The Marker - 2004 - Huntington's Disease Society of America

The Marker - 2004 - Huntington's Disease Society of America The Marker - 2004 - Huntington's Disease Society of America

08.01.2014 Views

CCA AR RE EGG I IV VE ER RS S ’ ’ L LI INN K K HDSA thanks The Bess Spiva Timmons Foundation, a Founding Benefactor, for its sponsorship of Caregivers’ Link, which includes the following articles in this issue: Caregiver Depression, Update on Social Security Disability and Planning Ahead with Long Term Care Insurance. Caregiver Depression One of today’s all-too silent health crises is caregiver depression. A conservative estimate reports that 20% of family caregivers suffer from depression, twice the rate of the general population. A study by the California Caregiver Resource Centers found that 41% of former caregivers of a spouse with Alzheimer’s or other form of dementia experience mild to severe depression up to three years after their spouse had died. In general, women caregivers experience depression at a higher rate than men. Caregiving doesn’t cause depression nor will everyone who provides care experience the negative feelings that go with depression. But in an effort to provide the best possible care for a family member or friend, caregivers often sacrifice their own physical and emotional needs. The resulting feelings of anger, anxiety, sadness, isolation, exhaustion – and then guilt for having these feelings – can extract a heavy toll. Unfortunately, feelings of depression are often seen as a sign of weakness. Comments such as ‘snap out of it,’ or ‘it’s all in your head’ are not helpful and reflect a belief that mental health concerns are not real. Ignoring or denying your feelings will not make them go away. People experience depression in different ways, and the type and degree of symptoms can vary by individual and change over time. The following symptoms may indicate depression if experienced for more than two consecutive weeks: • Change in eating habits that results in unwanted weight loss or gain; • Change in sleep patterns – too much or not enough sleep; • Feeling tired all the time; • Loss of interest in people and/or activities that once brought pleasure; • Becoming easily agitated or angered; • Feeling that nothing you do is good enough; • Thoughts of death or suicide, or attempting suicide; • Ongoing physical symptoms that do not respond to treatment such as headaches, digestive disorders and chronic pain. Early attention to symptoms of depression may help to prevent more serious depression over time. The National Institute of Mental Health offers the following recommendations to cope with depression: 1. Set realistic goals. 2. Break large tasks into small ones, prioritize and do what you can. 3. Try to be with other people and confide in someone; it is usually better than being alone and secretive. 4. Participate in activities that make you feel better such as exercise, going to a movie or attending a religious or social event. 5. Expect your mood to improve gradually. 20 continued on page 32

Social Security Disability Update By Suzanne Doggett, Esq. Huntington’s Disease is a hereditary brain disorder that slowly robs the individual of his/her ability to walk, talk, think and reason. Eventually, the person affected by HD will rely upon someone for assistance in all of their daily needs. However, long before that stage of the disease, most people affected by HD will lose their ability to work and find that they must apply to the Social Security Administration (SSA) for benefits under Social Security Disability Income Blue Book has limited information about Huntington’s Disease and even refers to HD as Huntington’s Chorea, thus ignoring the mental and emotional aspects of the disease. Individuals, family members, social workers and doctors at our HDSA Centers of Excellence report a variety of difficulties and delays in obtaining social security disability benefits. The difficulties in obtaining benefits can be categorized as follows: •The absence of readily apparent “...HDSA Centers of Excellence report a variety of difficulties and delays in obtaining social security disability benefits.” •Difficulty, given the often subtle onset of symptoms, in pinpointing exactly when a person with HD first became disabled; •Lack of familiarity with HD on the part of many caseworkers. (SSDI). This life line provides financial benefits for those determined to be disabled under a variety of definitions including medical, mental and emotional. Those who apply for this form of assistance are required to complete an extensive application for benefits including a medical report and supporting letter of disability from the patient’s neurologist or primary care physician familiar with the disease or condition. Currently, Social Security Administration caseworkers rely upon neurological medical criteria set forth in a book called Disability Evaluation Under Social Security (often referred to as the Blue Book because of its original blue cover) in making decisions about an individual’s eligibility for social security disability benefits. Unfortunately, the dysfunction especially if the chorea or movement disorder has not yet appeared or is the more subtle symptoms such as loss of fine motor coordination and the slowing of eye movements; •The belief on the part of the social security caseworker that the applicant and his or her symptoms will improve with treatment; •The relative youth of the applicant, especially for individuals applying in their thirties and forties; •The applicant’s lack of insight (which is a symptom of the disease itself) about the progression of the disease with the result that the affected individual is not able to give an accurate assessment of his or her condition to the caseworker; Last Spring, at the invitation of the Social Security Administration, HDSA offered its suggestions on how the Blue Book could be revised to better address Huntington’s Disease. Our suggestions have been well received and will be considered as part of SSA’s review of its neurological listings later this year. We hope that the changes, if finally implemented, would save time, money, resources and emotional energy on the part of the Social Security Administration and the individuals and families it serves who suffer with the effects of Huntington’s Disease. In the meantime, we will continue to monitor the progress of the neurological listings review. Suzanne Doggett, Esq. is a member of the HDSA national Board of Trustees and Chair of the national Advocacy Committee. 21

CCA AR RE EGG I IV VE ER RS S ’ ’ L LI INN K K<br />

HDSA thanks<br />

<strong>The</strong> Bess Spiva<br />

Timmons Foundation,<br />

a Founding Benefactor,<br />

for its sponsorship <strong>of</strong><br />

Caregivers’ Link, which<br />

includes the following<br />

articles in this issue:<br />

Caregiver Depression,<br />

Update on Social Security<br />

Disability and Planning<br />

Ahead with Long Term<br />

Care Insurance.<br />

Caregiver Depression<br />

One <strong>of</strong> today’s all-too silent health<br />

crises is caregiver depression.<br />

A conservative estimate reports<br />

that 20% <strong>of</strong> family caregivers suffer from<br />

depression, twice the rate <strong>of</strong> the general<br />

population. A study by the California<br />

Caregiver Resource Centers found that<br />

41% <strong>of</strong> former caregivers <strong>of</strong> a spouse with<br />

Alzheimer’s or other form <strong>of</strong> dementia<br />

experience mild to severe depression up<br />

to three years after their spouse had died.<br />

In general, women caregivers experience<br />

depression at a higher rate than men.<br />

Caregiving doesn’t cause depression nor will<br />

everyone who provides care experience the<br />

negative feelings that go with depression.<br />

But in an effort to provide the best possible<br />

care for a family member or friend,<br />

caregivers <strong>of</strong>ten sacrifice their own physical<br />

and emotional needs. <strong>The</strong> resulting feelings<br />

<strong>of</strong> anger, anxiety, sadness, isolation,<br />

exhaustion – and then guilt for having these<br />

feelings – can extract a heavy toll.<br />

Unfortunately, feelings <strong>of</strong> depression are<br />

<strong>of</strong>ten seen as a sign <strong>of</strong> weakness. Comments<br />

such as ‘snap out <strong>of</strong> it,’ or ‘it’s all in your<br />

head’ are not helpful and reflect a belief that<br />

mental health concerns are not real.<br />

Ignoring or denying your feelings will not<br />

make them go away.<br />

People experience depression in different<br />

ways, and the type and degree <strong>of</strong> symptoms<br />

can vary by individual and change over<br />

time. <strong>The</strong> following symptoms may indicate<br />

depression if experienced for more than two<br />

consecutive weeks:<br />

• Change in eating habits that results in<br />

unwanted weight loss or gain;<br />

• Change in sleep patterns – too much or<br />

not enough sleep;<br />

• Feeling tired all the time;<br />

• Loss <strong>of</strong> interest in people and/or<br />

activities that once brought pleasure;<br />

• Becoming easily agitated or angered;<br />

• Feeling that nothing you do is good<br />

enough;<br />

• Thoughts <strong>of</strong> death or suicide, or<br />

attempting suicide;<br />

• Ongoing physical symptoms that do not<br />

respond to treatment such as<br />

headaches, digestive disorders and<br />

chronic pain.<br />

Early attention to symptoms <strong>of</strong> depression<br />

may help to prevent more serious depression<br />

over time. <strong>The</strong> National Institute <strong>of</strong> Mental<br />

Health <strong>of</strong>fers the following recommendations<br />

to cope with depression:<br />

1. Set realistic goals.<br />

2. Break large tasks into small ones,<br />

prioritize and do what you can.<br />

3. Try to be with other people and<br />

confide in someone; it is usually better<br />

than being alone and secretive.<br />

4. Participate in activities that make<br />

you feel better such as exercise, going<br />

to a movie or attending a religious or<br />

social event.<br />

5. Expect your mood to improve<br />

gradually.<br />

20<br />

continued on page 32

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