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VOLUME 5 • EDITION 4

MILESTONE CONSULTING, LLC

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publisher

a letter from the firm

John T. Bair jbair@milestoneseventh.com editorial

dear friends,

Milestone Consulting is pleased to provide you with the latest issue of The Safety Report. This publication is produced in collaboration with a growing community of respected legal professionals, industry experts and consumer advocates called The Injury Board, committed to improving everyone’s quality of life by promoting safety across a number of areas. At Milestone, we believe that injured plaintiffs deserve strategies designed to ensure a lifetime of financial security. We advise plaintiffs and their attorneys on settlement issues including government benefits preservation, trust planning, Medicare Set-Asides, wealth preservation and annuities.

e d i to r - i n - c h i e f

Stephanie Andre sandre@thesafetyreport.com a s s o c i at e e d i t o r

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Keith Woods kwoods@thesafetyreport.com senior designer

Anthony James ajames@thesafetyreport.com

In this issue of The Safety Report, we explore the complexities of Alzheimer’s Disease. We also look at the other side of the story—how can you support those who serve as caregivers for loved ones facing debilitating conditions? As the end of the year fast approaches, we offer tips for beating shopaholic habits and important information for attorneys about the tax advantages to structuring their fees. As always, our goal is to arm you with useful, practical information for protecting your clients and loved ones. If you know someone who would appreciate a copy of The Safety Report or who may benefit from our representation, please do not hesitate to refer them to us.

Milestone Consulting, LLC 737 Main Street, Suite 300 Buffalo, NY 14203 (716) 883-1833 (855) 836-2676 www.milestoneseventh.com

From all of us at Milestone, have a safe and happy holiday season.

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VOLUME 5 • EDITION 4

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Š 2012 March of Dimes Foundation


INSIDE THIS ISSUE ON THE COVER

THE SAFETY

REPORT FEATURES

09

WHAT NO ONE TELLS YOU ABOUT … CANCER

23

ARE YOU A SHOPAHOLIC ?

24

DEALING WITH TOXIC COWORKERS

44

PUTTING THE KIDS FIRST IN DIVORCE

32 The Complexity of Alzheimer’s As the baby boomers head into retirement, there is a certain fear that with no cure or real origin discovered on Alzheimer’s disease, there could be a huge surge in the number of patients that begin to crop up. Already the sixth-leading cause of death among Americans, the disease is no closer to a cure now than it was 10 years ago. Here, we discuss rising numbers, promising study results and the impact on caregivers.

TRENDING TOPICS

05 16

THE RISE OF MOLLY

THE ADVENT OF THE ‘ FUN RUN ’

41

WHY THE RIGHT TEACHER MATTERS

56

TEACHING YOUR TEEN RESPONSIBLE DRIVING

-

PART 2

NEWS YOU CAN USE 18

UNDERSTANDING ER ‘ BOUNCEBACKS ’

55

TRAVELING THE WORLD FOR HEALTHCARE

64

THE DOS AND DON ’ TS OF

...

JOB SEEKING


Bullying STOPs HERE

NO MATTEr!

NO MATTER™ who you are, what you look like, your sexual preferences, your beliefs, we are ALL the same, we are ALL people, NO MATTER! That means no one should ever be bullied in any way -- NO MATTER! Everyone should be treated with kindness and respect … NO MATTER! Every kid and teen has a choice in how they treat others… NO MATTER!

A national anti-bullying and cyberbullying program for kids and teens

www.stompoutbullying.org 1.877.602.N0BULLY (8559) © STOMP Out Bullying

2011


THE PULSE

Synthetic drugs are on the move and on the rise by Michael Phelan ot necessarily a new player on the drug scene, the hallucinogen “Molly”—the pure powder form of MDMA, the main chemical in Ecstasy—has taken on heightened fame as celebs, specifically singers, have name-checked the drug in recent months. Similar to its cousin, Molly is typically used in social settings— especially at raves, dance clubs and concerts. Celebrities, including singers Madonna, Miley Cyrus and Kanye West, are just the latest notables to give unnecessary attention to the narcotic, making references to Molly in some of their songs, performances and interviews. In fact, quite recently, in a “Saturday Night Live” skit, Cyrus joked about the references to Molly in her songs.

@THESAFETYREPORT / THESAFETYREPORT.COM / 5


E V E N B I G G E R S P OT L I G H T

In late summer alone, numerous deaths were reported up and down the East Coast—all attributed to Molly. In August 2013, a 23-year-old Syracuse University graduate and a 20-year-old University of New Hampshire student died and at least four others fell seriously ill after taking what they believed to be Molly during the Electric Zoo music festival in New York City. On the same weekend, a University of Virginia student died at a rave in Washington, D.C., after ingesting Molly. During the previous week, a 19-year-old Boston woman died in a club and three concert-goers in Boston overdosed on the drug. T H E DA N G E R S O F I T A L L

MDMA can cause hyperthermia, a dangerously high increase in body temperature. Thus, users of Ecstasy or Molly may experience hyperthermic reactions from the physical exertion of dancing at an overheated show. Molly users face the same risk of death that haunted Ecstasy users decades ago. Ecstasy was popular in the late 1980s to the early 1990s. Its popularity waned after reports of a number of deaths and hospitalizations. One of the problems with Ecstasy tablets was that it was impossible to know what was actually in the tablet. Because it is an illegal, unregulated drug, the amount of MDMA, if any, varies significantly in each tablet. Indeed, not all Ecstasy pills even contain MDMA. In addition to containing varying levels of MDMA, Ecstasy also may contain varying levels of other stimulants, including MDA (methylene-dioxyamphetamine), caffeine and anesthetics, which can “significantly amplify potential harms.” W H Y M O L LY ?

Well, for starters, users describe its effect as making them feel open, accepting, unafraid and connected to people around them. These effects are stimulated by visuals, sounds, smells and touches. They want to intensify the experience of heightened sensations by dancing, talking and touching. Over the past few years, Molly has flooded the U.S. market. Recreational 6 / THE SAFETY REPORT / VOL 5 ED 4

users are under the mistaken belief that Molly is less dangerous than Ecstasy because it is pure MDMA. However, according to the Drug Enforcement Administration, many drugs sold as Molly are not actually MDMA. According to Rusty Payne, a spokesman for the DEA, “[m]ost of Molly is one of several synthetic designer drugs that have been flooding the U.S. and European marketplace from chemical labs primarily based in China.” China has a long history of exporting products laced with impurities, including toxic metals and radiator fluid. In fact, 80 to 90% of the time the DEA tests a chemical or substance believed to be Molly, it finds that the substance is “something completely different,” according to Payne. Many believe this directly correlates to the significant uptick in the number of emergency room visits for and overdoses related to Molly.

festivals featuring electronic bands like Pretty Lights, Krewella, Avicii, and others. People who use Molly or Ecstasy at such shows may complain of experiencing symptoms of overheating or even fainting.

The year MDMA was first created by Anton Köllisch

U.S. average age of Molly users

C AU T I O N

Recreational users of Molly should not only be concerned about breaking the law, but also with ingesting chemicals that have likely been laced with hazardous additives by some fly-by-night lab in China. Parents should know that Molly is prevalent at musical festivals, particularly

people who use Molly at least once a year

rare cases of subarachnoid hemmorrhage, intracranial bleeding or cerebral infarction excessive wear of teeth and resulting dental issues hyperthermia - core body temperature rising too high until major organs shut down at about 107°F (40°C) hyponatremia - low blood sodium levels as a result of drinking too much water rare instances of liver damage difficulty achieving erection and orgasm


DATA:

E-cigarettes Cause Sharp Increase in Calls to Poison Control Center by Stephanie Andre As the debate about electronic cigarette regulation continues with the U.S. Food and Drug Administration (FDA) and device manufacturers, data from one state poses concerns that should be part of the conversation. The Kentucky Regional Poison Control Center of Kosair Children’s Hospital has received 39 calls about e-cigarettes so far this year, a 333% increase from nine calls received in 2012. Nationally, poison control centers have seen a 161% increase in calls from people with concerns about these devices. With sales of e-cigarettes doubling to $1.5 billion in the past year, the calls are likely to increase. E-cigarettes consist of a rechargeable lithium battery, a liquid cartridge and an LED light at one end that simulates the burning effect of a regular cigarette. When the user inhales, or “vapes,” a heating element converts the liquid in the cartridge into a vapor. Cartridges typically contain nicotine, propylene glycol or glycerol, flavoring and other additives. “More than half of the calls we have received were concerning children,” said Ashley Webb, Pharm.D., boardcertified toxicologist and director of the Kentucky Regional Poison Control Center of Kosair Children’s Hospital. “Kids are picking up the liquid cartridge when cartridges are left accessible or when an adult is changing the cartridge,” she said. “They’re also getting a hold of the e-cigarette and taking it apart to expose the liquid. They then either ingest the liquid or get it onto their skin. Even on the skin, the nicotine is absorbed and can create adverse side effects.” These exposures raise a concern because of the concentrated nature of the cartridge fluid. “The amount of nicotine in the cartridges is not regulated, but many contain more than 14 milligrams of nicotine,” said George Rodgers, M.D., associate medical director, Kentucky Regional Poison Control Center and professor and division chief of pediatric pharmacology and toxicology at the University of Louisville School of Medicine. “Severe cases of toxicity requiring hospitalization have been reported with children consuming 1.4 milligrams per kilogram of weight— equivalent to an average 2-year-old consuming the amount found in a cartridge. And since children are not used to

consuming nicotine, their symptoms may be more severe at lower levels.” “Accidental exposure by children to e-cigarettes is a public health concern that we need to take seriously,” said LaQuandra Nesbitt, M.D., director of the Louisville Metro Department of Public Health and Wellness in Louisville, KY. “Parents need to be aware of the potential dangers to their children.” Symptoms of severe nicotine exposure include a pale appearance, flushing, sweating, headache, dizziness, hyperactivity or restlessness, vomiting, diarrhea, rapid heart rate, increased blood pressure, salivation and teary eyes. In very severe cases, the heart rate and blood pressure begin to drop to dangerously low levels and the patient can lapse into a coma, followed by difficulty breathing and even death. When on the skin, nicotine in liquid form is easily absorbed. Even small amounts can cause irritation and a burning sensation. “Only a few of the calls we have received have been from children inhaling nicotine from the e-cigarette,” Webb said. “And so far only two of the calls involved symptoms severe enough to require emergency care. But it’s only a matter of time before a child experiences a severe reaction.” “Parents need to consider these devices as a potential harm to children and, like other poisons, keep them out of reach,” said Stephen P. Wright, M.D., pediatrician and medical director of Kosair Children’s Hospital. “Since e-cigarettes are also unregulated, we don’t know what other toxins may be in them.” @THESAFETYREPORT / THESAFETYREPORT.COM / 7


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H E A LT H & W E L L N E S S

What No One Ever Tells You About...

A first-person account by Jon Lewis

In the last two years, my mother and my uncle were diagnosed with cancer.

My mother was diagnosed with lung cancer and my uncle was diagnosed with a melanoma tumor on his spine. It was very odd to have my mother and her brother treated for cancer at the same time. Both of their experiences have taught me that no one person or diagnosis is the same. We all react differently to cancer. With my mother, she went through six months of pain and difficulty breathing, while her doctor at the time kept telling her it was just a muscle problem. Finally, when she could hardly walk, I had to take her to the hospital in the middle of the night. It turned out that she had more than two liters of fluid in her heart and lungs. This led to more tests

and her cancer diagnosis. Then came the chemotherapy, and while her prognosis was not initially good, her most recent scan came back positively, and instead of talking cancer, she and her doctor spoke about baseball, and he said, “see me in three months.� My uncle, on the other hand, was diagnosed with his condition and had surgery to remove the tumor. All seemed well. He had radiation and was OK for a year. But, it came back, and he is now going through numerous treatments. Fortunately, he is at Johns Hopkins in Baltimore and is receiving incredible care. The treatments are incredibly sophisticated, and there is hope that he might even be cured. @THESAFETYREPORT / THESAFETYREPORT.COM / 9


My mother is 77; my uncle is 65. Twelve years apart, and right now (at press time), my mother is doing well, and my uncle is at the hospital for a three-week treatment plan. He was incredibly healthy before this diagnosis. All this shows is that cancer does not discriminate based upon age or gender. In light of my family experience, I have seen various things you just don’t think about until cancer hits close to home:

few years ago and assume that the same applies today. The technology to treat the various diseases changes so rapidly from year to year. Many times, it’s the little things you don’t know that really bother you. For example, people are always told they may lose their hair, but no one ever says, “you may lose your eyelashes.” It’s the simple, everyday things we take for granted, such as grocery shopping, cleaning house and

...cancer does not discriminate based upon age or gender. Chemotherapy is different for everyone. Everyone talks about how chemotherapy will make you sick and nauseous and you will lose your hair. Well, in some cases, yes, but with my mom, even at 77, she handled it incredibly well. With some of the nausea medications they have now, the effects are not as bad. While my mom had some issues, the anticipation and scare might have been worse than the treatments and effects themselves. I’m sure it is different for different people, different cancers and different medications. Cancer treatment is different and changes rapidly. With my uncle, they removed another tumor, extracted the good cells, regenerated them into more than a billion cells and they are injecting them back into his body with chemotherapy. This procedure is in hopes that these good cells will attack the bad ones and kill the cancer. If nothing else, there is hope that the cancer will be suppressed, and a new treatment will come along. This is why you cannot look at people you knew with cancer a 10 / THE SAFETY REPORT / VOL 5 ED 4

exercising that can be affected by the disease. It’s also the canceled plans and deferred dreams while you go through the time it takes to try to fight the cancer. It can be enormously frustrating. Then there’s the fear of the disease’s return. My mom’s scan was good this time, but what about in three months? My uncle was good for a year and then it returned. That fear factor is always there, and I guess it is something you learn to live with. Finally, no one ever tells you how to deal with people. Friends and family members want to help, but they don’t always say or do the right things. Someone may say, “cheer up” when you really don’t feel like cheering up. You still have emotions when you have cancer. For example, you may be angry or sad one day, but your children don’t know that, or your friends may try to get you to talk about your illness, and you just want to snap at them. Or, you might be in a good mood, and bringing up the disease just brings you down. It can be very hard, emotionally, when it comes to family and friends.

Needless to say, there are many unknowns when you are diagnosed with cancer, and for those of us not fighting the disease, we cannot put ourselves in those positions. For those of us who don’t know what it’s like, here is good advice: Laugh, Learn and Love:

Listen without judging, interrupting or feeling like you have to say something. Ask permission to give advice, to visit or to tell others of your friend’s problems. Understand that your friend is especially sensitive because of her or his trauma. Give it time if your friend doesn’t feel like talking or visiting now. Humor helps almost everyone cope. Funny movies and books can help.

Let go of the myth that everyone dies of cancer; keep hope alive! Empathize by trying to remember a time when you were terrified. Analyze your audience to determine what your friend needs and enjoys. Run interference; keep toxic friends away from the person who’s suffering. No horror stories—ever! They kill hope; people want to hear success stories.

Love her and show it by considering her needs rather than your own. Offer specific help such as picking up groceries or his kids, or doing laundry. Validate him by telling him that his feelings, even negative ones, are normal. Exercise caution by letting her bring up the subject of her health; she may want to forget.


The MAGIC of Olive Oil by Bret Hanna

he popularity of the Mediterranean Diet has led to a focus on olive oil as a socalled super food. The reason? Olive oil, a staple of the Mediterranean Diet, is readily available, very flavorful and offers an abundance of health benefits to those who consume it. Mediterranean Diet studies have long supported the notion that olive oil is “heart healthy.” A host of cardiovascular problems are caused by a gradual blockage of blood vessels and arteries, a condition known as atherosclerosis. Atherosclerosis is usually caused by one of two things, or a combination of the two. The first is caused by oxidative stress and damage to the cells lining blood vessels and arteries resulting from the presence of overly reactive molecules containing oxygen. The second is chronic inflammation of the cells lining blood vessels and arteries which can be caused by things such as exposure to environmental contaminants, or lifestyle and metabolism factors that are out of balance. Olive oil, however, provides a cardioprotective effect because it contains a key beneficial polyphenol antioxidant in the form of oleic acid, which is a monounsaturated, omega-9 fatty acid. Monounsaturated fats can have positive effects on one’s health when eaten in moderation, as opposed to saturated and trans fats, which can negatively impact health. Olive oil is the culinary oil that contains the highest percentage of

T

12 / THE SAFETY REPORT / VOL 5 ED 4

monounsaturated fat at about 75% of its fat content. This is a significantly higher percentage than other culinary oils, such as canola oil (60%), corn oil (60%), soybean oil (50-55%), sunflower oil (20%) and safflower oil (15%). Research shows that the specific antioxidant protection from olive oil is the result of a reduced risk of lipid peroxidation in the blood, or oxygen

Olive oil consumption can improve cognitive function, particularly in older adults, as well as support bone health in terms of density, and improving digestive tract health.

damage to fat molecules, such as LDL cholesterol, in the bloodstream. Reduced damage to LDL cholesterol molecules helps maintain a proper balance between LDL and HDL cholesterol, which is the balance of total cholesterol in the body. Olive oil has also been shown to reduce risky blood cell, or platelet clumping in the bloodstream, as well as lowering blood pressure. All of these benefits work to improve the cardiovascular health of those who consume olive oil. The magic of olive oil, however, is not limited to cardiovascular benefits. Consumption can also reduce the risk of certain types of cancer. Many

types of cancer begin and thrive when there is lipid peroxidation and chronic inflammation of cells in the blood vessels and arteries. Since the polyphenol benefit of olive oil reduces the risk of both of these conditions, the risk of those types of cancer are likewise reduced. These types of cancers include digestive tract cancers, respiratory tract cancers and breast cancers. There is also research that now suggests that olive oil consumption can improve cognitive function, particularly in older adults, as well as support bone health in terms of density, and improving digestive tract health. In addition to the reduced risk of digestive tract cancers noted above, studies now suggest that the polyphenols in olive oil can help balance bacteria in the digestive tract and reduce the growth of unwanted bacteria that can result in digestive tract infections. In light of all the praise that can be sung about olive oil, feel free to use it liberally in salads and pasta, when cooking fish and for any other culinary use you can think of for it. In this regard, there are a couple of things to keep in mind. When looking to purchase olive oil, conventional wisdom is that cold-pressed extra virgin olive oil is preferred over other types, including so-called pure olive oil, for its nutritional benefits. Since the United States has not adopted the International Olive Oil Council standards for labeling olive oils, look beyond the words “extra virgin olive oil” when looking at labels. Look hard to ensure that is what you are really buying. If you see “COOC,” “AOC,” “DPO” or “DO” on the label, you are fine. Those initials, which stand for several different labeling authenticating entities, provide assurance of authenticity and quality of the product. Also, purchase a bottle you can use in about two months and once purchased, store it in a spot away from light—in a dark pantry or cabinet, for instance. Finally, enjoy the flavor that olive oil brings to your table and the health benefits that it will bring to you and your family.


SUGAR:

THE SILENT KILLER by Jarome Gautreaux

It wasn’t all that long ago that we were told that we should focus on reducing saturated fat consumption if we wanted to live longer and be healthier. Over the last several decades, the medical establishment generally embraced the idea that saturated fat was the main dietary culprit, and that we should reduce our consumption of saturated fat. In response, food manufacturers switched to lower fat foods. The problem is that low-fat foods usually don’t taste very good. The solution? Add sugar, and lots of it, to make the low-fat food tasty. So the standard diet became lower fat but higher sugar. But the switch from saturated fat to low-fat foods has not correlated with a dramatic improvement in health. In fact, cardiothoracic surgeon Dwight Lundell, M.D., says that the generally accepted dietary recommendations about reduction of saturated fat “have created epidemics of obesity and diabetes.” Today, the average American consumes about 77 pounds of added sugar per year. In 1800, the average per capita consumption of sugar was about 18 pounds per year. Sugar has been referred to as the “silent killer” because of its numerous bad health effects. Authorities

such as well-known physician Mark Hyman, M.D. (internationally known in the field of Functional Medicine), food expert Michael Pollan and many others agree that sugar consumption is at dangerous levels, particularly in the United States. Yet, we seem to crave sweets. So sugar can’t be all bad, right? The most obvious benefit of eating sugar is that it simply tastes good. It is no accident that our primal ancestors sought ripe, sweet fruit and avoided unripe, bitter fruit. The ripe fruits were great sources of quick energy needed for survival. It is probably overkill to suggest that everyone completely avoid all refined sugars. The problem is that our world is flooded with refined sugar, and we may simply have too much of a good thing. The problems associated with excess sugar consumption are serious and varied. The main problem, according to researcher Robert Lustig, M.D., an expert in the field of diabetics, UCSF Diabetes Center, is that consumption of sugar leads to excess production of fats and insulin resistance. This, in turn, contributes to many disease processes, including heart disease, diabetes and cancer. Some research now suggests that Alzheimer’s

(see more, starting page 32) is also linked to excess refined sugar consumption. Also, consumption of sugar-sweetened drinks (the main source of added sugars in the American diet) are linked to more than 180,000 deaths worldwide each year. Excess sugar consumption is associated with $1 trillion per year in healthcare expenditures in the United States, according to a report by Credit Suisse. So, the way to eat better and live longer, healthier lives is probably fairly clear. It involves eating a diet of whole foods and limiting processed, sugary foods. As Pollan puts it: “if it came from a plant, eat it; if it’s made in a plant, don’t.”

Did You Know? NBA superstar Dwight Howard changed his diet last season after learning he ate sugar equivalent of 24 Hershey bars A DAY from candy and soda. -CBSSports @THESAFETYREPORT / THESAFETYREPORT.COM / 13


Exercise— Not Just for Losing Weight Why It’s Also Great for the Mind by Brett Emison

E

veryone knows (or should know) that exercise has health benefits for our bodies. Regular exercise helps control weight, maintains healthy blood pressure and can reduce the risks of diabetes and heart disease. Another, less obvious, benefit of exercise is that it is good for the mind as well. Though the reasons are not entirely understood, part of the reason for this benefit comes from blood flow. When exercising, our blood pressure and blood flow increase to provide energy to our muscles. This blood flow increases everywhere—including the brain. More blood=more oxygen and more energy. It’s like supercharging the brain. It goes beyond just blood flow, though. The human body recognizes a bout of exercise as stress and releases Brain-Derived Neurotrophic Factor (BDNF) to help compensate for that. BDNF protects and repairs neuron connections in the brain leading to improved brain function. One hypothesis for this mental benefit is that when our ancestors were physically active, they were likely either hunting or being hunted. In either of these circumstances, mental clarity and creativity could be the difference between life and death. Today, we aren’t usually “running for our lives,” but we still get some of the same benefits that our ancestors did. Researchers have determined that nearly every aspect of cognition—including creativity, memory, learning and mood 14 / THE SAFETY REPORT / VOL 5 ED 4

—improves after as little as 30 minutes of exercise and the benefits can last two hours or more afterward. This is why a short walk can “recharge the batteries” and jump-start creative processes. Another mental benefit of exercise is that the hippocampus—the part of the brain critical for learning and memory—revs up during exercise. The hippocampus is responsible for a number

Aerobic exercise among older adults increases the size of the hippocampus, reversing shrinkage and improving memory function.

of functions including spatial orientation, emotional responses, and consolidation of new memories, i.e. associating smell and sound to memories. The hippocampus typically begins shrinking around age 45, which can lead to cognitive decline including loss of memory and degenerative brain diseases like Alzheimer’s (see more in cover section, starting on page 32). While exercise can’t cure Alzheimer’s, research shows that regular exercise—especially between the ages of 25-45 —supports a healthy hippocampus and helps prevent cognitive decline. There is even research

that suggests that aerobic exercise among older adults increases the size of the hippocampus, reversing shrinkage and improving memory function. One important thing to note is that regular exercise is key to both the short-term and long-term benefits. In people who rarely exercise, any shortterm benefit is offset by the fatigue of exercise, rendering little, if any, benefit. Similarly, it seems to be the long-term exposure to the chemicals released through repeated bouts of exercise that have therapeutic effects on the brain.

For a generally healthy person, there is really no downside to exercise. However, you should: Consult your doctor before starting an exercise routine for guidance on what type of exercise is best for your health and fitness level. Start slowly—doing too much, too soon can lead to injuries which could sideline you, causing you to miss out on the benefits of exercise—possibly permanently. Try to incorporate a variety of exercises to keep it fun and to prevent over-use type injuries.

All of the physical and mental benefits of exercise are there for the taking. In the immortal words of Nike, “Just Do It.”


5 Steps for Keeping Your Skin Healthy in Cold Weather by Stephanie Andre

If cold weather hasn’t yet wreaked havoc on your skin, it most likely will; dry skin will be a battle for months. But, there are tactics you can use that can help you fight the battle and maybe even win the war. “You might imagine that you can relax once the obviously drying weather of summer is over,” says consultant dermatologist Sue Mayou, M.D., of the Cadogan Clinic, London, “but the winter season is very drying to skin, too. “There is less moisture in the air and what natural oil you do have in your skin can be blown away by the wind. Once inside, central heating is also very drying. “That’s why our skin feels much tighter in cold weather; but if you have sensitive skin, the dryness will lead to flaking and itching; if the barrier level is damaged you are much more likely to develop inflammation and bring on eczema. It’s very important to hydrate the skin with the right type of cream.” Here, “The Armchair Dermatologist,” New York-based dermatologist Bobby Buka, M.D., offers tips for keeping your skin healthy all winter long. Drink Plenty of Water Many people drink less water during the cold seasons because they are not perspiring as often as they would in the hot summer months. You should keep your water intake consistent. It not only contributes to better overall health, but also keeps your skin supple, soft, and healthy.

Limit Your Showers Everyone loves a hot shower during the cold months, but few people realize that it is drying out their skin quickly. Try to take showers with warm water whenever possible, or limit your hot showers to less than three minutes. Right after your shower, apply moisturizer. Water helps moisturizer absorb more effectively into the skin.

Stay Away From Cold Winds Cold winds do not only leave your skin dry, but also cause painful rough patches and redness. Cover up with long sleeved tops, pants or jeans, hats, and earmuffs to keep the wind off your skin.

Use Sunblock Sunblock isn’t just for summer. Apply a broad spectrum SPF 30 or higher sunblock at least 15 minutes prior to heading outdoors in cold weather. Be sure to use a quality lip balm with SPF 15 or higher, as well as a facial moisturizer.

Try Using a Humidifier Humidifiers deposit moisture into the air. These handy devices keep your skin supple and elastic. If you have a radiator, you can simply place a bowl of water on top of it to create a makeshift humidifier. @THESAFETYREPORT / THESAFETYREPORT.COM / 15


THE EMERGENCE OF THE FUN RUN How even the most novice athlete can get in on the action by Stephanie Andre Four or five years ago, had you ever really heard of fun runs? These days, there’s mud runs, color runs, zombie runs and even turkey trots. And that’s not a bad thing. Whether it involves running through foam-covered obstacles or getting splattered with colored powder, fun runs are just that: fun. And that is the key motivator, according to Edward L. Deci, Ph.D., a motivational researcher and professor of psychology at the University of Rochester. People who work out for the pure joy of working out rather than for a result (think: lose those last few pounds) actually stick

with workouts longer and reap better results, he says. These days, you don’t need to be a marathon runner to get the “runner’s high” nor do you need a year of training to complete your first race. For novice runners, a fun run is a great introduction to organized racing events; for those in training for longer races, it can help stoke your competitive edge. With a myriad of different themes—and difficulty levels—from which to choose, these races focus less on breaking records and more on getting active and having a good time. Here, we share 10 races, held in a city near you, courtesy of everymove.org.

2. Run for your Lives (www.the5kzombierun.com) Type: Obstacle & Mud Run Competitive Level: (you are “running for your life”) Obstacles: Series of man-made obstacles and chasing zombies Great for: Zombie lovers and people who like to be chased Charity Donation: None Run for your Lives is your traditional obstacle and mud run with a twist. As you are darting through mud and working around obstacles, such as a maze and blood pit, zombies chase you. The object is to make it through the race without the zombies getting all three of the flags around your waist. Sometimes this requires some extra sprinting and quick maneuvering depending on the zombie’s agility. 3. Warrior Dash (www.warriordash.com) Type: Obstacle & Mud Run Competitive Level: Obstacles: Series of man-made obstacles and mud Great for: Anyone interested in mud runs Charity Donation: None The original mud and obstacle run, the Warrior Dash is held in more than 40 locations, so if you wish to try out a mud and obstacle run, this is a great one to start with. They have flexible participation rules when it comes to the obstacles, so everyone can participate at the level they wish. And don’t forget to celebrate your success with a Turkey Leg! 1. The Color Run (thecolorrun.com)

4. Hot Chocolate 5k (www.hotchocolate15k.com)

Type: Road Race Competitive Level: (untimed race) Obstacles: None Great for: First-time 5k runners who like getting colorful Charitable Donation: Varies by city

Type: Road Race Competitive Level: Obstacles: None Great for: Classic 5k runners who love chocolate Charity Donation: Ronald McDonald House

The Color Run, also known as the Happiest 5k on the planet, is a unique paint race where participants are doused in different color powder at each kilometer. This race welcomes participants of any fitness level and encourages group participation.

America’s sweetest race, the Hot Chocolate 5k (and 15k) is a traditional road race with an amazing reward at the end. Upon completing the race, each participant receives a hot chocolate, chocolate fondue and various dipping treats.

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7. Dirty Girl (www.godirtygirl.com) Type: Woman-only Mud and Obstacle Run Competitive Level: (untimed course) Obstacles: Mud, ropes and more Great for: Women looking to try their first mud run Charity Donation: Various breast cancer charity organizations What we love the most about the Dirty Girl races is they are one of the few mud and obstacle races at the 5k level that support charity donations. The course itself is very similar to the Warrior Dash but with a female twist—expect a lot of pink tutus and female themed obstacle names. A great race to try with girlfriends!

8. Rugged Maniac (www.ruggedmaniac.com) Type: Mud and Obstacle Run Competitive Level: (lots of obstacles) Obstacles: Yes - 20+ Great for: Intermediate to advanced mud runners who want more obstacles Charity Donation: None Another newbie to the Mud and Obstacle race circuit, the Rugged Maniac is raising the bar on obstacles presented. Expect over 20 obstacles to complete, including a 100-foot water slide and jumping over fire. They offer opportunities to run the race for free by volunteering, so if you are looking for a more budget-friendly race this might be the one for you.

9. 5k Foam Fest (www.5kfoamfest.com)

5. Jingle Bell Run (www.arthritis.org/programs-events/jingle-bell-run) Type: Road Race Competitive Level: (walkers welcome) Obstacles: None Great for: Classic 5k runners who like to give back Charity Donation: Arthritis Foundation The nation’s largest 5k holiday race, this event coordinates runs all across the country. It’s a more traditional road race, which focuses on forming teams and fundraising for the main charity, the Arthritis Foundation. Participants are encouraged to dress in their favorite holiday-themed costumes and are given bells to tie to their shoes during the race as well.

6. Turkey Trot (Search active.com for local events) Type: Road Race Competitive Level: (walkers welcome) Obstacles: None Great for: Classic 5k runners who like fundraising Charity Donation: Varies The Turkey Trot has become a great holiday tradition for many families. Many U.S. cities and towns sponsor 5k runs on Thanksgiving day where families are encouraged to wear their best costumes and run/jog/trot for charity.

Type: Mud and Obstacle Run and Foam Run Competitive Level: (untimed) Obstacles: Yes – 20+ Great for: Beginner mud racers who love car washes Charity Donation: None A mud run meets a car wash, the Foam Fest is designed for those that want a little bit more than mud to run through. Obstacles on this course are a mix of traditional climbing walls, mud pits and rope courses as well as inflatable slides and bouncing contraptions covered in white foam. This event is more focused on the obstacles than the run, so if you are training for a real 5k, it’s best to try a different race. Bonus for families: in the spectator area there is a foam-only play area for kids.

10. Spartan Sprints (www.spartanrace.com) Type: Mud and Obstacle Run Competitive Level: (more difficult obstacles) Obstacles: Yes – 15+ Great for: Intermediate to advanced mud runners who want more obstacles Charity Donation: None The Spartan Sprint distance can vary, and typically can be a little longer than a 5k. There are longer distances to choose from if you prefer more of a challenge, but with any distance you choose, be prepared for a more concentrated and challenging amount of obstacles. The Spartan Sprint (shortest distance) boasts 15+ obstacles to complete, including mental challenges that are designed to get you out of your comfort zone. @THESAFETYREPORT / THESAFETYREPORT.COM / 17


Don’t Become an ER ‘Bounceback’ by Mark Kitrick

E

very year, millions of Americans visit emergency rooms, more than any other civilized country, mostly because many patients use them as primary care facilities. In these high-demand, stressful environments, ER physicians, triage nurses, physician assistants and technicians are the front line medical providers. These caregivers do their best, whether encountering common colds, strokes, heart attacks, rare diseases, catastrophic injuries, mysterious complaints and who knows what other maladies. Over the past few years, much research has been done on this subject, particularly by Michael Weinstock, M.D. and Kevin Klauer, M.D., co-authors of the book, “Bouncebacks! Emergency Department Cases: ED Returns,” which details patient cases to educate fellow ER doctors on how to improve our medical system.

“Bounceback” means that someone returns to the ER after being released hours or days earlier, and then does not survive. If you’ve never heard of a bounceback, you’re not alone. Quite simply, it is when a patient returns to the ER after being released hours or days earlier, and then does not survive. From research and experience, here are some suggestions on how to prevent yourself—or someone you know—from becoming a bounceback statistic. 18 / THE SAFETY REPORT / VOL 5 ED 4

1. Be Detailed. Give as much information as possible when visiting the emergency room. Don’t save your worst complaint for last, as most people do. Instead, begin with your worst maladies. If possible, write it all down and give it to the ER physicians. Include a complete list of medications and accurate personal and family histories.

2. Communication Down the Line. Don’t assume that your reason for being there is being transferred from one doctor or healthcare provider (nurse, physician assistant, tech) to another.

3. Actively Advocate. If possible, have someone with you at all times, one who can speak for you and help you understand and interpret what is going on. Many people become submissive when dealing with medical professionals. On the flip side, however, studies show that if a patient pushes a doctor through insinuation or blame or attack, this causes the doctor to think about short-term legal risks as opposed to the long-term patient health. The physician will then order expensive or inappropriate medicine and may make errors. Surprisingly, this causes a 21% higher risk of mortality. The main lesson: give your physician permission to practice good medicine.

4. Self Research and Diagnosis. Conducting your own research provides useful information. But, taken

out of context, what you learn can be misleading or frightening. Such knowledge can be dangerous because it can cause you to unintentionally mislead your physicians or act in ways that harm your health or situation. Let your doctors do their jobs.

5. Misperceptions. Physicians may not know exactly what is wrong with you in the ER. Sometimes, symptoms are so generalized or nonspecific that you could have a cold or a sprained chest or shoulder or be suffering from a heart attack. Diagnosing complaints can be very a complicated process. And quite often, as laypeople, we have misconceptions and a lack of basic knowledge.

6. Don’t Delay. An unfortunate, yet common, problem— usually with men—is waiting too long before going to the doctor. Denial and delay can cause death. If you feel something is wrong, get treatment, urgently. If you’re watching someone in distress, get them to the ER or call an ambulance. If you don’t and there is a bad result that could have been avoided, besides contending with a tragedy, one’s guilt can last a lifetime. Educate yourself and your loved ones. If you follow these six simple guidelines, you will better protect yourself and your family and reduce the likelihood of an emergency room bounceback.


You promised yourself you would quit smoking once you found your new job, after you got married, when you turned 35, when you had your first child or when you retired. Every year, millions of people make the promise to themselves and to their families to kick the cigarette habit once and for all. Many individuals who make that promise know that smoking is bad for their health and harmful to the people around them, but many don’t realize the immediate health improvements once they begin the process. According to the Centers for Disease Control and Prevention, within 20 minutes after you quit smoking, the healing process begins. The timeline below shows just how your body and health begins a series of changes that continue for years.

by Brittany Monbarren

20 Minutes After:

12 Hours After:

Two to Three Weeks After:

Your blood pressure and pulse rate will fall. The temperature of your hands and feet will return to normal.

The carbon monoxide in your body decreases to lower levels, and your blood oxygen levels increase to normal.

Your chances of heart attack decreases and your lungs are working better. Your ability to taste and smell is enhanced.

One to Nine Months After:

One Year After:

Five Years After:

Your body circulation improves. Your lungs start to function better, lowering your risk of lung infection.

Your risk of heart disease is lowered by 50 percent compared to when you were still smoking.

There is a large drop in your risk of having a stroke and this risk will continue to decrease over time.

Ten Years After:

Fifteen Years After:

Lung cancer death rate is similar to a nonsmoker. Your risk of mouth, throat, esophagus, bladder, kidney and pancreatic cancer decreases.

Your risk of coronary heart disease and having a stroke is close to that of a person who has never smoked. Risk will now be “normal.”

After you give up smoking, the improvements to your health begin almost immediately. If you focus on the benefits and sticking to your goal, it will help you stop once and for all.

@THESAFETYREPORT / THESAFETYREPORT.COM / 19


Behind this SUV is a group of daycare children. Not one of these children can be seen by the driver behind the wheel.

WORKING TO KEEP CHILDREN SAFE IN AND AROUND VEHICLES Before you turn the key‌make sure you can see! Most drivers are unaware of the large and very dangerous blindzone that exists behind all vehicles. Every week at least 50 children are seriously injured or killed after being backed over because a driver was unable to see them behind their vehicle.

Help save the life of a precious child Donate to KidsAndCars.org

LOG ON TO DONATE: http://kidsandcars.org/donate.html

FOLLOW US: @KidsAndCars


LIFESTYLE&LEISURE

You Are

What You Tweet HOW SOCIAL MEDIA AFFECTS YOUR DIET by Tom Atmore

YOU GET A FACEBOOK UPDATE

about a friend drowning her sorrows in a pint of ice cream. A friend sends you a link to Pinterest “food porn” showing photos of amazing salads. That exercise website you signed up for to receive blog updates or tweets reminding you to drink eight glasses of water today. Will you be drowning your sorrows in ice cream? Forgoing the pizza for a salad at dinner? Running to the water cooler? The science of the impact of social networks on individual behavior says, “most likely, yes.”

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In an (in)famous study published in the New England Journal of Medicine, scientists showed that if your friend becomes obese, you are 57% more likely to become obese, too. If your sibling or spouse gains weight, you are 47% and 37%, respectively, more likely to gain weight along with them. This phenomenon is called a “contagion” and—depending upon what your friends and family are coming down with—you may want to try to get inoculated or expose yourself. With the rise in social media, the contagion can

spread wider and faster than ever before. The impact of social media on diet was recently highlighted in a study that found that most buying decisions about what to have for dinner are made two hours before mealtime, that most Millennials learn to cook from YouTube, and that the “best advice” about what to have for dinner overwhelming comes from your own network of close friends (sorry mom) or a website or social networking site like Pinterest. It turns out, not surprisingly, that we prefer to learn about products— including food—by seeking out the advice, experiences and preferences of “people like us.” The study, which was designed to gather information that food companies can use in marketing their products, concluded that some of us are “spectators,” who use social media to extend our network of friends and family to find reviews, recipes and deals; some of us are “dreamers”

who want to show the world what we know and think about food and create a following; and some of us are “doers” who are actually creating the social media food content and pushing it out to others. Most of us are “spectators,” of course, and armed with the information about how we can be influenced by social media, we can take steps to make that influence positive and create our own, healthy “contagion.” For example, find a healthy eating website that provides tips and recipes and share it with your own network of friends and family. Post your positive food choices on your Facebook or Pinterest or tweet a photo of that healthy dinner you made to all your followers. There are also smartphone apps that you can use to track your eating habits and share information with other users. In no time at all, you can go from “spectator” to “doer” and start a “contagion” for which your friends and family will thank you.

TOP SMARTPHONE DIETING APPS For an extra boost in your weight loss plan, consider these apps below.

Calorie Counter & Diet Tracker by MyFitnessPal This easy-to-use app has a database of more than 1.5 million foods, nutritional information and food and exercise data entry. The app sets a daily calorie goal for you and records your daily calorie intake and exercise. (Free)

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Lose it!

Fooducate

Noom Weight Loss Coach

This app is all about calorie tracking. It logs your food and exercise information each day and provides a breakdown of your daily nutrients, along with connecting you to people, devices and food information. (Free)

This app is designed to help you lose weight by eating real food. Fooducate grades your food, explains what’s really inside each product and offers healthier alternatives. It also tracks your diet, calorie quality and exercise daily. (Free)

Along with a personalized and interactive weight loss plan, this app provides you with daily tasks to keep your program fresh, including health articles and daily challenges, and easy-to-use food and exercise logging. (Free)


Are you a

Shopaholic? by Katie Dunn

Compulsive buying is celebrated in the media—think of the Kohl’s commercial in which the mom is prepared to wrestle the dog to get her Kohl’s Cash, or the movie adaptation of “Confessions of a Shopaholic.” The past several years have marked the first time ever that many retailers chose to open their doors on Thanksgiving Day, much to the delight of frantic holiday deal-seekers everywhere. Unfortunately, many people find it difficult to control their spending, much to the detriment of their bank accounts and personal relationships. Psychologists have termed this behavior “Compulsive Buying Disorder,” which is characterized as an impulse control disorder with tendencies similar to those exhibited in eating disorder and substance abuse disorder cases. According to a 2006 article in the American Journal of Psychiatry, 6% of women and 5.5% of men in the United States can be categorized as compulsive buyers. How can you tell if you are an average spender or a compulsive buyer? Do you: » Lie about your purchases or the amount of money you’ve spent? » Frequently feel a sense of remorse after you’ve made a purchase? » Turn to shopping as a stress reliever? » Have closets full of items with the tags still on them? » Get to the end of the month and have no idea what happened to your paycheck? » Spend beyond your means? » Base your self-worth on how you look and what you own? If you answered “yes” to any of these questions, you likely land somewhere on the compulsive buyer spectrum. Luckily, depending on the severity of your behavior, there are steps you can take to curb your spending habits:

Create a Monthly Budget Keep track of your expenses over 30 days and use that data to create a monthly budget. If you have room, make sure you include some “fun money” in your budget.

wait five days before buying. Chances are, you’ll either forget about the purchase, or you will have given yourself enough time to think it over without the emotion involved in a spur-of-the-moment purchase.

Use Cash It’s much more difficult to fork over cash than it is to hand over your credit card. Although debit cards take the money directly from your bank account, paying in cash provides you with the opportunity to make the physical connection between the money in your wallet and the purchases you make.

Avoid Temptation Are you an online shopper? Do the Sunday ads immediately send you to the stores? Figure out what your biggest shopping temptations are and avoid them as much as possible.

Track Your Spending Still can’t figure out where your money is going? Keep a small notebook with you and track what you spend. If that’s not convenient, collect your receipts and write down your expenses on a weekly basis. For the more technologically inclined, there are also some great apps for tracking your spending, including Spendee, Mint and BUDGT. Give Yourself Time Make an agreement with yourself or your spouse to wait on purchases over a certain amount of money. For example, on purchases over $100,

Identify Your Triggers Compulsive buying is an emotional disorder. When these buyers experience certain emotions, such as sadness, depression, stress, anger or even excitement, those emotions drive their behavior. Once you’ve identified your triggers, select some healthy behaviors to replace your urge to shop. In some cases, you may need to seek professional help or a support group for help. Find a local therapist who specializes in impulse control disorders, or contact a support group like Debtor’s Anonymous or Shopaholics Anonymous. With the right combination of perseverance and support, you can take control of your spending habits.

@THESAFETYREPORT / THESAFETYREPORT.COM / 23


H o w t o P r o t e c t Yo u r s e l f f r o m

c owor k e rs by Stephanie Andre

e’ve all met at least one in our professional lives. That one person who seems to wreak more havoc than you could ever imagine coming from one individual. All you want to do is complete an honest day’s worth of work. Yet, for some reason—you are still trying to figure it out since he is lazy, insensitive and just overall, underproductive—he manages to skate by. There are a number of reasons this occurs, according to Blaine Loomer, author of the book, “Corporate Bullsh*t: A Survival Guide.” Here, Loomer details the different types of “toxic” employees and how you can protect yourself from getting infected.

Promotions based on merit are not what these schmoozers believe in. Instead, they participate in office politics—popping in the boss’s office every five minutes, declaring their indispensable worth. The Politician is consumed The Politician with company politics. Her work life becomes a game in which she is constantly trying to “win” the next job, the next promotion, the next project. However, she spends little or no time fulfilling her current responsibilities. How to protect yourself: If you’re looking to earn the promotion you deserve without playing the office politics game, first evaluate your boss. If your boss has a huge ego, then the Politicians will be tough to beat because they excel at stroking egos and kissing up to get what they want. If your boss isn’t an egomaniac, he will soon tire of the grandstanding. 24 / THE SAFETY REPORT / VOL 5 ED 4

These are those people who live on negative energy and are motivated by crisis. Drama drives their days. Although they usually have ample time to complete their assigned tasks, for whatever reason, they procrastinate or otherwise delay The Funeral progress until there is a crisis and Director something “just has to be done.” Any task you give them will eventually become the “end of the world” until it is accomplished. How to protect yourself: When you work with a Funeral Director, pad the schedule. Make sure the deadline you assign is earlier than the actual deadline. This will ensure that their crisis does not become yours.

These are interesting characters. Loomer calls them Roosters for two reasons: They seem to want to crow a lot about themselves and they also like to sit on the fence to avoid making decisions.

The Rooster

The Rooster is a bit of an egomaniac, and this affects his ability to make decisions. If a Rooster makes a poor one, it’s a huge bruise to his ego. At some point, he may have to admit that he was wrong. This fear of imperfection keeps the Rooster on the fence. He rarely, if ever, makes a decision. If he is lucky, someone else will make it, or if he waits long enough, the decision will make itself. Either way, the Rooster’s passive approach allows him to maintain a level of deniability. The Rooster is also always quick to assign blame. How to protect yourself: There are two things you can do if you have to work with a Rooster. Either force him to make a decision, or tear down the fence and watch him run around aimlessly. Whichever choice you make, you will need a lot of patience.


The Points Shaver: Anything she does for you is recorded on her mental scoreboard.

The Points Shaver

We all know someone who is a Points Shaver. She keeps score on everything. Anything she does for you is recorded on her mental scoreboard, and she expects to be repaid at some point—in the very near future!

How to protect yourself: When dealing with a Points Shaver, keep in mind that the score is never tied. Don’t bother keeping score unless it’s worth your time. The best way to keep your sanity may be to avoid the Points Shaver altogether.

Do you ever wonder who keeps the office rumor mill going? Or how your boss finds out about every little mistake from you and your colleagues right after it happens? Look no further than your office Tattletale. They deal mostly in The Tattletale negative office rumors and gossip, or in any other information that they think they can use to get ahead. They love to share bad news—as long as the bad news is about somebody else and not them. How to protect yourself: Keep your mouth shut and don’t disclose anything you don’t want everyone to know about. The only thing you can trust about Tattletales is that they will disclose any information you tell them if doing so will give them a leg up in the company. Remember, anything you say to them can and will be used against you!

I’m sure you recognize the Networker—the person who spends more time networking than actually working. They believe that the road to success is about whom you know, not what you know.

The Networker

How to protect yourself: Don’t get sucked into the web of a Networker. They name-drop and appear to be connected. In reality, they are just time thieves. They burn up a lot of your valuable time with meaningless office chitchat. It doesn’t take long for everyone to get tired of them. Hanging around them will not add much to your value.

I think we all know what this is by now. But look out for Office Flirts who do their flirting 21st centurystyle. You may become involved in an email back-and-forth or IM conversation that turns flirtatious before you even know it. Or you The Office Flirt could receive some questionable correspondence after becoming the Office Flirt’s friend on Facebook or another social networking site. Bottom line: keep all of your office conversations professional—whether it takes place by the water cooler or online. How to protect yourself: Just don’t get involved. End of story. Nothing good can come from it. Don’t even think about it!

Have you ever come across someone at work who spends all of his time worrying about what everyone else is doing, while at the same time complaining that no one else in the company ever does anything and that he is saddled The Taskmaster with all the work? This is the Taskmaster. Taskmasters are quick to assign tasks to other people to avoid having to do anything—and yet as soon as a task is completed, somehow the Taskmaster is there to take credit for getting it done. How to protect yourself: Beware of him. Keep him at a distance or you will spend your days doing his job.

Watch out! Wakeboarders are similar to Taskmasters in that they like to pass their work on to others; however, unlike Taskmasters, Wakeboarders hide their BS behind an outgoing personality. Coworkers like them, so they are more willing The Wakeboarder to help, and the Wakeboarder knows this. She spends a good deal of her time socializing, not to network, but to find gullible coworkers to whom she can pass her work. How to protect yourself: Like the Taskmaster, steer clear of Wakeboarders. Although Wakeboarders are typically good employees and produce high-quality finished products, they leave a wake a mile wide as coworkers bust their humps to help them complete their projects. Just imagine what these workplace BSers and the rest of their ilk are costing in productivity, not to mention the overall morale of their companies. The important thing is that you not get bogged down in their nonsense. @THESAFETYREPORT / THESAFETYREPORT.COM / 25


ONLINE SAFETY

is a Shared Responsibility Learn how to do your part to make the Internet safer and more secure for all.

facebook.com/STOPTHINKCONNECT

www.stopthinkconnect.org

@STOPTHNKCONNECT

STOP. THINK. CONNECT. is the national cybersecurity education and awareness campaign.


Is It Time to Break Up with Your Gym? by Stephanie Andre

You’re comfortable. You know how to work the key fob. You give the ‘ole head nod to the guy behind the front desk. You know where the locker room is and have your favorite locker. But most importantly, you know where “your” machines are and how to use them. You have it made. You rule that gym! But then, just like in all relationships, things slowly start to change and the things that never bothered you before are now front and center: the locker room is messy; you just can’t handle getting waitlisted one more time for the only spin class that fits your schedule; you start to notice some broken machines; and then there’s that weird guy—who looks like he smells (and not from sweat)—who keeps staring at you. So, what do you do? Do you leave? Can you salvage this relationship? Here are some classic examples of when others have reached the “7-year itch” with their gyms and some suggestions for how to handle them: Bad instructors/instructor turnover: Once you find a great spin teacher or body pump instructor, you may never want to let go. So, imagine your surprise when you show up to your 6 a.m. spin class to discover that your teacher—the one with the best spin mix ever!—was gone. While things like this are bound to happen, consider how important this is to your overall enjoyment level at the gym. The new instructor couldn’t be that bad, could she? Unfavorable group exercise schedules: If you’re busy like most people, you need a gym that offers classes at multiple times various times per week. If you’re not getting that then it’s obviously understandable why you’re frustrated. On the flip side, have you talked with the gym and asked about adding that abs class to the schedule?

Quick Tip Breaking up with your gym might seem like the easier thing to do—just like in real relationships—but think about the things you do like. Buzz kill: Many times, people join the gym right after the New Year and there’s a certain energy that comes with it. There are more new people, all eager to get fit. But then, that momentum dies and with it, so does the energy of the room. To combat this, try a brand-new mix of music to get you moving. Sell, sell, sell: It’s enough when you first sign up and they try to get you to sign up for personal training classes. Enough’s enough, right!? Solution: Ask them to mark your file that you are not interested and if that changes, you will approach them for more information. The intimidation factor: Most of us don’t show up at the gym with a sixpack. Don’t let the “pros,” so to speak, intimidate you. Most of the time, they’re just trying to get in a good workout, too. Don’t let this worry you or convince you that you shouldn’t be there. Read the fine print. Some gyms have introductory contracts—i.e., the first 12 month’s are one price and then it changes in month 13. If you feel like you were duped, consider talking with the manager. Breaking up with your gym might seem like the easier thing to do—just like in real relationships—but think about the things you do like you may be leaving behind. Before making a rash decision, try some of the suggestions above. If you’re still not satisfied then perhaps your dream gym still awaits. @THESAFETYREPORT / THESAFETYREPORT.COM / 27


CUTTING THROUGH THE

CLUTTER 5 Steps to

ORGANIZE YOUR LIFE by Cheryl Pope

Y

ou can’t see your desk through the clutter piled up on it. You don’t have time to eat lunch because you’ve got too much to do. Getting one child to soccer, one to gymnastics and the other to cheerleading practice all at 4 p.m. is the next challenge. When did life get so busy and where did the time go to deal with it all? More importantly, what can be done to streamline and manage everything? Well, it has nothing to do with the things on your desk or the number of meetings on your calendar. It all centers on you because it’s not an issue of time or clutter management, but of self-management. Time is not adaptable but you are, so you have to focus on yourself before you can focus on the things and people around you. Self-discovery is the key to personal freedom so it’s important to understand that everything you do or have either helps or hinders you. Unlike money, time can’t be unspent and your activities must be consistent with what you value most in life. Once you have identified what is absolutely critical in your life versus what is not, you can start to put together a plan for change. Make a list of what is most critical to you. Is it spending time with family and friends or is it having the cool new toys before everyone else? How does work mesh with your personal values? What must you have to live and what can you live without? Once you have your list, think about the way you spend your time and money then follow these steps:

1. Identify one habit you want to change. That’s it. Just one thing you want to change about the way you spend your time or your money. That pile on your desk started 28 / THE SAFETY REPORT / VOL 5 ED 4

with one thing being placed on top of another. Those extra 20 pounds started with the first bite. The good news is that one behavior cues another so change is possible if you start simple.

2. Clearly define how you want to behave. Close your eyes for a minute and picture what things look like in a perfect world. And be realistic. Write it down someplace you will see it every day.

3. Focus on that one thing every day. It’s really that simple. Just start doing the one thing you want to change. File the bills as they come in or spend five minutes each morning planning out your day. Whatever it is, shout it from the rooftop. Tell others what you are doing and ask them to help hold you accountable. Make it part of your routine.

4. Resist temptation. Don’t stray from the plan or cheat until your behavior is established. It’s only one thing so how hard can this be? Conventional wisdom says it takes three to four weeks to change a behavior. Before you know it, you won’t be able to imagine a time in your life when you didn’t act this way.


5. Keep working through your list. Choose the next thing you want to change and keep on working the list one item at a time. The more you believe and feel like you can control, the more you will control. As you start to change, your awareness will be replaced with accountability and you will move from feeling powerless to feeling powerful. Enjoy the ride!

@THESAFETYREPORT / THESAFETYREPORT.COM / 29


Is Your Income Secured? The Positives and Negatives of Income Protection Insurance by Evelyn Maguire

This is where seeking advice is advisable— and certainly, when it comes to the crunch, when we find ourselves unable to work through sickness or injury, legal advice about the next step to be taken surely tops our list of things to do, although by then it will be too late. THE SAFET Y NET

Only one in 10 working families is covered by income protection insurance, while 23% of families have pet medical insurance. Yet income protection is a vital element in that safety net we all try to build around our home and family, according to a recent study by the Consumer Federation of America (CFA) in partnership with Unum. However, a safety net is only useful if it is large enough and strong enough to catch us— so is your income protection insurance policy fit for purpose? There are pros and cons to be weighed before making any decision, but for anyone who has regular bills to pay, the decision surely must be only a matter of which policy to buy rather than whether to have one at all. Income protection insurance will pay you a portion of your income, which will help you pay your bills, maintain your family’s lifestyle and provide a buffer against debt.

Some policies will insure only against ‘activities of daily life,’ which can make them useless for anyone in a profession where risk is a necessity.

People generally see the point in insuring their home and material possessions, but have a rather different view when it comes to insuring their most basic and valuable asset—the income and the ability to earn it. Of course, on reflection, many people do take out income protection insurance, although the mere fact of that hesitation, even if it is only momentary, indicates that either most of us have an inherently positive outlook on life that tells us our earning power will never be at risk, or that there are negative aspects to income insurance that needs to be thought through. 30 / THE SAFETY REPORT / VOL 5 ED 4

Many people rely on savings to see them through such periods of hardship, while others who cannot afford to save trust only in blind luck, although according to the Consumer Federation of America, “Nearly all households (90%) say that they would suffer financial hardship if they were disabled and unable to work for a year.”


LIMITS ON PROTECTION

All income protection insurance policies have limits. You need to know how long it will pay out: is it for the full period of incapacity or for a fixed term only? What is the policy’s definition of ‘disability’—is it unreasonably limiting? Is it based on your occupation, which may expose you to certain hazards that the policy rules out? Some policies will insure only against ‘activities of daily life,’ which can make them useless for anyone in a profession where risk is a necessity. It is vital that the level of benefits match your needs and that limitations put on any payout, such as taking into account any continuing percentage of income from your employer, or payouts from other insurance policies, do not reduce your total income to an unmanageably low level. In the United States, under the Family and Medical Leave Act (FMLA) of 1993, an employee can take medical leave because of a serious health condition if they have been employed for at least 12 months, have worked at least 1,250 hours during that period, and if the company has 50 or more employees. At least 30 days’ notice is required, so this cannot apply to medical emergencies; nor can it run concurrently with Federal Employees’ Compensation, which compensates civilian workers for temporary or total disability due to employment-related injury or disease. In these circumstances, an employer “may request continuation of regular pay for the period of disability not to exceed 45 calendar days or sick annual leave,” although the amount is set at two-thirds of salary, or three-quarters if there are one or more dependents. For serious sickness or injury requiring long treatment and recovery, this cannot be relied on to meet your needs. Most statutory workers’ compensation systems around the world have similar limitations, though differ in the detail— i.e., the U.K. system allows for a longer period of leave, but pays only a fixed amount of £86.70 per week ($139.03). In the U.K., “if you are an employee and become ill or have an accident that

prevents you from working for at least four days in a row, you’ll be entitled to up to 28 weeks of statutory sick pay if your employer doesn’t have a sick leave payment scheme.” In both cases, hardship is inevitable without additional income insurance protection. M A N AG I N G T H E D E L AY

Federal Employees’ Compensation for loss of wages is paid only after a threeday waiting period. With individual disability income insurance, benefits are usually payable after a much longer waiting period, which may be anything from one week up to a year or two. This is something that you need to be aware of when purchasing a policy: does it cover you for the period after Federal Employee’s Compensation ceases? The problem here is that the longer the waiting period, the less you have to pay for the policy. This may become a trap for people with low wages, who then borrow at high interest rates and struggle to pay off the debt at a later date. THE SMALL PRINT

It is important to understand the details of any disability income insurance policy. If it has noncancelable protection, this means that the premium cannot be raised or benefits reduced as long as the premium is paid promptly. For the best investment in income insurance, it is advisable to buy noncancelable protection and do so at an early age when you can set a low premium. Alternatively, a guaranteed renewable policy gives you the right of renewal with the same benefits, although the insurer

can increase the premium if all other policyholders in the same class also have their premiums increased; in these cases, initial premiums may be low, but they can be increased over time. Most policies include optional benefits or riders to enhance payouts. A cost-of-living adjustment is based on the consumer price index or a preset percentage and is designed to keep payouts in line with inflation. A residual benefit pays out a percentage of your monthly benefit in cases of a

set percentage loss of income due to disability. A Social Security rider pays out additional benefits if you do not qualify for Social Security disability benefits. These usually go into effect after the policy’s waiting period and during the period of waiting for Social Security to start paying out, and if Social Security rejects your claim it will continue for the length of the benefit period. One vital question to consider is: how is disability defined? This will vary according to the terms of your policy and should be considered carefully when purchasing it in the light of your particular occupation and what are the hazards to health. @THESAFETYREPORT / THESAFETYREPORT.COM / 31


COV E R FO C U S


Origin of the term Alzheimer’s disease dates back to 1906 when Alois Alzheimer, M.D., a German physician, presented a case history before a medical meeting of a 51-year-old woman who suffered from a rare brain disorder. A brain autopsy identified the plaques and tangles that today characterize Alzheimer’s disease.

THE

COMPLEXIT Y OF

ALZHEIMER’S How the disease may define the baby boomer generation by Stephanie Andre

W

ith baby boomers now reaching 65, there is a certain fear that with no cure or real origin discovered concerning Alzheimer’s disease, a huge surge in the number of

patients will most likely occur. Already the sixth-leading cause of death among Americans, the disease is no closer to a cure than it was 10 years ago. As we speak, more than 5 million Americans are living with the disease and 1 in 3 of them will die from it. According to a report by the Alzheimer’s Association, it is expected an estimated 10 million baby boomers will develop Alzheimer’s. Of those who reach the age of 85, nearly 1 in 2 will get it. And because there is no way to prevent, cure or even slow the progression of the disease, every one of these 10 million baby boomers will either die with Alzheimer’s or from it.

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What to Watch for

Although every case of Alzheimer’s disease is different, experts have identified common warning signs of the brain disease. Remember, Alzheimer’s disease is not a normal part of aging, and it is important to look for signs that might indicate Alzheimer’s disease versus basic forgetfulness or other conditions. With Alzheimer’s disease, these symptoms gradually increase and become more persistent. Typical warning signs include:

Memory loss, especially of recent events, names, placement of objects, and other new information

Confusion about time and place

Struggling to complete familiar actions, such as brushing teeth or getting dressed

Trouble finding the appropriate words, completing sentences, and following directions and conversations

Poor judgment when making decisions

Changes in mood and personality, such as increased suspicion, rapid and persistent mood swings, withdrawal, and disinterest in usual activities

Difficulty with complex mental assignments, such as balancing a checkbook or other tasks involving numbers

A Look at the Next 20 Years For many baby boomers, Alzheimer’s is a disease they saw in their parents or grandparents—nothing they ever expected to consider for themselves. But now, it is their disease, estimated to reach epidemic proportions over the next 20 or so years. By 2030, the U.S. population aged 65 and over is expected to double, meaning there will be more and more Americans with Alzheimer’s—as many as 16 million by mid-century, when there will be nearly 1 million new cases every year. Those numbers, along with many others, are the findings from Generation Alzheimer’s: the Defining Disease of Baby Boomers. What’s more, 1 in 8 baby boomers will get the disease after they turn 65, and at age 85, that risk increases to nearly 1 in 2. And if they don’t have it, chances are they will likely be caring for someone who does (see more on caregiving, page 38).

False Positive? While it may not be great news, because the numbers have jumped so rapidly over the years, doctors now have a very high degree of accuracy when diagnosing the disease. In fact, it’s at just about 90%. Ultimately though, the final diagnosis can only be made at autopsy, during which pathologists look for the disease’s characteristic plaques and tangles in brain tissue, according to the Alzheimer’s Association. Clinicians can diagnose “probable” Alzheimer’s disease by taking a complete medical history

and conducting lab tests, a physical exam, brain scans and neuro-psychological tests that gauge memory, attention, language skills and problem-solving abilities. Proper diagnosis is critical since there are dozens of other causes of memory problems. Some memory problems can be readily treated, such as those caused by vitamin deficiencies or thyroid problems. Other memory problems might result from causes that are not currently reversible, such as Alzheimer’s disease.

Understanding the Warning Signs and Symptoms Alzheimer’s symptoms are divided into two categories: cognitive (intellectual) and psychiatric. Differentiating them is important so that behavioral problems that are caused by loss of cognitive functioning are not treated with anti-psychotic or antianxiety medications. Cognitive symptoms are amnesia, aphasia, apraxia and agnosia (the 4 As of Alzheimer’s).

Amnesia is defined as loss of memory, or the inability to remember facts or events. We have two types of memories: the short-term (recent, new) and the longterm (remote, old) memories. In Alzheimer’s disease, short-term memory storage is damaged first.

Aphasia is the inability to communicate effectively. The loss of ability to speak and write is called expressive aphasia. An individual may forget words he has learned, and will have increasing difficulty


with communication. With receptive aphasia, an individual may be unable to understand spoken or written words or may read and not understand a word of what is read. Sometimes an individual pretends to understand and even nods in agreement; this is to cover-up aphasia. Although individuals may not understand words and grammar, they may still understand non-verbal behavior, i.e., smiling.

Apraxia is the inability to do preprogrammed motor tasks, or to perform activities of daily living such as brushing teeth and dressing. An individual may forget all motor skills learned during development. Sophisticated motor skills that require extensive learning, such as job-related skills, are the first functions that become impaired. More instinctive functions like chewing, swallowing and walking are lost in the last stages of the disease.

Agnosia is an individual’s inability to correctly interpret signals from their five senses. Individuals with Alzheimer’s disease may not recognize familiar people and objects. A common yet often unrecognized agnosia is the inability to appropriately perceive visceral, or internal, information such as a full bladder or chest pain.

hallucinations and delusions— personality changes can become evident early on. Signs include irritability, apathy, withdrawal and isolation. Individuals may show symptoms of depression at any stage of the disease. Depression is treatable, even in the later stages of Alzheimer’s disease. Psychotic symptoms include hallucinations and delusions, which usually occur in the middle stage. Hallucinations typically are auditory and/or visual, and sensory impairments, such as hearing loss or poor eyesight, tend to increase hallucinations in the elderly. Hallucinations and delusions can be very upsetting to the person with the disease. Common reactions are feelings of fear, anxiety and paranoia, as well as agitation, aggression and verbal outbursts. Individuals with psychiatric symptoms tend to exhibit more behavioral problems than those without these symptoms. It is important to note that psychotic symptoms can often be reduced through the carefully supervised use of medications.

‘Living’ with the Disease

When dealing with more of the major psychiatric symptoms—including personality changes, depression,

While it may not be as immediately frightening as AIDS or cancer, Alzheimer’s disease is an incurable burden that typically progresses over two to 20 years; individuals live on average for eight to 10 years from diagnosis. Individuals with Alzheimer’s disease

The National Institute on Aging indicates that the prevalence of Alzheimer’s disease doubles every five years beyond age 65.

Age is the most important known risk factor for Alzheimer’s disease; the incidence of the disease is rising in line with the aging population.

are likely to develop co-existing illnesses and most commonly die from pneumonia. Alzheimer’s disease is among the top 10 leading causes of death in the United States.

Hope for the Future Researchers and doctors around the world are feverishly working to figure out both the origin as well as a cure for the debilitating disease. They continue to test the effectiveness of various drug therapies that will control symptoms; slow, reduce and/or reverse mental and behavioral symptoms; and prevent or halt the disease. Currently, there are five FDA-approved Alzheimer’s drugs that treat the symptoms of Alzheimer’s—temporarily helping memory and thinking problems. On average, these drugs are effective for about six to 12 months for about half of the individuals who take them. But these medications do not treat the underlying causes of Alzheimer’s. In contrast, many of the new drugs in development aim to modify the disease process itself, by impacting one or more of the many wide-ranging brain changes that Alzheimer’s causes. These changes offer potential “targets” for new drugs to stop or slow the progress of the disease (see below). Many researchers believe successful treatment will eventually involve a “cocktail” of medications aimed at several targets, similar to current state-of-the-art treatments for many cancers and AIDS. A breakthrough Alzheimer’s drug

It is estimated that one to four family members act as caregivers for each individual with Alzheimer’s disease.

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5.1

85

65

MILLION

45

It is estimated that as many as 5.1 million Americans may have Alzheimer’s disease.

Alzheimer’s disease is not a normal part of aging, yet the risk of developing the illness rises with advanced age.

would treat the underlying disease and stop or delay the cell damage that eventually leads to the worsening of symptoms.

Figuring Out the ‘Targets’ Over the last 30 years, researchers have made remarkable progress in understanding healthy brain function and what goes wrong in Alzheimer’s disease. The following are examples of promising targets for next-generation drug therapies under investigation in current research studies, courtesy of the Alzheimer’s Association:

Beta-amyloid is the chief component of plaques, one hallmark Alzheimer’s brain abnormality. Scientists now have a detailed understanding of how this protein fragment is clipped from its

X2 36 / THE SAFETY REPORT / VOL 5 ED 4

parent compound amyloid precursor protein (APP) by two enzymes—betasecretase and gamma-secretase. Researchers are developing medications aimed at virtually every point in amyloid processing. This includes blocking activity of both enzymes; preventing the betaamyloid fragments from clumping into plaques; and even using antibodies against beta-amyloid to clear it from the brain. Several clinical trials of investigational drugs targeting beta-amyloid are included below in the key clinical trial summaries.

Inflammation is another key Alzheimer’s brain abnormality. Scientists have learned a great deal about molecules involved in the body’s overall inflammatory response and are working to better understand specific aspects of inflammation most active in the brain.

X3

Approximately a halfmillion Americans younger than age 65 have some form of dementia, including Alzheimer’s disease. (This is referred to as young onset or early onset.)

These insights may point to novel antiinflammatory treatments for Alzheimer’s disease.

Tau protein is the chief component of tangles, the other hallmark brain abnormality. Researchers are investigating strategies to keep tau molecules from collapsing and twisting into tangles, a process that destroys a vital cell transport system.

Insulin resistance and the way brain cells process insulin may be linked to Alzheimer’s disease. Researchers are exploring the role of insulin in the brain and closely related questions of how brain cells use sugar and produce energy. These investigations may reveal strategies to support cell function and stave off Alzheimer-related changes.

As our population ages, the disease impacts a greater percentage of Americans. The number of people aged 65 and older will more than double between 2010 and 2050 to 88.5 million or 20% of the population; likewise, those 85 and older will rise threefold, to 19 million, according to the U.S. Census Bureau.


cientists have identified 11 more genes linked to Alzheimer’s disease, according to the recent results of an international study aimed at shedding light on how and why the disease develops. The research, published in Nature Genetics, analyzed DNA data from more than 74,000 people of European ancestry in 15 countries.

11

New Genes Linked to Alzheimer’s

The 11 newly identified genes more than double the number linked to an increased risk of developing Alzheimer’s, bringing the total to 21. “By combining the expertise and resources of geneticists across the globe, we have been able to overcome our natural competitive instincts to achieve a real breakthrough in identifying the genetic architecture that significantly contributes to our mapping of the disease,” said researcher Julie Williams of Cardiff University in Wales, according to Medical News Today. Some of the new genes are related to the body’s immune response in the brain, demonstrating that the immune system plays some role in developing Alzheimer’s and related dementias, said Williams, head of neurodegeneration at the Cardiff School of Medicine, which co-led the study along with the International Genomics Project. The study also “strengthens evidence” concerning genes, such as SORL1, that play a role in the abnormal buildup of amyloid protein in the brain, according to a statement by the U.S. National Institutes of Health and National Institute on Aging, which supported the research. Still, Williams added, “a large portion of the genetic risk for the disease remains unexplained.”

Studies and Testing Additionally, there are other approaches to testing experimental drugs, designed to be given before symptoms appear. These medications focus on individuals with rare genetic mutations that guarantee they’ll eventually develop Alzheimer’s disease. These currently known mutations affect beta-amyloid processing or production. One project is the Alzheimer’s Prevention Initiative (API), an international public-private consortium established to conduct research in an extended family in Antioquia, Colombia, in South America. At 5,000 members, this family is the world’s largest in which a gene for familial (inherited) Alzheimer’s has been identified. Familial Alzheimer’s disease is also known as autosomal-dominant Alzheimer’s disease (ADAD). API’s first clinical studies will test therapies targeting beta-amyloid in family members who are known to carry the Alzheimer’s-causing gene but who have not yet experienced symptoms. Delaying or preventing the appearance of Alzheimer’s in these family members could offer compelling evidence for the promise of beta-amyloid as a therapeutic target.

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SUPPORTING THE SUPPORTERS:

HELPING CAREGIVERS by John Bair

hances are, you know a caregiver: it’s your mom, who takes your elderly grandmother to her doctor’s appointments; it is your brother, who cares for his disabled son every day; it is your neighbor, who is oncall when her dementiaafflicted father has an episode. Caregiving requires a special kind of person, and that person is often not the type to ask for help. It can be easy to forget that those doing the “caring” need support, too.

What is a Caregiver? Caregivers serve in a variety of capacities. Many times, these are unpaid positions performed by family members and close friends for elderly, ill or disabled individuals.

There are three main areas in which caregivers provide assistance:

Managing Medical Needs » Medication » Home modifications » Hearing/speech/physical/mental impairments » Doctor/therapist appointments » Primary emergency contact

Managing Financial/Legal Responsibilities » Power of attorney » Advanced directive/health care proxy » » » » »

HIPAA authorization Living will Standard will Trust documents Guardianship/conservatorship documents

» Public benefits eligibility

In a 2009 study conducted by the Family Caregiver Alliance in collaboration with AARP and the MetLife Foundation, it was discovered that caregivers spend an average of 20.4 hours per week providing care. In the same study, it was noted that the majority of caregivers had received no formal training, leaving them with the difficult task of managing responsibilities for which they may possess little expertise. 38 / THE SAFETY REPORT / VOL 5 ED 4

Managing Personal Needs » » » » »

Comfort and companionship Bathing, dressing, and feeding Transportation Groceries and cooking Cleaning

When combined with a full- or part-time job and family responsibilities, caregiving can create overwhelming emotional, physical and financial strain, especially over the span of several years.

Personal and Professional Implications On a personal level, caregiving can be difficult on the family. It can complicate the simplest tasks— driving the kids to school, getting groceries, cleaning the house. The spouse and children may have to assume additional responsibilities, creating a domino effect of crowded schedules and added stress. This can create tension within the family dynamic and can affect how the caregiver communicates with family and loved ones. On a professional level, the stress of caregiving can make it difficult to focus on work. Caregivers may need to modify their schedules, or even take leaves of absence, sometimes to the detriment of their careers.

Having a Plan To alleviate some of the burden, the caregiver should encourage their loved one to develop a comprehensive medical, financial, and legal plan. For the parents of disabled children, one of the most profound stressors is the concern that after the primary caregiver(s) pass away, there will not be adequate financial resources to sustain a high level of care for the child. The peace of mind that comes from leveraging trusted advisors is critical during this time.


Depending on the situation, estate planners, trust advisors, and settlement planners can provide the caregiver and their loved one with the information they need so that the focus can be on the care.

Support for the Caregiver A 2009 Journal of the American Society on Aging article revealed that a strong support system of friends, family, support groups and experts helps caregivers reduce stress and adjust what might be a highly critical selfappraisal of how they are handling their role.

To provide much-needed support, you could offer to: » » » » » » » » » » » » »

Babysit Shop for groceries Cook dinner Do yard work Take the caregiver out for coffee or lunch Talk…or listen Run errands Help find experts to address specific medical or financial needs Assist with some caregiving duties Take their car in for an oil change Drop a meal off at the caregiving site Clean their house Help find a support group for caregivers

The caregiver will surely appreciate even the smallest acts of kindness. Knowing that they, too, are cared for can be the boost they need to continue providing support for their loved one.

Resources for Caregivers

Family Caregiver Alliance: www.caregiver.org

Today’s Caregiver: www.caregiver.com

Caregiver Action Network: caregiveraction.org

National Association of Professional Geriatric Care Managers: www.caremanager.org

National Association for Home Care & Hospice: www.nahc.org

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H O M E & FA M I LY

Why the Right Teacher Matters by Mark Bello

IF

you were asked what you remembered most about your favorite teacher growing up, it probably would not be the subject matter. You would most likely describe how that teacher made you feel as you learned, the excitement she put into every lesson, the ability to allow you to make mistakes, the confidence she instilled or the help you were given in a difficult situation. While some students may just need a little push to get those extra points for the A, others may be struggling through a personal issue and just need someone to confide in. Whatever the need to help excel, a lifechanging teacher will try to bring out the best in each and every student. A poignant example of this was illustrated in “Stand and Deliver,” a 1988 film based on the true story of high school

math teacher Jaime “Kemo” Escalante. Escalante was a new math teacher at Garfield High School in East Los Angeles where rebellion ran high and teachers were more focused on discipline than academics. Determined to challenge the students to a higher level of achievement, Escalante overcame numerous taunts and threats to transform even the most troublesome teens into dedicated students.

Through his innovative teaching styles, Escalante was able to go from teaching basic arithmetic to preparing his students for the Advanced Placement Calculus exam by their senior year. Despite the struggles in their home lives, Escalante helped his students find the courage to separate from society’s expectations for failure and rise to the standard that he set for them—passing the exam and believing in themselves. Most of us have had at least one amazing teacher who inspired, influenced or encouraged us to do better, aim higher or just be more confident. Studies and personal testimonials have shown the following as just a few ways teachers have built a strong relationship with a child, and affected a student well beyond term papers and standardized tests.

“They may forget what you said, but they will never forget how you made them feel.” - Carl W. Buechner

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“Mr. Posey was the person who convinced me that I could achieve anything if I worked hard and simply believed.” - Rep. Elijah E. Cummings (D-Md.)

Self-Esteem

Encouragement

Low self-esteem can cause major problems for a child, especially as s/he gets older. Teachers can help a child feel good about oneself with a little encouragement. Patience and a positive attitude when explaining coursework will build self-esteem. Understanding challenges and consistently encouraging students by providing opportunities to learn and succeed will improve self-esteem as well.

Teachers who are able to help a child better understand a difficult subject can increase the level of interest and willingness to learn. By using sincere, uplifting words, teachers change lives by being encouraging. A simple “you can do this” may be all it takes.

Time An influential teacher will truly invest in students, going beyond the call of duty to ensure that students are succeeding even after the bell rings. A teacher who takes extra time and is invested in students can impact a child’s life.

Challenge Have you ever had a teacher who inspired you to work harder or pursue a particular goal? Children need to be challenged in order to grow and feel a sense of pride. Inspiring students is integral to ensuring their success and encouraging them to fulfill their potential. An influential teacher provides an extra challenge to students, raising the bar and knowing exactly how to get students to reach their potential.

Care A patient teacher who shows genuine care for a student can promote a love for learning and success for life. A caring teacher can transform the school experience especially for students who face enormous difficulties, such as dropping out of school.

Teachers can help to fill in the gaps for students who need parental guidance, and they can have a positive impact on a child who may just need someone to talk to or confide in. There are an endless amount of stories that attest to the benefits 42 / THE SAFETY REPORT / VOL 5 ED 4

Support Any teacher can assign tasks and allow students to try and overcome a new challenge, but a truly influential teacher offers support and encouragement. This can include creating assignments that help a student understand a concept or offering after school tutoring.

of a strong relationship between an educator and pupil. A teacher who cares, who has a desire to make a difference, and who possesses a positive attitude and superior teaching skills can have a significant impact on a student.


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How Do We Do It? The Civil Justice Foundation is proud to award grants to grassroots organizations that are at the forefront of the consumer advocacy movement — particularly to groups that have difficulty securing traditional funding because they are newly organized and/or address a controversial issue. To date, the Foundation has awarded more than $1.4 million to more than 110 of these groups.

www.civiljusticefoundation.org


PRIORITIES,

PLEASE Putting the kids first … especially in divorce by Stephanie Andre

S

ometimes it just happens. Girl meets boy. Girl marries boy. Girl and boy try to make it work. Girl and boy divorce. But somewhere in the middle of this classic tale, children become part of the story’s fabric. And that’s where the mess really resides. Stuff is stuff. Who gets this couch, that bed, the dining room table. Who cares? The issues that matter most are those tiny people you brought into this world together. Divorce is never easy; life as you know it is over. But imagine that through the eyes of your children. To that end, think about the most important things you can do to help your kids through this transition: » Keep visible conflict, heated discussion and legal talk away from the kids. » Minimize the disruptions to kids’ daily routines. » Confine negativity and blame about each other to private therapy sessions or conversations with friends outside the home. » Stay involved in the kids’ lives. CONSISTENCY & ROUTINE

Consistency and routine can go a long way toward providing comfort and familiarity that can help your family during this major life change. When possible, minimize unpredictable schedules, transitions or abrupt separations. Especially during a divorce, kids will benefit from one-onone time with each parent. No matter how inconvenient, try to accommodate your ex-partner as you figure out visitation schedules. It’s natural that you’ll be concerned about how a child is coping with this change. The best thing you can do is trust your instincts and rely on what you know about your kids. Do they seem to be acting differently than usual? Is a child doing things like 44 / THE SAFETY REPORT / VOL 5 ED 4

regressing to younger behaviors, such as thumb-sucking or bedwetting? Do emotions seem to be getting in the way of everyday routines, like school and social life? Behavioral changes are important to watch out for—any new or changing signs of moodiness; sadness; anxiety; school problems; or difficulties with friends, appetite and sleep can be signs of a problem. Older kids and teens may be vulnerable to risky behaviors, such as alcohol and drug use, skipping school, and defiant acts. Regardless of whether such troubles are related to the divorce, they are serious problems that affect a teen’s well-being and indicate the need for outside help. NO FIGHTING IN FRONT OF THE KIDS

Although the occasional argument between parents is expected in any family, living in a battleground of continual hostility and unresolved conflict can place a heavy burden on a child. Screaming, fighting, arguing or violence can make kids fearful and apprehensive. Witnessing parental conflict presents an inappropriate model for kids, who are still learning how to deal with their own relationships. Kids whose parents maintain anger and hostility are much more likely to have continued emotional and


behavioral difficulties that last beyond childhood. Talking with a mediator or divorce counselor can help couples air their grievances and hurt to each other in a way that doesn’t cause harm to their children. Though it may be difficult, working together in this way will spare kids the hurt caused by continued bitterness and anger. Divorce can be a major crisis for a family. However, if you and your former spouse can work together and communicate civilly for the benefit of your children, the original family unit can continue to be a source of strength, even if stepfamilies enter the picture.

SUPPORT FOR ALL

Most adults going through separation and divorce need support—from friends, professionals, clergy and family. Don’t seek support from your kids, even if they seem to want you to. Here are some ways to help kids cope with the upset of a divorce: » Encourage honesty. Kids need to know that their feelings are important to their parents and that they’ll be taken seriously. » Help them put their feelings into words. Kids’ behavior can often clue you in to their feelings of sadness or anger. You might say: “It seems as if you’re feeling sad right now. Do you know what’s making you feel so sad?” Be a good listener, even if it’s difficult for you to hear what they have to say. » Legitimize their feelings. Saying “I know you feel sad now” or “I know it feels lonely without dad here” lets kids know that their feelings are valid. It’s important to encourage kids to get it all out before you start offering ways to make it better. Let kids know it’s also OK to feel happy or relieved or excited about the future. » Offer support. Ask, “What do you think will help you feel better?” They might not be able to name something, but you can suggest a few ideas—maybe just to sit together for a while, take a walk, or hold a favorite stuffed animal. Younger

kids might especially appreciate an offer to call daddy on the phone or to make a picture to give to mommy when she comes at the end of the day. » Keep yourself healthy. For adults, separation and divorce is highly stressful. That pressure may be amplified by custody, property, and financial issues, which can bring out the worst in people. » Finding ways to manage your own stress is essential for you and your entire family. Keeping yourself as physically and emotionally healthy as possible can help combat the effects of stress, and by making sure you’re taking care of your own needs, you can ensure that you’ll be in the best possible shape to take care of your kids. » Keep the details in check. Take care to ensure privacy when discussing the details of the divorce with friends, family or your lawyer. Try to keep your interactions with your ex as civil as possible, especially when you’re interacting in front of the kids. » Take the high road. Don’t resort to blaming or name-calling within earshot of your kids, no matter what the circumstances of the separation. This is especially important in an “at fault” divorce where there have been especially hurtful events, like infidelity. Take care to keep letters, e-mails, and text messages in a secure location as kids will be naturally curious if there is a high-conflict situation going on at home. » Get help. This is not the time to go it alone. Find a support group, talk to others who have gone through this, use online resources, or ask your doctor or religious leaders to refer you to other resources. Getting help yourself sets a good example for your kids on how to make a healthy adjustment to this major change. Raising kids is tough, and divorce only makes it harder. Be the best person you can be—not just for your kids, but for yourself.

The Fallout and Dealing with Kid Questions Be prepared to answer these and other questions: » Who will I live with? » Where will I go to school? » Will I move? » Where will each parent live? » Where will we spend holidays, such as Thanksgiving? » Will I still get to see my friends? » Will I have to go to a different school? » Can I still go to camp this summer? » Can I still do my favorite activities?

@THESAFETYREPORT / THESAFETYREPORT.COM / 45


Do It Yourself

Top 5

ways to get remote home security by Kate Voss

Y

our home is your haven—you invest your time, money and sweat in creating blueprints, setting up holiday decorations, painting the walls bright colors and installing that “much-needed” range top. You spend the majority of your life inside the walls of your home, and it houses everything you own and love. Since you devote part of your budget to the aesthetics of your home, why not spend the money to make sure it is also safe when you are home, and secure when you are not? You may not know it, but the statistics show that burglaries most often occur during daylight, when you are out of the house. According to the FBI, in 2012 alone, there were almost double the residential burglaries during the day as there were at night. With constantly evolving technolgy, we now have the ability to watch our home when we are away at work or out of town. Long gone are the days where we had to spend thousands to get a basic home security system. With DIY home security options, homeowners can pick and choose what they want and need 46 / THE SAFETY REPORT / VOL 5 ED 4

in home security, they can determine how much they want to spend (instead of confiding in the financial expertise of security companies), they can install the systems on their own, and best of all, the complexity and confusion has been largely taken out of securing your home. So, whether you want to watch a live feed of a video camera in your home, monitor your thermometer from your phone or make sure your home computer is protected, new DIY systems have got your (and your homes) back. BUYING NEW CAMERA SETS

There are many options out there to replace your outdated and confusing security systems with newer, sleeker and simple designs. Products, such as the newly launched Canary, have features that go beyond what you are accustomed to—night vision, two-way microphones, motion sensors and even climate sensors. The system comes along with a free iPhone app as well. Not only can you break away from the landline-based system and monthly payments, but you can make sure the

temperature in your home is set to the perfect degree. Other options include DropCam, a video-monitoring system that connects to your wifi and has the ability to zoom in 8x and move 130 degrees. It is simple to setup; simply plug the camera in, connect to your home wifi and start streaming from your phone. With newer and less expensive security cameras on the market, homeowners now have the capability to set them up in any room so they have all eyes on their home. Some systems even feature two-way microphones so you can speak to whoever is in the room, whether you are welcoming home your kids from high school, or telling your puppy to stop chewing the couch. USING EXISTING WEBCAMS AND OLD DEVICES

For those of us who already have a webcam (either installed into our computer or attached) or an old device (such as an iPhone or iPad), there are new programs available that transform your existing cameras into a powerful surveillance camera that can be watched from your smartphone at little to no cost. There are free iPhone apps, such as Presence and AtHome Camera, that can connect to a webcam or old devices. Both apps are completely free and you simply download the app on both devices and connect them under one account. Most of the camera apps for home security include an alert system which notifies you via your phone if there is any disruption or movement in your home. Using existing webcams for your home security saves you the expenses attached to complex cameras, plus they are discreet and out of the way. ADDING SECU RIT Y TO COMPUTER

We cannot forget about computer safety. Not only do we need to protect our identity and personal information, but also to simply protect our family by monitoring when and who is using the computer. Apps, such as Security Camera, take snapshots every time your computer is used. The photos are time stamped and saved to your Dropbox and on your


According to the FBI, in 2012 alone, there were almost double the residential burglaries during the day as there were at night.

home computer. That way, you can make sure your family members are using the computer at designated hours and even snap a photo of a thief in the case of a home invasion. There are also apps, such as 1Password and AntiVirus apps, that protect your computer from identity theft. Long gone are the days of using the same password for everything— 1Password creates and stores all your password information for each site and encrypts them so there is little to no chance that your personal information will be revealed to an online hacker. INVESTING IN H O M E AU T O M AT I O N

We are currently living in the future. Who would have thought that we could turn up the heat in our living room while we are sitting on the train? Who would have thought that we could turn on the lights on our front porch all from our smartphone? Well, it is now reality. With new home automation systems, such as Vivint and ADT Pulse, homeowners can

connect their appliances, cameras, thermometers and even door and window locks all to your phone. Home automation systems which include smart thermostats, like Nest, can help cut energy use by 20% and can save homeowners around $170 a year. This product also helps monitor carbon monoxide and smoke levels and could help save your family in the event of a fire. Vivint and ADT Pulse are both similar in that they are full remote home automation systems that can link to all your home systems (lighting, door locks, heating, appliances, security cameras) and you can pick and choose what is included in your package depending on your needs. While home automation may not be the easiest on your wallet, the multifeatured and innovation functions of home automation meet the needs of any homeowner. They also allow you to control all aspects of your home while you are away.

Nest Thermostat photo: nytimes.com

Home automation systems, which include smart thermostats, like Nest, can help cut energy use by 20% and can save homeowners around $170 a year. So, whether you want to simply convert your old iPhone into a powerful surveillance camera, or invest in a home automation system, choosing one of the many new DIY, dynamic and simple apps or devices will ensure your peace of mind and help better protect your home and loved ones, whether you’re at home or anywhere else. @THESAFETYREPORT / THESAFETYREPORT.COM / 47


Choosing the Right Preschool for Your Child by Brittany Monbarren

The time has finally come. Your little one is starting preschool. It’s the first step into a lifetime of learning. Since preschool can influence how your child views school and learning, the pressure is on you to find the right program that meets their individual needs. Here are some simple steps to follow that may help with this exciting, yet daunting, task.

Identify Your Priorities The best way to keep from becoming overwhelmed by the process is to decide what you want: » Are you looking for a preschool near your work or closer to home? » What kind of environment are you looking for? Busy and active or small and nurturing? » Are the school fees within your budget? » Does the preschool offer services that work with your schedule? » Are you looking for a specific approach to learning? Be sure to write down all of your priorities so you have something to refer to as you evaluate the different programs.

personal references are some of the best. Contact your friends, family members, your neighbors, your colleagues and your pediatrician for recommendations on quality programs in the area. Be sure to consider your list of priorities and ask questions that are relevant to you. Also, when discussing schools with your reference, always note what this person thought was important to mention (student-teacher ratio, fees, learning environment, discipline, location, etc.). Look Online. Nowadays, it seems like people look online for everything. So, why not use it to help research quality preschools? An easy way to start is to search for schools in your area. There will most likely be reviews and ratings for each school listed. You can also search the name of a specific program to find out if they have any health or safety violations, complaints from parents or any other noteworthy issues. Ask the Experts. To find licensed preschools in your area, visit the National Association of the Education of Young Children website (www.naeyc.org) or contact The Child Care Aware hotline (800-424-2246).

Do Your Research To help you find your ideal program, narrow your search down to two or three promising schools and continue your research process from there. Ask Other Parents. We all know that

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to the learning approaches, discipline, communication and nutrition, and also pay attention to things that spark your interest about the facility. Here’s a list of more things to consider, provided by www. Greatschools.org: » Student-teacher ratios. Be sure to note how many children are in each classroom. Most preschools range from one adult to three or four children or infants, and vary by age. » Quality and experience of the teachers and staff. Observe how they interact with the children. Do they have an approachable personality and a keen eye for safety? » Review the daily curriculum and schedule. Does it include hands-on, sensory-based learning activities, plus outside and play time? Will the teacher provide progress reports? Also, for older children, it’s important that the curriculum and schedule prepare them for kindergarten. » Atmosphere of the facility. Do the children seem happy? Are they having positive interactions with the teachers, staff and other students? » Drop-off and pick-up procedures. Consider the school’s hours of operation and if it fits your schedule.

Schedule a Visit Once you have narrowed down your search, it’s time to schedule a visit. At that time, it’s important to ask the director about everything from cost, hours, illness policies and vacation schedules

Choosing a preschool is an important process and can greatly influence the way your child views school and learning. Be sure to consider these steps to help you choose wisely.


Why

Alone Time is Essential for Every Parent by Stephanie Andre The scene is pretty typical: It’s morning and you’re trying to get the kids out of the house. They’re not getting out of bed; then not eating; followed by some classic sibling arguments on topics that are the furthest thing from important. After a long day—whether that’s a full-time job or being a full-time mommy—you’ve now picked up the kids and scenarios, similar to what you dealt with in the morning, are likely. And so it goes...day after day, week after week. It’s easy to get in a rut and feel like your life will forever follow the pattern demonstrated in that BIll Murray classic, “Groundhogs Day.” But it doesn’t have to be that way. Grabbing some time for yourself— whether it’s an hour at a yoga class or a night out with girlfriends (or dudes!)—is vital toward your own morale and gives you the chance to regroup and take some of the pressure off.

It’s natural to have thoughts of guilt over these feelings, but think of it this way: wouldn’t you rather your children have a fully charged parent who is in the moment and connected than a burnt-out parent cannot wait to pass out on the couch?

Quality vs. Quantity Like many things in life, the quality of the time you have away is more important than have long or how often you steal it. Experts agree, grabbing 30 minutes here or there can make all the difference. Most parents don’t have the time and/or resources to step out on a regular basis. Try some of these suggestions instead: Unplug. We are victims of our own technological success. Ten years ago, cellphones were not only not the necessity they are now, but the idea of data and more was made up of

“Jetsons” dreams. Fast forward to the present and we are addicted to our phones, TV, tablets and computers. Imagine the type of quality time you’d have with yourself if you just turned it all off? Be an Early Bird. As a parent, you’re already up early. It’s part of the deal. But a great option may just be disciplining yourself to get up a bit earlier, which, honestly, doesn’t sound great. However, that time of day is actually very peaceful and quite relaxing. Sitting down to catch up on the latest headlines with a cup of coffee may just be the slice of heaven you need to start your day off right. Put Out the ‘Busy’ Sign. If you’re in an office, shut your door and tell people you’re busy. If you’re at home during the day, don’t answer the phone or the door. There’s something very liberating about ignoring the world and regrouping with yourself. Actually Take a Lunch. Stop eating at your desk. Stop seeing how many errands you can cram into an hour. Instead, spend some time with yourself. Take a walk. Sit in the sun. Go to the park. Fresh air and a great book will do wonders! If All Else Fails, Pencil Yourself In. No seriously: Literally mark some time on your calendar for you. Take that time to turn away from the computer, put the phone on silent and just relax. Any time you can spend alone with yourself to meditate, focus, reboot, create and/or think deeply is better than no time. @THESAFETYREPORT / THESAFETYREPORT.COM / 49


Healthy Eating for Families on the Go by Brittany Monbarren WORK. FAMILY. HOMEWORK. ERRANDS. FRIENDS. Today’s hectic lifestyle has you and your family constantly on the go, spending several hours a week riding in the car, at the ballpark or running errands, often leaving you little time to prepare or even think about cooking healthy, nutritious meals. As obesity rates remain high, more and more families on the go are choosing quick, easy and cheap food before even considering the nutritional value of it. In fact, according to the Centers for Disease Control and Prevention, more than one-third of U.S. adults and approx. 17% of children and adolescents ages 2-19 years are obese. Whether you’re packing your kids lunches, driving your kids to their weekly activities or running errands, it’s important to consider what you and your family are eating. Here’s some tips for healthier eating for families on the go.

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According to the Centers for Disease Control and Prevention, more than one-third of U.S. adults and approx. 17% of children and adolescents ages 2-19 years are obese.


Cook Ahead When cooking meals, one simple thing you can do to keep healthy food handy is to prepare larger portions. This gives you the option to freeze the leftovers and use them during the week for lunchtime or dinner meals. Using a slower cooker is also a great way to make larger meals, plus they are simple to use. You can just add the ingredients to the pot before you leave for work and when you get home it’s ready for dinner. Once dinner is over, freeze the leftovers.

Healthy Breakfast Options It’s time to throw out those sugary, colorful breakfast cereals you love so much. They may be some of the tastiest items in your pantry to make for breakfast, but definitely not the healthiest. Instead, replace those neon shapes with the dozens of great-tasting, all-natural organic cereals that are available. You can also make a breakfast smoothie in the morning and let your kids drink it on the way to school.

Pack School/Work Lunches Even though most schools are designing lunch menus with healthier options, it’s still better to prepare your child’s lunch. You have the option to pack lunches with whole grains, fruits, lean, all natural meats and health snacks. While at work, it may be tempting to drive to the nearest fast-food restaurant, but don’t. When you’re packing your child’s lunch, pack yours too. This will not only help with eating healthier, it will also save you a few bucks.

Healthy Snacks in the Car During your afternoon errands, it may be tempting to pick up that bag of chips by the cash register or stop at a fast-food restaurant for a snack wrap, but don’t! There are healthier options. Try to keep sealed, non-perishable healthy snacks in your car for when you start feeling hungry. Some good healthier options include dried fruit, nuts and healthy individually packaged snacks.

Know Your Options With so many fast-food options at our disposal, it’s very easy to stop for dinner after a hectic day instead of cooking. If you do stop, it’s important that you read the labels and research the different nutrition values for the foods. When ordering, try making healthier choices such as sandwiches without cheese, salads with low-fat or fat-free dressing, replace french fries with sliced fruit and choose the grilled option for meats.

Stock Up On Supplies It’s always helpful to have at least a week’s worth of healthy ingredients in the kitchen when you need to prepare a healthy meal in a hurry. Some of the healthier food options to keep stocked in your pantry or freezer include whole-wheat pasta, brown rice, canned and frozen vegetables, pasta sauces, low-fat, low-sodium soups and cooked meats, such as chicken and turkey breast.

Make Time for Sit-Down Dinners As crazy and hectic as your life may be at times, it’s important to at least have family sit-down meals when you can. It not only helps strengthen the bond, it also helps show children the importance of spending time with each other as a family. It also introduces your children to different food they may not try if they hadn’t seen you try it first.

Try to keep sealed, nonperishable healthy snacks in your car for when you start feeling hungry.

Providing quick and healthy meals can be very challenging for families on the go, however, if you take a few minutes out of your hectic life and think about the different options, you will be able to provide your family the perfect healthy meal. @THESAFETYREPORT / THESAFETYREPORT.COM / 51


S M A R T T R AV E L

THE RAMIFICATIONS OF SLEEPY DRIVING by Frederick Schenk

M

ost people are familiar with the terms “driving under the influence” and “driving while intoxicated” and the very serious—often fatal—repercussions they can have. But some may not be aware of another common driving condition considered just as dangerous: driving while drowsy. Drowsiness can impair judgment and reaction times while behind the wheel of the car. In fact, various studies show that being awake for more than 20 hours results in impairment equal to a blood alcohol concentration of 0.08. According to the National Highway Traffic Safety Administration (NHTSA), drowsy driving causes more than 100,000 crashes a year, resulting in 40,000 injuries and 1,550 deaths. Many officials believe these numbers are actually higher making driving while drowsy an extremely serious public safety issue.

Look for the symptoms There are specific symptoms and actions that may occur if the urge to nod off at the wheel becomes overwhelming and imminent. According to the Centers for Disease Control and Prevention (CDC), drivers should pay careful attention to: • Frequent yawning or blinking and deep shallow breaths • Difficulty remembering the past few miles driven • Eyes getting heavy, nodding off and jerking awake • Loosening the grip on the wheel • Missing your exit • Hitting rumble strips on the center lane @THESAFETYREPORT / THESAFETYREPORT.COM / 53


During a long drive, it’s likely that at some point, sleepiness may make become an issue. There are preventative tricks and tips you can try, such as stopping and stretching every few hours, sharing the driving and drinking lots of water. However, if any of the above symptoms start to appear, it’s time to pull over safely, move into the passenger seat and take a power nap. Once you’re fully awake, walk around the car a few times to refocus. Shift workers are one of the most at risk drivers because natural sleep patterns are disrupted by long nights and irregular hours. For this reason, the NHTSA’s “Wake Up And Get Some Sleep” campaign provides educational brochures, tips and workplace posters for employers whose employees run the risk of leaving for home while already feeling the sleepy effects of a long shift ending at an irregular time of day.

How can we combat the risk of driving while drowsy? The obvious answer is to get some sleep! But let’s face it—our lives are

busy, and eight hours of sleep is not always an option. Our babies cry all night. We toss and turn from stress. We work crazy hours. Unfortunately, the results of all this non-sleep may mean putting yourself and others at risk the next day while driving to and from work or school. The Mayo Clinic gives these tips for a better night’s sleep: • Stick to a schedule • Pay attention to what you eat and drink • Create a bedtime ritual • Get comfortable • Limit daytime naps • Include physical activity in your daily routine • Manage stress

What’s being done? Because driving while drowsy is becoming such a widespread problem, many systems are in place and being developed to help drivers. Some auto manufacturers have installed voice alarms and vibrating seats to alert the driver before he/she nods off.

Other manufacturers are working on developing other new alerts like emitting puffs of air on the driver’s neck, vibrating steering wheels and auto steering that takes over if the driver begins to drift into another lane. On the not-so-technical side, many roads and highways are equipped with rumble strips—the bumps, grooves or rows of indents in the pavement are designed to alert inattentive or sleepy drivers through noise and vibration. If your car even once heads over toward the rumble strip, this is a very good indication that it’s time to pull over and take a nap. When we get into our cars nothing is more important than arriving at our destination safely. Eliminating drowsy drivers begins with prevention. Keeping on top of your sleep health, preventing over tiredness and knowing your personal sleepy signals are the best ways to prevent a driving while drowsy accident. For more information on driving while drowsy, visit American Academy of Sleep Medicine, UCLA Sleepdisorders Center and DrowsyDriving.org.

ATV’s & Kids: A Dangerous Mix From 1982-2008 nearly ONE-THIRD of the 9,633 All Terrain Vehicle (ATV) related deaths were children under 16. Over one hundred children are seriously injured EVERYDAY and approximately one dies EVERY OTHER day from an ATV related crash. Injuries to children from ATV accidents cost society OVER 2 BILLION DOLLARS annually in medical and economic costs.

PLEASE KEEP YOUR CHILD SAFE. Don’t allow children under the age of 16 to ride ATV’s Concerned Families for ATV Safety

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Visit www.ATVsafetynet.org for more information.


Medical Tourism:

Traveling The World for Healthcare by Jerry Trachtman

A 64-year-old woman, an insulindependent diabetic, was so obese she was not able to climb stairs or even take a leisurely stroll. Her family doctor said she was an excellent candidate for gastric bypass surgery, but her insurance would not cover it and she could not afford the $60,000 cost. After doing extensive research, she had the surgery in Monterrey, Mexico. Five months later, she had lost 80 pounds, was no longer insulin dependent and was in excellent health. Her total cost, including hotel, was $10,000. A young woman was in need of a heart valve replacement and repair of a hole between her heart chambers, but had no health insurance. She traveled to Delhi, India, for the surgery, and was hospitalized four weeks. Her total cost, including travel, was about 10 percent of what it would have cost in the U.S. These are examples of what has become a viable option in healthcare, and every year more people are leaving the U.S. for routine (and not so routine) medical procedures. Most make the choice based on finances, and most voice the same opinion when they return home: the personal attention and quality of care are fantastic, and they would do it again in a heartbeat. Compiling reliable data is difficult, and most sources seem to agree that between 1 and 2 million Americans are traveling overseas for medical care each year. It is predicted that with the implementation of Obamacare (the Affordable Care Act) medical tourism will increase as insurance companies look for ways to cut costs. Because the cost savings are so dramatic, some

of the largest health insurers in the U.S. are already considering medical tourism programs. Additional Factors to Consider While cost is the most significant factor most people consider, it isn’t the only factor driving people to travel outside the U.S. for healthcare. Sadly, medical desperation causes many people to spend a lot of money overseas on scientifically unproven treatments and procedures not available in the United States, such as stem cell therapy for spinal cord injuries. Do Your Research If you decide to seek medical care overseas, do your homework and choose a doctor based on education, qualifications, experience and reputation. When choosing a hospital, one factor to consider is whether it is accredited by Joint Commission International (JCI), an accrediting organization affiliated with the Joint Commission, which is the most important accrediting body in the United States for American hospitals. Most hospitals in the U.S. must receive Joint Commission accreditation to be financially viable and to hold themselves out to the public as providing high-quality care. JCI’s accreditation process is similar, but not identical, to the process used for U.S. hospitals. So far, JCI has accredited more than 500 health care providers in 50+ countries. JCI accreditation, together with a well-trained and qualified medical staff, can produce medical care comparable to that provided in U.S. hospitals.

how much

money

can be saved?

$75,000 The average cost for a hip replacement in the U.S.

$9,000 The average cost for a hip replacement in India.

$210,000 Average heart bypass surgery in the U.S.

$12,000 Average heart bypass surgery in Thailand.

$35,000 Average knee replacement in the U.S.

$13,000 Average knee replacement in Singapore.

@THESAFETYREPORT / THESAFETYREPORT.COM / 55


Parents Guide to Explaining the Responsibility of Driving to Teens: Part 2 by Nathaniel Fick

So you’ve talked about the risk factors that go along with the responsibility of driving, but how do you help educate your teen to help them truly understand the rules of the road? Here are some solutions that can help. Graduated Driver Licensing Laws In the mid-1990s, the National Highway Traffic Safety Administration (NHTSA) proposed a series of guidelines based upon teen driving research that were designed to reduce the teen crash rate. The Graduated Driver Licensing (GDL) model proposed that limiting welldocumented risk factors during the early stages of driving would have a positive effect and save lives. Then, by gradually allowing novice drivers greater exposure to risk, the experience they had gained would allow them to better handle those risks. The model broke licensing into three phases: the Learner’s Permit, an Intermediate license and a Full Privilege license. NHTSA’s ideal GDL design contains 56 / THE SAFETY REPORT / VOL 5 ED 4

seven components: 1. Establishing a minimum age for a teen to obtain a learner’s permit 2. Requiring a mandatory waiting period before the learner can apply for an intermediate license 3. A mandatory number of hours driving under adult supervision, a portion of which includes night driving 4. Establishing a minimum age to obtain an intermediate license 5. Placing restrictions on night time driving, recommending no driving after 9:00 p.m. 6. Limiting the number of passengers under the age of 21 in the vehicle; and, establishing a minimum age for full licensing. GDL has been credited with helping reduce teen fatal crashes from over 5,000 per year to the present 3,000 annually. States have each implemented some or all of these recommendations.

It is important to understand the laws in your state. GDL is based on decades of research and gives parents a framework for establishing family driving rules. Driving Agreements and Contracts Talking with your teen about driving safety is one thing. Sitting down for a family meeting and completing a written agreement covering driving rules that mom, dad and the teen discuss and ultimately sign is another. Research shows that setting rules around driving results in lower crash rates when the rules are documented and agreed upon by the teen. Insurance companies, the Centers for Disease Control & Prevention (CDC), the Safe Teen Driving Club and many others offer free parent-teen agreements. Parents can modify them to cover specific concerns and to build in sanctions for breaking the rules. According to the Journal of Safety Research, “parents have the potential to reduce teen driving risks by carefully


managing their teen’s early driving experience. Parents are involved in their teenagers’ driving from the beginning and they have the opportunities to teach teens to drive, determine when they can apply for a permit or license, govern their access to vehicles, and limit exposure. “Unfortunately, involvement for most parents does not extend much beyond supervising practice driving. The modest initial restrictions many parents place on their newly licensed children are generally not restrictive enough to be consistent with safety.“ In-Vehicle Monitoring Anne McCartt, senior vice president at the Insurance Institute for Highway Safety (IIHS), suggests parents consider using technology to watch over their teen drivers once they begin driving solo. Allowing a young driver with limited experience to transition from completely supervised driving during the Learner’s Permit stage of licensing to totally unsupervised driving begs for trouble. GPS trackers and other technology can alert parents by text message and email if their teen is driving recklessly. Online GPS mapping can show on your cell phone where he is driving, how fast he’s going and provides a mappedout history of his previous driving behavior. Some devices send alerts to flag aggressive acceleration, cornering and braking. This technology puts

mom and dad virtually in the passenger seat, watching over their teen’s driving behavior from afar, keeping up to date through their PC or cellphone. Knowing parents are monitoring encourages teens to drive safely. Defensive Driver Training Advanced driver’s ed schools across the country teach teens how to drive defensively. They show teens how it feels when the ABS takes over operation of the brakes during a panic stop. They teach the dangers of tailgating, driving on slippery roads, making emergency lane changes and how to make safe sudden turns to avoid an obstacle in the road. Such defensive training programs expose teens to conditions they are not often likely to meet during routine trips to school or work...but that will certainly present themselves at some point. Schools teaching defensive techniques should not be confused with “extreme driver training” programs. Those often teach aggressive techniques much like those provided to police departments: how to do a 180-degree turn, safely taking corners at high speed and so forth. There is some evidence that teaching those extreme measures to novice drivers makes them over-confident and more likely to engage in risky driving. Delay as Long as You Can Teen driving statistics from the U.S. and

other developed countries show that younger drivers have more crashes. If your teen isn’t eager to begin driving at 16, you’re fortunate. If at 17 there’s no urgency to begin driving, all the better. Resist the temptation to push your teen into driving to save you the inconvenience of driving them to and from events. As one Georgia driving instructor related, “On the first day of class I noticed a 16-year-old girl at the back of the classroom crying. I took her aside and asked her what was wrong. She said, ‘I don’t want to drive. I’m scared. My mother is making me get my license.’” Some teens find all the social interaction they need through school, texting and social media; others just don’t feel the need to begin driving. As well, you may feel your teen at 16 or 17 is not ready to begin driving no matter how much he insists it’s time to get a license. Poor grades in school, emotional development and other behavioral issues can lead a parent to delay the process. Be aware, too, that GDL laws do not apply to those 18 and older. Some in this age group feel they should be able to ignore and skip over the passenger restrictions, the night driving curfews and other proven risk reduction features of GDL. Even at 18 or older, following those guidelines can save lives. You can build them into your own driving rules.

In our next issue, read the final part of this series. In it, we’ll delve into driving rules and staying with the basics.

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Are You Prescreened? New options for frequent fliers by Jim Brauchle

Regardless of the travel season, everyone is looking for ways to save time at the airport. While there is no one best way to get through security faster, there are several available programs and techniques one may employ to streamline the process.

PRE✓

One program that allows passengers an expedited process through the TSA security screening is Pre✓. This unique, pre-check program allows select frequent flyers on Alaska Airlines, American Airlines, Delta Air Lines, United Airlines, US Airways and Virgin America to receive expedited screening services. The program is also available to members of U.S. Customs and Border Protection (CBP) Trusted Traveler Programs, such as Global Entry, NEXUS and SENTRI. Passengers in the Pre✓ program are allowed to go through dedicated Pre✓ screening stations. Participants are not required to remove shoes, 3-1-1 compliant liquids, laptops, jackets or belts. The Pre✓ program is currently available in 40 airports across the United States. NEW ELIGIBILITY

Until now, this program was only available for frequent flyers and participation was contingent upon being contacted by flyers’ respective frequent traveler airline. Once notified, flyers had the choice to participate or decline. Once enrolled, when a passenger reserves a flight, the airline forwards the passenger’s information to the TSA, and upon check-in at the airport, the flyer’s boarding pass will have a printed Pre✓ symbol. The TSA recently announced a major expansion of eligibility for the Pre✓ program. Travelers will now be able to apply directly to the U.S. government through the CBP Trusted Traveler Programs. First, you must register for a CBP Global Online Enrollment System (GOES) account and submit required information from your passport, driver’s license and other legal documents. Once conditionally approved, you make an appointment at one of the dozens of CBP interview and fingerprint locations. At the CBP center, you are interviewed, digitally fingerprinted, photographed and assigned your CBP Pass ID number. You provide your CBP Pass ID number to your airline for domestic travel with Pre✓. ADDITIONAL ADVANTAGES

The other advantage to enrolling in Global Entry is that travelers from abroad may 58 / THE SAFETY REPORT / VOL 5 ED 4


7 Tips for an Easier Time through Security Even if you are not enrolled in any prescreening programs, you may still make it through the TSA checkpoints efficiently‌if you are prepared:

Before arriving at the checkpoint, have your boarding pass and picture identification ready to hand to the agent. Know where you will secure those documents during screening.

Wear shoes that are comfortable and easy to take off and put on, such as slip-on shoes.

Wear a minimal amount of jewelry.

Place all liquids in a clear plastic zip-top bag while traveling.

speed through the often long wait at U.S. Customs by checking in at a Global Entry kiosk. Passengers whose responses require no further examination continue quickly to baggage claim. For some initial investment of money and time, this time-saving program can be worthwhile for passengers who frequently travel internationally. Above all, maintain a positive attitude and allow enough time to clear any security checks. Everyone is trying to get to their vacations, business meetings and other destinations as well. Losing your patience with the process will only delay your travel time and is a red flag to the TSA. Learn more about the Pre✓ and Global Entry Programs, traveler information and prohibited items at www.globalentry.gov, or download the MyTSA app to receive real time updates from the TSA.

All jackets and coats have to pass through the x-ray machine, so pack them in checked baggage if possible.

Pack your carry-on bag in as organized a fashion as possible so that items are clearly identifiable in an x-ray machine. This will provide better odds your carry-on will not be selected for hand screening.

Most airports use advanced imaging technology, more commonly known as body scanners. When having to pass through a scanner, you should remove everything from your pockets, including wallets, keys, money and cellphones. Removing these items will reduce the likelihood of having to be rescreened. @THESAFETYREPORT / THESAFETYREPORT.COM / 59


PASSPORT 101: Everything you need to know about applying, renewing and replacing by Brittany Monbarren

A

passport is your ticket to see the world and is required for everyone traveling outside of the U.S. If you’re looking to apply for your first passport, renew an old one or replace one that was stolen or lost, you need to make sure you know the process and are up-to-date on the rules and regulations. From forms and photos to fees and IDs, the U.S. State Department website has everything you need to know. However, here are some tips to get you started when applying, renewing and replacing. Applying If you are applying for your first passport, you must apply in person at either a regional passport agency or at a facility that accepts passport applications— courthouses or post offices. You most likely live near a facility that accepts passports; just use the search tool on the U.S. State Department website to help find a location. To submit a passport application for an adult, you will need to provide the following documents: » A completed DS-11 application form containing all the required information except for your signature. » Proof of U.S. citizenship or nationality, such as a certified copy of a birth certificate. » Valid form of photo identification 60 / THE SAFETY REPORT / VOL 5 ED 4

with a signature such as a Naturalization Certificate, a driver’s license, or a government or military identification card. » A photocopy of the front and back of the identification you’re providing on clean, white 8½” x 11” paper. » Passport photos taken within the last six months. The photos must be 2”x 2”, front view, full face, taken in normal street attire and with a plain background. » Your application fee. For a first-time adult, the total fee is $135. Fees vary between adults and minors. Also, the new passport application process time can vary depending on workload. If you’re planning a trip that requires a passport, always consider the processing time and how long it may take to obtain your passport. Renewing Adults and minors can have their passports valid for only so many years. Passports issued to adults are valid for 10 years. Passports issued to minors— under the age of 16—are valid for five years. Renewing your passport is an easy process. You can apply through the mail if your most recent passport is undamaged, was issued when you were at least 16 years old and isn’t more than 15 years old. If you meet that criteria,

you can mail your old passport with the following required documents: » A completed DS-82 form containing all required information and is signed and dated. » Your renewal fee. For adults, the total fee is $110. » Passport photos (see first-time requirements). » Your undamaged, previous passport. Also, if your name has changed due to marriage, divorce, adoption or court order since your last passport was issued, you must include a certified document or court order. If you don’t have your previous passport or changed your name and cannot provide the required name change documents, you must follow the procedure for first-time applicants. Replacing If your previous passport was stolen or lost, you will have to apply for a new one in person. You will need to follow the first-time applicant process and also bring a DS-64 form, which is a form that asks you to describe what happened to your previous passport. If you’re planning a trip out of the country, always make sure your ticket to see the world is in your hands and up-to-date.


Away from home Bringing the Fun Back to Business Travel by Brittany Monbarren

aiting in line for TSA screenings, battling for overhead space and sitting in the airport for hours may have not only earned you tons of frequent flier miles, but it may have also turned your joy for work and travel into a dreaded and unwanted task. When you first started your job, traveling for work sounded fun. Visiting cities you’ve never been to before, eating out, flying, time out of the office, who wouldn’t think that was fun? However, after many years of non-stop business travel, your idea of fun turned out to be less of the adventure than you imagined. Now, the only thing you focus on is getting there, your meetings and then getting home. To make the most of your next business trip and enjoy your time, consider these fun and productive tips:

W

1. Do Your Research. Before hitting the road for your next outof-town business meeting, consider doing some research of your own. Since you don’t often have a lot of leisure time between travel and meetings, learning a little bit more about the town you’re visiting will help make the most out of your time spent there. Instead of asking the person at the concierge’s desk for

last-minute advice on lunch spots or about the nightlife, which will probably be all tourist destinations, you’ll already have an idea of where you want to go and what you want to do. 2.Take Extra Time. Traveling can be very hectic, especially if you’re traveling to different time zones and overseas. Ask your boss for an extra day both on the way in and on the way out of your destination. This will help with adjusting and allow you to prep for the work you need to focus on or the presentation set up. If your travel time is only a day or two, try to thin out your schedule so you’re not always rushing between meetings during your stay. Also, if you’re headed somewhere really exciting or somewhere you’ve always wanted to go but haven’t, consider staying a few extra days to explore. Most companies will allow you to change your departure ticket and you would just pay the difference in airfare. This is a great way to add in some sightseeing or relaxation. 3. Consider Small Hotels. Your company may schedule your stay in an expensive or business-like hotel. However, if you’re @THESAFETYREPORT / THESAFETYREPORT.COM / 61


Apps for Business Travel To make business travel less stressful and more enjoyable, consider downloading these travel apps.

(Free)

(Free) headed to a major, touristy city, consider opting for a bed and breakfast or smaller locally owned hotel near the meetings you’re conducting. Typically, since you have more personal attention from the hosts and owners at these smaller places, they will be able to provide you with a lot more information about the city you’re staying in from a locals’ point of view. They will be able to guide you to delicious and local restaurants off the beaten path or just simply help you better navigate the streets. However, if you’re traveling to a lesshospitable city, it may be wiser to find a major chain hotel that you know best and trust. 4. Ask for Tips. Work your contacts— family, friends, friends of friends, colleagues, acquaintances—to find someone who lives in the city you’re traveling to and who is willing to show you around. Or use social media sites, such as Facebook and Twitter, to post a status about traveling to a specific city and ask your contacts for recommendations on anything— restaurant, local museums, shopping, nightlife, excursions, etc. Also, you may not know you have friends that lives in or near the city you’re visiting and a simple trip for work could be a great excuse to grab lunch or dinner with a 62 / THE SAFETY REPORT / VOL 5 ED 4

long lost friend. That said, if your contacts and social media posts fail, consider signing up for a guided walking tour of the city to gain insight from a local. 5. Pack Smart. While on the road, lugging around tons of bags can be stressful. Always remember to pack smart and think simple. Don’t pack too many items or unnecessary items. When packing, stick to a simple, basic wardrobe that is easy to mix and match. This will help make packing more of a routine and less stressful. Also, since hotels provide you with toiletries that is one less thing you should pack and allows more room for other items. It is also very important to think about the unexpected when traveling for work. Always check the local weather for the city to which you are traveling; you may need to pack an extra coat or a pair of shorts and flipflops. Scrambling to and from your destination, and sitting in a meeting room for hours can seem like the best use of your time, but it’s not. There’s so much more you can do and explore when traveling for work. Just remember these tips to make the most out of your next business trip—even if it is for only an hour.

(Free)

(Free)

(Free)

Triplt Triplt organizes travel plans into an itinerary that has all of your trip details in one place and you can access it at any time, either online or from your mobile device.

Hotel Tonight This app allows you to book hotel rooms the same day, easily and securely from your smartphone.

FlightTrack FlightTrack helps keep you on schedule for your flights and even provides maps of airports. This app also syncs with Triplt.

MyCityWay MyCityWay is a series of city guides that gives you the quick and dirty on 30-plus essential categories, including dining, transportation, pharmacies, weather and local news.

Expensify This app tracks all of your expenses. You sync your credit cards and debit cards and the app tracks each expense as you go and compiling an easy-tonavigate expense report at the end of your trip. If you pay cash, you just scan the receipt using your phone’s camera and the app files it.


ONE Second IS NOT A VERY LONG TIME.

But when you’re behind a steering wheel and your eyes leave the road—that ONE single second can change a life. ONE second is all it takes to be distracted. When you are driving, it should not be a secondary task—it should be the only task. EndDD.org (End Distracted Driving) was established to raise awareness and generate action against the epidemic of distracted driving. DISTRACTIONS INCLUDE:

Visual

Taking eyes off the road

Manual

Taking hands off the road

Cognitive

Taking mind off the road

While texting and talking on the phone are both mental and physical distractions, cellphone use is attributed to 18% of fatalities in distraction-related crashes.

What makes up the other 82%? » Putting on makeup » Reaching to grab a drink » Changing the music » Dealing with the GPS » Eating on the go The distractions are endless. But they don’t have to be. The Core Mission of EndDD Our core mission is to preserve life and promote safety on a large scale through advocacy, education and action. It is our hope that we can prevent families and friends from suffering the loss of a loved one because of distracted driving. Together, let’s work to prevent distracted driving from claiming another life.

VISIT US ONLINE web: twitter: facebook:

End Distracted Driving is sponsored by the Casey Feldman Foundation and is dedicated to inspiring individuals and communities to take action to end distracted driving. CONTACT US toll-free at 855-363-3478 or info@EndDD.org

endDD.org @end_DD EndDistractedDrving


the

DOs & DON’Ts

of...

SEARCHING FOR A NEW JOB by Brittany Monbarren

Start with a job search strategy.

Seek out executive recruiters.

Just push send.

Get discouraged.

DO

Assume networking sites are for personal use only.

Customize your resume and cover letter.

Wait around.

Use LinkedIn to boost your search.

DON’T

Research the job you’re applying for. Dress appropriately for an interview.

64 / THE SAFETY REPORT / VOL 5 ED 4

Bad mouth former bosses and colleagues.


THE INS AND OUTS OF STRUCTURED ATTORNEY FEES by Howard T. Saperston For attorneys who want to create a supplemental retirement fund, manage the cash flow of their law firm, or protect themselves from being bumped into a higher tax bracket, structured attorney fees should be considered as a viable investment option. Milestone Consulting, LLC is a comprehensive settlement planning and management firm. We believe that injured plaintiffs and their families deserve strategies designed to ensure a lifetime of financial security. Our consultants are licensed in all fifty states to provide guidance on settlement-related issues including government benefits preservation, trust planning, Medicare Set-Asides, wealth preservation and annuities. We also provide mediation support to assist the plaintiff in reaching a settlement that will meet their present and future medical and financial needs. In addition to our work with plaintiffs and trial attorneys, we actively support a number of civil justice organizations, including The Injury Board, the American Association for Justice, the Workers’ Injury Law and Advocacy Group, and statewide associations in New York, Pennsylvania, Massachusetts, Rhode Island and Washington, DC. For more information, please visit our website at www.milestoneseventh.com.

In Richard A. Childs, Et al. v Commissioner of Internal Revenue, the 11th Circuit U.S. Court of Appeals affirmed that attorneys who elect to structure their fees will not have to pay taxes on those payments until the year the income is received. This allows attorneys to spread out their income, rather than getting hit with a large tax bill in one year. At what point do I need to decide to structure my fees? You must elect to structure your fees prior to settlement; it must be included in the settlement agreement. You can’t have constructive receipt of the money to be structured. It should be paid to the life insurance company via an assignment company. What factors should I consider? There are a number of factors to take into account when deciding whether or not to do an attorney fee structure: »» Age »» Health »» Present financial needs and goals »» Future needs and goals (college, retirement, etc.) »» Tax bracket »» Risk tolerance

settlement proceeds in a lump sum? In most cases, you may structure your fees regardless of what your client decides to do. What if I worked on the case with another attorney? Am I still eligible? Yes, you can still structure your fees. The stream of payments can be split among more than one attorney. Should more than one decide to structure, each gets their own unique payment schedule. Is an attorney fee structure flexible? Yes. You should choose a plan that best fits your individual needs. How is the structure funded? It can be funded with an annuity from a highly rated life insurance company, providing the attorney with fixed payments. Certain firms also offer a product that uses a Single Premium Immediate Annuity (SPIA) to purchase a whole-life insurance policy, which may offer a greater return than a traditional annuity. How are payments made? Payments can be made either to you or to your firm. Fee payments can be affected by a number of factors, including the type of incorporation the firm has (e.g. LLC, PC, etc.), dissolution plans of the firm, tax advantage, etc. Disclaimer: Milestone Consulting, LLC does not provide legal or tax advice. Please consult an attorney and/or estate planning expert if you have questions regarding the legal or tax implications of your structured attorney fees.

Can I elect to do a fee structure if my client elects to receive their


milestone consulting s e t t l e me nt p l anni ng & manage me nt

{in life, there comes a time to move forward to the next milestone.}

At Milestone, we believe that injured plaintiffs and their families deserve strategies designed to ensure a lifetime of financial security. Our comprehensive planning services include the areas of government benefits preservation, trust planning, Medicare Set-Asides, and wealth preservation. We offer assistance during mediation to ensure that your client’s settlement will meet their future medical and financial needs.

Contact us today to learn more about what our solutions can do for your clients: 855.836.2676

Together, we will help your clients move forward.

john t. bair Founder/Member

howard t. saperston Founder/Member

737 Main Street, Buffalo, NY 14203 | phone 716.883.1833 | fax 716.883.2124 | toll-free 855.836.2676 | milestoneseventh.com

The Safety Report V5E4 - Milestone  

As the baby boomers head into retirement, there is a certain fear that with no cure or real origin discovered on Alzheimer’s disease, there...

The Safety Report V5E4 - Milestone  

As the baby boomers head into retirement, there is a certain fear that with no cure or real origin discovered on Alzheimer’s disease, there...

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