Author Archives: Margaret

Transitions

Newsletter-FFT-clip art-fall leavesThirty days hath September, April, June and November; or so the saying goes. It seems that the quantity of days is the only thing that our ninth month shares with these others. April invites a slow rebirth of a landscape once buried under snow, June ushers in all the excitement of warm weather activities that pull us from our homes and November once again lays the heavy cloak of winter.

September days slowly fade from the months of growth to months of respite. Ripening produce and subsequent harvesting will clear the way for fallow ground which will rest silently until spring comes again. The last warm days of summer soon fade into longer nights and cooler temperatures.

Our shorts and sandals will soon be replaced by favorite sweaters, jackets, boots, mittens and scarves. The cool crisp air of September carries the fragrance of apples and cider and unearthed vegetables and fallen leaves. The sun will begin to ride low on the horizon signaling that change is coming. As a result, the decrease in daylight and the cooling nights lift the green off the leaves exposing their rich purple, rust, orange and scarlet red petticoats. This is truly my favorite season.

With the celebration of Labor Day, even our foods begin to change. At our house the fruit plates, summer salads and ice tea will soon be replaced with steaming bowls of soups made from the summer’s bounty. Hot cocoa will become our night time brew of choice shared over board games or old movies. Of course this is also when the new TV season begins and many will nestle in to catch the season premier of their favorite sitcom or reality show. All in all, September is a time of transition. 

Change isn’t always easy. It isn’t always welcome. Those individuals who attend the Rebuilding at Bethel program are in the midst of change. For some the transition is a welcome relief yet for others it is mourned and feared. The members of my Dating Dementia class learn that they may need to change their approach to dating if they wish to find a healthier and happier relationship the next time around. Even the women in my Self-esteem class learn about the challenges and rewards of change as they attempt to tackle new relationship skills that could help them feel the full sense of what it means to be a whole, worthwhile, competent and adequate person.

Change can leave us feeling ambivalent; teetering between hanging on to the way things have been and stretching out to touch what could be. No matter what our life has been like we know what to expect from it even if it hasn’t been pleasant. The unknown doesn’t provide much information about how to handle what change has to offer. Sometimes we simply have to step into that unknown even when it is scary; having faith that it will all turn out for the best.

Gershen Kaufman, author of The Dynamics of Power, laid out some fundamental concepts about change. He stated that the process of change is often experienced ambivalently because it requires giving up the comfortable familiar in exchange for the feared unknown. Kaufman also reminds us that the process of change is slow and backsliding to old ways of approaching relationships should be expected.  He also points out that change takes practice and patience. And finally, he stresses that courage and determination cannot be taught, so we will need to discover these qualities in ourselves if we hope to evolve.

It might help to keep these ideas about change in mind when in the midst of transitioning or recognizing that it is on the horizon. Life will always place new opportunities or challenges in our path. However, it might be comforting to know that experience with change can make you more resilient and adept. I refer to this as having bounce-ability. It is important to be especially tender and kind to yourself as well as to have some faith in your ability to handle change.  How you face change can affect your emotional well-being and we know that reaching out to others can make the transition more tolerable. That is what my classes all have in common; bringing people together to make change a little more bearable with the support of other people.

Leave a reply

Patient Reported Outcomes (PROM)

BethWhen you think about health care, what comes to mind? For some, it’s a pursuit of wellness connecting mind, body, and spirit. For others, health care is like a car’s transmission – you don’t really notice or appreciate it until it’s making a noise, or completely broken. People in the middle of a crisis or transition in a significant relationship can feel especially stressed, which we all know affects our health. Some may find themselves both ill and alone for the first time.

My name is Beth, and I am writing a series of articles designed to help you navigate today’s complex health care system. I am a nurse by training, but several years ago I became interested in the study of “quality” care – especially for patients who are in the hospital. None of what I write will be an endorsement for a particular hospital or care system, nor is any of the content meant to recommend any course of treatment. Simply, I will be giving you information so that you can make educated choices about your own health care. I invite your comments and conversation.

One of the hot topics in primary health care these days is Patient Reported Health Outcomes (PROM). Some provider practices, and even some employers and insurers are starting to use patient-generated information to help them assess how the patient feels about their general state of health, or target areas of specific concern for health needs.

The engagement of patients in their own health assessment serves at least two purposes: using the voice of the patient in ways that may not be solicited during the face-to-face provider encounter; and getting the patient to start to really pay attention to how they assess critical components of their health status. Sort of completes the three-legged stool: the first leg is the provider assessment, the second is the patient accessing their health record; and the third is actually giving the patient a full partnership through self-assessment. Whether these PROM initiatives have long-term effects in health status improvement is still being studied.

I ran across a really cool web-based health assessment that you might want to take a look at. The website is www.howsyourhealth.org and you can complete an online assessment from an array of health status components. At the end of the assessment, you receive information based on the responses to the “checkup”. This summary can serve as a checklist of discussion items for your next provider visits, but there are also resources for reading and action you can take on your own. It doesn’t require a password or for you to identify yourself. You can also save any or all of the documents in case you want to track your progress on any health improvement interventions you work on. Enjoy!

Leave a reply

Write Your Own Declaration of Independence

In a few days we will be breaking out the grills, cracking open bottles of beer, waving flags and shooting off backyard fireworks. Some of us will attend big pyrotechnic displays at local municipal parks. Others will set up blankets and lawn chairs along crowded downtown streets to watch parades of high school marching bands, floats advertizing local businesses and organizations not to mention the shiny fire trucks, farm equipment and possibly the mayor and his wife. The local Boy and Girl Scout troops will brave the heat for that long walk down Main streets across the USA to toss Tootsie Rolls and suckers to children lining the curbs. Like people everywhere, Americans like to find reasons to celebrate and July 4th gives us reason to head out and do just that.

For the most part, the 4th of July is our time to celebrate.  But, I wonder how many  of us even think of this day as Independence Day and all that means in terms of the personal freedoms we enjoy today?

It has been a long time since I read the words of our Declaration of Independence so thank goodness for computers that put that information at my finger tips. As it reads, “When in the course of human events, it becomes necessary for one people to dissolve the political bands which have connected them with another…”  As I read the words of this manuscript penned in 1776 I was reminded that this declaration was one of divorce; one country divorcing itself from another and in doing so to “declare the causes which impel them to the separation.” The writers proceeded to list the numerous grievances that lead up to the decision to break away from the English governance. Eleven years later, the final draft of what is now our constitution was penned and when the final state ratified it in 1789 it became the supreme law of the land by which we govern ourselves. Since then there has been some fine-tuning in the form of the 27 amendments.

Our celebration of Independence Day is our way of acknowledging the struggles of people starting over. They divorced themselves from an intolerable past ruling so they could reach out and embrace a brand new future. They would draw from personal experience to devise a new document based on what they learned from their historical governing roots. They would write a pledge to each other and to the country about how they would act towards each other, for each other.

This led me down other paths of thought. What was this paper that such an important pledge would have been written on? With what would they sign such a significant document so the words to be inscribed could be view for generations to come? And finally, how would they protect such an important manuscript? The answer is that these documents were written on parchment but not ordinary parchment. The material was a vellum parchment which was the finest parchment used for all very important documents. It was made by stretching and scraping sheepskin until it was very thin; a product that could stand up to the elements and time. The ink too was the best of the time. It was called iron gall ink. These very extraordinary documents were given the best materials so they would last, so the words could be read by all who followed. Now they are safely housed in the rotunda of the National Archives building in Washington, DC. and are still being viewed today.

All in all, these documents represent the struggles of a people who recognized the need to break an unhealthy alliance in order to create a new system that would be just and equitable for all involved. They realized that what they were undertaking was important enough to warrant significant conversation and consideration as well as to mark it in history in such a way as to preserve it for generations to come. This is what we celebrate.

Are there personal lessons that can be drawn from this common history?  Many who read my blog are in the process of ending unhealthy alliances. Participating in the Rebuilding class involves recognizing that wrongs have been committed and naming those wrongs. It involves looking at personal relationship histories to see where the relationship constitution was either never defined and written down or not honored by one or both. But a big part of rebuilding after a relationship ends is to create a personal declaration of independence and to have a good and respectful breaking away so a happy new beginning can be written. A good ending involves honestly looking at what worked and what didn’t so that a new personal constitution can be written based on facts. How will you begin to write your personal code now that you are single? Will it need to be amended as new personal information is made conscious? How will you protect and preserve your personal constitution as you move forward connecting with new people?

Leave a reply

The Fine Art of Doing Nothing

Newsletter-clip art - watching cloudsThere is a Spanish proverb that states, “How beautiful it is to do nothing and then rest afterward.”  I don’t know about you but that certainly sounds inviting to me. How often do you take time to do nothing, to rest, to just be?  Rest from work, rest from play, rest from participating… again, or even rest from relationships?

It seems we Americans are plagued by busy-ness yet wonder why we feel tired, anxious, depressed, overwhelmed or any number of other feelings. Many of us are driven to one up someone else as to how much time we spend doing something, anything. Even our play has become work; something we have to do. Our time doing has become another national sport and everyone seems to be keeping score.

I recognize that I too can get caught up in doing. But, I have also noticed that when this happens my body gets angry and lets me know in one fashion or another. So, my goal is to take some time to do nothing and then rest afterwards… at least once in awhile. I have promised myself that this summer I will find a grass covered hillside which I will lie down on and just watch the clouds float by. I am confident that with a little practice I can make doing nothing a part of my life even if just for five minutes and as a result come back refreshed even if it means returning to more …. doing. I hope you too can find a little time this summer to just do nothing and when you are done to rest a bit.

Leave a reply

Don’t Blink, You’ll Miss It – Health care in a rapidly changing world

Beth“Don’t blink or you’ll miss it!” We city kids always joked about the little towns we’d drive through on our Sunday drives or on the way to summer vacation. Trees, crops, and barns interrupted by a brief braking to pass a bar, church, and post office. That’s how it seems with health care these days. Politics aside (and not discussed here), the delivery and payment for health care is changing so rapidly “don’t blink or you’ll miss it”!
After a change in a significant relationship, you may find yourself navigating the healthcare system one your own for the first time, or at least from a very different perspective. You may have moved away from your former residence, you may now be responsible for finding new healthcare coverage, or even finding a new provider. All of these are much more challenging than they were a year ago.
Before you think about making any changes in coverage, read the plan. Know the plan. Don’t be afraid to call the plan and ask questions – over and over – until you know what your coverage costs, and the benefits you have. Hospitals, physician groups, and insurers are aligning together in new ways called Accountable Care Organizations. The goals of the ACO’s are to deliver high quality care while saving money through lowered costs. Take a look at this website for more information. The ACO concept has been around for a couple of years, but new strategic alignments are being created all the time, even here in Wisconsin. Make sure you fully understand whether your plan is part of an ACO, and how that ACO affects availability and locations of primary and hospital care.
One of the key factors that your hospital and providers know is a success to their healthcare delivery model is “consumer engagement”. That means that your participation and satisfaction in your own healthcare experience is a primary driver for ACO sustainability. What does all that mean? In short, insurers and providers are spending MORE money than ever to find new ways to effectively educate and communicate with you, the consumer. You are likely to be invited to answer surveys, engage your health record electronically, create and work toward health goals, and do more “home-work” related to any chronic health conditions you may have (like high blood pressure, diabetes, obesity, etc.)
Likely, your outpatient provider and hospital are now offering patient advocacy services. These advocates can help you get resources you need to become more active in your own healthcare. From understanding your bill and insurance benefits to accessing post-discharge assistance, advocates and other professionals are helping consumers in ways that effectively “connect” you and try to make you feel more “in control” of your health. Your hospital or clinic is also engaging social media, like Facebook, or electronic newsletters with advice or news about the latest developments in health care. All of these strategies are designed to achieve a greater and safer patient health outcome.

Health care is changing at an historically accelerated pace – don’t blink!!!

Leave a reply

The Fine Art of Doing Nothing

There is a Spanish proverb that states, “How beautiful it is to do nothing and then rest afterward.”  I don’t know about you but that certainly sounds inviting to me. How often do you take time to do nothing, to rest, to just be?  Rest from work, rest from play, rest from participating… again, or even rest from relationships?

It seems we Americans are plagued by busy-ness yet wonder why we feel tired, anxious, depressed, overwhelmed or any number of other feelings. Many of us are driven to one up someone else as to how much time we spend doing something, anything. Even our play has become work; something we have to do. Our time doing has become another national sport and everyone seems to be keeping score.

I recognize that I too can get caught up in doing. But, I have also noticed that when this happens my body gets angry and lets me know in one fashion or another. So, my goal is to take some time to do nothing and then rest afterwards… at least once in awhile. I have promised myself that this summer I will find a grass covered hillside which I will lie down on and just watch the clouds float by. I am confident that with a little practice I can make doing nothing a part of my life even if just for five minutes and as a result come back refreshed; even if it means returning to more …. doing. I hope you too can find a little time this summer to just do nothing and when you are done to rest a bit.

Leave a reply

Do You Need a Spark to Start a Fire?

A graduate of my Dating Dementia class recently submitted a question and gave me permission to include it as one of my blog postings. I will put my comments here but I hope that others will click on the link below and add their own comments as well. It might help her or someone else who has struggled with this same concern.

A.T. wrote, “I had a blind date recently and there weren’t any ‘sparks.’ My inclination was to not pursue further yet he is a nice guy with other great qualities. If his values didn’t align with mine I would say it was a no brainer. But, his values DO align with mine so then what? Is it worth the time to get to know someone more if there are no sparks or fireworks? My therapist indicated that ‘healthy’ is likely to feel awkward and not-super-sexy (for lack of a better expression) to me at first because it’s so foreign from what I’ve been accustomed to in my past relationship. My therapist believes that a person can grow to become attracted to someone physically even if it is not apparent at the beginning. What are your thoughts on this?”

First off, let me say I like your therapist’s comments and I agree with the idea that attraction can happen even if it doesn’t arrive in a lightning bolt on the first date. You may remember these lyrics, I feel the earth move under my feet I feel the sky tumblin’ down, I feel my heart start to trembling whenever you’re around. We have grown to believe that nothing short of an earthquake should occur inside of us if it’s actually love.

Instant attractions, instant chemistry, sparks, fireworks, or even love at first sight are all ways to describe this thing we like to call love. This type of phenomenon tends to occur during what I have coined the “dating dementia” period—that moment of wild attraction that robs us of our senses, takes up a lot of our physical and mental energy, causes us to obsess about someone and can lead us to forget past relationship tsunamis. We have been writing about it for thousands of years so one would think there is something to be said for “falling in love.” Falling as in plunging, tumbling, or spiraling out of control seems to clearly reference this crazy time. Somehow it just seems more attractive when the image is connected with love than with falling off a rocky cliff into a raging sea below.

The fairy tale meeting we have come to believe in and even demand might be just that –a fairy tale. Happily ever afters that follow being swept off our feet don’t always materialize and when the good times vaporize a person is left feeling disillusioned, disappointed and hurt.

That instant attraction, that special chemistry that causes you to feel drawn to each other like magnets is just that –chemistry. Mother Nature’s designer love potion, specially formulated with the right mix of dopamine, testosterone, estrogen, and adrenaline to give that snap, crackle and pop experience called love. What we have come to expect is really Mother Nature’s way to move us quickly into a relationship to guarantee that our “special” DNA gets into the genetic pool before one person wakes up and notices that there isn’t enough glue to hold the relationship together for the long term. From an evolutionary perspective, this was very important. We needed to find someone who had the right outward characteristics that signified that a female had what it took to bear children and the male had the strength to protect his mate and their offspring; certainly not very romantic, but extremely practical for the times.

A genetic legacy is what is at stake but Mother Nature couldn’t care less if you are together in two or three years. Chemistry and real love are two different things. In fact, if we called the whole experience falling in lust, we might understand love in its truest sense of the word. True love is not a feeling like chemistry. Love is a decision that a couple needs to make each day despite life’s vicissitudes, where as chemistry is the flash in the pan that can quickly die out if not nurtured. When we love and experience being loved in return, we feel content, respected, understood, empathetic, accepted, supported, and a myriad other feelings.

If you are expecting your values and the sparks to align on that first date, you may continue to be disappointed or even distracted by the outward characteristics that nature has coded us to look for. It is a person’s character that will bring you either long-term contentment or pain. I say give this person a chance. You could discover a great deal about this man with some time and what you discover could be enough to light that fire you are longing for. If you end up realizing that you can never be more than friends, you have not lost anything but some time. The curious thing about people is that we tend to have friends who are like us in character. So, if this guy ends up just a friend, he could be the person to introduce you to someone who will not only have the same values but also that spark you are looking for.

Let me return to the second part of your comment, the part that suggests an unhealthy relationship past. Yes, this can be an issue. We tend to gravitate to people who seem the most familiar to us. If your relationship history included dysfunctional behaviors, in your first family or the one you married into, this can be your blue print for what relationships are supposed to look like. Healthy behaviors can appear foreign and therefore scary. But, you learned a great deal in the both the Dating Dementia class and the Self-Esteem class, about staying conscious when relating to others as a way to avoid rerunning old tapes. You may need to use that information as your road map and keep it close at hand as a quick reference until you can trust your own gut to safely guide you. Each person you meet is giving you a chance to teach them how to have a relationship with you. And as long as you take things slowly you can learn enough about each other to determine if this relationship has merit or if it needs to be the end of that story.

Do you recall the Choose Your Own Adventure books from your childhood? You can close the book here and call it end of story. But what if you decided to run through a few more pages of this story before closing the book on this guy? Maybe the adventure could lead you down a fruitful path one way or another.

One Response to Do You Need a Spark to Start a Fire?

  1. Thanks Margaret! I would assume at some point physical chemistry can and should develop for a romantic relationship to be sustainable. At least I think I would need that. Is that an appropriate expectation? And how much time do you invest in getting to know a person before it’s apparent that there just isn’t physical chemistry?

Leave a reply

Spring- the eternal reminder of hope renewed

Newsletter-spring flowersSpring has finally arrived here in Wisconsin. Winter only visits us five months out of the year yet it can seem like eternity; especially as we get closer to the month of April and  patches of that white stuff still hide in the shadows. However, once a 40 degree day presents itself we cast off the boots, heavy coats and scarves and race out to catch the first rays of warm sunlight, even if just briefly.

Spring and Easter are a time of renewal; a reminder that what we thought was dead is just being transformed. My garden is a wonderful example of that. All the flowers that seemed to have died under the heavy blanket of snow begin to poke through the crusted earth to reach for those first rays of warm sunlight. Unlike us, the flowers do not doubt that the dark, cold winter days will pass. They patiently wait in stillness for their time to come again when they can rise out of the gloominess to experience their purpose again.

Our lives are much like the changing seasons. Things are constantly in flux. We have our warm sunlit days and our gloomy days. We will experience wonder and awe just as we do when the first snow visits us once again. We will be disappointed just as when the forecast says warm and sunny but the clouds appear and drop a thunderstorm upon us. We will be delighted when the rainbow appears to remind us that the sun will come again or we awake to a new day that breaks the darkness with bright sunshine. Nothing stays the same; nothing is forever. Remember that time passes and we will get through even the darkest days. Something bright and exciting will appear on the horizon if we are just patient and let time take care of our disbelief. Something or someone will appear to distract us and show us a new and sunnier path. We need to be patient, we need to be open and we need to know that there comes a time when we need to let go of believing that life will always be this way. We need to have hope that time allows us an opportunity to be renewed again. And as this song reminds us, Keep your head up, things are going to turn our fine.

Leave a reply

Follow Margaret on Facebook!