Healing After Loss – by Martha Hickman
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Mental health is also just health, and this book’s about an underexamined area of mental health. We say “underexamined”, because for something that affects almost everyone sooner or later, there’s not nearly so much science being done about it as other areas of mental health.
This is not a book of science per se, but it is a very useful one. The format is:
Each calendar day of the year, there’s a daily reflection, consisting of:
- A one-liner insight about grief, quoted from somebody
- A page of thoughts about this
- A one-liner summary, often formulated as a piece of advice
The book is not religious in content, though the author does occasionally make reference to God, only in the most abstract way that shouldn’t be offputting to any but the most stridently anti-religious readers.
Bottom line: if this is a subject near to your heart, then you will almost certainly benefit from this daily reader.
Click here to check out Healing After Loss, and indeed heal after loss
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
In Crisis, She Went to an Illinois Facility. Two Years Later, She Still Isn’t Able to Leave.
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Series: Culture of Cruelty:Inside Illinois’ Mental Health System
State-run facilities in Illinois are supposed to care for people with mental and developmental disabilities. But patients have been subjected to abuse, neglect and staff misconduct for decades, despite calls for change.
Kaleigh Rogers was in crisis when she checked into a state-run institution on Illinois’ northern border two years ago. Rogers, who has cerebral palsy, had a mental health breakdown during the pandemic and was acting aggressively toward herself and others.
Before COVID-19, she had been living in a small group home; she had been taking college classes online and enjoyed going out with friends, volunteering and going to church. But when her aggression escalated, she needed more medical help than her community setting could provide.
With few viable options for intervention, she moved into Kiley Developmental Center in Waukegan, a much larger facility. There, she says she has fewer freedoms and almost nothing to do, and was placed in a unit with six other residents, all of whom are unable to speak. Although the stay was meant to be short term, she’s been there for two years.
The predicament facing Rogers and others like her is proof, advocates say, that the state is failing to live up to the promise it made in a 13-year-old federal consent decree to serve people in the community.
Rogers, 26, said she has lost so much at Kiley: her privacy, her autonomy and her purpose. During dark times, she cries on the phone to her mom, who has reduced the frequency of her visits because it is so upsetting for Rogers when her mom has to leave.
The 220-bed developmental center about an hour north of Chicago is one of seven in the state that have been plagued by allegations of abuse and other staff misconduct. The facilities have been the subject of a monthslong investigation by Capitol News Illinois and ProPublica about the state’s failures to correct poor conditions for people with intellectual and developmental disabilities. The news organizations uncovered instances of staff who had beaten, choked, thrown, dragged and humiliated residents inside the state-run facilities.
Advocates hoped the state would become less reliant on large institutions like these when they filed a lawsuit in 2005, alleging that Illinois’ failure to adequately fund community living options ended up segregating people with intellectual and developmental disabilities from society by forcing them to live in institutions. The suit claimed Illinois was in direct violation of a 1999 U.S. Supreme Court decision in another case, which found that states had to serve people in the most integrated setting of their choosing.
Negotiations resulted in a consent decree, a court-supervised improvement plan. The state agreed to find and fund community placements and services for individuals covered by the consent decree, thousands of adults with intellectual and developmental disabilities across Illinois who have put their names on waiting lists to receive them.
Now, the state has asked a judge to consider ending the consent decree, citing significant increases in the number of people receiving community-based services. In a court filing in December, Illinois argued that while its system is “not and never will be perfect,” it is “much more than legally adequate.”
But advocates say the consent decree should not be considered fulfilled as long as people with disabilities continue to live without the services and choices that the state promised.
Across the country, states have significantly downsized or closed their large-scale institutions for people with developmental and intellectual disabilities in favor of smaller, more integrated and more homelike settings.
But in Illinois, a national outlier, such efforts have foundered. Efforts to close state-operated developmental centers have been met with strong opposition from labor unions, the communities where the centers are located, local politicians and some parents.
U.S. District Judge Sharon Johnson Coleman in Chicago is scheduled in late summer to decide whether the state has made enough progress in building up community supports to end the court’s oversight.
For some individuals like Rogers, who are in crisis or have higher medical or behavioral challenges, the state itself acknowledges that it has struggled to serve them in community settings. Rogers said she’d like to send this message on behalf of those in state-operated developmental centers: “Please, please get us out once and for all.”
“Living Inside a Box”
Without a robust system of community-based resources and living arrangements to intervene during a crisis, state-operated developmental centers become a last resort for people with disabilities. But under the consent decree agreement, the state, Equip for Equality argues, is expected to offer sufficient alternative crisis supports to keep people who want them out of these institutions.
In a written response to questions, Rachel Otwell, a spokesperson for the Illinois Department of Human Services, said the state has sought to expand the menu of services it offers people experiencing a crisis, in an effort to keep them from going into institutions. But Andrea Rizor, a lawyer with Equip for Equality, said, “They just don’t have enough to meet the demand.”
For example, the state offers stabilization homes where people can live for 90 days while they receive more intensive support from staff serving the homes, including medication reviews and behavioral interventions. But there are only 32 placements available — only four of them for women — and the beds are always full, Rizor said.
Too many people, she said, enter a state-run institution for short-term treatment and end up stuck there for years for various reasons, including shortcomings with the state’s discharge planning and concerns from providers who may assume those residents to be disruptive or difficult to serve without adequate resources.
That’s what happened to Rogers. Interruptions to her routine and isolation during the pandemic sent her anxiety and aggressive behaviors into overdrive. The staff at her community group home in Machesney Park, unsure of what to do when she acted out, had called the police on several occasions.
Doctors also tried to intervene, but the cocktail of medications she was prescribed turned her into a “zombie,” Rogers said. Stacey Rogers, her mom and legal guardian, said she didn’t know where else to turn for help. Kiley, she said, “was pretty much the last resort for us,” but she never intended for her daughter to be there for this long. She’s helped her daughter apply to dozens of group homes over the past year. A few put her on waitlists; most have turned her down.
“Right now, all she’s doing is living inside a box,” Stacey Rogers said.
Although Rogers gave the news organizations permission to ask about her situation, IDHS declined to comment, citing privacy restrictions. In general, the IDHS spokesperson said that timelines for leaving institutions are “specific to each individual” and their unique preferences, such as where they want to live and speciality services they may require in a group home.
Equip for Equality points to people like Rogers to argue that the consent decree has not been sufficiently fulfilled. She’s one of several hundred in that predicament, the organization said.
“If the state doesn’t have capacity to serve folks in the community, then the time is not right to terminate this consent decree, which requires community capacity,” Rizor said.
Equip for Equality has said that ongoing safety issues in these facilities make it even more important that people covered by the consent decree not be placed in state-run institutions. In an October court brief, citing the news organizations’ reporting, Equip for Equality said that individuals with disabilities who were transferred from community to institutional care in crisis have “died, been raped, and been physically and mentally abused.”
Over the summer, an independent court monitor assigned to provide expert opinions in the consent decree, in a memo to the court, asked a judge to bar the state from admitting those individuals into its institutions.
In its December court filing, the state acknowledged that there are some safety concerns inside its state-run centers, “which the state is diligently working on,” as well as conditions inside privately operated facilities and group homes “that need to be addressed.” But it also argued that conditions inside its facilities are outside the scope of the consent decree. The lawsuit and consent decree specifically aimed to help people who wanted to move out of large private institutions, but plaintiffs’ attorneys argue that the consent decree prohibits the state from using state-run institutions as backup crisis centers.
In arguing to end the consent decree, the state pointed to significant increases in the number of people served since it went into effect. There were about 13,500 people receiving home- and community-based services in 2011 compared with more than 23,000 in 2023, it told the court.
The state also said it has significantly increased funding that is earmarked to pay front-line direct support professionals who assist individuals with daily living needs in the community, such as eating and grooming.
In a statement to reporters, the human services department called these and other improvements to the system “extraordinary.”
Lawyers for the state argued that those improvements are enough to end court oversight.
“The systemic barriers that were in place in 2011 no longer exist,” the state’s court filing said.
Among those who were able to find homes in the community is Stanley Ligas, the lead plaintiff in the lawsuit that led to the consent decree. When it was filed in 2005, he was living in a roughly 100-bed private facility but wanted to move into a community home closer to his sister. The state refused to fund his move.
Today, the 56-year-old lives in Oswego with three roommates in a house they rent. All of them receive services to help their daily living needs through a nonprofit, and Ligas has held jobs in the community: He previously worked in a bowling alley and is now paid to make public appearances to advocate for others with disabilities. He lives near his sister, says he goes on family beach vacations and enjoys watching professional wrestling with friends. During an interview with reporters, Ligas hugged his caregiver and said he’s “very happy” and hopes others can receive the same opportunities he’s been given.
While much of that progress has come only in recent years, under Gov. JB Pritzker’s administration, it has proven to be vulnerable to political and economic changes. After a prolonged budget stalemate, the court in 2017 found Illinois out of compliance with the Ligas consent decree.
At the time, late and insufficient payments from the state had resulted in a staffing crisis inside community group homes, leading to escalating claims of abuse and neglect and failures to provide routine services that residents relied on, such as help getting to work, social engagements and medical appointments in the community. Advocates worry about what could happen under a different administration, or this one, if Illinois’ finances continue to decline as projected.
“I acknowledge the commitments that this administration has made. However, because we had so far to come, we still have far to go,” said Kathy Carmody, chief executive of The Institute on Public Policy for People with Disabilities, which represents providers.
While the wait for services is significantly shorter than it was when the consent decree went into effect in 2011, there are still more than 5,000 adults who have told the state they want community services but have yet to receive them, most of them in a family home. Most people spend about five years waiting to get the services they request. And Illinois continues to rank near the bottom in terms of the investment it makes in community-based services, according to a University of Kansas analysis of states’ spending on services for people with intellectual and developmental disabilities.
Advocates who believe the consent decree has not been fulfilled contend that Illinois’ continued reliance on congregate settings has tied up funds that could go into building up more community living options. Each year, Illinois spends about $347,000 per person to care for those in state-run institutions compared with roughly $91,000 per person spent to support those living in the community.
For Rogers, the days inside Kiley are long, tedious and sometimes chaotic. It can be stressful, but Rogers told reporters that she uses soothing self-talk to calm herself when she feels sad or anxious.
“I tell myself: ‘You are doing good. You are doing great. You have people outside of here that care about you and cherish you.’”
This article is republished from ProPublica under a Creative Commons license. Read the original article.
Share This Post
Rewire Your OCD Brain – by Dr. Catherine Pittman & Dr. William Youngs
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
OCD is just as misrepresented in popular media as many other disorders, and in this case, it’s typically not “being a neat freak” or needing to alphabetize things, so much as having uncontrollable obsessive intrusive thoughts, and often in response to those, unwanted compulsions. This can come from unchecked spiralling anxiety, and/or PTSD, for example.
What Drs. Pittman & Young offer is an applicable set of solutions, to literally rewire the brain (insofar as synapses can be considered neural wires). Leveraging neuroplasticity to work with us rather than against us, the authors talk us through picking apart the crossed wires, and putting them back in more helpful ways.
This is not, by the way, a book of CBT, though it does touch on that too.
Mostly, the book explains—clearly and simply and sometimes with illustrations—what is going wrong for us neurologically, and how to neurologically change that.
Bottom line: whether you have OCD or suffer from anxiety or just need help dealing with obsessive thoughts, this book can help a lot in, as the title suggests, rewiring that.
Click here to check out Rewire Your OCD Brain, and banish obsessive thoughts!
Share This Post
Dodging Dengue In The US
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Dengue On The Rise
We wrote recently about dengue outbreaks in the Americas, with Puerto Rico declaring an epidemic. Cases are now being reported in Florida too, and are likely to spread, so it’s good to be prepared, if your climate is of the “warm and humid” kind.
If you want to catch up on the news first, here you go:
- UN health agency cites tenfold increase in reported cases of dengue over the last generation
- Puerto Rico has declared an epidemic following a spike in dengue cases
- Dengue fever confirmed in Florida Keys as US on watch for rise in mosquito illness
Note: dengue is far from unheard of in Florida, but the rising average temperatures in each year mean that each year stands a good chance of seeing more cases than the previous. It’s been climbing since at least 2017, took a dip during the time of COVID restrictions keeping people at home more, and then for the more recent years has been climbing again since.
What actually is it?
Dengue is a viral, mosquito-borne disease, characterized by fever, vomiting, muscle pain, and a rash, in about 1 in 4 cases.
Which can sound like “you’ll know if you have it”, but in fact it’s usually asymptomatic for a week or more after infection, so, watch out!
What next, if those symptoms appear?
The good news is: the fever will usually last less than a week
The bad news is: a day or so after that the fever subsided, the more serious symptoms are likely to start—if they’re going to.
If you’re unlucky enough to be one of the 1 in 20 who get the serious symptoms, then you can expect abdominal cramps, repeat vomiting, bleeding from various orifices (you may not get them all, but all are possible), and (hardly surprising, given the previous items) “extreme fatigue and restlessness”.
If you get those symptoms, then definitely get to an ER as soon as possible, as dengue can become life-threatening within hours of such.
Read more: CDC | Symptoms of Dengue and Testing
While there is not a treatment for dengue per se, the Emergency Room will be better able to manage your symptoms and thus keep you alive long enough for them to pass.
If you’d like much more detail (on symptoms, seriousness, at-risk demographics, and prognosis) than what the CDC offers, then…
Read more: BMJ | Dengue Fever
Ok, so how do we dodge the dengue?
It sounds flippant to say “don’t get bitten”, but that’s it. However, there are tips are not getting bitten:
- Use mosquito-repellent, but it has to contain >20% DEET, so check labels
- Use mosquito nets where possible (doors, windows, etc, and the classic bed-tent net is not a bad idea either)
- Wear clothing that covers your skin, especially during the day—it can be light clothing; it doesn’t need to be a HazMat suit! But it does need to reduce the area of attack to reduce the risk of bites.
- Limit standing water around your home—anything that can hold even a small amount of standing water is a potential mosquito-breeding ground. Yes, even if it’s a crack in your driveway or a potted bromeliad.
Further reading
You might also like to check out:
Stickers and wristbands aren’t a reliable way to prevent mosquito bites. Here’s why
…and in case dengue wasn’t bad enough:
Mosquitoes can spread the flesh-eating Buruli ulcer. Here’s how you can protect yourself
Take care!
Share This Post
Related Posts
Ready to Run – by Kelly Starrett
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
If you’d like to get into running, and think that maybe the barriers are too great, this is the book for you.
Kelly Starrett approaches running less from an “eye of the tiger” motivational approach, and more from a physiotherapy angle.
The first couple of chapters of the book are explanatory of his philosophy, the key component of which being:
Routine maintenance on your personal running machine (i.e., your body) can be and should be performed by you.
The second (and largest) part of the book is given to his “12 Standards of Maintenance for Running“. These range from neutral feet and flat shoes, to ankle, knee, and hip mobilization exercises, to good squatting technique, and more.
After that, we have photographs and explanations of maintenance exercises that are functional for running.
The fourth and final part of the book is about dealing with injuries or medical issues that you might have.
And if you think you’re too old for it? In Starrett’s own words:
❝Problems are going to keep coming. Each one is a gift wanting to be opened—some new area of performance you didn’t know you had, or some new efficiency to be gained. The 90- to 95-year-old division of the Masters Track and Field Nationals awaits. A Lifelong commitment to solving each problem that creeps up is the ticket.❞
In short: this is the book that can get you back out doing what you perhaps thought you’d left behind you, and/or open a whole new chapter in your life.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
Red-dy For Anything Polyphenol Salad
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
So, you’ve enjoyed your Supergreen Superfood Salad Slaw, and now you’re ready for another slice of the rainbow. Pigments in food aren’t just for decoration—they each contain unique benefits! Today’s focus is on some red foods that, combined, make a deliciously refreshing salad that’s great for the gut, heart, and brain.
You will need
- 1 cup crème fraîche or sour cream (if vegan, use our Plant-Based Healthy Cream Cheese recipe, and add the juice of 1 lime)
- ½ small red cabbage, thinly sliced
- 1 red apple, cored and finely chopped
- 1 red onion, thinly sliced
- 10 oz red seedless grapes, halved
- 10 oz red pomegranate seeds
- 1 tsp red chili flakes
Method
(we suggest you read everything at least once before doing anything)
1) Combine all the red ingredients in a big bowl.
2) Add the crème fraîche and mix gently but thoroughly.
3) If you have time, let it sit in the fridge for 48 hours before enjoying, as its colors will intensify and its polyphenols will become more bioavailable. But if you want/need, you can serve immediately; that’s fine too.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Resveratrol & Healthy Aging
- Tasty Polyphenols For Your Heart And Brain
- Pomegranate vs Cherries – Which is Healthier?
- Capsaicin For Weight Loss And Against Inflammation
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
Overdone It? How To Speed Up Recovery After Exercise
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
How To Speed Up Recovery After A Workout (According To Actual Science)
Has your enthusiasm ever been greater than your ability, when it comes to exercise?
Perhaps you leapt excitedly into a new kind of exercise, or maybe you made a reprise of something you used to do, and found out the hard way you’re not in the same condition you used to be?
If you’ve ever done an exercise session and then spent the next three days recovering, this one’s for you. And if you’ve never done that? Well, prevention is better than cure!
Post-exercise stretching probably won’t do much to help
If you like to stretch after a workout, great, don’t let us stop you. Stretching is, generally speaking, good.
But: don’t rely on it to hasten recovery. Here’s what scientists Afonso et al. had to say recently, after doing a big review of a lot of available data:
❝There wasn’t sufficient statistical evidence to reject the null hypothesis that stretching and passive recovery have equivalent influence on recovery.
Data is scarce, heterogeneous, and confidence in cumulative evidence is very low. Future research should address the limitations highlighted in our review, to allow for more informed recommendations.
For now, evidence-based recommendations on whether post-exercise stretching should be applied for the purposes of recovery should be avoided, as the (insufficient) data that is available does not support related claims.❞
…and breath! What a title.
Hot and Cold
Contrast bath therapy (alternating hot and cold, which notwithstanding the name, can also be done in a shower) can help reduce muscle soreness after workout, because of how the change in temperature stimulates vasodilation and vasoconstriction, reducing inflammation while speeding up healing:
Contrast Water Therapy and Exercise Induced Muscle Damage: A Systematic Review and Meta-Analysis
If doing this in the shower isn’t practical for you, and you (like most people) have only one bathtub, then cold is the way to go for the most evidence-based benefits:
Whole-Body Cryotherapy in Athletes: From Therapy to Stimulation. An Updated Review of the Literature
Eat protein whenever, carbs after
Eating protein before a workout can boost muscle protein synthesis. Be aware that even if you’re not bodybuilding, your body will still need to do cell replacement and repair, including in any muscle tissue that got damaged* during the workout
If you don’t like eating before a workout, eating protein after is fine too:
Pre- versus post-exercise protein intake has similar effects on muscular adaptations
*Note: muscle tissue is supposed to get damaged (slightly!) during many kinds of workout.
From lactic acid (that “burn” you feel when exercising) to microtears, the body’s post-workout job is to make the muscle stronger than before, and to do that, it needs you to have found the weak spots for it.
That’s what exercise-to-exhaustion does.
Eating carbs after a workout helps replace lost muscle glycogen.
For a lot more details on optimal nutrition timing in the context of exercise (carbs, proteins, micronutrients, different kinds of exercise, etc), check out this very clear guide:
International society of sports nutrition position stand: nutrient timing
Alcohol is not the post-workout carb you want
Shocking, right? But of course, it’s very common for casual sportspeople to hit the bar for a social drink after their activity of choice.
However, consuming alcohol after exercise doesn’t merely fail to help, it actively inhibits glycogen replacement and protein synthesis:
Also, if you’re tempted to take alcohol “to relax”, please be aware that alcohol only feels relaxing because of what it does to the brain; to the rest of the body, it is anything but, and also raises blood pressure and cortisol levels.
As to what to drink instead…
Hydrate, and consider creatine and tart cherry supplementation
Hydration is a no-brainer, but when you’re dehydrated, it’s easy to forget!
Creatine is a very well-studied supplement, that helps recovery from intense exercise:
Tart cherry juice has been found to reduce muscle damage, soreness, and inflammation after exercise:
Wondering where you can get tart cherry powder? We don’t sell it (or anything else), but here’s an example product on Amazon.
And of course, actually rest
That includes good sleep, please. Otherwise…
Effects of Sleep Deprivation on Acute Skeletal Muscle Recovery after Exercise
Rest well!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: