Managing Pain

Posted on January 6, 2020 by jwatrel

Managing Pain

Learn more at content.accenthealth.com/pain

At some point, everyone feels pain. It might be the result of an injury, surgery or overuse. Or it might be related to a medical condition such as arthritis or fibromyalgia. Whatever the cause, pain can interfere with your ability to sleep, work and enjoy life.

Pain often goes away quickly. But pain can also last for many months and sometimes years. This is called chronic pain. Today there are many options to help you find relief.

 

Talk with your doctor:

Whether this is your first visit or a follow up ask your doctor.

*What is causing my pain?

*How long should I expect the pain to last?

*Are there any lifestyle changes that might improve my pain?

*Are there any alternative therapies that might help?

*What should I do if there pain gets worse?

Tell your doctor if :

*The locations type or severity of your pain has changed since your last visit.

*You think your medications are causing any side effects.

*You are trying any alternative treatments like acupuncture or taking an herbal remedy.

What is pain?

Pain is an unpleasant feeling of discomfort, often caused by illness or injury.

Pain can serve as a warning that something is wrong. Pain can also help with healing. It tells you to avoid touching a wound or using a joint that’s on the mend. Pain can also be felt for no clear reason.

There are two main types of pain:

*Nocieceptive pain: This is that occurs when body tissue is injured. Examples include burns, sprains, broken bones or inflammation from an infection or arthritis.

When you band your finger, the signal starts at the very tips of the nerve cells, travels to and up the spinal cord and into a part of the brain called the thalamus.

The thalamus sends the signals out to several parts of the brain including those that control touch, emotion, physical reaction and memory.

*Neuropathic pain: This kind of pain, also called nerve pain, happens when the nerves themselves become irritated. Nerves that were once a mere messenger of pain become a source of pain.

Conditions that cause neuropathic pain include a “pinched nerve” (like sciatica), diabetes, shingles and multiple sclerosis.

Understanding types of pain:

Pain can be classified by how long it lasts:

*Transient pain: this is a sensation that accompanies a bang, bump or nick as well as the occasional headache. It lasts for a few seconds to a few hours.

*Intermittent pain: this type of pain comes and goes.

*Acute pain: Acute pain lasts from a few minutes to a few weeks. It usually results from disease, inflammation or injury. Examples include burns and sprains. Its cause can often be identified and treatment. It usually goes away once the injury or disease has healed.

*Chronic pain: Chronic pain lasts for months or eve n years. Conditions that cause chronic pain include arthritis, fibromyalgia, irritable bowel syndrome and others.

Diagnosing pain:

When diagnosing pain, the first and most important task is to rule out serious causes, such as heart disease or cancer.

Your doctor will typically ask several questions about your pain, including:

*When it started

*Its location

*Its intensity

*Other symptoms that accompany it

*Its impact on your daily activities

*Any treatments you’ve already tried

The doctor will perform a physical examinations. He or she may also order blood tests or imagining tests, like an x-ray, to help identify what is causing the pain. It isn’t always easy to identify the cause of pain.

Describing your pain:

Your doctor may ask you to rate your pain:

When your doctor asks you to describe your pain, try to use descriptive words such as:

*sharp/stabbing, dull, hot/burning, cold/freezing/sensitive, tender, itchy, shooting, stinging, numb, tingling, cramping/squeezing, radiating/spreading, throbbing/pounding, aching, and gnawing/biting.

Your doctor may ask these questions:

Is the pain steady or does it come and go? Does it get better and worse or stay the same? What relieves or worsens the pain? Is the pain better or worse at different times of day? Does it vary based on whether you are active or inactive?

Keep a pain journal:

Try to record the frequency, intensity and duration of your pain in a pain journal. It can help you and your doctor identify what triggers your pain and track whether or not it improves over time.

Medicines for pain:

When your aren’t in pain, it’s easier to work, care for family, participate in daily activities and enjoy life.

Analgesics:

Medications used primarily to relieve pain are called analgesics. Nonprescription or over the counter pain relievers are generally used for mild to moderate pain. Prescription analgesics are used for moderate to severe pain or pain that doesn’t respond to over-the-counter medications. There are two common classes of analgescis:

*Nonsteroidal anti-inflammatory drugs (NSAIDs) relieve pain and also reduce inflammation. Some are available over the counter; some require a prescription.

*Acetaminophen helps relieve pain but does not reduce inflammation.

Anticonvulsants and antidepressants:

These drugs, mainly used to treat seizure disorders and depression are sometimes used to treat pain.

Opioids (narcotics):

Opioids relieve pain. But they must be taken with care because they can be addictive.

Other treatments:

Topical pain relievers are applied to the skin.

Creams and gels: These contain a wide variety of substances. Ones that contain salicylates reduce inflammation. Others contain “counterirritants,”such as menthol or eucalyptus, which provide a cooling or warming sensation intended to distract from the pain.

Corticosteriod shots:

These shots are injected into an inflamed part of your body such as a joint. The cortiscosteroid is usually mixed with a local anesthetic.

Nerve block:

Nerve block used drugs, chemical or surgical techniques to block the transmission of pain messages between specific areas of the body and the brain.

Surgery:

In some cases, surgery may be needed to relieve pain.

Treating pain without drugs:

Some nondrug treatments can relieve pain.

These may be used instead of medications or in addition to it:

Cold and heat:

*Cold can reduce swelling and decrease pain. Apply a store bought cold pack, a bag of frozen vegetables or ice cubes wrapped in a towel to the affected area-for no more than 20 minutes at a time, four to eight times a day.

*Heat can relax muscles and ease pain. Try moist compresses, hot packs, warm baths and showers, hot whirlpools and heat lamps to temporarily relieve pain. Don’t use heat or cold for too long.

Pain relieving devices:

Special devices can help support painful joints, relieve pressures on irritated nerves and soothe aches and pains. They include splints and braces canes, crutches, walkers and shoe inserts.

Longer-term pain relief options:

*Physical and occupational therapies:

Physical therapists use techniques and exercises to help ease pain and improve strength and range of motion. They customize programs to fit your goals. Occupational therapists help improve your ability to perform activities of daily living, such as dressing, bathing and eating.

*Exercise:

An exercise program can help relive chronic pain. It should include regular, gentle aerobic activity, stretching and range of motion exercises and strengthening exercises. Extra weight on joints can cause pain. If you are overweight, losing weight may help relieve pain.

*Alternative therapies:

Therapies that address the whole person, including the mind and emotions, can help restore a sense of control over pain. Some techniques include:

*acupuncture, biofeedback, breathing exercises, chiropractic, cognitive behavioral therapy, hypnosis, massage therapy, mediation, progressive muscle relaxation, yoga and tai chi.

Common kinds of pain:

Finding the right treatment often takes time and patience. Here are some of the most common types of pain:

*Shingles nerve pain:

Shingles is painful, blistering rash. For people, shingles pain remains long after the rash is gone. This continued nerve pain is called postherpetic neuralgia. Posttherpetic neuralgia is a difficult type of pain to treat. Certain medications may help.

A shingles vaccine is recommended for older adults. The vaccine reduces the risk of getting shingles. It also reduces the risk of postherpetic neuralgia if you do get shingles.

*Diabetic neuropathy:

Diabetic neuropathy is nerve damage caused by diabetes. It most often affects the nerves in the feet. In addition to pain, it also causes numbness. It increase the risk of serious foot injury. Keeping your blood sugar close to the normal range helps prevent diabetic neuropathy.

People experience pain differently based on the type of pain and how their brain responds.

*Low back pain:

Most people with back pain get better within a week or two with a combination of brief rest, cold packs and pain relief medication. But for some people, low back pain persists for weeks or months.

If you have or periodic bouts of low back pain, you may find relief with:

*exercise, including yoga and tai chi

*physical therapy, particularly back-strengthening exercises

*therapeutic massage

*topical pain relievers

*Abdominal pain:

Irritable bowel syndrome (IBS) can cause pain, diarrhea, bloating, cramps or constipation. Avoiding foods containing a group of poorly digested sugars and fibers called FODMAPs may help. Probiotic supplements might be worth trying, too.

Other approaches include cognitive behavioral therapy, antidepressants and mind-body relaxation therapies.

Other common kinds of pain:

Osteoarthritis:

Osteoarthritis causes stiffness and pain in the joints, especially the knees and hips. Osteoarthritis  develops when cartilage-the connective tissue that covers bones and acts as a cushion-deteriorates. Over time, the space between the bones narrows and the surfaces of the bones change shape. This eventually damages the joint. A combination of medicines, weight loss and physical therapy can help relieve osteoarthritis pain.

Fibromyalgia:

Fibromyalgia causes pain and stiffness in multiple tender points throughout the body . It leaves people feeling achy and fatigued.  People with fibromyalgia may be more sensitive to pain than others. Medications to decrease symptoms often include the same drugs prescribed for nerve pain, such as antidepressants and antiseizure medications.

Nondrug therapies, including alternating cold and heat; tai chi, yoga and other forms of exercise; acupuncture and therapeutic massage can also be helpful.

Additional types of pain:

Cancer Pain:

Pain often occurs when cancer spreads to or presses on bones, nerves or organs. The type of cancer you have and how far it has spread usually determines whether you have pain, the amount of pain you have and how it can be treated.

Migraine headaches:

Migraine headaches are intense, throbbing headaches that tend to affect one side of the head. They can be excruciating and debilitating. Many migraine sufferers also experience nausea and vomiting or become sensitive to light and sound.

Migraines are best managed with medications to:

*head off symptoms if you have a warning (aura) before the headache starts.

*relieve symptoms when you have a migraine

*prevent migraines from occurring

Avoiding migraine triggers also helps. These are foods, drinks, smells, activities or situations that can set off migraines.

Get more information on managing pain:

content.accenthealth.com/pain

Disclaimer: This information was taken from the AccentHealth pamphlet on Managing Pain and I give them full credit for the information. Please contact them for more information.

 

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Chronic Obstructive Pulmonary Disease

Posted on January 5, 2020 by jwatrel

Chronic Obstructive Pulmonary Disease

Learn more at content.accenthealth.com/copd

Chronic obstructive pulmonary disease (COPD) is a lung disease that makes it harder to breathe. Some people have one of two types of COPD chronic bronchitis or emphysema. Others have a combination of both. COPD is often stable for periods and then suddenly flares up.

If you smoke, quitting now can keep COPD from getting worse. With medication, exercise and other steps, you can live well for decades with COPD.

Talk with your doctor:

Whether this is your first visit or a follow up, ask your doctor:

*Do I have chronic bronchitis, emphysema or both?

*Should I be on any additional medication or therapies to help my breathing?

*Am I using my inhaler correctly?

*Should I get the flu shot and pneumococcal vaccine?

*What are the warning signs that my COPD is flaring up?

*What should I do if I get a lung infection?

*Would I benefit from pulmonary rehabilitation?

Tell your doctor if:

*You have had any respiratory infections since your last visit

*Your activity level has decreased due to trouble breathing

*You think your medications are causing any side effects

What is COPD?

COPD stand for chronic obstructive pulmonary disease

COPD is a lung disease that makes it hard to breathe. COPD is a lung disease that makes it  hard to breathe. COPD includes chronic bronchitis and emphysema, two lung conditions that often share a common cause-smoking.

Normally, when you take a breath, air travels from you nose and mouth through your windpipe and into the bronchi. Bronchi are air passages that branch off into each lung. The bronchi branch further into thousands of smaller, thinner tubes called bronchioles. These tubes end in grape like clusters of small, round air sacs called alveoli.

Tiny blood vessels, called capillaries, absorb oxygen from the air through the walls of the alveoli and deliver it to cells throughout the body. Carbon dioxide moves in the opposite direction. It passes out of the bloodstream and back into the alveoli and is then eliminated from the body when you breathe out.

How COPD affects the lungs:

In COPD less air flows in and out of the airways for several reasons:

*The airways and air sacs can’t expand and contract as they should.

*The walls between air sacs break down. This means less surface area for oxygen to pass into the capillaries and the rest of the body.

*The walls of the airways become thick and inflamed.

*The airways make more mucus, making it hard for air to flow freely.

Normal Airways:

In healthy lungs, millions of alveoli exchange oxygen for carbon dioxide. A fine web of blood vessels picks up oxygen to be used by tissues and organs throughout the body.

Airways in COPD:

In patients with emphysema, air sacs are damaged and stale air is trapped. When chronic bronchitis is also present, the bronchioles are narrowed and clogged by mucus.

Focus on: Chronic Bronchitis

Chronic bronchitis develops when the bronchi are irritated day after day.

The body’s immune system attacks the irritants in an effort to destroy them. This immune response can trigger overproduction of mucus along with inflammation and swelling of the airways.

Inflammation narrows the airways. Mucus blocks them further. Like traffic crawling on a congested road, air moves slowly in and out of your lungs. You may wheeze as you work hard to breathe and cough to clear mucus from your airways.

People with chronic bronchitis find it increasingly difficult to exercise and remain active.

Symptoms of chronic bronchitis include:

*ongoing cough with mucus

*wheezing

*shortness of breath

Focus on: Emphysema

Emphysema affects the lung tissue itself.

This is different from chronic bronchitis which affects the passages that carry air to and from the lungs.

Emphysema destroys the walls between the tiny air sacs (alveoli). This leaves the lungs less able to deliver oxygen to the bloodstream and remove carbon dioxide from the bloodstream.

Lung tissue also loses its resilience, which prevents it from stretching and contracting properly. When  the lungs lack resilience, they cannot fully push out air. Instead, some air remains trapped in the air sacs.

Symptoms of emphysema include:

*Shortness of breath

*Weight loss

*Loss of muscle

The main symptoms of emphysema is breathlessness. At first, you have difficulty catching your breath during activity. Over time, you may feel breathless after taking a few steps or when sitting or lying down.

How is COPD diagnosed?

Your story of your health and how you are feeling can alert your doctor to test you for COPD.

Medical history and physical exam:

Your doctor will ask whether you smoke. He or she may also ask whether you have breathed in toxic chemicals on the job.

The doctor will need to know how easily you become short of breath and when. Do you have trouble climbing stairs? How long can you walk before you have to stop and rest?

Next, the doctor will listen to your lungs through a stethoscope for telltale signs of COPD.

Laboratory test:

Lab tests can show how much COPD has affected your lungs ability to take up oxygen and eliminate carbon dioxide.

*Pulse oximetry: the doctor places a probe on your finger that measures whether the oxygen level in your blood is normal or low.

*Arterial blood gas: this blood test measures how much oxygen and carbon dioxide are in your blood.

Pulmonary function tests:

Pulmonary function tests show how well your lungs work. You breathe in and out through a spirometer, a tube that is connected to various machines. These tests measure two things:

*Forced vital capacity shows the maximum amount of air you can breathe out in one breath.

*Forced expiratory volume in one second is the maximum amount of air you can exhale in one second. If it low (below 80%), you may benefit from taking COPD medications. If it is very low (less than 50%) ask your doctors if you should see a lung specialist.

Pulmonary function tests are simple and painless.

X-Rays:

If you have emphysema, your lungs may appear larger than normal on a chest x-ray and hold abnormally large amounts of air. Your diaphragm (the main muscle involved in breathing) may appear flattened. If you have chronic bronchitis, a chest x-ray is likely to look normal.

Smoking is the main cause of COPD:

Most people who develop COPD smoke.

*Smoking: in most people with COPD, years of smoking irritate the respiratory tract. The body’s immune system sends out inflammatory cells to attack the irritants. This triggers a cascade of events that damages the airways and lung tissue.

Breathing in secondhand smoke over a long period of time also increases the risk of developing COPD.

*Other causes: Inherited problems can cause COPD. So can long-term exposure to toxic fumes, industrial smoke and dust.

Taking control of COPD:

If you smoke, quitting is the most important thing you can do to stop COPD from getting worse. Smoking leads to both physical and behavioral addiction. So it is hard habit to break.

Medications and therapy can help you overcome physical addiction to nicotine.

Quit-smoking medications:

Nicotine-replacement medications deliver a low dose of nicotine into your bloodstream to ease or erase withdrawal symptoms. Gradually you wean yourself off tobacco and nicotine replacement.

Nicotine replacement products are available in several forms:

*patches

*gum

*nasal sprays

*inhalers

*lozenges

Two other prescription quit-smoking medications don’t contain nicotine. They act on the brain to decrease cravings, withdrawal symptoms or both.

Behavioral therapy:

Therapy either one on one with a counselor or group counseling with people who have quit or are trying to can help you break long-held habits.

Treating COPD

Medications and other treatments won’t cure COPD. But they can help breathe better and remain active.

Bronchodilators:

Bronchodilators open up the airways. They are the cornerstone of COPD treatment. Once you begin using a bronchodilator, you should have less shortness of breath and more capacity for exercise.

Long-acting bronchodilators are used every day to keep airways open and relaxed. Short acting bronchodilators are used mainly for quick relief during a flare-up. Bronchodilators are usually inhaled.

Corticoteroids:

Corticosteroids are powerful drugs that curb inflammation and help open airways. They are available in inhalers and as pills.

Inhaled corticosteroids are effective but can increase the risk of pneumonia. They are mainly for people with severe COPD or those who have frequent lung infections.

Corticosteroids in pill form can cause even more serious side effects. But they can effectively control flare-ups.

Antibiotics:

Antibiotics are used to treat lung infections caused by bacteria. People with COPD often need antibotics for respiratory infections. Early treatment is very important.

Oxygen Therapy:

As COPD becomes more severe, the oxygen level in your blood may become dangerously low. If this happens to you, breathing in extra oxygen can help you live longer. And it can help you avoid problems that can occur when your body isn’t getting enough oxygen on its own.

Some oxygen delivery systems are small and lightweight enough to use while doing regular activities such as shopping or running errands.

Surgery:

Surgery may help if you have emphysema. Lung volume reduction surgery involves removing some damaged lung tissue. This gives healthier lung tissue more room to expand and contract. It also helps the lungs work more effectively.

A lung transplant may be an option for people with severe emphysema who cannot benefit from other types of lung surgery.

Pulmonary Rehabilitation:

Pulmonary rehabilitation can help individuals with COPD control their symptoms.

Rehabilitation can improve quality of life, helping individuals carry out day to day activities with greater ease and independence. Rehabilitation includes:

Exercise therapy: Exercise particularly aerobic exercise increases your endurance and strengthens your muscles.

Breathing retraining: Rehabilitation teaches you to adjust your breathing so you don’t run out of air when you are active. This should improve your stomach and decrease breathlessness.

Education: A nurse may demonstrate how to sue an inhaler correctly. Or you may get some tips on how to use oxygen therapy most effectively.

Psychological support: Ongoing breathing difficulties can lead to depression and anxiety. Therapy can help you sort through your feelings and teach stress reduction techniques to help you cope.

Get Immunized:

COPD increases your risk of lung infections. These infections can make COPD symptoms worse. Such flare up are called exacerbations. If you have COPD, get a flu shot every year. Request the injectable flu shot, which contains killed virus, rather than the nasal spray vaccine, which is made with live, weakened flu virus.

You should also get the pneumococcal vaccine, which protects against the most common type of pneumonia.

Have a COPD Action Plan:

Your doctor should discuss an action plan with you in case you have an exacerbation. If you have symptoms of increased cough with thick, discolored mucus, particularly if you have shortness of breath, contact your doctor right away. Your doctor right away. Your doctor will determine if you need an antibiotic, oral corticosteroids or both to manage your symptoms.

Get more information on COPD: content.accenthealth.com/copd

Disclaimer: This information was taken from the AccentHealth pamphlet on COPD and i give them full credit for this information. Please call or email them at the above numbers for more information.

 

 

 

 

Posted in New Jersey Senior Programming, New York City Senior Programming, Senior Caregiver Programs, Senior Services, Uncategorized | Tagged , , , , , , , , , , , , , | 1 Comment

Bergecco-Parc Consulting Inc Film Team Project

Posted on December 21, 2019 by jwatrel

via Bergecco-Parc Consulting Inc Film Team Project

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Did you know: Firefighters are at an increased risk of developing cancer

Posted on December 17, 2019 by jwatrel

Please check with your doctor and make sure to have regular visits.

Posted in Bergen County NJ Programs, Fire Fighting/First Responder Programming, Uncategorized | Tagged , , , , , , , , , , , , , | 1 Comment

HIV Testing-Get the Facts

Posted on December 10, 2019 by jwatrel

HIV Testing-Get the Facts

New Jersey Department of Health & Senior Services/Division of HIV/AIDS Services

What is the HIV test? It’s a simple and reliable test shows if you’ve been infected with HIV, the virus that causes AIDS.

HIV is mainly spread through:

*unprotected vaginal, oral or anal sex.

*sharing infected needles or syringes.

HIV is not spread by coughing, touching or other casual contact.

Testing can help you:

*learn how to avoid HIV if you are not infected.

*get proper treatment and avoid spreading HIV to others if you are infected.

Testing is available at many places, including HIV testing centers and health clinics. For more information, contact:

*your local health department.

*the Centers for Disease Control and Preventative (CDC)

1-800-CDC-INFO (1-800-232-4636)

1-888-232-6348 (TTY)

http://www.cdc.gov/hiv/

*HIV stands for the human immunodeficiency virus. AIDS stands for acquired immunodeficiency syndrome.

Who should get tested?

Think about an HIV test: If you or your partner has ever:

*shared needles or syringes (or other drug equipment to inject drugs or for body piercing, tattooing or any other reason.

*had unprotected vaginal, anal or oral sex

*had sex with other people.

*had certain illness, including TB (tuberculosis) or an SID (sexually transmitted disease).

If you are pregnant (or planning to be), testing is very important, HIV can be passed from a pregnant woman to her baby before or during birth or through breastfeeding. (Treatments can help lower the risk).

Please read: Talk to your health care provider! This folder is not a substitute for the advice of a qualified health-care provider. The photos in this folder are of models. The models have no relation to the issues presented.

How does HIV testing work?

The test checks for HIV antibodies (the immune system makes these to fight HIV). It does not tell you if you have AIDS.

A sample is taken of blood, urine or oral fluid (from cells in the mouth).

If no HIV antibodies are found, the test is “negative”. Note: In general, it takes about 3 months (up to 6 months in rare cases) for the body to make enough HIV antibodies for the test to detect.

If HIV antibodies are found, the test is “positive”. The sample is then retested to confirm the results.

You’ll receive your results at a later date. (Some testing sites may offer a rapid HIV test. It can give preliminary results during the same visit.) Be sure to find out your test results-whether they are positive or negative. It’s important to know for sure.

What do the results mean?

A counselor will explain what your test results mean. In general:

A negative result does not mean you are immune to HIV.

*You could still be infected if you have been exposed to HIV in the last 6 months. You should get tested again in a few months.

*You can still become infected in the future.

A Positive result (one positive test confirmed by a follow-up test) means you have HIV. It does not mean you have AIDS or will get sick soon, though it is possible.

An indeterminate result means the results were unclear. You will probably need to be tested again.

Choose a testing site that offers counseling before and after the test.

What to do after the test:

If you are positive, work with a supportive, experienced health care provider. Ask about:

*treatments for HIV

*testing and treatment for other STDs and for TB

*healthy diet and exercise

*rest and stress management

*proper hygiene

Avoid using alcohol, tobacco and other drugs

If you test negative, take steps to reduce your choices of getting HIV.

HIV test results are confidential. Without your written permission, only certain people-such as your health-care provider or public health officials-may see the results.

Anonymous testing is also available. Your name is never used. You are the only person who knows the results. Anonymous testing is available at some testing sites and through an FDA-approved home collection test kit. (Do not use any home testing kit that is not FDA-approved).

Protect yourself and others: no matter what your HIV test results!

Not having sex is the only sure way to prevent getting HIV and other STDs through sex.\

If you do have sex, always use a new latex condom. Condoms are not 100% effective. But they can help protect against HIV and other STDs. (Some STDs can be caused by contact with infected areas not covered by a condom.)

Be sure to use a new latex condom properly for each act of vaginal, anal or oral sex. Remember, you can get HIV (and STDs) from anal and oral sex too.

Never share needles or syringes.

If you are infected and become pregnant, treatment can reduce the risk of giving HIV to your baby. Consider an HIV test-and help stop the spread of HIV.

If you have questions about AIDS, call:

New Jersey AIDS/STD Hotline

1-800-624-2377

(All calls are strictly confidential. You do not have to give your name)

Disclaimer: This information was taken directly from the New Jersey Department of Health & Senior Services/Division of HIV/AIDS Services and I give them full credit for this information. Please call them directly for more information.

 

 

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Matching your infant’s or toddler’s style to the right care setting

Posted on December 9, 2019 by jwatrel

Matching your infant’s or toddler’s style to the right care setting: Child Care Aware

ChildCareAware.org

1-800-424-2246

This offers some guidelines on how to use what you know about your infant or toddler-like personal style and activity level-to select a child care setting that’s just right.

The question below can help your develop a profile of your child, and learn more about the type of care that might best meet your child’s needs.

What is your child’s personal style?

Pick the one that describes your child most of the time.

Adaptable:

*Flexible

*Approaches new people/situations with ease

*Good with transitions

Looking group setting providing social interaction and new experiences

Cautious:

*Thoughtful

*Approaches new people/situations cautiously

*Has difficulty with transitions

Look for:

Small group settings that are less over-whelming

Feisty:

*Passionate, feels things intensely

*Has difficulty controlling her strong feelings, wants and needs

Look for:

Programs where each child has a primary caregiver, someone who knows and understands your child (Note: All children would benefit from this)

How does your child react to the world?

Big Reactors: communicate their feelings and don’t hold back!

Looking for: Caregivers who respect your child’s emotions but help him/her to express them in a more controlled way.

Low Activity: children sit quietly, exploring through their eyes and ears.

Look for: Caregivers who engage children in sensory-rich activities.

How social is your child?

Super Social children:

*Enjoy approaching new people

*Are happiest interacting with others

Look for:

*Opportunities for group play

Take it slow:

*Are shy around strangers

*Need time to warm up

Look for:

*Programs that allow children to choose when they’d like to play with others.

Is your child tolerant of changes and challenges?

High Tolerance children:

*Aren’t bothered by changes

*Are adaptable

*Cope well with frustration

Look for:

*Mixed age settings that offer enjoyable challenges and stimulation.

Low Tolerance children:

*Are sensitive to change

*Get upset when daily routine is altered

*Are easily frustrated and impatient

Look for:

Same age settings with developmentally appropriate toys and activities.

Health and Safety Issues to Consider:

High-quality child care providers are ones that also make health and safety issues their top priority. Use the questions below as general guidelines and contact Child Care Aware for more information (1-800-424-2246):

*Are diapering, sleeping, food preparation and play areas separate?

*Are there clearly written sanitation procedures specific to each area? Are there instructions posted on proper diapering and food storage/preparation procedures?

*Do staff receive training on health and safety issues?

*Are infants and toddlers toys washed and disinfected regularly?

*Is there a sick-child policy?

*Do adults regularly conduct safety checks of all areas inside and out for potential safety hazards?

*Do staff maintain children’s personal grooming standards (for example hand washing)?

*Are all infants put to sleep on their backs?

*Is the staff equipped with appropriate first aid materials? Do staff members know basic first aid techniques (for example, CPR)?

*Do staff practice fire drills and evacuation procedures? Is there a written policy in place for evacuation procedures?

What are your child’s unique needs?

Sleep:

Look for child-friendly settings offering:

*Individual schedules

*Separate sleeping area and

*Appropriate lighting (dim) temperature (comfortable) and noise level (low)

Cultural Identity:

*Are staff interested in your family’s culture?

*Do staff speak your home language or find effective ways to communicate with you about your child?

*Are staff open to including books and other aspects of your child’s culture?

*Are staff’s values and practices consistent with your family’s?

Special Needs:

*Are staff enthusiastic about working with your child?

*Do staff understand the medical and therapeutic procedures and assistive technology necessary to support your child?

*Are staff trained and supported to work with children with special needs?

*Is the setting accessible to your child?

*Do any books/toys feature children with special needs?

*Are staff willing to help your child develop the skills that match what your family believes are important?

Responsive Care:

Among the items we’ve discussed, there is one common thread; the need for caregiving staff to adapt their approach to meet your child’s needs. This is called responsive care. To do so, caregivers need to be excellent observers of the children in their care and search for the meaning behind children’s gestures, gurgles, cries and glances. Responsive caregivers wonder why a particular behavior is occurring, come up with an educated guess and interact with the child to see if they’re correct. Is a crying baby tired? Hungry? Wet? Lonely? Frustrated?

Responsive caregivers adapt their responses based on the reason behind the behavior as well as the style of the individual child.  This ensures that all children are treated as unique with their own thoughts, feelings, preferences and needs.

Responsive Child Care Issues to Consider:

*Are children allowed to function on individual schedules?

*Do parents receive daily written reports about their children’s day (and formal progress reports twice per year)?

*Are parents free to visit at any time during the day?

*Does the caregiver adhere to state-regulated caregiver/child ratios?

*Is the caregiver’s turnover rate for families under 20%? Why do families leave?

*When caregivers leave, how do staff help children understand the transition?

*Do staff receive medical benefits, vacation leave and continuing education support?

*How do caregivers respond to child-initiated interests?

*How can parents get involved in the program?

*If you’re nursing, is the caregiver responsive and accommodating?

Child Care Aware is a program of NACCRRA. The National Association of Child Care Resource & Referral Agencies committed to helping parents find the best information on locating high-quality child care and child care resources in their community. Child Care Aware in partnership with local CCR&R’s, builds consumer awareness and supports families in making choices for the care and education of their children.

For additional resources or for help in locating your local Child Care Resource & Referral agency, call:

1-800-424-2246

TTY Line: 1-866-278-9428

ChildCareAware.org

Disclaimer: This information was taken directly from the Child Care Aware pamphlet and I give them full credit for the information. Please call them directly for more information on the program.

 

 

Posted in Child Program Services, New Jersey Children's Programs, Uncategorized | Tagged , , , , , , , , , , , , , | 1 Comment

Zeze Flowers 938 First Avenue New York, NY 10022

Posted on December 6, 2019 by jwatrel

In honor of Small Business Saturday, I am sending out some of the merchants I have found on MywalkinManhattan.com.

ZeZe Flowers IIII

The beautiful items for sale at ZeZe Flowers.

 

jwatrel's avatarLittle Shop on Main Street

Zeze Flowers

938 First Avenue

New York, NY  10022

(212) 753-7767

http://zezeflowers.com/

Open: Monday-Saturday 8:00am-6:00pm/Closed on Sundays

What I love best when walking into Zeze Flowers in the Sutton Place neighborhood of Manhattan is the beauty in their window displays. They really greet you with a quiet elegance and a whimsical touch.

ZeZe Flowers V

The back of the store

From the outside of the store where colorful potted plants and garden flowers such as pansies and violets line the walk ways and potted rhododendrons and hydrangeas encase the look by the doorway, you are greeted into the sites and smells of this elegant florist on Sutton Place. Even the Man in the Moon is smiling at you when you walk in.

Once inside, the shelves are lines with all sorts of vases, bowls and elegant flower containers that are ready to be filled with their beautiful flowers. There is a variety of…

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Posted in Bergecco-Parc Consulting Inc. Projects, My walk in Manhattan Blog, Uncategorized | Tagged , , , , , , , , , , , , , , , , | Leave a comment

Clean Water: It’s up to you New Jersey

Posted on November 11, 2019 by jwatrel

Clean Water: It’s up to you New Jersey

If you litter in the street, you might as well litter in the river. Rain washes pollutants into storm drains and directly into our lakes, rivers and the ocean. So what can you do?

http://www.cleanwaternj.org

What’s the problem with litter?

When was the last time you saw someone littering? Litter just doesn’t appear-it’s the result of careless actions. No matter where litter is discarded, it usually ends up in the street, where it washes down storm drains and ultimately flows to local waterways.

Littering is not only unsightly, it’s a threat to wildlife and their habitat. Before you flick a cigarette butt out of your window or throw out a plastic bottle, consider this: Cigarette filters have been found in the stomachs of marine life, birds and other animals, because they thought it was food. Birds and marine life have also been found trapped or tangled in plastic items such as six pack drink holders, plastic bags and fishing lines. Please be considerate and protect our wildlife and our water.

You can help!

*Set up an example for others, especially children by not littering.

*Carry a litter bag in your car.

*Make sure trash cans have lids that can be securely fastened.

*If you have curbside trash collection, don’t put loose trash in boxes.

*Prevent trash cans from being knocked over by the wind and animals.

*Tie papers in a bundle before placing them in a curbside recycling bin.

*If you own a business, check dumpsters daily to see that top and side doors are closed.

*If you or a family member is involved in a civic group, scouting or recreational sports program, encourage the group to “adopt” a spot in your town and maintain it on a regular basis.

*Report areas where people have illegally dumped garbage and debris and ask that the material be removed.

*Volunteer to help organize a cleanup.

Why should you care about clean water?

Storm water pollution is one of the greatest threats to New Jersey’s clean water supply. Clean water provides access to safe drinking water, places for recreation, commercial opportunities, healthy wildlife habitats and adds beauty to our landscape. Rain washes pollution from streets, parking lots and lawns into storm drains, then directly to our streams, rivers, lakes and the ocean.

Did you know more than 60% of water pollution comes from things such as motor oil, fertilizers, pet waste and detergents? By sharing the responsibility and making small, easy changes in our daily lives, we can keep common pollutants out of storm water.

Clean Water http://www.cleanwaterNJ.org

Disclaimer: This information was taken directly from the Clean Water NJ pamphlet and I give them full credit on the information provided. Please call or email them directly for more information on the subject.

Posted in Clean Water Programming, New Jersey Senior Programming, New Jersey State Program, Swimming Safety Programs, Uncategorized | Tagged , , , , , , , , , , , , , , , | 1 Comment

Let’s Talk about Mammograms: American Cancer Society

Posted on November 11, 2019 by jwatrel

Let’s talk about Mammograms: American Cancer Society

Why should I have one?

*As you get older, your chances of having breast cancer go up. Women can get breast cancer even after menopause.

*Even if you have no changes or lumps in your breast , you should get regular mammograms.

*Even if you have no breast cancer in your family, you still need mammograms.

*If you do have breast cancer, finding it early could help you live to do the things that are important to you.

I have heard it hurts:

When the plates press your breast, this “squeeze” might hurt for a minute. Some women say that it’s painful; others say that it doesn’t hurt at all.

What happens if they find something?

If something is seen on the mammogram, it doesn’t mean that you have breast cancer. You might need more tests. Then your doctor can make the best plan for you.

How much does a mammogram cost?

Most health plans and Medicare cover the cost of mammograms. If you have Medicaid or have no insurance, you may be able to get a free mammogram in your state. Check with your health department.

To get my mammogram I should call:

*My doctor or nurse

*My local health center or women’s clinic

*The American Cancer Society at 1-800-227-2345 and ask for help getting a mammogram where I live.

What is a mammogram?

A mammogram is an x-ray of your breast. It can find breast changes that are too small for you or your doctor or nurse to feel.

How is a mammogram done?

You stand in front of the x-ray machines and place your  breast between two plastic plates. Those plates press each breast to make it flat to get a good pitch.

Remember:

* Anyone can get breast cancer. But your chances go up as you get older.

*Even small breast cancers can be found with a mammogram.

*If breast cancer is found when it’s small and before it has spread, it’s easier to treat.

Steps I’m willing to take for my health:

*I will call 1-800-227-2345 to find out more about mammograms and breast cancer.

*I will ask my doctor or nurse how to get a mammogram.

*I will schedule my mammogram.

*I will call if I don’t get the results of my mammogram.

For cancer information, day to day help and emotional support, call the American Cancer Society at 1-800-227-2345. We’re here when you need us-24 hours a day, 7 days a week.

American Cancer Society

MakingStridesWalk.org

cancer.org/1-800-227-2345

1-866-228-4327

Disclaimer: This information was taken directly from the American Cancer Society pamphlet and I give them full credit for the information. Please call them directly for more information on testing.

Posted in Cancer Programming, Federal Caregiver programs, New Jersey Senior Programming, New York City Senior Programming, Senior Caregiver Programs, Senior Services, Uncategorized | Tagged , , , , , , , , , , , , , , , , | 1 Comment

Looking for Child Care? We can Help! The Bergen County Office for Children

Posted on November 1, 2019 by jwatrel

Looking for Child Care? We can Help!

The Bergen County Office for Children

The Bergen County Office for Children is your one-stop for child care information.

Contact us for:

*Information on the importance of quality child care programs and how to choose a provider.

*FREE referrals for child care in Bergen County.

*Financial assistance programs for child care to qualified applicants.

*Training to become registered to care for children in your home.

*Professional Development training for child care professionals.

Bergen County Office for Children

One Bergen County Plaza, 2nd Floor

Hackensack, NJ  07601

(201) 336-7150

http://www.co.bergen.nj.us

ofc@co.bergen.nj.us

Find us on Facebook

http://www.facebook.com/childcarebergencounty

Disclaimer: This information was taken directly from the Bergen County Office for Children pamphlet and I give them full credit for this information. Please call them directly for more information on the program.

 

Posted in Bergen County NJ Programs, Child Program Services, New Jersey Children's Programs, Uncategorized | Tagged , , , , , , , , , , , , , , | 1 Comment