Thursday, December 29, 2011

Up All Night: Schizophrenia and Sleep Disturbance

"He has nights and days reversed."  That is a statement that I make A LOT about my loved one with schizophrenia.  I tell psychiatrists who want to do morning appointments as well as social workers, case managers, therapists and much of the known universe.

It's not easy scheduling appointments for a person who has trouble waking up by 4 p.m. But that is very, very common for people with schizophrenia, a new study out of Oxford indicates.

The Oxford research team studied 20 patients with schizophrenia. All 20 were stable on medication. And all 20 had severe disruption in their sleep.

The study, reported in the British Journal of Psychiatry, found all of the individuals with schizophrenia took longer to fall asleep, stayed in bed longer, slept longer and had variable sleep patterns. Half of them had irregular body clocks, meaning they often had nights and days reversed. When awake, they have, in effect, constant jet lag.

The Oxford team says the issue is not that people with schizophrenia tend to have unstructured days, as the control group was unemployed people who also had no structure.

The research said the severe impact of the sleep disturbances needs to be considered in treatment, because it has a strong impact on mood, social function, mental abilities and quality of life. The only problem is too few psychiatrists have office hours at 1 a.m. when the patient is awake and ready.

Monday, December 26, 2011

What the Cats Taught Me About God

Eleanor arrives at the vet: How could Cat Mom allow me to suffer so?
God loves cats. (Yes, He does, you cat-dislikers.) Consider the evidence: He made 49 known species of cat, big and small but otherwise quite similar.  And He made sure to have cats on all continents around the world.  I think it's, in part, because cats remind Him so much of people.

A few years ago, He sent me two of them ... one rescued from a barn and the other who had been abandoned as a newborn kitten at a vet's front door.  These two ... Eleanor and Clarence ... are just the latest of God's creatures to teach me a lot about God ... and the mysteries of suffering.  This happens every time we go to the vet. 

In this scenario, I play the God role, while the cats are people. I know why we are going to the vet.  Sometimes we are healing an injury. Sometimes we are getting an inoculation so the cat won't have something more awful happen to it. 

I would love to explain to Eleanor and Clarence why, but I can't.  Face it, I'm a lot smarter than they are.  And we can't communicate directly about this.  So I just have to hope that they trust me as we get out the carrier and head for the vet. 

Well ... to Eleanor and Clarence  ... trust isn't a natural reaction. They run when they see the carrier.  They fight me with claws and bad attitudes when they are getting in the carrier. They howl in the car. They are scared. Clarence is so scared that he actually poops in the carrier as we drive to the vet and when we are driving FROM the vet.  Every single time. At the vet, neither wants to get OUT of the carrier. They look at me as if I have betrayed them. When the vet offers them cheese ... a favorite snack ... they sniff it with suspicion and refuse the gift. And it takes as much as 24 hours after the vet trip before the cat will allow me to approach them again. 

Frankly, that's a lot like God, me and suffering.  I don't understand why I have to go the Symbolic Vet of Suffering, and God can't tell me.  Face it, He's a lot smarter than I am, He's driving the car, and He understands why I have to get a shot of suffering, even if I don't. 

Eleanor at the vet not speaking to me
God hasn't changed when I suffer, just as I haven't changed when I take the cats to the vet. I'm doing what's best for them. And I wish I could explain it. But I can't.

Saturday, December 10, 2011

How Caregiving Impacts Business. And Why You Should Care.

The bottom-line first.  More than one in six Americans with a part-time or full-time job -- 17 percent -- is a caregiver. They means that they assist with the care for an elderly or disabled family member or friend. And they have to take time off work to do it.

Recent Gallup research sponsored by Pfizer/ReACT (Respect a Caregivers Time) found that caregivers miss an average of 6.6 days of work every year because of their responsibilities. The cost of lost productivity due to absenteeism among the full-time working caregivers is more than $25 billion annually, a figure that rises to $28 billion when you include the part-time workers.

Who are these people?  Take a look.

The time off is generally paid or unpaid vacation time.  Which means the caregivers are the ones losing, not the employers.

But Gallup did analyze the the options that employers can provide to see which helped reduce absenteeism.  The four top benefits were:
  • Counselors to discuss options for assisted living and nursing homes.
  • Access to networks of support groups.
  • Employee Assistance Programs to discuss emotional distress.
  • Health counselors to answer questions about the person being cared for. 
The recommendations suggested that businesses with fewer than 1,000 employees could offer access to support groups and health counselors, while the larger businesses would most benefits from Employee Assistance Programs.

Why should you care? If you work with more than six people, you likely work with a caregiver.  It would be better for you if they has enough support that they could concentrate on doing a good job.