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APSCARES




                                                                                                          FO ck
                                                                                                             RU pa
                                                                                                               M ge
                                                                                                                S
 FALL / WINTER    2010



   HCQU Director’s
   Thoughts...
        Dear Colleagues,
        I would like to take a moment to share some statistics related to the level of effort in which
        the APS HCQU was engaged during the 2009-10 fiscal year. Our associates conducted 792
        instructor-led trainings to 10,533 participants, and an additional 3,700 people utilized the
        44 online training modules that are hosted on our website. We were involved in 27 separate
        capacity building projects in the community to increase quality and access of services for
        those with ID/DD in associated support systems such as medical systems, dental systems,
        behavioral health, and transportation, to name a few. In one hospital system, we provided 45
        training sessions to 400 hospital employees on best practice supports for people with ID/DD
        in an acute care setting. We also held three, one day sessions for 103 psychologists on various
        topics related to best practice in the support of individuals with ID/DD. We continued to offer
        technical assistance to providers and Administrative Entities related to supporting individuals
        with both medical and behavioral challenges so that individuals can have the highest level of
        quality service in the community. In this capacity, we invested 2,800 hours of staff involvement
        in 48 technical assistance cases, of which 33 were successfully resolved. We have recently
        enhanced our website with a blog and forum to provide both information and an environment
        for the sharing of ideas related to the ID/DD system.
        As we look forward to the 2010-11 fiscal year we anticipate training an even greater number of
        direct support professionals, individuals, and caregivers as we expand the number of both our
        instructor-led trainings and online course offerings to support the training needs of our service
        delivery systems. We at APS continue to be committed to providing quality support for the
        ID/DD community. Please visit us at www.hcqu.apshealthcare.com. As always, the APS HCQU
        wishes you a safe and healthy fall and winter.
                                                                             — By Kevin McElligott, MEd




What’s Inside...
Smoking Cessation              Fall Prevention            Weather Woes              Surviving the
Pg. 2                          Pg. 5                      Pg. 6                     Holidays
                                                                                    Pg. 9
    Smoking CESSATION                                                            — By Carrie Perrell, RN

    “It’s easy to quit smoking. I’ve done it hundreds of times.” This famous quote by American writer
    Mark Twain humorously illustrates the challenge of quitting the use of tobacco; however, people
    who are trying to quit smoking may not find any humor in the process. This article contains
    information about tobacco usage and quitting strategies.

    History of Tobacco Use                             pleasant feelings which make smokers want
                                                       to smoke more. The nervous system adapts
    Evidence of tobacco use in the Americas
                                                       to nicotine. Smokers develop tolerance to
    can be traced back thousands of years with
                                                       nicotine, meaning it will take more nicotine
    worldwide use of tobacco going back about
                                                       (more cigarettes) to get the same effect
    500 years. Research into the effects of
                                                       previously attained from smaller amounts.
    tobacco use, however, only began about 50
                                                       When smokers attempt to cut back, the lack
    years ago. Globally, 14,500 people die each
                                                       of nicotine causes withdrawal symptoms, which
    day from tobacco use, with the United States
                                                       may include: irritability, sleep disturbances,
    reporting 433,000 deaths annually.
                                                       headaches and increased appetite. These
    Addictive Properties of Tobacco                    symptoms can cause smokers to start
    Nicotine, which is found in tobacco, is reported   smoking again after quitting.
    to be as addictive as heroin. Nicotine causes


     Health Benefits of Quitting
     In 1990 the US Surgeon General concluded that quitting smoking has immediate
     and long-term health benefits such as:
       • After 20 minutes: Heart rate and blood pressure drop
       • After 12 hours: Carbon monoxide level in the blood drops to normal
       • After 2 – 3 weeks: Circulation improves and lung function increases
       • After 1 – 9 months: Shortness of breath and coughing decrease
       • After 1 year: Risk of coronary heart disease is cut in half
       • After 5 – 15 years: Stroke risk is reduced to that of a non-smoker
       • After 10 years: Lung cancer death rate is cut in half; decrease in risk of mouth, throat,
         esophagus, bladder, cervix, and pancreas cancers
       • After 15 years: Risk of coronary heart disease is the same as a non-smoker’s

     Financial Benefits of Quitting
     The cost of a pack of cigarettes varies greatly from state to state. Taking an average of $6/
     pack, a pack-a-day habit would amount to $2,190 per year for cigarettes or $21,900 after
     10 years. This figure does not take into account increased costs for health and life insurance
     and possible medical care costs associated with tobacco use.




2
Health Consequences of Smoking                      resources for smoking cessation are available
                                                    and are listed at the end of this article.
As many as 4000 chemicals, natural and
                                                    These resources contain various supports
added, may be found in tobacco products.
                                                    and methods for quitting smoking. For the
All tobacco products contain carcinogens
                                                    best chance of success, two or more of the
(cancer-causing agents). Diseases and other
                                                    methods recommended should be included in
ailments associated with tobacco usage
                                                    a plan to quit smoking.
include cancer of the lungs, mouth, voicebox,
throat, esophagus, bladder, kidney, pancreas,       Withdrawal from nicotine is inevitable and may
cervix, stomach and certain leukemias,              be divided into two parts: physical and mental.
lung diseases such as chronic obstructive           The physical symptoms may be relieved with
pulmonary disease (COPD), bronchitis, heart         medication or nicotine replacement products.
attacks, peripheral vascular disease, strokes,      For the mental withdrawal it is recommended
macular degeneration (most common cause             that individuals recognize and avoid
of blindness in older people), premature            rationalizations such as “Life is not fun without
wrinkling of the skin, bad breath, gum and          smoking” or “It’s my only vice.” There are
tooth problems, blood clots,                                   many more. Write these down and
miscarriage and lower birth                                         have a plan in place to deal with
weight babies for pregnant                                             these thoughts. A change of
female smokers.                                                          routine and avoiding places
                                                                           where the temptation
How To Quit                                                                  to smoke exists may
There does not seem                 “It’s easy to quit smoking.               help. Deep breathing
to be any one fail-safe         I’ve done it hundreds of times.”              is recommended
method to successfully                                                        by several smoking
quit smoking. The                                     — Mark Twain            cessation plans. Deep
American Cancer                                                               breathing reduces
Society outlines a four-                                                    stress. Remember that
step approach as follows:                                                 even very strong cravings
The decision to quit smoking                                            will go away after just a few
should come from the smoker.                                         minutes. Reward oneself as
Even though others may want the                                   part of a plan to quit. Individuals
smoker to quit, it’s a decision that should                could save the money that would
be made by the individual. Smokers should           have otherwise been spent on cigarettes to
consider the reasons why they wish to quit.         get a treat. The reward could also be doing
                                                    something enjoyable such as visiting a park,
Picking a specific quit date is an important        seeing a play or attending a concert.
step. Time should be allotted for a physician
visit if prescription medication to aid in          The maintenance phase is the period of time
quitting, such as Zyban or a nicotine patch,        after an individual has gone through withdrawal.
is to be used. Individuals may wish to inform       Months or years after quitting an unexpected
family and friends about the quit date as part      strong desire to smoke may arise. The goal
of their plan to quit. Other tips include: getting during these moments is to avoid a relapse.
rid of cigarettes and ashtrays; stocking up on      Reviewing the reasons for quitting in the first
oral substitutes such as gum, candy, cinnamon place may help. Also, the tips for quitting still
sticks; figuring out what worked best in any        apply, such as avoiding rationalizations and
past attempts; joining a support group. Many        remembering there is no such thing as “just
                                                    one puff “or “just one cigarette.”




                                                                                                        3
    How to Support Individuals with                    of successful smoking cessation is breaking
    Smoking Cessation                                  routines that have been associated with
                                                       smoking. Caregivers can be role models by
    There is a lack of scientific research relating
                                                       refraining from smoking during their breaks.
    to ways to assist individuals with intellectual
                                                       This will also increase the health benefits for all
    and developmental disabilities (ID/DD)
                                                       involved.
    who are trying to quit smoking. However,
    there are websites that offer some tips in         Caregivers may also help individuals with ID/DD
    this regard. Common among the various              to quit smoking by assisting with following the
    smoking cessation resources is the caution         steps suggested by the American Cancer Society.
    to not threaten, lecture or nag about the          Caregivers can create a social story illustrating
    dangers of smoking. Focus on the benefits of       the quitting process. Caregivers may help
    quitting. If an individual is going to use oral    individuals list reasons they wish to quit and
    substitutes such as cinnamon sticks, hard          assemble these in a booklet. Caregivers could
    candy, low calorie snacks such as carrots          help the individual create a calendar with
    or fruit, the caregiver can make sure those        pictures depicting the quit date. Caregivers
    items are available. Be sympathetic. Realize       can help individuals come up with pleasurable
    that individuals who are attempting to quit        or healthful activities to replace smoking.
    may become edgy at times. Give praise and          If an individual is prescribed a medication or
    encouragement during the day, and offer            oral substitute, caregivers can be helpful in
    congratulations at the day’s end.                  assuring that these are given as prescribed
                                                       and when indicated. Caregivers may wish
    The smell of smoke may trigger a desire to
                                                       to visit the various websites dedicated to
    smoke. Therefore, environments should be
                                                       smoking cessation to learn of other methods
    smoke-free. Caregivers may be in the habit of
                                                       of support.
    enjoying cigarette breaks with individuals. Part

     Resources
     There are many sources of support available for people seeking help with quitting smoking.
     People may call 1-800-QUIT NOW (1-800-784-8669). This service is provided nationally
     through state health departments. People may speak with a live staff person who will offer
     a choice of free services, materials, programs and one-on-one phone counseling. Other
     resources include the American Heart Association, 1-800-242-8721, www.americanheart.
     org; American Lung Association 1-800-548-8252, www.lungusa.org; Nicotine Anonymous
     1-877-879-6422, www.nicotine-anonymous.org and QuitNet,
     www.quitnet.com.

     References:
     The Globalization of Tobacco Use: 21 Challenges For The 21st Century, A Cancer Journal for
     Clinicians, retrieved on 7-6-10 from http://caonline.amcancersoc.org
     Smoking quotes, retrieved 7-6-10 from http://thinkexist.com/quotations/smoking/
     Guide to Quitting Smoking, retrieved 7-6-10 from www.cancer.org
     Do You Want to Help Someone to Quit Smoking, retrieved on 7-7-10 from
     www.quitsmokingsupport.com/helpinghand.htm
     Quitting Tips, retrieved on 7-2-10 from www.anti-smoking.org/quitting1.htm
     How to Quit, Centers for Disease Control and Prevention, retrieved on 7-6-10 from
     www.cdc.gov/tobacco/quit_smoking/how_to_quit/index.htm


4
FALL PREVENTION                                                                   — By Sharon Childs, RN


A    ccording to the National Safety Council,
      falls are the second leading cause of
accidental death in the United States and
                                                      availability of fall prevention strategies, care
                                                      providers are being held legally accountable.
                                                      Though many of these providers address fall
the leading cause of death due to injury for          prevention in various ways, many are still in
individuals age 73 and over. It is interesting to     need of a formal fall prevention program.
note that the Public Health Service estimates
                                                      A formal fall prevention program is a
that two-thirds of deaths due to falls are
                                                      multifaceted approach to the prevention and
preventable.
                                                      reduction of falls. It involves staff at all levels
Although little information is available              of an organization. Fall prevention should be
concerning the relationship of falls and the          considered in strategic planning and resource
population with intellectual and developmental        allocation.
disabilities (ID/DD), it is known that falls are
                                                      The APS HCQU has developed a resource
responsible for a large number of serious
                                                      manual to assist providers in the development
injuries within the population. Individuals
                                                      of an individualized fall prevention program
with ID/DD often have multiple factors that
                                                      specific to the population they support. The
place them at risk for falls. These may include
                                                      manual guides agencies through the steps
impaired cognition, impaired mobility as
                                                      needed to create a program and provides
a result of gait and balance disturbances,
                                                      tools and resources that can be utilized in the
visual impairment, seizures, adaptive and
                                                      implementation of the program. This resource
maladaptive behaviors, and the use of various
                                                      manual is available for download from the
medications that may contribute to instability
                                                      HCQU website (www.hcqu.apshealthcare.com)
during ambulation.
                                                      Other Resources page (in the Fact Sheets and
There are wide-ranging consequences from              Other Information drop-down window) or by
falls to one’s overall well-being. Physical health,   calling the HCQU office at 1-888-321-5861.
emotional health, mental health, quality of life,
                                                        The benefits of having a fall prevention program
and financial well-being can all be affected.
                                                        in place are tremendous and may include include:
Fractures, traumatic brain injury, prolonged
hospitalization, and even death can occur.               • Creates a teamwork culture
Mobility and independence can be affected,               • Allows focus on prevention strategies
leading to a diminished quality of life. In many
instances, fallophobia, or the fear of falling,          • Reduces number of falls
develops and can place a person at risk of               • Reduces number of serious injuries
falling again. Extensive medical costs can be              associated with falls
incurred due to hospitalization, rehabilitation,
                                                         • Preserves and improves quality of life
and possible long term care placement. All
of this can lead to anxiety and depression.              • Reduces healthcare costs
Caregivers and families may incur injuries as a          • Provides information on falls related to
result of trying to keep the person from falling           individuals with ID/DD
or in trying to help them up after a fall.
                                                         • Can prove a valuable asset if litigation occurs
Preventing and reducing falls poses a significant
                                                         • Creates a culture of change, not a culture of
challenge to all agencies that provide care for
                                                           blame
individuals with ID/DD. With the advent and



                                                                                                             5
                                                                                   — By Mark Parker, RN


    E   nvironmental emergencies arise everyday and vary widely in nature. They include storms
         (snow/rain), fires, floods, and power outages. Emergency situations can be stressful
    and they require appropriate management to ensure the safety of all. Agencies should have
    emergency management policies and procedures in place, and it is a good idea for staff to
    review these documents on a regular basis.
    Sometimes an emergency situation may lead to being confined at home for a period of time,
    due to impassable road conditions or travel restrictions that are imposed due to a State of
    Emergency that has been declared for the area. This was experienced by many last winter when
    one of the worst winter storms in recent history hit the region. Were you prepared? It is best to
    be prepared before an emergency occurs, rather than trying to gather items during one.

      Some helpful hints for managing a home confinement situation are:

      Water                                                 – Cookies, hard candy, cereals, instant
       Store water in plastic containers                     coffee, and tea bags
         such as soft drink bottles and plastic             – Foods for people on special diets
         milk containers. Refrain from using
         containers that will decay or break, such          – Have a supply of low salt, low fat, low
         as paper milk cartons or glass bottles.              sugar items available for people on
                                                              special diets
        Store one gallon of water per person
         per day; two quarts for drinking and two        Paper cups, plates and plastic utensils
         quarts for food preparation/sanitation.         Manual can opener
        Keep at least a three-day supply of           Tools & Supplies
         water for each person.
                                                         List of emergency numbers posted by
      Food & Supplies                                     each phone.
        Store at least a three-day supply of            Battery-operated radio and extra
         non-perishable food per person. Select           batteries
         foods that require no refrigeration,
                                                         Flashlight and extra batteries
         preparation or cooking, and little or no
         water. Examples are:                            Cash
           – Ready-to-eat canned meats, fruits           Tape
             and vegetables                              Electric generator, if permissible, for
           – Canned juices, milk, soup (not               electric powered medical equipment
             condensed soup)                             Blankets
           – Sugar, salt, pepper                         First aid kit
           – Peanut butter, jelly, crackers, granola
             bars, trail mix




6
Medical Concerns
In the event of loss of electricity, furnaces and air conditioners may cease to work. This may lead
to extremes in environmental temperature, putting some individuals at risk for hypothermia or
hyperthermia.
Hypothermia is when the body reaches a subnormal temperature, usually 95 F or less.
Symptoms of hypothermia include lack of coordination and shivering. This condition can be fatal
and emergency treatment should be sought. If the furnace stops working, wrap individuals in
blankets and outerwear, paying attention to cover the head, ears, and hands. Seek shelter in a
warm environment. Keep agency administrators aware of the situation.
Hyperthermia is when the body temperature is too high. It may be a result of heat exhaustion.
Symptoms of heat exhaustion are heavy sweating, muscle cramps, weakness, and fainting. If it
is extremely warm individuals should stay out of the sun, avoid strenuous activities, and drink
plenty of fluids.
People who are more at risk for developing these conditions are the elderly, the very young,
and those with chronic illnesses such as diabetes, chronic obstructive pulmonary disease, heart
disease, and compromised immune systems. Individuals who take a lot of medications may also
be at risk.

Stress
Emergencies can be frightening, and the inability to go about normal routines due to weather
conditions can be very stressful for both staff and individuals receiving services. It is important
for staff to manage their own stress so that they can assist individuals through an emergency
situation that requires being confined at home for a period of time. Some tips for staff
regarding personal stress management are:
 • Recognize signs of stress in yourself. There are many signs of stress; some common ones
   are irritability, racing heart, sweating, abdominal discomfort and symptoms, and anxiety.
 • Practice stress reduction techniques. Common stress reduction techniques include
   deep breathing, imagery, time out or counting to ten, muscle relaxation protocols, and
   aromatherapy. The situation may demand that there is not a lot of time to spend on these
   activities, but taking a few minutes at least every hour may be beneficial to positively impact
   the effects of stress.
 • Get adequate rest. In a care giving situation that requires 24 hour awake staff this may be
   challenging. Discuss the situation with your supervisors and make arrangements to develop
   a work schedule that allows for periods of rest and rejuvenation.
 • Eat a healthy diet. Good nutrition in times of stress can minimize physical symptoms and
   reduce feelings of fatigue.

Individuals receiving services may also experience stress related to being confined at home
during a state of emergency. There may be an increase in challenging behaviors due to
limitations that may be present in verbal communication abilities. It may be helpful to review
each individual’s support plan for information pertaining to working with him or her. Some
techniques that staff can utilize when working with individuals who may be experiencing a high
degree of stress are:




                                                                                                      7
     • Remain calm. Refrain from raising your voice or displaying fear. These measures will convey
       confidence and safety to the individuals.
     • Avoid continued exposure to media reports of the situation.
     • Talk with individuals, explaining the situation in simple and concrete terms. Allow them to
       express their feelings. Acknowledge their feelings, letting them know that these feelings are
       normal and that everyone will get through this by working together.
     • Encourage the use of relaxation techniques, such as deep breathing and imagery for those
       who are able to participate.
     • Provide diversional activities that are appropriate to the individual’s interest and skill level.
       Be prepared to provide activities that do not require electricity, such as puzzles, games, arts
       and crafts, storytelling, and completing household tasks.
     • Encourage individuals who are able to participate in emergency management activities.
       Perhaps someone can go to the storage area to retrieve food and water while someone
       else shovels snow from the walkway.

    Additional Suggestions And Reminders
    The strategies listed here can help people to get through a home confinement situation due to
    emergency conditions. Additional suggestions are:
     • Store First-Aid kit in a convenient place known to all.
     • Keep items in air-tight plastic bags.
     • Change stored water and rotate stored food every six months to maintain freshness.
     • Replace batteries yearly.
     • Practice emergency situation drills on a regular basis.
    The APS HCQU has an Emergency Preparedness Resource Manual available on the HCQU
    website at (www.hcqu.apshealthcare.com). To download this manual, click on the Other
    Resources tab and then on the Emergency Preparedness Resource link.
    Please note, follow your agency’s policies and procedures regarding emergency management.


     References
     Disaster Preparedness, retrieved on July 29, 2010, from
     http://www.statefarm.com/learning/disasters/learning_disas_prepare.asp
     United States Search and Rescue Task Force, Family Disaster Supplies, retrieved on July 29,
     2010 from http://www.ussartf.org/family_disaster_supplies.htm
     Emergency Preparedness Resource Manual, APS Healthcare
     Southwestern Pennsylvania Health Care Quality Unit, retrieved on July 29, 2010, from
     http://hcqu.apshealthcare.com/content/pages/OtherResource.aspx
     Heat Exhaustion, retrieved on July 29, 2010, from
     http://www.medicinenet.com/heat_exhaustion/article.htm




8
Surviving
                                                   Blues
                                                                   The Holiday
the Holidays                                                             — By Amy Kanich, RN, BSN

“Chestnuts roasting on an open fire, Jack Frost nipping at your nose. Yuletide carols
being sung by a choir…” A familiar line from a popular Christmas song paints mental
images of a greeting card like festive season. For many, the holidays are looked forward
to with great anticipation, a time set aside for family and friends, invitations to festive
parties, and the excitement over the exchange of beautifully wrapped gifts. The holiday
season is so often referred to as the “most wonderful time of the year!” However, for
some individuals, the holiday season may be better described as one of the most
difficult times of the year. For these individuals, the holidays are looked to with dreaded
anticipation: days filled with less than merry emotions, often described as uninvited
loneliness, sadness, anxiety and depression. The familiar colors of red and green, so
often used to color the holiday season, are replaced with blue, dark blue — the
Holiday Blues.


T     he holiday blues are defined as “a feeling
      of sadness, loneliness, depression and
even anxiety that often occurs in and around
                                                   Holiday Blues Coping Strategies:
                                                   Maintenance of routines – The hustle
                                                   and bustle of the holiday season can bring
the holiday season.” Individuals with ID/DD who
                                                   mayhem to the routines of everyday life.
are experiencing a loss in their lives, changes
                                                   Routines provide direction, consistency
in living environment, symptoms of an acute
                                                   and comfort to individuals. Ensuring the
or chronic medical condition or reliving painful
                                                   consistency of routines, with minimal
memories of past holidays are especially at risk
                                                   distraction, helps individuals avoid excessive
for the holiday blues. The holiday blues can
                                                   anxiety that often accompanies the uncertainty
also occur in individuals who are enthusiastic
                                                   and unfamiliarity. Giving the individual
about the holidays, but the stress of altered
                                                   an opportunity to prepare and anticipate
routines, lack of financial means, and unmet
                                                   events will likely lessen the anxiety that often
expectations soon overshadow the excitement
                                                   accompanies change.
of the season. The symptoms of the holiday
blues often mimic those of depression. Unlike      Choice – Allowing individuals to choose the
the characteristics of depression, the blues       holiday activities in which they would like to
symptoms are short in duration and usually         participate can increase the positive feelings
resolve once the holiday season has ended          associated with the choice and decrease the
and the normalcy of everyday life returns.         sense of anxiety that often accompanies lack
Although no prescriptive medical intervention      of control and change in routine.
is usually needed for resolution of the blues,     Create new traditions – Traditions can
a consultation with the individual’s physician     provide a sense of excitement, familiarity
is recommended. Recognizing symptoms,              and belonging. For some individuals
seeking medical advice and incorporating a         though, memories of past traditions may
few coping strategies into the everyday lives of   evoke feelings of depression and sadness
the individuals can help to provide them much      surrounding this time of reminiscence.
needed support throughout this difficult time      Talking to someone about past holiday events
of the year.


                                                                                                      9
 and exploring opportunities to create new          in treating the holiday blues. Choosing safe
 traditions may help the individual to connect      winter activities can help people to enjoy the
 to the past, while creating new memories that      beauty of the season while combating any
 provide hope for the future.                       unsettling feelings related to the holiday blues.
 Talk about feelings – Giving an individual an      Seek an increase in community
 opportunity to talk about personal feelings        participation – The holiday season often
 in regard to holiday events can prove to be        brings an assortment of wonderful community
 very beneficial. Expressing one’s feelings         activities such as holiday concerts, plays,
 allows for “therapeutic venting” and gives         parades and dinners. Participation in
 caregivers an opportunity to see the holidays      community activities allows one to celebrate
 through the eyes of the individual. Validating     the holidays with a larger group of people,
 individuals’ feelings about the holidays           which may help to combat feelings of
 helps to acknowledge their heart’s concern         loneliness. The holiday season also provides
 and provides an increased opportunity of           an increase for volunteer opportunities.
 understanding for all involved.                    Individuals who are able to volunteer may find
 Encourage healthy                                                          a sense of purpose
                              The symptoms of the holiday blues are:        and pride when given
 eating – Overeating of
 sweet and rich foods          • Headaches                                  the opportunity to help
 often associated with                                                      others. Volunteering
                               • Inability to sleep or sleeping to
 the holidays can cause                                                     serves the recipient as
                                  much
 unhealthy weight gain                                                      well as the volunteer.
                               • Changes in appetite
 and lead to fatigue,                                                       As noted previously, the
 anxiousness and               • Agitation and anxiety                      true “holiday blues” are
 irritably. Enjoying rich      • Excessive or inappropriate feelings        usually short in duration
 foods in moderation              of guilt                                  and often subside after
 allows for people                                                          the holiday season
 to fully enjoy the            • Diminished ability to think clearly or     ends. Individuals who
 bounty of the holidays           concentrate                               experience prolonged
 while preventing              • Decreased interest in activities that      symptoms of irritability,
 the ill-effects from             are usually enjoyable                     anxiety, inability to
 overeating. Providing                                                      sleep, lack of appetite
 healthy alternatives to the season’s rich          and decreased interest in activities beyond the
 foods and encouraging individuals to make          holiday season could possibly be exhibiting
 healthy choices when celebrating can help to       a more serious condition such as Clinical
 combat symptoms associated with sugar and          Depression or Winter Seasonal Affective
 carbohydrate overload.                             Disorder. These mood disorders, unlike the
 Participate in physical activities –               holiday blues, usually present with symptoms
 Encouraging participation in physical activities   lasting 3-6 months or longer in duration
 can help individuals lower stress and anxiety      and therapeutic medical management
 levels, and promote an overall feeling of          interventions are often needed for a full
 wellbeing. Winter provides an abundance of         recovery. Any questions or concerns about the
 outdoor activities that can be fun and provide     symptoms of the blues should be directed to
 ample amount of exercise. Exercising outdoors the individual’s personal care physician.
 in the winter also exposes individuals to
 sunlight, which has been proven to be effective




10
References:
Mrazek MD, David (2008, December). Managing the Holiday Blues, Mayo Clinic, retrieved on
7-7-2010 from www.mayoclinic.com/health/holiday-blues/MY00492
Cleveland Clinic (2008, October). Managing Holiday Stress. Cleveland Clinic Healthy
Living. Retrieved on 7-7-2010 from http://my.clevelandclinic.org/healthy_living/Stress_
Management/hic_Managing_Holiday_Stress.aspx
University of Maryland Medical Center ( 2006, May). Mental Health: Symptoms of Holiday
Blues. Retrieved on 7-7-2010 from www.umm.edu/mentalhealth/holsymps.htm




                                                                                           11
                     Colaborative and Responsive Educational Support
     www.hcqu.apshealthcare.com  1-888-321-5861 or 742-864-0715  (Fax) 724-864-3750
                                 North Huntingdon, PA 15642
                                8775 Norwin Avenue, Suite 103
                                   Norwin Hills Office Center
 APS CARES is published by APS Healthcare, Inc. / Southwestern PA Health Care Quality Unit (HCQU)




                                                                       North Huntingdon, PA 15642
                                                                       8775 Norwin Avenue, Suite 103
                                                                       Norwin Hills Office Center
                                                                       Southwestern PA Health Care Quality Unit (HCQU)
                                                                       APS Healthcare, Inc.




INTRODUCING . . .
THE APS HCQU’S
BLOGS AND FORUMS
BLOGS
The APS HCQU recently added a “Blog” page to its website with the intent of providing an online
environment where users may gain new and useful information to support people with intellectual
and developmental disabilities (ID/DD).
By providing researched information, the APS HCQU hopes to inspire providers and caregivers
to share their own experiences and resources and to raise questions that will give others food for
thought and better insight into caregiving.

FORUMS
The Forum page is set up as a series of online “rooms.” Each room will address a different topic of
interest related to serving people with ID/DD. Users must register with an email address from an
approved agency to access these Forum rooms. Users are encouraged to post information to provide
opportunities for on-going dialogue with both the APS HCQU staff and people from other agencies.
The APS HCQU hopes that users will find the information posted to these Forums to be of use in the
care and support they provide to people with ID/DD.
To participate, please join us at our website: www.hcqu.apshealthcare.com

We look forward to hearing from you soon!

				
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posted:11/3/2011
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