Health and Family, April 2015

Health&Family FREE TAKE ONE! • FREE TAKE ONE! • FREE TAKE ONE! Southern Kentucky

Vol. 11 Issue 4 • April 2015

A PUBLICATION OF THE COMMONWEALTH JOURNAL

Journal

The Art of Slowing Down Living with Rosacea Child Abuse Awareness Month

Walk-in Clinic vs ER Visit Addressing the Homeless in Pulaski County

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Southern Kentucky Health & Family Journal - April 2015

This child is in line. We all like to be “in line” don’t we?

That means soon, we are going to get some sort of attention.

But, we don’t want to be in her line. She is in line to be one of the estimated 1,640 children who die as a result

of abuse and neglect.

That equals between four and five children per day….in the United States.

Did you know that more than 70% of children who died as a result of abuse or neglect were 2 years of age or younger? More than 80% were not yet

old enough for kindergarten? That around 80% of the deaths involve at least one parent as perpetrator?

Adanta’s Parenting Classes provide knowledge, skills, and resources to promote the social and emotional well-being of your child.

Call us. We Help People Every Day. 1.800.954.4782 x 0 Southern Kentucky Health & Family Journal - April 2015

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&

INDEX

Health Family Journal Southern Kentucky

Walk-in Clinic vs ER Visit

by Tricia Neal.............................................. 5

Volume 11 Issue 4 April 2015

PUBLISHER

Time for Some Financial “Spring Cleaning” Edward Jones Advertorial.......................... 9

Rob McCullough

EDITOR-IN-CHIEF Ken Shmidheiser

CONTRIBUTING WRITERS Cindy Lackey Tim Minton Tricia Neal

Catherine Pond Don White

LAYOUT & DESIGN Pam Popplewell

Red in the face?

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There’s help for that by

ADVERTISING

Cindy Lackey

Mike Hornback/Advertising Director Mary Ann Flynn Mike McCollom Amanda McIntosh Kraig Price Craig Wesley Southern Kentucky Health & Family Journal is a publication of and is distributed by Newspaper Holdings, Inc. All rights reserved. No part of this publication may be reproduced or stored for retrieval by any means without written permission from the publisher. Southern Kentucky Health & Family Journal is not responsible for unsolicited materials and the publisher accepts no responsibility for the contents or accuracy of claims in any advertisement in any issue. Southern Kentucky Health & Family Journal is not responsible or liable for any errors, omissions, or changes in information. The opinions of contributing writers do not necessarily reflect the opinion of the magazine and its publisher.

mhornback@somerset-kentucky.com 4

Joint Therapy

by Tricia Neal............................................ 27

Menopause 101 Things Your Mother (Probably) Didn’t Tell You Catherine Pond........................................ 30

Janie Gumm-Wright

Southern Kentucky Health & Family Journal P.O. Box 859 Somerset, KY 42502 Email:

April is Alcohol Awareness Month Jamie S. Burton, Adanta.......................... 22

Signs Your Aging Loved One Needs Support Helping Hands advertorial...................... 28

Kathy M. Lee

© 2015 Newspaper Holdings, Inc.

Wanna Know a Secret?

Child Abuse Awareness Month Jamie S. Burton, Adanta.......................... 14

Container Gardening for Senior Health Comfort Keepers advertorial................... 33 Addressing the Homeless of Pulaski County

by Tim Minton......................................... 35

24 The Art of Slowing Down by

Catherine Pond

Don’t Let Injuries Put You on the Bench Total Rehab advert.................................. 37 Senior Calendar Lake Cumberland Regional Hospital....... 38

COVER PHOTO: Spring is a great time of year to reemerge from bad habits or winter-forced seclusions. We are outside again, we can be in the natural world, and we might start to plan vacations, go to the golf course, or fish, or take a boat out on Lake Cumberland.

Southern Kentucky Health & Family Journal - April 2015

vs

Walk-in clinic

By Tricia Neal

Illnesses and injuries pay no attention to time. If you wake up on a Monday morning with symptoms of a sinus infection, you might be lucky enough to be able to see your family doctor by Monday afternoon. But many times, problems arise at night or on weekends – or your doctor might not have an appointment available until the following day - and then, sometimes, it’s hard to know the best course of action to take.

Your child starts vomiting at 7 p.m. on a Friday. Your latenight woodworking project leads to a nasty cut. Disconcerting chest pain at the end of your work day makes you think you shouldn’t put off seeing a doctor.

Sometimes it isn’t so much the time of day as it is the severity of the problem which leaves you wondering whether you should see a regular doctor or go to the emergency room.

Is your husband’s sudden stomach pain a simple belly ache or a sign of something much worse? Is your baby’s 103 degree fever high enough to warrant a trip to the emergency room?

The staff at Lake Cumberland Regional Hospital and Lake Cumberland Medical Associates wants you to know that there are plenty of options available for all kinds of patients – and that there are a few guidelines you can follow when deciding which option is best for you at the time.

When to see your family physician:

Medical professionals encourage all individuals to develop a relationship with a family doctor. Your physician can see you on a regular basis for general health check-ups, and can monitor the progression of your health over a period of time.

If you have or develop certain conditions such as diabetes, high

Southern Kentucky Health & Family Journal - April 2015

ER visit

blood pressure, or chronic illnesses, your family doctor is the best person to give you advice concerning how to handle those issues.

Since your family doctor will be the most knowledgeable about your medical history and any current health conditions, he or she will also be the best person to prescribe medicine or other treatments if you, for example, come down with a cold, develop a rash, or notice that you’re having recurring headaches.

The only disadvantage to getting treatment from your family doctor is that most doctors’ offices have daytime hours, and they are usually closed on weekends. During those times, it’s important for you to know that you have other options available if you or a loved one needs medical attention.

When to get to the emergency room:

Some emergencies are obvious. A broken bone, loss of consciousness, or a severe allergic reaction are all examples of instances which require immediate medical attention.

Sometimes, though, patients question whether certain conditions are severe enough to require a trip to the emergency room. In those cases, Patrick Shepherd, RN, RCIS, director of Emergency Services at LCRH, says it’s better to be safe than sorry. Emergency room workers are required to treat any patient who comes to the hospital with any condition, regardless of his or her ability to pay, and no one will be penalized for coming to the emergency room for help with an issue which doesn’t turn out to be critical.

“If your perspective is that you’re having an emergency, 5

Patrick Shepherd, RN, RCIS, Director of Emergency Services at Lake Cumberland Regional Hospital, reviews emergency room patient information with Lisa and Tammy, Emergency Department nurses.

you should go to the emergency room,” Shepherd says. “If it turns out that it’s not an emergency, that’s OK.” It should be noted, however, that patients who arrive in the emergency room are seen based on their “Emergency Severity Index” (ESI) rating, and not on a first come, first served basis. Your ESI will be determined by a triage nurse when you arrive at the ER. “We are here to treat everyone, but our main goal is to prevent death or disability,” Shepherd says. “We will take care of our sickest patients first.”

One or two physicians are on duty in the emergency room at all times, along with several mid-level providers, registered nurses, paramedics and ER technicians.

While it is important to go to an emergency room for treatment for severe illnesses or injuries, the cost to the patient is usually significantly higher for an ER visit than it is for a visit to a family doctor or to a walk-in clinic - so it would be wise to only go to an emergency room when absolutely necessary. If your minor illness or injury occurs during a time when both your family doctor’s office and the Walk-In Clinic are closed, however – and if you feel that you 6

can’t wait until a time when either of those places are open – a trip to the emergency room might be necessary.

Here are some illnesses and injuries which should be treated in an emergency room: -Sudden or severe abdominal pain -Allergic reactions with difficulty breathing, swallowing, or accompanied by a swollen tongue -Severe asthma attacks -Broken bones -Severe burns or cuts -Chest pain or chest pressure -Coughing up or vomiting up blood -Sudden eye pain -High fever -Head trauma -Loss of consciousness -Mental confusion or sudden difficulty talking -Sudden change in vision -Numbness in the arms, legs or face -Weakness on one side of the body Southern Kentucky Health & Family Journal - April 2015

-Sudden or severe shortness of breath -Fever accompanied by stiff neck -Severe bleeding Shepherd says you or someone you know should call 911 so you can be transported to the emergency room in an ambulance if you’re having chest pains or experiencing any symptoms of a heart attack or stroke. (The most obvious symptoms of a heart attack include chest pain or pressure; pain in the arms, neck, back, jaw, or stomach; shortness of breath; or nausea, lightheadedness, or a “cold sweat.”

The most obvious stroke symptoms include “facial droop,” slurred speech or difficulty speaking, or an inability to raise one arm.) Ambulances are equipped with machines which can check your vital signs and transmit that information to the hospital before you even arrive – shaving many valuable minutes off the length of time it will take you to get treatment.

Michael E. Pope DMD

www.southerndentalgroup.net • 606-678-0874

Another convenient option is available for patients who might not have an emergency, but who don’t want to wait to make an appointment with their doctor.

This option might not only save time, but it will also likely save money when compared to making a trip to the emergency room.

The Lake Cumberland Medical Associates Walk-In Clinic is located on the first floor of the Lake Cumberland Medical Arts building, right behind Lake Cumberland Regional Hospital. The clinic is open Mondays through Fridays from 8 a.m. to 8 p.m., Saturdays from 9 a.m. to 8 p.m., and Sundays from 10 a.m. to 6 p.m. It is not necessary to make an appointment at a walk-in clinic.

Patients are seen in the order in which they arrive, and the wait time should be manageable for people who have nonemergency illnesses or injuries.

The operating hours of the Walk-In Clinic probably provide you with your first clue about when you should choose to get medical attention there as opposed to a regular doctor’s office. If your daughter develops a sore throat on a Friday night, you’re going to want to find out whether she needs medicine or other treatment before the doctor’s office opens on Monday morning. If you cut your finger while cooking Sunday dinner, you might need stitches right away. Any illness or injury which doesn’t require emergency treatment can be treated at the Walk-In Clinic – and that treatment can be obtained at a time that’s convenient for you.

“We are an acute care clinic,” explains Robin S. Goff, APRN, MSN, NP-C. “We treat minor illnesses and injuries which are not quite severe enough for the emergency room, but which you might not want to wait on a doctor’s

When to visit a “walk-in” clinic:

Southern Kentucky Health & Family Journal - April 2015

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Laura, LPN, LRT (left) and Evelyn, LPN, LRT (right) review a patient’s chart with Robin Goff at the Lake Cumberland Medical Associates’ Walk-in Clinic. Goff is a Family Nurse Practitioner with 18 years of healthcare experience, caring for patients both at Lake Cumberland Regional Hospital and Lake Cumberland Medical Associates.

appointment for. … We don’t take regular patients here, though. We keep a list of family doctors who are taking patients, and we encourage you to schedule an appointment with a family doctor if you don’t have one.”

Main health care providers at the LCMA Walk-In Clinic are Goff; David Reilly, M.D.; and Venda Kelly, APRN. Patients may also see Daniel Gallo, M.D., FAAP, FACP; Jonathan Ruby, M.D.; J. Barry Dixon, M.D.; and Jeffery W. Golden, M.D. “We can do most bloodwork, we can do X-rays, we can do suturing, splints, and minor procedures,” Goff says. “If it’s not severe, we can take care of it. We can also make referrals – send you to a specialist – for recurring problems.”

Here are some illnesses and injuries which can be treated at a walk-in clinic: -Nausea or vomiting -Mild abdominal pain -Diarrhea -Minor allergic reactions -Rashes and skin irritations -Animal bites -Mild shortness of breath -Mild asthma attacks -Sprains and strains -Back pain -Injuries requiring stitches -Painful urination -Minor burns, cuts and scrapes -Common cold, sinus, and flu symptoms -Minor coughs and sore throats -Ear aches -Eye redness -Mild to moderate fevers -Minor headaches 8

While you are welcome to go to the emergency room with any of the above-listed symptoms, bear in mind that you will be seen based on the severity of your condition. At the Walk-In Clinic, patients are, for the most part, seen in the order in which they arrive. If you come to the emergency room with an ear ache, you won’t be treated until patients with heart attack symptoms or severe injuries have been treated. If you come to the Walk-In Clinic with an ear ache, you’ll be seen after those who have come ahead of you have been seen.

The staff at the Walk-In Clinic is trained to recognize illnesses or injuries which require more advanced treatment than they can give – or which require immediate treatment. Therefore, if you come to the Walk-In Clinic with chest pains, the staff will most likely transport you by wheelchair to the emergency room so you can be checked to see if you’re having a heart attack.

Goff says the cost to a patient to visit a walkin clinic is usually comparable to the cost of a visit to a family doctor – which is significantly lower than a visit to an emergency room.

The Walk-In Clinic is closed on Thanksgiving Day and Christmas Day. The clinic may also be closed due to winter weather. If there is any question about whether the clinic may be open, patients can call (606) 451-2601 or check Lake Cumberland Regional Hospital’s Facebook page.

Patrick Shepherd has been the director of emergency services at LCRH for nearly three years. He has worked for LCRH in various positions off and on since 2000, and has also worked in hospitals in Tennessee and Georgia.

Robin Goff began working as a nurse’s aide when he was 19 years old. He’s obtained several degrees, with his most recent being a master’s degree in 2014. He started working as a nurse at the Walk-In Clinic in 1999, and progressed to become supervisor of occupational medicine and, later, nursing supervisor. This year, he became a full time Family Nurse Practitioner at the clinic. He just completed his 18th year as an LCRH/LCMA employee.

Tricia Neal is a freelance writer

Southern Kentucky Health & Family Journal - April 2015

FINANCIAL FOCUS

Time for Some Financial “Spring Cleaning” We’ve just about arrived at spring, the time when many people spruce up their homes, yards and other parts of their surroundings. This year, why not extend that practice a little further and give your financial and investment environment a good “spring cleaning”?

Here are a few suggestions for doing just that:

CHUCK SOBIECK

FINANCIAL ADVISOR

BY APPOINTMENT ONLY 71 IMAGING DRIVE SOMERSET, KY 42503 BUS. 606-678-0326 TF. 800-585-2659

www.edwardjones.com Edward Jones Member SIPC

Reduce duplication. If you’ve ever worked to “de-clutter” your home, you may have discovered a lot of extraneous items. Did you really need three blenders?

Did you have more remote control devices than you did televisions? As you look through your investment portfolio, you might also find some duplication, perhaps in the form of multiple stocks of companies in the same industry. You might want to consider whether you’d be better off by reducing this concentration and using the proceeds to broaden your investment mix to create new potential for growth, income or a combination of both.

Repair your “roof.” As part of your exterior spring-cleaning efforts, you might examine your roof to determine if you need to repair or replace any torn or missing shingles. After all, a strong roof is essential to protecting your home. And your financial foundation needs protection, too — so, review your life and disability insurance to ensure they are still adequate to meet your family’s needs. You also might want to consult with a financial professional for ways of dealing with the potentially devastating costs of an extended nursing home stay or another type of longterm care.

Plant some “seeds.” Spring is a good time for re-seeding parts of your lawn that

may be bare. Once you’ve planted the seeds, of course, you’ll need to water and fertilize them to encourage growth. As you look over your financial landscape, you may also find areas that are somewhat barren. For example, you might be adequately funding your own retirement goals through your employer-sponsored retirement plan and other investments, but are you putting away enough money for your children’s college education? If not, you might need to “plant some seeds” for potential growth by investing in a college savings account, such as a 529 plan. And you may need to continually “nourish” your plan by contributing money each year.

Update your “furnishings.” When you bought and arranged your home’s furnishings, they might have been perfectly suited for your needs. But now, many years later, your situation may be quite different. Perhaps you’ve said goodbye to grown children who have struck out on their own, so you might want to make new uses for old rooms. And maybe your old “stuff” just isn’t as comfortable as it was before, or the layout of your furniture isn’t as efficient. Whatever the case, it may well be time to update your environment.

And the same thing can happen with your financial “house.” To reflect changes in your family situation, employment, economic circumstances, retirement goals and other factors, you will need to periodically review your financial strategy and your investment portfolio, and make adjustments as needed.

Tidying up your living space may help improve your overall outlook on life. The same might be said of a financial spring cleaning — and you won’t even need a mop.

This article was written by Edward Jones for use by your local Edward Jones Financial Advisor.

Southern Kentucky Health & Family Journal - April 2015

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Red in the face?

There’s help for that

By Cindy J. Lackey Do you blush easily? Is your face red most or all of the time? Are you frustrated by breakouts of what appears to be acne?

Then you may have rosacea – a skin condition that afflicts 16 million Americans.

Rosacea faces you may recognize include President Bill Clinton, actress Cynthia Nixon, singer Sam Smith, celebrity chef Lisa Faulkner, and Diana, Princess of Wales.

Anyone can develop rosacea. If you have fair skin, or if you are older than

30, then you are more likely to have it.

The cause is unknown.

Rosacea often begins with a tendency to blush easily. Over time, your face – especially in the center – may appear red all the time.

If you think you have rosacea, then seeking help is important. There is no cure, but treatment can prevent the worst symptoms, which can become permanent.

Also, what you may mistake for rosacea could be a more serious skin problem. Only a dermatologist can tell you for sure.

Confirming Rosacea “A lot of people who have red faces are thought to have rosacea, but they actually don’t,” explained Robert H. Schosser, MD, a board-certified dermatologist at Dermatology of Southern Kentucky. “It could actually be something else, such as sun damage.”

Schosser, a native of Benham, Ky., has practiced dermatology for 34 years.

He moved to Somerset last year at the invitation of his former medical school student, Brian L. Baker, MD, who opened Dermatology of Southern Kentucky in 2008.

Subtype 1 (erythematotelangiectatic rosacea) symptoms are flushing, redness and perhaps visible blood vessels.

Credit: The American Academy of Dermatology, National Library of Dermatologic Teaching Slides.

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Southern Kentucky Health & Family Journal - April 2015

“It’s easy to overlook these things,” he said. “Particularly on the face, around the nose, you may see a bump and dismiss it as acne or rosacea. It may fade, and you think, ‘Good, it’s gone,’ but then it comes back. It could turn out to be a basal cell skin cancer.”

“That actually happened to me,” Schosser admitted. “For about four months, I had a bump on my nose.

I thought it was just a zit. It wasn’t something other people noticed, but I saw it.”

“It took me four months to finally think, ‘I wonder if this could be a basal cell skin cancer?’” he said. “So, I finally asked a colleague, and he said, ‘Could be.’ Turns out that it was a skin cancer.”

“If you let a basal cell skin cancer go, it can really do damage,” he warned.

“Be aware of your skin,” he emphasized. “If you’ve got something, don’t let it go too long. Let someone who knows what they’re doing check it out.”

Subtype 2 (papulopustular rosacea) is characterized by persistent redness, swelling and acne-like breakouts.

Credit: The American Academy of Dermatology, National Library of Dermatologic Teaching Slides.

Spotting Rosacea

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There are four subtypes of rosacea, and each looks a little different. You may have just one subtype. Or, you may experience two or more subtypes at the same time or over time.

Facial redness is the tale-tell sign of Subtype 1 rosacea. This could be a blush or flush that fades, or it could be persistent redness. Blood vessels may be visible. The skin may sting or burn, and it may become swollen, rough or scaly.

Acne-like breakouts are seen in Subtype 2. In addition to redness, bumps or pimples appear. They may come and go.

The bulbous red nose of W.C. Fields is the classic image of Subtype 3. In this type of rosacea, the skin thickens and may become irregular. This typically happens on the nose, but it may affect another area of the face.

Even the eyes may be impacted by rosacea. In Subtype 4, your eyes appear bloodshot, watery or swollen. A sty may arise. You may feel irritation, burning or stinging in your eyes.

y

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important to protect your skin from the sun,” Dr. Schosser explained. “Rosacea patients often have more than one skin condition. We have to consider how to treat each condition properly and how to deal with their interaction.”

Medical therapies are available for many rosacea cases.

“For acne-like rosacea, we can bring it under control and prevent scarring,” he offered.

“The red-faced type of rosacea is the most difficult to treat,” he said. “There is a relatively new product for folks with really red faces. It’s a prescription gel, and the generic name is brimonidine.”

Choosing the right skin care products and cosmetics can help reduce and disguise symptoms. Look for products designed for sensitive skin and avoid irritating ingredients, such as alcohol, witch hazel and fragrance, according to the National Rosacea Society. Men may find that an electric razor irritates their skin less than a razor blade.

“I suggest patients with acne-type rosacea use oil-free cosmetic products,” Dr. Schosser said. “For patients with redness, I often recommend a green concealer under foundation. That makes the redness less visible.”

In Subtype 3 (phymatous rosacea), the skin thickens – which could lead to an enlarged nose – and may have a bumpy texture

Credit: The American Academy of Dermatology, National Library of Dermatologic Teaching Slides.

“Just because you have one type of rosacea doesn’t mean you will develop another,” Dr. Schosser explained. “Just because you have acne-like bumps doesn’t mean you’ll get the big nose.”

Living with Rosacea “Unfortunately, curing your rosacea probably isn’t going to happen,” Dr. Schosser said.

However, it is possible to reduce your symptoms and avoid permanent damage.

“Number one, you should know and avoid your triggers,” he said.

“Triggers” are environmental and lifestyle factors that can aggravate your rosacea. Triggers vary from person to person, and they can include certain foods, drinks, weather conditions, products and even stress. To help control your rosacea, try to identify your triggers and then limit your exposure to them.

Protecting your skin from the sun is also key.

“Even though sun damage doesn’t turn into rosacea, it’s 12

Learning More about Rosacea To learn more about rosacea, Dr. Schosser recommends the National Rosacea Society. The toll-free phone number is 1-888-NO-BLUSH. The web site is www.rosacea.org.

The society’s web site includes many user-friendly resources. A photo gallery will help you recognize the signs of rosacea. You will find tips for managing the condition, including makeup ideas and how to identify your triggers.

There are even stories from celebrities who live with rosacea.

To learn more about a variety of skin conditions, visit the Dermatology A to Z web site of the American Academy of Dermatology: www.aad.org/dermatology-a-to-z.

ROSACEA TRIGGERS

Environmental and lifestyle factors can trigger a flare up of rosacea.

Triggers vary from person to person. To help control your rosacea, try to identify your triggers and avoid them. Below are the most common triggers identified in a survey by the National Rosacea Society.

Trigger Percent Affected Sun exposure 81% Emotional stress 79% Hot weather 75% Wind 57% Heavy exercise 56% Alcohol consumption 52% Hot baths 51% Cold weather 46% Spicy foods 45% Humidity 44% Source: National Rosacea Society, www.rosacea.org/patients/materials/triggersgraph.php

Southern Kentucky Health & Family Journal - April 2015

Your Heart, Your communitY our mission is to prevent and treat heart disease, so you can have a healthy and productive life. Committed to quality healthcare in the Somerset area, Baptist health offers two convenient locations.

currentLY accepting new patients L-r James Kennett, PA-C robert Cameron, md, FACC Nathan Bennett, PA-C

L-r ginger Fitzgerald, APrN Natarajan Thannoli, md, FACC

For appointments: (606) 451-9448

For appointments: (606) 677-0854

349 BogLe STreeT, SuiTe B SomerSeT, KY 42503

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Formerly the office of Natarajan Thannoli

Southern Kentucky Health & Family Journal - April 2015

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Wanna 14

Know a Secret?

Secrets can be fun, can’t they? Surprise birthday parties kept secret among your best pals, Christmas gifts, and awards or recognition from school or work delivered at just the right time – in front of a crowd. Did you know some people keep secrets – sometimes for a lifetime – that are not fun and often damage relationships with their family and friends, keep them from getting or holding a job, and sometimes end in tragedy?

Research shows that the impact of child abuse and neglect damages a child’s growing brain and has psychological implications, such as cognitive (intellectual) delays and emotional difficulties. These psychological problems, depression and anxiety for example, often manifest as high-risk behaviors such as making the person more likely to smoke, abuse alcohol or drugs, or overeat.

High-risk behaviors, in turn, can lead to long-term physical health problems, such as sexually transmitted diseases, cancer, obesity, and diabetes, to name a few. Not all children experiencing abuse or neglect will have long-term consequences, but it makes them more susceptible.

Southern Kentucky Health & Family Journal - April 2015

What is Child Abuse and Neglect?

The first step in helping abused or neglected children is learning to recognize the signs of child abuse and neglect.

The presence of a single sign does not mean that child maltreatment is occurring in a family, but a closer look at the situation may be warranted when these signs appear repeatedly or in combination. Federal legislation lays the groundwork for State laws on child maltreatment by identifying a minimum set of acts or behaviors that define child abuse and neglect. The Federal Child Abuse Prevention and Treatment Act (CAPTA), (42 U.S.C.A. §5106g), as amended and reauthorized by the CAPTA Reauthorization Act of 2010, defines child abuse and neglect as, at minimum: “Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation; or an act or failure to act which presents an imminent risk of serious harm.”

What are the Major Types of Child Abuse and Neglect?

Physical Abuse is non-accidental physical injury (ranging from minor bruises to severe fractures or death) as a result of punching, beating, kicking, biting, shaking, throwing, stabbing, choking, hitting (with a hand, stick, strap, or other object), burning, or otherwise harming a child, that is inflicted by a parent, caregiver, or other person who has responsibility for the child. Such injury is considered abuse regardless of whether the caregiver intended to hurt the child. Physical discipline, such as spanking or paddling, is not considered abuse as long as it is reasonable.

Neglect is the failure of a parent, guardian, or other caregiver to provide for a child’s basic needs. Neglect may be: • Physical (e.g., failure to provide necessary food or shelter, or lack of appropriate supervision) • Medical (e.g., failure to provide necessary medical or mental health treatment) • Educational (e.g., failure to educate a child or attend to special education needs) • Emotional (e.g., inattention to a child’s emotional needs, failure to provide psychological care, or permitting the child to use alcohol or other drugs) Sometimes cultural values, the standards of care in the community, and poverty may contribute to maltreatment, indicating the family is in need of information and assistance.

When a family fails to use the information and resources, and the child’s health and safety is at risk, child welfare intervention may be required.

Southern Kentucky Health & Family Journal - April 2015

Sexual abuse includes activities by a parent or caregiver such as fondling a child’s genitals, penetration, incest, rape, sodomy, indecent exposure, and exploitation through prostitution or the production of pornographic materials.

Emotional abuse (or psychological abuse) is a pattern of behavior that impairs a child’s emotional development or sense of selfworth. This may include constant criticism, threats, or rejection, as well as withholding love, support, or guidance. Emotional abuse is almost always present when other types of maltreatment are identified.

Abandonment is now defined in many States as a form of neglect. In general, a child is considered to be abandoned when the parent’s identity or whereabouts are unknown, the child has been left alone in circumstances where the child suffers serious harm, or the parent has failed to maintain contact with the child or provide reasonable support for a specified period of time.

Substance abuse is an element of the definition of child abuse or neglect in many States. Circumstances that are considered abuse or neglect in some States include the following: • Prenatal exposure of a child to harm due to the mother’s use of an illegal drug or other substance • Manufacture of methamphetamine in the presence of a child • Selling, distributing, or giving illegal drugs or alcohol to a child • Use of a controlled substance by a caregiver that impairs the caregiver’s ability to adequately care for the child Recognizing Signs of Abuse and Neglect It is important to recognize high-risk situations and the signs and symptoms of maltreatment. If you do suspect a child is being harmed, reporting your suspicions may protect him or her and get help for the family. Any concerned person can report suspicions of child abuse or neglect. Reporting your concerns is not making an accusation; rather, it is a request for an investigation and assessment to determine if help is needed. Some people (typically certain types of professionals, such as teachers or physicians) are required by State law to make a report of child maltreatment under specific circumstances—these are called mandatory reporters.

The following signs may signal the presence of child abuse 15

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or neglect: THE CHILD: • Shows sudden changes in behavior or school performance • Has not received help for physical or medical problems brought to the parents’ attention • Has learning problems (or difficulty concentrating) that cannot be attributed to specific physical or psychological causes • Is always watchful, as though preparing for something bad to happen • Lacks adult supervision • Is overly compliant, passive, or withdrawn • Comes to school or other activities early, stays late, and does not want to go home • Is reluctant to be around a particular person • Discloses maltreatment THE PARENT: • Denies the existence of—or blames the child for—the child’s problems in school or at home • Asks teachers or other caregivers to use harsh physical discipline if the child misbehaves • Sees the child as entirely bad, worthless, or burdensome • Demands a level of physical or academic performance the child cannot achieve • Looks primarily to the child for care, attention, and satisfaction of the parent’s emotional needs • Shows little concern for the child THE PARENT AND CHILD: • Rarely touch or look at each other • Consider their relationship entirely negative • State that they do not like each other The lists above may not be all the signs of abuse or neglect.

It is important to pay attention to other behaviors that may be unusual or concerning. In addition to these signs and symptoms, below are risk factors and perpetrators of child and abuse neglect fatalities: Signs of Physical Abuse Consider the possibility of physical abuse when the child: • Has unexplained burns, bites, bruises, broken bones, or black eyes • Has fading bruises or other marks noticeable Southern Kentucky Health & Family Journal - April 2015

after an absence from school • Seems frightened of the parents and protests or cries when it is time to go home • Shrinks at the approach of adults • Reports injury by a parent or another adult caregiver • Abuses animals or pets Consider the possibility of physical abuse when the parent or other adult caregiver: • Offers conflicting, unconvincing, or no explanation for the child’s injury, or provides an explanation that is not consistent with the injury • Describes the child as “evil” or in some other very negative way • Uses harsh physical discipline with the child • Has a history of abuse as a child • Has a history of abusing animals or pets

• Abuses alcohol or other drugs • States that there is no one at home to provide care

Signs of Neglect Consider the possibility of neglect when the child: • Is frequently absent from school • Begs or steals food or money • Lacks needed medical or dental care, immunizations, or glasses • Is consistently dirty and has severe body odor • Lacks sufficient clothing for the weather

Signs of Sexual Abuse Consider the possibility of sexual abuse when the child: • Has difficulty walking or sitting • Suddenly refuses to change for gym or to participate in physical activities • Reports nightmares or bedwetting • Experiences a sudden change in appetite • Demonstrates bizarre, sophisticated, or unusual sexual

Consider the possibility of neglect when the parent or other adult caregiver: • Appears to be indifferent to the child • Seems apathetic or depressed • Behaves irrationally or in a bizarre manner • Is abusing alcohol or other drugs

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knowledge or behavior • Becomes pregnant or contracts a venereal disease, particularly if under age 14 • Runs away • Reports sexual abuse by a parent or another adult caregiver • Attaches very quickly to strangers or new adults in the environment Consider the possibility of sexual abuse when the parent or other adult caregiver: • Is unduly protective of the child or severely limits the child’s contact with other children, especially of the opposite sex • Is secretive and isolated • Is jealous or controlling with family members Signs of Emotional Maltreatment Consider the possibility of emotional maltreatment when the child: • Shows extremes in behavior, such as overly compliant or demanding behavior, extreme passivity, or aggression • Is either inappropriately adult (parenting other children, for example) or inappropriately infantile (frequently rocking or head-banging, for example) • Is delayed in physical or emotional development

• Has attempted suicide • Reports a lack of attachment to the parent Consider the possibility of emotional maltreatment when the parent or other adult caregiver: • Constantly blames, belittles, or berates the child • Is unconcerned about the child and refuses to consider offers of help for the child’s problems • Overtly rejects the child HOW DO I REPORT CHILD ABUSE OR NEGLECT? If you believe a child is being abused or neglected, call the Child Protection Hot Line at 1-877-KYSAFE1 or 1-877-597-2331.

THE IMPACT OF CHILDHOOD TRAUMA ON WELL-BEING Child abuse and neglect can have lifelong implications for victims, including their well-being. While the physical wounds heal, there are several long-term consequences of experiencing the trauma of abuse or neglect. A child or youth’s ability to cope and even thrive after trauma is called “resilience,” and with help, many of these children can work through and overcome their past experiences.

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cognitive delays and emotional difficulties, among other issues. Childhood trauma also negatively affects nervous system and immune system development, putting children who have been maltreated at a higher risk for health problems as adults.

GET ON BOARD DURING CHILD ABUSE PREVENTION MONTH IN APRIL! April 10 is Wear Blue Day to promote Child Abuse Prevention. Wear Blue!

Some employers have a “dress down day” on April 10 with proceeds going to a group supporting child abuse prevention or a group that works with children who have been abused.

Create a storyboard for your workplace that provides education about child abuse prevention.

Adanta Behavioral Health Services has child and adult outpatient clinics that provide Parenting Classes, as well as mental health counseling, alcohol and drug abuse counseling, medication management, and more. Licensed and certified staff serve the counties of Adair, Casey, Clinton, Cumberland, Green, McCreary, Pulaski, Russell, Taylor and Wayne. If you need help or would like more information, call toll free 1.800.954.4782 x 0, or visit Adanta’s website at www.adanta.org.

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Southern Hearing Aid, Inc. in conjunction with Siemens Hearing Instruments is working to raise public awareness on the subject of hearing loss and its consequences.

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influence of alcohol.

Teens that experiment with alcohol before age 15 are four times more likely to become alcohol dependent when they are older than those that wait until age 20.

This is why education and prevention are so critically important to reducing alcohol-related problems and alcoholism.

Unfortunately, still too many of our children are drinking alcohol, at too early an age. Much of it goes unnoticed and unchecked by adults. Unconcerned or unaware of the health risks, lacking in other coping skills, and eager to find peer acceptance, many teens are involved in regular alcohol use, which puts them at greater risk for alcoholism, as well as related problems like drunk driving, sexual assault, and further drug use.

Alcohol Awareness Month held every April since 1987, was founded by and has been sponsored by the National Council on Alcoholism and Drug Dependence Inc, (NCADD). The purpose of the recognition is to increase public awareness and understanding aimed at reducing the stigma associated with alcoholism that too often prevents individuals and families from seeking help.

For the 27th Anniversary of NCADD Alcohol Awareness Month, NCADD has chosen the theme “Help for Today. Hope For Tomorrow”.

More than 18 million individuals or 8.5% of Americans suffer from alcohol-use disorders. In addition, there are countless millions of individuals, family members and children who experience the devastating effects of the alcohol problem of someone in their life. In fact, 25% percent of U.S. children have been exposed to alcohol-use disorders in their family.

Alcoholism places an enormous emotional, physical and financial burden on family members and children of the person who is addicted to alcohol: 75% of domestic abuse is committed while one or both members are intoxicated and family members utilize health care twice as much as families without alcohol problems. Emotional and physical abuse often occurs as a result of parents or spouses losing control with family members because of alcohol. Drinking and driving causes 16,000 deaths per year, and thousands more injuries.

Up to 75% of the crimes are committed by people under the 22

What Is The Difference Between Alcoholism and Alcohol Abuse?

Not all alcohol abusers develop alcohol dependence or alcoholism, but it is a major risk factor. Sometimes alcoholism develops suddenly in response to a genetic predisposition from a family history of alcoholism or due to a stressful change, such as a breakup, retirement, or another loss.

Other times, it gradually creeps up on you as your tolerance to alcohol increases. If a person is a binge drinker or drinks every day, the risks of developing alcoholism are even greater.

Common Signs and Symptoms of Alcohol Abuse include: Alcohol abuse is a pattern of drinking that results in harm to one’s health, interpersonal relationships, or ability to work including: • Repeatedly Neglecting Responsibilities: Because of drinking, repeatedly neglecting responsibilities at home, work, or school. For example, neglecting the children, performing poorly at work, poor or failing grades in school, skipping out on work, school, personal or social commitments because you’re hung over.

• Alcohol Use in Dangerous Situations: The use of alcohol in situations where it can be physically dangerous, such as drinking and driving, drinking in a bad neighborhood, mixing alcohol with prescription medication against the advice of your doctor or operating machinery while drinking.

• Legal Problems Due to Drinking: If, due to drinking, you are experiencing repeated legal problems. For example, Southern Kentucky Health & Family Journal - April 2015

getting arrested for fights, drunk and disorderly conduct, domestic disputes, or driving under the influence.

• Continued Drinking Despite Relationship Problems: Alcohol is causing or making problems worse in your relationships with your friends, family or spouse, and you continue to drink. For example, fighting with your family because they don’t like how you act when you drink or going out to drink with your buddies even though you know your wife will be very upset.

• Drinking to De-Stress: Many drinking problems start when people use alcohol to relieve stress. Because alcohol is a sedative drug, over time, you will need more alcohol to have the same effect. Getting drunk after a very stressful day more often, for example, or reaching for a bottle after you have an argument with boss, a friend or your spouse more frequently.

Signs and Symptoms of Alcoholism: Alcoholism involves all the symptoms of alcohol abuse, but also involves another element: physical dependence tolerance and withdrawal.

1. Tolerance: Tolerance means that, over time, you need more alcohol to feel the same effect. Do you drink more than you used to? Do you drink more than other people without showing obvious signs of intoxication?

2. Withdrawal: As the effect of the alcohol wears off you may experience withdrawal symptoms: anxiety or jumpiness; shakiness or trembling; sweating, nausea and vomiting, insomnia, depression, irritability, fatigue or loss of appetite and headaches. Do you drink to steady the nerves, stop the shakes in the morning? Drinking to relieve or avoid withdrawal symptoms is a sign of alcoholism and addiction.

In severe cases, withdrawal from alcohol can be lifethreatening and involve hallucinations, confusion, seizures, fever, and agitation. These symptoms can be dangerous and should be managed by a physician specifically trained and experienced in dealing with alcoholism and addiction.

3. Loss of Control: Drinking more than you wanted to, for longer than you intended, or despite telling yourself that you wouldn’t do it this time.

4. Desire to Stop But Can’t: You have a persistent desire to cut down or stop your alcohol use, but all efforts to stop and stay stopped, have been unsuccessful.

Southern Kentucky Health & Family Journal - April 2015

5. Neglecting Other Activities: You are spending less time on activities that used to be important to you (hanging out with family and friends, exercising- going to the gym, pursuing your hobbies or other interests) because of the use of alcohol.

6. Alcohol Takes Up Greater Time, Energy and Focus: You spend a lot of time drinking, thinking about it, or recovering from its effects. You have few, if any, interests, social or community involvements that don’t revolve around the use of alcohol.

7. Continued Use Despite Negative Consequences: You drink even though you know it’s causing problems. As an example, you realize that your alcohol use is interfering with your ability to do your job, is damaging your marriage, making your problems worse, or causing health problems, but you continue to drink.

National Council on Alcoholism and Drug Dependence Self-Test: What Are the Signs of Alcoholism?

Are you concerned about the role alcohol plays in your life?

With 26 questions, a simple self-test is intended to help you determine if you or someone you know needs to find out more about alcoholism. To take a self-test focused specifically on drug use, take the Drug Abuse Screening Test. You can locate both tests at the following website: https://ncadd.org/ learn-about-alcohol/signs-and-symptoms.

Do You Want Help or More Information?

Adanta Behavioral Health Services has nine outpatient clinics that provide Alcohol Education and Treatment, as well as mental health counseling, medication management, and more. Licensed and certified staff serve the counties of Adair, Casey, Clinton, Cumberland, Green, McCreary, Pulaski, Russell, Taylor and Wayne. If you need help or would like more information, call toll free 1.800.954.4782 x 0, or visit Adanta’s website at www.adanta.org.

Adanta has been providing services to community partners and members for the Lake Cumberland area since 1969.

Adanta is CARF accredited in Adult, Child, & Adolescent Outpatient Treatment: Mental Health and Alcohol and Other Drugs; Adult Mental Health Crisis Intervention and Crisis Stabilization; and Adult, Child, and Adolescent Mental Health and Alcohol and Other Drugs: Prevention. #Adanta #EnhancingTheLivesOfOthers Resource: www.ncadd.org Submitted by: Jamie S. Burton Chief Executive Officer, Adanta 23

The Art of Slowing Down by

Just Unplug

Catherine Pond

“The great benefit of slowing down is reclaiming the time and tranquility to make meaningful connections—with people, with culture, with work, with nature, with our own bodies and minds”

― Carl Honoré, In Praise of Slowness: Challenging the Cult of Speed

We live in a modern world where our technology has enabled us to get things immediately and almost as fast as we need them—through instant messaging, a cell phone in almost everyone’s pocket, the world an inquiry away with the Internet. Meanwhile, our friends are a post away on social media, there is e-mail piling up in our inboxes, and often 24

a compulsion to photograph ourselves and everything else and then to share it with everyone. Sadly, in our increased technological connections with the world we are becoming devoid of true communication: whether it is with our family, friends or just quiet moments to ourselves. How often do you go out and see people at tables or in crowds just scanning their cell phones? Who is looking around and observing, let alone interacting with each other?

Imagine the day when business was conducted largely by letter or telegram, perhaps a phone call, or extended travel by train. Our entire industrial age was empire-built this way. Despite the lack of our present technology, things got done and there was time to do them. In a very real way, time is truncated by the demands we put upon it. We feel rushed, hurried, harried, and as if we can’t quite get it all done whether it is on our to-do list or for our families and Southern Kentucky Health & Family Journal - April 2015

employers. Stress increases, illness often follows, and before we know it we’re left in the dust of our own whirlwinds.

Spring is a great time of year to reemerge from bad habits or winter-forced seclusions. We are outside again, we can be in the natural world, and we might start to plan vacations, go to the golf course, or fish, or take a boat out on Lake Cumberland.

“Spending more time with friends and family costs nothing. Nor does walking, cooking, meditating, reading or eating dinner at the table instead of in front of the television. Simply resisting the urge to hurry is free.”

― Carl Honoré, In Praise of Slowness

Here are some ideas to try for yourself or your family in order to de-stress in the modern world of plugged-in and immediate communication. These notions might be considered basic or old-fashioned in their simplicity but they are tried and true and they work. Imagine that this used to be how most of us lived regularly only a few decades ago.

Write a letter, phone a friend—Instead of texting, pick up the phone and call someone you haven’t spoken to in a while.

Call your mother or a friend you haven’t seen. Or, get some nice stationary or a note card and write to them. Writing a

Southern Kentucky Health & Family Journal - April 2015

letter allows us to slow down and pause, rather than banging out a rapid response that we might regret later.

Visit—It used to be that Sunday afternoons were reserved for family time or visiting. This is before television took over our culture and was often tied into Sunday dinner with friends or family members after church. Call a friend and ask them to lunch—better yet, drop in on your friend and invite them somewhere. Just make sure you do it without cell phones or televisions on.

Family Time—Insist that your family gather together in the same room at least once a day for a meal, or real conversation. Do not allow any phones, tablets or computers to intrude upon this time. Have a game night or start a book together and take turns reading it aloud to each other. If you have younger children, make sure you read to them every day or at night before they go to sleep. Above all, don’t allow the television or any other computers or games to dominate your free time together. Yes, this is easier said than done but if you make it a priority at least a few times a week, it will go far.

Sit Down to Dinner—Another great time to bond with your family or friends is over a meal. Children, or friends, often like to gather to help and food is one of the best ways to get anyone talking and sharing. Make your kitchen the heart of your home, even if you don’t cook every day. A useful way to connect with your children and teenagers is to talk to them while you are driving one-on-one in the car or have them do homework at the kitchen table where they can get your help or attention if needed.

Get Outside—Open the doors and windows, let fresh air in, turn off anything noisy and electrified. Go for a walk, play in the yard, find a great place to go hiking for the day. Most of us were raised on, “Go outside. I don’t want to see you until dinner!”

Find a Hobby—Crafts like woodworking, knitting, crochet, sewing, or scrapbooking, a sport, even gardening or car restoration, allow us to pause and work on something that we like to do with keen interest. It also gets us out of our heads and into our hands and can be both reenergizing and productive.

Buy and Shop Locally—There is a successful “Slow Foods” movement in this country that has grown out of people wanting to know what’s in their food, and buying or preparing it with fresh and local produce or other products. If you grow your own food or buy it from someone you know, you are automatically halting the rapidity of factory farming and our chain food supplies. You are appreciating where the food comes from and who made it.

When you shop locally you are supporting a small business and the people that own it, as well as their families. There is a direct connection that is established that is not as likely to happen in the larger chain stores and certainly not with online shopping. You sometimes might pay a bit more but you are also contributing directly to your local economy and there is a reward in that for everyone.

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Plan a Daytrip or “Staycation”—If you are unable to plan a true family vacation away from home, take a day, a few days, or a chunk of vacation time to do things as a family on short or longer day trips. Plan a picnic or lunch out, consult a map, and fill your car with gas, and away you go.

With gas prices continuing to drop this can be an affordable way to feel you’ve left your familiar, even if only for a short while. Kentucky is blessed with so many interesting places and small towns, museums, and natural sites to see.

Look at the Stars—Whether you live in a well-lit city or town or out in the country, we are fortunate in the region to have large areas that are clear enough to see the night sky.

Stargaze with your children and learn about the constellations and planets and then find them in the sky. There is nothing more relaxing, or humbling, than looking out into the vast universe and realizing you are but a small speck within it. For a little while it makes everything rather unimportant in the grand scheme.

Alone Time—Every day, if you can, spend some time alone. This is especially important if you are a busy parent.

Work out, walk, read, do a craft, weed a garden, take a long bath. We need to nurture ourselves to be more effective spouses, parents, and working people. These activities also help us to slow down sometimes.

Be Still—Try spending time being more mindful. Notice the room or landscape around you, listen to the natural

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sounds, think about the task at hand and try to worry about nothing else apart from what you are doing in the moment.

Make daily tasks less of a chore by taking the time you need to do something right—whether it is cleaning, cooking, working on a project, or folding laundry.

We’ve all heard the expression, “Haste makes waste.”

Whenever you can, slow down and take all the time you need. After all, it’s not going anywhere.

“This is where our obsession with going fast and saving time leads. To road rage, air rage, shopping rage, relationship rage, office rage, vacation rage, gym rage. Thanks to speed, we live in the age of rage.”

― Carl Honoré, In Praise of Slowness

Catherine Seiberling Pond is a freelance writer

Southern Kentucky Health & Family Journal - April 2015

t n i o J THERAPY

By Tricia Neal In the last edition of Southern Kentucky Health and Family, readers learned about Lake Cumberland Regional Hospital’s Total Joint Replacement Pre-Surgery Seminar. This teaching program allows patients who are facing total knee or total hip replacement surgeries to meet in a discussion-type setting with surgeons, nurses, and therapists so they can obtain information and ask questions so they’re better prepared for what is ahead of them.

Patients learn how to prepare for surgery, what to expect on the day of surgery and after surgery, how to manage pain and reduce the risk of complications, what types of exercises and foods will promote healing, and how to perform daily activities following surgery.

Knowing what to expect helps ease any fears patients might have, and it enables them to return to a normal lifestyle faster and with less pain.

This month, we talked to Linda Cornell, a local resident who has had two knee replacement surgeries since February of 2014. The seminar wasn’t available for patients when Linda had her first surgery, but when she had her second knee replacement, in January of this year, she was contacted about attending a session.

Linda, who admits she can have a bit of a “grumpy side,” said she initially didn’t want to attend the seminar.

“I was a little apprehensive,” she said. “Honestly, I was a little ticked off that I had to attend a class about this, because I had already been through it once.”

But her attitude quickly changed once she got to the class.

“I thought the atmosphere was very cordial and candid, and I appreciated that,” she said, adding that there had been little communication with her from anyone at the hospital prior to her first surgery.

“When you’re in a hospital bed, you’re at the mercy of those around you,” she said. “Your mental attitude has an impact on how you heal physically, so it helps to be educated and know what you’re going to be going through. … You have to know that you are the one who is going to make a difference in your recovery.”

Linda said the staff answered her questions during the seminar, leaving her with no doubts.

“They were very good about reassuring me,” she said. “They really listen to the patients, and realize that these aren’t just silly fears. The patients’ concerns may sound like nothing, but they’re important to the patients. … It’s important that people understand what’s going to be done to them and what’s going to be required of them.”

Thanks to the class, Linda learned the benefits of eating a high protein diet during her recovery – something she wasn’t aware of, and wouldn’t have done on her own.

“The nutritional part is a critical part of this class,” Linda said.

“Eating foods like peanut butter, meats, eggs, cheese, and yogurt is important when you’re rebuilding your system. Most people are not Southern Kentucky Health & Family Journal - April 2015

Sunda Hansford, Jeff Herndon, and Jammie Smith, all members of the Total Joint Replacement Program teaching team, met with former patient Linda Cornell recently to discuss her knee surgery.

on a high protein diet, so it’s good to know this ahead of time so you can prepare for the changes you’ll need to make.”

After having been through two knee surgeries, Linda has come up with some of her own comparisons which weren’t necessarily learned in class. For example, after Linda’s first knee surgery, she spent two weeks getting therapy at the hospital. Following this year’s surgery, she got her therapy through Amedisys, at home. She says that, while she would recommend Amedisys to anyone, she felt that the therapy program offered at the hospital “offered a broader range of exercises and equipment to prepare you to go home,” and that the staff “was considerate and courteous, and really listened to you when you spoke.”

She feels that she has recovered much faster this time compared to her first surgery, but she believes it’s because she pushed herself more.

“You can either push yourself, or you can lay back and take ten months to recover,” she noted.

Looking back now, Linda says she’s glad she attended the seminar, even though she had experienced the surgery before.

“Everything they recommended, I can see now that it was beneficial to me,” she said. “Education is what makes the difference. I believe it helped me immensely. … At first, I thought, ‘Why do I have to go sit through this meeting?’ But now, I would tell anybody to go.”

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Signs Your Aging Loved One Needs Support How do you know whether a loved one needs help? First, trust your instincts. If you “have a feeling” when you get off the phone with your aging parent that something “isn’t quite right”, then there is very likely something to that.

You may see some subtle changes in your parent’s behavior or mood. Little “red flags” that it is becoming harder for them to remain safe while they live independently at home. That doesn’t mean you get out a list of nearby Assisted Living Facilities. Older adults can live in their homes for years with some modifications to their daily routines. The changes you notice may be caused by an illness, hospital and/or rehab stay, decline in cognitive and memory faculties or might be due to normal aging of the body and mind.

Step One - Assess Their Abilities Observe how they manage their ADLs which include: bathing & grooming, dressing, transferring (getting up from bed or a chair), toileting and feeding. Health problems or balance problems fear of falling, arthritis, spinal stenosis, and memory impairment can affect their ability to complete their personal needs. Other activities that are essential for anyone living independently include: cooking, shopping, driving or taking transportation, medication management, bookkeeping, laundry, keeping appointments and other routine activities of maintaining the household and schedules.

1: Unkempt Home If there has been a drastic change in the way that your loved one keeps their home that may be a sign they lack the energy or physical ability to pick up and clean. Extra support at home can ensure that your loved one lives in a healthy, safe environment.

2: Missed Medications Forgetfulness is common in older individuals. Missing medications can lead to withdrawal and the return of symptoms of medical problems. It can lead to more serious problems as well – stroke, heart attack, etc. Help at home can remind your loved one to take medications as prescribed.

3: Missed or Canceled Medical Appointments Forgetfulness and the inability to drive to appointments can lead to failing health. A senior care worker can provide transportation and encouragement to attend all medical appointments.

4: Body Odor Just as cleaning and picking up the home can be physically demanding, taking a shower or bath is too. With someone to assist in the home, your loved one can get the assistance needed to get safely into and out of the shower to keep clean and feeling refreshed.

5: Sudden Change in Weight Medical problems can cause lost pounds, not cooking and preparing healthy meals can be the reason as well. Since it can be difficult to cook when feeling tired or lacking energy, 28

Southern Kentucky Health & Family Journal - April 2015

assistance in the home can make sure meals are prepared and/ or set up a meal program that allows for meals to be delivered on a schedule.

6: Problems with Mobility Balance and walking can become more difficult as people age. This can lead to falls causing serious injuries. Help with completing daily tasks can reduce the risk of falls and increase mortality.

7: Depression Losing interests in hobbies or activities that used to enjoyable can be a sign of depression that can lead to many other problems.

Having a caregiver provide support and encouragement can help your loved one feel better and get the mental health and stimulation they need.

8: Mail Piling Up or Unpaid Bills It can be easy to forget to pay a bill from time to time, but if it becomes a habit, it might be a good idea to have someone help with going through mail and managing bills. This is one of the services that senior care workers provide in addition to helping with other daily tasks.

9: Diagnosis of an Age-Related Medical Problem Alzheimer’s or dementia can cause a loved one to forget or engage in risky behaviors. Having someone by your loved one’s sides most of the day can help minimize the risk of him hurting himself.

Step Two - Take Action with a Health Care Plan If something has occurred or is happening which is causing your elderly parent to struggle with things that have always been routine you will need to formulate a health care plan. *Speak with them- share your observation and concerns in a caring way, not accusatory. Expect some defensiveness, this is normal. *Speak with their health care providers, neighbors, and friends - find out what is going on in their everyday lives. *Build in safety features in the home - grab bars in shower, an Emergency Response button, non-slip rugs, night lights, medication box, and alarm reminders.

Once you’ve determined that your aging mother or father is unable to manage their own personal care and/or household chores, wishes to remain independent at home, and then help needs to be brought into their home for both SAFETY and PERSONAL CARE needs.

Start off slowly if possible by introducing assistance in the home a few hours a week and increase as the needs increase. Be proactive, formulating a long term health care plan for the future needs. Building a caring, compassionate, trusting relationship is what Helping Hands Personal Care specializes in. We individualize each health care plan to meet the immediate and future needs of our clients and their families. We work together to formulate the principal methods to allow independence and safety with all activities of daily living. Our clients not only live at home, they thrive in their homes. We understand that no two situation are the same, our professional care plan allows for specialty and individualized care. Whatever the situation, we can help with a tailored solution.

How to Choose the Best Private Duty Service Research has shown patients not only live longer, more fulfilling lives, but they would rather remain in their home than be institutionalized. Non-medical personal care services, such as Helping Hands Personal Care, can empower families to promote better outcomes, cost effectiveness, and care coordination. Utilization of non-medical personal care reduces hospital visits and re-hospitalization of chronically ill patients by maintaining a safe, comfortable home environment.

It is essential to choose the appropriate in-home personal care agency. The National Private Duty Association recommends specific criteria to consider.

•Inquire about the company’s experience or familiarity with in-home care. Their experience should provide an accurate plan of care for the client. Our Clinical Director has over 25 year’s clinical in-home care experience.

•The caregiver screening process should include reference checks, criminal history and drug screening. We also provide prescreening competency testing for each caregiver and a comprehensive physical exam.

•Caregiver recruitment should provide suitable caregivers and trained back-up caregivers that are necessary if a schedule conflict occurs. Helping Hands Personal Care believes in continuity of care and we also provide additional caregivers for back up when needed.

•Personal care service agencies should employ the caregiver, not use contract employees. Helping Hands Personal Care caregivers are employees of the company, they are covered with workman’s compensation insurance, bonding and employment taxes that are paid by the company, not the client or their family.

At Helping Hands Personal Care, we hire our caregivers because of their professionalism, enthusiasm and compassion.

Our unique process allows us to create a beneficial relationship between clients and caregivers. Our personnel are more than caregivers; they’re life givers.

Helping Hands Personal Care is a locally-owned and operated business dedicated to providing professional and caring in-home assistance for you and your loved ones with customized services to meet all your needs. Please call our office at 606-636-4400 and speak with our helpful staff for more information on what we can provide for you and your loved ones or visit us on our web at helpinghandspersonalcare@ yahoo.com.

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Menopause 101—

Things Your Mother (Probably) Didn’t Tell You

By Catherine Pond

“A woman must wait for her ovaries to die before she can get her rightful personality back. Postmenstrual is the same as pre-menstrual; I am once again what I was before the age of twelve: a female human being who knows that a month has thirty days, not twenty-five.”

––Florence King, Lump it or Leave It

My introduction to the word “menopause,” and a glimpse of what the word actually meant, was defined by the character of Edith Bunker “going through the change” on the popular 1970s sitcom, All In the Family. In the episode “Edith’s Problem,” Edith experiences hot flashes, is forgetful and irritable, emotional, angry, reactive, and everything but her sweet sunny self. Daughter Gloria shows her an article from a women’s magazine on “the change of life.” “Don’t tell your father,” Edith insists.

Her husband, the cranky and generally insensitive Archie Bunker, is baffled and takes her to the “groinocologist” where Edith gets “a realignment job on (her) glands.” Gloria later uses the word “menopause” to which Archie shushes her and asks why she would talk so loudly about her “mother’s interior problems” in public. The whole episode is perfect sitcom fodder and, as I’ve discovered, not far from real life.

The characters of Archie and Edith seemed very old to me when I was eleven but the actors were only in their late 40s at the time. The average age of menopause is 51, a time that is defined by the complete cessation of a woman’s period after twelve months (or cycles). Perimenopause defines the time when periods become irregular and the following symptoms (some or all) occur with regularity: •Hot flashes •Breast tenderness •More severe premenstrual syndrome •Lower sex drive •Fatigue •Irregular periods •Vaginal dryness and discomfort •Urine leakage when coughing or sneezing •Need to urinate more frequently •Drier skin •Hair loss on head; more hair growth on face 30

•Mood swings (moderate to severe, often frequent) •Trouble sleeping or disruption in sleep patterns In sum, most women do not feel like themselves (the lucky few emerge from this time relatively unscathed) and few of the post-war baby boomer generation were prepared because our mother’s generation just didn’t talk about it. It was a taboo subject and there was no shared journey. As a result, I didn’t think about “the M word” much and just thought you woke up one day and, boom, your period was gone. A year ago I called my mother back in New England, a recently retired nurse of 40 years, to ask her about it. “Oh I don’t remember. It was so long ago.” Change of subject.

In September 2011, during Menopause Awareness Month, Jacki Lyden led a panel discussion on National Public Radio.

“Whether the conversation’s full of laughter or tears - or both, or maybe because baby boomers just aren’t the type to go quietly, women going through menopause want to be able to talk more openly about the experience,” she said. One of the panelists, author Ellen Sarver Dolgen, wrote, “You begin Southern Kentucky Health & Family Journal - April 2015

to question everything…we thought - because our mothers didn’t talk about it – that it was something that happened for five days.” Hardly.

In addition to physical and hormonal changes (diminishing estrogen levels for starters), perimenopausal women might experience feelings of loss, sorrow, or things undone.

Depression can be a manifestation for some women as well as emotional surges and reactions that echo similar moments in puberty when the body experiences its first major hormonal surges and changes.

Menopause is the opposite end of the spectrum and all women will experience it, as will their families, in varying degrees. It is the time when a women’s period has stopped for at least twelve months. With many women delaying childbirth until their thirties, some often go through menopause while one or all of their children are also going through adolescence. This is no easy challenge to navigate. It is also important to state that women in perimenopause can, and do, become pregnant.

Post-menopause is the time when a woman is no longer ovulating. She is then considered post-menopausal for the rest of her life. [Note: after menopause, any vaginal bleeding is abnormal and should be looked at by a gynecologist.]

Anne Turcea, MD, at Women’s Care for the Commonwealth in Danville, Kentucky [WomensCareDanville.com], said with the average age of

menopause at 51, perimenopause usually begins 5-7 years prior (unless ovaries have already been surgically removed).

“A woman should call her doctor if she has spotting between her periods or significant symptoms that are affecting her daily life such as hot flashes, night sweats, vaginal dryness, mood changes and/or insomnia.” She recommends black cohosh, soy isoflavones, and over the counter name brand herbal supplements that work well for some symptoms.

“The symptom that I think is the most difficult to deal with and affects women the most is insomnia and sleep disturbance. So I recommend exercise, melatonin herbal supplements, good sleep hygiene (as in no screen time an

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31

hour before bed), and avoiding caffeine late in the day,” Dr. Turcea added.

Exercise—both aerobic and weight-bearing—helps with overall well being, mood, body changes (increased weight is common), and issues that may develop around osteoporosis.

Some women also experience mild to severe depression, some for the first time in their lives, and exercise helps that, also (and often with prescribed medication). Other physical symptoms or diseases can become heightened because the body is going through significant hormonal change and resetting.

Ann Louise Gittleman, PhD, renowned author and nutritionist, wrote: “As many as 70 million American women are menopausal—and that number is growing at about 4200 more a day. Add on another 35 million women who are experiencing perimenopause and you realize that a huge portion of our female population is going through profound hormonal changes. Without the proper nutritional reinforcements, these changes can become health crises rather than natural transitions. Explore these resources for a wealth of natural solutions from diet and exercise to supplementation and bio-identical hormones—it’s time to revitalize the last half of every woman’s life!”

Marie Hoag, who writes about women’s health issues at her website, MenopauseMoxie.com, notes, “Estrogen deficient woman are nothing but the walking dead.”

It is important for all women to visit their gynecologist at least once a year, but also to monitor perimenopausal symptoms and consult with their doctors about hormone issues and possible help for persistent problems like increased mood swings, pain, or fibroids (benign tumors which can grow significantly during perimenopause). While prior hormone therapies have been reevaluated in the past few decades, there are other alternatives and the benefits and potential risks should be discussed with your doctor.

Above all, perimenopausal women are not alone and do not have to suffer in silence. In addition to the many physical changes and transformations, this can be a time of life to reevaluate, work on untreated issues, and to possibly visit different opportunities, and important health changes or

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SOURCES: www.npr.org/2011/09/27/140843101straight-talk-on-menopause www.MenopauseMoxie.com Before the Change—Taking Charge of your Perimenopause, by Ann Louise Gittleman, PhD

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Southern Kentucky Health & Family Journal - April 2015

The Great Outdoors Container Gardening and Senior Health Fresh air and a bit of sunshine are perhaps two things we all take for granted, not realizing the impact both can have on our health. The benefits of spending time in the great outdoors are bountiful - sharper mental states, happier moods, overall improved physical health and a sense of well being. For these reasons, alone, it is important for seniors to be encouraged to enjoy a bit of time every day outside when possible.

A brisk walk around the neighborhood may be sufficient for many seniors. But, consider another outdoor activity which can also boost levels of health and well being: gardening.

Gardening has long been declared by healthcare professionals

Continued on page 34

Southern Kentucky Health & Family Journal - April 2015

33

as an activity that can lower blood pressure, reduce stress and alleviate depression. The physical aspects of gardening promote greater mobility as well as fine motor coordination, which is important for seniors as they grow older.

Many people think of gardens in terms of large, dirt-filled plots of land, which may be inappropriate for most seniors. However, over the past decade, gardening in containers of various shapes and sizes has become quite the trend. People of all ages grow shrubs, flowers, trees and even herbs and vegetables in containers rather than planting them in the ground. Container gardens are more manageable for those who have limited time and space, but who enjoy the aspects of gardening. Container gardening is perfect for seniors, as it requires less strenuous work, while offering the health benefits of spending time outside as well as the visual colorful fruits of one’s labor.

When helping seniors shop for container gardening supplies it is important to choose items conducive to the senior’s outdoor space and appropriate for their physical abilities. Be sure to choose plants that require low light for shady spaces, or if the spot is sunny, pick plants appropriate for full-sun. Choose a watering can that is easy for the senior to manage when filled. Plastic pots may be easier to relocate during winter months, but glazed terra cotta pots can add a burst of color if desired. A good pair of pruners and

a pair of gardening gloves are essential in maintaining any garden.

Container gardening is a perfect activity for family members or caregivers of seniors to become involved in doing. The responsibility of caring for something gives seniors a sense of purpose. The interaction while gardening together can cultivate a greater sense of self-worth for the senior and reduces the sense of isolation many seniors experience. The rewards can be two-fold providing the satisfaction of caring for and watching your gardens grow and a sense of togetherness which grows in tandem.

References WebMD (2000). Gardening for health. Retrieved on April 28, 2012 from webmd.com/healthy-aging/features/gardening-health.

Skay, Nicole. Vida, Inc. Gardening for senior health. Retrieved on April 28, 2012 from vidaseniorresource.com/blog/2009/10/ gardening-for-senior-health/.

Better Health Channel. Gardening for seniors. Retrieved on April 28, 2012 from betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/ pages/Gardening_for_seniors.

Natural Health Restored. Get a breath of fresh air! Retrieved on April 28, 2012 from natural-health-restored.com/fresh-air.html.

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Southern Kentucky Health & Family Journal - April 2015

Addressing the Homeless in Pulaski County

By Tim Minton Steve Hall is the Minister of Music & Education for High Street Baptist Church in Somerset, KY. He has served this position for nearly 23 years. One of his duties at High Street is to be one of the facilitators of the church’s benevolence fund which helps assist people with needs such as food, clothing, or in some instances, helping with utility bills. He also serves as a Board member for God’s Food Pantry in Pulaski County.

During his tenure serving in these positions, he started to see a problem of homelessness rising in the community within recent years. “I began to notice, in the last two or three years, an increasing number of people who identified themselves as homeless when they were asking for help,” stated Hall, “In talking with some of the other churches and agencies in the area, this seemed to be something they were experiencing also.”

Although he has not collected any official research or data, Hall concedes that the problem is accelerating in the community.

“It’s just happening and it is becoming something that has concerned me and others,” implied Hall.

In Hall’s estimation, a majority of those who currently identify themselves as homeless have ties and former residency in Somerset and Pulaski County. He indicated there were a minority of people who were transients passing through; but, most were from the community. “Most people I deal with have lived here in Pulaski County, have family in Pulaski County, and even have kids in the schools,” proclaimed Hall. He calculated they initially may turn to friends or family for help. However, this is only temporary and hard for those who are facing this as an entire family. “We are finding that it’s difficult for some to keep all their family together while meeting and balancing their financial obligations,” stated Hall. He also asserted it’s not unusual to learn that some are having to live out their car, or come in on foot requesting help with no means of transportation.

After the previous local elections in November 2014, Hall believed it would be a good time to put forth this increasing issue to the community. He submitted his open letter to the Commonwealth Journal’s editorial section. He challenged the community and local officials to address the dilemma and suggest or propose possible solutions for the problem. In the Southern Kentucky Health & Family Journal - April 2015

letter, Hall presented logical arguments of how the homeless population has began to rise and how he believed the issue is often correlated with other factors including: economic hardships (such as loss of employment); inability to pay rent or eviction; a family crisis; a family break-up; or a health crisis, etc. He addressed the important concern that many who face homelessness in Pulaski County have children enrolled in our local schools. To Hall’s satisfaction, the letter to the editor received a lot of attention from many in the community and a conscious voice was expressed by many with how to address the problem.

From the popular response, an initial meeting was held in January 2015 at the Rocky Hollow Community Room. Hall served as the commentator for the meeting, while Daisha Hall, of the Mayor’s Office, was also active in representing intraagencies of local government. According to Hall, nearly 300 people turned out for the event. “The response was a surprise to many of us, we really didn’t know what to expect as far as turnout,” insisted Hall. From this first meeting, an official contact list was created to correspond with others about the next meeting and what progresses could be achieved. From here, Steve Hall, Daisha Hall, and Robin Wheeldon of the Somerset Housing Authority began to collect information and contact the list of interested people, organizations, agencies, and businesses who were willing to help. Their objective was to develop an agenda by exploring and brainstorming possible motions.

In addition, the Intra-Agency Council, consisting of representatives from local government agencies, health institutions, non-profit agencies, schools, and members of the religious community became more involved with addressing specific problems and working to determine plans and resolutions. One of their actions was beginning to develop a website that would provide information, via computer access, to provide a “one-stop” location for people to identify resources and services available from agencies and groups in the community. Currently, the website is in its beginning stages of development.

It was agreed that a second meeting would be held in March, at the High Street Baptist Church. Although the second meeting didn’t have as many respondents to turn out (perhaps due to the 35

inclement weather conditions), it was successful in providing information on what the organizers had learned about possible resources and what initiatives had been taken up. Again, this second meeting encouraged others to brainstorm ideas, share information, and suggest possibly what could be done. In addition, they were able to develop an “official” registration list consisting of multiple individuals and organizations committed to assistance in some manner. They asked registered members for assistance and volunteer efforts with helping the homelessness. According to Hall, they had registered about 50 names of individuals who would be willing to volunteer in some capacity.

Thus far, such issues that have been suggested concern location, availability of resources, and people willing to help.

They also want to construct an official directory of participating agencies in the county that have agreed to help or assist Steve Hall, in some fashion. And, in Minister of the future would be listed Music & upon the website. Lastly, Education, they would like to get High Street more churches and people Baptist involved.

Church A third meeting

is currently being planned to further advance efforts and provide even more information to interested parties. “At the third meeting we will look at what needs to be done to move forward,” claimed Hall, “We want something concrete to present with goals and objectives for an action plan.” The members of the group hope to institute substantial, upcoming ambitions for homeless outreach programs. “At this point, we are just looking for people to commit their time to help with establishing community goals,” stated Hall. He added, “We want to get a consensus for what’s best now... Is it a temporary service? Can it be a full-time program?” He is hopeful that with the combined efforts of community partners and local government that a devisable plan with allowable resources can be created.

“Right now, we don’t have much to offer them [the homeless],” stated Hall, “The churches and the organizations currently helping can’t address all the problems by themselves.”

Hall believes it is a community-wide problem and there needs to an organized, central location where the homeless may go to in order to find out about what help is available. “I have been pleased with the commitment from the people and the organizations we have received thus far and hope wan can continue to involve others,” stated Hall.

Hall wanted to extend further recognition to Daisha Hall and Robin Wheeldon, of the Somerset Housing Authority, along with the numerous others who have agreed to help. “We just want all to understand that it’s not just the perception that this is another charity cause asking for money... What we need most is participation and no member is seeking any compensation for their work or efforts,” insisted Hall.

We would like to thank everyone who voted us the #1 Nursing Home in Somerset and the #1 Best Place to Work in Somerset for 2014.

Please stop by our facility and see why we were voted one of the best of the best.

Call our Admissions Coordinator to discuss a possible referral or set up a personal tour.

2014

Experience the Best in Rehabilitation and Long-Term Care

Examples of Rehabilitation Services Include:

• Orthopedic Rehabilitation • Stroke Rehabilitation • Falls and Balance Program • Cardiac Rehabilitation • Swallowing Therapy

• Daily Living & Self-Care Retraining • Wound Care • Adaptive Equipment Training • Pre-Discharge Home Evaluations

106 Gover Street, P.O. Box 1121, Somerset, KY 42502

Phone (606) 679-8331 • Fax (606) 679-6670

www.somersetnursing.com • Jennifer Davis, Administrator • Licensed by the Kentucky Cabinet for Health & Family Services 36

Southern Kentucky Health & Family Journal - April 2015

Total Rehab Center

Don’t let injuries put you on the bench

CJ photo

More than five million kids under the age of 18 suffer a sports related injury each year with approximately half of these due to overuse. April is Youth Sports Safety Month, an important time to increase awareness of the increasing injuries seen in our young athletes.

At Total Rehab Center we have already seen some injuries from young boys playing baseball.

Even though there have been recommendations on limits for pitching in little leagues for several years, a recent study in Sports Health found that 27% of coaches admitted to not following the safety guidelines. Combine this with the players desire to keep playing and it is no wonder that injuries continue to increase.

Coaches and parents should listen and react appropriately to a youth pitcher when he/she complains about arm pain. A pitcher who complains or shows signs of arm pain during a game should be removed immediately from pitching.

Parents should seek medical attention if pain is not relieved within four days or if

Southern Kentucky Health & Family Journal - April 2015

the pain recurs immediately the next time the player pitches.

Baseball pitchers should compete in baseball no more than nine months in any given year.

For at least three months a year, a baseball pitcher should not play any baseball, participate in throwing drills, or participate in other stressful overhead activities (javelin throwing, football quarterback, softball, competitive swimming, etc.).

They should continue to perform exercises to prepare for the next season.

The same advice should be applied to all athletes. All coaches and parents should know that:  Sports participation has become a major cause of serious injury among youth.  Sports activities are the second most frequent cause of injury for boys & girls.

Most sports injuries are preventable, because they are often related to the following issues.

•Fatigue •Not warming up properly •Playing while injured •Stress and inappropriate pressure to win.

•Lack of preseason conditioning Total Rehab Center is an independent, locally owned clinic that specializes in sports & orthopaedic problems and rehabilitation. If you have had a fracture, surgery, injury, or want to prevent one, contact one of our highly trained staff.

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April 2015 Calendar Should there be a change in location, date or time for any Senior Friends event for which you have pre-registered, we will notify you prior to the event.

SENIOR FUN & FITNESS CLASS Each Tuesday and Thursday, 10 a.m.11:00 a.m. April through May 07, 2015.

Lake Cumberland Cancer Treatment Center Community Classroom, located at 112 Tradepark Drive. These are gentle exercises for EVERYONE- the overweight, the diabetic, those recovering from surgery, illness or injury, heart patients, and especially those who are sedentary. Every joint and muscle in the body will be utilized yet the exercises are not difficult. The purpose is to regain use and strengthen muscles and joints, improving posture and mobility, increase circulation and to enjoy fellowship with others. For more information or to register, since space is limited, call (606) 678-3274.

TUESDAY, APRIL 14 DINE WITH THE DOCS LCRH Conference Center, Located in the LCRH basement.

5:30 p.m. – Complimentary Dinner in Chatters Café & Grill 6:30 p.m.–Speaker: Camilo Santiago, M.D., General Surgery Topic: To be announced Join us on the 2nd Tuesday of each month for a special complementary dinner and an informative meeting presented by leading medical specialists.

Space is limited. Call (606) 678-3274 for your required reservations.

THURSDAY, APRIL 16 MOVIE -N- MUNCH LCRH Conference Center, Ste. A 1:30 p.m.

Rescheduled from February, due to snow.

Synopsis of “If I Stay”: Life changes in an instant for young Mia Hall after a car accident puts her in a coma. During an outof-body experience, she must decide whether to wake up and live a life far different than she had imagined. The choice is hers if she can go on. Call (606) 6783274 by Thurs., April 9, for your required reservation.

WEDNESDAY, APRIL 8 GET ACQUAINTED BRUNCH 9:15 a.m. – Free Breakfast in Chatter’s Café and Grill 10:00 a.m. – Senior Friends Benefits Presentation Have you ever been a Senior Friend?

Our Get Acquainted Brunch is designed to offer you a free one-year membership if you have never been a member before.

Come to this “Get Acquainted Brunch” and enjoy a FREE delicious breakfast in Chatters Café & Grill while hearing about all the benefits of your free NEW one-year membership – a $15 value! Call (606) 678-3274 for your required reservation

by Friday, April 3, 2015.

FRIDAY, APRIL 17 PARKINSON SUPPORT GROUP April is National Parkinson’s Disease MONDAY - WEDNESDAY, APRIL 13-15 MASQUERADE JEWELRY SALE ($5/item) Awareness Month 10:00-11:00 a.m.

Around the clock sale!

LCRH Small Dining Room, located in the Beginning Monday at 7:00 basement near the Senior Friends Office. p.m. through Wednesday at A support group for persons 3:00 p.m. diagnosed with Parkinson’s LCRH Basement Foyer disease and their family and Experience the Frenzy of the Complimentary $5.00 Jewelry and Accessories Sale. friends.

Sponsored by the LCRH Volunteer lunch will be provided. For Auxiliary/ The Gift Shop. All proceeds additional information and reservations benefit the LCRH Volunteer Auxiliary/ The required Gift Shop which sponsors Allied Health please call (606) 678-3274.

Scholarships at the Somerset Community College.

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TUESDAY, APRIL 21 MONTHLY MEETING LCRH Conference Center A 11:30 a.m.

Speaker: R.T. Jefferson, State Manager with Woodmen of the World Topic: How to Make Your Money Stretch in Retirement!

Join us for a complimentary lunch and an informative presentation. Space is limited.

Please call (606) 678-3274 by Tuesday, April 14 for your required reservation.

THURSDAY, APRIL 23 BIRTHDAY PARTY LCRH Conference Center, Ste A 2 pm –4 pm It’s time for those April “Senior Friend” babies to come and party. Bring a friend and share an afternoon of fun, games, delicious cake and ice cream. Call (606) 678-3274

by Thursday April 16, for your required reservation.

FRIDAY, APRIL 24 BINGO LCRH Conference Center, Ste A 2 pm – 4 pm Bring a $3.00 donation for the March of Dimes. Spend the afternoon with “Friends.” A perfect time for fun, fellowship, & refreshments. Senior Friends will provide t h e coverall prize. Reservations are required and must be received by Friday, April 17.

Please call (606) 678-3274 to reserve your spot.

SATURDAY, APRIL 25 MARCH OF DIMES March for Babies Rocky Hollow Recreation Center: Registration : 4:15 p.m.

Walk: 5:00 p.m.

Donations for the March of Dimes will be accepted in the Senior Friends office through Friday, April 24, 2015.

Southern Kentucky Health & Family Journal - April 2015

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Southern Kentucky Health & Family Journal - April 2015