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Robert Goodman, MSW

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How is Your Mental Health
How is Your Mental Health 150 150 Robert Goodman, MSW

How is Your Mental Health
The Savvy Senior
By Robert Goodman, MSW
Many older adults experience problems with gambling, misuse of prescription drugs, alcohol, anxiety, and depression. It is estimated that around 20% of older adults face mental health issues. Anxiety and depression are the most common mental health problems faced older adults.
There are many symptoms associated with depression. Some of the most common symptoms are:

  • Hopelessness
  • Sleep problems
  • Social withdrawal
  • Eating more or less than usual
  • Loss or interest in once pleasurable activities, including sex
  • Frequent crying
  • Difficulty focusing, remembering, or making decisions
  • Thoughts of death or suicide, or a suicide attempt

If you have several of these symptoms for more than two weeks, you may have depression.
The abuse or misuse of drugs was once considered a problem only among the young. According to the American Geriatric Society, substance abuse has become a growing problem among older adults as well. Misuse of alcohol or other drugs is a common cause of physical and mental health problems among older adults, especially men.
Four questions can provide a quick way to determine alcohol abuse:

  • “Have you ever felt you should slow down on your drinking?”
  • “Have you ever felt annoyed at criticism about your drinking?”
  • “Have you ever felt guilty or bad about drinking?”
  • “Have you ever felt the need for an “eye opener” in the morning to steady your nerves?”

A “yes” answer to any two of these questions indicates that a problems is likely? A “yes” answer to even one of question indicates a possible problem that should be further evaluated.
(Source: AGS Foundation for Health in Aging)
According to the Florida Council on Compulsive Gambling a growing percentage of Florida seniors are developing serious gambling problems. Symptoms of problem gambling among older adults include:

  • Preoccupation with gambling
  • Withdrawing from family, friends or regular activities because of gambling
  • Neglecting personal needs or health due to gambling
  • Gambling larger amounts of money to experience the thrill
  • Betting more than planned
  • Experiencing unaccounted blocks of time due to gambling
  • Communicating a sudden need for money or loans
  • Uncomfortable feelings or lying when questioned about gambling habits
  • Gambling to calm nerves, forget worries or reduce depression
  • Experiencing mood swings based upon winnings and losses 
  • Pawning or selling personal items
  • Feeling restless or having anxiety when trying to cut down or stop gambling
  • Using retirement funds or other savings to gamble
  • Attempting to stop gambling but unable to do so

Answering “yes” to one of more of these questions may indicate a gambling problem. For information or help contact the 24 hour FCCG helpline at 1-888-236-4848.
There is no shame asking for help if you have one of these problems. Help is available through psychotherapy, consumer education, inpatient or outpatient management of symptoms, medication.
Call 211 for information on local programs to assist you in dealing with depression, anxiety, problem drinking, or problems related to gambling.
Take action today! If you or if you know of someone who may have an alcohol or gambling problem get help. There are several state and Palm Beach County resources for help with these issues. They include:
Gamblers Anonymous 855-222-5542
Alcoholics Anonymous 561-994-5000
Crossroads Club 561-278-8004
Jewish Recovery Center 561-450-5503

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Women’s Heart Health
Women’s Heart Health 150 150 Robert Goodman, MSW

Women’s Heart Health
By Robert Goodman, MSW
Do you know the signs of a heart attack? They differ between men and women. I learned this recently when a close friend experienced chest discomfort after exerting herself in the gym and ignoring the symptoms. After this recurred over several days she decided to find out what was happening. She called the doctor who immediately sent her to the hospital after hearing the symptoms. She was admitted to the hospital and needed a stent put into an artery.
I have learned from this experience that many women do not know the signs of angina or a heart attack and often ignore them thinking that it is stress related or indigestion. Heart attacks are the number one killer of women with strokes the number three killer according the American Heart Association.
Angina is a warning sign of heart disease, and recognizing it and getting treated early may prevent a heart attack. As heart disease progresses, you may have tightness, pressure or discomfort in your chest during physical activity or when stressed. But it goes away shortly after you stop the activity or get rid of the stress. 
Angina symptoms in women can also include feeling out of breath, nausea, vomiting, midepigastric discomfort or sharp chest pain.  Once the extra demand for blood and oxygen stops, so do the symptoms.
Heart Attack Signs in Women

  1. Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes, or goes away and comes back.
  2. Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  3. Shortness of breath with or without chest discomfort.
  4. Other signs such as breaking out in a cold sweat, nausea or lightheadedness.
  5. As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

If you have any of these signs, don’t wait more than five minutes before calling for help. Call 9-1-1 and get to a hospital right away.
 
Recognizing the signs and seeking treatment is the first step. Understanding your risk factors, such as a family history, is also important to stay in tune with changes in your health. Heart disease is preventable. See your physician regularly, exercise, if you smoke: quit, eat healthy, and know your pressure, cholesterol (total, HDL, LDL, and triglycerides), and blood sugar levels..
(Source: American Heart Association: www.heart.org)
Other sources of Information: www.womenshealth.gov, http://www.nlm.nih.gov/medlineplus/womenshealth.html, http://www.cdc.gov/women/, www.webmd.com. You can also call the government’s Office of Women’s Health: 1-800-994-9662

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Cell Phone Etiquette
Cell Phone Etiquette 150 150 Robert Goodman, MSW

Cell Phone Etiquette

By Robert Goodman

 

Each day I ride the buses I hear cell phones going off and people having loud conversations about private health and personal matters, arguments over personal things, or what they are cooking for dinner. I remember on several occasions sitting in restaurants and the person next to me taking a call. First of all some of the ring tones are really annoying. But this patron was talking so loud that the manager had to ask her to step outside and not disturb his customers. I have heard some of the most intimate conversation that I have no interest in knowing about.

 

These are topics unwilling eavesdroppers can do without. Sometimes we need to take calls to confirm appointments or to discuss an urgent situation. There are some rules of etiquette that many cell phone users may not be aware of so I thought I would share a few.

 

  1. Private conversations should be private.
  2. Speak quietly when taking calls in public.
  3. Keep calls brief when they are necessary to take in a public place. Let the other party know that you are in a public place and will call them back.
  4. Identify yourself when texting
  5. Always turn off your cell phone or put it on vibrate when on line in the supermarket, on buses, in restaurants, in offices, etc. Store clerks find it annoying and difficult to help a customer or ring up an order while the person is holding their cell phone and having a conversation on it.
  6. Don’t light up your phone’s screen in a dark theatre.
  7. Don’t talk and hold your cell phone while driving.
  8. You should stay about 10 feet away others when talking on your cell.
  9. In the company of others excuse yourself when taking a call.

 

I hope these tips will make your cell phone use less intrusive to others.

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Grandparenting with a Disability
Grandparenting with a Disability 150 150 Robert Goodman, MSW

Grandparenting with a Disability
The Savvy Senior
By Robert Goodman, MSW
Grandparenting, in general, can be fun and also exhausting. Adding a disability into the mix raises a number of issues. Having a disability gives you the opportunity to teach your grandchildren how to interact with people with disabilities.
The question of grandparenting with a disability was raised at our visually impaired support group last year. Many members were concerned that they could no longer care for their grandchildren. Grandparents with disabilities can still enjoy their grandchildren.
Young children are curious and notice changes in your health. They are eager to be helpful. The best approach is to explain your visual, hearing or physical disability in a way they can understand. Explain your abilities and limitations and how the grandchild can be of help. For example, if you have a visual disability you can explain that you cannot see small print but ask if they have any books with big print. Many children’s books are written in larger print. You can explain the proper etiquette in meeting a blind person such as not leaving a room without telling the person with a visual impairment. Teach about color contrast and use it when interacting with them. There are many games that are available in large print such as cards, Scrabble, and more.
Teaching your grandchildren about disability and people with disabilities can make them more compassionate toward others as they grow up. It also teaches them the best way to interact with someone with a disability. Another lesson you teach them is about overcoming obstacles in their lives. You have to have a positive attitude about your disability so that your grandchildren will better understand you and learn not to fear people with disabilities.
Babysitting was raised as a concern for someone who has a visual disability. My experience has taught me to be sure the grandchildren are in a safe place where you can see them or know where they are. Interact with them with games while they are awake. Putting them to bed should not be too difficult if they cooperate. Perhaps an older child can be of assistance. A monitor could help you keep an “eye” on the sleeping child.
There are two websites that offer suggestions on how to interact with grandchildren when you have a disability: www.karmanhealthcare.com/learning-from-grandparents-with-disabilities and
http://grandparents.about.com/od/grandparentingtoday/a/DisabledGPs.htm.
Some of their suggestion include the following:

  • Eat right and get plenty of rest. This will help with your interaction with your grandchildren.
  • If you are in a wheelchair ask someone to place a young baby in your lap so you can hold him or her
  • Tell stories about your life and family history
  • Use technology to communicate with your grandchildren. They can probably help you with your tech concerns. There are computer programs and games that can make it easier to interact with grandchildren.
  • Be a good listener. Discuss with them their concerns about their lives
  • Use assistive devices, such as wheelchairs to travel with your grandchildren.
  • You can do art and crafts projects with your grandchildren. If you can help them visually you can explain how to make things that you may have done in your life.
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Advocacy
Advocacy 150 150 Robert Goodman, MSW

Advocacy
The Savvy Senior
By Robert Goodman, MSW
The word advocacy has been in the news a lot lately. You have the #MeToo movement, the Parkland students fighting for tighter gun controls and people fighting for legislation that impacts their lives.
Some people find that advocacy helps when they feel they are not being heard, or are not getting what they need. They would like some support. Anyone may need advocacy at some time in his or her life, but it becomes especially relevant where:

  • People are being treated unfairly as a result of other people’s prejudices, or their own vulnerability, or both.
  • People feel they have no family, friends or anyone in the wider community to whom they can turn for support.
  • People may have professional paid workers involved in their lives who are not providing services which take into account their needs..

Think back to one experience where you either had witnessed or participated in where a social justice issue was effectively addressed by working on influencing public policy. How effective were your efforts?
There are two types of advocacy, self-advocacy and cause advocacy. Self-advocacy is speaking for, representing the interests of, or defending the rights of oneself. Cause or Public advocacy is speaking for, representing the interests of, or defending the rights of a particular group of people, or the general public. This includes legislative advocacy or advocating for a change in a policy or program.
Being a good advocate also includes letting your elected officials know of your concerns. Write and visit with your elected officials. Greet them when they come to Century Village. If you have an issue of concern prepare a statement describing the issue, how it impacts on your life, and what you would like your elected official to do about it. When the Florida legislature meets, they will be considering many laws that impact your life as a condo owner, renter, or senior. Your elected officials need to know how what they do in Tallahassee or Washington impacts your life.
As we enter the campaign season, here is a great opportunity to get involved and influence policies that will affect your future. Issues like Social Security, health care and Medicare are important federal issues that the U.S. Senate candidates will be addressing. State issues include Medicaid, health care, senior services and condominium legislation.
Here are a few pointers to help you be an effective self-advocate and better navigate the health care and social service systems.
You must be able to make your needs known and stand up for your rights as a patient in the hospital, a doctor’s office, or trying to procure services,
Before you go to the doctor’s office or call an agency, have a list of questions to ask and make sure you understand the answers you are given. Keep a list on the refrigerator of your medications and special needs in case of an emergency or pending hospitalization.
When speaking to a doctor you want to be sure you understand your diagnosis and what impact it will have on your life and family. You want to be aware of what medications he/she is prescribing and what effect they will have, how they interact with your other medications, vitamins, and supplements, and any of its side effects. Also, ask about any community resources that may relate to your diagnosis. An example would be someone who is diagnosed with macular degeneration may need information on the Lighthouse for the Blind or low vision aids.
If you end up in the emergency room you should be able to clearly describe your situation at home. Are you living alone? Is there anyone at home who is capable of assisting you when you are discharged from the hospital? What medical equipment do you have at home, such as grab bars, a hospital bed, a walker, or a shower chair?
When calling an agency, be prepared with a list of questions. You should include information on what you or the person you are calling for needs and who, if anyone is available to meet those needs.
Here are ten steps to help you become an effective self-advocate:
1. Believe in yourself.
2. Realize you have rights.
3. Discuss your concerns with your service provider.
4. Get the facts in writing.
5. Use the chain of command to solve a problem-ask to speak to a supervisor if an issue isn’t resolved to your satisfaction.
6. Know your appeal rights if services are denied.
7. Be assertive and persistent, not aggressive.
8. Outline your concerns and be a good listener.
9. Ask for help from other agencies.
10. Follow-up. Be sure you’re getting the service that meets your
needs…and say thank you.

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Aging in Place
Aging in Place 150 150 Robert Goodman, MSW

Aging in Place
By Robert Goodman, MSW
As we grow older (not me!) our first choice is to remain in our homes for the rest of our lives. How many of us develop a plan to “age in place”? Just like you plan for college or retirement, we must also plan for the years beyond retirement. Aging in place refers to a person’s desire to remain in their own home and receive services, if needed, in their home or community. To successfully age in place one has to plan for the physical and mental changes that may occur as we age. This may include modifying your living space.
Several professionals can help you plan for your future. These include elder law attorneys, financial planners, health care providers, home accessibility consultants, for profit health related companies, and non-profit organizations.
An elder law attorney handles general estate planning issues and counsels clients about planning for their incapacity. The attorney would also assist the client in planning for possible long-term care needs, including nursing home care. An elder law attorney can help you locate the appropriate type of care, coordinate private and public resources to finance the cost of care, and work to ensure the client’s right to quality care. There are many elder law attorneys in our area. Ask any attorney if he/she is certified in this field. To locate an elder law attorney contact the Academy of Florida Elder Law Attorneys at www.afela.org or 850-656-3038.
A Certified Financial Planner (CFP) is someone who is specially trained in personal finance.  To become licensed Certified Financial Planners must have demonstrated competency in seven important subjects: the General Principles of Financial Planning, Risk Management and Insurance Planning, Employee Benefits Planning, Investment Planning, Income Tax Planning, Retirement Planning, and Estate Planning.  These are the areas one would need to consider when planning for long-term care expenses either immediately or in the future.  CFP’s have been subjected to a background check and must also have demonstrated experience before becoming licensed. Select a certified financial planner who specializes in Medicaid, VA benefits, and elder care planning. Be sure to ask any prospective planner if this is their area of expertise. To locate a certified financial planner contact the Certified Financial Planner Board of Standards at www.cfp.net or call 800-487-1497.
Writing a living will and choosing a health care surrogate are important steps to take while one is healthy. A living will lets your doctor know what steps should be taken or not taken in the event that you cannot communicate your needs. A health care surrogate is a person you appoint to make decisions regarding your health care in case you are unable to. These forms are available at most hospitals or by going online to Aging with Dignity at www.fivewishes.org or calling 1-888-594-7437.
Safety is a major concern in the home as we age. Good lighting, use color contrast, eliminating throw rugs, and installing grab bars are all things that help make the home safer. There are home accessibility specialists that can help you determine what is needed in your home to make it safe and easier to use should you become disabled. Contact the Center for Independent Living Options for a referral at 561-966-4288.
As part of the planning process you may want to select a home care provider now who can provide you needed services in the future. You may also want to look at housing alternatives, such as an assisted living facility or nursing home if the need arises. www.floridahealthfinder.gov is a great website aid in locating all kinds of health care facilities.

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Florida Civil Rights Law
Florida Civil Rights Law 150 150 Robert Goodman, MSW

Florida Civil Rights Law
Chapter 760, Florida Statutes
It is against the law to discriminate in employment on the basis of race, color, religion, sex, national origin, age, handicap or marital status.
It is against the law to discriminate in the sale, rental, financing, appraisal, or insuring of housing, in the provision of real estate brokerage service, or in the advertising of a dwelling on the basis of race, color, religion, sex, national origin, handicap or familial status (families with children under 18, pregnant women and people securing custody of children under l8). Steering and blockbusting are also illegal. In addition, it is against the law to fail to design and construct new multi-family housing in an accessible manner or to refuse certain modifications or accommodations to persons with a mental or physical disability.
It is against the law to discriminate in evaluating an application for membership in certain defined “private” clubs on the basis of race, color, age, sex, religion, national origin, handicap or marital status.
It is against the law to refuse accommodations or service to any person on the basis of race, color, creed, sex, national origin, or physical disability.
It is against the law to retaliate against an individual because a complaint was filed with the Commission alleging employment discrimination. It is against the law to harass, coerce, intimidate, or interfere with anyone exercising or assisting someone else who is exercising rights provided under the Fair Housing Act.
Public Accommodations
It is unlawful for an individual to be denied access or to receive poor service or lesser quality accommodations because of his or her race, color, national origin, sex, disability, familial status or religion.
To file a complaint contact the Florida Human Rights Commission at 1-800-342-8170 http://fchr.state.fl.us/

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Care Giver Solutions Info Show Interview
Care Giver Solutions Info Show Interview 150 150 Robert Goodman, MSW

An Interview with Robert Goodman, MSW and Marcia Teele of CareGiverSolutions.Info Show
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Pitfalls of Traveling
Pitfalls of Traveling 150 150 Robert Goodman, MSW

Pitfalls of Traveling
The Savvy Senior
By Robert Goodman, MSW
I have written many columns on fall prevention and the consequences of a fall. Now I can speak from experience. I had many falls this past summer and am now using a walker. My worst fall was on a cruise where I broke my ankle.
Falls are a major issue for older adults and can be prevented. While most falls occur at home, some occur when traveling.
Falls can lead to fractures, trauma, and death.
1.  Over 13 million older adults fall every year; 1 of 3 if over 65, and 1 of 2 if over 80 years old.
 2.  2.8 million older adults are treated in the ER for falls. 800,000 are hospitalized.
 3.  40% of nursing home admissions are fall-related. 
4. About 27,000 older adults died from unintentional fall injuries.
There are a number of causes of falls among the elderly. They include:

  • Lack of physical activity and muscle weakness
  • Balance and gait problems
  • Visual impairment
  • Mobility impairment
  • Cognitive impairment
  • Drop in blood pressure when standing up
  • Fear of falling
  • Alcohol abuse
  • Inappropriate footwear
  • Dehydration
  • Talking on cell phones and texting while walking

This is the time of year when people travel and take cruises. You have to be careful when going into a new environment. Look for any obstacles that may make the area unsafe. Be sure areas are free of clutter, aisles are wide if you use a wheelchair or walker. Check for steps, slippery areas, and other hazards. Be sure there is adequate lighting and grab bars. Look for obstacles in on sidewalks or in parking areas. When traveling in places such as Amsterdam or London, be sure to be aware of traffic patterns (driving on the left) and bike paths.
If you use a walker or wheelchair ask for a handicapped accessible
room or cabin. If you have a visual disability ask for information in large print and a well-lit room or cabin. When touring, explain to the tour guide any special needs you may have.
Limit the amount of alcohol you drink. Even a small amount can affect your balance and reflexes. Choose safe footwear. Lastly, drink plenty of water to avoid dehydration.
There are a number of devices that can help prevent falls, but one must remember to use them. They include: canes, walkers, reachers, and emergency medical alerts. There are new types of medical alerts that can be used when traveling.

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Coping with the Holidays
Coping with the Holidays 150 150 Robert Goodman, MSW

Coping with the Holidays
By Robert Goodman, MSW

The holidays are supposed to be a time for family gathering, happiness, joyous celebrations, and hope. Unfortunately, for many, it is a time of loneliness and sadness. The stress of the holidays can cause anxiety and depression.
Here are some suggestions by psychologists and social workers on how to cope with the holidays:

  1. Understand how the holidays affect you. What do they mean to you?
  2. If your holiday blues are a result of the stress from all the extra demands of the holidays, do some things to reduce the demands. Rethink how you view and approach the holidays.
  3. If your holiday blues are stemming from past losses, take advantage of the holidays to help you complete your mourning and lessen your grieving over the loss.
  4. Organize and plan your activities during this period. Stay busy and avoid unstructured time. Spend time in the clubhouse, participating in the many activities that are available. Exercise. Get involved in synagogue or church activities.
  5. Don’t isolate yourself. If you can’t be with family, invite some close friends over to share the holidays.
  6. Think of the blessings in your life: friends, children, grandchildren, etc.
  7. Volunteer your time.
  8. Try to avoid alcohol.
  9. Watch your finances. Overspending will cause worry over bills after the holidays are over.
  10. Don’t deny or try to hide your feelings of sadness. Seek professional help.
  11. Take time to reflect on past friendships and pleasant memories.
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Robert Goodman, MSW

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4037 Wolverton B
Boca Raton, FL 33434

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