Category: Uncategorized

Coulda, Woulda, and Should Have!

I’m wondering why my relatives who coulda, woulda, and should have thrown out the trash chose to hang on to it? I just spent yet another weekend in my hometown cleaning out my mom’s cousin’s house. Although I thought I’d already emptied all of the bags and boxes that have to be slowly sorted, I discovered I was wrong!

There were bags behind a chair, boxes under the dresser and the beds, and piles on top of the cedar chest. There’s unopened mail from 1987 mixed with family photos, used Kleenex, financial records for still active accounts, pharmacy bags with prescriptions attached, and pill bottles filled with quarters all in the same box or bag.
bags
In the past 3 years, I’ve been tasked with cleaning out two houses and a 3000 sqft storage building filled with similar mixtures of trash, recycle, shred, keep, and donate. Trash, recycle, shred, keep, donate. Trash, recycle, shred, keep, donate.

I can quickly think of four relatives no more distant than second cousins who have stopped throwing things away. They don’t shop compulsively. They are proponents of recycling. They pay their bills. They have active social lives. And they keep trash. And they mix trash with non-trash. And they leave the trash casserole for someone else to deal with.

This weekend I was joined in the cleanup by my psychologist cousin who thinks this is a form of hoarding or obsessive-compulsive behavior. Of course, my first question was, “Is it genetic?” According to Dr. Nancy, there is most likely a genetic component, but no specific marker has been identified. I know I came home with a compulsive desire to get rid of something.

In my mom’s house, there was an identifiable point in time at which filing and organization stopped. Prior to that, she saved a lot of things, but it wasn’t unheard of for her to pare down. There is an identifiable year when things changed in her cousin’s house as well.

While the cousin’s change in habits seems timed to correlate with the loss of her mother, my mom’s appears to correspond with her marriage to her second husband. I guess the commonality in the two is significant life change.

Logically I understand how loss might trigger a desire to hang onto things that belonged to a person you lost or that hold fond memories of a person lost. It’s interesting that it might trigger hanging onto junk mail or ceasing to file.
pile
I think it’s possible that a triggering change can cause a freeze response that manifests in an inability to take care of yourself in some way. Perhaps it interrupts your maintenance of your environment or perhaps you struggle to feed yourself.

Saying it’s a triggering change implies a previous wound or a latent biological response. Obsessive-Compulsive disorders and Eating Disorders are closely related to anxiety. Anxiety is at its most simple, distress.

Distress can come from old or new feelings of terror, grief, sadness, helplessness, humiliation, danger, distrust, rejection, invisibility, shunning, defectiveness, and unloveability. Old incidents of neglect, abuse, or cruelty sensitize us to anything that feels the same.

All of these feelings can be so powerful that we can become overwhelmed. Pushing ourselves gently into action may seem like the straw that will break us. Of course, the reality is that the only way to heal the distress is to find a way to feel then release the feelings.

Hopefully most of us will find a way to do this instead of ceasing to throw away trash. Living in the midst of clutter weighs us down. The dust collected can irritate allergies. Piles can create a falling or fire hazard.

Neglected kitchens and bathrooms can pose other health risks. During my weekend, I observed that canned vegetables can sit unused long enough that the can begins to disintegrate and leak thick, black tar-like liquid that runs out of the cabinets and drips onto the countertop. I’m not sure I can describe to you how gross this is!

I donned a mask and gloves, but I felt like I needed a full hazmat suit to dispose of the cans. An antique Kerr jelly glass with a metal lid accidentally tumbled into the contractor bag along with a can. I did not go after it. I realize they sell for almost $20 on Etsy. It still wasn’t worth the dive.

Yesterday, I drove the three hours home wanting nothing more than to wash the day off of me and go to bed. Now that I’m back, everything in my house is suspected trash! I’m looking to see if there’s anything I coulda, woulda, or should have thrown away by now.

I sometimes feel like taking the position of my mom’s cousin Jimmy. Jimmy had a barn in disrepair that he wanted to tear down. The barn was located on the original homestead and contained some family heirlooms. Jimmy tried to get the family to come claim those treasures so he could proceed with demolition.

Instead, they stalled, lobbied, guilted, humiliated, and generally made him so miserable that for 15 or 20 years whenever someone mentioned that barn he’d just shake his head and say, “Light a match!” That was almost 40 years ago. He never demolished or torched the barn.

In fact, he finally sold the land to my dad and I now own the repaired, refurbished barn. I have no idea what’s in it. Maybe I coulda, woulda, or should have, but I’m afraid to open the door!

…Light a match?

https://www.psychiatry.org/patients-families/hoarding-disorder/what-is-hoarding-disorder

https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml

https://www.eatingdisorderhope.com/information/eating-disorder/eating-disorders-anxiety
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Out of the Mouth of Babes, Snakes, and Scientists – Smell Begins With the Tongue

Sometimes a new idea comes out of the mouth of babes, snakes, and scientists. A study published last week online in advance of the print edition in Oxford Academic Chemical Senses finds that smell may begin with the tongue rather than the brain. One of the study’s authors, Mehmet Hakan Ozdener, MD, PhD, MPH, became intrigued with the idea when his adolescent son asked whether snakes stick their tongues out in order to smell.
tongue
A current model of taste and smell shows two genetically different receptor systems located in anatomically distinct locations that send signals to different targets. While the two are known to intertwine to form the perception of flavor, scientists thought that the first merger occurred in the insular cortex – a part of the cerebral cortex in the brain. The insulae are believed to play a role in functions that include perception, motor control, self-awareness, cognitive functioning and interpersonal experience.

The abstract of this new study states: “Here we report that olfactory receptors are functionally expressed in taste papillae…The results provide the first direct evidence of the presence of functional olfactory receptors in mammalian taste cells. Our results also demonstrate that the initial integration of gustatory and olfactory information may occur as early as the taste receptor cells.” (1) Other experiments confirm that smell and taste receptors may be found within the same cell.

There are 400 different types of functional human olfactory receptors and scientists do not know what molecules activate the vast majority of them. While fascinating, this study alone does not answer that question or have a practical application other than to advance knowledge that will lead to other studies.

That’s the beauty of science. It’s a living body of changing knowledge. One layer builds on another. The more we understand about how things work, the more options we have for enhancing our lives. It’s good to remind ourselves of that occasionally.

Believing science has become a battle cry among those who want to stand firm on what we currently know. There’s a danger in that because tomorrow we will know more and that may mean that what we know today is no longer supported by the evidence. It also makes science sound like a restrictive rule book. Who wants to learn a bunch of rules? Certainly not bright minds that can imagine big ideas.

Instead of believing science, I’d rather we love it! And while we’re loving it, let’s be curious. Curiosity leads to advancement. Questioning is good. Skepticism can play a valuable role. Allowing our understanding to shift and change does not threaten our way of life. It has the potential to vastly improve it.

But don’t take that from me, take it from the mouth of a scientist: “I have no special talents. I am only passionately curious.” – Albert Einstein.

(1)https://academic.oup.com/chemse/advance-article-abstract/doi/10.1093/chemse/bjz019/5470701?redirectedFrom=fulltext

https://www.sciencedaily.com/releases/2019/04/190424083405.htm

https://encyclopedia.thefreedictionary.com/insular+cortex
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Treasures Among the Trash

recipeYou never know what treasures you’ll find among the trash when you begin to clean out clutter. I’m sure the reason most of us have clutter is that we think too many things are treasures. Marie Kondo is making sure we know how to see the difference. But when we clean out an incapacitated or deceased relative’s home, we don’t have the luxury of choosing what is saved. We only have the opportunity to discover treasures among the trash.

Every month or two I spend a couple of days in my 98-year-old cousin’s house cleaning out the compilation of trash and treasure that includes: bank records from 1972, unopened mail from 1987, family photos from 1896, report cards from 1910, a wedding invitation from 1919, and a baby book from 1920. Because these items are mixed in with junk mail, decaying candy, promotional products, and wadded Kleenex, it is an arduous and sometimes icky process. I love it when I find some treasure that makes the effort worth it!

Recently, I’ve been working my way through the den toward the kitchen. Kitchens have the best variety of memorabilia. A few years ago, I discovered my grandmother’s ceramic green pepper spoon rest in my mom’s kitchen. I was thrilled. Now it’s on my counter by the stove. I love that visual reminder of my grandmother.
pepper
I also love finding old recipe cards. Not only do they give me a chance to prepare my favorite family dishes, there’s something charming about the varying shapes, sizes, and legibility of old recipes. Some assume you are extremely knowledgable about cooking techniques. Some have an ingredient list. Some do not. Many are spattered with remnants of food. Some are in handwriting I recognize. Some have clearly been handled more than others.

This look into the past seems more enticing to me than an old photograph or a tarnished silver service. Perhaps it’s because the recipes are a living memory. They can be created again and again. They can be shared with generation after generation along with stories of previous times they were enjoyed! If you think your kids don’t appreciate those stories, tell them to your grandkids.

At 2-and-a-half, JD loves any story about my experiences; he asks me to repeat them over and over. He never tires of hearing the details again and again. Adding food into the mix creates an indelible experience that he will no doubt share with his children and grandchildren. The recipe cards may not be preserved, but hopefully the recipes will find their way into his heart and his smart appliances or voice-activated replicator or whatever generates food in 2077.

Experimenting with unfamiliar flavor combinations is fun for me, but when I’m tired and hungry or it’s my birthday I’ll take my grandmother’s beef and noodles and a lemon meringue pie any day. Throw in some fresh green beans with new potatoes and I can smell the dirt from the garden when I helped my grandmother dig potatoes. These memories bring with them a sense of belonging to my family and to the earth. I had a place and a purpose.
pie
Such simple things can have a large and lasting effect. In this era of disconnection and short attention spans, we are often lacking a feeling of belonging and purpose. If you can provide that for your family by sharing the stories and food that you loved, is time spent in the garden or the kitchen worth it? I think so! I know time spent connecting is.

https://konmari.com/

https://ideas.ted.com/finding-our-way-to-true-belonging/

http://www.cooking2thrive.com/blog/the-benefits-of-cooking-part-1-the-food/

http://www.cooking2thrive.com/blog/the-benefits-of-cooking-part-2-the-fun-2/

http://www.cooking2thrive.com/blog/the-benefits-of-cooking-part-3-the-lessons/

Disclosure of Material Connection: I have not received any compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: “Guides Concerning the Use of Endorsements and Testimonials in Advertising.”

Patient and Family Centered Care You can make a difference

When it comes to Patient and Family Centered Care (PFCC), you can make a difference. My family has spent a lot of time in the hospital this past year-more than 160 days since April 2018. That’s a lot of time to observe a lot of things.
hands
Every hospital is different. Like families, each has its own culture. Departments and even units within a hospital have their own subcultures. In some institutions, the lack of an overall policy results in units developing their own policies.

Communication between units is often lacking so a patient may be transferred from one unit to another within an institution only to experience a confusingly different policy on patient communication tools, changing bed linens, who attends rounds, visitor access, response time to patient calls, etc.

As a patient, you are most likely sick, injured, or weakened in some way. On top of that, you are vulnerable to the expertise, decision making, and implementation of treatment plans at the hand of many, many strangers who you have no chance to vet. That is distressing enough. Adding confusion, inconsistency, and unresponsiveness creates an environment that’s, let’s just say, less than healing.

If you have been a patient and/or family member who has experienced less than acceptable care, you may want to explore your hospital’s policies and participation in Patient and Family Centered Care. There could be an opportunity to provide input that will improve the hospital’s process to benefit patients.

Although Patient and Family Centered Care as a concept has been around for more than 20 years, it has not always been treated as important to healthcare. With participation in Hospital Consumer Assessment of Healthcare Providers and Systems Surveys (also known as Hospital CAHPS®) through Medicare and Medicaid and the public reporting of resulting data, hospitals are increasingly focussed on learning about and improving the patient experience. This has brought additional attention to PFCC.

Patient and Family Centered Care seeks to collaborate with patients and families as partners in care. The four basic tenants of PFCC are:
1. Dignity and Respect
2. Information Sharing
3. Participation
4. Collaboration
Simple enough, right? Of course not when you’re attempting to implement these into a system that has avoided information sharing and often treated patients as subjects rather than people. The good news is that you do not need medical training to relate the patient experience so your voice can be powerful in implementing change.

I sit on a PFCC Hospital Advisory Council. Over the past year, we have helped mold new ICU security policies, changed the language used in scheduling phone scripts and advance directives, given input on opioid risk assessment tools and MyChart content, reviewed food service menus, revised design and use of patient communication boards, and helped implement a hospital-wide linen policy.

In May, council members will begin sitting in each hospital unit to observe and speak to the nurses to determine the obstacles that prevent prompt response to patient calls. The information we gather will be transmitted to our Director of PFCC who will then meet with hospital leadership to determine how best to improve response times.

Our council is a mix of volunteers, hospital staff, and an MD who serves as the Associate Chief Quality Officer for Patient Experience. Some volunteers are retired nurses and medical school professors. Others are business people and community members who are patients or patient family members. Volunteers are required to attend orientation, be familiar with hospital codes, and get a yearly TB test and flu shot (or wear a mask during flu season).

For projects like call response observation, we also receive training for the task. It is our role to be a friendly ear to gather information, not to criticize or make suggestions while in the units. If we have specific concerns, those will be communicated to the Director of PFCC for inclusion in her presentation to leadership. The process is working well enough that current hospital leadership has given PFCC a great deal of authority and priority.

If you feel the patient experience could be improved at your local hospital, you may want to volunteer to assist with, or help the hospital explore implementing, Patient and Family Centered Care. Dedicating your time now can result in a better patient experience for you and/or your family in the future.

Given the amount of time my family is having to spend at the hospital, that seems like a worthwhile investment.

http://www.ipfcc.org/

https://www.medicare.gov/hospitalcompare/data/overview.html

https://www.cms.gov/Medicare/Quality-Initiatives-patient-assessment-instruments/hospitalqualityinits/hospitalhcahps.html

https://medium.com/@cooking2thrive/id-tell-you-but-then-i-d-have-to-b49d9b2d3900

http://www.cooking2thrive.com/blog/heres-an-idea-for-an-app/