All posts by Paul Susic

Aricept (Donepezil): Medicine for Alzheimer’s Disease?

Aricept: Brand Name

Donepezil: Generic Name

Aricept (Donepezil): Medicine:Overview

Aricept is a medicine used to treat Alzheimer’s disease and other forms of dementia in the earlier stages of the disease process. It is not a cure but may offer some improvements in an individual’s memory, language skills, attention, and ability to perform normal activities of daily living. Aricept is a medicine that is usually prescribed in the earlier stages for what is usually referred to as mild or moderate dementia. The generic form of Aricept, donepezil has been approved by the FDA. In order to receive the best price on Aricept at your local pharmacy ask for the generic form, donepezil.

Aricept (donepezil) medicine information your doctor needs to know:

In order to prescribe this medicine for Alzheimer’s disease, your doctor needs to know if you have any of the following conditions:

• if you’re breast-feeding, pregnant or trying to get pregnant
• if you have any allergies to this medicine or any other medicines, foods, dyes or preservatives
• if you have any stomach ulcers and bleeding or stomach or intestinal disease
• if you have severe headaches
• seizures or convulsions
• Parkinson’s disease
• low blood pressure
• liver problems or disease
• heart disease or problems associated with heart rhythm
• any head injury
• difficulties passing urine

How is this medicine usually taken?

Aricept (donepezil) is in a tablet form and is taken by mouth. These tablets should be taken with a glass of water or may be taken with food. Always follow the dosing routine prescribed by your doctor. This medicine is frequently taken before bedtime and should never be taken more often or less than the recommended frequency. It should continue to be taken even if symptoms get better. You should never quit taking this medicine unless your physician tells you to. You should contact the pediatrician to find out if this medication can or should be used for children.

Aricept (donepezil) dosage;

Aricept (donepezil) dosage for mild to moderate Alzheimer’s disease:
For adults, the usual starting dosage is 5 mg once a day. Your doctor may then increase your dosage as necessary or appropriate.

Aricept (donepezil) dosage for severe Alzheimer’s disease:

The usual dosage for severe Alzheimer’s disease for adults is 10 mg once a day. Sometimes a dosage of 10 mg a day is also used for maintenance for individuals with severe Alzheimer’s disease. Your dosage will be adjusted by your doctor according to your own individual needs.

If you miss a dose of your medicine, you should take it as soon as possible. If it is almost time for your next dose you should only take the upcoming dose. You should never take extra dosages or double up on your medicine.

Side effects of Aricept (donepezil):

Side effects may occur with the use of this medicine. If you notice any Aricept side effects you need to report them to your doctor immediately. Some of the main side effects can include:

• weight loss
• vomiting
• unusual bruising or bleeding or red or purple spots on the skin
• uncontrollable movements
• sweating
• stomach pain
• heart palpitations or slow heartbeat
• hives or a skin rash
• agitation, increased confusion or nervousness
• fainting, falls or dizziness
• severe diarrhea
• changes in vision or balance

Some of the following Aricept side effects usually don’t require medical treatment but should be reported to your doctor if they continue or seem to be problematic:

• muscle cramping
• pain in the joints
• nausea
• limited or loss of appetite
• heartburn or indigestion
• headache
• drowsiness
• mild diarrhea

Is there anything else that may interact negatively with donepezil?

You should tell your doctor about all medications you are taking including nonprescription medicines, herbal products and nutritional supplements. Also, you should tell your doctor if you are a frequent user of drinks that contain caffeine or alcohol, if you smoke or use any illegal drugs. These can have an effect on how your medicine works. You should also consult with your healthcare practitioner prior to discontinuing or reducing any of your medications. Some of the following medications may interact negatively with Aricept:

• some antidepressants such as fluoxetine, fluvoxamine, paroxetine, sertraline
• some antibiotics such as erythromycin and clarithromycin
• some diabetes drugs
• atropine
• benztropine
• bosentan
• carbamazepine
• dexamethasone
• dicyclomine
• digoxin
• galantamine
• glycopyrrolate
• hyoscyamine
• Ipratropium
• Itraconazole or ketoconazole
• medications for motion sickness
• medicines for treating HIV infection or AIDS
• muscle relaxers for surgery
• modafinil
• nonsteroidal anti-inflammatory drugs such as ibuprofen
• oxybutynin
• phenytoin
• phenobarbital
• propantheline
• quinidine
• rifampin, rifabutin, rifapentine
• rivastigmine
• St. John’s wort
• tacrine
• trihexyphenidyl

Where should I store Aricept?

Aricept may be stored at room temperature between 15° and 30°C (59° and 86°F). You should always keep it out of the reach of children. Always throw away any unused medications after the date of expiration.

Some final words about Aricept (donezepil) medicine for Alzheimer’s disease:

Aricept is a medicine that has been found to assist in delaying the gradual deterioration associated with dementia and Alzheimer’s disease. However, there is no cure for Alzheimer’s disease and only an experienced clinician can help to determine whether you or your loved one has Alzheimer’s or some other type of dementia that may be assisted with Aricept (donezepil).

Some information adapted by Paul Susic Ph.D. Licensed Psychologist from the AARP Guide to Pills by Maryanne Hochadel PharmD BCPS, (editor-in-chief)

See Related:

Alzheimer’s Disease Medications: What You Really Need to Know
Alzheimer’s Disease: Causes, Symptoms and Diagnosis
Dementia Types and Causes: Tell Me About it

Aging and the Decline in Physical Activity 

Aging and the Decline in Physical Activity 

Aging and Physical Activity:

Obviously, the aging process usually results in decreased physical activity and accompanying changes in body composition, which may result in some declines in body metabolism and a reduced functioning of your cardiovascular system.  Also, the aging process results in several changes in the ability of our body to acquire and deliver oxygen to its tissues.  These changes also include increasing stiffness of the chest wall, frequently and impaired blood flow through the lungs, reduced strength with each contraction of the heart and decreased muscle mass.  It’s probably not that surprising that because of these physical changes, that aging takes a toll frequently on the physical work capacity of the elderly.  The work capacity of the average 70-year-old is about half that of a 20-year-old.  Many experts believe that the decreases in work capacity over this 50 year period of time are progressive, with the rate of loss usually accelerating after an individual’s mid-50’s. 

Aging and metabolism: 

The total body metabolism of an aging person will decline slightly but steadily over time.  The maximum oxygen consumption during exercise (which may be considered a measurement of fitness) declines more rapidly because of the decrease in lean muscle mass and due to a reduction in the maximum heart rate as we get older.  While it is very important to understand that there is great variability among different individuals, the maximum oxygen consumption tends to be higher in physically active people much more than in sedentary individuals.  It is even higher in older athletes who are still in training.  Maximum oxygen consumption is higher in men than women even after correcting for height, weight and other differences. 

Aging and physical exercise: 

Many studies are continuing to find that regular physical exercise is the best antidote to many of the effects of aging.  The many benefits from regular exercise include favorable effects on reducing fats in your blood, better handling of blood sugar, increased maximum oxygen capacity, greater strength, denser bones, improved sense of well-being and better sleep.  While it has not yet been proven, many feel that an exercise regimen reduces the chance of eventual disability and prolongs life expectancy.  Current studies on aging however will probably demonstrate over the next several years, that many of these benefits truly do occur as a result of regular physical exercise. 

Some information from the American Geriatrics Society Complete Guide to Aging and Health by Mark E. Williams M.D.
Additional information and web page by Paul Susic Ph.D. Licensed Psychologist (Health Psychology) 

Alzheimer’s Disease Medications: What You Really Need to Know

Alzheimer’s Disease Medications Overview:

Alzheimer’s disease medications have been prescribed over the last couple of decades and have had some benefit for individuals suffering from this devastating disease. However, it is essential to recognize that medications for Alzheimer’s disease and other forms of dementia are not a cure and have some limitations in preventing the continuing deterioration of the brain. The American Academy of Neurology concluded that these drugs which are primarily cholinesterase inhibitors “should be considered in patients with mild to moderate Alzheimer’s disease although studies suggest a small average degree of benefit.” Clinicians who prescribe these drugs frequently will give them for about a two months trial and may discontinue their use if no improvement is seen.

Alzheimer’s Disease Overview:

In order to determine the necessity for Alzheimer’s disease medications, first you must have a good understanding of the disease and its various forms. Alzheimer’s disease is a progressive deterioration of the brain that significantly impairs memory, thinking, problem-solving and eventually activities of daily living. It is most commonly found among the elderly, and currently is believed to account for 50% to 60% of all cases of dementia. It is estimated that by the year 2050 a possible estimated 11.3 million to 16 million Americans may suffer from Alzheimer’s disease.

It is not currently understood what causes Alzheimer’s disease, although several factors have been identified which may impact upon its development including family history and genetics and advanced age. Some estimates state that approximately 10% of individuals over the age of 65 may have the disease and nearly half of individuals over the age of 85 may be affected by the disease as well.

It is believed that Alzheimer’s disease causes a loss of brain cells resulting in memory loss, language difficulties, problems performing familiar tasks, disorientation to time and place, problems in abstract thinking, changes in mood or behavior, and even changes in personality. The disease process is varied and progressive and may occur over several years or many.

Alzheimer’s Disease Medications and Diagnosis:

In order to determine whether Alzheimer’s disease medications are necessary or appropriate, a definitive diagnosis is required. The most well defined diagnosis can only be conducted by examining the brain tissue upon autopsy. Obviously, prior to an autopsy, in order to have the most probable diagnosis, a complete medical examination needs to be completed evaluating a complete medical history, physical assessment, neurologic and mental evaluation, radiological findings and laboratory tests by a doctor familiar with the disease and the testing process associated with Alzheimer’s disease. There is no one test that can be conducted at this time to determine whether Alzheimer’s disease exists. Research and clinical experience has found that the disease progression for Alzheimer’s can vary from 3 to 20 years after the onset and possibly another 8 to 10 years after it has been diagnosed. This extensive diagnostic process will be conducted prior to prescribing any Alzheimer’s disease medications.

Alzheimer’s Disease Medications and Treatment:

Currently there are no medical treatments or medications known to cure or even stop the progression of Alzheimer’s disease although several have been found to delay the progression. Currently the most widely used Alzheimer’s disease medications are:

donepezil (Aricept),
rivastigmine (Exelon),
galantamine (Razadyn, Reminyl),
memantine (Namenda)
and tacrine (Cognex).

These medications are believed to primarily increase a neurotransmitter (brain messenger) called acetylcholine in the brain, which is believed to be affected by the Alzheimer’s disease process.

Alzheimer’s Disease Medications and the Progression of the Disease:

The Alzheimer’s disease medications currently on the market cannot cure or even stop the progression of the disease process. However, they are believed to limit the severity of the symptoms of confusion and memory loss for a period of time and to delay its progression.

Two types of medications have been approved by the US Food and Drug Administration (FDA) to treat the symptoms of Alzheimer’s disease. The first is the cholinesterase inhibitors which includes Aricept, Exelon and Razadyn and memantine (Namenda). These are used to treat some of the basic symptoms of memory loss, confusion, disorientation, problem solving and reasoning. More recently there is a medication that combines one of the cholinesterase inhibitors (donepezil) with memantine called Namzaric.

Medications for the Early to Moderate Stages of Alzheimer’s Disease:

The medications that are currently used to treat the early to moderate stages of Alzheimer’s disease all fall within the classification of cholinesterase inhibitors. These medications are used to treat the symptoms of memory loss, language difficulties and the basic thinking and reasoning skills.

The cholinesterase inhibitors are believed to prevent the breakdown of acetylcholine, which is a neurotransmitter in the brain. This chemical messenger is very important in the process of learning and memory and is involved in the communication process between nerve cells. It is believed to be necessary to keep the acetylcholine levels high in the brain if possible. By keeping the levels of these chemical messengers high it seems to delay or slow down the progression of the disease process. The effectiveness however varies from individual to individual. These medications are usually well-tolerated although side effects have been noted to include nausea, vomiting, increased frequency of bowel movements and loss of appetite.

Alzheimer’s Disease Medications for the Moderate to Severe Stages:

The only medications prescribed for the moderate to severe stages of Alzheimer’s disease are memantine (Namenda) and a combination of memantine and donepezil referred to as Namzaric. Memantine is usually prescribed to improve memory, reasoning, language skills, attention and the ability to perform simple tasks. Memantine can be used alone or with donepezil (Aricept). There has been some research that indicates that taking a cholinesterase inhibitor such as Aricept along with memantine may be helpful. Namzaric combines the two into one medication.

Memantine is believed to regulate glutamate in the brain which is a chemical involved in information processing, as well as storage and retrieval of information. It has been found to improve the mental and daily functioning for some people. No medication however is harmless and side effect free, with some of the basic side effects including confusion, dizziness, headache and constipation.

Alzheimer’s Disease Medications and the Future:

Medications used to treat Alzheimer’s disease are relatively new and have been developed primarily over the last couple of decades. Currently, there is no cure for Alzheimer’s disease and medications are used to moderate and possibly delay the progress of the disease. Research is constantly being developed using people with mild cognitive impairment compared to healthy volunteers used as control subjects. However, we are only on the cutting edge of developing effective Alzheimer’s disease medications.

Some information adapted by Paul Susic Ph.D. Licensed Psychologist from Worst Pill Best Pills: A Consumer’s Guide to Avoiding Drug-Induced Death or Illness and additional information from

See Related:

Alzheimer’s Disease: Causes, Symptoms and Diagnosis
Dementia Types and Causes: Tell me about it.
Alzheimer’s Disease Medications: What You Really Need to Know.

Alzheimer’s Disease: Causes, Symptoms and Diagnosis

Alzheimer’s Disease Introduction:

The most common form of dementia is Alzheimer’s disease. Although it is very uncommon before the age of 60, the incidence of Alzheimer’s disease becomes more common as an individual ages. Although it seems to effect only about 1% to 3% of people between the age of 60 to 64, the incidence of developing this dementia increases to approximately 30% for those over the age of 85. In the United States, as many is 4 million people may currently have the disease.

In Alzheimer’s disease, the brain deteriorates in a specific way resulting in the loss of nerve cells in the brain. Specific abnormalities develop in the brain cells referred to as tangles (neurofibrillary tangles) and plaques (senile or amyloid plaques) which then form between the nerve cells. It is also believed that there is disruption resulting in a reduction in the neurotransmitter (brain messenger between the cells) acetylcholine.
Some individuals may also have atherosclerosis, which then may lead to strokes. The strokes made then result in a vascular dementia, sometimes resulting in a mixed dementia. Mixed dementia is when an individual has both vascular dementia and Alzheimer’s disease or another form of dementia.

Cause of Alzheimer’s Disease:

At the present time, the cause of Alzheimer’s disease is unknown. The current belief in the medical community is that the development of Alzheimer’s disease may be as a result of some combination of genetics and the environment, although the environmental factors contributing to its development are not currently known. Although it is not known the relative contributions between genes and the environment, it is known to run in families and may possibly be more inheritable among individuals who develop it at an early age.

Alzheimer’s Disease Symptoms and Progression:

Alzheimer’s disease symptoms are very similar to the symptoms of other forms of dementia including a loss of memory, language problems, disorientation, behavioral problems and difficulties in activities of daily living. A person with Alzheimer’s disease is not required to have all of these symptoms however.
A couple of the more prominent changes in memory observed in people with Alzheimer’s disease is that changes are subtle and progressive. Some of the early changes may be almost unnoticeable at first but will progressively become worse over time, and will eventually get to the point of being totally disruptive in an individual’s activities of daily living.

The first change noticed in people with Alzheimer’s disease is a change in recent or short-term memory. Also, personality changes may be noticed as well. Some have been known to develop emotional changes such as depression, anxiety or an unusual level of fearfulness. There may be a higher level of fluctuation emotions noticed as well. Also, in the earlier stages, individuals may also notice minor changes in language abilities such as difficulty finding the correct words, misusing words or using general rather than specific language. Also, they quickly develop problems in judgment and the ability to think abstractly.

Unfortunately, some individuals may begin to develop behavioral problems. These problems result in their becoming irritable, agitated and sometimes physically aggressive. Also, they may begin to pace or even wander. Many Alzheimer’s patients develop insomnia, having trouble either initiating or maintaining sleep and sometimes may confuse night and daytime.

As the disease process continues, some individuals may even develop psychosis. Psychotic symptoms associated with Alzheimer’s disease are usually hallucinations, paranoia and/or delusions.

The progression of Alzheimer’s symptoms and ultimately the disease process is very unpredictable with people usually living approximately 8 to 10 years after the earliest signs of the disease. In the initial phases of the disease process, individuals experience things pretty much in the way they always have, enjoying the same activities and entertainment. However, as in all dementias, eventually memory problems become so pronounced that they can no longer participate in activities they have always enjoyed and will eventually become totally dependent on others. Once Alzheimer patients get to the stage of not been able to walk anymore, most individuals will only live an average of about six months. There is a lot of variation however with some individuals becoming bedbound and continue to live for several years.

Alzheimer’s disease diagnosis:

One of the first distinguishing characteristics in diagnosing an individual with Alzheimer’s is whether the individual develops a dementia that seems to have a progressive pattern. The Alzheimer’s disease diagnosis is initially based upon the pattern of symptoms, usually asking the individual and family members or other caregivers about memory problems and other symptoms of deterioration in activities of daily living. The diagnosis will later include a physical examination and other tests such as mental status exam, urine and blood tests, possibly computed tomography (CT) or magnetic resonance imaging (MRI). Some of these tests are used to exclude other possible diseases and conditions which could either cause or exacerbate underlying memory problems. After completing these tests, doctors are usually fairly accurate in their diagnosis of Alzheimer’s disease.

Confirmation of the diagnosis of Alzheimer’s disease can only be done upon death when a sample of the brain tissue is then examined under a microscope. At that time, the previously mentioned neurofibrillary tangles and senile plaques may then be seen throughout the brain. Newer tests such as positron emission tomography (PET) and analysis of spinal fluid are also believed to have possible utility in assisting with confirmation of Alzheimer’s disease. At the present time however, these tests are not believed to be very accurate and are not used very often.

Treatment of Alzheimer’s disease:

Similar to the treatment of other dementias, cholinesterase inhibitors seem to sometimes stabilize or mildly improve memory and mental functioning, but they cannot stop the progression of Alzheimer’s disease. Although inconclusive as to its effectiveness, ginkgo biloba has sometimes been used as an herbal treatment for Alzheimer’s disease.

New drugs continue to be researched constantly which may prevent or slow down the progression of Alzheimer’s disease. One recent example is the use of nonsteroidal anti-inflammatory drugs (NSAID’s) which are commonly used in the treatment of arthritis. Vitamin E is believed to possibly prevent or slow the progression of the disease process, although research is currently inconclusive related to the use of this vitamin. Obviously, risk and benefits of these and all treatments should be discussed with the patient’s physician.

Finally, individuals diagnosed with Alzheimer’s disease also have a high incidence of atherosclerosis or conditions which make it worse. This is of concern in that those individuals will then be at high risk for stroke, which is obviously a serious concern which needs to be eliminated to the best degree possible.

Some information adapted by Paul Susic Ph.D. Licensed Psychologist from the Merck Manual of Aging

See Related:

Alzheimer’s Disease: Causes, Symptoms and Diagnosis
Dementia Types and Causes: Tell me about it.
Alzheimer’s Disease Medications: What You Really Need to Know.

Dementia Types and Causes: Tell me About It.

Dementia Types and Causes: An Introduction

Dementia is a term that refers comprehensively to a variety of symptoms and diagnoses related to a multitude of different causes. Ultimately, dementia is a disorder that results in an individual developing difficulties in thinking, remembering, understanding, communicating and ultimately in controlling behaviors.

Dementia : An overview

The most prominent dementia type is Alzheimer’s disease. However, different forms of dementia affect different mental abilities and are manifested in very different ways. In addition to the way the symptoms are presented, they also progress in very different ways. Dementia by its very nature progresses. At the present time, it cannot be cured. Eventually people with dementia require complete care.

Although dementia can begin at any age, for the most part, it is a disease of the elderly. About 6% to 8% of people over the age of 65 have dementia. As people get older the rate of dementia continues to climb to a higher level with approximately 35% of people over the age of 85 having dementia. Even though it is a fact that the rate of dementia increases as people become more elderly, it is not inevitable as many people never develop dementia although they may get to the age of 100 and older.

Unfortunately, as people get older and begin to forget or misplace things they began to fear that they are developing dementia and in particular Alzheimer’s disease. Much of this forgetting is normal and not dementia, although some of these people may develop dementia at a later point in time.

Dementia Types and Causes:

The most common and most notorious dementia type is Alzheimer’s disease. Additionally, there are many other types of dementia such as vascular (multi-infarct) dementia which is a result of strokes and Lewy body dementia. Some people may have a mixed dementia which may include more than one dementia cause. Some of the less common dementias are as a result of Parkinson’s disease or a tumor or may be the result of normal-pressure hydrocephalus.
In Alzheimer’s disease as in some other dementias, the neurotransmitter acetylcholine in the brain may be low. These neurotransmitters are chemical messengers that help the nerve cells (neurons) to communicate with each other. In addition to helping with many different bodily functions, acetylcholine assists in learning, memory and concentration. Sometimes there are other changes that take place in the brain, although it is not clear whether they are the result or the cause of these specific types of dementia.

If certain disorders are not adequately treated dementia may increase. Some of these underlying disease processes are chronic obstructive pulmonary disease (COPD), diabetes and heart failure. When these diseases are adequately treated, many individuals have improvement in their dementia symptoms.

Medication and Dementia:

There are many medications that can temporarily cause or worsen symptoms of dementia. Some of the worst contributors to either causing or increasing symptoms of dementia are medications used to assist with sleeping such as over-the-counter sleep aids or sedatives, cold remedies and medication used to treat depression and anxiety. Some of these remedies can be purchased over-the-counter without a prescription. Also, drinking even moderate amounts of alcohol can increase the symptoms of dementia in a vulnerable individual.

Delirium is also known to cause symptoms that may be believed to be dementia. Delirium is a temporary disorder usually attributable to some underlying cause such as medication use, disease and even lifestyle changes such as hospitalization. Delirium is not considered to be a dementia type although it may be a causative factor.

Some information adapted by Paul Susic Ph.D. Licensed Psychologist (Health and Geriatric Psychologist) from The Merck Manual Health & Aging

See Related:

Alzheimer’s Disease: Causes, Symptoms and Diagnosis
Dementia Types and Causes: Tell me about it.
Alzheimer’s Disease Medications: What You Really Need to Know.

Dementia and Alzheimer’s Caregivers Make the Holidays Wonderful

Holidays may be hard:

The holidays are expected to be a bright and cheerful time, filled with family and friends. For those caring for another it can be a time filled with stress, disappointment, frustration and sadness. For individuals who have been experiencing MCI, Dementia or Alzheimer’s, they may feel even greater distress and a deeper sense of loss. This is caused by the changes he or she has experienced. Caregivers far too often are overwhelmed. Family may want too much from the senior and the caregiver as well. For the Caregiver, they can end up feeling pulled in many directions at the same time. They may want to participate in the holiday hub bub, and spend long periods of time with the other family members or have them to the house. This can be overwhelming physically, emotionally, and financially. Caregivers may be concerned about how family will react to the changes that have happened to the loved one as a result of the advancing of the disease.

Get honest about your family. If they have not been involved all year long, then they do not understand the changes that have occurred. As the primary caregiver, it is up to you to ensure they understand the circumstances surrounding your loved one, and respect that you know what is best for them.

Some simple rules of thumb:

Do not expect that any of your family members understand the changes that have taken place. They may not understand how the loved one will react with the entire family and extended family gathered together. You need to be the one to make sure everyone else understands that Dad or Mom may not be able to participate as they did in the past, and neither can you.

Extremely long drives to the sister that lives 90 miles away may not be feasible. These drives can be physically exhausting, and the strange house may cause unnecessary anxiety and acting out.

Large gatherings with lots of noise, and small children, are difficult. They may not be able to hear well with so many people talking and a lot of noise. This may very well cause your loved one much anxiety and fear. Your family may not have truly understood that Mom or Dad, may not remember their names, or confuse or forget grandchildren. They may take it personally, and have feelings of hurt and dismay.

About the Author:

Coach Chez is a recovery coach, helping individuals make lasting change in behavior and emotions. Senior Motivate 4 Success helps Seniors and Families find ways to deal with change as we age. Check us out at  Senior Motivate 4 Success and be sure to see our special program for the holidays at Holiday Program

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Severe depression associated with sexual harrassment by colleagues


Employees who also experience sexual harassment in the workplace by colleagues and supervisors experience a much higher level of depression than individuals who experience harassment only by others such as customers and clients. This according to a new research study out of Denmark.

Sexual harassment research study:

Previous research has found an increased risk of long-term sickness absence for employees who have experienced sexual harassment by colleagues and supervisors but have not found a subsequent increased risk of depression associated with sexual harassment by clients or customers. Dr. Ida Elisabeth Huitfeldt Madsen, National Research Centre for the working environment in Denmark, and author of the research stated “We were surprised to see the differences between the effects of harassment by clients or customers compared to harassment by other employees and supervisors.

She also concluded that “Our findings suggest that sexual harassment from clients or customers has adverse consequences and should not be normalized or ignored. In this study we found that sexual harassment from clients or customers, which is more prevalent than harassment from fellow employees, is associated with an increased level of depressive symptoms. This is important as some workplaces, such as in person-related work like care work or social work, may have an attitude that dealing with sexual harassment by clients or customers is ‘part of the job’.”

This study utilized a measurement scale referred to as the Major Depression Inventory (MDI) which is a self-report questionnaire of mood that results in a possible diagnosis of depression along with a rating of the severity of symptoms. Scores on this inventory range from 20 for minor depression to 30 or more for a diagnosis of major depression. Researchers found that when employees not exposed to sexual harassment by other employees were later harassed by clients they scored a level of 2.05 points higher on the MDI. Employees who were also sexually harassed by colleagues and supervisors and then harassed by clients, scored 2.45 points higher on the same inventory.

A total of 7603 employees participated in this research study. Of the study participants 2.4% were exposed to sexual harassment by customers or clients while 1% were exposed to harassment by colleagues. More women were exposed to sexual harassment by colleagues and customers. Individuals working in care work were exposed to more harassment by clients or customers than those working in other occupational areas such as industrial or service work or education.


The total number of exposed individuals was relatively small in this research study especially as it relates to men, making this study less certain then may be expected of future research studies with larger study populations. It also seems to be much more reflective of women’s experiences. However, in spite of its limitations, this study is an indication of the necessity of studying sexual harassment in the working environment by colleagues and supervisors as well as the harassment experienced from customers or clients and their effect on symptoms of depression.

Information adapted by Paul Susic Ph.D. Licensed Psychologist from “Sexual harassment by colleagues may be associated with more severe depression” (September 25, 2017, ScienceDaily)

Story Source:

Materials provided by BioMed Central. Note: Content may be edited for style and length.

Journal Reference:

Maria K. Friborg, Jørgen V. Hansen, Per T. Aldrich, Anna P. Folker, Susie Kjær, Maj Britt D. Nielsen, Reiner Rugulies, Ida E. H. Madsen. Workplace sexual harassment and depressive symptoms: a cross-sectional multilevel analysis comparing harassment from clients or customers to harassment from other employees amongst 7603 Danish employees from 1041 organizations. BMC Public Health, 2017; 17 (1) DOI: 10.1186/s12889-017-4669-x

Paying for Home Health Care: What Do Medicare and Medigap Cover?

Prescribed only by a physician, home health care is skilled nursing care that aids in the recovery from illness, injury, or surgery in the patient’s home. And fortunately for many seniors who are now opting for care at home, Medicare insurance covers most costs related to home health care.

The government, however, has set some limitations on payouts – you are only eligible if you need intermittent care (usually defined as seven days a week or less than eight hours a day over 21 days or less) (1), physical/occupational therapy or speech language pathology; you are homebound; and the home health care agency providing care is approved by your Medicare insurance program.

In addition to medication administration, general supervision, and therapy services, the Medicare home health benefit covers a number of other necessities, including medical aids and supplies to aid in recuperation. On the occasion, though, you may be required to cover some of the costs associated with home health care. But what can you expect to pay out-of-pocket that’s not covered by Medicare dollars?

Medicare Insurance: Part A and Part B

Hospital Insurance (Medicare Part A) helps cover the costs of your inpatient care at hospitals, skilled nursing facilities, or religious non-medical health care establishments. Part A can also help cover hospice and home health care services. Individuals aged 65 and older are usually automatically enrolled in Medicare Part A and do not have to pay a monthly premium if Medicare taxes were paid while working. If you did not pay taxes, you are still eligible, but you will be required to pay a monthly premium.

Medical Insurance (Medicare Part B) helps cover services such as those offered by your physician and outpatient care. Many seniors maintain their enrollment in Part A, but elect not to use Part B, which requires a monthly premium that is dependent upon income, the requirements of which change yearly. Unfortunately, if you didn’t sign up for Part B when you were first eligible for insurance, your premium may be slightly higher (2).
For questions on your Medicare insurance benefits, you should contact 1-800-MEDICARE or read the handbook mailed to you each year entitled “Medicare and You.”

What’s Covered and What’s Not?

Medicare insurance pays for physical and occupational therapy and speech language pathology services, counseling, some medical supplies, durable medical equipment (which must meet coverage criteria), as well as general assistance with daily activities which include dressing, bathing, eating, and toileting. For most other medical equipment, Medicare insurance will cover 80% of its cost (3).However, Medicare will not cover twenty-four hour care at home, meals delivered to your home, and services unrelated to your care such as housekeeping. Of course, as mentioned above, you will be required to pay 20% for medical equipment not fully covered by Medicare insurance such as wheelchairs, walkers, and oxygen tanks (4).In some cases, your home health care agency may present you with a Home Health Advance Beneficiary Notice (HHABN), which, simply put, means if your agency is ceasing your care services, you will be presented with a written statement outlining the supplies and services the agency believes your Medicare insurance benefits will not cover as well as a detailed explanation of why. Should this situation arise, you do have recourse – the HHABN lists directions on acquiring the final decision on payment issues or filing an appeal if Medicare refuses to cover costs for home health care. In the meantime, you should continue receiving home health care services, but keep in mind that you will be paying for these services out-of-pocket until Medicare accepts your claims and remits past expenses.

Medigap and Other Out-of-Pocket Expenses

Medigap, a supplemental insurance policy, is sold privately and covers the services and supplies not paid for by Medicare insurance. When used in conjunction, Medigap and Medicare can often cover a large majority of the costs of your home health care. Insurance companies offer a variety of different Medigap policies (A through L), but since each one comes with specific benefits, you’ll need to compare the highlights closely. Medigap policies vary by cost, and many insurance companies require you to have both Medicare Parts A and B in order to purchase a supplemental plan (5). For seniors with both Part A and Part B Medicare, your home health care situation is usually covered, save for the 20% out-of-pocket expenses for medical equipment. Just remember to keep track of your Medicare insurance benefits (and Medigap if applicable) by verifying with your physician, home health care agency, and insurance representative. Paying for home health care does not have to cost you an arm and a leg, but do be prepared for the occasional (but necessary) out-of-pocket medical expenses.

1. Centers for Medicare and Medicaid Services, Medicare and Home Health Care, page 6
3. Ibid.
4. Ibid.

Article Source:

About the Author:

Jill Gilbert is the President and CEO of Gilbert Guide, a comprehensive website helping seniors and their loved ones find a senior care provider along with extensive tools and resources to solve the challenges of aging. She is the author of “Leading by Example,” a monthly column in McKnight’s Long-Term Care News, the chief industry publication for long-term care providers. Jill has been interviewed for a CBS News special, was a key presenter at the Pennsylvania Assisted Living Association’s annual conference, and was recently interviewed on San Francisco TalkBack. Gilbert Guide was founded on the concept that quality matters, and its primary goal is to educate consumers on a breadth of senior care issues. Visit for a comprehensive provider database, expert advice, and quality assessment tools that help consumers conduct their own “expert” evaluations of providers.

Finding the Best Nursing Home

Finding the Best Nursing Home

Making the decision to put ourselves or a loved one into a nursing home is one of the hardest we face. Placing somebody in one of these facilities is rarely the ideal situation and can be emotionally draining. It is important to us that we take care of our families as they have taken care of us, and negative media coverage, as well as social stigma regarding nursing homes make facing this dilemma even more troublesome.

In addition to considering all of the negative news coverage, one must also take into account several other factors, such as nursing home staff, quality, environment, and life. There are so many options from which to choose that, at first, making an informed decision may seem impossible. Just knowing whether to choose a nonprofit nursing home, private nursing homes or a chain can be a daunting task. Fortunately, there are tools available to us that can help us ensure that we are making the best choice.

When beginning your search you should also consider and special needs you or your loved one may have and find the facilities that are best equipped to handle those needs. Does your loved one need skilled care which allows them access to Medicaid which is accepted by most nursing home chains? Or would you prefer a private-pay or nonprofit facility? Figuring out the answer to this question can help you narrow the field of possibilities.

Once you’ve figured out which type of facility you prefer you can begin contacting these types of nursing homes near you. Before scheduling visits, you should narrow your search even further by conducting phone interviews. When calling get the answers to important questions like: “What’s your staff turnover rate?”, “Do you offer skilled care?”, “How much can I expect to spend with your facility?” Asking these questions will help you to figure out which facilities you would like to tour.

While touring a facility it is important to remember that cleanliness is more important than newness. Although a nursing home may be brand new or may have recently been renovated, the cost the entity has incurred is normally passed on to you. A long standing facility that is clean is more likely the best choice.

Long standing homes are also more likely to have staff that have been with the facility for many years. A nursing care home with staff members that have worked there for a long time points to job satisfaction; satisfied employees usually enjoy working with the residents and are likely to administer higher quality care. Perhaps the most important thing to us when we look into an assisted living facility is making sure that our loved one is well taken care of.

You can ensure that your loved one is getting the fairest treatment by becoming familiar with the rights of residents. Nursing homes across the United States must honor the Resident’s Bill of Rights according to federal law. This bill includes but is not limited to the right to: information about one’s medical condition, choose one’s own physician, manage one’s own personal finances, privacy, dignity and respect, be free from abuse and unnecessary restraint, voice grievance without retaliation, no unfounded discharge or transfer, be allowed visitors and to control visits, and legal counsel. All nursing homes in the United States are required to make the Resident’s Bill of Rights available at all times to residents and their families. For a complete list of these rights you should be sure to ask for a copy at any of the nursing care homes you visit.

Making the decision to place yourself or a loved on into a nursing home does not have to be a bad experience. There are many options available and with a little bit of research it is easy to become educated enough to make the best choice possible. Nursing home life can be fulfilling, so long as we or our loved ones are properly cared for. Be sure to check into your options thoroughly, doing this will to ensure that you have chosen a clean facility with a low staff turnover rate; a facility that regularly schedules activities for the residents outside of the campus, and which adheres to the Resident’s Bill of Rights, easy. 

About the Author:

Jennifer Carnduff Narrates beautifully the complete picture of the nursing home and pain is unavoidable yet can be constructive if treated on time in Nursing homes.
Article Source:

Webpage by Paul Susic Ph.D. Licensed Psychologist  


Aging and the “Fountain of Youth” by Paul Susic Ph.D. Licensed Psychologist

Aging introduction:

Aging information in the form of books, videos and the Internet abound, providing information about how you can stay young and live longer.  Almost everyone is interested in a long life and looking and feeling younger.  However, Ponce De Leone no longer lives, traveling the land in search of the “fountain of youth”.  Instead, the aging process is being studied intensively by researchers looking at genes, cells, hormones, eating patterns and other factors that give a clue of what causes aging and how it can be prevented or delayed. 

Aging: Three strategies to reduce the effects 

Researchers on aging have continued to identify three strategies that help people live longer and healthier.  The strategies include exercising, following certain types of diets and eating fewer calories.

Almost everyone is aware of the benefits of exercise and recognize that people who exercise are healthier than those who do not.  Exercise contributes many health benefits including improving and maintaining the ability to function, helping to sustain a healthy level of weight and preventing or postponing various disorders such as diabetes and coronary artery disease.
Aging studies have also concluded that people who eat a low-fat diet which includes fruits and vegetables are much healthier than people who eat a diet higher in fat and starch.  It has been found that people who live in the Mediterranean countries and consume the so-called Mediterranean diet seem to live longer.  This diet is believed to be healthier then the diets of individuals living in northern Europe and America, as it consists of more grains, fruits, vegetables, nuts, fish and less red meat.  Also, the main fat consumed is olive oil which contains many vitamins and monounsaturated fat rather than saturated fat.  Monounsaturated fats do not increase cholesterol levels like the saturated fats do and seem to have little negative effect on the aging process.
Aging has also been found to be affected by a low-calorie diet in general.  A low-calorie diet over your lifetime may lead to a longer life as it tends to reduce the number of certain damaging substances in your body.  Research on the aging process continues to find that these substances, called free radicals, are the natural byproducts of normal cellular activity. The damage done to cells by free radicals is considered to contribute to such disorders as coronary artery disease and cancer.

Utilizing these three strategies to reduce the effects of aging would require a change in lifestyle for most people.  However, many people in our society look for shorter and easier ways to prevent or slow the aging process.  Some, for example, try to manage free radicals using antioxidant vitamins such as vitamins C and E.  Some people take large amounts of these vitamins in the form of supplements in the hope of slowing the aging process.  Other antioxidants such as beta-carotene (a form of vitamin A), are also frequently taken.  In theory, the use of antioxidants to reduce aging actually makes sense.  However, current studies have not found that high doses of the antioxidants prevent or slow the aging process. 

Aging is also affected by decreases in certain hormones.  Some people try to delay or slow the aging process by taking supplements of these hormones including testosterone, estrogen, DHEA, human growth hormone and melatonin.  However, whether hormonal supplements actually affect the aging process is still to be determined.  Also, some of these supplements have known health risks. 

Some people have a belief that some of the Eastern practices such as yoga, tai chi and qigong can slow the aging process.  These practices are based upon holistic theory that health involves the whole person including the physical, emotional, mental and spiritual components, which need to be kept in balance.  These practices also may include relaxation, breathing techniques, diet, meditation and exercise. These practices are safe for older people and probably will increase the level of health.  But, whether these practices actually affect the aging process still need to be determined. 

Some information from The Merck Manual of Health of Aging 

Additional information and article by Paul Susic Ph.D. Licensed Psychologist (Health Psychology)