Holy Week and our Present Juxtaposition

For millions of Christians Holy Week is an emotionally turbulent time if one permits him or herself to become immersed in the reality of the events. One can experience a full range of emotions including loss, fear, anxiety, depression, joy, hope, and eternal love. Indeed, this is by design with Easter Sunday representing a day of triumph and celebration of faith.

Today, it is nearly impossible to not experience the same roller coaster of emotions granted us by the seemingly endless parade of evil in our world. Consider your emotions stirred by these events and as we witness horror on our television screens or computers.  I watch with obvious concern as to how humans can get to such a point as to hate and to kill fellow humans. I listen to men and women share ideas of how to cleanse the planet from such evil and I continue to be led to the teachings of Christ.

We are again a planet and people confronted by evil while simultaneously living in real time the Holy Week celebrated by so many and understood by even more. The obvious lessons this week teaches all of us continue to be so critical today, especially today. Love will always triumph over hate;  forgiveness, no matter how difficult or evil the deed against us, brings us salvation. Our answers we seek will not be found by earth-bound beings. Such answers lie in a greatness far greater than us and I believe our entire human race is in dire need of connecting with the greater power we call God.

For all Christians and all humans, I pray we can take some time this Holy Week and regardless of one's background or religion, consider the teachings of Christ. He was put to death by evil and yet he forgave so that we might also be forgiven. Love triumphs even when juxtaposed to hate and evil.

If you read this anywhere on the planet, reach out to someone and express love to them (perhaps even a simple "high five" for love). It sounds basic, but there are many more of us who are filled with love than those filled with hate. Follow the teachings of Christ this week and let love guide us to a more peaceful planet.

Happy Easter to All.

Dr. Nussbaum

TBI: Get the Facts

Overview

Traumatic brain injury (TBI) is a major cause of death and disability in the United States, contributing to about 30% of all injury deaths.¹  Every day, 138 people in the United States die from injuries that include TBI.  Those who survive a TBI can face effects lasting a few days to disabilities which may last the rest of their lives.  Effects of TBI can include impaired thinking or memory, movement, sensation (e.g., vision or hearing), or emotional functioning (e.g., personality changes, depression).  These issues not only affect individuals but can have lasting effects on families and communities.

What is a TBI?

A TBI is caused by a bump, blow, or jolt to the head or a penetrating head injury that disrupts the normal function of the brain. Not all blows or jolts to the head result in a TBI. The severity of a TBI may range from “mild” (i.e., a brief change in mental status or consciousness) to “severe” (i.e., an extended period of unconsciousness or memory loss after the injury).  Most TBIs that occur each year are mild, commonly called concussions.²

How big is the problem?

• In 2010, about 2.5 million emergency department (ED) visits, hospitalizations, or deaths were associated with TBI—either alone or in combination with other injuries—in the United States. 
• TBI contributed to the deaths of more than 50,000 people.
• TBI was a diagnosis in more than 280,000 hospitalizations and 2.2 million ED visits.  These consisted of TBI alone or TBI in combination with other injuries.
• Over the past decade (2001–2010), while rates of TBI-related ED visits increased by 70%, hospitalization rates only increased by 11% and death rates decreased by 7%. 
• In 2009, an estimated 248,418 children (age 19 or younger) were treated in U.S. EDs for sports and recreation-related injuries that included a diagnosis of concussion or TBI.³
• From 2001 to 2009, the rate of ED visits for sports and recreation-related injuries with a diagnosis of concussion or TBI, alone or in combination with other injuries, rose 57% among children (age 19 or younger).³

What are the leading causes of TBI? 

• From 2006–2010, falls were the leading cause of TBI, accounting for 40% of all TBIs in the United States that resulted in an ED visit, hospitalization, or death.  Falls disproportionately affect the youngest and oldest age groups:
• More than half (55%) of TBIs among children 0 to 14 years were caused by falls.               
• More than two-thirds (81%) of TBIs in adults aged 65 and older are caused by falls.

• Unintentional blunt trauma (e.g., being hit by an object) was the second leading cause of TBI, accounting for about 15% of TBIs in the United States for 2006–2010.
• Close to a quarter (24%) of all TBIs in children less than 15 years of age were related to blunt trauma
• Among all age groups, motor vehicle crashes were the third overall leading cause of TBI (14%).   When looking at just TBI-related deaths, motor vehicle crashes were the second leading cause of TBI-related deaths (26%) for 2006–2010.
• About 10% of all TBIs are due to assaults. They accounted for 3% of TBIs in children less than 15 years of age and 1.4% of TBIs in adults 65 years and older for 2006–2010.  About 75% of all assaults associated with TBI occur in persons 15 to 44 years of age.

Risk factors for TBI

Among TBI-related deaths in 2006–2010:

• Men were nearly three times as likely to die as women.
• Rates were highest for persons 65 years and older.
• The leading cause of TBI-related death varied by age.
• Falls were the leading cause of death for persons 65 years or older.
• Motor vehicle crashes were the leading cause for children and young adults ages 5-24 years.
• Assaults were the leading cause for children ages 0-4.

Among non-fatal TBI-related injuries for 2006–2010:

• Men had higher rates of TBI hospitalizations and ED visits than women.
• Hospitalization rates were highest among persons aged 65 years and older.
• Rates of ED visits were highest for children aged 0-4 years.
• Falls were the leading cause of TBI-related ED visits for all but one age group.
• Assaults were the leading cause of TBI-related ED visits for persons 15 to 24 years of age.
• The leading cause of TBI-related hospitalizations varied by age:
• Falls were the leading cause among children ages 0-14 and adults 45 years and older.
• Motor vehicle crashes were the leading cause of hospitalizations for adolescents and persons ages 15-44 years.

References

1. Faul M, Xu L, Wald MM, Coronado VG. Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2010.
2. Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control. Report to Congress on mild traumatic brain injury in the United States: steps to prevent a serious public health problem. Atlanta (GA): Centers for Disease Control and Prevention; 2003.
3. Centers for Disease Control and Prevention. Nonfatal Traumatic Brain Injuries Related to Sports and Recreation Activities Among Persons Aged ≤19 Years — United States, 2001–2009. MMWR 2011; 60(39):1337–1342.

All You Need is Love

Each year we are provided with a day to celebrate Love and it is called Valentine's Day. This day involves the typical last minute anxiety laced behavior by men to select their sweetheart a special gift.  It is true we men sometimes wait until the last minute, but hopefully the thought and gesture is well intentioned and sincerely felt.

The day also is an opportunity for all of us to become conscious of the most powerful energy on the planet-Love. Sometimes referred to as an emotion, chemical, force and more, Love has been the subject of stories both romantic and tragic since the written history began. Our most intelligent people have not been able to define or understand Love and the phrase "love is blind" has more neuroanatomical truth behind it than most realize!

While all the gifts are nice and the time spent with our loved ones is so important, I want to emphasize how important it is now that all humans begin to tap into, feel, and express Love not just this day, but all days. I believe the human race is in some serious need of a good dosage of Love as we have become rather bitter, hostile, and angry towards one another. There is too much war and unnecessary death. Each of these are the exact opposite of Love and once again a completely different set of systems in the brain are being used.

God gave us a brain and in the brain a reward system that carries with it the ability to love and to feel the euphoria of love. Let us all try to spend a little time each day using this gift and sharing this thing called Love with as many people as we can. This means even with those who we might think least deserve it.

In the words of St. Paul, "in the end there are but three truths, Love, Hope, and Faith and the greatest of these is Love."

Happy Valentine's Day,

Dr. Nussbaum
Brain Health Center
www.brainhealthctr.com
@brainhealthctr

Merry Christmas and A Prayer for Love, Forgiveness, and Hope

            The Christmas Holiday Season is upon us and represents a very important day for Christians all across the planet. This season brings an opportunity to stop, reflect, and to heal. Regardless of belief system or background, all humans benefit from feeling and expressing love, forgiveness, and hope.

            Today, we are a nation in need of healing in many ways. We seem to be split on too many factors from politics, socioeconomic structure, religion, race, gender, etc. Our days are spent engaged in hurtful and harmful behavior, judgment, and gossip towards one another. We seem to have lost a sense of grace, kindness, and compassion and we might need to be reminded that we are all humans with so much in common.

            It is not difficult to turn the television on and witness much violence, hatred, and killing across the world. Once again, humans with so much in common have instead turned to rage and hatred that splits us and keeps us from the greatness the human race can and should be.

            We often turn to political leaders to resolve such issues and we might believe there are laws that can fix the problems we face. While that will continue to be a strategy worldwide, I think Christmas offers another strategy, one that is much more human and indeed real.

            My prayer for this Christmas and Holiday Season is for all Americans and indeed all humans on planet earth to turn to the greatest healing medicines of all time: Love, Forgiveness, and Hope. Let us work to express our love for one another, to forgive those who have hurt us, and to offer hope to those in need.

            It is very true that there are those in our world who will not join me in this prayer. However, there are millions of us on this planet who are filled with Love, Forgiveness, and Hope and together we can unite our nation and world for a better tomorrow.

            Jesus taught us to love others, as we want to be loved, to forgive those who trespass against us, and to always have hope. We are meant to help others and to be compassionate to those most in need. We are to free ourselves from angst and bitterness and all anxiety. Each of us has this power within and it really is the best path to our healing and feeling whole as a world again.

            Join me this Christmas and Holiday Season in prayer for and expression of Love, Forgiveness, and Hope!

God Bless Everyone,

Dr. Nussbaum

www.brainhealthctr.com

Money and Dementia: A Crisis Starting to Happen

It seems that there is always a looming catastrophe on the horizon as the huge group of boomers move toward their senior years.  With boomers turning 65 at a rate of 10,000 per day and this phenomenon continuing until 2030, any problem skyrockets into a catastrophe.  Add to the vast number of boomers becoming seniors, the fact that $42 trillion (yes, that’s a T) worth of assets rests in their hands and the hands of their parents.  Now as wealth and large groups of seniors converge, stir in the projected incidence of dementia and you now have a picture of an impending crisis.

Let’s step back from the ledge for a moment and get down to the individual impact memory loss has on financial competency.  There are normal declines that occur to the brain as we age.  Problem solving skills diminish with age; memory, analytical reasoning and processing speed decline with age.  Reasoning skills actually drop steadily after a peak at age 53.  Finally aging erodes financial acumen resulting in mistakes with credit cards, home-equity loans, and how to pay for healthcare.

The ability to take care of our finances is termed financial capacity which includes routine tasks like basic monetary skills, carrying out cash transactions, managing a checkbook. bank statement, and exercising financial judgment.  Financial literacy takes financial knowledge a little farther.  Concepts of investing and inflation are part of the landscape of financial literacy.  And guess what – financial literacy decreases with age.  Older investors are less effective in applying their investment knowledge and demonstrated worse investment skill. 

Everything I just described occurs with normal aging and sustaining these types of losses puts older people at a greater risk for frauds and scams. 

Now let’s look at the financial abilities of someone who is cognitively impaired (e.g. Alzheimer’s disease).  Diminished financial capacity becomes apparent when it becomes difficult to identify and count money, understand debt and loans, conduct cash transactions, and pay bills– the most basic of financial skills.  Financial capacity is one of the first abilities to decline with the onset of cognitive impairment.  These declining skills are apparent even before a diagnosis of dementia is made.  Loss of financial skills is a dilemma for this group because in all other aspects of their lives they may appear to be performing normally.  So how are these people found out?  This might be the first indication to family members that there is a problem.  They stop in to say hi and see a pile of unpaid bills sitting on the desk.  They could notice receipts for outrageous purchases.  And they are usually met with resistance when asking about these issues because there is so much fear on the part of their loved one that they will lose financial autonomy.  Even though they are clearly not able to take care of their financial responsibilities, they don’t understand why this is a problem that needs to be attended to.

There are six warning signs of diminished financial capacity:

1.     Memory lapses: bill paying is dependent on memory – forgetting to pay a bill or repeatedly paying the same bill; multiple trips to the ATM or the bank to withdraw money; errors in check writing

2.     Disorganization:  handling bills, keeping track of finances, managing important financial documents – actions that are difficult to perform because there is so much disorganization of paperwork

3.     Decline in checkbook management skills:  this is one of the very first skills to decline; requires procedural skills which are dependent on executive abilities of the brain

4.     Arithmetic mistakes:  decline in both written and oral arithmetic skills

5.     Conceptual confusion:  new difficulty understanding financial terms and concepts

6.     Impaired judgment:  new interest in get rich quick schemes; change in risk preference regarding investment decisions; new found enthusiasm for questionable investments; new reports of erratic, unusual, or uncharacteristic purchases, withdrawals, or gifts.; with poor judgment comes the risk of succumbing to telephone, mail, and internet schemes; problem with impulsivity leading to gambling and overspending.

The inability to handle financial decisions puts this group at high risk for exploitation and abuse. This group possesses a large portion of our nation’s wealth.  A 2011 Metlife Mature Market study found older adults lose $2.9 billion annually.  1 in 10 adults is a victim of mistreatment.  5.2% experience financial mistreatment by a family member.  Of all forms of elder abuse, the highest rate of mistreatment was major financial exploitation.  Bringing this tragedy home was the appearance of Micky Rooney before Congress.  He testified how his family had mistreated him and exploited his finances.  This is a cold, heartless act of abuse.

Are there any solutions emerging for this impending crisis?  The financial industry is taking steps to put safeguards in place to protect their older clients.  The Financial Industry Regulatory Authority reported that some financial firms are including paperwork to access referrals to relatives, or others in the event that signs of diminished capacity surface with their client.  Wells Fargo Advisors launched an Elder Client Initiatives team to answer questions from their advisors around the country on how to handle cases of possible dementia.  AARP is working with the American Bankers Association Foundation on education materials for consumers, financial caregivers and bankers on age-friendly banking -> how to address dementia, fraud, and financial caregiving.

This educational push is critical to alert bankers, financial planners, and families on recognizing signs of dementia and appropriate steps to safeguard assets of clients and family members.  These solutions and safeguards need to be in place as soon as possible because this problem grows bigger by the day.

´  Ambrose,E. (October, 2015). Money and memory: a coming crisis. AARP Bulletin/Real Possibilities.

´ Financial Capacity and Competency in an Aging America. (Summer, 2012). Generations 36(2). Published by the American Society on Aging. 71 Stevenson Street, Suite 1450, San Francisco, CA 94105-2938.

´ Ross,V. (Nov. 18, 2010). Older but not wiser? The psychology behind seniors’ susceptibility to scams. Retrieved September 4, 2015 from http://www.scientificamerican.com/article/older-but-not-wiser/?print=true

Power of Thank You

Thank You

Two simple words that can make a difference. By saying Thank You it indicates you are appreciative of someone for something they did. It also means that there is someone in your life who has done a good deed or said something nice to you. It seems to me that as difficult as our world can be at times these two words might help to make our lives just a little bit better.

In the near future we will celebrate a holiday known as Thanksgiving. This holiday has historical import for our nation and it also provides an annual opportunity for all of us to stop, reflect, and to give Thanks.

Families will gather, friends will unite, and a celebration of unity and food will mark a day for expression of love, humility, and indeed Thanks. The most precious gifts we have do not come in boxes or bags. Rather, family members who may be with you in person or in spirit represent what is most important. It is good to share a smile, tell each and everyone that you love them, and just hold on to a hug for an extra moment as you smile and feel the spiritual connection that love brings.

For some, this holiday might spark tension and offer the opportunity to think about small battles that might be present between family members. I encourage all to use the Holiday as a time to heal, to share love, and to express Thanks. Do so with those where some tension exists and you will feel the healing power of grace even more.

Happy Thanksgiving to you and please take a moment to be with those who mean so much to you. Regardless of our particular situation, we have much to be thankful.

Dr. Nussbaum

Patience Really is a Virtue:

Most of us feel a bit rushed now and then. Most of what we need yesterday is not worth the angst that fills our body and brain. A deep breath and reconnection with the big picture can help in such situations. In general, slow your life down and work on the virtue of patience.
Dr. N.
@brainhealthctr
www.brainhealthctr.com