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Be aware that hiring a worker from an agency or private source does not guarantee the quality o f serv ices provided. It is important to monitor the quantity and quality o f services rendered. Thus, it is important to maintain regular contact with care providers. I f you live far, let them know they can call you collect. Keep caregivers updated on your relative’ s health condition and have them contact you if they notice any changes. B e on the lookout for signs o f trouble. Check for signs that work isn’t being done. Be alert for signs o f abuse. I f your elder seems frightened or withdrawn, there m ay be a serious problem. B e supportive o f the care worker and be aware o f cultural differences that could affect quality o f service. Volunteer and low-cost services can supplement or even reduce the hours o f home care services. They can be secured by contacting a variety o f community organizations: community centers, seniors’ organiza tions, church groups, w om en’s groups, or agencies on aging. Services frequently provided by these groups include friendly visitors who can read to the elderly o f perform chores, home-delivered meals, escort services to doctors’ appointments, telephone reassurance serv ices, and transportation to senior centers or shopping. Such services can help prevent feelings o f isolation. A volunteer who maintains regular contact with your elder helps to bridge the gap between the older person and the outside world. This can be a vital force in pre venting institutional care. Maintaining an older person at home involves a great deal o f planning, research, and monitoring. It requires an ongoing, active involvement in our par ents’ lives. The home care process is not static; it can change from day to day. A careful assessment o f needs and risks, open communication, continuous monitoring, and making use o f available community services are the keys to success. The rewards o f help ing an elderly parent or relative to live at home far outweigh the demands that are placed on the caregiver. Secure and well cared for in a comfortable and familiar setting, this person w ill enrich the lives o f all fam ily members and w e can all benefit from their wisdom and life experiences. The author's next article will be on Nursing Home Care: Choosing, Advocacy and Survival. irritable Bowel Syndrome by Ihor Magun, M.D., F.A.C..P. One o f the most common gastrointestinal dis eases encountered in clinical practice is the irritable bowel syndrome (IBS). This condition occurs three times more often in women than in men. Many individuals who have the disease are not even aware that it is a problem. Because symptoms are intermittent and are not life- threatening they often assume that this is a "normal" bowel pattern. IBS is actually defined as a functional disorder that has altered bowel patterns, is characterized by ab dominal pain, and is present for at least three months. There are several subtypes described primarily by other predominant symptoms - constipation, diarrhea, or pain. The pattern may include a combination o f all three or alternating between diarrhea and constipation. The condi tion is usually not associated with changes in appetite, weight, or temperature. There is generally no evidence of any bleeding noticed by the patient or evaluated by a physician. Given the lack o f a clear biological test, diagno sis of IB S relies on an evaluation o f symptoms. The diag nostic criteria specify that for at least twelve weeks in a twelve-month period, the patient has suffered from ab dominal discomfort or pain, which is relieved by defeca tion, or has experienced a change in stool frequency and a change in the form or appearance o f the stool. Clinical manifestations may also include upper abdominal symp toms such as feelings o f improper digestion or nausea. If the above criteria are fulfilled, limited labora tory tests are necessary. For patients younger than fifty, an office evaluation o f the lower part o f the colon (sig moidoscopy) may be sufficient. For patients older than fifty, a colonoscopy is recommended. Individuals with a family history o f colon cancer or whose symptoms change rapidly or worsen require additional evaluation. Treatment is focused on controlling predominant symptoms. IB S is a disease, but it rarely leads to surgery or decreased life-expectancy. For individuals with mild symptoms, dietary changes may be necessary and may include avoidance o f certain food types, among them caffeine, alcohol, and gas-producing foods (for example, foods from the cabbage family). Soluble fiber is recom mended for constipation. Care must be used when eating raw fruits and vegetables because these may exacerbate symptoms by increasing gaseous distention. Medications are available, but should be used only on a limited basis due to the chronic nature of the disease. A patient's symptoms are the primary determi nant o f which medication should be used. Communicat ing with your physician about this chronic problem is important. There is no reason to suffer the chronic dis comfort associated with IB S when advice and help are readily available. 18 “НАШЕ ЖИТТЯ”, СІЧЕНЬ 2003 Видання C оюзу Українок A мерики - перевидано в електронному форматі в 2012 році . A рхів C У A - Ню Йорк , Н . Й . C Ш A.
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