#certain things within the elderly and disabled care system

[briarandhissecretgarden]

Notes abt Piglin Culture

Hello!! Back again with another post about Piglins and their culture!! These are all headcanons of course and while some are based off the lore in-game, some are def based off my own ideas!!

I do wanna say Piglin culture is something I like to insert my own culture into, so be aware some things might be influenced by Aztecan and Mexican culture as well as Salvadorian. Usually these won't be too impactful, but I am speaking from my own experiences. I also want to state we'll be delving into a bit of lore from Minecraft Legends!! And happy holidays and merry christmas to my fellas out there! I'll try to post more soon, I have a theory/headcanon on Drowned I wanna show off here!!

this is a long post so yeah :0)

Firstly,

I wanted to touch one some small notes about the jobs Piglin culture has, as well as what they do for their community. I'm certain it's very clear their people are attached very heavily to each other, all raising children together, fighting, harvesting, protecting and living as one unit. I think Bastions represent a lot of different needs their people used to have in the days of old, namely the time of Minecraft Legends. The 4 Piglin leaders put into place their values into the Bastion structures. The Unbreakable implemented the Bastion system in the first place!! They were the one who first had the idea of Treasure Bastions, as a way to keep their history and treasures secure no matter what would happen. The Devourer designed the Housing Units, The Beast created the Hoglin Stables, and lastly, The Great Hog developed the Bridge Units. With these different units, different Piglins are required to choose a job and serve their community once they reach the age of 20. These jobs are Protectors, Nether-Roaming, and Bastion Dwellers.

Bastion-Dwelling piglins are ones that work preparing food, creating bricks for repairs, making beds and linen from stem trees, and creating music and clothes. They also take care of the elderly and children, usually are very social and polite. This job is usually for Piglins who aren't able to fight/don't know how, have disabilities that might make constant movement difficult, have children, or are generally more interested in this kind of work. It is slightly lighter work,though it is constant and takes a lot of effort to complete. (this is what Briar worked as due to his overgrown tail and ears as well as his physical hypo sensitivity due to his autism, also hes good with medicine lol)

Nether-Roaming works as scavengers, collecting bones, quartz, gold, blackstone and netherrack. As well as raiding any older chests around Ruined Portals and abandoned Bastions/Fortresses. Next are hunters who will kill magma cubes for medicines and potions as well as hoglins for meat and hides. Another job is Messagers. They will also communicate between Bastions, sending messages and pushing to form alliances.

Lastly are Protectors! Protectors are trained from a very young age (15 or so) to be ready for this kind of work. Protectors train in combat and mental fortitude especially. They are given a strict amount of rules to live by and support, are taught to not fear zombification and zombies. Protectors are needed to protect and secure any and all treasures inside of Bastions as well as all the Piglins who live inside of it!!

Another thing i wanted to mention briefly is the importance of gold and how its used to show a kinship within their culture.

Piglins usually have at least 2-4 different piercings on their body. Most keep to 2 piercings though. The most common are nose and ear piercings, as they're the easiest to care for. But!! It is normal to have them in a variety of other places and to have multiple in the same place!! (Dagger has two gauges in both ears.) Tail, nipple, belly button, eyebrows, lip and a variety of eyebrow n mouth related piercings.

Piercings are done by heating a quartz rod and poking it into the cartilage around where the piercing is meant to be placed. after the incision is done, a golden hoop, clip or small stud is placed within it. It is left to heal and is cleaned consistently with a mixture of water and magma cream. The piercing is always entirely golden and is always kept for the rest of their lives.

One piercing is done when the piglet is born, and another when they are an adult (20). The more piercings a Piglin has, the more revered and attractive they are seen as!! In general though, height, strength and overall size are attractive traits among piglins, as well as curlier/patterned hair/fur! (yes this means canonically Dagger is attractive but i think it's funnier that Briar is very much unattractive)

I also want to say i believe Piglins have a dormant winter gene in their DNA, back when their ancestors lived in a frozen tundra or the prehistoric Nether. (yes this is an idea presented by MatPat, but also its common sense with irl geography and history) This gene only comes up with Piglins who have moved to the Overworld.

Lastly, I will talk about how Piglins are perceived in the Overworld. The legend presented in Minecraft Legends is very much what V/Illager folk believe about the Piglin race. Brutish, disgusting, unappealing and violent. They usually look down on them and have no intentions of going to the Nether to actually see if these things are true. V/Illagers despise Piglins usually, though some don't see them as a threat as these prejudices spawn from old stories. Even so, the disdain is seen in how Villagers have their Iron Golems attack Piglins on sight. In the current story, most V/Illagers care not for Piglins, though some are of course hesitant around them. Unfortunately, this isn't much better as there are some V/Illagers who only like Dagger n Briar n such bc they see them as 'exotic', 'feisty' and 'cutesy' so :/ but its just part of being in a new place where people misinterpret you and your culture

en ee ways im going to bed now goodnight happy holidays folks byeeee

#sorry for piglin racism mention lol #minecraft theory #minecraft #minecraft oc #minecraft oc ask blog #minecraft ask blog #minecraft piglin #mineblr #theory #minecraft lore

[mfenvs3000f23]

Bustling Bugs and Productivity Praising

(continued)

I think knowing that there are teeny tiny insects who have mastered a skill considered to be a “human” skill, such as agriculture, causes people to reflect.

Clearly, other species are capable of using practices that we use. What makes humans so dominant? What makes us think and act as though we are above all other species? Multiple animals much smaller than us figured out the agricultural system way before we did, and that has to count for something. Do we measure worthiness through productivity? This is a flaw in our own society, we often do measure people’s worthiness by their contributions and ability to work. We sometimes speak a certain way (denoting lesser worth or importance) about certain demographics such as people who don’t choose to work a 9-5, the elderly, people who are unable to have a steady/traditional job etc. Shouldn’t being human mean being worthy? So what about other life forms? I think sometimes in order for people to care about something, it has to be humanized in some way. In western society, we have a self-centered approach to existing on the Earth. In my opinion, I think our need to recognize something as “human” before we deem it worthy is a flaw of ours. Ants and beetles are not as charismatic as let’s say bears or deer. If this information about insect agriculture is new to you, do you find yourself caring more about them now that you know of these abilities they have? Maybe that is a stretch, but I think the underlying theme is important. We are quick to judge species’ relevance by seeing how they measure up to us humans, when I think we should be seeing species in their own light.

You might be thinking, okay I was reading some interesting stuff about bugs and then it turned into a lesson on human ethics and now I’m not really following. That would be understandable because when you hear “insect agriculture” your mind probably doesn’t jump to “the elderly/the unemployed/the disabled/the sick/etc/etc/etc should be seen as worthy as the CEO”.

I think it is important to find lessons within nature where we can. I was very much in awe when I first learned about insect agriculture, and I thought my reaction could say something about the way we treat not only animals and plants, but eachother as people. Sometimes the way we reflect on nature can tell us what kind of things we need to be changing in our society. To me, the way I felt more connected to these agricultural insect species reminded me of how we need to move away from using productivity to measure people’s value.

I hope it makes sense, let me know your thoughts!

[nemaeldercare12]

The Top Things To Consider When Choosing An Old Age Home

When looking to choose an old age home, it is important to consider a variety of factors. Here are the top 10 things to consider:

1. Location

It is important to choose an old age home that is located in a safe and accessible location. This will help ensure that you have easy access to all the resources and services that the home has to offer.

2. Accessibility

It is also important to make sure that the old age home is accessible for those with disabilities. If you need assistance in accessing certain areas of the home, be sure to discuss this with the care provider beforehand.

3. Health and Medical Facilities

If you are elderly or have any medical conditions, it is important to make sure that the old age home has adequate health and medical facilities available. This includes both general health care needs, as well as specialized care related to your specific condition or needs.

4. Cost

One of the most important factors when choosing an old age home is cost; it is essential not to overspend on this decision. It is also important to be aware of hidden costs, such as long-term insurance premiums or monthly fees associated with living at the home. Keep these costs in mind before making a final decision about where to live!

5. Support Systems

It is also necessary for older adults to have support systems in place when they move into an old age home - these can include family members who can provide emotional support, as well as friends who can provide socialization opportunities and assistance with day-to-day tasks.

6. Activities and Socialization Opportunities

7. Rehabilitation Services

8. Level of Care

9. Safety

10. Reputation

When choosing an old age home, it’s essential that you take into account both its reputation (positive or negative) among other residents currently residing there – this will give you a good idea of how likely it would be for you personally feel safe and comfortable within its walls.

To know more information about  elder care gurgaon

#elder care gurgaon #senior living gurgaon #senior citizen home in gurgaon

[juuls]

Yeah, maybe don't try falling out of bed in the middle of the night and then sleeping there (believe you me, it was not my idea) for hours and hours, apparently, based on what my body is telling me. It is also telling me it hurts like a motherfucking bitch because a) Spoonie here, I can just tell when my body can handle something and this--- it cannot; and b) that carpet is literally older than I am and I'm 31 and it is as hard as a rock and I would actually prefer if the floor was lava!!!!

Because I would no longer be around to suffer this, thank god. I mean, I don't think you have any idea how much this hurts and next time you complain about your parent or grandparent falling out of their bed AGAIN with a roll of your eyes, think of me. Think of me shoving you into a volcano.

So, for my next trick, my whimpering self is going to try and take my whimpering dogs outside (they're so sweet; they were the ones who finally found me and licked my hand until I woke up), try not to fall down two sets of stairs---been there, done that, now remember again: I will hunt you down if you bitch about your elderly loved one falling again---and then put myself into bed.

This message is not for those who actually care about their elderly and spoonies (chronic illness/pain sufferers who often need some form of assistance---then often can't get govt help so now their families suffer too). This message is for the jackasses but also for those who are very tired and burned out from helping granny get back in bed again, too often ignoring the aches and pains, let alone the newly developing bruises that can actually be life-threatening.

So just remember: ....the floor is fucking lava and I am coming for you.

After I feel better. *rolls eyes at self*

#spoonie #chronic illness #chronic pain #falling out of bed #falling down #falling down stairs #floor is lava #respect your elders #respect those in pain #don't be a jerk #it fucking hurts #fuck #fucking fuckity fuck FUCK #social services #social welfare #disability assistance #all of it needs more funding not cuts #and i'm talking about Canada here - not just the U.S. which is both worse and better than us at certain things #certain things within the elderly and disabled care system #everything else is just a joke with a $2000 price tag #and someone trying not to crack uo #........................................................................................................................................... #oh look now i fell asleep in my pc chair #time to go to bed for real byeeee

[desempleopandemico-blog]

Interesting features of Affordable Health Insurance Plans

PUA

When consumers search for affordable medical health insurance, they have price in their head as the top priority. A general conceiving among the consumers is that affordable health plans should not be costly-the cheapest health plan in the market is their target. But this approach is not good. Often, paying for a cheap health insurance strategy but still not getting the required a higher level coverage results only within wastage of money.

PUA

With the execution of the affordable care work, the reach of reasonably priced health plans is set to enhance. Or at least, this is what is regarded as the objective of healthcare reforms. Still lots of consumers are still inside confusion about how things works. In this article, we will discuss a number of detailed options that shoppers can try while looking to acquire affordable health plans.

To have a hand on affordable medical insurance plans, consumers need to take involving certain things. First one of them is about knowing the options from the particular state of the property. There are lots of state and national government-run programs that could be suited to consumers. Knowing the options is definitely important. Next would be to be familiar with terms and conditions of all the programs along with check the eligibility criteria per one of them. Further, consumers should be aware their rights after the rendering of healthcare reforms, the other within a few days, they may be eligible for a particular program or may be allowed to avail a particular health care insurance plan. If consumers manage these steps, there is no good reason that consumers can't land on a cost-effective health plan that could serve the medical care needs.

Let's take a discuss some options linked to affordable health insurance plans state-wise:

State-run affordable health insurance courses in California

While taking into consideration California, there are three very affordable health insurance plans that are manage by the state government. Consumers could surely get benefitted through these if they are eligible for the huge benefits.

• Major Risk Medical care insurance Program (MRMIP)

This program certainly a handy one offering restricted health benefits to California locals. If consumers are unable to order health plans due to a current medical condition, they can see if that they qualify for this program and get positive aspects.

• Healthy Families System

Healthy Families Program presents Californians with low cost wellness, dental, and vision protection. This is mainly geared to young children whose parents earn excessive to qualify for public aid. This program is administered simply by MRMIP.

• Access with regard to Infants and Mothers Plan (AIM)

Access for Newborns and Mothers Program supplies prenatal and preventive look after pregnant women having low earnings in California. It is applied by a five-person board containing established a comprehensive benefits deal that includes both inpatient in addition to outpatient care for program enrollees.

Some facts about affordable health coverage in Florida

While discussing affordable health insurance options throughout Florida, consumers can take into consideration below mentioned options:

• Floridians who lost employer's group health insurance may are entitled to COBRA continuation coverage with Florida. At the same time, Floridians, who have lost group health insurance caused by involuntary termination of job occurring between September one particular, 2008 and December thirty-one, 2009 may qualify for analysis tax credit. This credit score helps in paying COBRA or maybe state continuation coverage payments for up to nine months.

• Floridians who had been uninsured regarding 6 months may be eligible to obtain a limited health benefit program through Cover Florida.

• Florida Medicaid program could be tried by Floridians obtaining low or modest family income. Through this program, expectant mothers, families with children, clinically needy, elderly, and handicapped individuals may get help.

• Florida KidCare program can assist the Floridian children underneath the age of 19 years and not necessarily eligible for Medicaid and at present uninsured or underinsured.

• A federal tax credit to help you pay for new health coverage for you to Floridians who lost their very own health coverage but are receiving advantages from the Trade Adjustment Aid (TAA) Program. This credit rating is called the Health Coverage Taxation Credit (HCTC). At the same time, Floridians who are retirees and are long-standing 55-65 and are receiving retirement benefits from Pension Benefit Ensure Corporation (PBGC), may are eligible for the HCTC.

Some info about affordable health insurance in Florida

While talking about affordable medical health insurance options in Virginia, individuals need to consider their protection under the law:

• Virginians who missing their employer's group medical insurance may apply for COBRA as well as state continuation coverage within Virginia.

• Virginians have to note that they have the right to get individual health plans via either Anthem Blue Get across Blue Shield or CareFirst Blue Cross Blue Face shield.

• Virginia Medicaid software helps Virginians having very low or modest household revenue may qualify for free or even subsidized health coverage. Through this method, pregnant women, families with little ones, and elderly and impaired individuals are helped.

• Household Access to Medical Insurance Security (FAMIS) helps Virginian children beneath the age of 18 years acquiring no health insurance.

• Throughout Virginia, the Every Lady's Life Program offers totally free breast and cervical cancers screening. Through this program, in the event that women are diagnosed with cancer tumor, they may be eligible for treatment throughout the Virginia Medicaid Program.

A number of facts about affordable health insurance inside Texas

While talking about inexpensive health insurance options in The state of texas, consumers need to consider all their rights:

• Texans diagnosed with group insurance in Mississippi cannot be denied or minimal in terms of coverage, nor may be required to pay more, because of the health and fitness status. Further, Texans getting group health insurance can't get exclusion of pre-existing situations.

• In Texas, insurance firms cannot drop Texans off of coverage when they get sick. Simultaneously, Texans who lost their own group health insurance but are HIPAA eligible may apply for COBRA or state continuation insurance coverage in Texas.

• Tx Medicaid program helps Texans having low or small household income may acquire free or subsidized coverage of health. Through this program, pregnant women, young families with children, elderly as well as disabled individuals are helped. As well, if a woman is diagnosed with chest or cervical cancer, this lady may be eligible for medical care by way of Medicaid.

• The Colorado Children's Health Insurance Program (CHIP) offers subsidized health coverage certainly uninsured children. Further kids in Texas can time in their parent's health insurance insurance policy as dependents till age 26 years. This term has been implemented by the medical care reforms.

• The The state of texas Breast and Cervical Cancers Control program offers free of charge cancer screening for certified residents. If a woman is afflicted with breast or cervical malignancy through this program, she may well qualify for medical care through Medicaid.

Like this, consumers need to look at state-wise options when they seek out affordable health coverage. It goes without saying in which shopping around and getting oneself well-equipped with necessary information can be quite much important to make sure customers have the right kind of health ideas.

[rgr-pop]

i have been thinking about what you said about that person you knew who is now a social worker... you said something offhand like "people who go into social work are terrible" / "social workers are terrible," i can't remember the exact phrase. but i've been thinking about getting a degree in social work to become a LSW, and i wanted to know more of your thoughts about social work and why going into it is a bad decision? or what is flawed about social work as a whole?

I didn’t say no one should go into it! I don’t think…I’m assuming…  I’m not gonna look up what I actually said, lol. (although: low pay, burnout, student loans, etc.) u.s.-centric response follows.

people (like myself) who have been at the mercy of social workers and other kinds of state bureaucrats etc. (sometimes doctors, mileage varies) (other public servants like teachers, librarians) often hate them because of an entanglement of the following problems:a) social workers are the face (the interface) of a system that is fundamentally designed to restrict access to survival needs. here I am imagining a disability caseworker: we only have disability caseworkers because we have a system in which very few people are permitted benefits for, ex., disability. disability caseworkers exist to tell some people “no.” people whose lives are at the mercy of disability caseworkers frequently hate their disability caseworker even if that caseworker is very nice and has done everything they can, because we’ve all heard “no” enough times, and because you can’t say “yes” to everyone. one function of these state social workers is as kind of a social buffer, absorbing discontent of underclasses. that’s why you gotta be a social worker and not just any old bureaucrat!!

b) when you are a social worker in any field, every single client you encounter will have likely already interfaced with social workers who they perceived to be incompetent, ineffectual, or uncaring (see above), or who were abusive. I can only think of one or two out of many many social workers I’ve interfaced with as a client who were not one of these things.

b.1) social workers are often some kind of abusive to poor people, children, disabled people, the elderly, etc. because most of the structures that employ/deploy social workers are fundamentally abusive institutions (carceral institutions and incarcerating mental health institutions, to some extent public schools) that explicitly mobilize a power imbalance between social worker and client where the former is empowered (symbolically or in real ways) to restrict a client’s access to survival needs, wants, freedom, health, money, everything (see above). this is already a fundamentally exploitative relationship within fundamentally violent institutions, but it also frequently sanctions interpersonal abuse by social workers. I refer to abuse intentionally broadly here: I know many stories of people being sexually harassed or assaulted by their social worker or caseworker, I’ve heard many stories of people being physically abused, and everyone I know who has been in the systems over and over again has experienced “microaggressions” with high stakes at the hands of social workers. there is rarely recourse, and because the role of the “social worker” in our lives is one controlling access to resources (or else interfacing with us when we are in an institution against our will), we can’t exactly opt out of the relationship. it’s fundamentally non-consensual, and that’s an environment that breeds abuse.

b.2) I would imagine most abusive (racist, bigoted, uncaring) social workers did not become social workers to inflict harm on vulnerable people or restrict access for them, I mean, optimistically, that wouldn’t make sense. but the thing is that a lot of social workers become that way, and one of the reasons, I think, is because the institutions I’ve described are also designed to create a working class of bureaucrats who have power over more vulnerable people. and that’s just…what happens. as a non-social worker myself, I can really tell you a lot of ways I’ve seen this play out with teachers and librarians, other kinds of public servants who “serve” the poor.

b.3) but more importantly, of course, the public services are designed to make it basically impossible for social workers to do…social work. to help people. chiefly they do this through, uh, being a bureaucracy not actually designed to give anyone anything lol rip welfare state, but along with that, of course, the people with the crucial “caring” jobs and the hardest paperwork jobs (social workers, both) are not paid enough, are not given enough resources, and have to endure certain kinds of vicarious traumas and sometimes violence in these fundamentally violent institutions. so very few social workers can really do their job (see a) and many of them experience a kind of embittering burnout that makes them inclined to become something on a spectrum from uncaring to abusive (see above). and that’s just that!

and in the end, it doesn’t matter if you’re doing a good job or not, because you’re probably going to be working for an institution that’s doing a bad job, lbr (there are other kinds of social work outside of these things! can’t think of any just now…). and the fact is that none of your clients will like or trust you. none! never. you will never have a grateful client! which is fine! let us be! but many social workers I’ve encountered are made especially mad that the grateful, desperate underclass they imagined never materialized, and it makes them bitter and hard (see above).

[sotatekglobal]

UX DESIGN: WHY IS IT IMPORTANT IN HEALTHCARE SOFTWARE DEVELOPMENT?

The more industries rely on Mobile Applications and Software Platforms, the more essential user experience (UX) design will be in any given practice. Healthcare industry, where tech tools are empowering all kinds of new solutions right now, is not the exception. Not only is it beneficial to the doctors but it improves the patient’s experiences as well. Anyone involved in any stage during a healthcare cycle can benefit from UX. Now, let’s dig deep into UX design in Healthcare Software Development.

1. What Is UX Design In Healthcare?

Healthcare UX, which stands for Healthcare User Experience, is a broad term to illustrate the overall experience a user has when interacting with healthcare technologies and systems, such as Electronic Hospital Records and mobile health apps. The users mentioned can be varied, be it professionals with clinical experience, patients or even the general public. To get insights into their experiences, UX relates to how consumers interact with the application, how difficult it is to acknowledge its functionality or how it can cater to their needs.

Three criteria, including Usability, Enjoyability and Accessibility, need to be taken into consideration when describing a good healthcare UX in software development. Usability reflects the goals users can achieve when using your product while enjoyability determines whether they are satisfied with your products or not. Lastly, accessibility is about the ability to consume a product or service despite a disability, be it real (blindness) or perceived (being elderly).

2. How Is Healthcare UX Design Beneficial To Physicians?

Most hospitals all over the world have become increasingly digitized, with over 90% of medical institutions having their health information computerized within the past decade, a move that is meant to help doctors work more effectively and efficiently. However, such a newly implemented system of electronic medical records turned out to do the opposite things. This was mainly because of the poor information systems, many of which were outdated, complex, and inefficient. Moreover, it is no exaggeration to say that the software in healthcare can affect doctors’ decisions, hence patients’ health, and even cost lives in certain cases. Research in the US shows that medical errors are one of the leading justifications of deaths globally. To be more specific, more than 250,000 people in the US die due to medical errors every year. In such circumstances, a good healthcare UX design becomes more significant than ever before, which not only saves the physicians time but also delivers more accurate results to patients.

Firstly, clinicians have to take care of a huge number of patients, thus completing work means that they need to deal with a large amount of information including patients’ medical records, test results, lab results, just to name a few. Having better UX design in software development would ensure that such information can be in better format with sound visual hierarchy and informatics principles, which helps significantly with smoothing the tasks. With this organized data, doctors can easily read the results and diagnose better, followed by better treatment for each patient. Compared to the past when they were snowed under with papers and can get misleading figures, confusing data and even mistaken medical records, UX design has come in handy for reducing any misunderstanding that may occur during the healthcare cycle.

Furthermore, physicians simply do not have enough time to sift through mountains of data, randomized controlled clinical trials or spend an afternoon on the phone with colleagues for every single patient. With the aforementioned sorted data thanks to UX Medical Database Software, doctors can now easily get consultation from others without having to explain in detail the medical background and conditions of the patients. Colleagues can access the resources through the UX interface, and all the information needed will be available at any point.

3. What Can A Good Healthcare UX Design Do For Patients?

Health is always a top priority for many people. However, in the hustle and bustle of life, people tend to get caught up in work to make ends meet so they have little time left to go to hospital and have a periodical check-up. This has led to the increasing number of people turning to healthcare applications as a great alternative. To provide the best services to patients, the UX becomes the must-have factor in Healthcare App Design, especially in helping improvise the usability and efficiency of the design systems. A proper healthcare UX design can contribute to creating better services for patients and making their healthcare journey less daunting.

a. Easy Communication

All industries have a number of jargons and healthcare is not the exception. Imagining that the patient is diagnosed with a result full of medical jargon, how can they be satisfied with the service? In contrast, they are seemingly confused and stressed when reading them. Therefore, a good healthcare UX design which can deliver information to customers in a clear way is the first factor that needs to be taken into consideration. Some suggested methods are making use of visuals, diagrams, just to name a few, to illustrate the patients’ diseases. Besides, after listing all of the diagnoses, healthcare applications should rank the level of risk so that patients can somehow evaluate their diseases by themselves, then decide whether they need to make an appointment with doctors or not.

b. Personalizing Healthcare Delivery

It is not seemingly strange for us to search for our symptoms on Google, for example, “Diseases related to headache” or “Why do I have a headache all morning?”. However, such practice often comes with confusion and worry because Google tends to exaggerate the symptoms. To combat the dangers of self-diagnosis, a number of healthcare apps have existed to provide better care and more informative resources for their users.

In the past, Healthcare Applications just simply took the information they already offered on the website and delivered it via mobile. However, thanks to AI and machine learning, healthcare providers now can track access to patient data and easily find out their diseases. Some accessible data often ranges from patients’ medical history to health metrics, such as steps of walking, heart rate,… This transformation not only makes apps more effective but it also serves to provide better care. Everyone’s healthcare needs are unique, so it is significant to improve the personalization of care delivery to cater to the patients’ needs.

c. Protecting Patients’ Information

As other industries, working in the medical area requires strict regulations involving the severity and sensitivity of the information. Therefore, strict compliance with regulations such as HIPAA, or the Canadian equivalent PIPEDA, is a must-have consideration in healthcare app design. Such regulations would govern the customers’ information, how that data is attained, used and stored. Everything has to be made with the consent of customers.

To accomplish this, relying on familiar user journeys can be a good choice. Instead of introducing entirely new experiences, improving the existing UX design is likely to ensure that the app is still instinctive for the user.

4. Final Thoughts

To sum up, UX Design in Healthcare industry calls for innovation and creativity in the experience delivery while always adhering to guidelines to keep a user’s information safe. This creativity comes in the form of being able to communicate the same message, in an accessible way, using simple workflows and adhering to regulations through UX design.  This can be done through reducing distractions within the software, minimizing supply chains/processes and establishing connections with the users.

If you ever wonder “How to get started with mobile app development with good healthcare UX design?” or “Which is the best Medical Software Provider?”, simply leave us a message. We have R&D in healthcare industry and strong UX desgin, which can cater to all customers’ needs. With 10+ years of experiences and hundreds of successful global projects, our SotaTek team is confident to provide you with various Web & Mobile App Development Services, especially Healthcare Software Development Service.

#Healthcare Software Development #custom software development #web app development #sotatek healthcare app

[mansoorahmed-stuff]

What is Internet of Things (IoT)?

What is Internet of Things (IoT)?

The internet of Things, or IoT, refers to the billions of physical devices around the world that are now connected to the online , collecting, sharing and analyses of data . It describes the network of physical objects that are embedded with sensors, software, and other technologies for the aim of connecting and exchanging data with other devices and systems over the online.

Because of cheap processors and wireless networks, it's possible to point out anything, from a pill to an aero plane to a self-driving car into a neighborhood of the IoT.

Overview

IoT will control the Fourth industrial revolution.

The Fourth industrial revolution is changing the very software-defined automation allows manufacturers to link all stages of the price chain, rapidly adapt to changing markets, and make highly personalized products on a mass scale.

The opportunities presented by this revolution are incredible. According to McKinsey, the economic impact of smart factories could reach up to $2.3 trillion once a year by 2025.

At the center of the Fourth industrial revolution is that the Internet of Things (IoT), which uses digital technology to connect sensors, actuators, and machines to each other and to factory workers.

Definition

The web of Things is that the network of physical devices that combine IP connectivity with software, sensors, actuators, and other electronics to directly integrate the physical world into our computer-based systems, resulting in efficiency improvements and economic benefits.

Simpler Definition:

the web of Things could also be a network of Internet connected devices that communicate embedded sensor data to the cloud for centralized processing.

Applications

The extensive set of applications for IoT device is typically divided into consumer, commercial, industrial, and infrastructure spaces.

Consumer applications

A growing portion of IoT devices are created for consumer use, including connected vehicles, home automation, wearable technology, connected health, and appliances with remote monitoring capabilities.

Smart home

IoT devices are an area of the larger concept of home automation, which can include lighting, heating and air conditioning , media and security systems and camera systems.

Long-term benefits could include energy savings by automatically ensuring lights and electronics are turned off or by making the residents within the home aware of usage.

Smart Planet (Green environment)

Environmental sensors.

Water power leak detection

Pollution, weather monitoring

Smart cities (Connected communities)

Lighting, water management

Monitoring and security

control

Smart Energy (Electric grid)

Voltage and power sensors

Meters and breakers

Fault detection

Smart Transport

Electric mobility

EVs and HEVs

High speed trains

Infrastructure ,V21, V2v,V21+1

Smart Industry (Industrial environment)

Lightening, security, actuators, production control, Robotics

Elder care

One key application of a wise house is to provide assistance for those with disabilities and elderly individuals. These home systems use assistive technology to accommodate an owner's specific disabilities.

Voice control can assist users with sight and mobility limitations while alert systems are often connected on to cochlear implants worn by hearing-impaired users.

They can also be equipped with additional safety features. These features can include sensors that monitor for medical emergencies like falls or seizures. Smart home technology applied during this way can provide users with more freedom and a far better quality of life.

The term "Enterprise IoT" refers to devices utilized in business and company settings. By 2019, it's estimated that the EIoT will account for 9.1 billion devices

The Current and Future Impact of IoT

The IEEE has compiled data and makes the next claims about its current and future impact:

In 2015, the worldwide wearables market had already increased 223% from the previous year (and data on Statista shows it increasing by another 243% between 2015 and 2022)

By 2020, 250 million vehicles are getting to be connected to the online

IoT will add 15 trillion dollars to the worldwide economy over subsequent 20 years

There are getting to be 50 billion Internet-connected devices by the year 2020.

Benefits of IoT

The interconnection of these multiple embedded devices are getting to be resulting in automation in nearly all fields and also enabling advanced applications. this is often often resulting in improved accuracy, efficiency and economic benefit with reduced human intervention. the most benefits of IoT are:

Improved Customer Engagement

Technical Optimization

Reduced Wastage

Integrate and Adapt Business Model

Better Business Decision

IoT Enabling Factors

Miniaturization

Connectivity

Advanced power sources and power management

Inexpensive processors, sensors, and actuators

Cloud-based processing

Ubiquitous computing

Challenges to IoT

Security, Privacy and compliance.

Market fragmentation

Legacy infrastructure

LAWN/WAN Connectivity

Underutilized data

Interoperability and Standards

IoT Devices vs Computers

IoT Device features a main function break free Computation

Cars drive, Phone make calls, TVs displays shows

Computation could also be a means to an end

Computers main function is to compute, they're general purpose machines

IoT Devices are Special Purpose Devices, software and hardware are efficient for the task - but inefficient for other tasks

Technological Trends that cause IoT

Cost of hardware has decreased allowing to be added to devices

Smaller size and lesser weight needed to incorporate computation into devices

Computation ability has increased tremendously

Internet is out there everywhere

Wireless Access (4G, Wi-Fi) has become cheap and ubiquitous, 5G on the way (No physical cables required)

Data transmission cost is fairly low, internet bandwidth is high

Cloud computing is getting used extensively (IoT devices are a window to those cloud services)

Rise of Open Source Software (Rust, Web Assembly, Docker, Kubernetes, etc.)

Environmental sustainability impact

A priority regarding Internet-of-things technologies pertains to the environmental impacts of the manufacture, use, and eventual disposal of of those semiconductor-rich devices.

Modern electronics are replete with an honest sort of heavy metals and rare-earth metals, also as highly toxic synthetic chemicals.

This makes them extremely difficult to properly recycle. Electronic components are often incinerated or placed in regular landfills.

Furthermore, the human and environmental cost of mining the rare-earth metals that are integral to modern electronic components continues to grow.

Although IoT devices can help in some cases to reduce the energy consumption of certain applications, the impact of getting billions of devices connected and consuming power from batteries and from the grid will have a huge impact on energy consumption and CO2 emissions.

#iot #cyber security

[paladinsheadcanons]

paladins college au?

*puts on sunglasses* LET’S DO THIS. Also, @mal-dambra. -Mod Inara (by the way, I don’t actually know how colleges work exactly and had to google a lot of this stuff, so some info might be inaccurate)

Makoa: The old professor teaching Marine Biology. He owns a massive saltwater aquarium at home. He often takes his students to the local Marine Life Rescue Organization, where a green turtle he personally rescued years ago currently lives. Makoa is well-known as one of the wisest and most knowledgable professors on campus, and most of his students don’t have a problem seeking him for advice for their studies. All the students do need to know one special rule though, Don’t ever challenge Professor Makoa when he’s angry.

Fernando: A former Fine Arts student himself, Fernando now works as an artist’s model at his former university. He doesn’t mind holding some really extravagant poses for long periods of time, and he loves chatting with the artists (when they feel comfortable with it). He sometimes flirts with his fellow artist models for fun. He cosplays during his free time, and he makes all his own armor and props. Also takes up salsa dancing.

Ruckus: Real name Russel. Dropped out of a geology major to get into Robotic Engineering. He’s a really eccentric person, and honestly a huge Sci-Fi geek. His dormmate and partner for the majority of his projects is a reserved dude named Bart. They nicknamed each other Ruckus and Bolt respectively, Ruckus due to his tendency to be loud-mouthed, and Bolt with his immense interests in electrical systems. They argue a lot, but are surprisingly close friends.

Barik: Head of the Engineering department, and a professor specifically for the Mechanical Engineering branch. His personal inventions and projects are often made to help those with disabilities and such, his motivation being his own struggles as a little person. Absolutely no one can deny his genius when it comes to how the stuff works, and he’s won a few awards for it but wants to continue teaching so that hopefully, he would be able to directly encourage more people to do the same with their inventions. He’s rather brash and really direct with both his praise and critiques, but is overall a pretty fun person to be around.

Ash: A Sports Management student, she takes every aspect of her studies very seriously. She’s pretty popular and known to be a strong leader figure in general. She’s also the president of the university’s rugby (For Americans: football) team, which is somewhat ironic to those who know her personally, as she’s someone who likes her personal space, a lot. She’s not huge on social events, but does enjoy the vacation/celebration parties her friends and teammates like to organize, provided they aren’t too wild. There’s a rumour going around that basically anyone attracted to girls has a crush on her. @Mod Ash :3

Torvald: The elderly head librarian at the university, and everyone affectionately calls him Grandpa Torvald. He is very healthy and energetic for his age, and loves chatting with the students and staff if they need any help finding material for their projects. He has a side interest in inventing things, and hangs out with Barik a lot. He gets extremely excited when one of his own inventions, no matter how “insignificant” it is.

Inara: One of the most well-known professors on campus, Inara teaches in Environmental Studies and always encourages her students to be mindful of nature. She has a few rock gardens at home, and collects stones and fossils as a hobby, with enough knowledge of it to help out students and even fellow professors in the Geology departments. She volunteers at an environmental organization called Mother Earth’s Grace frequently. Occasionally, students come to her to talk about personal troubles, and she would always take the time to listen and try to give them advice.

Drogoz: A Herpetology student struggling with student loans. A lot of people accuse him of being greedy and hoarding his money, but in reality he just wants to save up enough as soon as possible to get out of those college debts. (SAVE HIM.) Is a huge nerd when it comes to anything related to dragons, and in spite of his financial state he has a pet bearded dragon he named Pogoz. He loves the little guy, and would punch anyone who makes fun of his little dragon.

Bomb King: A Chemical Engineering student who simply goes by B.K, he was suspended at least twice for his more…explosive projects during classes. He’s often called a pyromaniac by his peers, but he doesn’t particularly care. He does actually take safety very seriously, so he knows his little experiments won’t actually harm anyone, and in reality most of his professors know this too. It’s just that he tends to cause a lot of disruptions.

Cassie: First year student in a Zoology. She loves animals, especially birds, and keeps her pet Greenwing Macaw, Zigs, in her dorm room (it’s technically not allowed, but Zigs is very well-behaved and her roommate Kinessa doesn’t mind all that much). She’s a rich kid who’s friendly to everyone and loves parties, especially those on the beach. She sometimes adopts a stereotypical valley-girl accent to mess with people as a joke, or when she wants to annoy someone who makes fun of her.

Lian: Another rich kid, but with attitude. Her family has very high expectations of her, and she takes those expectations to heart. She’s aiming for a degree in International Relations and takes her studies very, very seriously. She tends to be bossy and demanding in group projects, which results in her not being very well-liked in her classes. However she’s the president of the debate club as well as vice president of the shooting club (with air rifles mind y’all) and is well-respected for her skills in those departments. She has a reputation to uphold, but her guilty pleasure is watching random Japanese anime, and her favourite characters are often the noble girls with the obnoxious laugh.

Kinessa: Cassie’s roommate and a Business student, but she doesn’t actually give much thought to her studies. Was held back in high school due to a few disciplinary issues, thus about two years older than Cassie despite them both being first years. She has an interest in firearms and is the president of the shooting club. She likes watching movies of military stories, and has at one point considered joining the army herself, but decided against it, mostly due to her uncle, Strix. 

Sha Lin: The resident playboy who doesn’t actually date anyone, and a student majoring in World History. He enjoys learning for the most part, but there are certain classes which put him to sleep. He’s also that person who refuses to sleep early and regrets it the next morning, as he is in no way a morning person. He survives on coffee and energy drinks. He absolutely hates exams with every fibre of his being but does study a lot for them. He’s in the archery club and considered to be one of their best, but has refused the position of leadership. Has plans to travel the world and visit major historical places of interest someday.

Viktor: He’d hoped to attend college in his youth, but was unable to, and ended up in the army forces. Now a retired soldier, he has decided to pursue a degree in Government Studies despite knowing how challenging the whole thing would be, especially as a much older student compared to his peers. However, he plans to take the lessons he learned during his time in the army and apply them to his studies, and has no intention of backing out regardless.

Tyra: A Archaeology student who absolutely loves the outdoors and exploring new places. Part of the reason she decided to pursue such a degree was due to the hopes of one day exploring new places with challenging terrain. She is also a well-trained survivalist, and thoroughly enjoys hiking and camping, especially in mountainous areas. It’s a well-known rumour that she fought a bear and won, which was how she got that bear skin she hung on the wall of her dorm room, but in reality she just bought the fake skin off a random pawn shop one day cuz she thought it was cool. 

Willo: Everyone thinks she’s not supposed to be there cuz she’s too young. She’s actually a child prodigy, and is among the top of her classes. She’s pursuing a degree in Botany and dreams of one day founding a botanical garden and being able to take care of all the flowers growing there. She’s a bit of a prankster, and usually gets away with her pranks by playing the “just a kid” card. This evil prick. 

Evie: Currently putting off going to college for the time being and enjoying some time out of high school. She does visit her local university frequently, mostly for the crazy-good ice cream cafe they had there, but she does wonder if there would be something she’d like to study there. 

Skye: She’s one of the most notable students in Fashion Design, as well as a pretty notorious student on her own. She’s a little older than most of the other studies, as she took a few years off to work before attending college, and she likes flirting with many of the other students and even the staff, provided they were within her own age range. She has some interest in chemistry and botany, and some say that she once used that knowledge to poison someone who did something bad to her. This rumour was actually true, except that the “poison” was actually just terrible coffee and the guy was just being overly-dramatic. 

Androxus: Dropped out of college halfway through his second year, but a few years later returned to work there as a night guard, considering he already knew the place well and knew his way around a fight. He’s very quiet and the other guards are wary of him, but he doesn’t intend to bother them as long as they don’t bother him.

Buck: He’s a yoga instructor in an on-campus fitness centre. He’s a lot louder than most people would expect, but he knows how to be patient with his students and colleagues. He’s a fairly religious Buddhist, and was allowed to set up a small shrine in the studio, which he prays at for prosperity everyday. 

Maeve: Hasn’t started college yet, due to a really bad financial situation and being homeless. She isn’t really sure she even wants to get into college though, as she doesn’t particularly see any fulfilling futures for herself just yet. She hasn’t given up on the idea yet though. 

Zhin: A really notorious problem student, with a small band of delinquents at his side. He doesn’t really do anything particularly serious, but definitely has a severe attitude problem with every one of his professors and many of his classmates. He’s technically a student in International Relations along with Lian, but he hardly shows up to classes. Has been threatened with expulsion several times, but he doesn’t care much. 

Lex: He has dreamed of becoming a police officer as a kid, but eventually decided to pursue a degree in Law and become a court prosecutor, feeling that it would be more fulfilling to do so. He’s a really serious student, and actively tries his best to participate wholeheartedly in every class. He’s a bit of a sci-fi nerd when he isn’t studying, and has a thing for surfing. 

Mal’Damba: That one creepy Medical Science professor with a ton of wild rumours surrounding him, one of the most well-known rumours being him secretly being possessed by some evil demonic spirit. Students staying late in any of the school of medicine’s buildings literally pray they don’t run into him at night. In truth Mal’Damba is just super skinny due to a mild metabolism issue and doesn’t get a lot of sleep thanks to his pet snakes being noisy jerks at night (he won’t move them from his room though, he loves them too much despite everything). He runs on several cups of coffee everyday. Someone save this man.

Pip: An overly-enthusiastic Chemical Engineering student, a year below B.K. He’s easily fascinated with chemical reactions in general and always asks a ton of questions. Some of his professors have literally had to ask him to give them a break from answering his questions. He likes studying a little more than most, and likes to work on pretty much all of his projects as soon as possible. Whenever he has any problems he either seeks out his professors or tries to find them in the library. Luckily for him, Torvald loves excitable students like him. Pip has a little fennec fox plushie he cuddles to sleep, which helps him deal with being away from home. 

Grover: The head caretaker of the campus greenhouse and gardens. He’s a very quiet and gentle person, and is often visited by Inara, Willo, and Grohk. Whenever students have classes while he was caring for the plants, he likes to teach them a few more trivial details about the plants, or maybe tell the students some interesting experiences he has had in the gardens, such as the time he fell asleep under one of the larger trees and was awoken when a chick fell from the tree onto his lap. 

Grohk: A student in Environmental Science, Grohk has a love of nature almost rivalling that of Inara. He loves to visit gardens, and has a particular fondness of thunderstorms. He volunteers at Mother Earth’s Grace along with his professor Inara, though not as often. He sometimes struggles in classes due to a minor speech problem, but other than that he’s pretty happy with his college life so far. That being said, he tends to stress out quite a bit when his projects’ deadlines and exams start coming up.

Seris: She’s the head nurse at the infirmary located in the school of medicine. She’s a very quiet and mysterious person, who pretty much only ever spoke when necessary. Some people are scared of being treated by her as she is visually impaired, but Seris has never made a mistake with her treatments in the infirmary, especially when her assistant Ying is there to help. 

Ying: A recent Medical Science graduate, Ying is currently an intern assistant nurse at the infirmary at her former school. She’s still new, but has a lot of fun helping the patients. She also enjoys working with Seris and has a lot of respect for her. Ying is very outgoing and friendly, and when she’s not working at the infirmary she’s out volunteering at an orphanage. She carries around a small antique mirror everywhere, which she considers to be her lucky charm. 

Jenos: A professor in Astronomy & Space Sciences, he’s kinda that professor that gets on everyone’s nerves due his more arrogant side. He’s good at what he does when he teaches, and is fair with his grading, though he has a bad habit of making dumb comments about his students or colleagues to their faces. He genuinely enjoys his work though, finding joy in thinking about the mysteries of space and the stars. He likes to go stargazing on his own every now and again.

Strix: Kinessa’s uncle, and an old friend of Viktor’s from their shared time in the army. Unlike Viktor, he chose a simpler life after the military, and instead crafts small trinkets to sell. He does visit the college often though, sometimes to visit Viktor, sometimes to check in on Kinessa as he lives closest to the institute within their family. Kinessa and him don’t particularly get along due to a serious disagreement regarding Kinessa’s initial plan to become a soldier at one point. 

#all champions #paladins #paladins champions of the realm #paladins headcanons #long post #college au #i got a little carried away #but it was fun

[vacanpaathy]

BRYONY HAWTREY  

GENERAL INFORMATION

Bryony Enid Hawtrey Nickname: Bri/Bry, Enid, Kitten Age: 19 to 100+ verse dependent  Nationality: English Species: Human Ethnicity: White Sexual Orienation Physical Disorders / Disabilities etc: None currently / None currently known Mental Disorders / Disabilities etc: None currently / None currently known Religion: None, raised Anglican  City of birth: London, England Currently living: Verse dependent Occupation: verse dependent, usually  Income: generally none just a barter / trade system with other magic types Marital Status: single, refuses to mingle Language ( s ): English, French, German, Spanish more probably but with varying skill Dialect: some Received Pronunciation Bullshit Birthday:  November 26 NOTE: Bryony is the Guardian of a magical artifact that is the source of her immortality and some of her more impressive abilities. I intentionally do not give much information about this artifact pretty much anywhere for 2 reasons: 1) Bryony actively withholds as much information about it as she can get away with and never really speaks of it, so not having much info on it to be read means less chances for ooc knowledge accidentally slipping into ic content 2) While I’ve got the basic nature / idea of it nailed down the details / backstory are still pretty vague so there’s no point in getting into it now.  Really what’s useful to know about it is that :         1. It’s the source of her immortality         2. It’s stupid powerful but she can’t tap into it whenever she wants         3. It’s not something ON her person it’s literally INSIDE her and she will only admit to              this in a truly dire situation ( ex. someone is after it, might actually succeed and she                needs her allies to know important info  )         4. It creates forcefields or repels things that could potentially harm her as she is still just          a squishy human, this can in theory be overcome if the attacker is a strong enough                  magic user         5. It allows her to do incredibly powerful magic that can potentially negate standard                laws of magic if the correct conditions are met ( these conditions vary with context )

PHYSICAL CHARACTERISTICS

Height: 5′3″ Eyes: Blue Hair: Dark Brown Skin: Aristocratic Pale  Style: As close as you can get to looking like an Edwardian woman without looking like you stepped out of a BBC drama FAMILY

Mother:   Martha Hawtrey ( nee Price ) Father:    Richard Hawtrey Brother ( s ) :  Bennet ( first ) , Eugene ( second ), Willas ( fourth ), Thomas ( seventh ), Sister ( s ) :   Nora ( third ) , Philomenia ( fifth ) , ( Bryony is 6th in  birth order )

PERSONALITY / HABITS

Addictions: None Bad Habits: brusk, stubborn, bulldozers over other people, very demanding, tends to treat things like a business transaction, talks over people Good Habits: very patient and understanding of complications / troubles, stands up for others even strangers, efficient traveler / packer,  Hobbies: reading, knitting, sewing, hunting through markets, learning about where ever she is at the moment, discovering new restaurants / bakeries / coffeeshops / etc Likes: books, fabrics and clothing, useful trinkets ( usually magical ) , traveling, lengthy discussions and chats, long walks, meeting new people Dislikes: bullies, aristocracy, bigotry, driving, how quiet you have to be in a library, musical theatre Strengths: intelligent, passionate, compassionate, independent, business savvy, highly adaptable, cunning, always eager to learn Weaknesses: petty, self-serving, at times needlessly cruel, belligerent, aloof, unable to settle in one place for too long, bossy Fears: that the magic artifact in her care is forcibly taken from her Hopes: to continue traveling and seeing the world and seeing how it changes over time

ABILITIES / TRAITS / TALENTS

Education: Largely governesses, a few attempts at proper schools which ended thanks to her unruly behavior and essentially an internship at the shop of an old man she befriended Intelligence: 8/10  Overall very smart and ever eager to learn more and educate herself about everything Naturalist: 7/10  Knows a lot about plants, mainly for medicinal or magical use Musical: 8/10 Can play piano, violin and guitar and is a solid singer. has dabbled with various other instruments over the years as well with varying success Logical-mathematical: 9/10 Excellent  Existential: 9/10 the perk of immortality : a lot of time to think about stuff Interpersonal: 8/10 While she tends to shoot herself in the foot with her attitude, bryony is very sensitive to others and very good at at least reading the mood and engaging with others generally  Bodily-kinesthetic: 7/10 enjoys most physical activities and doing / making / solving things manually  Linguistic: 7/10 she's had like 100 years to pick up a few languages and skills for learning them Intra-personal: 7/10 not the most introspective person but has a decent capacity for it and has engaged with it more over the years Spatial: 5/10 about as good as the next guy

MAGIC & PSYCHIC ABILITIES:  Before becoming the Guardian Bryony already had potent psychic abilities and aptitude for magic though her psychic abilities were largely untrained and she’d only started truly practicing magic a few years before. Once she became the Guardian the what magic she could do / how she did it changed wildly, while still able to perform all usual spells that rely on incantations, items, ingredients etc she also became able to do things that are best described as miraculous but only if certain conditions / parameters / prices are met. examples of sub-abilities/applications: Clairvoyance, Minor Clairaudience, Clairsentience, Claircognizance, Divination, Psychometry, Retrocognition ( largely via psychometry ) , Scrying , Automatic Defensive Forcefields ( Guardian Ability only ) , Improved Healing / Durability against Mundane Damage ( Guardian Ability only ) , Magic usually considered impossible / too dangerous for a human ( Guardian Ability only ) AREA OF EXPERTISE: TBA 

MENTAL

Self-perception: Fairly healthy and positive, does a good job of not beating herself up or getting too angsty about the immortality thing though she can also be blind to her own failings or overly defensive about things about herself when she really should be Assumed external perception: A potent world traveler with a strong personality and an untamable woman  Self-Confidence:  incredibly healthy  Rational Or Emotional ? Largely very rational even when she’s getting fired up but once you hit a certain threshold or topic boom instantly 1000000000% emotional.  Introvert or Extrovert ?  Extrovert Prefer to Give or to Take ? Give, she prefers to keep her books largely balanced but also knows it’s better to have others in your debt than you in theirs  Nice or Rude ? Is in actuality a pretty dang nice person but can come off as rather rude and bossy since she’s a very strong personality.

BACKGROUND

TLDR VERSION

      ►  Bryony is born to the upper class Hawtrey family in the Victorian era       ►  It becomes quickly clear that she is a fucking menace and cannot be tamed       ►  Notices in her later childhood she can do weird things / gets hunches and                           occasionally follows up on them       ►  Her relationships within her family become increasingly strained as she continues to            submit to expectations and in fact actively work against them       ►  Around 16 befriends local elderly shopkeeper and effectively interns with him,                     learning how to run an efficient business       ►  Officially enters society and gets sent out to events at 19 with the express order from         her father to find a husband, proceeds to intentionally spike her reputation into the                 ground       ►  One of her many plans pulls through and the nice old shop keep leaves his estate .            and store to her, she immediately leaves home and sets up there       ►  Runs her new business and begins to form a more paranormal based one on the side         over the years       ►  Somewhere around 25-35 she becomes the new Guardian of the mysterious magical         artifact       ►  Stays in London for a few years as she gets her affairs in order and finds a someone           to take over her business then begins to travel the world alone.       ►  Literally just travels around the globe from then until now.    

LONGER

TBA

#bryony tbt

[serenavangstuff]

Juniper publishers-Aging In Grace and the Effects of Social Isolation on the Elderly Population

Abstract

Our conception, birth and developmental processes are as a result of human cooperation which establishes a necessity of our dependence on others for success, personal progress and well-being. Without this cooperation our full growth into adulthood will be grossly hampered. This article will discuss such cooperation and confirm the reality that we are summed by the contributions made in our lives by people we have been privileged to encounter in our journey of life.

It identifies successful aging or aging in grace within a framework of factors and conditions that encourage the potential development of the 'untapped reserves' of the elderly population. It is also aims at demonstrating how social isolation is a problem in the general wellbeing of the elderly population and "social death” as a devaluation of the humanity of others and of the human person in general. Finally, it recommends social support systems as imperative in promoting general well-being among older adults.

Introduction

In the light of our collective cynicism and stereotyping of aging and the elderly—elderly people are sick, elderly people are ugly, elderly people are obsolete, the question arises: is there any hope to age in grace or successfully, and experience some kind of tranquility and happiness in the process, and what would that entail? Aging in grace, graceful aging, successful aging, optimal aging, positive aging, productive aging, active aging, adaptive aging, or aging well, are all ideas without universally accepted definitions. A focus on aging includes concepts such as health, life satisfaction and quality of life and genetic, biomedical, behavioral and social factors.

Aging in Grace and Other Nuances

The terms aging in grace, graceful, successful, positive or optimal aging are usually used interchangeably, but, according to many gerontologists these terms focus on life-style choices that promote quality aging, and therefore minimize age-related problem. The term successful aging was made popular by Rowe and Kahn [1] in order to describe quality aging well into old age. Aging in grace is one of the ways of describing the other ways of growing old happily, successfully and normally, or the average aging development as assessed on any measure and with any age definition, and pathological aging, which incorporates acute or chronic disease that hampers a normal aging pattern and accelerates decline. Many people, view aging as 'something to be denied or concealed', but aging in grace and successful aging have to do with 'aging well' which is not the same as 'not aging at all'.

Successful aging is no longer an oxymoron but a reality. Nevertheless, a standard or uniform definition for successful aging still does not exist. Part of the problem in defining the term is a lack of consensus on what aging is, when it starts, and finding general criteria for success, since social and cultural values both play a role in the definitions [2]. Successful aging can be defined as the process of promoting gains and preventing losses through a process called 'Selection, Optimization and Compensation' (SOC). An inclusive definition of successful aging necessitates a value-based, systemic, and an ecological perspective. Both subjective and objective indicators need to be considered within a given cultural context with its particular contents and ecological demands. The solution according to Rowe and Kahn [1] is thus to use various subjective and objective criteria for successful aging, focusing on individual variability within a given culture.

Successful aging is the result of the interaction between an aging individual within his or her society over the life span, and can also be described as the process of 'adaptive competence'with regard to the challenges of later life, using both internal and external resources. Since dynamics in society influence the aging process, successful aging is not solely an inherent quality of an aging person. There is a bidirectional relationship between an aging individual's adaptive competence and the developmental tasks of society. Successful agers appear to fare well on developmental tasks. There does not seem to be clear scientific agreement on a definition of developmental tasks, but Featherman et al. [3] describe them as sequences of tasks over the life course whose satisfactory performance not only is important for the person's sense of competence and esteem in the community, but also serves as preparation for the future. Developmental tasks require using one's cognitive, emotional and behavioral skills to manage one’s life circumstances. Examples of adaptive competence include gathering social support, maintaining independence as far as possible and adjusting well to retirement. Featherman et al. [3] are of the opinion that as aging progresses, ill-structured tasks out-number well-structured tasks. Well-structured tasks are sometimes defined as problems with standard solutions or techniques, and ill-structured tasks as more ambiguous problems with relative solutions. Reflective planners tend to fare better in retirement because of their accumulated expertise in solving ill-structured problems.

I. With Rowe and Kahn, we identify three key aspects in successful aging

i. preventing disease and disability as far as possible, inter alia through good lifestyle choices,

ii. continuing with mental and physical exercise throughout the life span, and

iii. Keeping up an active life-style, by being productive and by fostering strong social relationships.

This identification was based on the 10-year MacArthur study involving a multi-disciplinary team of professionals that wanted to answer three questions:

i. the meaning of successful aging,

ii. what can be done to age successfully, and

iii. What changes are necessary in American society to facilitate successful aging.

This equally helped with a paradigm shift away from conceptualizing aging as more focused on disease and disability, to a more hopeful approach. However, research confirms that few very old people (older than 90 years) age successfully. Thus, the concept aging in grace, Ihenetu [2] suggests is more 'comprehensive' than successful aging, because aging in grace focuses on 'quality of life and a sense of well-being' despite age- related decline or ill health. Successful aging for some researches is an idealized term that is not necessarily in accordance with the present reality of aging, due to the fact that restrictive factors such as ageism, affordable housing, adequate income and quality healthcare are not taken into consideration. On the other hand, the value of successful aging lies in understanding that an individual can contribute to aging well, for example through specific activities or life-style choices. Nevertheless, few elderly people fit neatly into the categories of successful, normal or pathological aging for all capabilities and suggests that one should maximize successful aging in the capabilities one can control as early in life as possible, employing preventive measures to delay age-related decline for as long as possible.

Social Death and Social Isolation Among The Elderly Population

With the advance of science and modernity, the meaning and understanding of death has been evolving. Death can be defined on a variety of different levels but most people define death as a physical event in which there is a cessation of all bodily functions including beating of the heart. Some in the medical field will broaden this to include 'clinical' or 'biological' death. The 'social death’  phrase evolved and relates to those who die in a social sense consequent to degeneration of the brain or disease, which limits interaction with those around them.

The first available presentation of social death came from Glaser and Strauss (1966), during a discussion of 'hopelessly comatose’ patients, these authors describe their receipt of 'nonperson treatment from hospital personnel when talking freely about things that would matter to the conscious patient. They said that socially he is already dead, though his body remains biologically alive. They also describe some 'senile patients' as 'socially dead as if they were hopelessly comatose’ in the eyes of the families who consign them to institutions and thereafter fail to visit. Some individuals according to Ihenetu [4] regard certain health challenges as a result illness or old age as a social death in which the person is no more connected to society and is dying a little at a time with no hope for recovery. A person's true worth does not diminish as a result of certain health challenges, it becomes an assault for a system of society to diminish and devalue the humanity of others as socially dead or insignificant based on the condition of life.

It is important to debate the idea as to whether elderly persons who are faced with the challenges of old age can be considered socially dead because how they are perceived would directly correspond to how they are cared for and valued in society. A good place to start would be to ask the question; what it is that makes an individual into a whole person? What is it that would allow one to say that an individual has a worthwhile life or life of value? The perception of social death may have some correlation to anticipatory grief that precedes the impending death of an elderly patient. What this means is that the caregiver or family member who is in the position of contributing to the social life of the individual might have given up long before exhausting every available opportunity to communicate. Labeling someone as socially dead is a serious allegation. In essence, it is the end of an individual's social existence. It might even be considered as a self-fulfilling prophecy that could speed up actual physical death. Social death occurs when a person is treated as a corpse although he or she is still clinically and biologically alive. For instance, this is much like allowing someone who was brought into a hospital in a near death state to remain on the stretcher overnight for the fear of unnecessarily having to dirty a bed. Social death does not always lead to biological death nor is it a definite concept.

A survey by Pat Robertson (2011) which referred to Alzheimer’s patients as socially dead, 100% of the responses received from surveys sent out to caregivers show otherwise. When specifically asked if those with Alzheimer's are to be considered socially dead, here below are some of the responses received from caregivers: "Absolutely not; each time my father saw me I could see a twinkle in his sad blue eyes. He did not know my name but he called me pretty’. Another said, 'Not at all - we still can enjoy church; sing and he still goes to Sunday school but does not recall anything except the Lord 's Prayer” To the same question, a Hospice Medical Director writes 'No, because they are still relational to the family to which they belong. They interact with loved ones even until death.' Another doctor who specializes in geriatrics notes, "In those with advanced dementia though the interaction/conversation may be basic or repetitive, they can still interact and thus are not socially dead.” A palliative care doctor said, "I believe they are far from socially dead. Although they may not be able to verbalize, they do communicate in other ways - why can’t people see it?”

Self-perceived social death occurs when an individual accepts the notion that he or she is as good as dead. When a patient is given a terminal diagnosis, it can be a cause to precipitate such thought. However Kastenbaum [5] is of the view that social death must be defined situationally. In particular, it is a situation in which there is absence of those behaviors which we would expect to be directed towards a living person and the presence of behaviors we would expect when dealing with a deceased or non-existent person. Thus, although an individual may be potentially responsive and desperately seeking recognition and interaction, that individual will by this definition be socially dead if others cease to acknowledge his or her continued existence. Consequently, it is paramount to get this right. Non-cognitive or elderly persons should never be looked upon as those who cease to have continued existence [4].

On the other hand, when we look at social isolation among elderly adults, we discover that there are so many researches on the effects of isolation on children and young adults, but only a few on the effect of isolation on the elderly. However, the human need for social connection does not fade away among the elderly, which is to say, the elderly have the need for social connections. Decline of social connection is considered one of the various interrelated factors which compose well-being among the elderly. Hence, it is necessary and important to deepen the knowledge about social isolation among the elderly. According to some authors, social isolation is a subject concerned with the objective characteristics of a situation and refers to the absence of relationships with other people, that is to say, they believe that persons with a very small number of meaningful ties are socially isolated, (ibid.,35).

Meanwhile, Ihenetu [4] enumerated five attributes of social isolation as: number of contacts, feeling of belonging, fulfilling relationships, engagement and quality of network members. Consequently, even loneliness, depression symptoms and their temporal connection are not attributes of social isolation, but those concepts can be causes of being socially isolated. Therefore, lack of a sense of social belonging, lack of social contacts, lack of fulfilling and quality relationships, psychological barriers, physical barriers, low financial/resource exchange and a prohibitive environment can be possible reasons leading to social isolation.

Turning to the effects of being socially isolated, it has been associated with increased vascular resistance, elevated blood pressure, impaired sleep, altered immunity, alcoholism, progression of dementia, obesity and poorer physical health. In other words, socially isolated individuals have a higher possibility of suffering from health issues. Also, drinking, falls, depressive symptoms, cognitive decline and poor outcome after stroke, nutritional risk, increased rates of re-hospitalization, loneliness and alteration in the family process were are also specific effects of social isolation. These truly existing negative effects prove that social isolation has a far-reaching impact on elderly well-being.

Its effects on the elderly well-being are phenomenona which cannot be ignored. The socially isolated elderly persons are among the risk group for myriad other negative health consequences, such as poor nutrition, cognitive decline and heavy alcohol consumption. Therefore, social isolation has a non-ignorable influence on elderly well-being [4]. It is more prevalent in older adults due to diminished vitality and health. In other words, diminished vitality and health are direct causes for being socially isolated among the elderly. Simultaneously, vitality and health are considered a vital dimension of elderly well-being. In sum, the relevance between elderly well-being and isolation is arising from interaction.

Isolation

Working Definition

'Belonging' is a multi-dimensional social construct of relatedness to persons, places, or things, and is fundamental to personality and social well-being. If belonging is connectedness, then social isolation is the distancing of an individual, psychologically or physically, or both, from his or her network of desired or needed relationships with other persons. Therefore, social isolation is a loss of place within one’s group(s). The isolation may be voluntary or involuntary. In cognitively intact persons, social isolation can be identified as such by the isolate.

Some researches portray social isolation as typically accompanied by feelings related to loss or marginality. Apartness or aloneness, often described as solitude, may also be a part of the concept of social isolation, in that it is a distancing from one's network, but this state may be accom¬panied by more positive feelings and is often vol-untarily initiated by the isolate. Some researchers debate whether apartness should be included in, or distinguished as a separate concept from, social isolation. Social isolation as we can see has several definitions and distinc¬tions, dependent upon empirical research and the stance of the observer.

When Isolation Becomes A Problem

Social isolation ranges from the voluntary isolate who seeks disengagement from social intercourse for a variety of reasons, to those whose isolation is involuntary or imposed by others. Privacy or being alone, if actively chosen, has the potential for enhancing the human psyche. On the other hand, involuntary social isolation occurs when an individual's demand for social contacts or communications exceeds the human or situa¬tional capability of others. Involuntary isola¬tion is negatively viewed because the outcomes are the dissolution of social exchanges and the support they provide for the individual or their support system(s). Some persons, such as those with cognitive deficits, may not understand their involuntary isolation, but their parent, spouse, or significant other may indeed understand that involuntary social isolation can have a negative and profound impact on the caregiver and care recipient.

When social isolation is experienced neg¬atively by an individual or his or her significant other, it becomes a problem that requires man¬agement. In fact, according to much of the liter¬ature, only physical functional disability ranks with social isolation in its impact on the patient and the patient’s social support network (family, friends, fellow workers, and so forth). Therefore, social isolation is one of the two most important aspects of chronic illness to be managed in the plan of care.

The Nature and Distinctions of Social Isolation

Social isolation is viewed from the perspective of the number, frequency, and quality of con¬tacts; the longevity or durability of these contacts; and the negativism attributed to the isolation felt by the individual involved. Social isolation has been the subject of the humanities for hundreds of years. Who has not heard of John Donne's excla-mation, 'No man is an island', or, conversely, the philosophy of existentialism— that humans are ultimately alone? Yet the concept of social isola¬tion has been systematically researched during only the last 50 years. Unlike some existential¬ists and social scientists, healthcare professionals, with their problem-oriented, clinical approach, tend to regard social isolation as negative rather than positive,(ibid.). However, isolation can occur at four layers of the social concept. The outermost social layer is community, where one feels integrated or isolated from the larger social structure. Next is the layer of organi¬zation (work, schools, churches), followed by a layer closer to the person, that is, confidantes (friends, family, significant others). Finally, the innermost• layer is that of the person, who has the personality, the intellectual ability, or the senses with which to apprehend and interpret relationships.

In the healthcare literature, the primary focus is on the clinical dyad, so the examination of social isolation tends to be confined to the levels of con¬fidante and person, and extended only to the orga¬nization and community for single clients, one at a time. For the healthcare professional, the most likely relationships are bound to expectations of individually centered reciprocity, mutuality, car¬ing, and responsibility. On the other hand, health policy literature tends to focus on the reciprocity of community and organizations to populations of individuals, and so it deals with collective social isolation. At the level of the clinical dyad, four patterns of social isolation or interaction have been identified; although these were originally formulated with older adults in mind, they can be analogized easily to younger persons by making them age-relative:

a. Persons who have been integrated into social groups throughout their lifetime.

b. The 'early isolate’ which was isolated as an adult but is relatively active in old age

c. The 'recent isolate' who was active’ in early adulthood but is not in old age.

d. The 'lifelong isolate' whose life’ is one of isolation.

Normally there are feelings that isolation brings which are often characterized by boredom and marginality or exclusion. Boredom occurs because of the lack validation of one's work or daily routines; therefore, these tasks become only busy work. Marginality is the sense of being excluded from desired networks or groups. Other feelings ascribed to social isola-tion include loneliness, anger, despair, sadness, frustration, or, in some cases, relief.

Progressions In Social Isolation

Regardless of how social isolation occurs, the result is that basic needs for authentic intimacy remain unmet. Typically this is perceived as alien¬ating or unpleasant, and the social isolation that occurs can lead to depression, loneliness, or other social and cognitive impairments that then exacerbate the isolation. Several predisposing reasons for social isolation have been proposed: status-altering physical disabilities or illnesses; frailties associated with advanced age or developmental delays; personality or neurologic disorders; and environmental constraints, which often refer to physical surroundings but are also interpreted by some to include diminished personal or material resources.

A typical course of isolation that evolves as an ill¬ness or disability becomes more apparent is the change in social network relationships. Friends or families begin to withdraw from the isolated individual or the individual from them. This process may be slow or subtle, as with individuals with arthritis, or it may be rapid, as with the person with AIDS. Unfortunately, the process of isolation may not be based on accurate or rational information. Individuals with serious chronic illnesses come to perceive themselves as different from others and outside the mainstream of ordinary life. This perception of being different may be shared by others, who may then reject them, their disability, and their differences. Part of this sense of being different can stem from the ongoing demands of the illness. For example, social relationships are interrupted because fam¬ilies and friends cannot adjust the .erratic treatment to acceptable social activities. From such real events, or from social perceptions, social isolation can occur, either as a process or as an outcome.

Individuals with chronic illness often face their own mortality more explicitly than do others. Even if death does not frighten those with chronic illness, it frequently frightens those in their social networks, which leads to guilt, and can lead to strained silences and withdrawal. For those who lack this social support, social isolation is not merely a metaphor for death but can hasten it.

Possible Causes

The list to the possible causes of social isolation is endless. Retirement, death of a spouse or significant other, health problems and even reduced income can create situations where one becomes separated from social contacts. The key, however, is how the elderly person and caregivers choose to respond to these changes because the responses can make the difference in creating a positive or negative result.

Social isolation can develop when living at home causes a lack of communication with others. This results in the elderly person feeling lonely due to the loss of contact or companionship, as well as a deficit of close and genuine communication with others. It also can be the self-perception of being alone even when one is in the company of other people. We discuss the impact of these few:

A. Stigma: Social isolation may occur as one effect of stigma. Many persons will risk anonymity rather than expose themselves to a judgmental audience. Because chronic illnesses can be stigmatizing, the concern about the possibility of revealing a discredited or discreditable self can slow or paralyze social interaction. In a study examining chronic sorrow in HIV-positive patients, stigma created social isolation. Therefore, social roles and the robustness of network support affect social isolation. The individual with chronic illness or their families grapple with how much information about the diagnosis they should share, with whom, and when. If the illness is manageable or reasonably invisible, its presence may be hidden from all but a select few, often for years. Parents of children with chronic illnesses often manage stressful encounters and uncertainty by disguising, withholding, or limiting information to other, an action that may add to limiting their social network.

For example as siblings of children with infectious disease deal with the isolation of their brother or sister, they became vulnerable to being socially isolated themselves. Social isolation not only burdens those with chronic illness, it also extends into fam¬ily dynamics and requires the healthcare profes¬sional to consider how the family manages. Nurses must explicitly plan for the isolation in families with children who are chronically ill. Thus, with social isolation being a burden for the family, it requires the healthcare professional to consider how. The family manages the illness and the  isolation. Where the stigmatized disability is quite obvious, as in the visibility of burn scars or the odor of colitis, the person who is chronically ill might venture only within small circles of under¬standing individuals. Where employment is possible, it will often be work that does not require many social interactions, such as night work or jobs within protected environments (sheltered workshops, home offices). Regardless of what serves as reminders of the disability, the disability is incorporated into the isolates sense of self; that is, it becomes part of his or her social and personal identity.

B. Social Rules: Any weakening or diminishment of relationships or social roles might produce social isolation for individuals or their significant others. Those who lose family, friends, and associated position and power are inclined to feelings of rejection, worthlessness, and loss of self-esteem. These feelings become magnified by the person's culture if that culture values community. An example of social isolation of both caregiver and care recipient occurred in a situation of a woman whose husband had Alzheimer’s disease. The cou¬ple had been confined for more than 2 year? In an apartment in a large city, from which her confused husband frequently wandered. Her comment, "I'm not like a wife and not like a single person either," reflected their dwindling social network and her loss of wifely privileges but not obligations. This ambiguity is common to many whose spouses are incapacitated. Moreover, after a spouse dies, the widow or widower often grieves as much for the loss of the role of a married person as for the loss of the spouse.

The loss of social roles can occur as a result of illness or disability, social changes throughout the life span (e.g., in school groups, with career moves, or in un accepting communities), marital dissolution (through death or divorce), or secondary to ostracism incurred by membership in a• "Wrong" group. The loss of social roles and the resultant isolation of the individual have been useful analytic devices in the examination of issues of the aged, the widowed, the physically impaired, or in psychopathology.

C. Age: Old age with its possible many losses of physical and psychological health, social roles, mobility, eco¬nomic status and physical living arrangements, can contribute to decreasing social networks and increasing isolation. This will become even more of an issue as the numbers of older adults are expected to increase arithmetically and proportionately in the next two decades. The prevalence of social isolation in older adults has been approximated now to be at 2-20% and even as high as 35% in assisted-living arrangements [4].

Social isolation has been linked with con¬fusion, particularly in older adults with chronic illness. But when the socially isolated are also immobilized, the combination of isolation and immobilization can lead to greater impairments, such as perceptual and behavioral changes (e.g., confusion, noncompliance, or time distortions). Physical barriers (such as physical plant designs) or architectural features (such as heavy doors) also contribute to social isolation or home-boundedness. All of these limits contribute to social isolation in ways that motivation alone cannot eas¬ily overcome.

Social isolation has been shown to be a serious health risk for older adults, with studies indicating a relationship between allcause mortality, coronary disease, and cognitive impairments. In a converse finding, older adults with extensive social networks were protected against dementia. And, as described earlier, although low social engagement may not be a form of social isolation per se, it is a psychological isolator and thus a risk factor in social isolation. For example, depressive symptoms in older adults were shown to be decreased by social inte-gration. Isolated older adults were shown to have increased risk for coronary heart disease, and death related to congestive heart failure was predicted by social isolation. Similarly, post-stroke outcomes, for exam¬ple, strokes, myocardial infarction, or death, were predicted by pre-stroke isolation.

The extent and nature of a, social network from local to community, and integrated to contained, as well as the positive; or negative nature of the social relationships in the social network, impact health as well as social isolation. In fact, the quality of the social relationship may have more impact than the number of ties, which suggests that a few solid relationships may be more beneficial than many ties of poor quality.

Social Isolation and Well-being

Generally discussions on well-being both the best methods for achieving it and whether or not it is an appropriate goal of human activity, have been frequent throughout history. It is known that health status and personality are the most important predictors of well-being. In consideration of the relationship between health status and age, studies show that overall dysfunction comes along with the aging process. However, it can also be influenced by the quality of life especially of social isolation and loneliness. In order to understand better wellbeing in the elderly, We shall analyze the meaning of well-being, the relationship between well-being and elderly and well-being with other predictors in order to find out if they are mutually contradictory [4].

In the contemporary policy and practice, Well-being has become a high profile issue. Rather than talking just about 'improving health' we are more likely to read about 'improving health and wellbeing', and similarly, the notion of 'welfare' is now accompanied by 'well-being': as well as 'doing well', the aim should be to 'be well.' Well-being has been associated with 'happiness', with 'quality of life’ or 'life satisfaction'. And sometimes it is talked about as 'subjective well-being’ or 'mental well-being.' So the idea of well-being involves how we feel about ourselves and our lives, rather than how our lives might be assessed by others [4].

In relation to elderly people and others who use social care services, the importance of 'activity' or 'healthy lifestyles' are highlighted as factors that contribute to quality of life, wellbeing and remaining independent. This is also based on the idea of 'choice'- which we can benefit from choosing how we live our lives and what services or supports will help us do so.

Psychologically, well-being is considered as a vital dimension of the elderly person’s quality of life. Psychological well-being is generated by two dimensions which are absence of depression and emotional loneliness; and presence of happiness, life satisfaction, feeling of security, and plans for the future. An individual will be high in psychological well-being to the degree in which positives affect or predominate over negatives. On the other hand, when negative effects are in a dominant position, the individual will be low in well-being. That is to say, to gain subjective well-being, pleasure usually predominates over pain in one's life experiences.

It not surprising therefore, that some elderly people have talked about the significance of all kinds of relationships to their well-being. These included relationships with families, friends, neighbors, service providers, and also for some at least, the nature of casual encounters with strangers at bus stops, at the checkout counter of supermarkets and elsewhere. People feel a sense of security knowing a neighbour is looking out for them, and the opportunity to have a chat and cup of tea can help if someone feels isolated. The opportunity to strike up conversations in public spaces can also help people who have limited social contact to feel connected, particularly if families are rarely seen and friends have died. Losing friends can also mean losing the chance to share memories and some people suggested that, not only is it hard to make new friends in old age, 'new friends’ do not carry the history that 'old friends’ do. So that when people join in activities in the hope that they may develop new connections, this may not always positively contribute to a sense of well-being.

Friendships are important at any age. The older people we interviewed talked about how friends contributed to well-being through offers of practical help, sustaining connections with their past, and also by enabling them to give back and contribute to the well-being of others. Family relationships can be a source of support, security, joy and pleasure. They can also enable older people to contribute to others' well-being; not only caring for partners, grandchildren or other relatives, but offering their knowledge and experience (e.g. of places they have visited, journeys they have made) for the benefit of younger people starting out on exploring the world. Two way learning and support (e.g. grandchildren helping them use the internet) helps older people feel they are involved in reciprocal relationships, helps them feel valued, stay in touch with the world and maintain their sense of identity.

Social support in isolation

Social support was initially defined by taking cognizance of the number of friends an individual has; but this definition has been extended to include the person's satisfaction with the support that is rendered. Social support could include esteem support, whereby a person's self-esteem is boosted by other people, informational support that includes information provided by other people, and social companionship, which consists of support rendered by means of activities. Finally, instrument support involves a form of physical assistance. Social support has also been defined by some authors as any input that can further the goals of the receiver. Social support can be tangible, including provision of physical resources that can be beneficial to the individual in some way, or psychological, that assists the individual in developing emotional well-being Social support can also be explained as the specific people or community resources to which an individual turns for emotional and instrumental assistance. While social support could be defined as the active participation of significant others in the caregiver's efforts to manage stress, caregivers can easily become isolated from social support as a result of their confinement and responsibilities, which places them increasingly at risk for stress-related illnesses. Both the caregiver's as well as the patient's quality of life can be adversely affected, as social support is important for coping and satisfies the need for attachment, a feeling of self-worth, stress relief, and so on. However, social support is generally defined as any action that is to the advantage of the receiver of such support.

Categories of Social Support

There are six criteria of social support that researchers have used to measure the level of overall social support available for the specific person or situation [2]. First, they would look at the amount of attachment provided from a lover or spouse. Second, measuring the level of social integration that the individuals involved with, it usually comes from a group of people or friends. Third, the assurance of worth from others such as positive reinforcement that could inspires and boosts the self-esteem. The fourth criterion is the reliable alliance support that provided from others, which means that the individual knows they can depend on receiving support from family members whenever it was needed. Fifth, the guidance of assurances of support given to the individual from a higher figure of person such as a teacher or parent, the last criterion is the opportunity for nurturance. It means the person would get some social enhancement by having children of their own and providing a nurturing  experience.

Two other major categories of social support have also been identified [4], tangible support, which may include physical resources that could be beneficial to the receiver; and psychological support, which assists the receiver in developing beneficial affective or emotional states. Psychological support helps a person to feel more content (or to feel better). It is clear that social support from family and friends have an important role to play in assisting a person to translate intentions into health behaviours, while the absence of social support can have a detrimental effect on the individual’s overall health. Social support can also consist of support from individuals such as friends, family members, neighbors, co-workers, professionals and acquaintances. All types of support have been found to be beneficial in helping individuals to cope during a serious illness. There is enough evidence to suggest that in general people who receive support enjoy better health than those who do not receive such support.

Therapeutic effects of social support

Social support is one of most important factors in predicting the physical health and general well-being of everyone, ranging from children through older adults. The absence of social support shows some disadvantages among the impacted individuals. In most cases, it can predict the deterioration of physical and mental health among the victims. A regular social support is a determining factor in successfully overcoming life stress. It significantly predicts the individual's ability to cope with stress. Knowing that they are valued by others is an important psychological factor in helping them to forget  the negative aspects of their lives, and thinking more positively about their environment. It not only helps improve elderly person’s wellbeing, it affects the immune system as well. Thus, it becomes a major factor in preventing negative symptoms such as depression and anxiety from developing. Social support and physical health are two very important factors that help the overall well-being of an elderly person. A general theory that has been drawn from many researches over the past few decades postulate that social support essentially predicts the outcome of physical and mental health for everyone.

Studies have equally shown that social support can effectively reduce psychological distress during stressful circumstances. In addition to providing psychosocial benefits, it appears to reduce the likelihood of illness and to speed up recovery from illness. It is clear therefore that social support helps individuals to obtain a more positive outlook on life, increases self-esteem and resistance to illnesses, and encourages people to engage in more positive, health-promoting behaviours. The form of it received can play an important role. For example, if someone needs emotional support and receives only tangible support, it can further add to the person's frustration and stress. Studies have shown that immuno-suppression may be reduced by social support, which confirms the notion that social support promotes health in general [6]. It also indicates that people with a high quantity and sometimes a high quality of social relationships have lower mortality rates. Social support appears to help people to effectively resist illnesses and minimize complications from serious medical conditions.

Its regular provision essentially predicts the outcome of elderly adults' general health condition. Inadequate social support at any time would predict that elderly adults will develop depressive symptoms over time. Elderly adults would be able to ignore the negative effects in their lives with help and reinforcement from others. This is considered a psychological effect. A lack in the availability of social support would likely make the individuals notice their daily hassles and life stressors much more clearly. This step could accelerate the deteriorating effect of their physical and mental health [7].

Conclusion

There is evidence that social experience is very essential in predicting successful aging and well-being for everyone, ranging from childhood through older adults [8]. After a few decades of studies, researchers have finally gained some understanding about the relationship between social support, successful aging and well-being. Nonetheless, some areas of research still face some problems because they sometimes focus on one population, ignoring the generalization rules for using the random samples to generalize the result to a whole population [4].

The continuity of research on the effects of social isolation and the relationship between social support and general wellbeing of elderly population will enable us to understand better the effects of good social support toward physical and mental health, along with a general well-being. Many studies have shown that if a high level of social support becomes available to the elderly population, it will benefit their overall health in a long run. The importance of social support implies to everyone in our society, ranging from young childhood through older adulthood. The providers of social support can be anyone in society who brings positive environment and reinforcement to the individuals, especially from their family members. This article is optimistic that we can have a dramatic impact on the success or failure in aging, and that there is the possibility of continued growth and development in the later years. Not only physical well-being will be improved, but also emotional and spiritual well-being, when retirement and 'aging in place' become the best stage of all instead of an indirect isolation.

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[ansu-gurleht]

So, what is the technological advancement in your world? Is magic common or rather somewhat rare? Are some species more likely to be magical than others? Classical distinction between good and evil or more complicated than that? How about healthcare? And what do the people believe in, many Gods, Religions, maybe Major Religions? What about love? Special Cuisine? (Sorry, many questions)

okay let’s get CRACKIN! gonna put in a read more here for people who don’t care, b/c this is about to get LENGTHY

technologically we’re not too far ahead! maybe think early renaissance europe? no gunpowder, tho’ we have magic gun staves. we got crossbows, siege weaponry, and also magical prosthetic limbs! a lot of “technological” advances here are b/c of magic, but i don’t think that makes them any less valid.

magic is common enough that everyone knows it exists, but not everyone knows its scope. somebody (esp. like, a human in a rural village) might be surprised to meet somebody who can use magic, but they wouldn’t really doubt that it’s real magic. and also, there’s a bit of mystery in exactly what magic can do, how much there is in the world. think lotr, although in practice, my magic is much more of a hard magic system. (see sandersons laws of magic for what i mean by that!)

the three sentient races in my world (orcs, humans, and elves) can all practice magic to varying degrees. orcs tend to be born with an innate gift, and if you aren’t, then you either can’t do magic, or you can barely do magic with great effort. humans don’t tend to have innate ability, unless they have an innate gift for studying. b/c studying magic is the only way for humans to be able to learn and practice it. you might consider orcs to be d&d sorcerers, whereas humans are wizards.

elves….are a different story. they’re ALL inherently magical. their entire BEING is magic. that’s not to say they’re not flesh and blood, real people - they just treat magic like breathing. that doesn’t mean they’re all wizards or sorcerers or shaman, but they have the best “starting point,” so to speak. orcs have the worst “starting point” in that some of them can’t practice it at all, but orcs ALSO have they highest potential of power.

good vs. evil is absolutely not a thing - this setting really focuses on the grey aspects. it’s important to note - my original premise for this setting was, “what if a huge good vs evil battle like in lotr happened, except the ‘evil’ won?” naturally, orcs aren’t inherently “evil,” they were just slaves to a relatively “evil” force, the trolls. i won’t elaborate on the trolls too much, since even in my head i’m purposefully keeping them somewhat vague, but they were a powerful race who created the orcs as slave-warriors to try to destroy and conquer the world. but then the orcs won and realized being slaves wasn’t great, and that they didn’t like what they’d been made to do, and so they killed their gods, their makers.

there’s another force in the world, one which you MIGHT could consider a “truer” evil than even the trolls, but i won’t elaborate on them. spoilers ;P

(as a small note on my races: i’m using rather familiar names for them, like “orcs” and “elves” and “trolls,” but they’re really very different from what you’d expect. i shan’t elaborate on how, esp. wrt elves, b/c, again, spoilers.)

orcs are a very communal race, and always seek to protect and take care of their sick, weak, and disabled. i’ve already mentioned magical prostheses (orcs, esp. those who regularly fight, tend to lose limbs a lot :P), but magic and traditional medicinal cures are also used to tend for the sickly. the elderly and infirm are cared for and protected as well.

humans are a bit less caring, and esp. in communities w/o orc rule or influence, sometimes even discard the sick, elderly, and disabled. they tend to excuse it as being barely a dent in their population, b/c, well…..humans fuck like rabbits. that’s the primary reason that the orcs and trolls couldn’t completely destroy them. they destroyed their cities and homes, slaughtered them by the millions, but there were always those hiding in the forests and jungles, who just refused to die.

b/c of their magicalness, elves rarely NEED to worry about healthcare. magical healing and remedies are either something anybody can do, or something somebody down the street can do. it’s a non-issue to them.

ooh, boy, religion. humans believe in either a vague almighty God, or a vague almighty Pantheon of gods (possibly derived from old elvish religion), but it’s really not very well established. it really depends on the place, b/c a lot of places developed different religions due to their isolation after the war. 

orcs, and a lot of the humans under their rule/influence, have a very flexible system. they are ancestor-worshipers with some animist aspects. they also worship certain primordial elemental spirits (who they also consider ancestors) of the four elemental planes (earth, air, water, fire). it’s a bit odd to call them “planes”. they’re really like four pieces to the puzzle that is the world; they overlap with one another and their interactions create the world as we know it.

anyways, some orcs tend to have cults devoted to specific proposed ancestors, certain sacred sites, as well as some of the elemental spirits. it depends really on the specific culture - there’s a lot of variety.

elves worship “star gods” who speak to them (and only them) from the heavens, and also send their “emissaries” in the form of “dragon gods” to rule over/protect/guide the elven people. it’s quite a bit more complicated than that, but a lot of stuff about elves is spoilery, so that’s all you get.

ah, love. i’ll give you this: love for humans isn’t exciting. it’s about par for the course either in the real world, or in other fantasy worlds.

orcs, though? it’s very different. there’s not really “soulmates” in the sense of exclusive partners throughout your life. sure, some might be pretty attached and stick together, but it’s not exclusive, and not an end-all-be-all. gender/sex is irrelevant when it comes to orc love/mating. if they like somebody, and that somebody loves them back, they’re gonna fuck. sometimes publicly, but they try to keep it somewhat private, if not always quiet.

it works mostly off of hormones/pheromones. it’s worth noting that orcs age very differently from humans: orcs reach the size of an adult human by age 3 or 4. they reach full orc adulthood by age 8 or so. most orcs live until about age 40, rarely longer.

anyways, once an orc reaches adult age, their reproductive glands responsible for producing and receiving sexy-times pheromones are fully developed. (it makes it a bit difficult to determine exactly what “adult age” is for orcs, since some orcs finish developing by age 6, while others don’t finish until they’re 12, or at all. northern, “civilized” orcs tend to assume an age of 8.) 

for orcs, “rape” is basically an incomprehensible concept. orcs can literally only fuck if they are receiving the same pheromones they’re putting out for somebody. (this is why human-orc relationships are very, very rare, even not considering stigma; a human is just not equipped, from an orc’s point of view, to have sex.) 

way back when, during the big ol’ war, humans and elves spread rumors about the orcs “raping” and pillaging, but what they were really talking about was post-battle orc orgies. these were (and still are, occasionally) very real things. the adrenaline and excitement of battle, as well as the closeness with your comrades that results, tends to result in a lot of orcs getting really horny for each other. this was also effective, especially from the trolls’ point of view, in replenishing losses from the battle by reproducing. so after battles, humans within earshot miles around could hear, uh. a lot of orcs getting it on.

elves are different. obviously. when are they not? they DEFINITELY have life-partners, although sometimes multiple at a time. elvish culture is highly female-driven, and as a result, the most common er, “configuration” for an elvish couple is a lesbian couple. men are also usually expected to be together, b/c a lot of them have a hard time getting with women, due to their lower status. women will have multiple female life-partners, and typically only one male life-partner, which is how they reproduce. (elves are also very romantic, except not so much usually in “hetero” relationships. those guys are just there for babies, more or less.) it’s typically sort of a “competition” among elvish females to see who can pick the least deplorable man to mate with, just as it is for men to try to elevate their status by mating with powerful women.

one quick note on “gender.” humans, culturally, tend to be pretty cisnormative, i guess? there are men, and women, and transgender people are generally considered, er, not good. except in certain northern, orc-dominated territories, where nonbinary people are often considered to be almost as great and important as their genderless orc superiors.

orcs, as i’ve said, just don’t have a concept of gender, nor do their “sexes” look different from one another. there are no secondary sexual characteristics, and their primary sexual characteristics aren’t immediately obvious. 

elves consider there to be three genders : women, men, and “something in between”, as they refer to it. that third gender is sort of a catch-all for noncomformative elves, and have a sort of middle-of-the-road social status: not as high as women, but not as low as men. 

okay, last question! special cuisine…..i haven’t actually thought much of this! which is good, b/c i need to. orcs like to use a lot of spices and herbs, either that they gather in the wilds themselves, or grow in small gardens. they also have a special fermented alcoholic drink which only orcs enjoy, that gives a sort of energy boost, kinda like caffeine. humans tend to eat what they get, and tend to shy away from too many flavors. elves eat…uh….magical food i guess. fish? lots of fish probably. 

#worldbuilding #ask #anon

[steven-heisler-law-firm]

Ellen Platt: Why You Need a Geriatric Case Manager For Your Loved One

About Ellen: Ms. Platt is founder and owner of The Option Group, LLC. Her team conducts comprehensive evaluations, makes recommendations, implements a plan of care and coordinates resources to support it. They provide a thorough knowledge of the healthcare industry and can help families skillfully navigate the maze. Additionally, they provide advocacy services and can assist with care in the home or placement in a facility. Ongoing monitoring can also be set up so that the most appropriate plan of care can be implemented at all times and changes can be made to address changes in condition and avoid crises. The goal is to identify ways to enhance the quality of life for the clients she serves, in the safest, yet least restrictive environment possible, taking safety, independence, function, and comfort levels into consideration.

Ellen is both a Certified Rehabilitation Counselor, and a Certified Professional Geriatric/Aging LifeCare Manager, with a span of 30 years providing care management and case coordination services to those with catastrophic injury, chronic diseases and disabilities. Out of that experience, she created The Option Group to address similar needs and services specifically for seniors or those with special conditions and their family caregivers and guardians. Her primary practice focuses on working with caregivers and aging families and the large variety of issues and needs specific to that population.

In this episode, Steve and Ellen discuss:

1. Ellen, can you tell our listeners what a geriatric care manager does?

Care managers cover a wide variety of tasks. We help people navigate longevity, whatever that means for them, we go to the person where they are in that stage of life, and we help them navigate the system. It’s really a holistic, client centered approach of caring for people. We look out for people with a variety of health challenges. We’ll do an assessment. We’ll make recommendations for care and come up with an individualized care plan. Then we monitor it and tweak it to make sure that it’s meeting their needs and we also do some health, education, advocacy, family coaching, and crisis intervention. So we cover a wide scope of variety of tasks and a variety of people in situations.

2. Would it be correct to say that you are geriatric care managers, more focused on seniors and the elderly?

We do a lot of work with seniors in cognitive or physical decline but we also utilize our team to help  younger people with M.S., mental health issues, traumatic brain injury, or catastrophic injury. People with these issues still need an advocate and someone to help them navigate the resources and their care.

3. What issues, would you say, are generally the most important to the senior and elderly community?

One of the biggest things is that people want to know what their options are, understand the options, given their situation, and they want to understand why they might pick one over the other. We’re able to educate them, give them ideas of what the options are, what the costs associated with those options are, and they know who is paying for it. Is it an insurance paid benefit, or is it something that they’re paying out of pocket? We’re helping them to pull together this holistic care plan and create a solution that’s going to help them remain safe, as independent as possible, functioning as well as they can, and maintaining their dignity in the process.

4. What are some of the significant injuries that you deal with and see the most?

With an aging population, we see all different types of dementia, Parkinson’s, or stroke tend to happen more frequently with people who are advanced in age. We also deal with folks who have had traumatic brain injuries, concussions, a medical malpractice case, catastrophic injury that left them with significant residual disabilities, or they sustained a permanent injury of some type and now they need to reclaim their lives and have the best quality of life possible and function as well as they can give in their new circumstances. So they often need some help navigating that process.

5. At what point during the process does either a senior, an injured individual or their family contact a certified geriatric manager after a catastrophic injury?

People are often contacting us when there’s been a crisis and they don’t know how to navigate the various systems involved. We often are able to jump in pretty quickly to do that assessment and come up with recommendations and stabilize the situation. First thing we address is safety issues. Then we also look short term, then ideally, long term. So that’s where we come in with that full assessment, looking at the clinical picture, and figuring out what it is they need and care managers really have eight core areas of expertise that we work within.  We navigate health care for people, look at the clinical picture of their health and disability, the financial picture, their housing situation, advocacy, and we look at their legal documents to make sure that they have their planning documents in place. We often do crisis intervention. Ideally, we’d like to be called before the crisis so that we can do some planning and they have some options in place.

6. What are some examples of crises that you see a lot?

Often we’ll see a husband and a wife living together and maybe one spouse has a lot of physical disability and there’s another spouse that has the cognitive disability. And together they make one person but if something happens to one of them, things start unraveling quickly prior to that they were compensating for each other’s difficulties and were able to maintain their living situation. But if something happens to that it topples pretty quickly. And families are looking to us to help. Right things.

7. If someone reached out to a geriatric care manager would they provide someone who would be able to step in and make sure that everything financially in a household is kept up to speed?

Yes, exactly. We would be able to link them with somebody who would be able to step in quickly and be able to keep them fiscally organized, make sure that they’re not receiving collections notices, or getting things ready for their accountant.

8. What’s the important part of consulting with a geriatric care manager before a loved one is placed in a nursing home?

Many times people say they want to stay at home. We’re able to help them bring in resources and services and put in that infrastructure that allows someone to stay at home longer. Sometimes there are situations where it’s going to either make more financial sense, or they have certain needs that need a special level of care on a consistent basis that you’re not able to establish in the home. We would then help them navigate to a facility. Working with a care manager, you have somebody who knows the systems, knows the local resources, and can look at the clinical picture and find a care facility that is going to support their particular needs. The care managers can help with all the paperwork and the legwork needed to be able to move into a facility. We also work to help set up the expectations with the care facility and how we expect the care to be provided to this individual.

9. What is the difference between what a geriatric care manager does as compared to a placement agency?

The primary difference between us and a placement agency is our payment source. We don’t get any payments whatsoever from our referral sources, whether we’re referring them to facilities or home care agencies, or other senior services. So there’s no temptation or no tendency to see things from a financial perspective of where that person is going to go for their care.

Care managers also work across the continuum of care. It could be somebody who’s independent, somebody who needs assisted living memory care, or skilled nursing so we can work in any level of care all the way through end of life. When you use a certified care manager, you’re getting someone that has a master’s level education and they’re held to a code of ethics. They have ongoing peer review meetings and ongoing continuing educational requirements so that they’re staying on top of the latest information. Care managers will work directly with the client and the family and are really their advocates. Our concern is the clients best interest.

10. Is a placement agency always going to place a patient in the best possible place for their needs? 

You want somebody with a minimum standard and code of ethics that really understands the resources and the various systems out there to be placing an individual into the proper facility for them.

11. What is the most important thing for a geriatric care manager to do for a senior or elderly individual who has just sustained a catastrophic spinal injury? 

In an incident like that, we would probably use a catastrophic case manager, a nurse case manager that we would have because they would be more in tune with the medical issues that are involved with a spinal cord injury.

That case manager would be getting the information from the physicians, the hospital, discharge records, and health history information to really understand the injury itself and how any underlying conditions may impact that injury.

12. Would a nurse case manager go with the individual to their  medical appointments, review records, and keep an eye on what’s going on to make sure they’re getting the best possible care?

They do a lot of medical care coordination. They may even be doing things like scheduling appointments, requesting medical records, taking them to get imaging, coordinating surgery, and being there the day of surgery so we can do some really hands on stuff.

13. Do nurse case managers have a specialty like orthopedic injuries?

Yes, that’s possible.

14. Is it correct that another catastrophic injury that you might see a lot is traumatic brain injury?

Yeah, especially when in a sports world. We do work with some professional sports teams that have issues with head injury and concussion, and then older sports retired players who need assistance with coordinating their care as maybe they have dementia developing or other medical conditions and they need they have special circumstances that we need to help navigate.

15. Can you work with older individuals who have had sports injuries earlier in their lives?

Yes, and many of them need help navigating because they’re no longer able to do it for themselves. If you think about it, whether it’s football, rugby, soccer, ice hockey, boxing, there’s all different sports, where people are sustaining head injuries and over time, they may have some special circumstances arise.

16. When are you brought in to handle care for a patient with dementia?

In the instance of dementia, often people have symptoms or issues relating to dementia, possibly even 10 years before they actually get a diagnosis. It might be mild forgetfulness, it might be getting lost in a familiar area while they’re driving their car, it might be starting to forget names, more than just the typical stuff you see with aging, it becomes problematic and that’s when we get the call. It becomes problematic and difficult for somebody or the family to function given the person’s new ability or declining ability to function independently. That’s typically when we get the call and when services will be started because that’s when they’re really noticing it.

17. Are you brought in when you have individuals who might have gotten a clostridium difficile infection, pneumonia, or sepsis?

We do, but that is generally secondary to something else going on. Or while we’re managing their care, they get an infection. For instance, it may be because they have a catheter, they get a urinary tract infection, maybe pneumonia, maybe they have swallowing issues, and they have aspirated and it leads to pneumonia. So those are conditions that we’re always keeping our antenna up on. That’s not typically why we’re called but it definitely is something that needs to be watched.

18. What other professionals would you make part of your team in a situation where you had a senior or elder with catastrophic injury or dementia?

We could bring in a Certified Daily Money Manager to keep them fiscally organized on a day to day basis, a professional called a Senior Move Manager who can help coordinate and orchestrate a move from beginning to end, and a home care company to bring in all the hands on caregivers that are going to help with those activities of daily living. We also put into place systems for medication management, transportation, housekeeping, meal planning, and cooking.

“When you use a certified care manager, you’re getting someone that has a master’s level education and they’re held to a code of ethics.” —  Ellen Platt

To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530

Connect with Ellen Platt:  

Website: Aging Lifecare Association LinkedIn: Ellen Platt Email: [email protected] Phone: [phone]

CONNECT WITH STEVE H. HEISLER:

Website: http://www.injuredseniorhotline.com Facebook: https://www.facebook.com/attorneysteveheisler/ LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: [email protected]

  Show notes by Podcastologist: Kristen Braun

Audio production by Turnkey Podcast Productions. You’re the expert. Your podcast will prove it. 

  The post Ellen Platt: Why You Need a Geriatric Case Manager For Your Loved One appeared first on The Maryland Injury Lawyer.

[raystart]

The Covid-19 virus is not politically correct

The Covid-19 virus is not politically correct. It discriminates against the old and the unhealthy. The biggest risk factor in dying from the virus is age. If you’re 60 to 70 years old, you’re 30 times more likely to die from Covid-19 than if you’re under 40. And if you’re over 80, you’re 180 times more likely. It’s not that the young don’t get sick or die, but the odds are dramatically different.

In the early days of the virus epidemiologists, who believed that the virus would equally kill the young and old, predicting a million or more deaths in the U.S., wanted everyone to shelter. The result has crashed our economy. Meanwhile, economists view 15% unemployment as an unacceptable and unsustainable cost of protecting everyone and want the economy to rapidly reopen, accepting that some additional deaths are inevitable.

They both may be missing the obvious. We’ve created an equal opportunity recession when in fact, the pandemic is not equal at all.

If the data about the demographics is correct, it may be possible to dramatically reduce cases and deaths if we shelter those at greatest risk and pay them to stay sheltered until a vaccine is available. This would allow those with dramatically lower risk to get back to work and bring a faster economic recovery.

Here’s how.

We’ve spent the last 50 years working to not discriminate for age or disabilities so it’s hard to acknowledge what, if these number are correct, or even in the ballpark, the data seems to say that people over 60 are 30-180 times more likely to die of Covid-19. And ~1/3rd of those U.S. deaths have been in nursing homes.

  Age           Relative Death Rate 18 <40             0.07% 40 <50             0.31% 50 <60             1.00 (reference) 60 <70             2.09 70 <80             4.77 80+                  12.64

Compounding the age risk factor are chronic health problems (i.e. heart disease, high blood pressure, asthma and other respiratory diseases, obesity and diabetes.) In addition, racial and ethnic minorities seem to have been at greater risk.

A good visualization of the fatality rates by age is below. It takes data from South Korea, Spain, Italy and China. The relative fatality rates by age in the U.S. seem to track these.

For COVID-19, data suggests that 80% or more of infections are mild or asymptomatic, 15% are severe infection, requiring oxygen and 5% are critical, requiring ventilation.  If you’re under 40, the data says you’re five times more likely to die from Covid-19 than the seasonal flu.

Today, federal and state plans to reopen the economy focus on reducing the density and duration of exposure to the virus equally, across all ages. But little emphasis has been on focusing resources to keep safe the actual people who get sick and die.

We Got it Backwards – Protect the Old Versus Everyone The consequences of mixing young, largely asymptomatic and much lower risk, with the old who are at significantly higher risk seems like a deadly game of whack-a-mole.

As states loosen shelter-in-place restrictions, mixing young versus old as we reopen restaurants, live entertainment (theaters, concerts, sports venues,) crowded office buildings etc. guarantees unnecessary deaths.

20% of those over 60 work. 12.5% of workforce is over 60 What if we acknowledged that the virus (much like the flu) discriminates against the old. As a thought experiment, how would we design a recovery that protected the old but required minimal restricting of our economy and a rapid return to normal?  Here are some ideas.

Continue sheltering in place adults over 60 (or some other age that the data shows most elevated risk), plus those with chronic health risks as well as other affected populations

Open up the economy to everyone else

Offer everyone over 60 (and those with chronic health problems) whose job can be done remotely the option to work at home. Pay for their computer, network, etc. Offer their employer an incentive to compensate for lost productivity – until a vaccine is available

Provide Americans over 60 and those with chronic health problems whose job cannot be done remotely with a “personal payroll protection program” –pay to have them not show up at work – until a vaccine is available.

Focus our scarce testing tools first on nursing homes and their employees and front line medical workers, next to everyone over 60, then those whose illness puts them at risk and then to the general population

Provide this protected population with full health care

Provide resources ($’s for separate housing via empty hotel/airbnb rooms etc) to protect the elderly who live in multi-generational housing

Where possible continue wearing masks and distancing to the risks to those under 60

Broadcast the comparative risk of getting sick/dying from Covid-19 to typical risks we lived with pre-pandemic. This would allow everyone to make comparative informed decisions.

For example, car accidents ~39,000 deaths in 2019 and over three-fourths of a million dead since 2000, ~70,000 drug overdose deaths in 2019 and over three-fourths of a million dead since 2000. All of these are avoidable, but as a society we decided that we are not shutting down our economy to solve these problems.

Understanding deaths from seasonal flu in 2018/2019 ~34,000 deaths (~25,000 deaths >65, ~8,000 <65) provides a reference to the current prediction of 150,000 deaths from Covid-19 this year (5 times the risk of dying with seasonal flu.) Just for scale Covid-19 fatalities are closer to the 100,000 died in the 1968 flu pandemic, and the 116,000 dead in 1957/58. We made different decisions in those pandemics. We may want to think about why.

Remove all business restrictions for workers and customers under a certain age. As a thought experiment, imagine restaurants serving only those under 40 (carding at the door). They would have no distancing requirements. Or that business rate themselves based on how age appropriate their virus safety is. Imagine movie theaters with special distancing showings for those over 60, nightclubs for under 30 or over 60. Same for sports and entertainment venues. Those who do attend will understand that the risks are not zero, but within the range of those they live with today.  Same with offices.

Create special hours and venues (stores, restaurants, workplaces, etc.) for those who need to shelter. Offer businesses who cater to them large financial incentives.

Create special mass transit options with over 60 subways cars, buses, etc.

This would do five things:

We’d protect the most vulnerable at-risk population

With those over 60 sheltering, jobs are now opened up for unemployed younger people

Businesses can return to normal without the burden of significant additional overhead costs

Businesses can make additional revenue catering to those who remain sheltered

The potential burden on the healthcare system would be lowered by removing the vulnerable from risk

And this plan would dramatically reduce the overall economic cost of sheltering and accelerate the recovery

We’ve spent the last 50 years fighting age discrimination, but the virus is the ultimate discriminator against the elderly. It’s unequal and unfair. But it exists. Let’s look for ways to move beyond the choice between exploding death rates and economic disaster by acknowledging what the data is showing. Shape a plan to protect the most vulnerable and let everyone else get back to work.

Note: the author is over 65 and willing to abide by these restrictions

Lessons Learned

We need to run some thought experiments about different ways we can protect the most vulnerable and restore our economy

We need to put the risks in context with other risks we’ve taken and accepted as a society versus the damage that sustained 15% unemployment would bring

#startups #text #startup #advice #busieness #howto #news #tech