed to personal care. Today, that figure is only 5%.
Just over half today's workers say they suffer back pain, commonly as a result of lifting clients, and eight in 10 think the role has become both more demanding and more stressful. Yet pay rates are typically less than £5.50 an hour, even in the local authority sector, and can be little more than the £3.70 statutory minimum. As Malcolm Wing, Unison's head of local government, says: "Pay levels have fallen behind those in local catering, cleaning and retail jobs and equivalent jobs elsewhere in the public sector. So it is hardly surprising that staff are voting with their feet and going to work in less demanding jobs for better pay."
This is not mere union propaganda. Bill McClimont, who chairs the UK Home Care Association, representing independent sector employers, says the recruitment picture is "patchy, but pretty dire as a whole". Where the home care workers of the future are going to come from is an increasingly alarming question.
An estimated 200,000 people are employed in home or domiciliary care in England alone - roughly the same as the car industry. About two-thirds are in the independent sector, with either for-profit providers or voluntary groups, which now delivers more than half all state-funded care. As recently as 1993, it was responsible for just 2%.
Although demand for home care is growing, with an ageing population and policy imperatives to help people stay out of long-term care, services are increasingly focused on the more dependent. As a result, the amount of state-funded care in England rose 3% in 1999 while the number of households receiving it fell 5%. This has been the general trend for the past decade and figures for last year, due later this month, are unlikely to buck it.
Philip Mickleborough, of care market analysts Laing & Buisson, confirms the dramatic change in the nature of the home carer's function. "I would agree it has become more demanding - and much more responsible," he says. "If you're Hoovering for somebody and you do it badly, then they have a dirty carpet. If you're helping them with their medication and that goes wrong, then the consequences can obviously be more severe.
"The important thing to bear in mind is that people who do this are working without supervision. They are on their own and there is no one there to consult or get guidance from."
While Mickleborough agrees that the job as it is today may well not appeal to those who did it when its essential nature was domestic - "home help" - he points out that others may be attracted for that very reason. "Helping someone to get dressed, perhaps lifting them into bed or taking them to the lavatory, is all very different," he says. "But there are many people who enjoy taking care of others, who get satisfaction from helping people in this way."
The Unison survey, conducted by NOP among more than 3,000 union members who completed questionnaires, lends some support to this. Notwithstanding the overwhelming concern about the job's growing stress, 35% said they were happy and satisfied at work and just 23% expressed a contrary view, the remainder not giving an opinion.
One respondent said: "Although I am off work at the moment with back pain, work-related, I enjoy my job and I do get a lot of satisfaction in knowing that I am helping to keep people in their own environment." Another commented: "Despite the negative comments, I love my job and hope to see things improve soon."
Almost all the respondents were employed by a local authority or had recently been transferred to a contractor. More than 97% were women and one in three was over 55, indicating a looming issue of replacing retirees. Ninety-six per cent said they normally looked after elderly people, but 75% said their clients also included those with dementia or mental health problems, 46% younger people with disabilities and 20% people with learning disabilities.
Only one in 10 of those surveyed said they never worked unsocial hours. One said: "I personally work from 7.30 to 10.30 every weekday night and alternate weekends. But I am not paid for unsocial hours. I get the same basic rate as daytime staff, which I feel is unfair." Another reported: "Split shifts sometimes means working from 7am to 11pm in one day, with a couple of hours off in between - not conducive to family life." A third said: "I am on the run all day, checking my watch for my next job. We are very short of good staff."
Whereas domestic tasks were largely done during the day, personal care tends to focus on helping people get up and helping them prepare for bed. Again, this shift has prompted a change in the type of person attracted to the job, militating against those with child care responsibilities.
As one respondent put it: "We carers, I feel, are taking on the job of district nurses almost." And the survey report, Homecare - the Forgotten Service, expresses concern at the kind of tasks - medication, dressings, catheter and even colostomy assistance - being expected of the workers without apparent specialist training. It asks: "Who should be doing this work, who should be paying for it and what would happen to clients if they stopped?"
Mickleborough points out that the immediate shortage of home care workers is likely to ease when the economy slows, with the disappearance of competing job vacancies in the retail and service sectors. He also believes that the development of "assisted living" or "very sheltered" housing schemes will help cluster demand, saving some carers the journeys between clients, and that technological advance will do away with the need for visits simply to check on the client.
Yet both Mickleborough and McClimont agree with Unison that home care is fundamentally underfunded. Unless and until local authorities are able to offer more for the service, facilitating the payment of better terms and conditions, they say it is always going to struggle to recruit and retain staff of the right calibre.
Home care contractors have faced a decade or more of prices being driven down, says McClimont. "What we need to see is local authorities setting a floor at least on pay and conditions, so that the competition takes place on the management of the service and the value that the provider is adding, rather than always bearing down on the workers' remuneration."
Homecare - the Forgotten Service is available free from Local Government, Unison, 1 Mabledon Place, London WC1H 9AJ.
As a home care worker myself, I would agree with the above comments. With little training, I have dealt with catheters, hoists,convenes. The agencies are making good money. I have seen individual invoices.
Friday, 14 August 2009
Thursday, 30 July 2009
Swine Flu, pregnancy and young children
The Department of Health are clarifying their guidelines on how pregnant mothers and parents with children under five can deal with the outbreak of Swine Flu. This is because expectant mothers and young children have proven to be particularly vulnerable to the disease. So far the government advice is:
For pregnant mums:
The Royal College of Midwives have issued a statement that expectant mothers should 'avoid crowded places and unnecessary travel'. Obviously for some pregnant mums this will be unavoidable, but if you can't avoid crowded places you should always follow good hygiene rules such as washing your hands and using an antiseptic gel after using public transport. Using tissues to cover the mouth and nose when coughing and sneezing and disposing of tissues promptly has also been suggested.
The reason pregnant women are at risk, is because when you are pregnant your immune system is lowered slightly so that your body doesn't reject your growing baby. For this reason pregnant women are more susceptible to any type of flu and therefore swine flu. At present the Government are under pressure to reveal whether pregnant women will be vaccinated against swine flu when the flu vaccine batch is expected in the autumn. This is because pregnant women are normally advised NOT to have vaccinations.
In short, if you are pregnant and can avoid being in crowded places and public transport - do so. If you are pregnant and have the any of the Swine Flu symptoms:
- sudden fever (a high body temperature of over 38C or 100.4F), and
- sudden cough
Other symptoms include:
- headache
- tiredness
- chills
- aching muscles
- limb or joint pain
- diarrhoea or stomach upset
- sore throat
- runny nose
- sneezing, and
- loss of appetite
Can pregnant women take antivirals?
Anti virals are safe for pregnant women to take but you should always talk to your GP first before taking them. The Department of health has purchased Relenza, an inhaled antiviral drug that can treat swine flu without reaching your developing baby. Relenza should not affect your pregnancy or growing baby. Don't forget that talking Paracetamol when pregnant is safe and can also be used to counter the effects of any type of flu symptoms.
Most people who have contracted Swine Flu recover within a week and do not suffer complications, even without being given antiviral medicine. If you are pregnant and worried about Swine Flu or have any of the symptoms listed above, call NHS direct on 0845 4647
For young children:
Call your GP immediately if your child has any of the following symptoms AND a temperature of 38C and above or feels hot.
- tiredness
- headache
- runny nose and sneezing
- sore throat
- shortness of breath
- loss of appetite
- vomiting and diarrhoea
aching muscles, limb and joint pain
If you are worried about your child or your child has any of the symptoms above, call your GP for more advice. You can also get more information by calling the Swine Flu Information Line on 0800 1 513 513.
If your child has Swine Flu:
If your GP confirms your child has Swine Flu (normally by a telephone assesment where you will be asked to describe your child's symptoms), they should stay at home and you should treat their symptoms like any other cold or flu. So, plenty of liquids, plenty of rest and medicine to bring their fever down. Your GP will advise you on whether your child needs an antiviral drug such as Tamiflu. However, antiviral drugs are only effective if taken within 48 hours of symptoms appearing so if you are worried about your child, call your GP immediately.
Are antivirals safe for children to take?
Antivirals are safe for infants aged one and over at a reduced dose, but again it is always best to talk to your GP first to explain your child's symptoms and to tell your GP the age of your child. Relenza (an inhaler) can be used by children aged five and over under the supervision of an adult. Tamiflu and Relenza are not licensed for use in babies under the age of one, although under medical supervision (i.e probably in a hospital) they may be used.
How do I get antiviral drugs for my child?
Your GP will give you an authorization code which one of your flu friends ( a friend or relative who does not have any symptoms or swine flu) takes to the antiviral collection point in your area - your GP can tell you where these are.
What is Swine Flu?
Swine flu is a respiratory disease which has some elements of a virus often found in pigs. At present time, swine flu has been confirmed in a number of countries (mostly Mexico and the US) and is spreading from human to human. This quick spreading of a virus is referred to as a pandemic flu outbreak. Because it is a virus, no one has immunity to it, which means it can affect the old, the young, healthy adults and those who are sick already.
How does swine flu spread?
Like normal flu that we are used to, swine flu spreads when you cough or sneeze without covering your mouth or nose, releasing tiny droplets into the air. They are then inhaled by other people or can be spread on everyday items such as computer keyboards, door handles and surfaces that the droplets may have settles on.
Is there protection against swine flu?
The government have been stockpiling antiviral drugs (including Tamiflu and Relenza) so there is enough to treat 33 million people (roughly half of the population). They are planning to increase this. At present there is no vaccination against swine flu, as it can only be developed when a specific strain has been identified. After this it will take a few months to produce a suitable vaccine.
Here are answers to questions that I asked the Department of Health earlier today:
Are antivirals safe to use on children?
All medicines that are licensed have to go through checks on their safety, quality and efficacy before they are licensed. Licensed doses of Tamiflu are available for all children over one in lower dose capsules. The size of the capsules depends on the age of the child. As licensed medicines there is good evidence about their safety and efficacy.
Relenza is only licensed for treatment of influenza of children over five years old except in very limited circumstances.
Will we be issuing antivirals prophylactically to children?
No, our aim is just to provide treatment for flu cases. We are not considering prophylaxis in adults or children.
Are antivirals safe for babies?
Tamiflu is not licensed for under one's. However, we have evidence from clinical trials in Japan that it is safe for children under one to take in small doses. We have plans to manufacture Tamiflu solution in designated hospital pharmacies from stocks which we have stockpiled. This process is now underway. The royal college of Paediatrics and Child Health has developed a consensus statement which supports the use of oseltamivir in babies under one.
Is one of the antivirals more appropriate for pregnant women and people with certain kidney conditions?
Relenza is an inhaled drug that will be used for pregnant women and people with certain kidney conditions who are unable to take Tamiflu.
Is it safe to eat pig meat?
Yes. The WHO says there is no evidence that swine flu can be transmitted through eating meat from infected animals. However, it is essential to cook meat properly. A temperature of 70°C (158°F) would be sure to kill the virus. Pig meat includes pork, bacon, ham and pork products.
So, what can you do to protect yourself and your family from swine flu?
Always carry tissues on you to use if you sneeze or cough (or if your kids sneeze or cough)
Always try to cover your mouth and nose when you sneeze or cough
Throw the tissue away after you have used it on yourself or your kids
Wash your hands often with soap and hot water and encourage your children to do the same
Do I need a facemask?
Apparently, there is no scientific evidence to say basic face masks can protect you from swine flu - it's better to follow the steps above in order to help prevent the spread of disease.
What are the symptoms of swine flu?
Symptoms of swine flu include:
a sudden onset of fever
a cough
shortness of breath
headache and sore throat
tiredness
aching muscles
chills
sneezing
runny nose
loss of appetite
If you are worried about swine flu or need information about it, call the government's Swine Flu Information Line on: 0800 1 513 513
If you are suffering from any of the symptoms above, the advice is NOT to go to your GP surgery or A&E department, but phone your surgery and describe your symptoms or phone NHS Direct: 0845 46 47
If you have recently returned from Mexico or the US and are experiencing any of the symptoms mentioned above, call the Swine Flu Information Line on: 0800 1 513 513
The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.
Thanks to NHS direct
www.medisave.co.uk
For pregnant mums:
The Royal College of Midwives have issued a statement that expectant mothers should 'avoid crowded places and unnecessary travel'. Obviously for some pregnant mums this will be unavoidable, but if you can't avoid crowded places you should always follow good hygiene rules such as washing your hands and using an antiseptic gel after using public transport. Using tissues to cover the mouth and nose when coughing and sneezing and disposing of tissues promptly has also been suggested.
The reason pregnant women are at risk, is because when you are pregnant your immune system is lowered slightly so that your body doesn't reject your growing baby. For this reason pregnant women are more susceptible to any type of flu and therefore swine flu. At present the Government are under pressure to reveal whether pregnant women will be vaccinated against swine flu when the flu vaccine batch is expected in the autumn. This is because pregnant women are normally advised NOT to have vaccinations.
In short, if you are pregnant and can avoid being in crowded places and public transport - do so. If you are pregnant and have the any of the Swine Flu symptoms:
- sudden fever (a high body temperature of over 38C or 100.4F), and
- sudden cough
Other symptoms include:
- headache
- tiredness
- chills
- aching muscles
- limb or joint pain
- diarrhoea or stomach upset
- sore throat
- runny nose
- sneezing, and
- loss of appetite
Can pregnant women take antivirals?
Anti virals are safe for pregnant women to take but you should always talk to your GP first before taking them. The Department of health has purchased Relenza, an inhaled antiviral drug that can treat swine flu without reaching your developing baby. Relenza should not affect your pregnancy or growing baby. Don't forget that talking Paracetamol when pregnant is safe and can also be used to counter the effects of any type of flu symptoms.
Most people who have contracted Swine Flu recover within a week and do not suffer complications, even without being given antiviral medicine. If you are pregnant and worried about Swine Flu or have any of the symptoms listed above, call NHS direct on 0845 4647
For young children:
Call your GP immediately if your child has any of the following symptoms AND a temperature of 38C and above or feels hot.
- tiredness
- headache
- runny nose and sneezing
- sore throat
- shortness of breath
- loss of appetite
- vomiting and diarrhoea
aching muscles, limb and joint pain
If you are worried about your child or your child has any of the symptoms above, call your GP for more advice. You can also get more information by calling the Swine Flu Information Line on 0800 1 513 513.
If your child has Swine Flu:
If your GP confirms your child has Swine Flu (normally by a telephone assesment where you will be asked to describe your child's symptoms), they should stay at home and you should treat their symptoms like any other cold or flu. So, plenty of liquids, plenty of rest and medicine to bring their fever down. Your GP will advise you on whether your child needs an antiviral drug such as Tamiflu. However, antiviral drugs are only effective if taken within 48 hours of symptoms appearing so if you are worried about your child, call your GP immediately.
Are antivirals safe for children to take?
Antivirals are safe for infants aged one and over at a reduced dose, but again it is always best to talk to your GP first to explain your child's symptoms and to tell your GP the age of your child. Relenza (an inhaler) can be used by children aged five and over under the supervision of an adult. Tamiflu and Relenza are not licensed for use in babies under the age of one, although under medical supervision (i.e probably in a hospital) they may be used.
How do I get antiviral drugs for my child?
Your GP will give you an authorization code which one of your flu friends ( a friend or relative who does not have any symptoms or swine flu) takes to the antiviral collection point in your area - your GP can tell you where these are.
What is Swine Flu?
Swine flu is a respiratory disease which has some elements of a virus often found in pigs. At present time, swine flu has been confirmed in a number of countries (mostly Mexico and the US) and is spreading from human to human. This quick spreading of a virus is referred to as a pandemic flu outbreak. Because it is a virus, no one has immunity to it, which means it can affect the old, the young, healthy adults and those who are sick already.
How does swine flu spread?
Like normal flu that we are used to, swine flu spreads when you cough or sneeze without covering your mouth or nose, releasing tiny droplets into the air. They are then inhaled by other people or can be spread on everyday items such as computer keyboards, door handles and surfaces that the droplets may have settles on.
Is there protection against swine flu?
The government have been stockpiling antiviral drugs (including Tamiflu and Relenza) so there is enough to treat 33 million people (roughly half of the population). They are planning to increase this. At present there is no vaccination against swine flu, as it can only be developed when a specific strain has been identified. After this it will take a few months to produce a suitable vaccine.
Here are answers to questions that I asked the Department of Health earlier today:
Are antivirals safe to use on children?
All medicines that are licensed have to go through checks on their safety, quality and efficacy before they are licensed. Licensed doses of Tamiflu are available for all children over one in lower dose capsules. The size of the capsules depends on the age of the child. As licensed medicines there is good evidence about their safety and efficacy.
Relenza is only licensed for treatment of influenza of children over five years old except in very limited circumstances.
Will we be issuing antivirals prophylactically to children?
No, our aim is just to provide treatment for flu cases. We are not considering prophylaxis in adults or children.
Are antivirals safe for babies?
Tamiflu is not licensed for under one's. However, we have evidence from clinical trials in Japan that it is safe for children under one to take in small doses. We have plans to manufacture Tamiflu solution in designated hospital pharmacies from stocks which we have stockpiled. This process is now underway. The royal college of Paediatrics and Child Health has developed a consensus statement which supports the use of oseltamivir in babies under one.
Is one of the antivirals more appropriate for pregnant women and people with certain kidney conditions?
Relenza is an inhaled drug that will be used for pregnant women and people with certain kidney conditions who are unable to take Tamiflu.
Is it safe to eat pig meat?
Yes. The WHO says there is no evidence that swine flu can be transmitted through eating meat from infected animals. However, it is essential to cook meat properly. A temperature of 70°C (158°F) would be sure to kill the virus. Pig meat includes pork, bacon, ham and pork products.
So, what can you do to protect yourself and your family from swine flu?
Always carry tissues on you to use if you sneeze or cough (or if your kids sneeze or cough)
Always try to cover your mouth and nose when you sneeze or cough
Throw the tissue away after you have used it on yourself or your kids
Wash your hands often with soap and hot water and encourage your children to do the same
Do I need a facemask?
Apparently, there is no scientific evidence to say basic face masks can protect you from swine flu - it's better to follow the steps above in order to help prevent the spread of disease.
What are the symptoms of swine flu?
Symptoms of swine flu include:
a sudden onset of fever
a cough
shortness of breath
headache and sore throat
tiredness
aching muscles
chills
sneezing
runny nose
loss of appetite
If you are worried about swine flu or need information about it, call the government's Swine Flu Information Line on: 0800 1 513 513
If you are suffering from any of the symptoms above, the advice is NOT to go to your GP surgery or A&E department, but phone your surgery and describe your symptoms or phone NHS Direct: 0845 46 47
If you have recently returned from Mexico or the US and are experiencing any of the symptoms mentioned above, call the Swine Flu Information Line on: 0800 1 513 513
The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.
Thanks to NHS direct
www.medisave.co.uk
The number of new cases of swine flu in England
The number of new cases of swine flu in England appears to be levelling off, with an estimated 110,000 new cases reported last week. This compares to an estimated 100,000 cases the week before.
Sir Liam Donaldson, the Chief Medical Officer, noted that the change coincided with the break up of schools for the summer and the introduction of the National Pandemic Flu Service last week.
H1N1 Flu (Swine Flu)
CDC Advisors Make Recommendations for Use of Vaccine Against Novel H1N1 (07/29/2009, Centers for Disease Control and Prevention)
Prioritize Pregnant Women to Get Swine Flu Shot, Experts Say (07/29/2009, HealthDay)
Save Swine Flu Drugs for Younger Patients (07/28/2009, HealthDay)
Drugs Work Best When Swine Flu Found Early (07/27/2009, Reuters Health)
FDA Authorizes Emergency Use of Another Test for 2009 H1N1 Influenza Virus (07/24/2009, Food and Drug Administration)
First Defense Against Swine Flu - Seasonal Vaccine (07/24/2009, Reuters Health)
Swine Flu Could Eventually Affect 40% of Americans (07/24/2009, HealthDay)
Swine Flu Spreads; Health Officials Plan Vaccines (07/24/2009, Reuters Health)
U.S. Expects 160 Million Doses Of Swine Flu Vaccine By October (07/23/2009, HealthDay)
Guard Against Swine Flu at Summer Camp (07/18/2009, HealthDay)
CDC Fears More Swine Flu Cases in Fall (07/17/2009, Reuters Health)
Swine Flu Vaccine on Track for Fall (07/17/2009, HealthDay)
H1N1 Pandemic Spreading Too Fast to Count (07/16/2009, Reuters Health)
Swine Flu Vaccine Taking Longer Than Expected (07/13/2009, HealthDay)
Obesity Emerges as Risk Factor in Severe Flu (07/11/2009, Reuters Health)
Swine Flu Summit Focuses on Preparedness (07/09/2009, HealthDay)
Experts Keep Wary Eye on Tamiflu-Resistant Swine Flu (07/08/2009, HealthDay)
U.S. Health Department Response to H1N1 Mixed (07/07/2009, Reuters Health)
U.S. Parents Think Twice About Sending Kids to Camp (07/03/2009, Reuters Health)
New Flu May Not Spread Like Regular Flu (07/02/2009, Reuters Health)
WHO Chief Identifies "Warning Signs" of Severe Flu (07/02/2009, Reuters Health)
WHO Says Tamiflu-Resistant H1N1 "Isolated Case" (06/30/2009, Reuters Health)
Air Traffic Patterns Predict Swine Flu Spread (06/29/2009, HealthDay)
Younger People Appear More at Risk from New Swine Flu (06/29/2009, HealthDay)
New H1N1 Flu Not Going Away (06/26/2009, Reuters Health)
1 Million Americans Likely Stricken by Swine Flu (06/25/2009, HealthDay)
CDC Sees "Something Different" with New Flu (06/19/2009, Reuters Health)
Swine Flu Continues to Flare Up, CDC Says (06/19/2009, HealthDay)
New Swine Flu Strain Found in Brazil (06/17/2009, HealthDay)
First Batch of Swine Flu Vaccine Already Here (06/12/2009, HealthDay)
Swine Flu Now a Pandemic (06/11/2009, HealthDay)
WHO Declaration Of Swine Flu Pandemic Looks Imminent (06/10/2009, HealthDay)
Global Testing Shows No Variation in Swine Flu Virus (06/04/2009, HealthDay)
WHO Close to Declaring Swine Flu Pandemic (06/03/2009, HealthDay)
WHO Official Says World Edging Towards Pandemic (06/02/2009, Reuters Health)
Swine Flu Now Reported in All 50 States (06/01/2009, HealthDay)
FDA, FTC Warn Public of Fraudulent 2009 H1N1 Influenza Products (05/30/2009, Food and Drug Administration)
Swine Flu Vaccine Won't Be Ready Until October: CDC (05/29/2009, HealthDay)
Swine Flu Vaccine Won't Be Ready Until October (05/28/2009, HealthDay)
U.S. Considering Emergency Use of Booster in H1N1 Vaccine (05/28/2009, Reuters Health)
Possible Return of Swine Flu in Fall Has U.S. Health Officials on Alert (05/27/2009, HealthDay)
U.S. Prepares for Possible Return of Swine Flu in Fall (05/26/2009, HealthDay)
Viable Swine Flu Shot Closer to Reality (05/25/2009, HealthDay)
WHO Chief Says World Should Prepare for Severe Flu (05/24/2009, Reuters Health)
Regular Flu Vaccine Little Help against New Strain (05/21/2009, Reuters Health)
Swine Flu Outbreak May Be Subsiding, CDC Says (05/21/2009, HealthDay)
Older Adults May Have Some Immunity to Swine Flu (05/20/2009, HealthDay)
U.S. Officials Consider Bumping Up Flu Shot Season (05/20/2009, Reuters Health)
Could H1N1 Start to Resist Drugs? (05/19/2009, Reuters Health)
Sicker People More Vulnerable to Swine Flu (05/19/2009, HealthDay)
Adequate Supply of Swine Flu Vaccine Uncertain (05/18/2009, HealthDay)
New Methods Could Speed Production of Flu Vaccines (05/18/2009, HealthDay)
Swine Flu Fatality Rate a 'Little Bit' Higher Than That of Seasonal Flu (05/18/2009, HealthDay)
Swine Flu May Have Infected More Than 100,000 Americans (05/17/2009, HealthDay)
Focus On Children Best Way to Stop Flu Bugs (05/14/2009, Reuters Health)
Fewer Than a Third in U.S. Would Get Swine Flu Jab (05/13/2009, Reuters Health)
Pregnant Women Should Take Flu Drugs Promptly (05/13/2009, HealthDay)
Study Supports Swine Flu's Pandemic Potential (05/12/2009, HealthDay)
Swine Flu May Pose Problems for Pregnant Women (05/12/2009, HealthDay)
CDC Shifts Swine Flu Focus to Likely Impact in the Fall (05/11/2009, HealthDay)
Third U.S. Swine Flu Death Reported (05/10/2009, HealthDay)
Scientists Still Baffled About Origins of Swine Flu (05/08/2009, HealthDay)
Flu Spreads in U.S., World, Winds Down in Mexico (05/07/2009, Reuters Health)
U.S. Swine Flu Count Nears 1,900; Person-to-Person Transmission Now Common (05/07/2009, HealthDay)
FDA Approves New Influenza Vaccine Production Facility (05/06/2009, Food and Drug Administration)
Swine Flu Likely to Return to U.S. Next Winter (05/06/2009, HealthDay)
Younger Age of More Severe Swine Flu Cases Worries Experts (05/06/2009, HealthDay)
Swine Flu Kills Second Person in U.S. (05/05/2009, Reuters Health)
1976 Swine Flu Outbreak Offers Echoes, Lessons Today (05/04/2009, HealthDay)
Swine Flu Cases Still Up, but U.S. Officials Are Guardedly Optimistic (05/04/2009, HealthDay)
Swine Flu Outbreak Not a Pandemic at This Point (05/03/2009, HealthDay)
Swine Flu: A Primer (05/03/2009, HealthDay www.medisave.co.uk
Sir Liam Donaldson, the Chief Medical Officer, noted that the change coincided with the break up of schools for the summer and the introduction of the National Pandemic Flu Service last week.
H1N1 Flu (Swine Flu)
CDC Advisors Make Recommendations for Use of Vaccine Against Novel H1N1 (07/29/2009, Centers for Disease Control and Prevention)
Prioritize Pregnant Women to Get Swine Flu Shot, Experts Say (07/29/2009, HealthDay)
Save Swine Flu Drugs for Younger Patients (07/28/2009, HealthDay)
Drugs Work Best When Swine Flu Found Early (07/27/2009, Reuters Health)
FDA Authorizes Emergency Use of Another Test for 2009 H1N1 Influenza Virus (07/24/2009, Food and Drug Administration)
First Defense Against Swine Flu - Seasonal Vaccine (07/24/2009, Reuters Health)
Swine Flu Could Eventually Affect 40% of Americans (07/24/2009, HealthDay)
Swine Flu Spreads; Health Officials Plan Vaccines (07/24/2009, Reuters Health)
U.S. Expects 160 Million Doses Of Swine Flu Vaccine By October (07/23/2009, HealthDay)
Guard Against Swine Flu at Summer Camp (07/18/2009, HealthDay)
CDC Fears More Swine Flu Cases in Fall (07/17/2009, Reuters Health)
Swine Flu Vaccine on Track for Fall (07/17/2009, HealthDay)
H1N1 Pandemic Spreading Too Fast to Count (07/16/2009, Reuters Health)
Swine Flu Vaccine Taking Longer Than Expected (07/13/2009, HealthDay)
Obesity Emerges as Risk Factor in Severe Flu (07/11/2009, Reuters Health)
Swine Flu Summit Focuses on Preparedness (07/09/2009, HealthDay)
Experts Keep Wary Eye on Tamiflu-Resistant Swine Flu (07/08/2009, HealthDay)
U.S. Health Department Response to H1N1 Mixed (07/07/2009, Reuters Health)
U.S. Parents Think Twice About Sending Kids to Camp (07/03/2009, Reuters Health)
New Flu May Not Spread Like Regular Flu (07/02/2009, Reuters Health)
WHO Chief Identifies "Warning Signs" of Severe Flu (07/02/2009, Reuters Health)
WHO Says Tamiflu-Resistant H1N1 "Isolated Case" (06/30/2009, Reuters Health)
Air Traffic Patterns Predict Swine Flu Spread (06/29/2009, HealthDay)
Younger People Appear More at Risk from New Swine Flu (06/29/2009, HealthDay)
New H1N1 Flu Not Going Away (06/26/2009, Reuters Health)
1 Million Americans Likely Stricken by Swine Flu (06/25/2009, HealthDay)
CDC Sees "Something Different" with New Flu (06/19/2009, Reuters Health)
Swine Flu Continues to Flare Up, CDC Says (06/19/2009, HealthDay)
New Swine Flu Strain Found in Brazil (06/17/2009, HealthDay)
First Batch of Swine Flu Vaccine Already Here (06/12/2009, HealthDay)
Swine Flu Now a Pandemic (06/11/2009, HealthDay)
WHO Declaration Of Swine Flu Pandemic Looks Imminent (06/10/2009, HealthDay)
Global Testing Shows No Variation in Swine Flu Virus (06/04/2009, HealthDay)
WHO Close to Declaring Swine Flu Pandemic (06/03/2009, HealthDay)
WHO Official Says World Edging Towards Pandemic (06/02/2009, Reuters Health)
Swine Flu Now Reported in All 50 States (06/01/2009, HealthDay)
FDA, FTC Warn Public of Fraudulent 2009 H1N1 Influenza Products (05/30/2009, Food and Drug Administration)
Swine Flu Vaccine Won't Be Ready Until October: CDC (05/29/2009, HealthDay)
Swine Flu Vaccine Won't Be Ready Until October (05/28/2009, HealthDay)
U.S. Considering Emergency Use of Booster in H1N1 Vaccine (05/28/2009, Reuters Health)
Possible Return of Swine Flu in Fall Has U.S. Health Officials on Alert (05/27/2009, HealthDay)
U.S. Prepares for Possible Return of Swine Flu in Fall (05/26/2009, HealthDay)
Viable Swine Flu Shot Closer to Reality (05/25/2009, HealthDay)
WHO Chief Says World Should Prepare for Severe Flu (05/24/2009, Reuters Health)
Regular Flu Vaccine Little Help against New Strain (05/21/2009, Reuters Health)
Swine Flu Outbreak May Be Subsiding, CDC Says (05/21/2009, HealthDay)
Older Adults May Have Some Immunity to Swine Flu (05/20/2009, HealthDay)
U.S. Officials Consider Bumping Up Flu Shot Season (05/20/2009, Reuters Health)
Could H1N1 Start to Resist Drugs? (05/19/2009, Reuters Health)
Sicker People More Vulnerable to Swine Flu (05/19/2009, HealthDay)
Adequate Supply of Swine Flu Vaccine Uncertain (05/18/2009, HealthDay)
New Methods Could Speed Production of Flu Vaccines (05/18/2009, HealthDay)
Swine Flu Fatality Rate a 'Little Bit' Higher Than That of Seasonal Flu (05/18/2009, HealthDay)
Swine Flu May Have Infected More Than 100,000 Americans (05/17/2009, HealthDay)
Focus On Children Best Way to Stop Flu Bugs (05/14/2009, Reuters Health)
Fewer Than a Third in U.S. Would Get Swine Flu Jab (05/13/2009, Reuters Health)
Pregnant Women Should Take Flu Drugs Promptly (05/13/2009, HealthDay)
Study Supports Swine Flu's Pandemic Potential (05/12/2009, HealthDay)
Swine Flu May Pose Problems for Pregnant Women (05/12/2009, HealthDay)
CDC Shifts Swine Flu Focus to Likely Impact in the Fall (05/11/2009, HealthDay)
Third U.S. Swine Flu Death Reported (05/10/2009, HealthDay)
Scientists Still Baffled About Origins of Swine Flu (05/08/2009, HealthDay)
Flu Spreads in U.S., World, Winds Down in Mexico (05/07/2009, Reuters Health)
U.S. Swine Flu Count Nears 1,900; Person-to-Person Transmission Now Common (05/07/2009, HealthDay)
FDA Approves New Influenza Vaccine Production Facility (05/06/2009, Food and Drug Administration)
Swine Flu Likely to Return to U.S. Next Winter (05/06/2009, HealthDay)
Younger Age of More Severe Swine Flu Cases Worries Experts (05/06/2009, HealthDay)
Swine Flu Kills Second Person in U.S. (05/05/2009, Reuters Health)
1976 Swine Flu Outbreak Offers Echoes, Lessons Today (05/04/2009, HealthDay)
Swine Flu Cases Still Up, but U.S. Officials Are Guardedly Optimistic (05/04/2009, HealthDay)
Swine Flu Outbreak Not a Pandemic at This Point (05/03/2009, HealthDay)
Swine Flu: A Primer (05/03/2009, HealthDay www.medisave.co.uk
WHAT IS SWINE FLU Fever
Swine flu was declared a global pandemic by the World Health Organisation on June 11, 2009. The initial outbreak of the new strain of the swine flu, or H1N1, virus was in Mexico before spreading to the rest of the world. On July 21, the WHO reported the global death toll had reached more than 700; the agency has now stopped counting laboratory-confirmed cases as it is a waste of resources.
In Britain, Prof Nigel Dimmock, a virologist at Warwick University, has claimed that half the UK population could come down with swine flu this year. His worst case scenario is that 150,000 people could die in Britain.
WHAT IS SWINE FLU?
It is a flu virus that affects pigs, often hitting farms in autumn and winter. It rarely spreads to humans. But when it does, the outbreak begins with someone being in contact with an infected pig.
Flu viruses have the ability to mutate quickly, and pigs provide an excellent host for this. The new version has developed the ability to spread among humans, who then infect each other through coughing and sneezing. It cannot be spread by eating pork or pork products.
This outbreak has been caused by a version of the H1N1 strain of influenza type A. It is the same strain as causes flu outbreaks in humans, however the new version contains genetic material from strains of the virus that affect humans, birds and swine.
Fresh research from the University of Winsconsin suggests the new strain is related to the 'Spanish flu' virus of 1918 that killed millions. The study suggests it penetrates deeper into the respiratory tissues - making it more likely to cause pneumonia. Blood tests show that people who lived through the 1918 flu pandemic are immune to swine flu, but not to the seasonal flu that hits every year.
On the plus side, the H1N1 strain is far less dangerous than H5N1, or bird flu, and despite the similiarities it is not (yet) as severe as the 1918 version.
WHAT ARE THE SYMPTOMS?
The symptoms are the same as with normal seasonal flu: fever (a body temperature of over 38C or 100.4F), coughing, sore throat, aching muscles, limb or joint pain, runny nose, lack of appetite and nausea. Some patients have also reported diarrhoea and vomiting.
Several of those diagnosed with swine flu after trips to Mexico mistook the first signs as the effects of jetlag. Those who have died suffered from pneumonia and respiratory failure.
WHO IS CATCHING IT?
The illness has spread rapidly, with 'hotspots' developing in urban areas. In Britain, these are London, Glasgow and the West Midlands. In July the Government warned that cases could reach 100,000 a day in August.
Early fears that it was most lethal to people aged 25 to 45 have subsided. In the UK symptoms exhibited by victims have not been severe. People with long term health conditions are deemed most at risk by the NHS and so far there have been very few deaths among who did not have underlying health issues.
IS THERE A VACCINE?
Large quantities will be manufactured after human trials which began in Australia on July 20. The first batch of vaccine is not expected in Britain until August or September. Despite a claim by the Government that it could be 'fast-tracked', the WHO announced that trials taking several weeks would be necessary.
However, it is not plain sailing. Scientists have told the WHO that the 'seed strains' grown to produce the vaccine are giving poor yields of antigen. The yield is a quarter to a half of that vaccine makers typically get for seasonal flu vaccine production.
The good news is that Tamiflu and other antiviral drugs are also effective against swine flu viruses, although they may not work against new strains if they emerge.
HOW IS BRITAIN DEALING WITH THE OUTBREAK?
When the new vaccine arrives there are plans to vaccinate the entire population, with high risk groups and medical workers first on the list.
Because of the recent bird flu scare, Britain also has a stockpile of the antiviral drugs Tamiflu and Relenza, enough to treat half the population. These drugs do not completely cure swine flu, but they can reduce its severity and help limit its spread.
New cases are now being diagnosed by phone and sufferers being asked to quarantine themselves for up to two weeks.
On July 23, the Government is due to launch the National Pandemic Flu Service which will allow people to self-diagnose online or by phone and order Tamiflu without visiting doctors' surgeries.
SHOULD WE BE WEARING FACEMASKS?
It is unnecessary. The Department of Health advises that "available scientific evidence does not support the general wearing of facemasks by those who are not ill whilst going about their normal activities". However, the Department is making efforts to increase its stock of facemasks for use by hospital staff in the event of a pandemic being declared.
www.medisave.co.uk
In Britain, Prof Nigel Dimmock, a virologist at Warwick University, has claimed that half the UK population could come down with swine flu this year. His worst case scenario is that 150,000 people could die in Britain.
WHAT IS SWINE FLU?
It is a flu virus that affects pigs, often hitting farms in autumn and winter. It rarely spreads to humans. But when it does, the outbreak begins with someone being in contact with an infected pig.
Flu viruses have the ability to mutate quickly, and pigs provide an excellent host for this. The new version has developed the ability to spread among humans, who then infect each other through coughing and sneezing. It cannot be spread by eating pork or pork products.
This outbreak has been caused by a version of the H1N1 strain of influenza type A. It is the same strain as causes flu outbreaks in humans, however the new version contains genetic material from strains of the virus that affect humans, birds and swine.
Fresh research from the University of Winsconsin suggests the new strain is related to the 'Spanish flu' virus of 1918 that killed millions. The study suggests it penetrates deeper into the respiratory tissues - making it more likely to cause pneumonia. Blood tests show that people who lived through the 1918 flu pandemic are immune to swine flu, but not to the seasonal flu that hits every year.
On the plus side, the H1N1 strain is far less dangerous than H5N1, or bird flu, and despite the similiarities it is not (yet) as severe as the 1918 version.
WHAT ARE THE SYMPTOMS?
The symptoms are the same as with normal seasonal flu: fever (a body temperature of over 38C or 100.4F), coughing, sore throat, aching muscles, limb or joint pain, runny nose, lack of appetite and nausea. Some patients have also reported diarrhoea and vomiting.
Several of those diagnosed with swine flu after trips to Mexico mistook the first signs as the effects of jetlag. Those who have died suffered from pneumonia and respiratory failure.
WHO IS CATCHING IT?
The illness has spread rapidly, with 'hotspots' developing in urban areas. In Britain, these are London, Glasgow and the West Midlands. In July the Government warned that cases could reach 100,000 a day in August.
Early fears that it was most lethal to people aged 25 to 45 have subsided. In the UK symptoms exhibited by victims have not been severe. People with long term health conditions are deemed most at risk by the NHS and so far there have been very few deaths among who did not have underlying health issues.
IS THERE A VACCINE?
Large quantities will be manufactured after human trials which began in Australia on July 20. The first batch of vaccine is not expected in Britain until August or September. Despite a claim by the Government that it could be 'fast-tracked', the WHO announced that trials taking several weeks would be necessary.
However, it is not plain sailing. Scientists have told the WHO that the 'seed strains' grown to produce the vaccine are giving poor yields of antigen. The yield is a quarter to a half of that vaccine makers typically get for seasonal flu vaccine production.
The good news is that Tamiflu and other antiviral drugs are also effective against swine flu viruses, although they may not work against new strains if they emerge.
HOW IS BRITAIN DEALING WITH THE OUTBREAK?
When the new vaccine arrives there are plans to vaccinate the entire population, with high risk groups and medical workers first on the list.
Because of the recent bird flu scare, Britain also has a stockpile of the antiviral drugs Tamiflu and Relenza, enough to treat half the population. These drugs do not completely cure swine flu, but they can reduce its severity and help limit its spread.
New cases are now being diagnosed by phone and sufferers being asked to quarantine themselves for up to two weeks.
On July 23, the Government is due to launch the National Pandemic Flu Service which will allow people to self-diagnose online or by phone and order Tamiflu without visiting doctors' surgeries.
SHOULD WE BE WEARING FACEMASKS?
It is unnecessary. The Department of Health advises that "available scientific evidence does not support the general wearing of facemasks by those who are not ill whilst going about their normal activities". However, the Department is making efforts to increase its stock of facemasks for use by hospital staff in the event of a pandemic being declared.
www.medisave.co.uk
Swine flu is spreading unexpectedly fast in Germany
Swine flu is spreading unexpectedly fast in Germany, doubling in less than a week, according to the country's infectious disease center. Most new cases have resulted from people returning from vacation.
More cases of H1N1 swine flu are to be expected in Germany, according to the Robert Koch Institute (RKI), Germany's center for infectious diseases.
There were 2,455 confirmed cases of swine flu in Germany on Wednesday, 637 more were reported on Tuesday. The current number of infections represents an increase of nearly 30 percent in two days. On July 15, there were just 834 cases, officials from the institute told reporters on Thursday.
"We see it this way: the increase is worrisome for us, but not a reason to panic," RKI head Joerg Hacker told the dpa news agency.
Most of the cases in Germany were mild but "serious cases could arise, as they have in other countries," RKI Vice President Reinhard Burger told German public broadcaster SWR.
The increase in infections is largely due to people returning from vacation with the virus, Hacker said, adding that about 20 percent of Germans diagnosed with the virus caught it in Germany.
"The general rule applies that when a lot of people gather in a small area there's a chance of infection," Hacker added.
Burger called on people to follow simple personal hygiene procedures, including washing their hands often with soap and warm water, to slow the virus' spread.
"The virus can be spread through contact, so measures like regular hand washing and, particularly, avoiding touching the eyes, nose and mouth, are very important," he said.
Pharmaceutical sales up
Bildunterschrift: Großansicht des Bildes mit der Bildunterschrift: Simple hygienic practices might help slow the virus' spread
Anticipating that the virus will continue to spread around the globe, the Swiss pharmaceutical giant Roche said Thursday it would sell another 658 million euros worth of anti-flu drug Tamiflu by the end of 2009, having already sold a similar amount this year.
"Additional government stockpiling orders and increased demand in the retail pharmacy market contributed to the particularly strong sales recorded in the second quarter," the company said in a statement.
The group expected to sell "around 1 billion (Swiss) francs" more of the drug, one of two recommended by the World Health Organization to treat swine flu, Roche chief executive Severin Schwan told journalists.
GlaxoSmithKline said sales of Relenza, the other drug approved for use in swine flu cases, had also increased.
"GSK now expects to increase its annual production capacity of Relenza to 190 million treatment courses by the end of 2009. This represents a threefold increase to GSK's previous maximum capacity of 60 million treatment courses," the company said in a statement.
sms/AFP/dpa/Reuters
www.medisave.co.uk
More cases of H1N1 swine flu are to be expected in Germany, according to the Robert Koch Institute (RKI), Germany's center for infectious diseases.
There were 2,455 confirmed cases of swine flu in Germany on Wednesday, 637 more were reported on Tuesday. The current number of infections represents an increase of nearly 30 percent in two days. On July 15, there were just 834 cases, officials from the institute told reporters on Thursday.
"We see it this way: the increase is worrisome for us, but not a reason to panic," RKI head Joerg Hacker told the dpa news agency.
Most of the cases in Germany were mild but "serious cases could arise, as they have in other countries," RKI Vice President Reinhard Burger told German public broadcaster SWR.
The increase in infections is largely due to people returning from vacation with the virus, Hacker said, adding that about 20 percent of Germans diagnosed with the virus caught it in Germany.
"The general rule applies that when a lot of people gather in a small area there's a chance of infection," Hacker added.
Burger called on people to follow simple personal hygiene procedures, including washing their hands often with soap and warm water, to slow the virus' spread.
"The virus can be spread through contact, so measures like regular hand washing and, particularly, avoiding touching the eyes, nose and mouth, are very important," he said.
Pharmaceutical sales up
Bildunterschrift: Großansicht des Bildes mit der Bildunterschrift: Simple hygienic practices might help slow the virus' spread
Anticipating that the virus will continue to spread around the globe, the Swiss pharmaceutical giant Roche said Thursday it would sell another 658 million euros worth of anti-flu drug Tamiflu by the end of 2009, having already sold a similar amount this year.
"Additional government stockpiling orders and increased demand in the retail pharmacy market contributed to the particularly strong sales recorded in the second quarter," the company said in a statement.
The group expected to sell "around 1 billion (Swiss) francs" more of the drug, one of two recommended by the World Health Organization to treat swine flu, Roche chief executive Severin Schwan told journalists.
GlaxoSmithKline said sales of Relenza, the other drug approved for use in swine flu cases, had also increased.
"GSK now expects to increase its annual production capacity of Relenza to 190 million treatment courses by the end of 2009. This represents a threefold increase to GSK's previous maximum capacity of 60 million treatment courses," the company said in a statement.
sms/AFP/dpa/Reuters
www.medisave.co.uk
If you've ever considered a career as a
Professional Yoga Teacher...
... but weren't sure where to get straight answers to your biggest questions about what it's like to train and work as a professional Yoga instructor, then you've come to the right place!
Teaching Yoga can be an incredibly rewarding - and profitable - way to earn a living - if you know what you're doing! Well, you can know, without having to spend thousands at a studio!
I've developed a program that teaches you everything you need to know to teach yoga AND run a successful yoga business.
And you can learn it from home, at your own pace.
I call it the Yoga Teacher "Training-Camp-in-a-Box"
for Home Study Yoga Teacher Certification.
Plus, we've created a website to support our students and you're invited to use it for free. It includes forums for discussing yoga teaching, blogs with articles about teaching yoga, free yoga videos, newsletters, podcasts and more. Join our free yoga site and you'll agree - you simply won't find a better long-distance yoga certification program - ANYWHERE! Yoga Certification
Professional Yoga Teacher...
... but weren't sure where to get straight answers to your biggest questions about what it's like to train and work as a professional Yoga instructor, then you've come to the right place!
Teaching Yoga can be an incredibly rewarding - and profitable - way to earn a living - if you know what you're doing! Well, you can know, without having to spend thousands at a studio!
I've developed a program that teaches you everything you need to know to teach yoga AND run a successful yoga business.
And you can learn it from home, at your own pace.
I call it the Yoga Teacher "Training-Camp-in-a-Box"
for Home Study Yoga Teacher Certification.
Plus, we've created a website to support our students and you're invited to use it for free. It includes forums for discussing yoga teaching, blogs with articles about teaching yoga, free yoga videos, newsletters, podcasts and more. Join our free yoga site and you'll agree - you simply won't find a better long-distance yoga certification program - ANYWHERE! Yoga Certification
Yoga Teacher Salary
What kind of salary can you expect to earn as a Yoga teacher? If you are looking at an hourly rate, anywhere from $35 to $120 is about right in North America.
There are many factors involved in pricing, such as demographics and demand. If a Fortune 500 company hires you to teach Yoga, or stress management, to their executive staff, you know the price should reflect your preparation and travel time.
Lastly, if you feel the calling to teach Yoga, please do the following. Write your plans down, take action, and go after your goal of becoming a Yoga teacher. The public needs more compassionate Yoga instructors and the job is very rewarding. Yoga Teacher Salary
There are many factors involved in pricing, such as demographics and demand. If a Fortune 500 company hires you to teach Yoga, or stress management, to their executive staff, you know the price should reflect your preparation and travel time.
Lastly, if you feel the calling to teach Yoga, please do the following. Write your plans down, take action, and go after your goal of becoming a Yoga teacher. The public needs more compassionate Yoga instructors and the job is very rewarding. Yoga Teacher Salary
Your Goal: Become a Yoga Teacher
What are your goals in regard to your Yogic career? Plan long term and short term goals, but add your continuing education to both lists. At least, make it a point to read Yoga books and watch Yoga DVD's. Audio books are handy too.
What is your estimated time frame to become a Yoga teacher? All you have to do is pencil in a realistic deadline. It does not have to be tomorrow and the idea should not create any stress. You should have fun, and "enjoy the journey," when you are working toward your goal of teaching Yoga. Your Goal: Become a Yoga Teacher
What is your estimated time frame to become a Yoga teacher? All you have to do is pencil in a realistic deadline. It does not have to be tomorrow and the idea should not create any stress. You should have fun, and "enjoy the journey," when you are working toward your goal of teaching Yoga. Your Goal: Become a Yoga Teacher
Yoga Teacher Correspondence Courses
On the other hand, Yoga teacher correspondence courses are much more reasonable, but can vary in the number of study hours and overall quality. For example: A forty hour Yoga course is just not enough time for anyone to safely learn to teach Yoga students. Once again, you should research the syllabus and get a complete Yoga teacher training course.
If you are considering a Yoga teacher correspondence course, you should have sufficient knowledge of Yoga. Also, make sure that customer service is always a priority to the Yoga teacher training center after the sale has been made to the Yoga teacher intern. If you call during business hours and get a live person who answers your questions diplomatically, that will give you some indication of the technical service you should expect.
While you are at it, make sure that you are calling a Yoga teacher training center and not a "diploma house." If they certify everything from pet sitting to web design, what do you think they really know about teaching Yoga?
Once you have received the study material, there will undoubtedly be questions, concerns, or need for further assistance, via email, or telephone, from the intern who has purchased the Yoga teacher course. Make sure you get answers if you are "stuck" during your Yoga teacher internship. Yoga Teacher Correspondence Courses
If you are considering a Yoga teacher correspondence course, you should have sufficient knowledge of Yoga. Also, make sure that customer service is always a priority to the Yoga teacher training center after the sale has been made to the Yoga teacher intern. If you call during business hours and get a live person who answers your questions diplomatically, that will give you some indication of the technical service you should expect.
While you are at it, make sure that you are calling a Yoga teacher training center and not a "diploma house." If they certify everything from pet sitting to web design, what do you think they really know about teaching Yoga?
Once you have received the study material, there will undoubtedly be questions, concerns, or need for further assistance, via email, or telephone, from the intern who has purchased the Yoga teacher course. Make sure you get answers if you are "stuck" during your Yoga teacher internship. Yoga Teacher Correspondence Courses
Yoga Teachers Education
Unfortunately, these Yoga teachers are often trained to teach Yoga as an exercise program by learning a dozen or two dozen asanas, and not much beyond this. The fact is, Yoga is much more than an exercise program. Yoga is the most complete health maintenance system known to mankind, with a lineage of thousands of years. Whole health needs to be addressed by much more than an exercise program.
On-site training is not cheap and can vary from the low $2000.00 range to very expensive. When you consider travel, lodging, and all of the expenses involved a typical Yoga teacher training may well cost you $6000.00 or more. Does anyone offer Yoga teacher interns a guarantee? Not often, and as of today, I only know of only one guaranteed Yoga teacher training course in existence. Yoga TeacherYoga teachers Education
On-site training is not cheap and can vary from the low $2000.00 range to very expensive. When you consider travel, lodging, and all of the expenses involved a typical Yoga teacher training may well cost you $6000.00 or more. Does anyone offer Yoga teacher interns a guarantee? Not often, and as of today, I only know of only one guaranteed Yoga teacher training course in existence. Yoga TeacherYoga teachers Education
Designing a Plan to Become a Yoga Teacher,
If you have decided that becoming a Yoga teacher is your passion, your next step is to create a plan of action. When doing anything that requires a major change, a call to action is one of the hardest hurdles to overcome. There are so many people who wish for goals, but do not plan to go after them. Let's look at a few ways to make your plan of action to become a Yoga teacher.
What kind of help or support system do you need to teach Yoga? Remember the saying, "no man is an island." Everyone needs encouragement, even if you are very confident in your abilities. Will you need financial help, educational resources, or to be mentored by a local Yoga teacher? Make an assessment of what you need and plan accordingly. Become a Yoga Teacher
What kind of help or support system do you need to teach Yoga? Remember the saying, "no man is an island." Everyone needs encouragement, even if you are very confident in your abilities. Will you need financial help, educational resources, or to be mentored by a local Yoga teacher? Make an assessment of what you need and plan accordingly. Become a Yoga Teacher
Wednesday, 10 June 2009
Dementia, Telling it to the kids
LifeWire) - When a grandparent or other loved one is diagnosed with Alzheimer's disease, it can be the children of the family who are most affected. Adults are capable of understanding the disease, its symptoms and what to expect. Parents and other relatives need to pass along this knowledge - in an age-appropriate way - to children who will be impacted by the disease.
Breaking the News
At any age, children can sense discord and stress in their environment, so it's important to address any concerns before kids make erroneous assumptions.
The conversation will differ depending on the child's age. For younger children, you don't necessarily need to use the term Alzheimer's disease. Instead, talk about how the child's loved one is sick, will have trouble remembering things and might sometimes be confused. Be sure to mention that their loved one will probably get sicker and that it's important for the family to help out. Depending on their level of understanding, try to prepare them for the changes they'll see in their loved one.
Teenagers, who are more capable of understanding the diagnosis, should hear more details, such as how long their loved one is expected to live and what treatment options are available. Talk to them before inviting a loved one to move in for full-time care. While parents might not always abide by teens' opinions, it's important that everyone's voice be heard.
Reassure children that Alzheimer's disease is not infectious. If the loved one was diagnosed before age 65, talk to older teens about the possibility that the disease is inherited. If early-onset Alzheimer's disease has affected several immediate relatives, the family might consider genetic testing for the disease.
Continue to talk to children and teens about the situation when the disease progresses to the point where their loved one no longer recognizes them. Acknowledge their feelings and assure them that their loved one still loves them and still appreciates their visits. Allow them to grieve this loss, and don't force them to continue visiting if they are truly uncomfortable.
Emotions and Reactions
Children can experience a variety of emotions relating to their loved one's condition, but they might not volunteer their feelings. In some cases, parents might need to anticipate these emotions and be proactive about initiating a conversation.
These emotions can include:
Fear that parents, other relatives or they themselves might be diagnosed with the disease
Anxiety, sadness or fear regarding changes in their loved one's behavior or personality
Frustration over having to say things many times or needing to repeatedly identify themselves
Remorse over acting frustrated or guilt about not having the disease themselves
Self-consciousness about being in public with their loved one or, if the loved one lives with the family, feeling ashamed of their living situation
Remember, kids and teenagers don't always express their emotions in the same ways that adults do. Instead of talking about their fears, worries and guilt, they might exhibit behavioral problems, be distracted from schoolwork, avoid interaction with the family and even complain about physical ailments. If this occurs, try having another conversation; if necessary, ask a trusted teacher, another adult or a school counselor to sit in on it.
Parenting Strategies
Offer continuous support to children while they cope with their loved one's disease. It's important to allow them to express themselves, to avoid judging their feelings and to answer all of their questions as honestly as possible. For more help, visit the Alzheimer's Association website for kids and teens.
It can also be helpful to engage the children in family-related activities, such as making a family tree or looking at old photographs. These activities can help children feel connected to their loved one.
Parents or guardians can also engage children in making a memory book for their loved one. Memory books, which have been shown to ease behavioral symptoms in people with Alzheimer's disease, usually consist of family photos and other memorabilia. The book can help a loved one with Alzheimer's disease reconnect with memories. Children can also write a letter or draw a picture for their loved one to be included in the book.
Sources:
Bourgeois, Michelle. "History of Memory Books." Department of Communication Disorders: Research Lab and Caregiver Resources. 2007. Florida State University. 23 May 2008.
Callone, Patricia, Connie Kudlacek, Barbara C. Vasiloff, Janaan Manternach, and Roger A. Brumback. . A Caregiver's Guide to Alzheimer's Disease: 300 Tips for Making Life Easier. First. New York: Demos Medical Publishing, 2006.
"Helping Children Understand Alzheimer's Disease." Alzheimer's Care. Apr. 2007. Alzheimer's Society of Canada. 3 Jun 2008..
"Talking to Teens and Kids." ALZ.org. 27 Oct. 2006. Alzheimer's Association. 3 Jun 2008..
LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Betsy Lee-Frye is an independent journalist living in Kansas City, Mo. Her work has appeared in The Dallas Morning News, Better Homes and Gardens Special Interest Publications and Kansas City Magazine.
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Breaking the News
At any age, children can sense discord and stress in their environment, so it's important to address any concerns before kids make erroneous assumptions.
The conversation will differ depending on the child's age. For younger children, you don't necessarily need to use the term Alzheimer's disease. Instead, talk about how the child's loved one is sick, will have trouble remembering things and might sometimes be confused. Be sure to mention that their loved one will probably get sicker and that it's important for the family to help out. Depending on their level of understanding, try to prepare them for the changes they'll see in their loved one.
Teenagers, who are more capable of understanding the diagnosis, should hear more details, such as how long their loved one is expected to live and what treatment options are available. Talk to them before inviting a loved one to move in for full-time care. While parents might not always abide by teens' opinions, it's important that everyone's voice be heard.
Reassure children that Alzheimer's disease is not infectious. If the loved one was diagnosed before age 65, talk to older teens about the possibility that the disease is inherited. If early-onset Alzheimer's disease has affected several immediate relatives, the family might consider genetic testing for the disease.
Continue to talk to children and teens about the situation when the disease progresses to the point where their loved one no longer recognizes them. Acknowledge their feelings and assure them that their loved one still loves them and still appreciates their visits. Allow them to grieve this loss, and don't force them to continue visiting if they are truly uncomfortable.
Emotions and Reactions
Children can experience a variety of emotions relating to their loved one's condition, but they might not volunteer their feelings. In some cases, parents might need to anticipate these emotions and be proactive about initiating a conversation.
These emotions can include:
Fear that parents, other relatives or they themselves might be diagnosed with the disease
Anxiety, sadness or fear regarding changes in their loved one's behavior or personality
Frustration over having to say things many times or needing to repeatedly identify themselves
Remorse over acting frustrated or guilt about not having the disease themselves
Self-consciousness about being in public with their loved one or, if the loved one lives with the family, feeling ashamed of their living situation
Remember, kids and teenagers don't always express their emotions in the same ways that adults do. Instead of talking about their fears, worries and guilt, they might exhibit behavioral problems, be distracted from schoolwork, avoid interaction with the family and even complain about physical ailments. If this occurs, try having another conversation; if necessary, ask a trusted teacher, another adult or a school counselor to sit in on it.
Parenting Strategies
Offer continuous support to children while they cope with their loved one's disease. It's important to allow them to express themselves, to avoid judging their feelings and to answer all of their questions as honestly as possible. For more help, visit the Alzheimer's Association website for kids and teens.
It can also be helpful to engage the children in family-related activities, such as making a family tree or looking at old photographs. These activities can help children feel connected to their loved one.
Parents or guardians can also engage children in making a memory book for their loved one. Memory books, which have been shown to ease behavioral symptoms in people with Alzheimer's disease, usually consist of family photos and other memorabilia. The book can help a loved one with Alzheimer's disease reconnect with memories. Children can also write a letter or draw a picture for their loved one to be included in the book.
Sources:
Bourgeois, Michelle. "History of Memory Books." Department of Communication Disorders: Research Lab and Caregiver Resources. 2007. Florida State University. 23 May 2008
Callone, Patricia, Connie Kudlacek, Barbara C. Vasiloff, Janaan Manternach, and Roger A. Brumback. . A Caregiver's Guide to Alzheimer's Disease: 300 Tips for Making Life Easier. First. New York: Demos Medical Publishing, 2006.
"Helping Children Understand Alzheimer's Disease." Alzheimer's Care. Apr. 2007. Alzheimer's Society of Canada. 3 Jun 2008.
"Talking to Teens and Kids." ALZ.org. 27 Oct. 2006. Alzheimer's Association. 3 Jun 2008.
LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Betsy Lee-Frye is an independent journalist living in Kansas City, Mo. Her work has appeared in The Dallas Morning News, Better Homes and Gardens Special Interest Publications and Kansas City Magazine.
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The Dementia Café, share experience, make new friends
The Dementia Café is a place to get advice, share experiences and make new friends.
It's aim is to build a community of carers and people with Dementia who can support one another through the most difficult situations when dealing the effects of dementia. If you have been diagnosed with dementia; are caring for someone with dementia; or are involved with any aspect of the illness, please register on the website and join the community.
Please click on the Message Board logo to be taken to The Dementia Café Message Boards page. Once registered, you'll be able to post messages, get replies, and join in the discussions.
Why not register and get involved ?
Message Boards
Please click on the Online Support logo to open the Online Support page.
Come and join in the discussions !
It's aim is to build a community of carers and people with Dementia who can support one another through the most difficult situations when dealing the effects of dementia. If you have been diagnosed with dementia; are caring for someone with dementia; or are involved with any aspect of the illness, please register on the website and join the community.
Please click on the Message Board logo to be taken to The Dementia Café Message Boards page. Once registered, you'll be able to post messages, get replies, and join in the discussions.
Why not register and get involved ?
Message Boards
Please click on the Online Support logo to open the Online Support page.
Come and join in the discussions !
Early Indiactors, Dementia, Alzheimer's
Early symptoms
Every person is unique and dementia affects people differently - no two people will have symptoms that develop in exactly the same way. An individual's personality, general health and social situation are all important factors in determining the impact of dementia on him or her.
The most common early symptoms of dementia are:
Memory loss
Declining memory, especially short-term memory, is the most common early symptom of dementia. People with ordinary forgetfulness can still remember other facts associated with the thing they have forgotten. For example they may briefly forget their next-door neighbour's name but they still know the person they are talking to is their next-door neighbour. A person with dementia will not only forget their neighbour's name but also the context.
Difficulty performing familiar tasks
People with dementia often find it hard to complete everyday tasks that are so familiar we usually do not think about how to do them. A person with dementia may not know in what order to put clothes on or the steps for preparing a meal.
Problems with language
Occasionally everyone has trouble finding the right word but a person with dementia often forgets simple words or substitutes unusual words, making speech or writing hard to understand.
Disorientation to time and place
We sometimes forget the day of the week or where we are going but people with dementia can become lost in familiar places such as the road they live in, forget where they are or how they got there, and not know how to get back home. A person with dementia may also confuse night and day.
Poor or decreased judgement
People with dementia may dress inappropriately, wearing several layers of clothes on a warm day or very few on a cold day.
Problems with keeping track of things
A person with dementia may find it difficult to follow a conversation or keep up with paying their bills.
Misplacing things
Anyone can temporarily misplace his or her wallet or keys. A person with dementia may put things in unusual places such as an iron in the fridge or a wristwatch in the sugar bowl.
Changes in mood or behaviour
Everyone can become sad or moody from time to time. A person with dementia may become unusually emotional and experience rapid mood swings for no apparent reason. Alternatively a person with dementia may show less emotion than was usual previously.
Changes in personality
A person with dementia may seem different from his or her usual self in ways that are difficult to pinpoint. A person may become suspicious, irritable, depressed, apathetic or anxious and agitated especially in situations where memory problems are causing difficulties.
Loss of initiative
At times everyone can become tired of housework, business activities, or social obligations. However a person with dementia may become very passive, sitting in front of the television for hours, sleeping more than usual, or appear to lose interest in hobbies.
If you are experiencing any of these symptoms or are concerned about a friend or relative, visit your doctor and discuss your concerns.
Where next?
Diagnosis
Frequently Asked Questions
World Alzheimer's Day™ 2002 - Recognising dementia
About Alzheimer's disease
Every person is unique and dementia affects people differently - no two people will have symptoms that develop in exactly the same way. An individual's personality, general health and social situation are all important factors in determining the impact of dementia on him or her.
The most common early symptoms of dementia are:
Memory loss
Declining memory, especially short-term memory, is the most common early symptom of dementia. People with ordinary forgetfulness can still remember other facts associated with the thing they have forgotten. For example they may briefly forget their next-door neighbour's name but they still know the person they are talking to is their next-door neighbour. A person with dementia will not only forget their neighbour's name but also the context.
Difficulty performing familiar tasks
People with dementia often find it hard to complete everyday tasks that are so familiar we usually do not think about how to do them. A person with dementia may not know in what order to put clothes on or the steps for preparing a meal.
Problems with language
Occasionally everyone has trouble finding the right word but a person with dementia often forgets simple words or substitutes unusual words, making speech or writing hard to understand.
Disorientation to time and place
We sometimes forget the day of the week or where we are going but people with dementia can become lost in familiar places such as the road they live in, forget where they are or how they got there, and not know how to get back home. A person with dementia may also confuse night and day.
Poor or decreased judgement
People with dementia may dress inappropriately, wearing several layers of clothes on a warm day or very few on a cold day.
Problems with keeping track of things
A person with dementia may find it difficult to follow a conversation or keep up with paying their bills.
Misplacing things
Anyone can temporarily misplace his or her wallet or keys. A person with dementia may put things in unusual places such as an iron in the fridge or a wristwatch in the sugar bowl.
Changes in mood or behaviour
Everyone can become sad or moody from time to time. A person with dementia may become unusually emotional and experience rapid mood swings for no apparent reason. Alternatively a person with dementia may show less emotion than was usual previously.
Changes in personality
A person with dementia may seem different from his or her usual self in ways that are difficult to pinpoint. A person may become suspicious, irritable, depressed, apathetic or anxious and agitated especially in situations where memory problems are causing difficulties.
Loss of initiative
At times everyone can become tired of housework, business activities, or social obligations. However a person with dementia may become very passive, sitting in front of the television for hours, sleeping more than usual, or appear to lose interest in hobbies.
If you are experiencing any of these symptoms or are concerned about a friend or relative, visit your doctor and discuss your concerns.
Where next?
Diagnosis
Frequently Asked Questions
World Alzheimer's Day™ 2002 - Recognising dementia
About Alzheimer's disease
Tuesday, 9 June 2009
Alzheimer's, Dementia, Poetry, Please submit your
Poetry
Have a go at writing poetry yourselves if you've never done it, before opportunity knocks at diagnosis' door.
Please send us your poems at friends@alzheimersforum.org.
Barry has compiled a book of poems called Poetic Thoughts taken from Alzheimer's Forum and Alzheimer's Society websites about Alzheimer's and dementia. Have a look and read them at your leisure.
Latest poems
Left Alone, by Barry
My day started with harmony I was feeling on a highSince my body and mind had awakened seeing eye to eye,But my exultation within was not that long to remainAs I'd forgotted this day I was to be left alone again.
'Twas 7 in the morning as my darling gave me a kiss and a hugWith the dilemma in her eyes much clearer than the sky above,I'm not that far away she soothingly and withassurance expressed,Just keep a calm mind and don't let yourself get stressed.
As she walked out the door I locked it tight from behind,Switching on the alarms for some extra security of mind,If intruders should encroach to confuse my day even more,Then a piercing warning would echo through the solitudeof my air.
Thus my lonesome day slowly pursued its own path,I wandered from room to room with my inner fears noone to convey,But what if I should stumble? And now where is my lunch, I cried!Thought I'm sure you must have told me you had preparedit in advance.
Then disorientation seized me as the walls all started to close in,Is that my shadow on the wall? Or is it an evil spirit within?I was trying to conquer the hallucinations now castbefore my eyes,When all of a sudden scurrying commotions overhead did arise,Was it merely trickery inside my ears? Or maybe it's just a mouse!
So I tried watching the TV but it was to be of little avail,Since the voices and images to my mind had all become veiled,I sat at the computer to write down my inner fears of the day,Yet my eyes and fingers would not correspond in the same way,Yes, my early morning harmony lay around me shattered in affray.
Then as the evening moon finally took turn from the sinking sunMy wife at last returned, her day's hard labour had been done,She embraced me ever lovingly asking, 'Have you been ok?'I nodded with a smile and a Yes, it's been a very good day!But now it's even better that you're back in my arms,As we lay our heads together on pillows of soft silky downI quietly gave thanks to God that my lonely day was at an end.
Of Two Perspectives, by Barry
We live in our own world of delusions and fearsThat distraught our mind throughout days and nightsBut do we reflect about the one we most loveBe it our partner, husband or wife?They take upon their shoulders our continuous careWithout thoughts of themselves or their quality of life,Yet do we remember to give that loving embrace?Or do we cast criticisms, emotions and tears to their face,We should never forget the one we truly love so dear,Giving them space to cope with their own inner fears,Time to be alone with their own thoughts to dwell,Some solitude in peace from the turmoils of our hell,Yes the problem is complexity from both points of view,As we want eternal loving affection, but then so do you.This is surely an equation that even Einstein couldn't solve,It's just one more conundrum in an illness that has no resolve,Now one thing I realise as the days slowly languish byAs I can see from the anguish within your own loving eyes,This illness is not only affecting the life of just me,But tearing out the heart and soul of the one most dearest to me.
The Fight Never Ends, by Norrms:
Is it too soon to be talking of this?Secretly remembering our first kiss,Of how you will manage when I'm gone,When my fight is finished, over and done,I ask you this with tears in my eyes,Trying to stifle a million cries,Don't be so silly, you'll outlast me!Is always your answer, but please will you see,I neeed to make sure that life will be kind,And then you can rest and have peae of mind,I need to say this before the AD,Removes all my memories and steals them from me,I didn't mean to make you cry,Just want to be sure that you will get by,You take hold of my hand and say, Listen to me,You're going nowhere, why can't you see,We are in this together, no matter how long,Nobody's singing their last song,You have provided for us, all of your life,And I'm proud to say that I am your wife,We have wonderful kids, and grandchildren too,All of them grateful for the kindness from you.Then I say, Shh, please just let me say,That when my time comes, no matter what day,You shall remember, that very first kiss,And how all our life has been absolute bliss,And do me one favour, is my question to you,When you look up, at a sky that's so blue,Always remember, I will always love you,And please say goodby to all of my friends,Especially on TP, The Fight Never Ends.
You can read previous poetry contributions by clicking on the links below. The most recent contributions are at the end of the list.
Information on Poetry
The times that were not!
I once eloped with a petticoat
'Blog, blah, blah, blah'
Look at life
My shadow
Memories
Two poems
Don't treat me like a mattress
Simple as ABC
Has Life Passed By?
My Sister
Of Endless Days
Tree of Life
Reality or Dream
Perspective
There is no turning back
Now I have gone
Laughing at dementia and why not
A passing year
A poem by Frank - let the words flow
Distant Memories
My Mum and Dad's day with Alzheimer's
Never a Typical Day
Memories Lament
Going Too Fast?
Field of Dreams
Watching the World Go by
Ups and Downs
Bewildered
Gardening with Alzheimer's
It's OK to be scared
The Time Has Come
The Fight Never Ends
Of Two Perspectives
Say to yourself
You are never alone
Friends
Moments
My, my, another day
For one more day
Coping or not... with Alzheimer's
Of my eyes
Who can help?
He Gave In But He Never Gave Out
Of my Dementia
Spirit of Life
Of Courage
Do You Remember?
Reflections of Timeless Love within Dementia
Misty Horizons
Out of the Shadows
Nan
Al Zimer
Of the night
Hello Alzheimer's
The Alzheimer's Train
That's Asda Price
Distorted Day
Love's Lone Rose
Explaining to Mum
Gone Wandering
Alzheimer's Mountain
If My Eyes Could Talk
In Remembrance
I've Got Through Another Day
Betwixt Two Worlds
Just Once More
Left Alone
Have a go at writing poetry yourselves if you've never done it, before opportunity knocks at diagnosis' door.
Please send us your poems at friends@alzheimersforum.org.
Barry has compiled a book of poems called Poetic Thoughts taken from Alzheimer's Forum and Alzheimer's Society websites about Alzheimer's and dementia. Have a look and read them at your leisure.
Latest poems
Left Alone, by Barry
My day started with harmony I was feeling on a highSince my body and mind had awakened seeing eye to eye,But my exultation within was not that long to remainAs I'd forgotted this day I was to be left alone again.
'Twas 7 in the morning as my darling gave me a kiss and a hugWith the dilemma in her eyes much clearer than the sky above,I'm not that far away she soothingly and withassurance expressed,Just keep a calm mind and don't let yourself get stressed.
As she walked out the door I locked it tight from behind,Switching on the alarms for some extra security of mind,If intruders should encroach to confuse my day even more,Then a piercing warning would echo through the solitudeof my air.
Thus my lonesome day slowly pursued its own path,I wandered from room to room with my inner fears noone to convey,But what if I should stumble? And now where is my lunch, I cried!Thought I'm sure you must have told me you had preparedit in advance.
Then disorientation seized me as the walls all started to close in,Is that my shadow on the wall? Or is it an evil spirit within?I was trying to conquer the hallucinations now castbefore my eyes,When all of a sudden scurrying commotions overhead did arise,Was it merely trickery inside my ears? Or maybe it's just a mouse!
So I tried watching the TV but it was to be of little avail,Since the voices and images to my mind had all become veiled,I sat at the computer to write down my inner fears of the day,Yet my eyes and fingers would not correspond in the same way,Yes, my early morning harmony lay around me shattered in affray.
Then as the evening moon finally took turn from the sinking sunMy wife at last returned, her day's hard labour had been done,She embraced me ever lovingly asking, 'Have you been ok?'I nodded with a smile and a Yes, it's been a very good day!But now it's even better that you're back in my arms,As we lay our heads together on pillows of soft silky downI quietly gave thanks to God that my lonely day was at an end.
Of Two Perspectives, by Barry
We live in our own world of delusions and fearsThat distraught our mind throughout days and nightsBut do we reflect about the one we most loveBe it our partner, husband or wife?They take upon their shoulders our continuous careWithout thoughts of themselves or their quality of life,Yet do we remember to give that loving embrace?Or do we cast criticisms, emotions and tears to their face,We should never forget the one we truly love so dear,Giving them space to cope with their own inner fears,Time to be alone with their own thoughts to dwell,Some solitude in peace from the turmoils of our hell,Yes the problem is complexity from both points of view,As we want eternal loving affection, but then so do you.This is surely an equation that even Einstein couldn't solve,It's just one more conundrum in an illness that has no resolve,Now one thing I realise as the days slowly languish byAs I can see from the anguish within your own loving eyes,This illness is not only affecting the life of just me,But tearing out the heart and soul of the one most dearest to me.
The Fight Never Ends, by Norrms:
Is it too soon to be talking of this?Secretly remembering our first kiss,Of how you will manage when I'm gone,When my fight is finished, over and done,I ask you this with tears in my eyes,Trying to stifle a million cries,Don't be so silly, you'll outlast me!Is always your answer, but please will you see,I neeed to make sure that life will be kind,And then you can rest and have peae of mind,I need to say this before the AD,Removes all my memories and steals them from me,I didn't mean to make you cry,Just want to be sure that you will get by,You take hold of my hand and say, Listen to me,You're going nowhere, why can't you see,We are in this together, no matter how long,Nobody's singing their last song,You have provided for us, all of your life,And I'm proud to say that I am your wife,We have wonderful kids, and grandchildren too,All of them grateful for the kindness from you.Then I say, Shh, please just let me say,That when my time comes, no matter what day,You shall remember, that very first kiss,And how all our life has been absolute bliss,And do me one favour, is my question to you,When you look up, at a sky that's so blue,Always remember, I will always love you,And please say goodby to all of my friends,Especially on TP, The Fight Never Ends.
You can read previous poetry contributions by clicking on the links below. The most recent contributions are at the end of the list.
Information on Poetry
The times that were not!
I once eloped with a petticoat
'Blog, blah, blah, blah'
Look at life
My shadow
Memories
Two poems
Don't treat me like a mattress
Simple as ABC
Has Life Passed By?
My Sister
Of Endless Days
Tree of Life
Reality or Dream
Perspective
There is no turning back
Now I have gone
Laughing at dementia and why not
A passing year
A poem by Frank - let the words flow
Distant Memories
My Mum and Dad's day with Alzheimer's
Never a Typical Day
Memories Lament
Going Too Fast?
Field of Dreams
Watching the World Go by
Ups and Downs
Bewildered
Gardening with Alzheimer's
It's OK to be scared
The Time Has Come
The Fight Never Ends
Of Two Perspectives
Say to yourself
You are never alone
Friends
Moments
My, my, another day
For one more day
Coping or not... with Alzheimer's
Of my eyes
Who can help?
He Gave In But He Never Gave Out
Of my Dementia
Spirit of Life
Of Courage
Do You Remember?
Reflections of Timeless Love within Dementia
Misty Horizons
Out of the Shadows
Nan
Al Zimer
Of the night
Hello Alzheimer's
The Alzheimer's Train
That's Asda Price
Distorted Day
Love's Lone Rose
Explaining to Mum
Gone Wandering
Alzheimer's Mountain
If My Eyes Could Talk
In Remembrance
I've Got Through Another Day
Betwixt Two Worlds
Just Once More
Left Alone
Alzheimer's and Dementia Forum
Welcome to Alzheimer's Forum
Your weekly magazine on the web
A website designed and written by people with dementia from around the world.
Being diagnosed with dementia does not mean the end of life. We still have brains, we can still laugh and cry. We still have feelings!
This website highlights how having any type of dementia or memory related problem can affect us all through the different stages of the illness.
'Dementia is not just an illness - it's a whole new way of life for us and for our families.'
Although this website is designed for people with memory problems, even families and carers will find it of use in broadening awareness of the illness.
We're in a class of our own worldwide. This website is written BY and FOR people with dementia
WANTED!
People with dementia involved in trying to make a change
The Bradford Dementia Group at Bradford University are looking for 25 people across the UK who are interested in bringing about change or who speak out or campaign on issues which matter to them.
They are looking for a variety of people: it may be that you are involved in community events, or that you write letters to newspapers, sign petitions or speak out in public. Maybe you keep a blog, have volunteered your skills to get better services or are involved in campaigns on a local or national level.
Whatever your level of involvement, they are interested in finding out why you get involved and how your activities affect you, your family and your life in general. The project will take place from August 2009.
To volunteer you need to
- have a dementia diagnosis
- be interested in changing things, speaking out or campaigning
- be prepared to talk to a researcher
- be prepared to keep a diary for up to one month; you can keep a written, photo or audio diary, whichever suits you best.
They are also looking for 5 people with dementia who are interested in piloting the materials they are going to use to make sure they have got them right. The pilot will last two weeks and will take place in June 2009.
If you are interested in finding out more please email socialchange@bradford.ac.uk or ring EJ on 01274 236 494 or Ruth on 01274 236 468.
What's new on Alzheimer's Forum
A FIRST! 2009 CALENDAR - you can still download the remaining months of the year.
For the first time on Alzheimer's Forum, download and print a calendar for 2009. You will find it in the Multimedia section under Photos. We also have a Screensaver calendar and you can download and use each month as your screensaver.Alzheimer's Forum is viewed from around the world Have a look at our summary of website views and a breakdown of the pages viewed to see the global impact of this website. Thank you for your support and for making Alzheimer's Forum so successful in broadening the awareness of Alzheimer's and dementia.
We have lots of new contributions under Thoughts and Experiences. Barry has written of his own thoughts about the Two Perspectives of Dementia, to show how the illness has affected him.
Go to the Multimedia section and listen Barry talk about the Four years within Alzheimer's. Download and print the new book Poetic Thoughts - a book of poems about Alzheimer's and dementia.
There are lots of new word puzzles for you to try. Have a look at our latest puzzle, it's all about the things you will find at the seaside.
Do you have a Predicament of the Month? Please send us your thoughts for the current predicament: WALKING, STUMBLING, BUMPING INTO EACH OTHER OR EVEN TRYING TO CROSS THE ROAD - HOW DOES IT AFFECT YOU? Email us and let us know. Share your views with others.
Look at the new poems in the Poetry section. There are two new very thought provoking poems from Norrms and Barry. Maybe you could send us a poem. Sometimes it's easier to get the message across through a poem. Why not have a go?
Remember you are never alone so email us as we want to hear from you. Click on the links on the left-hand-side menu to browse the contributions from other visitors to our website. Email us at friends@alzheimersforum.org.
Dementia and Sexuality
Sexuality and dementia
DownloadSexuality and dementia (pdf)
Information for people with dementia, their carers and their families. It looks at sexuality and intimacy when someone with dementia is living at home.
As dementia progresses needs change: existing relationships may have to adapt, new relationships may form, desires may fluctuate. What does not change is the right of every adult to be sexually alive should they wish to be so, regardless of age, ability or sexual preference. Sexuality is a basic need which people with dementia and their carers should be able to express without fear of disapproval.
Key pointsExisting relationshipsBalancing needs and desiresUnderstanding behaviour which seems sexualNew relationshipsSafe sexFurther helpFurther reading
Key points:
People with dementia have lived with their sexuality for much longer than they have lived with dementia.
Not everyone with dementia is old – in Scotland there are approximately 1600 people with early onset dementia (under 65).
Not everyone with dementia is heterosexual.
Not everyone chooses to exercise their right to be a sexual being.
Couples who work on their relationships can keep them stronger for longer.
Maintaining a healthy sex-life can improve overall quality of life for carers and people with dementia
Carers need to consider their own needs alongside those of people with dementia.
Sex and sensuality encompass a kaleidoscope of feelings and activities; from the deepest longings for mutual affection to the simple enjoyment of the company of a loved one. Sexuality also covers a gamut of behaviours – touching, kissing, caressing and cuddling, genital intercourse with mutual orgasm and feelings of closeness and being wanted and valued as a human being -Sex, Intimacy and Aged Care
Existing relationships
All relationships change with time. However, the increased physical and emotional dependency between partners which dementia brings can have a massive impact on even the strongest relationships.
People with dementia experience its progression in different ways and at different rates. As the ability to cope with ordinary life is gradually impaired, alterations in personality, presentation and behaviour (including sexual behaviour) may become more obvious. Loss of memory, declining physical health, inability to concentrate and growing confusion lead to greater dependency on carers. Inevitably this will impact on relationships and affect the way in which partners relate to each other both physically and emotionally.
Being provided with intimate personal care by a loved one can be a positive emotional experience for some people with dementia. For others it represents a loss of dignity and can have negative impact on how they feel about a sexual partner and about themselves.
Similarly for carers, the emotional effect of a partner’s increased dependency and need for physical care might change their sexual feelings towards them. Some carers may simply be too tired for sex or too emotionally overwhelmed to expend precious energy on the sexual aspects of their relationship. There are no easy solutions to coping with the ongoing changes in relationships. However, understanding that these changes are experienced by many people and having some insight into their causes can help.
Seeing beyond dementia
Sometimes what appear to be personality changes in a person with dementia are caused by sheer boredom, frustration at a misunderstood situation, unfamiliar surroundings or tasks which have become too difficult. Depression can be an underlying cause of personality changes in people with dementia but it can be successfully treated. Carers too can become overwhelmed, frustrated, depressed, anxious and stressed - emotions which their partner may sense and in turn be affected by.
It is important for many couples to have a safe place (this might be a friend, a support group, a helpline, a confidential internet chat-line, a counsellor) in which to air emotional issues affecting their relationship. Supportive family and friends are often vital both to the person with dementia and his or her carer. Support groups for people with early stage dementia and for carers are an excellent way for some people to exchange feelings, experiences and frustrations.
Other coping mechanisms that people have found useful include planning positive time apart to relax and build-up self-esteem. Some people are able to retain their sense of self by channelling energy into creative projects like writing poetry, listening to music, gardening, painting or keeping a journal.
If time apart is difficult to arrange or is not wanted then couples can focus on the positive aspects of their relationship by engaging in activities they still enjoy doing together. For example, putting together albums of photos and souvenirs which prompt positive reflections of past and present events, taking short trips to places and people they like visiting, dancing to favourite music, working together to complete simple household projects like baking or gardening. (See Alzheimer Scotland’s Activities booklet for more ideas.)
Redefining sexual intimacy
Redefining sexual intimacy is an enormous challenge, especially as the needs of both partners must be considered. A person with dementia may experience a loss of sexual manners and appear to be less thoughtful than they once were. A partner can address this by taking a more active role in finding a way to make sex pleasurable for both.
Although a person with dementia may forget how they used to please their partner and themselves during sex, what they will not lose is the need for intimacy and touch. However, for both partners feelings of guilt, despair, resentment, anger, worry and fear for the future can interfere with their ability to sustain a close intimate relationship. Therefore communication between partners is vital – sharing feelings and thoughts is a far more positive response to stress than nursing anxieties and grievances.
Increased interest in sex
Sometimes a person with dementia forgets that they have just had sex, or tries to initiate more sex than their partner can cope with. If a partner feels unequal to a person with dementia’s sexual needs then perhaps they can help them to masturbate in private. Where repeated demands for sex become overwhelming then gentle diversionary tactics may help such as getting involved in an activity together, or avoiding outright refusal by saying -
maybe later after I’ve...
Reduced interest in sex
Whilst some people with dementia may lose interest in sex they are likely to retain their need for physical contact. Gentle stroking and touching may be enough to replace a full sexual relationship and there are several other ways to incorporate touch into a care routine. For example, regular kissing and cuddling or patting and rubbing to allay distress and to communicate reassurance and love. The positive benefit of gentle hand massage using aromatherapy oils has been reported(1) and is another simple way to enjoy the feeling of shared touch.
For partners who no longer share a bed it may help the person with dementia to have something to cuddle, such as a soft toy, covered hot water bottle or even a pillow. This may seem a patronising response but should not be dismissed if it is found to be of comfort, especially to someone who has been used to the presence of another warm body beside them in bed for most of their adult life.
Different approaches
Physical ill-health or the side-effects of medication may affect either partner’s ability to have vigorous intercourse. Mutual masturbation and fondling can provide a less physical substitute but still be a rewarding way in which to express love and desire for each other. You should speak to your doctor if you think the side-effects of medication may be having an adverse effect or if you are worried about problems which may have an underlying physical cause – such as inability to have or to maintain an erection, premature ejaculation, vaginal dryness or loss of libido. (See Alzheimer Scotland’s booklet – Getting help from your doctor.) Couples should feel comfortable with whatever works for them within the context of a loving relationship and they should try not to be embarrassed if they need to seek help.
Balancing needs and desires
In some relationships the partner who is the carer may feel guilty because they still wish to have sex but the person with dementia has become passive and unresponsive. In these circumstances some carers start to feel that continuing to have sex with their partner is an abuse of the relationship, whilst others see maintaining their sex life as quite normal. Men in particular may feel that they are taking advantage of a partner who is compliant and unable to signal enjoyment, or indeed consent. It is important to learn to read non-verbal signals and to respect any sign of fear or reluctance from a partner with dementia. If this does becomes a matter of concern, it may help to speak to other carers, a relationship counsellor, or to a psychiatrist (see Further help).
Those involved with the support and care of the person with dementia will need to determine a number of things including:
is your partner still able to recognise you?
is your partner able to say no or able to show an ability to express their wishes and views?
As with all of us, a person with dementia’s sex life is deeply personal. If a person with dementia becomes the subject for discussion with professionals, their confidentiality and right to be treated with dignity and respect should be maintained, as should that of their carer.
Sexual aggression and an excessive interest in sex
Sometimes people with dementia can show an excessive interest in sex. They may appear to be sexually aggressive, demanding repeated sex from partners or they may attempt to have sex with people other than their partner. They may masturbate frequently or try to touch other people inappropriately. However, all of these kinds of behaviour are fairly rare(4) .
Dementia causes gradual damage to the brain which can change the way a person behaves. As with any behaviour it is helpful to consider the reasons the apparently sexual behaviour has occurred. Is the person with dementia signalling their need for closeness and reassurance? Are they angry because they no longer feel able to satisfy their partner? Could it be a by-product of medication they have been prescribed? This last is especially important as some drugs, including some anti-depressants, have side-effects which can cause excessive sexual interest and sexual arousal.
In extreme situations, where sexual aggression occurs, it may be difficult to manage. This is especially so when male partners are still physically strong. A carer may have to seek help to keep their partner, themselves and those around them safe in situations where the attentions of the person with dementia are violent or too persistent. It is important for a carer to recognise that their partner’s behaviour may be a component of their illness.
Domestic violence is a difficult subject to discuss because of the shame associated with it and an added sexual element may make it more embarrassing. For some couples the behaviour may be part of a long-learned pattern in a relationship which has been exacerbated by dementia. Although this is a difficult problem to discuss, other carers may provide useful help by sharing their experiences and advice. Day care workers, community psychiatric nurses (CPNs) and psychiatrists should also be a good source of practical support and guidance.
Understanding behaviour which seems sexual
There may be times when a person with dementia behaves in sexually inappropriate ways. For example, undressing at the wrong time, exposing themselves, masturbating in public, making what seem like sexual approaches, using obscene or sexually explicit language. Although this can embarrass a carer it is vital to remember that dementia affects a person’s understanding of social situations and therefore their ability to behave as might be expected.
Realising that apparently sexualised behaviour is the effect of dementia and seldom involves sexual arousal can help to depersonalise it and gives a carer the emotional distance to devise strategies for managing. Rather than "sort" the behaviour, it is helpful to consider the reasons why a person, any person – not just a person with dementia, would behave that way. For example, are they:
removing clothes because they are too hot, itchy, tight or uncomfortable?
exposing themselves because they need to go the bathroom?
bored and frustrated?
mistaking someone else for their partner?
expressing a need for touch?
misinterpreting the behaviour of other people?
How to help
When sexualised behaviour happens in public it is hard not to be shocked and to over-react. However, it is important to try to remain calm and not to communicate anger or distress to the person with dementia. What is not a good solution is to stop going out in public. Becoming isolated is bad for both carers and people with dementia.
Try to focus on the reasons why the person with dementia is behaving in a particular way (see above) and, if it is causing embarrassment, to distract them with something else.
If necessary, lead the person with dementia away from the situation, calmly and gently. Unless the situation is serious try to avoid physically restraining the person with dementia, as this may cause them to become more frustrated.
Speak to family and friends about understanding and dealing with potentially embarrassing situations.
Seek practical advice from other carers, and from social workers and healthcare professionals.
Learn from previous experiences. Try to identify the circumstances in which this behaviour is likeliest to happen. Are there cues? For example – is it when the person with dementia is tired or bored, is restless, starts blushing, or when they start picking at their clothing, or when they are in the company of particular people?
If you do manage to identify situations and/or triggers you will you be more prepared and better-equipped to cope if they happen again. Also, when you need a break from caring, you will be able to pass on practical guidance about how to look after your partner to a substitute carer.
New relationships
Respecting autonomy
Older people with dementia are faced with society’s reluctance to accept that sex is not the sole preserve of the young. Whilst younger people with dementia are less likely to have their sexual needs questioned they too may find that relatives worry on their behalf.
People with dementia are usually capable of forming new intimate relationships. Relatives, especially grown-up children, may have difficulty in acknowledging that parents are sexually alive or feel resentment that a new partner appears to be taking the place of a parent who has died. But all adults, regardless of age, have the right to make choices about their relationships and to have a private life. If those closest to a person with dementia are satisfied that their friend or relative is not physically or mentally vulnerable as the result of a relationship, and that no-one else is being harmed, then they should not attempt to interfere.
As long as a person with dementia is able to make decisions about their life then these decisions should be respected. Whilst a person with dementia is still capable of understanding what they are doing they may choose to set up a welfare power of attorney. A welfare power of attorney allows a person to make their wishes for the future clear and it only comes into force when the person to whom it applies becomes incapable. For more information see Alzheimer Scotland’s booklet Dementia - Money and Legal Matters: A Guide.
If protection becomes necessary
If families are still concerned that a relative with dementia is open to physical or emotional abuse in a relationship, then there are steps they can take. Initially they should share their fears with any professionals involved with their relative, such as GPs and social workers. If it becomes necessary to consult others about a person with dementia it is essential to respect their dignity and right to privacy. Those involved with the support and care of the person with dementia will need to determine a number of things including:
is that person comfortable with the relationship?
is that person still able to avoid exploitation?
is that person’s behaviour consistent with their prior beliefs and values?
is that person capable of saying no?
Sexual abuse of a person with dementia can constitute a criminal offence. It may also be a reason for the local authority to intervene to protect that person. Where an adult is unable to take decisions to protect their own interests, there are procedures to allow a family member to act on their behalf. For example, the person with dementia may have granted a welfare power of attorney. It is also possible for a family member or other concerned persons to seek an intervention or guardianship order.
For more help with this you can speak to your local authority social work department, a solicitor, the Public Guardian or the Mental Welfare Commission (see Further help). For more information see Alzheimer Scotland’s booklet Dementia - Money and Legal Matters: A Guide. Whatever the level of capacity of a person with dementia, their rights must come first.
Safe sex
The risk of sexual infection does not diminish with age. Contraception should still be a consideration for men of all ages and for younger women in heterosexual relationships. Sexually transmitted diseases (STDs), including HIV (human immunodeficiency virus) which causes AIDS (acquired immunodeficiency syndrome) are a potential danger to all those who are sexually active. Although most people in long-term relationships will have addressed the need for safe sex, in new relationships it is important that both partners discuss how they are going to protect themselves. GPs are a good source of advice on both family planning and safe sex.
Further help
For carers and people with dementia
Alzheimer Scotland Dementia Helpline The 24 hour Dementia Helpline, 0808 808 3000 is for:
people with dementia
carers
relatives
and anyone concerned about dementia.
DASN – Dementia Advocacy and Support NetworkA worldwide organisation run by and for those with dementia working together to improve their quality of life. As well as information about dementia, their website has links to chat rooms where people can meet on-line and to their e-mail community.Website: www.dasninternational.org/
Relationship counselling
GPSome surgeries now have NHS counselling services available.
Person Centred Therapy ScotlandTel: 0870 7650871E-mail: info@pctscotland.co.ukWebsite:www.pctscotland.co.ukHave a leaflet called 'Finding a counsellor in Scotland' and a directory of counsellors.
Couple Counselling Scotland40 North Castle Street, Edinburgh. EH2 3BNTel: 0131 225 5006E-mail: enquiries@couplecounselling.orgWebsite:www.couplecounselling.org/ Offers couples and individuals an opportunity to explore their intimate personal relationships in a safe and comfortable setting.
SPOD (Association to Aid the Sexual and Personal Relationships of People With a Disability)286 Camden Road, London. N7 OBJHelpline: 020 7607 8851. Tuesday 11.00am - 2.00 pm, Thursday 11.00am - 2.00pmE-mail: info@spod-uk.orgOffers advice on sex, sexuality and personal relationships tailored to the needs of disabled people.
The British Association for CounsellingBACP House, 35-37 Albert Street, Rugby. CV21 2SG.Tel: 0870 443 5252 (calls charged at national rate)E-mail: information@bacp.co.ukWebsite:www.bacp.co.uk Has a searchable database of therapists and holds a list of trained counsellors and psychotherapy organisations.
Lesbian, gay, bisexual and transgender support
Gay and Lesbian Carers Network, Alzheimer's SocietyGordon House, 10 Greencoat Place, London. SW1P 1PHE-mail: gaycarers@alzheimers.org.ukTel: Roger - 01843 220932, Arthur - 01273 628047, Bruce - 01865 847471 , Sally - 020 8675 0660Lesbian women and gay men caring for a partner, relative or friend with dementia face many challenges. The Network has trained and skilled volunteers able to offer a listening ear.
Scottish lesbian and gay switchboardsProvide telephone counselling and support on: sexuality, relationships and ‘coming out’; safer sex and sexual health and information on social life, support groups, housing, legal issues and employment. The service is completely confidential - regional numbers listed below.
Ayrshire - 01292 619 000Borders Gay Switchboard -Thursdays 7:30pm - 10 pm, Tel: 01896 756 611LGBT Youth Scotland: Dumfries & Galloway Service - Tel: 01387 739888; text line 0778 527 4147; e-mail: dandg@lgbtyouth.org.uk . Runs a group every Friday evening (6-9.30) for LGBT people over 26 plus a lunch-time drop in every Tuesday (12-2). Contact Christine.Layden@lgbtyouth.org.ukDundee LGB Switchboard - Mondays 7pm - 10 pm, Tel: 01382 202 620Fife Friend Fridays - Fridays 7:30pm - 10pm, Tel: 01592 266 688Grampian LGB Switchboard - Wednesdays and Fridays 7pm - 10pm, Tel: 01224 633 500Lothian Gay & Lesbian Switchboard - Nightly 7:30pm - 10pm, Tel: 0131 556 4049Lothian Lesbian Line - Mondays and Thursdays.7:30pm - 10pm, Tel: 0131 557 0751Moray LGB Switchboard - Men: Fridays. 7pm - 10pm, Tel: 01343 541 188 , Women: Thursdays 7pm – 10pmStrathclyde G&L Switchboard - Nightly 7pm - 10pm, Tel: 0141 332 8372Strathclyde Lesbian Line - Wednesdays 7:30pm - 10pm, Tel: 0141 354 0400
Help with intervention or guardianship orders
Mental Welfare Commission for ScotlandArgyle House, 3 Lady Lawson Street, Edinburgh. EH3 9SHTel: 0131 222 6111E-mail: enquiries@mwcscot.org.ukWebsite: www.mwcscot.org.ukSafeguards the rights and welfare of people with mental illness and learning disability both in hospital and living in the community.
Public GuardianOffice of the Public Guardian, Hadrian House, Callander Business Park, Callander Road, Falkirk. FK1 1XRTel: 01324 678300, Fax: 01324 678301E -mail: opg@scotcourts.gov.ukWebsite: www.publicguardian-scotland.gov.ukThe Public Guardian registers continuing and welfare powers of attorney, authorisations to access funds, guardianship orders and intervention orders pronounced in terms of the Act.
Further reading
Sex, Intimacy and Aged Care by Barbara ShermanJessica Kingsley Publishers Ltd, London 1999. £13.95.This book challenges us to examine our own attitudes. Stories of the experiences of caregivers, families of people affected by dementia illustrate the difficulties encountered by sexual partners, as well as the complexity of the situations confronting professional careworkers.
Sexuality and Dementia Video and Training Handbook by Carole ArchibaldUniversity of Stirling, 1994.Training handbook and supporting video focusing on the expression of sexuality by people with dementia and the subsequent difficulties experienced by care staff.It costs £40 to buy the full training pack, or £9.00 for the carers’ video but both can be borrowed from the Dementia Services Development Centre (details below). They also have, available for loan only, an American video about heterosexual couples where one partner has dementia, called A Thousand Tomorrows. Contact:Dementia Services Development Centre, University of Stirling, Stirling. FK9 4LATel: 01786 467740
Activities - a guide for people concerned about their memory, people with dementia and their carers, Alzheimer Scotland. £1.50 (post and packing free within the UK) – single copies free to carers and people with dementia in Scotland via the 24 hour Dementia Helpline 0808 808 3000. For carers who look after someone who has moderate to severe dementia and need help with planning daily activities. Keeping someone with dementia busy and engaged will become more difficult as the dementia progresses. However by focusing on what he or she can do, even when the illness is quite advanced, you can both enjoy a range of stimulating activities and outings together.
Getting help from your doctor – a guide for people worried about their memory, people with dementia and their carers, Alzheimer Scotland. £1.50 (post and packing free within the UK) - single copies free to carers and people with dementia in Scotland via the 24 hour Dementia Helpline 0808 808 3000. It will help you to find out how doctors and other health workers can help you. The information in this booklet will also help relatives or carers of people with dementia, and there is a section especially for them.
Don’t make the journey alone, Alzheimer Scotland. £1.50 (post and packing free within the UK) - single copies free to carers and people with dementia in Scotland via the 24 hour Dementia Helpline 0808 808 3000. Clearly presented information about dementia written by people with dementia for people with dementia.
Dementia – Money and Legal Matters: A Guide, Alzheimer Scotland. £3.50 (post and packing free within the UK) - single copies free to carers and people with dementia in Scotland via the 24 hour Dementia Helpline 0808 808 800. A 52 page booklet. This information is for people with early stage dementia and for people helping or caring for someone with dementia.
Acknowledgements
Thanks to Dr Carole Archibald of the Dementia Services Development Centre at the University of Stirling and staff at Alzheimer Scotland.
Feedback
Alzheimer Scotland actively seeks the views of people with dementia and their carers. If you have any comments or suggestions about this information sheet please send them to:Information DepartmentAlzheimer Scotland22 Drumsheugh GardensEdinburgh EH3 7RNE-mail: alzheimer@alzscot.org
DownloadSexuality and dementia (pdf)
Information for people with dementia, their carers and their families. It looks at sexuality and intimacy when someone with dementia is living at home.
As dementia progresses needs change: existing relationships may have to adapt, new relationships may form, desires may fluctuate. What does not change is the right of every adult to be sexually alive should they wish to be so, regardless of age, ability or sexual preference. Sexuality is a basic need which people with dementia and their carers should be able to express without fear of disapproval.
Key pointsExisting relationshipsBalancing needs and desiresUnderstanding behaviour which seems sexualNew relationshipsSafe sexFurther helpFurther reading
Key points:
People with dementia have lived with their sexuality for much longer than they have lived with dementia.
Not everyone with dementia is old – in Scotland there are approximately 1600 people with early onset dementia (under 65).
Not everyone with dementia is heterosexual.
Not everyone chooses to exercise their right to be a sexual being.
Couples who work on their relationships can keep them stronger for longer.
Maintaining a healthy sex-life can improve overall quality of life for carers and people with dementia
Carers need to consider their own needs alongside those of people with dementia.
Sex and sensuality encompass a kaleidoscope of feelings and activities; from the deepest longings for mutual affection to the simple enjoyment of the company of a loved one. Sexuality also covers a gamut of behaviours – touching, kissing, caressing and cuddling, genital intercourse with mutual orgasm and feelings of closeness and being wanted and valued as a human being -Sex, Intimacy and Aged Care
Existing relationships
All relationships change with time. However, the increased physical and emotional dependency between partners which dementia brings can have a massive impact on even the strongest relationships.
People with dementia experience its progression in different ways and at different rates. As the ability to cope with ordinary life is gradually impaired, alterations in personality, presentation and behaviour (including sexual behaviour) may become more obvious. Loss of memory, declining physical health, inability to concentrate and growing confusion lead to greater dependency on carers. Inevitably this will impact on relationships and affect the way in which partners relate to each other both physically and emotionally.
Being provided with intimate personal care by a loved one can be a positive emotional experience for some people with dementia. For others it represents a loss of dignity and can have negative impact on how they feel about a sexual partner and about themselves.
Similarly for carers, the emotional effect of a partner’s increased dependency and need for physical care might change their sexual feelings towards them. Some carers may simply be too tired for sex or too emotionally overwhelmed to expend precious energy on the sexual aspects of their relationship. There are no easy solutions to coping with the ongoing changes in relationships. However, understanding that these changes are experienced by many people and having some insight into their causes can help.
Seeing beyond dementia
Sometimes what appear to be personality changes in a person with dementia are caused by sheer boredom, frustration at a misunderstood situation, unfamiliar surroundings or tasks which have become too difficult. Depression can be an underlying cause of personality changes in people with dementia but it can be successfully treated. Carers too can become overwhelmed, frustrated, depressed, anxious and stressed - emotions which their partner may sense and in turn be affected by.
It is important for many couples to have a safe place (this might be a friend, a support group, a helpline, a confidential internet chat-line, a counsellor) in which to air emotional issues affecting their relationship. Supportive family and friends are often vital both to the person with dementia and his or her carer. Support groups for people with early stage dementia and for carers are an excellent way for some people to exchange feelings, experiences and frustrations.
Other coping mechanisms that people have found useful include planning positive time apart to relax and build-up self-esteem. Some people are able to retain their sense of self by channelling energy into creative projects like writing poetry, listening to music, gardening, painting or keeping a journal.
If time apart is difficult to arrange or is not wanted then couples can focus on the positive aspects of their relationship by engaging in activities they still enjoy doing together. For example, putting together albums of photos and souvenirs which prompt positive reflections of past and present events, taking short trips to places and people they like visiting, dancing to favourite music, working together to complete simple household projects like baking or gardening. (See Alzheimer Scotland’s Activities booklet for more ideas.)
Redefining sexual intimacy
Redefining sexual intimacy is an enormous challenge, especially as the needs of both partners must be considered. A person with dementia may experience a loss of sexual manners and appear to be less thoughtful than they once were. A partner can address this by taking a more active role in finding a way to make sex pleasurable for both.
Although a person with dementia may forget how they used to please their partner and themselves during sex, what they will not lose is the need for intimacy and touch. However, for both partners feelings of guilt, despair, resentment, anger, worry and fear for the future can interfere with their ability to sustain a close intimate relationship. Therefore communication between partners is vital – sharing feelings and thoughts is a far more positive response to stress than nursing anxieties and grievances.
Increased interest in sex
Sometimes a person with dementia forgets that they have just had sex, or tries to initiate more sex than their partner can cope with. If a partner feels unequal to a person with dementia’s sexual needs then perhaps they can help them to masturbate in private. Where repeated demands for sex become overwhelming then gentle diversionary tactics may help such as getting involved in an activity together, or avoiding outright refusal by saying -
maybe later after I’ve...
Reduced interest in sex
Whilst some people with dementia may lose interest in sex they are likely to retain their need for physical contact. Gentle stroking and touching may be enough to replace a full sexual relationship and there are several other ways to incorporate touch into a care routine. For example, regular kissing and cuddling or patting and rubbing to allay distress and to communicate reassurance and love. The positive benefit of gentle hand massage using aromatherapy oils has been reported(1) and is another simple way to enjoy the feeling of shared touch.
For partners who no longer share a bed it may help the person with dementia to have something to cuddle, such as a soft toy, covered hot water bottle or even a pillow. This may seem a patronising response but should not be dismissed if it is found to be of comfort, especially to someone who has been used to the presence of another warm body beside them in bed for most of their adult life.
Different approaches
Physical ill-health or the side-effects of medication may affect either partner’s ability to have vigorous intercourse. Mutual masturbation and fondling can provide a less physical substitute but still be a rewarding way in which to express love and desire for each other. You should speak to your doctor if you think the side-effects of medication may be having an adverse effect or if you are worried about problems which may have an underlying physical cause – such as inability to have or to maintain an erection, premature ejaculation, vaginal dryness or loss of libido. (See Alzheimer Scotland’s booklet – Getting help from your doctor.) Couples should feel comfortable with whatever works for them within the context of a loving relationship and they should try not to be embarrassed if they need to seek help.
Balancing needs and desires
In some relationships the partner who is the carer may feel guilty because they still wish to have sex but the person with dementia has become passive and unresponsive. In these circumstances some carers start to feel that continuing to have sex with their partner is an abuse of the relationship, whilst others see maintaining their sex life as quite normal. Men in particular may feel that they are taking advantage of a partner who is compliant and unable to signal enjoyment, or indeed consent. It is important to learn to read non-verbal signals and to respect any sign of fear or reluctance from a partner with dementia. If this does becomes a matter of concern, it may help to speak to other carers, a relationship counsellor, or to a psychiatrist (see Further help).
Those involved with the support and care of the person with dementia will need to determine a number of things including:
is your partner still able to recognise you?
is your partner able to say no or able to show an ability to express their wishes and views?
As with all of us, a person with dementia’s sex life is deeply personal. If a person with dementia becomes the subject for discussion with professionals, their confidentiality and right to be treated with dignity and respect should be maintained, as should that of their carer.
Sexual aggression and an excessive interest in sex
Sometimes people with dementia can show an excessive interest in sex. They may appear to be sexually aggressive, demanding repeated sex from partners or they may attempt to have sex with people other than their partner. They may masturbate frequently or try to touch other people inappropriately. However, all of these kinds of behaviour are fairly rare(4) .
Dementia causes gradual damage to the brain which can change the way a person behaves. As with any behaviour it is helpful to consider the reasons the apparently sexual behaviour has occurred. Is the person with dementia signalling their need for closeness and reassurance? Are they angry because they no longer feel able to satisfy their partner? Could it be a by-product of medication they have been prescribed? This last is especially important as some drugs, including some anti-depressants, have side-effects which can cause excessive sexual interest and sexual arousal.
In extreme situations, where sexual aggression occurs, it may be difficult to manage. This is especially so when male partners are still physically strong. A carer may have to seek help to keep their partner, themselves and those around them safe in situations where the attentions of the person with dementia are violent or too persistent. It is important for a carer to recognise that their partner’s behaviour may be a component of their illness.
Domestic violence is a difficult subject to discuss because of the shame associated with it and an added sexual element may make it more embarrassing. For some couples the behaviour may be part of a long-learned pattern in a relationship which has been exacerbated by dementia. Although this is a difficult problem to discuss, other carers may provide useful help by sharing their experiences and advice. Day care workers, community psychiatric nurses (CPNs) and psychiatrists should also be a good source of practical support and guidance.
Understanding behaviour which seems sexual
There may be times when a person with dementia behaves in sexually inappropriate ways. For example, undressing at the wrong time, exposing themselves, masturbating in public, making what seem like sexual approaches, using obscene or sexually explicit language. Although this can embarrass a carer it is vital to remember that dementia affects a person’s understanding of social situations and therefore their ability to behave as might be expected.
Realising that apparently sexualised behaviour is the effect of dementia and seldom involves sexual arousal can help to depersonalise it and gives a carer the emotional distance to devise strategies for managing. Rather than "sort" the behaviour, it is helpful to consider the reasons why a person, any person – not just a person with dementia, would behave that way. For example, are they:
removing clothes because they are too hot, itchy, tight or uncomfortable?
exposing themselves because they need to go the bathroom?
bored and frustrated?
mistaking someone else for their partner?
expressing a need for touch?
misinterpreting the behaviour of other people?
How to help
When sexualised behaviour happens in public it is hard not to be shocked and to over-react. However, it is important to try to remain calm and not to communicate anger or distress to the person with dementia. What is not a good solution is to stop going out in public. Becoming isolated is bad for both carers and people with dementia.
Try to focus on the reasons why the person with dementia is behaving in a particular way (see above) and, if it is causing embarrassment, to distract them with something else.
If necessary, lead the person with dementia away from the situation, calmly and gently. Unless the situation is serious try to avoid physically restraining the person with dementia, as this may cause them to become more frustrated.
Speak to family and friends about understanding and dealing with potentially embarrassing situations.
Seek practical advice from other carers, and from social workers and healthcare professionals.
Learn from previous experiences. Try to identify the circumstances in which this behaviour is likeliest to happen. Are there cues? For example – is it when the person with dementia is tired or bored, is restless, starts blushing, or when they start picking at their clothing, or when they are in the company of particular people?
If you do manage to identify situations and/or triggers you will you be more prepared and better-equipped to cope if they happen again. Also, when you need a break from caring, you will be able to pass on practical guidance about how to look after your partner to a substitute carer.
New relationships
Respecting autonomy
Older people with dementia are faced with society’s reluctance to accept that sex is not the sole preserve of the young. Whilst younger people with dementia are less likely to have their sexual needs questioned they too may find that relatives worry on their behalf.
People with dementia are usually capable of forming new intimate relationships. Relatives, especially grown-up children, may have difficulty in acknowledging that parents are sexually alive or feel resentment that a new partner appears to be taking the place of a parent who has died. But all adults, regardless of age, have the right to make choices about their relationships and to have a private life. If those closest to a person with dementia are satisfied that their friend or relative is not physically or mentally vulnerable as the result of a relationship, and that no-one else is being harmed, then they should not attempt to interfere.
As long as a person with dementia is able to make decisions about their life then these decisions should be respected. Whilst a person with dementia is still capable of understanding what they are doing they may choose to set up a welfare power of attorney. A welfare power of attorney allows a person to make their wishes for the future clear and it only comes into force when the person to whom it applies becomes incapable. For more information see Alzheimer Scotland’s booklet Dementia - Money and Legal Matters: A Guide.
If protection becomes necessary
If families are still concerned that a relative with dementia is open to physical or emotional abuse in a relationship, then there are steps they can take. Initially they should share their fears with any professionals involved with their relative, such as GPs and social workers. If it becomes necessary to consult others about a person with dementia it is essential to respect their dignity and right to privacy. Those involved with the support and care of the person with dementia will need to determine a number of things including:
is that person comfortable with the relationship?
is that person still able to avoid exploitation?
is that person’s behaviour consistent with their prior beliefs and values?
is that person capable of saying no?
Sexual abuse of a person with dementia can constitute a criminal offence. It may also be a reason for the local authority to intervene to protect that person. Where an adult is unable to take decisions to protect their own interests, there are procedures to allow a family member to act on their behalf. For example, the person with dementia may have granted a welfare power of attorney. It is also possible for a family member or other concerned persons to seek an intervention or guardianship order.
For more help with this you can speak to your local authority social work department, a solicitor, the Public Guardian or the Mental Welfare Commission (see Further help). For more information see Alzheimer Scotland’s booklet Dementia - Money and Legal Matters: A Guide. Whatever the level of capacity of a person with dementia, their rights must come first.
Safe sex
The risk of sexual infection does not diminish with age. Contraception should still be a consideration for men of all ages and for younger women in heterosexual relationships. Sexually transmitted diseases (STDs), including HIV (human immunodeficiency virus) which causes AIDS (acquired immunodeficiency syndrome) are a potential danger to all those who are sexually active. Although most people in long-term relationships will have addressed the need for safe sex, in new relationships it is important that both partners discuss how they are going to protect themselves. GPs are a good source of advice on both family planning and safe sex.
Further help
For carers and people with dementia
Alzheimer Scotland Dementia Helpline The 24 hour Dementia Helpline, 0808 808 3000 is for:
people with dementia
carers
relatives
and anyone concerned about dementia.
DASN – Dementia Advocacy and Support NetworkA worldwide organisation run by and for those with dementia working together to improve their quality of life. As well as information about dementia, their website has links to chat rooms where people can meet on-line and to their e-mail community.Website: www.dasninternational.org/
Relationship counselling
GPSome surgeries now have NHS counselling services available.
Person Centred Therapy ScotlandTel: 0870 7650871E-mail: info@pctscotland.co.ukWebsite:www.pctscotland.co.ukHave a leaflet called 'Finding a counsellor in Scotland' and a directory of counsellors.
Couple Counselling Scotland40 North Castle Street, Edinburgh. EH2 3BNTel: 0131 225 5006E-mail: enquiries@couplecounselling.orgWebsite:www.couplecounselling.org/ Offers couples and individuals an opportunity to explore their intimate personal relationships in a safe and comfortable setting.
SPOD (Association to Aid the Sexual and Personal Relationships of People With a Disability)286 Camden Road, London. N7 OBJHelpline: 020 7607 8851. Tuesday 11.00am - 2.00 pm, Thursday 11.00am - 2.00pmE-mail: info@spod-uk.orgOffers advice on sex, sexuality and personal relationships tailored to the needs of disabled people.
The British Association for CounsellingBACP House, 35-37 Albert Street, Rugby. CV21 2SG.Tel: 0870 443 5252 (calls charged at national rate)E-mail: information@bacp.co.ukWebsite:www.bacp.co.uk Has a searchable database of therapists and holds a list of trained counsellors and psychotherapy organisations.
Lesbian, gay, bisexual and transgender support
Gay and Lesbian Carers Network, Alzheimer's SocietyGordon House, 10 Greencoat Place, London. SW1P 1PHE-mail: gaycarers@alzheimers.org.ukTel: Roger - 01843 220932, Arthur - 01273 628047, Bruce - 01865 847471 , Sally - 020 8675 0660Lesbian women and gay men caring for a partner, relative or friend with dementia face many challenges. The Network has trained and skilled volunteers able to offer a listening ear.
Scottish lesbian and gay switchboardsProvide telephone counselling and support on: sexuality, relationships and ‘coming out’; safer sex and sexual health and information on social life, support groups, housing, legal issues and employment. The service is completely confidential - regional numbers listed below.
Ayrshire - 01292 619 000Borders Gay Switchboard -Thursdays 7:30pm - 10 pm, Tel: 01896 756 611LGBT Youth Scotland: Dumfries & Galloway Service - Tel: 01387 739888; text line 0778 527 4147; e-mail: dandg@lgbtyouth.org.uk . Runs a group every Friday evening (6-9.30) for LGBT people over 26 plus a lunch-time drop in every Tuesday (12-2). Contact Christine.Layden@lgbtyouth.org.ukDundee LGB Switchboard - Mondays 7pm - 10 pm, Tel: 01382 202 620Fife Friend Fridays - Fridays 7:30pm - 10pm, Tel: 01592 266 688Grampian LGB Switchboard - Wednesdays and Fridays 7pm - 10pm, Tel: 01224 633 500Lothian Gay & Lesbian Switchboard - Nightly 7:30pm - 10pm, Tel: 0131 556 4049Lothian Lesbian Line - Mondays and Thursdays.7:30pm - 10pm, Tel: 0131 557 0751Moray LGB Switchboard - Men: Fridays. 7pm - 10pm, Tel: 01343 541 188 , Women: Thursdays 7pm – 10pmStrathclyde G&L Switchboard - Nightly 7pm - 10pm, Tel: 0141 332 8372Strathclyde Lesbian Line - Wednesdays 7:30pm - 10pm, Tel: 0141 354 0400
Help with intervention or guardianship orders
Mental Welfare Commission for ScotlandArgyle House, 3 Lady Lawson Street, Edinburgh. EH3 9SHTel: 0131 222 6111E-mail: enquiries@mwcscot.org.ukWebsite: www.mwcscot.org.ukSafeguards the rights and welfare of people with mental illness and learning disability both in hospital and living in the community.
Public GuardianOffice of the Public Guardian, Hadrian House, Callander Business Park, Callander Road, Falkirk. FK1 1XRTel: 01324 678300, Fax: 01324 678301E -mail: opg@scotcourts.gov.ukWebsite: www.publicguardian-scotland.gov.ukThe Public Guardian registers continuing and welfare powers of attorney, authorisations to access funds, guardianship orders and intervention orders pronounced in terms of the Act.
Further reading
Sex, Intimacy and Aged Care by Barbara ShermanJessica Kingsley Publishers Ltd, London 1999. £13.95.This book challenges us to examine our own attitudes. Stories of the experiences of caregivers, families of people affected by dementia illustrate the difficulties encountered by sexual partners, as well as the complexity of the situations confronting professional careworkers.
Sexuality and Dementia Video and Training Handbook by Carole ArchibaldUniversity of Stirling, 1994.Training handbook and supporting video focusing on the expression of sexuality by people with dementia and the subsequent difficulties experienced by care staff.It costs £40 to buy the full training pack, or £9.00 for the carers’ video but both can be borrowed from the Dementia Services Development Centre (details below). They also have, available for loan only, an American video about heterosexual couples where one partner has dementia, called A Thousand Tomorrows. Contact:Dementia Services Development Centre, University of Stirling, Stirling. FK9 4LATel: 01786 467740
Activities - a guide for people concerned about their memory, people with dementia and their carers, Alzheimer Scotland. £1.50 (post and packing free within the UK) – single copies free to carers and people with dementia in Scotland via the 24 hour Dementia Helpline 0808 808 3000. For carers who look after someone who has moderate to severe dementia and need help with planning daily activities. Keeping someone with dementia busy and engaged will become more difficult as the dementia progresses. However by focusing on what he or she can do, even when the illness is quite advanced, you can both enjoy a range of stimulating activities and outings together.
Getting help from your doctor – a guide for people worried about their memory, people with dementia and their carers, Alzheimer Scotland. £1.50 (post and packing free within the UK) - single copies free to carers and people with dementia in Scotland via the 24 hour Dementia Helpline 0808 808 3000. It will help you to find out how doctors and other health workers can help you. The information in this booklet will also help relatives or carers of people with dementia, and there is a section especially for them.
Don’t make the journey alone, Alzheimer Scotland. £1.50 (post and packing free within the UK) - single copies free to carers and people with dementia in Scotland via the 24 hour Dementia Helpline 0808 808 3000. Clearly presented information about dementia written by people with dementia for people with dementia.
Dementia – Money and Legal Matters: A Guide, Alzheimer Scotland. £3.50 (post and packing free within the UK) - single copies free to carers and people with dementia in Scotland via the 24 hour Dementia Helpline 0808 808 800. A 52 page booklet. This information is for people with early stage dementia and for people helping or caring for someone with dementia.
Acknowledgements
Thanks to Dr Carole Archibald of the Dementia Services Development Centre at the University of Stirling and staff at Alzheimer Scotland.
Feedback
Alzheimer Scotland actively seeks the views of people with dementia and their carers. If you have any comments or suggestions about this information sheet please send them to:Information DepartmentAlzheimer Scotland22 Drumsheugh GardensEdinburgh EH3 7RNE-mail: alzheimer@alzscot.org
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