Unknown Facts How Diet Affects Mental Fatigue & Burnout A Guest Post by Katrina Jane Rice



When you first think about fatigue, what usually comes to mind is the physical kind. But there is another form of fatigue that potentially wreaks havoc on your thought processes, motivation and overall success – it is called mental fatigue.

Mental fatigue is usually a result of carrying out extensive and difficult cognitive tasks. One good example to mention is studying for the bar exams. If you put your body in this kind of stress day in and day out, you will start to feel a strong case of mental fatigue. They call it burnout.

Karla Ivankovich, professor of psychology at the University of Springfield, Illinois said that a key sign of mental fatigue is the difficulty in initiating and sustaining cognitive performance and voluntary activities.

Typically, mental fatigue is a normal thing. It usually disappears after you take a break from tedious cognitive tasks. But if you do not rest, you potentially jeopardize your efficiency in every task you perform. It means it could feel too difficult to go to the gym, go back to work or even buy some groceries..

According to Ivankovich, mental fatigue affects your motor control and coordination and it is normally expected that mental fatigue can truly impact your optimal performance in every aspect in life.

Your body can only take so much stress until it starts to burn out. 

In serious cases, mental fatigue can become extremely draining that the associated health problems become chronic or irreversible. As per Ivankovich, employing effective coping mechanisms can be helpful to combat mental fatigue, and this starts with living a healthy lifestyle and eating a balanced diet.

Anybody who is experiencing mental fatigue or burnout has surely not followed a healthy eating pattern. If you feel like you are headed down this path, there are a number of dietary reasons behind it. Below are only some of the common causes that you can immediately reverse making changes your diet.

Lack of Magnesium

Magnesium helps support your nervous system.

It can alleviate stress levels by boosting your energy production and improving your quality of sleep. You can help reverse this lack of mineral in your body by eating more nuts, seeds, legumes and tofu. It is also found in whole grains, wheat bran and leafy vegetables.

Lack of Vitamin C

The adrenal gland has a huge responsibility in regulating your stress.

And when you do not get enough vitamin C, it cannot produce the stress hormones, particularly cortisol, your body needs. Cortisol helps regulate your metabolism, control your blood sugar levels and reduce inflammation. It also assists memory functions which are vital when you are feeling mentally fatigued.

Increase your vitamin C intake by eating more fruits like oranges, mandarins and kiwis. some vegetables like broccoli and other green leafy vegetables are rich in vitamin C too. For most people who do not have the time to eat right, they source their vitamins from dietary supplements.

Lack of Vitamin B

Your adrenal gland has a huge responsibility in regulating stress and it needs vitamin B to maintain its optimal function. The B vitamins are considered to be your friends in helping fight stress and supporting your energy levels. You can get more B vitamins from fish, milk, legumes, whole grains, chicken and red meat.

Too Much Caffeine

Every stressed person probably has a love for caffeine. It stimulates your fight and flight response and helps generate cortisol which gives you that temporary energy boost. But drinking too much caffeine can ultimately contribute to sleeping problems and anxiety.

Reverse this problem by swapping your morning coffee to a decaf tea. Watch out for other caffeine sources like chocolate, sodas, and black tea. Drinking green tea is preferable as it contains lower levels of caffeine but ranks high in antioxidants.

Adding an exercise routine to your lifestyle can also help you relieve mental fatigue and burnout.

Try to lose the fat you have gained from all the stress you just went through. After cutting out the other stressors in your life, get a gym membership or join a fitness club. This will also help your body release endorphins – a “feel good” hormone responsible for that happy feeling you get after every workout session.

The lack of vitamins and minerals is not just the only source of your stress. Though getting that in check will help you reverse mental fatigue, you also need to learn how to delegate your work.

If you are in the position to give away some of your tasks to other, do it for your own sake. If not, find the main source of your mental fatigue, prioritize what needs to be kept and cut out what you can. Know where your limits are so that you can alleviate and prevent mental burnout in the future.

Email Katrina at katrina.earthwell@gmail.com with any questions.

Health Care Bill Endangers Coverage: A Message From AARP


Premiums would become unaffordable for many older Americans: Originally published |Comments: 14

New Numbers: Same Bad Bill
The Congressional Budget Office just released its report on the health care bill. What does it mean for you?

A new analysis of the American Health Care Act passed by the House of Representatives estimates that 23 million people would lose their health insurance if the bill were enacted into law. People age 50 to 64 would be hit particularly hard, especially those with lower incomes.

According to the nonpartisan Congressional Budget Office (CBO), premiums for a 64-year-old earning $26,500 a year would increase by a whopping $14,400 in 2026. In addition, people with preexisting conditions may not even be able to purchase health insurance because the prices would be prohibitively high.

Three weeks ago, the House voted 217 to 213 to repeal and replace the Affordable Care Act (ACA) without waiting for the CBO to analyze the effects of the legislation. Today the CBO and the staff of the Joint Committee on Taxation (JCT) provided their assessment, which is required before the bill can be sent to the Senate for consideration.

Among other things, the CBO estimated a reduction in the deficit of $119 billion under the bill over a 10-year period.  The bill would lower health-related spending by the federal government through steep reductions in Medicaid and the replacement of current subsidies with less-generous tax credits. At the same time, the bill would grant large tax cuts to drugmakers and insurance companies.

The congressional analysts warn that for a significant segment of the population, the individual insurance market “would start to become unstable in 2020” because of two provisions added to the House bill in the days before the May 4 vote. One would allow states to receive waivers allowing insurers to eliminate coverage for essential health benefits, such as emergency services, hospitalization and chronic disease management. The other is a waiver that would allow insurers, contrary to current law, to charge higher premiums to people with preexisting conditions such as cancer and diabetes.

According to the report, “less healthy people would face extremely high premiums” in states likely to receive these waivers. “People who are less healthy (including those with preexisting or newly acquired medical conditions) would ultimately be unable to purchase comprehensive nongroup health insurance at premiums comparable to those under current law, if they could purchase it at all.”

AARP reiterated its strong opposition to the bill and called on the Senate to shelve the House-passed legislation. AARP said the bill would impose an “age tax” on older Americans by allowing insurers to charge premiums five times what they charge others and cutting the current level of subsidies.

“The CBO analysis found that premiums would go up to unaffordable levels by inflicting an age tax and removing current protections for people with common conditions including diabetes and weight gain,” said Nancy LeaMond, AARP Executive Vice President. “Putting a greater financial burden on older Americans is not the way to solve the problems in our health care system.”

AARP said it rejected the bill because it worsens the financial outlook for Medicare by reducing Medicare’s revenue and slashes Medicaid spending by over $800 billion over 10 years.


Trump Calls for a Massive Cut in Medicaid

New budget proposal also would slash health research funding

Play Video

AARP Opposes Proposed Budget
It cut billions from programs older Americans depend on

En español | The Trump administration today released a federal budget proposal that would cut more than a trillion dollars over 10 years from Medicaid, the nation’s largest source of health care coverage, which provides a lifeline for children and adults with disabilities and low-income seniors.  Under the president’s proposal, Medicaid would face a $600 billion decrease. That’s in addition to the more than $800 billion cut in the American Health Care Act (AHCA) passed this month by the House of Representatives.

The budget, released while President Trump was in the Middle East on his first foreign trip as president, also would shrink funding for the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), the Children’s Health Insurance Program (CHIP), Social Security disability, environmental protection, and housing and transportation assistance.

At the urging of the president’s daughter Ivanka Trump, the budget proposes spending $25 billion over the next 10 years on paid parental leave, a new initiative.

Members of both parties in the House and the Senate have strongly opposed trimming Medicaid in the past.

Many of the other cuts also face strong bipartisan opposition on Capitol Hill. For example, Rep. Tom Cole (R-Okla.), chairman of the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies, has sharply criticized the cuts earmarked for the NIH and CDC.

White House Budget Director Mick Mulvaney reiterated the administration’s view that the AHCA does not go far enough on Medicaid. “We go another half a step further and ratchet down some of the growth rates that are assumed into AHCA,” he said in a call with reporters on Monday.

During today’s press briefing, Mulvaney said that “we’re no longer going to measure compassion by the number of programs or the number of people on those programs, but by the number of people we help get off of those programs.”

AARP staked out a strong position against the president’s budget.

AARP “opposes the budget proposed today because it explicitly harms the very people we are counting on the President to protect,” said AARP Executive Vice President Nancy LeaMond in a statement. “Today’s budget proposes to cut Social Security benefits, as well as funding for critical health, hunger, housing and transportation assistance to low and middle income seniors.  The budget sends a powerful message to older Americans and their families that their health and financial security is at risk.”

AARP sounded a positive note on the administration’s parental leave initiative. “We do want to acknowledge the Administration’s paid leave proposal,” LeaMond said.  “Although it must be improved so that it addresses the workplace needs of family caregivers, we hope that it leads to a national conversation about ways to support family caregivers in the workplace.”

The budget assumes economic growth reaching 3 percent a year by 2021, a figure widely seen as unrealistic.

The budget also includes a dramatic decrease in the Supplemental Nutrition Assistance Program (SNAP), also known as food stamps. “If you are on food stamps, we need you to go to work,” said Mulvaney. “If you are on disability and should not be, we need you to go back to work.”

The president’s budget is the first step in a lengthy process. Congress will set its own priorities as it develops its own budget resolution.

6 Easy Ways To Stay Organized and Productive as a Caregiver A Guest Post by Maggie Drag


Being a caregiver is arguably one of the most noble professions out there – but it can also take a serious toll on your personal life. Here are 6 work-life balance tips to help you reduce stress, and ultimately make you the best caregiver for not only your clients, but for yourself, too!

1.) Plan Ahead

If you have multiple clients, or work as a live-in caregiver, keeping track of their favorite foods, interests, and medications may seem like a job in itself. Keeping a daily planner can help! If you’re constantly on your phone, try downloading an app like Fantastical, ReQall and Evernote. They are super easy to use and will allow you to set up alerts and various notifications in case you’d like to be reminded of their doctor appointments, and even your own appointments with your caregiving agency, for example. At the end of the day, keeping on top of your clients’ needs and preferences will save you a lot of stress and in the future.

2.) De-Clutter

From old receipts and grocery lists, you may have trouble remembering which documents belongs to who! Here are some easy ways to help both yourself and your client, and try doing it together and make it fun while you’re at it! First, organize your bills and clients’ bills in a binder for safe-keeping. Next, divide up your coupons into a handy coupon organizer for easy access. Finally, keep track of your own caregiving documents, from contracts, care plans and emergency contacts in a folder. Try organizing each folder by client if you have multiple, and keep a small notepad to jot down any other helpful information.

3.) Think Ahead

As a caregiver, you know that life as you know it may change in a second, whether it be your client’s health, a sudden re-assignment, and not to mention changes in your personal life. First, make sure you have a list of emergency contacts (including your agency) prepared in case you are unable to help your client or need to be relieved at any point. Next, be sure you have a plan set up for a medical emergency based on your client’s health history. Keeping track of their food allergies for one is a simple but critical step to preventing emergencies in the future.

4.) Reconnect with Loved Ones

If you’ve lost touch with a close friend, since you started another assignment, remember this: Caring about your job is one thing, but caring about your relationships is far more important in the long run. Call your distant relative via Facetime – you could even plan a day where you help your client Facetime their grandchildren after you connect with your own family!

You carry a great responsibility as a caregiver, and while your friends and family should understand that you are often very busy, don’t forget to show them some appreciation and keep in touch!

5.) “Me” Time

Being a caregiver takes a lot of work, but it is incredibly rewarding and allows you to build meaningful relationships and touch so many lives. However, as much as you may love your job, don’t forget to carve out some time for yourself each day– even if for only an hour, to do some gardening, watch some old movies, surf the internet, and even go out for a relaxing day at the spa. If you are a live-in caregiver, ask your client if they’d like to join in on the fun! This will help you stay productive and engaged in your assignment in a much more meaningful way.

6.) Take Care of Yourself

As much as you care about your job as a caregiver, don’t forget that the first step to being an amazing caregiver is taking good care of yourself. Keep up with exercise, eat a balanced diet but make sure you’re getting the necessary rest between assignments first and foremost- especially if you work overnight. Sleep allows your body and brain to replenish, not to mention stay alert on important assignments and throughout the day if your client needs extra supervision when taking medications, for example. Losing sleep can ultimately take a serious toll on your health in the long run, so don’t be afraid to ask your agency about rescheduling your assignments or for tips on how to manage your sleep schedule to help you be your best for your clients.

About the author:

Maggie Drag is the owner and founder of a homecare agency located in central Connecticut. With over 27 years of experience in the industry, Maggie shares her knowledge and tips about care at home.  Visit homecare4u.com  to learn more about Maggie Drag.

A Geriatric Psychologist’s Perspective on Aging Parents: Guest Post by Dr. Melissa Henston



Spending quality time with loved ones is usually something you look forward to. But when you have aging parents or loved ones, going home to see them can sometimes signify a rather different, and at times, stressful experience.

You may already have an inkling that Mom, Dad or a favorite aunt or uncle is having trouble with everyday life, but sometimes seeing changes in family members after months – or maybe years – of not seeing them can be disquieting. People change in their later years, and sometimes they can decline in health and spirit faster than you expect.

A Place for Mom expert and geriatric psychologist Dr. Melissa Henston provides some guidance on how to not only spot common problems, but tips on how to deal with any issues to get your elderly loved one the help they need.


You can spot problems the minute you drive up to your loved one’s house, Henston says.

“There are a whole bunch of warning signs that are easy to spot. For example, the exterior of the house has peeling paint, or the driveway isn’t shoveled or the walkway isn’t treated. Once you enter the home, newspapers are still in plastic wrap and mail is piled up. Maybe the house isn’t as clean as normal or has an odor. You can usually tell when something is ‘off’.”

Having a grandmother who suffered from Alzheimer’s in tandem with working in the nursing home practice in her ‘previous life’ (during college), Dr. Henston has a personal connection to the elderly. She decided from a young age that her primary focus in psychology would be issues in aging, and she has devoted her practice to improving the lives of the elderly, informing families about the signs that their loved ones need help, and helping find the right care options for each unique situation.

Since a health crisis in the elderly can escalate quickly and catch everyone involved off guard, it’s important to not ignore signs that something may be wrong. Ideally, families will have conversations with their children or loved ones about getting their affairs in order and end of life care well in advance of having any issues, but here are some signs to be cognizant of when visiting aging loved ones:

  • House and yard need care / maintenance
  • Disheveled clothing
  • Broken appliances
  • Spoiled / expired groceries
  • Poor personal hygiene
  • Cluttered / disorganized house
  • Depressed or low energy temperament

Henston emphasizes the importance to noting anything out of character or outside of normal behavior. She remembers personally having the discussion of green eggs and ham with her own father. “I told my dad, ‘Dad, you can’t eat this stuff. Ham isn’t supposed to be green.'”

If health or happiness seems to be compromised, it’s time to have a conversation and address problems.


Tread delicately when it comes to discussing retirement plans or end-of-life care. Henston comments, “Typically you need to look for the opening and opportunity, rather than just jumping in. Don’t try to take control. Try to get a natural conversation going.”

Remember that parents still consider you their child. You need to respect this relationship. Here are a few tips for setting the right ambiance for a positive and effective talk:

    • Sit in a comfortable location, such as over coffee.
    • Start with a normal, conversational tone.
    • Ask open-ended questions, such as “How is it around the house?” or “How is driving going?” or “What have you and Dad been doing for fun lately?” to get the conversation flowing.


Henston relays that guilt is one of the biggest problems for family members. Many families make promises to their loved ones that they will care for them, but sometimes this just isn’t feasible. Senior living is often the best option for expert care, socializing and good quality of life. She notes:

“Mom, Dad, aunts and uncles — even spouses — feel a tremendous amount of guilt about putting their loved ones in senior living. But the most important thing is to overcome the guilt and assess the situation. Look at the logistics and whether caring for your loved one is accommodating to everyone’s life. If there is a single parent, finances may be a problem. But the biggest problem is often that caring for them can be a huge disruption to your life and their life. In reality it doesn’t work out well.”

It’s important to also remember that the role of caregiver may fall solely on the elderly partner — who may have physical limitations. In many cases, caregiving is passed to family members who may or may not have the time, finances or necessary skills to provide the best care for their aging loved one. Families need to re-evaluate their initial promise and determine what is truly the best choice for their loved one.

So much goes into the decision of caring for an older relative. Here are some questions Henston notes are important to consider:

      • Can I take time off from work?
      • Can I afford to stop work for an extended period of time?
      • Can my children and older relative co-exist in harmony?
      • Will my children be able to tolerate not always coming first?
      • How will this impact my relationship?
      • How will this impact my relationship with my older relative?
      • How will my siblings and I manage this as a team?
      • How will any of this be paid for?

This line of questioning is totally realistic and an important part of the process of making informed decisions. It’s important to consider these questions before having the ‘tough conversation’ with your loved one. Henston comments,

“The ‘promise’ is often made during an emotional time in which we do not feel we have many options. There are common emotional roadblocks when making difficult choices about caregiving, and families might want to consider seeking practical guidance to help all parties feel more confident during the transition.”


Elderly loved ones usually appreciate an honest conversation. If you discuss that it’s important to communicate their wishes for retirement and end-of-life care, you’ll go farther than if you are condescending or dishonest.

Include them in the decision-making as it helps them feel as though they’re not being “put out to pasture.” Talk to them about their options; whether they include staying in their family home and what that entails, or if they want to explore and tour senior living and retirement communities to see if any seem to be the right ‘fit.’ Many people still have a stereotypical image of what assisted living and nursing homes look like. Today communities offer anything from comfortable and intimate settings to large, almost resort-like communities that offer social activities and amenities. Does your loved one like fancy, intimate, or down-home and cozy? If they help you find one that is appealing, they may be able to get over the stigma and stereotypical view.


Henston discusses that it’s important to think of the risks involved if seniors live alone if they’re no longer capable. “There are many risks to consider if someone is truly living alone and shouldn’t be,” she relays. “For example, if there’s a physical issue where the senior has trouble getting around and they fall or get hurt it can be very scary. There was an elderly lady sitting on her bathroom floor who had fallen and couldn’t get up for 18 hours. Finally a neighbor noticed she hadn’t picked up the paper and checked on her to discover the problem.”

Here are some other issues to consider:

      • Elder Fraud
      • Isolation
      • Physical Constraints
      • Mental Constraints

If your loved one suffers from any of the above, there could be many consequences. From economical problems to depression and health problems; there are many things to think about. “If an elderly person can’t drive and get out easily, they can become depressed – it can become a situation of being imprisoned,” Henston candidly notes.

Above all else, approach the conversation as though it is a gift. You are concerned about their well-being and welfare. Henston reminds us, “Treat your aging loved one with love, respect, kindness and compassion. Consider what is truly the best decision for everyone involved.”

About Dr. Melissa Henston, Geriatric Psychologist

Dr. Melissa Henston is a geriatric psychologist in private practice with Colorado NeuroBehavioral Health, where she helps seniors and caregivers understand and navigate physical, cognitive and mental health changes. Additionally, Dr. Henston is a professor at the University at Denver, Graduate School of Psychology, where she teaches “Aging and Geriatric Psychology” to doctoral students.

Dr. Henston’s philosophy is that getting older is a unique process that requires self-acceptance and awareness to life values in order to achieve successful aging. She has worked with the Alzheimer’s Association, presented at conferences on aging, and lectured at the University of Colorado Health Sciences Center. She diligently works with families who are facing problems that may develop as parents transition into needing more care and performs neuropsychological evaluations on older clients to help them understand cognitive issues that can arise with aging.


Answers Your Top Medicare Coverage Questions A Guest by GoHealth


Whether you’re a first-time Medicare buyer or a long-time enrollee, finding the right Medicare coverage can be confusing.

In an effort to help you find the right combination of plans, we’re answering the top consumer Medicare questions, including what your first step should be, your prescription drug coverage options, and much more.

Top 10 Medicare Coverage Questions

1. If I have Part A, how do I add Part B?

In order to complete your Original Medicare coverage and enroll in Part B, you must contact the Social Security office and actively enroll. Once you have both Parts A & B, you can complete your Medicare coverage with additional options.

2. What is a Medicare guaranteed issue right, and do I have it?

A Medicare guaranteed issue right is your right in certain situations to be granted a Medicare Supplement plan – or Medigap policy – regardless of certain other details concerning your health. In these specific situations, insurance companies must sell you a Medicare Supplement plan, cover all your pre-existing conditions, and not charge you more for a policy because of any health problems. Most commonly, you may have a guaranteed issue right if you lose coverage or your current health coverage changes.

3. If I only have Part A, what other types of Medicare can I get?

If you only have Part A, you are eligible to also get Part B. You cannot move forward with exploring other types of Medicare coverage until you have both Parts A & B.

4. Can I enroll in Part D without having Part B?

Unfortunately, you cannot. In order to move forward with additional Medicare options (including Part D), you must first have both Parts A & B.

5. What are my coverage options when it comes to prescription drugs?

If you need prescription drug coverage, you have a few different options. Once you get Parts A & B, you can choose to switch to Medicare Advantage, which sometimes offers prescription drug coverage. You can also choose to enroll in a Prescription Drug plan – or Part D – which offers different coverage options depending on which drugs you take.

6. How do I find my Medicare claim number?

You can call Social Security, and a representative there can help you locate your Medicare claim number.

7. How do I enroll in Medicaid?

You should call your state’s Medicaid department if you’re interested in Medicaid health insurance coverage.

8. What is the difference between Medicare Supplement and Medicare Advantage plans?

Medicare Supplement – or Medigap – plans help you complete your coverage. They can help you pay for health care costs that may not be covered by Original Medicare, such as copayments, coinsurance, and deductibles. Medicare Advantage is a private health insurance option that is required to cover all the same benefits as Parts A & B, plus additional benefits, such as prescription drug coverage. You cannot have a Medicare Supplement plan and Medicare Advantage at the same time.

9. Why would I enroll in Medicare Advantage instead of Original Medicare? Aren’t they the same thing?

While they are similar, there are also differences between Medicare Advantage and Original Medicare. By law, Medicare Advantage plans are required to cover all the same benefits as Original Medicare, or Parts A & B.

However, there may be some differences in how you pay your out-of-pocket costs with a Medicare Advantage plan, or you may have a smaller or larger deductible. There also may be some differences in the coverage itself. For example, while Original Medicare does not cover prescription drugs, some Medicare Advantage plans do offer that coverage.

10. How do I avoid gaps in my Medicare coverage?

There are many different types of Medicare coverage available to help you avoid any gaps in your coverage. It’s important to explore all of your options and coverage combinations with a licensed agent.

Call 1-877-568-1851 – TTY 711 to speak with one of our licensed sales agents. To enroll in Original Medicare, please contact your local Social Security office.

Medicare has neither reviewed nor endorsed this information.

Related Articles:

GoHealth Answers Your Top Medicare Coverage Questions posted by GoHealth

America’s Family Caregivers Can’t Wait: Tell Congress to Pass the RAISE Act Now Guest Post by Nancy A. LeaMond

Originally Posted http://www.blogAARP.org on 08/22/2016


After Labor Day, when Congress returns from its summer recess, there will only be 33 working days left for the U.S. House of Representatives before the end of the year. That’s not a lot of time to address some of our nation’s biggest challenges. One item awaiting action that should be an immediate priority is the RAISE (Recognize, Assist, Include, Support and Engage) Family Caregivers Act.  This bipartisan, commonsense step to aid America’s greatest support system — family caregivers — is long overdue.

Passed unanimously by the U.S. Senate, the RAISE Act would develop a national strategy to support family caregivers, bringing together stakeholders from the public and private sectors — including state and local officials, health care and long-term services and support providers, employers, federal agencies, older adults, persons with disabilities and family caregivers themselves — to identify specific actions communities, providers, government, employers and others can take, including with respect to: promoting person- and family-centered care in a range of settings; assessment and service planning involving both care recipients and family caregivers; information, education, referral and care coordination; and respite options so caregivers can reset and recharge.
Today, more than 40 million family caregivers care for veterans, parents, spouses, children and adults with disabilities and other loved ones so they can continue to live at home. The unpaid care family caregivers provide — valued at about $470 billion annually — helps delay or prevent more costly care and unnecessary hospitalizations, saving taxpayer dollars.

I know from firsthand experience that caring for a loved one is a tremendous responsibility. While I have much in common with my fellow caregivers, my experience is unique in many ways. Indeed, each of our caregiving experiences is individual, seen through our own personal family lens. Everyday duties can include bathing and dressing; preparing and feeding meals; transportation; handling financial, health care and legal matters; and often complex medical tasks like wound care. Many family caregivers are working full time and raising families. They are often on call 24/7.

That’s why AARP, together with a number of other organizations and family caregivers themselves, is calling for the U.S. House to pass the RAISE Act now.   

One such organization, the Elizabeth Dole Foundation, works with military and veteran caregivers. In a recent radio news story, former senator Dole said:

“Five and a half million military and veteran caregivers are caring for loved ones with devastating wounds, illnesses and disabling injuries — visible and invisible. By passing the RAISE Act, we can create an important path forward so military family caregivers, all family caregivers, get the support they need.”

Another group pressing the U.S. House to pass the RAISE Act is Autism Speaks. Executive Vice President of Programs and Services Lisa Goring says:

“Millions of family members are forced to step in as full-time caregivers to keep their loved ones with autism and other developmental disabilities safe and supported. Now is the time for a national strategy to support all family caregivers to ensure their loved ones a better future.”

For me, it’s the stories and experiences of family caregivers that really underscore why the RAISE Act must pass now. Britnee Fergins cares for her father. She says:

“My 91-year-old father, who’s a World War II veteran, requires a lot of attention. I also have a very energetic 3-year-old son — and work 12-hour shifts as a chemist. It’s a constant juggling act, and some days, I’m afraid I’m going to drop the ball.”

Family caregiving is a unique and deeply personal issue that affects just about all of us, wherever we are on the political and ideological spectrum. We are either family caregivers now, were in the past, will be in the future — or will need care ourselves one day.

The RAISE Act would implement the bipartisan recommendation of the federal Commission on Long-Term Care, requiring the development of a national strategy to support family caregivers, similar in scope to the national strategy developed to address Alzheimer’s disease. The need is urgent and time this year is running out.

AARP urges the U.S. House to pass the RAISE Family Caregivers Act now. And I urge you to contact your representative about the RAISE Act today.  Call 844-259-9351 or click here.

The following U.S. representatives are cosponsors of the bipartisan RAISE Act as of Aug. 22:

Lead Sponsors
Reps. Gregg Harper (R-Miss.) and Kathy Castor (D-Fla.)


Rep. Lujan Grisham (D-N.M.)

Rep. Black (R-Tenn.)

Rep. Pascrell (D-N.J.)

Rep. Emmer (R-Minn.)

Rep. Pocan (D-Wis.)

Rep. Deutch (D-Fla.)

Rep. Katko (R-N.Y.)

Rep. Pompeo (R-Kan.)

Rep. O’Rourke (D-Texas)

Rep. Amodei (R-Nev.)

Rep. Duckworth (D-Ill.)

Rep. Chu (D-Calif.)

Rep. Schakowsky (D-Ill.)

Rep. Fortenberry (R-Neb.)

Rep. Gibson (R-N.Y.)

Rep. Pingree (D-Maine)

Rep. Bonamici (D-Ore.)

Rep. Napolitano (D-Calif.)

Rep. Lujan (D-N.M.)

Rep. Hastings (D-Fla.)

Rep. Kirkpatrick (D-Ariz.)

Rep. Kuster (D-N.H.)

Rep. Blumenauer (D-Ore.)

Rep. Lofgren (D-Calif.)

Rep. Freylinghuysen (R-N.J.)

Rep. Murphy (R-Pa.)

Rep. Frankel (D-Fla.)

Rep. Dingell (D-Mich.)

Rep. Lee (D-Calif.)

Rep. Brady (D-Pa.)

Rep. Rice (D-N.Y.)

Rep. DesJarlais (R-Tenn.)

Rep. Beatty (D-Ohio)

Rep. Davis (D-Calif.)

Rep. Beyer (D-Va.)

Rep. Roe (R-Tenn.)

Rep. Stefanik (R-N.Y.)

Rep. Courtney (D-Conn.)

Rep. Langevin (D-R.I.)

Rep. Meehan (R-Pa.)

Rep. Kilmer (D-Wash.)

Rep. Takano (D-Calif.)

Rep. Payne (D-N.J.)

Rep. Allen (R-Ga.)

Rep. Ashford (D-Neb.)

Rep. Peters (D-Calif.)

Rep. Matsui (D-Calif.)

Rep. Larson (D-Conn.)

Rep. Denham (R-Calif.)

Rep. Bishop (R-Mich.)

Rep. Hunter (R-Calif.)

Rep. Smith (D-Wash.)

Rep. Meng (D-N.Y.)

Rep. Cramer (R-N.D.)

Rep. Clark (D-Mass.)

Rep. Boyle (D-Pa.)

Rep. Esty (D-Conn.)

Rep. Dold (R-Ill.)

Rep. Thompson (R-Pa.)

Rep. Lipinski (D-Ill.)

Rep. Messer (R-Ind.)

Rep. Jenkins (R-Kan.)

Rep. Moore (D-Wis.)

Rep. Smith (R-N.J.)

Rep. Clarke (D-N.Y.)

Rep. Watson Coleman (D-N.J.)

Rep. Carolyn Maloney (D-N.Y.)

Rep. MacArthur (R-N.J.)

Rep. Curbelo (R-Fla.)

Rep. Wasserman Schultz (D-Fla.)

Rep. Grayson (D-Fla.)

Rep. Corrine Brown (D-Fla.)

Rep. Takai (D-Hawaii)

Rep. Joe Heck (R-Nev.)

Rep. Cicilline (D-R.I.)

Rep. Joe Wilson (R-S.C.)

Rep. Frederica Wilson (D-Fla.)

Rep. Bennie Thompson (D-Miss.)

Rep. Peter King (R-N.Y.)

Rep. Sessions (R-Texas)

Rep. McKinley (R-W.Va.)

Rep. Slaughter (D-N.Y.)

Rep. Simpson (R-Idaho)

Rep. Kelly (D-Ill.)

Rep. Nolan (D-Minn.)

Rep. Holmes Norton (D-D.C.)

Rep. Capps (D-Calif.)

Rep. Zeldin (R-N.Y.)

Rep. Guinta (R-N.H.)

Rep. Miller (R-Mich.)

Rep. Walberg (R-Mich.)

Rep. LoBiondo (R-N.J.)

Rep. Tonko (D-N.Y.)

Rep. LaHood (R-Ill.)

Rep. Lance (R-N.J.)

Rep. Sean P. Maloney (D-N.Y.)

Nancy LeaMond, chief advocacy and engagement officer and executive vice president of AARP for community, state and national affairs, leads government relations, advocacy and public education for AARP’s social change agenda. LeaMond also has responsibility for AARP’s state operation, which includes offices in all 50 states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands.

You can follow her on Twitter @NancyLeaMond.



Originally published in the AORN Periop Insider Weekly Newsletter  July 28, 2016.      Authored by Carina Stanton

The term “bully” is often used incorrectly to classify both bullies and those expressing incivility. Understanding the distinction between the two can help to put structure around communication and action in attempts to weed out bad behavior in perioperative nursing care, according to nursing Career Coach Phyllis Quinlan, PhD, RN-BC.

“The 10% of nurses who are true bullies have a personality defect,” Quinlan says. “Knowing the distinction is key to protecting your staff and deciding whether to develop a plan of remediation or to get rid of a toxic staff member.”

Understanding Incivility vs. Bullying

Quinlan describes bullying as a threatening behavior based in intimidation that stems from the bully’s issue with personal power. “For a bully, their personal power is far more important than the other person’s needs—if the other person needs to feel supported, a bully says ‘tough.’”

A person who indulges in bullying is very egocentric and has far more limited opportunity for personal growth, introspection and a commitment to change.

In the practice setting, a bully will intimate to someone that “you are on your own, if you don’t do what I want I have the power to isolate you,” Quinlan explains. She says bullying is not distinct to one professional level because this bad behavior knows no direction. It can be top down (leadership to staff), down up (staff to leadership) or lateral (peer to peer).

Although incivility is also bad behavior, it stems more from not being fully respectful of the other person’s perspective. Incivility is commonly seen by Quinlan during patient hand-offs or when a patient is transferred to a different area of care, such as from the OR to PACU. “As the nurse is explaining the patient’s state and previous care, an uncivil reaction by the nurse listening is to act as though they are being inconvenienced or worse to provide negative judgment about the previous care, making the nurse handing off the patient feel as though they must justify themselves and their actions.

With 80% of communication being non-verbal, much uncivil behavior is expressed with a less-than-polite facial expression or a toe-tapping type of stance indicating the nurse talking should speed it up and finish what they are saying.

Seeing Bad Behavior as Neurotic Need

One common thread between incivility and bullying is denial of wrongdoing. “If you ask an uncivil or bullying nurse to assess their behavior, they will report they were unaware of wrong doing and may say the nurse who reported their behavior was ‘too sensitive’ or ‘took it the wrong way.’”

Yet research indicates that both uncivil and bullying nurses essentially know exactly what they are doing because it fills a neurotic need.

Quinlan recalls the words of Abraham Lincoln, in which he suggested you can see the character of a person when you give them power. “Someone with good character will take a role in power and be collegial, find common ground and be generous enough to give praise for a job well done. On the flip side, someone with problematic character will use a power role to offer criticism and make remarks that are self-serving.”

Catching It Early

For new employees, Quinlan recommends a set time frame for a probationary period in which the hire is observed for both clinical and behavioral performance. Quinlan says nurses who are good clinically but lacking in collegial behavior are often kept on staff to work on the behavior piece, what she hears nurses refer to as the “soft stuff.”

“Nonsense, behavior is the tough stuff and should be viewed as equally important to clinical skills,” Quinlan stresses. She advises a strong collaboration between nursing, hospital administration and human resources to establish strict behavioral boundaries that are reviewed wisely through the probationary period to measure knowledge, skills and behavioral benchmarks that are demonstrative of culture.

“Make sure everyone is on same sheet of music with clear descriptives of bullying and incivility weaved into your code of conduct and stand behind a zero-tolerance approach to toxic behavior,” she suggests. “If a true bully is identified, cut your losses quickly, otherwise you will lose good staff members.”

For Managers

Register now to attend “Bringing Shadow Behavior into the Light of Day: Understanding and Addressing Incivility and Bullying Behavior,” AORN’s Nurse Executive Leadership Seminar with Phyllis Quinlan, and get the skills to build your own zero-tolerance policies and practices against bullying and incivility.

6 Ways to Restore Your Nursing Resilience: An Interview with Phyllis

Image of a tired nurse

Publish Date: July 20, 2016 in Periop Insider by AORN written by Carina Stanton

Nursing in the twenty-first century requires a new set of tools to go the distance, according to nursing Career Coach Phyllis Quinlan, PhD, RN-BC. “To have the vitality and resilience to practice nursing today, we need to pay attention so our insides match our outsides.”

Quinlan says nurses need to realize that technical skills and knowledge are not enough to truly meet the needs of patients without their well of nursing compassion running dry. “We have done an excellent job of getting technical certifications, championing evidence-based practices and collaborating under shared governance, but this is all outside of the individual nurse.”

Looking Inward

Quinlan says it’s time for nurses to do more introspective soul searching so they can build skills such as emotional intelligence to strengthen positive interactions with patients and positive relationships with coworkers. This emotional intelligence can also be a powerful tool to keep workplace incivility in check.

“Ask yourself how well you are developing relationships with colleagues—are you trying to do everything yourself or are you holding your colleagues accountable to do their fair share?” she asks. “We need to work on our ability to be patient enough to hold our ground and fight the temptation to be an enabler. In the name of good patient care, safety and time management, we tend to dip our toe into enabling behaviors that can sabotage collegial relationships and build our own frustration and resentment toward others we work with.”

Assessing Physical and Emotional Health

Quinlan describes nurses as professional doers for whom caring is deeply intertwined into their energetic makeup. “When you are constantly in a caring or doing mode, it can be depleting, yet nurses may not take the time to realize that their well of compassion gets a little bit lower if they don’t take time to renew themselves,” Quinlan suggests. “Before you know it, you find yourself giving from fumes of a compassionate nature as opposed to giving from a full heart.”

Nurses don’t always honor the fact that we are not made up of a renewable energy source, that we need to check in with ourselves even if we would rather put time into caring for others, she adds. Part of this self-care is recognizing habitual behaviors nurses have developed to endure when they are depleted and acknowledging how these behaviors can harm instead of help.

“Pay more attention in your downtime for more personally renewing activities,” Quinlan advises. “Resist the urge to give too much free time to friends, neighbors or family members if a little ‘me-time’ is needed.”

Building Resilience

Learning how to say “no” to others and “yes” to yourself can be a challenge for nurses who have spent a lifetime putting others first. That’s why Quinlan recommends nurses build personal time into their daily life and monthly calendar of appointments to renew mind, body and spirit in order to maintain a resilient attitude in professional and personal life. Here are her top five “me-time” activities to put on the schedule.

1. Sleep

Caregivers need more sleep than others to process the emotional strains of their day and give their bodies time to physically renew from expended energy. Make a commitment to get a set amount of sleep every day and shift activities that could jeopardize this rest and recovery.

2. Massage

This is as important as getting your flu vaccine and it should be something you make time for monthly. If you get your nails done, pay a little extra to get a 10-minute massage, even just a few minutes of massage is powerfully renewing for the body.

3. Nutrition

Make the healthy food choices you advocate for your patients to make. Look carefully at the way you nourish your body and look for ways to up the nutritional value to keep you from feeling run down, especially with sugars and carbohydrates that can leave you crashing when you need to be at your best for your patients.

4. Attire

Think about how you “tool-up” for the day. Make sure you are mindful of supporting your physical well-being for the demands of your job. If you are on your feet for long periods of time, find supportive stockings for circulation and footwear to support posture. Consider wearing a supportive belt to reduce the risk of secondary injury if you lift or position patients on a regular basis. Think about ergonomics and proper lifting techniques, but also be proactive about reducing the risk of injury before there is a chance for it to occur.

5. Attitude

Recognize the power of a positive attitude in which you are aware of the good things to be grateful for on a daily basis because this can help keep you renewed and maintain an even perspective. Maybe it’s sunny outside and you take a few minutes to soak it up; maybe your favorite co-worker is on your shift today; maybe you got a great parking spot. Positivity can be hard to maintain when you are tired and powering through in endurance mode. When this happens you are not in a state of resilience and you can feel like the world is coming down on you.

6. Emotional Intelligence

Take time to build your knowledge and skills for areas within nursing practice such as emotional intelligence that also support you in your individual growth and well-being. Reading up on strategies and tools for emotional intelligence should be part of developing professional nursing practice, as it’s beneficial in nursing interactions with patients, families, and co-workers.

Start Small

“You can start small with making time in the day for yourself—perhaps you take 10 minutes to read a book or listen to soothing music through your headphones while on break,” Quinlan suggests. “Make a plan at the beginning of each day to schedule at least one activity that is only for you.”

She says nurses may be resistant to make time for themselves. “It can begin with one simple change in thinking, in recognizing a habitual behavior that no longer serves you, in being disciplined to complete one renewing activity per day for only you—the self satisfaction and joy you will feel on the other side is immeasurable.