Monthly Archives: January 2012

Does Diet Impact Parkinson?

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Today we have some great information from The National Parkinson’s Foundation.

If you or someone you know has Parkinson’s disease (PD) you are not alone.  In the United States, 50,000-60,000 new cases of PD are diagnosed each year, adding to the one million people who currently have PD. The Center for Disease control rated complications from Parkinson’s disease as the 14th leading cause of death in the United States. Worldwide, it is estimated that four to six million people suffer from the condition. There is hope, however, as scientists work towards a cure and make progress in identifying the best treatment options for patients. Learn more about PD now.

What are some common nutritional concerns for people with PD?

1. Bone thinning

  • Studies have shown that people with PD are at increased risk for bone thinning.
  • As PD advances it can increase the likelihood of falls.
  • For those with PD, it is especially important to eat meals that provide the bone-strengthening nutrients including: calcium, magnesium, vitamins D and K.
  • Regular exposure to sunlight is also important, as it increases vitamin D in the body and serves as a bone-strengthening agent.
  • Walking and other weight-bearing exercises can also help in keeping bones strong and less likely to fracture or break.

2. Dehydration

  • PD medications can raise the risk for dehydration leading to: confusion, weakness, balance problems, respiratory failure, kidney problems and death.
  • Drink plenty of fluids throughout the day to avoid dehydration.

3. Bowel impaction

  • PD can slow the movement of the colon, thus causing constipation.
  • Therefore, you must get enough fiber in your diet.
  • If the constipation does not get resolved it can lead to bowel impaction where a mass of dry, hard feces becomes impossible to pass normally.
  • When bowel impaction occurs it may require hospitalization and even surgery.

Did you know that in the United States alone, dehydration is responsible for 1.8 million days of hospital care each year (about ten days per patient) and costs more than $1 billion annually?

4. Unplanned weight loss

  • People with PD often lose weight without meaning to, due to nausea, loss of appetite, depression and slowed movement.
  • Unplanned weight loss along with malnutrition can lead to a weakened immune system, muscle wasting, loss of vital nutrients and risk for other diseases and possibly even death over an extended period of time.

5. Medication side effects

  • While medications play an important role in managing the symptoms of PD they may also have unwanted side effects.
  • Taking more than one medication may increase the level of unwanted side effects.
  • Common side effects include:
    • Nausea
    • Appetite loss, often followed by weight loss
    • Edema (fluid retention)
    • Compulsive eating and weight gain
    • Talk to your doctor if you are experiencing anything unusual.

6. Protein-levodopa interaction

  • One of the more important medications used to treat PD is levodopa.
  • However, levodopa must compete for absorption from the small intestine with proteins in food, and it may be necessary to take care with the timing of meals and medications.

A healthy diet with plenty of water is the foundation for good health, regardless of whether or not you have PD. However, for those with PD, it is even more important. The reason why it is so critical for those with PD is that healthy eating can help keep your bones strong, thus decreasing the likelihood of a fracture if you fall. It also helps you fight constipation, which is common with PD.

The following are a few guidelines for healthy eating:

  • Eat a variety of foods to get the energy, protein, vitamins, minerals and fiber you need for good health.
  • Balance the food you eat with physical activity.
  • Maintain or improve your weight to reduce chances of having high blood pressure, heart disease, stroke, certain cancers and most common types of diabetes.
  • Choose a diet with plenty of grain products, vegetables, and fruits, which provide vitamins, minerals, fiber, and complex carbohydrates and which can help you lower your intake of fat.
  • Choose a diet low in fat, saturated fat, and cholesterol to reduce your risk of heat attack, certain types of cancer, and to help you maintain a healthy weight.
  • People with PD often lose weight without meaning to, due to nausea, loss of appetite, depression, and slowed movement. Unplanned weight loss together with malnutrition can lead to an weakened immune system, muscle wasting, loss of vital nutrients and risk for other diseases.
  • Reduce your sugar intake! A diet with lots of sugar can have too many calories and too few nutrients. It can also contribute to tooth decay.
  • Reduce how much salt and sodium you eat to help reduce your risk of high blood pressure.
  • Drink alcoholic beverages in moderation as they have empty calories and little to no nutrients. Drinking alcohol can also cause many health problems and accidents.

If you are interested in learning more about our Parkinson’s fitness video series please follow this link. NEVCO Education

For further information on Parkinson’s Disease you can visit  

http://www.michaeljfox.org or http://www.pdf.org/en/index


Learning Cultural Diversity in Nursing: Building Rapport Part Two

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Rapport is defined in the American Heritage Dictionary of the English Language as a noun meaning relationship, especially of mutual trust or inherent emotional similarity or natural personal attraction.

Part two of our series will focus on we communicate and how we present ourselves when we communicate

The way we say it. (How we communicate to the patient)

It involves mutual trust. To attain emotional trust of your patients you need to know their emotions. Your speech needs to originate from the same emotional platform.

To illustrate this concept we will use the example of teacher and student, while this example is not directly connected to nursing, remember a allot of your job is teaching the patient or the caregiver on healthcare issues.

 For instance, a teacher may have a set of preconceptions regarding the way parents train, discipline and otherwise mold the lives of the little ones they teach. The teacher may or may not be right about some but not necessarily all parents. The parents will fall somewhere in a continuum of good to poor parenting skills.

If the teacher looks at the parents with the preconception of being poor in parenting skills, unless a Oscar caliber actor, the presentation wave length will not harmonize with the majority of parents. That is because we give off signals as to what we truly believe within our speech. The ones she does connect with will have further fuel to look down on the others.

If however the teacher approaches the audience from the viewpoint they are doing all they can, it will be possible to connect with a majority of the audience.

How?

A Teacher would first have to frame a viewpoint that if a parent was doing the best they knew how to, they were doing the best they could. If a parent was doing the best they physically could, be it economic reasons, physical limitations, or educational reasons, then no improvement would be possible.

That is, without further training. There is room for improvement. However, it is not the teachers place to improve the world. The only improvement purview is the children.

So in speaking to the audience from a kind, empathetic, and understanding viewpoint, they would relate to the teacher as a concerned party. The first harmonization on the way to making rapport has been taken. Harmonizing with the audiences view of the world they live in.

Next comes the inherent emotional similarity. Nobody loves the children more than the parents. When that love is shown within the smile and audience contact of the speaker in relation to the children, a connection is made. A harmonization takes place. The audience feel like we can trust this teacher with our children. They will love them almost as much as the parents will.

Then comes natural personal attraction. If the teacher can love the children, then can the same emotions be extended to the audience. Relate it to being an aunt or uncle to the children. What does the audience now become to you. Your brothers and sisters.

The commonality of peoples viewpoints and thought processes that harmonize with each other is the final harmonization. Here, even if viewpoints are diametrically opposed, if as a speaker, it is possible to frame the opposing viewpoint within one that can be accepted or embraced, you will have one of the essential elements needed to attain rapport.

Finally, the third pillar.

The way we present ourselves.

To add the final element, mirror and approximate their movements. To do this, if they are rather rigid and formal, be formal, if they are out going and friendly, be that from the platform. Let your body language talk to them the way their body language is talking to you.

Rapport is not some trick. It is not necessarily a gift. It is something that can be learned. It will take practice, experimentation and constant learning. It requires constant and never ending improvement. Can anyone learn it? Anyone who is willing to apply them selves can.

This is said from personal experience. When you have someone come up to you and they express how your care and communication has touched them. How somehow you got inside their mind and got them to turn off their filters. How your nursing got them to consider or even accept something that was otherwise a closed issue, you will know you have attained rapport.

Learning Cultural Diversity in Nursing: Building Rapport Part One

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How Can You Attain Rapport With Your Patient

Rapport is defined in the American Heritage Dictionary of the English Language as a noun meaning relationship, especially of mutual trust or inherent emotional similarity or natural personal attraction.

In psychology it is considered an important feature or aspect of subconscious human interaction. It relates to commonality of peoples viewpoints and thought processes that harmonize with each other.In the field of Neuro Linguistic Programming it is taught rapport can be obtained with the control of body functions like breathing, hand-body-face gestures and eye movement. It is thought that if you follow or match the person your trying to gain rapport with in these functions (respiratory rate and depth for instance) you will gain rapport.

Additionally developing skills like active listening will further enhance this ability.

The ability to attain rapport in a one on one situation is evident. Is rapport possible for a nurse with an patient. Can a nurse learn how to connect with the patient on a subconscious level?

The answer is yes.

To prove the reality of rapport to a large audience, if you watched AI and saw the little boy robot laying in the bottom of the pool how did you feel.

Or Robin Williams in Millennium Man, did you feel a connection.

Did you hurt when you saw C3PO and R2D2 were being hurt? These were just actors and even just robots in some cases. It was all special effects.

Yet the story and words were so compelling, you had feelings for the people or actually the robots they were portraying. That feeling, those emotions were rapport.

Yes, even with out special effects and the multi-million dollar contract, you can develop rapport.

Same Wave Length.

The first concern with rapport has to do with the first pillar of great communication. It has to do with what you say.

Take the patient down the path of something they will find agreement with or comfort in. Validate their feelings and conclusions. Approve of them.

Then offer new ways to accomplish the goal within the frame work of what they think is acceptable. In other words, within the same wave length.

Look for the same wave length words that will keep the spam filters of our mind turned off and the receptors open. Look for words that build mutual trust. Words that build relationship.

Relationship building words might include sincere praise. Honest compliments could work. Hearty commendations too. Use what will allow the audience to see you as seeing them in their world. Any words that allow you to connect to them.

One word of caution. It has to be sincere and honest. A patient will be able to discern insincerity.

 

Emotional Similarity

To create emotional similarity or natural personal attraction mirror the style of words they use. Don’t use words above or below their socioeconomic level. Talk and use the words as if you were one of them.

Don’t imitate colloquialisms unless you’re a native speaker.

For instance, how would you tell someone they have a terminal illness? Think about this one. How would you want to be told?

 

More importantly, how would you tell someone else so as to deliver the message how they would like to be told. How would you tell it if you were a parent, a grown child, an employer, an employee telling a fellow employee? What words would you use?

 

Consider the words to use to build rapport with an patient. The ones they will want to hear. But don’t over do it so much that you appear as familiar unless you are. Act as though you’re a guest who has been told to make your self at home but still recognizing that you’re a guest.

One caveat, if they are not out going and friendly, still use a friendly conversational style. Be friendly but tone it down.

Use expressions and words that express the commonality of viewpoints. This is one of the reasons it is important to know your audience. To attain commonality you need to meet and greet. But that is not enough. You need to ask viewpoint questions.

 

To find viewpoints and save the individuals from feeling like your putting them on the spot, ask questions related to what popular opinion is. What are the feelings of the folks/ people/ the neighbors/ the community/or what ever you pick up on as the local way of referring to the audience at large.

Next week we will, give attention to the second pillar of great rapport. 

The way we say it.

 

Learning Cultural Diversity in Nursing: Basic Concepts Part Two

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Cultural Diversity in Nursing
Commonalities and Differences to Public Speaking

The cultural diversity in nursing can be mastered by learning the model of thinking that successful public speakers use to communicate to audiences. Likewise public speakers can improve their public speaking by looking at the challenge presented in the cultural diversity in health care and specifically, nursing.

The core commonalities of nursing and public speaking involve education, motivation and implementation of the teaching. The diversity spoken of here includes ethnic groups, people of color, marginal and or vulnerable people in society.

To manage the challenges cultural diversity presents, nurses have been referred to as cultural brokers. Cultural differences may result in the expression and description of their symptoms in ways that are less familiar to the listener.

Simple Cultural Diversity Solution

Diversity is so varied and is constantly changing how can one keep up with all the changes?

An example of constant change is the knuckle bump also called the fist bump. A 2010 study found that the about 50% of North Americans prefer the knuckle bump vs the hand shake. The reason for the change was to prevent the spread of germs. Yet immigrants from other countries still offer a hand shake and may not be familiar with the knuckle bump.

A simple way to learn is adopting a simple process to understand and learn the cultural diversity of those being provided care and or the cultural diversity in healthcare. Here are some of the skills public speakers do to become masters of cultural diversity. Nurses could do the same.

Learn to Listen-Hearing vs Listening

Hearing is the ability of perceiving sound by the ear. If you hearing is intact, hearing happens.

Listening requires conscious effort to choose to do. Listening requires a measure of mental concentration so that your brain processes meaning from words and sentences.

Hearing and Listening: The Difference and Definition

Listening is more than the sum of its parts. There are various kinds of listening.

Listening for information

Information could include facts, figures, details, knowledge, instruction, advice, guidance, direction, counsel enlightenment, news words, thought content or knowledge. Listening can be to understand or to learn.

Listening for Emotional Content

Emotional content is the underlying feelings that are based on emotion rather than reason. It can also include things like the tone for voice, gestures, body language and micro-expressions.

Is the person happy and satisfied or dispirited or dejected. Is there anger or pleasantness noted in in the affect. proud or humble emotions manifest by speaker.

Listening for the Unspoken

Listening for what is unsaid what is implied but not stated, inhibited from being said or what may really be meant.

What is Involved in Effective Listening?

Listening is defined as applying oneself to hearing something. In verbal communication it is to hear while giving attention to what is being said. It is an ability that can be cultivated and practiced into a skill. From this standpoint it can be viewed as an art.

As a public speaker, it is an art that requires a conscious choice to master. As a married person, it is a necessity.

The Listening Test

This will help you master your listening efficiency.

Now the test.

For one whole day, your entire time your awake, devote yourself to not making any comment, giving an opinion, not even validating anything said by anyone else.

Not even a yes. This might require some artful and creative thinking. You might respond to someone calling out to you with something like…did you call? If someone needs an affirmation, the challenge is giving it while delivering a legitimate question rather than something nonsensical.

All that is required to pass the test is to listen. If needs be, you can ask more questions to further your ability to listen. Offer no comment, suggestions, or affirmations.

Do this for an entire day.

Most people who have tried it have found it too difficult to do.

This will help you to learn how to listen. Really listen to what others are saying.

More important than passing the test is the value of what you will learn. You will start to see how often you speak. You will start to find something wonderful as well. You will become very much liked by those around you.

Why, because people appreciate someone who is a good listener.

NEXT WEEK WE WILL LOOK AT BUILDING RAPPORT.