Saturday

BALINESE LEGEND

It is said that once upon a time the people of a remote mountain village used to sacrifice and eat their old men. 

A day came when there was not a single old man left, and the traditions were lost. They wanted to build a great house for the meetings of the assembly, but when they came to look at the tree trunks that had been cut for that purpose, no one could tell top from bottom: If the timber were placed the wrong way up, it would set off a series of disasters.   A young man said that if they promised never to eat the old men anymore, he would be able to find a solution. They promised. He brought his grandfather whom he had hidden; and the old man taught the community to tell top from bottom.



From The Coming of Age by Simone deBeauvoir

"Settlement Proposed To Broaden Medicare Coverage"



While this article is timely for political "points", the bottom line is that Medicare still only pays for "rehabilitative" or purely "skilled" services in a nursing home.  

Only a small percentage of people ultimately qualify for the full Medicare benefit (up to 120 days maximum).  It's true that a large number of people fall through the cracks -- and always have-- when they have a condition that could be stabilized by additional care and therapy.  The system is far from perfect.  I hope this doesn't trigger a class action lawsuit and deplete Medicare further!   

While it would be great if they could cover more bases in the program, I'm not sure if it is realistic right now.  In the meantime it is important to consult with a Geriatric Care Manager to implement any and all services that might be available to you -- under Medicare and otherwise.  

Many people qualify for additional Home Care services (PT, OT, Speech, Social Work and nursing) and they don't even know it.   

Friday

Obama Care and Health Policy: CH-CH-CH-CH-CHANGING!



Lately there are so many changes on the healthcare front that our heads are spinning! From having a laptop computer between you and your practitioner --- to finding out that the policies have changed dramatically since the last time you visited your hospital or clinic. How to keep track of the changes? I'm not sure you can. The most important thing you can do is to try to stay aware of current trends.

Like this one which poses hope for better hospital care the First Time Around:
Click HERE for the article.

There is nothing perfect about Obama Care and its coverage. Up until now I have been looking at it primarily from a recipient's point of view. However, I've been doing some work for a Medicare-based home health agency here in Yavapai County and the ObamaCare changes have been affecting policies and procedures on a corporate level already. Some of those changes are positive ones. There are patients receiving care who really should have been discharged long ago. Taxpayer dollars pay dearly for the daily care they receive from a multi-level, comprehensive care team. The new rules are forcing their discharges at an appropriate time -- not too early, no. And no longer too late.


I don't know how this will pan out over time, but thus far from the systemic level, there will be significant taxpayer relief coming down the pike. A drop in the bucket compared to our national defense plan and national debt, perhaps, but nonetheless an improvement for the national budget. It may be a big player in the survival of Social Security and Medicare.

The most important thing -- as I see it - is that the patients who are being discharged from hospitals, hospices and home care programs are to be treated with compassion and receive the very best information they can to help themselves once they are on their own again.

Make the best use of the discharge planner at the hospital, the social worker in the hospice or home care agency or hire yourself a geriatric care manager to get an effective long term plan in place!

Wednesday

I Need A New Individual Health Plan


 Happy Fourth of July, Independence Day.   My latest story is timely.  Those of you who know me well, know that I was quite ill last Fall and Winter.  One thing led to another and I ended up leaving my MSW position at Hospice Compassus to strike out on my own again.   


Leaving the job meant leaving my benefit package behind.  I was aware that this would cause some increased "insecurity" if I allowed it to. Overall the transition has been a good one and I am back in control of my own work life and schedule and I am happy to report that it is going very well!  


A few days ago I called a friend of mine, Susie Clarke, in Prescott.  Susie and her husband Dennis have been selling health insurance for years.  They do more than just sell insurance.  They do for people who need health insurance what I do for seniors --- they teach them, they guide them, they help them to navigate the system; to make the system work for them.   I told Susie my situation.  I knew she would give me the right answer.


Upon my resignation from hospice, I planned to remain covered with my BC/BS of Arizona policy under COBRA.   COBRA allows you to keep a health insurance policy for a period of 18 months.  What I didn't plan on was the increased premium based on my "unwell" status.   I may have left my Unwell status behind me but I find that now it keeps following me!  


When I contacted Susie to assist me in finding a good policy at a better price, she suggested waiting --- she suggested I establish a Track Record of WELLNESS before I apply for a new insurance plan.  Insurance companies review our health status much like they review a Financial Credit Report.  I will be better off improving my "score" by improving my health over the next 6-12 months.  


The real reason I write this post is because it may be Independence Day here in America, but we need to wonder how independent we really are.  Privacy laws and HIPAA, the Patriot Act are all supposed to protect our privacy, our identity.  But did you know this:  


There is a website you can log on to -- Go ahead, log onto it now.  It is www.mib.com  
You can apply for a full report on yourself -- and at no charge.  All you need to do is fill out a digital online disclosure form and you will have your own copy of your personal medical history report within 15 days.


The MIB database is a program that -- with your permission of course -- can access any and all of your medical records.  Much like a credit report, it shows your entire medical history from the day you were born until the present.  Insurance underwriters typically use this information to assign premiums and policies.   Physicians, hospitals and health care agencies are being required to be computerized, which helps MIB have timely and (hopefully) accurate digital information.  


The MIB Group has been in existence since 1902. 



Monday

Pain Doesn't Last Forever



"...Yet pain is part of being alive, and we need to learn that.  Pain does not last forever, nor is it necessarily unbearable, and we need to be taught that. 

 
Adolescents need to accept the fact that broken hearts, like broken bones, hurt dreadfully but ultimately they heal, and that there is life beyond the hurting.  People whose shameful secret is about to be revealed need to be assured that there is forgiveness as well as condemnation, that there are people in the world and a God in the world capable of forgiving and loving even the most flawed and imperfect of us.  The terminally ill need to be reassured that we will cherish them and spend time with them and take them as seriously as we did when they were healthy. 
 
Most of all, we have to learn to trust our own capacities to endure pain.   We can endure much more than we think we can; all human experience testifies to that.  All we need to do is learn not to be afraid of pain.  Grit your teeth and let it hurt.  Don't deny it, don't be overwhelmed by it.  It will not last forever,   One day, the pain will be gone and you will still be there."  
 
~Harold S. Kushner

Tuesday

Roommate Has The Bed By The Window



Two men, both seriously ill, occupied the same hospital room. One man was
allowed to sit up in his bed for an hour each afternoon to help drain the
fluid from his lungs. His bed was next to the room's only window.

The other man had to spend all his time flat on his back. The men talked
for hours on end. They spoke of their wives and families, their homes, their
jobs, their involvement in the military service, where they had been on
vacation.

Every afternoon when the man in the bed by the window could sit up, he
would pass the time by describing to his roommate all the things he could
see outside the window.  The man in the other bed began to live for those one hour 
periods where his world would be broadened and enlivened by all the activity and 
color of the world outside.

The window overlooked a park with a lovely lake. Ducks and swans played on
the water while children sailed their model boats. Young lovers walked arm
in arm amidst flowers of every color and a fine view of the city skyline
could be seen in the distance.  As the man by the window described all this in 
exquisite detail, the man on the other side of the room would close his eyes 
and imagine the picturesque scene.

One warm afternoon the man by the window described a parade passing by.
Although the other man couldn't hear the band - he could see it. In his
mind's eye as the gentleman by the window portrayed it with descriptive
words.

Days and weeks passed.
One morning, the day nurse arrived to bring water for their baths only to
find the lifeless body of the man by the window, who had died peacefully in
his sleep. She was saddened and called the hospital attendants to take the
body away.

As soon as it seemed appropriate, the other man asked if he could be moved
next to the window. The nurse was happy to make the switch, and after making
sure he was comfortable, she left him alone. Slowly, painfully, he propped himself up 
on one elbow  to take his first look at the real world outside.
He strained to slowly turn to look out the window beside the bed.

It faced a blank wall. The man asked the nurse what could have compelled
his deceased roommate who had described such wonderful things outside this
window

The nurse responded that the man was blind and could not even see the
wall. She said, "Perhaps he just wanted to encourage you."

Grief: Losing A Parent

Mourning is also prolonged when guilt is involved.
 Some adults are inconsolable at the death of their elderly parents because 
they recognize that their childhood has also died. 

 ...There is no grief which time does not lessen and soften.
From Love, Hate, Fear, Anger by June Callwood

Sunday

Forgiving Our Families

A woman asked me for help in placing her father in a nursing home. He was 89 years old and had never been sick a day in his life; had worked construction until he was 81.

One day he had a massive stroke that rendered him incapable of caring for himself. It also made him incapable of controlling his emotions and he was crying most of the time.

The day we got him settled into his nursing home room; him with his huge hands and furrowed brow! The smiling courteous polite daughter asked me to step outside of his room. When we did she sputtered, with tears in her own eyes: "That SON OF A BITCH! He was a miserable ___ ___ bastard all of his life and now he's vulnerable. How DARE HE?! NOW he needs us to be kind to him?? It's just not fair."

This was her lesson in forgiveness. And actually.... the story turned out quite nicely. Forgiveness works. We are given opportunities to learn its power.




It's A State of Mind


Tuesday

Today I heard a story about a man and a woman who had been married 73 years.  She had cared for him for nearly a decade; he had Parkinson's Disease and complications.  One night they both went to the hospital by ambulance.  She had had a stroke that left her with significant impairment, but overall she was in much better condition than her husband.  In the morning the young doctor went in to check on his patients and the wife had died during the early morning hours.  The doctor was quite surprised, as her vital signs had been stable throughout the night.  "What happened?"  he asked the husband, who seemed amazingly calm and accepting.  "A gentleman always lets the lady go first."  The husband passed that night.  This was a true story.


Sunday

Pet Therapy Services

Hi My name is Jack.  I am Kate's 90 pound collie poodle afghan and I am a Pet Therapist.  Today we are on the road again!  I love riding in the car and often wherever Kate goes, I go! Sometimes she takes me to the nursing and retirement homes and we visit people. 

I remember one guy, he was pretty young (about 7 in dog years). He was very disabled and didn't "connect" with anyone, ever! Kate took me in and his eyes slowly raised to meet mine and his hand reached out and ruffled the hair on my head. You could tell he was really weak and tired. They say it was the only time he made eye contact or reached out for anything. It was with ME?! 

I heard he died the next day. I am so glad I was there with him.

Aging With Grace


I am a weekend gardener.  Here are my roses this morning... Look at the old and then look at the new..  How exquisite the aging petals are!!! Getting older can be quite beautiful when it is approached with grace.

Saturday


Funny how long it takes us to Grow Up.  It takes our whole lives doesn't it?  I have realized that no matter how old people are (and I've worked with old people all my life) that we are all just children when we are in an area of life that we have never been exposed to.  Learning to deal with a new challenge in life is not much different than walking through the door of your kindergarten class on the first day of school.  There's always more to learn!

We are reminded that we are still children when we get caught up in emotional waves of concern, fear, overwhelm or feeling a loss of control over our life circumstances.

No matter how old we are we are still just children.  If we are blessed we have our parents alive and well for a long time.  If we are really blessed we will know how blessed we are to have our parents alive and well.  I am one of them!  My parents are doing well and I thank my lucky stars when I look at statistics and when I work everyday with people who are struggling to survive and to live.

I am also well aware that it is just a matter of time and the situation will change.  It makes me very thankful for Right Now for what I have, for what we have together as a family.

Look around at all the parents who aren't doing well.  All those who struggle with memory loss; dementia.  All those who rely on walkers and wheelchairs to get them from one place to another.  All those who rely on their adult children to meet their most basic needs on a daily basis.

This Mother's Day (and Father's Day) upcoming, please take a moment to thank your parent for being self-sufficient and healthy.  And if they aren't, take a moment to breathe in and think of ways to help them --- and to help yourself to help them.  You don't have to do it all.

If you don't know where to start, get yourself a geriatric care manager who can make it all easier for you.  

Thursday

Family Eldercare Statistics - A Recent Study



This just from the National Association of Professional Geriatric Care Managers (NAPGCM):  

NAPGCM's Public Relations Committee recently contracted with Harris Interactive to conduct a study, interviewing 2,215 adults age 18+, of which 900 are either caring for aging parent(s)/family member(s) or are concerned about caring for aging parent(s)/family member(s) in the future. 

1) Key Findings - Those Caring For/Concerned About Caring For Aging Parents or Family Members


  • Over one in four U.S. adults (41%) is either currently caring for aging parent(s) or family member(s) or is concerned about caring for aging parent(s) or family member(s) in the future.
  • Nearly one quarter of adults (23%) are currently caring for aging parent(s)/family member(s).
  • Nearly one quarter of U.S. adults (24%) are concerned about caring for aging parent(s)/family member(s) in the future.
  • 59% of adults do not currently care for aging parents/family members and are not concerned about doing so in the future.

2) Key Findings - Attitudes about Managing Care for Aging Parent(s)/Family Members

  • Overall, more than three quarters (78%) of caregivers and those concerned with caring for aging family members in the future, agree that a geriatric care manager would be a valuable resource when caring for an aging parent/family member.
  • Older adults age 45+ who care for or are concerned about caring for aging family members (85%) are more likely to agree that a GCM would be a valuable resource than those who are age 18-34 (71%) or 35-44 (75%).
  • Those in the Midwest (80%) and South (82%) are significantly more likely to agree with this statement than those in the West (69%).
  • Six in ten caregivers (60%) agree that balancing responsibilities caring for an aging parent/family member with their own work/family responsibilities is sometimes a struggle.
  • More than half of caregivers (54%) agree that there are times they need help with certain aspects of caring for an aging parent/family member and don't know where to get that help.

Happy Care Management Month.  
By helping you to plan your future, coordinate care and services, Care Managers help people to be happy again which makes care managers happy.


AboutFamousQuotes

Click Here to go to Catholic Charities in Cottonwood AZ


Wednesday

Growing Old Is Sometimes Optional

The Agency For Healthcare Research and Quality Remind Us of the
Health Benefits of Regular Physical Activity
Regular physical activity has beneficial effects on most (if not all) organ systems, and consequently it prevents a broad range of health problems and diseases. Physical activity in older persons produces three types of health benefits:
  1. It can reduce the risk of developing chronic diseases such as heart disease.
  2. It can aid in the management of active problems such as high blood pressure, diabetes, obesity, or high cholesterol.
  3. It can improve the ability to function and stay independent in the face of active problems like lung disease or arthritis.
Although the benefits of physical activity increase with more frequent or more intense activity, substantial benefits are evident even for those who report only moderate levels of activity—i.e. washing a car for 60 minutes, raking leaves for 30 minutes, or brisk walking or swimming for 20 minutes. All of the benefits of physical activity are especially important for older men and women since they are more likely to develop chronic diseases and are more likely to have conditions such as arthritis that can affect their physical function.
Regular physical activity has beneficial effects on a variety of health outcomes, effects that are supported by consistent scientific evidence. These include:
  • Lower overall mortality. Benefits were greatest among the most active persons but were also evident for individuals who reported only moderate activity.
  • Lower risk of coronary heart disease. The cardiac risk of being inactive is comparable to the risk from smoking cigarettes.
  • Lower risk of colon cancer.
  • Lower risk of diabetes.
  • Lower risk of developing high blood pressure. Exercise also lowers blood pressure in individuals who have hypertension.
  • Lower risk of obesity.
  • Improved mood and relief of symptoms of depression.
  • Improved quality of life and improved functioning.
  • Improved function in persons with arthritis.
  • Lower risk of falls and injury.
Additional possible benefits of physical activity (research is less consistent) include:
  • Lower risk of breast cancer.
  • Prevention of bone loss and fracture after the menopause.
  • Lower risk of developing depression.
  • Improved quality of sleep.
Research studies have demonstrated these benefits in both middle-aged and in older persons, and in men and women. Because these chronic diseases increase with age, older persons may benefit even more than those in middle-age from physical activity. A recent study of older men in Baltimore demonstrated that leisure time activity was more important for protecting against heart disease in men over 65 than in younger men (Talbot, Morrell, Metter et al., 2002).

Of great importance to older adults, regular physical activity sustains the ability to live independently. Research has shown that virtually all older adults can benefit from regular physical activity. In particular, the mobility and functioning of frail and very old adults can be improved by regular physical activity. The large potential ability of regular physical activity to prevent chronic diseases and sustain active living means that an active lifestyle is a key component of healthy and successful aging.

Tuesday


Click Here to hear the April 25, 2012 NPR program on how Geriatric Care Management can relieve families and their aging parents.

Sunday

It's A Privilege
One chilly November Friday I went to my doctor's office for a megadose shot of intravenous Vitamin C.  As I pulled into a parking spot, I saw a very old woman sitting in the passenger seat of the car next to me; she was covered in a big quilt and reading a magazine.  She looked up as I passed by; I smiled and she smiled in return.  Meanwhile I observed her with my eldercare vision, pretty sure she had Alzheimer's/Dementia.

Inside I got settled into my seat and was hooked up the IV.  There was an elderly gentleman to the left of me.  Very likable and cheerful.  I imagined that he was probably a Navy veteran from perhaps WWII or the Korean War or both.  Perhaps, he even belonged to the lady parked in the car outside.


Right on both counts.  WWII and Korea.  His wife with Alzheimer's too.  But this is not about my insight and intuition.  This is about the man who had to put considerable effort into getting up out of the chair just to go into the bathroom --- we were both there for about an hour and a half and during that time he had to get up to go to the bathroom six times, carefully dragging his IV behind him.  He was riddled with arthritis and he was legally blind --and then some.

He joked with the nurse at the station and at one point I made a comment to him stating that At His Age he could probably get away with just about anything.  "Yes." he replied "When I do certain things they just say 'Oh there goes that Crazy Ol' Guy again!"  He went on to talk about the fact that he had been caring for his wife with Alzheimer's for nearly 10 years (she was 90).  His only child, a son, was living with them and helped them, but he was going to be moving away in a  few weeks -- he had gotten a job in another state.  The man did not look upon this with bitterness, he was simply glad he had had his son around for this long.

He talked about the war years and he talked about his resulting disabilities.  He talked and talked and talked and the beautiful thing was that everything he talked about mattered.  Everything had value.  And the bottom line when he talked about being nearly 90 (blind!  incontinent!  riddled with arthritis!)  "It's a privilege to get older.  It's an adventure."  he says  "So many never got the chance."



It may be a privilege to get older, yes, (and sometimes we DO need a reminder!)  but it was a privilege to meet this seemingly "ordinary" man in the doctor's office.   I think of him now and again and I hope he and his wife are blessed every extraordinary day.

Sedona Seniors in the Spotlight

I am happy to report that I will be speaking at the Spotlight on Seniors program at Sedona Sunrise at the Sedona United Methodist Church on May 19.  It's the first public speaking engagement I have had in quite some time and I am looking forward to it!.  And honored to be part of the great lineup.  If you are in the area and have a chance to attend, please do!!!  Not only will it be a great program, but your contribution goes to a great cause, to support the center.   Hope to see you there!

Friday

SOMETIMES YOU JUST HAVE TO MAKE IT HAPPEN

Every day I hear many amazing stories in my line of work!  When you work with people and you care about them, you hear what they say with their lips --and with their hearts... and there's ultimately enough fodder for a screenplay!  I speak each one in confidence and with the utmost respect.  I decided I would start posting them here now and again so others can learn from them too:  

ELDERPLANNING STORY

Roy and Angela had been dating since high school.  Same age, same year - both were now graduating college.  On Graduation Day Roy grabbed his diploma in New England, hopped the train and got to Seattle in time to see Angela graduate with honors.  She was always such a smart girl!  And pretty too!   Roy was stalling, however.  Angela had been saying for years that she wanted them to marry as soon as they finished college.  He loved her, yes, but was he indeed ready for marriage?  Children?  Career?  


Everett, WA Depot 1900's
Two days later they boarded the train together.  He was taking her to Chicago for a family gathering.  She looked at him with such admiration.  After all, he was such a gentleman!  She felt fortunate to have such a smart, handsome and chivalrous man at her side.  As they boarded the train she carried only her purse while he carried both of their bags and her bookbag too.  He was so strong!

They settled into their seats, their tickets were punched and the train started moving. Angela ruffled through her bag for a book and some magazines for the long ride.  Roy was preparing to take a nap.  He was a contented man. 

As the train picked up speed, she nudged him on the elbow.  He turned to her as she handed him the latest issue of the Seattle Times.  "Here" she said "there might be something of interest to you."  He gladly took the paper with a nod and began to read.  

'Of Interest', sure enough!  There, on page 3: "Holstein and McFarland to Wed".  He did a double-take.  Sure enough there was a recent portrait of the two of them, Roy and Angela, taken over the holidays the year before.  The article went on to announce that the two would wed in Chicago on the upcoming Saturday.  Roy was taken completely by surprise.  

Angela had taken it upon herself to make all the arrangements. They were married that Saturday in Chicago and have been happily married for 77 years.  

"How can you argue with a woman like that?  And she's been telling me what to do ever since!"  he says with a smile-- and absolutely no regret.  


 Couple Discuss Their Plans

Monday

Great Search Tool - Arizona 211!

Elderplanning of Arizona provides Community Information and Referral but we're going to pass this along to you! If you want to find community help of any kind anywhere in Arizona, here are two great links that will help you to help yourself and your loved ones!


and


Sunday

Understanding Memory Loss

Learn the difference between mild forgetfulness and more serious memory problems in this 24-page booklet. Also discussed are various causes of memory problems and how to get help for serious memory loss.  Download your Free Booklet from the National Institute on Aging by clicking here.


You can also review one of our previous posts which discusses forgetfulness vs. memory loss.

Thursday


Today I went to visit Evelyn (not her real name) at the local nursing home. She is in bed day after day after day, she has significant pain and she often questions her worth. I sat on the edge of her bed and held her hand as we caught up on the recent events of life. At one point I made the comment to her that She Is Loved, and she said with a surprising strength of voice: "I KNOW." "You do? You know?" "Yes" she said "I've learned that." "How?" I asked. "Because you have taught me."

Sometimes we make a difference in someone's life in ways we never plan or dream possible. I have had a strong sense of connection with Evelyn since day #1, so we had that in our favor. However it is important to practice love and kindness in everything we do with everyone we come into contact with. Evelyn's learning that she is loved helped ME to know that I make an important difference. My helping her to see HER worth helped me to see my own.

Thursday

Active Grandparenting


More and more grandparents are finding themselves taking care of their children's children. Please visit a website I recently discovered as I was assisting clients in their 90's who were taking care of their great-grandchildren in their single digits.

Tuesday


50 Simple Ways To Reduce Stress at Home and at Work – From King'sCounty.gov

1. Touch, hug someone, hold hands, stroke a pet, make non-sexual physical contact with someone close to you, brush your hair.

2. Breathe, when you feel tense, take 10 slow, deep breaths in through your nose, out through your mouth.

3. Communicate, be honest with your Self and others. Ask for what you want. Express your true feelings when they occur.

4. Drink at least eight, 8 oz. glasses of good water a day. This flushes toxins out of our body.

5. See the humor in life. Laugh at yourself and life. Have fun and "play" in your life.

6. Meditation 15 minutes a day. Take time to relax, sit, breathe deeply, quiet your mind.

7. Be Human. Be kind to yourself. Forgive yourself and others. Slow down and enjoy being alive.

8. Communicate with friends. Spend time with each other. Share the good stuff.

9. Hug three people each day.

10. Quit worrying about the Future. Concentrate on what you can do NOW.

11. Make a TO DO list of your agreements for each month. Schedule both play time and free time, and SO THEM.

12. Write it down. Make notes to yourself. Make a list. Write special dates down on your calendar.

13. Allow yourself to say "NO". Make clear boundaries. Don't over commit yourself. Put yourself first; say YES to you.

14. Clean it up. Recycle old junk and papers. Clean your physical and mental house of old garbage.

15. Wear comfortable, clean clothes, that make you feel good about yourself.

16. Avoid doing anything to excess, keep things balanced.

18. Express and receive love as often as possible to yourself and others.

19. You always have choices in life. Re-Order your priorities. If you are not happy, choose something new.

20. Express your anger to the person involved the moment it's experienced.

21. Be honest with yourself concerning your fears. Ask for more information or assistance.

22. Crying is nature's way of releasing -- releasing stress, or expressing joy.

23. Change is constant. You can choose to change your choice anytime you want.

24. Trust your Self, and value your needs and choices. Follow your own intuition.

25. Live in the moment. Stop fantasizing about "What If ". Choose from what IS available, Now.

26. Feel good about yourself and your choices in life. Value what you Believe in. Walk your Talk.

27. Forgive yourself and others. Withholding Love does not nurture relationships.

28. When you do not love yourself first, you cannot be satisfied by loving and doing for others.

29. Make a commitment to expand your Mental, Emotional, and Physical well-being.

30. Your most valuable and limited resource is your time. Value it, so others will.

31. Obtain a written job description from your boss. Make any changes needed to keep your agreements.

32. Take pride in your work. You only get One First Impression!

33. Be responsible for your work. Do your best with every opportunity.

34. Only do your job. Do not get conned into permanently assuming another person's job responsibilities.

35. Do not play office politics. Be open and above board in all your relationships. Honor your Integrity.

36. Do not listen to, encourage, or spread gossip. It damages your credibility and others.

37. Talk with your co-workers about how to work together to solve problems.

38. Don't be a "fix it " person for other people's problems.

39. When you have a problem, go to the person who can solve that specific problem. Ask questions.

40. Ask questions. When you are not sure, or don't know, get information before taking action.

41. Contribute Become a solution provider for problems, not just a problem discoverer.

42. Leave work. When you go home, Go Home! Work can be a part of your life, not your whole life.

43. Put your family, career, and Self in perspective; know which is most important and nourish it.

44. Value your emotions. Feel your feelings. Allow yourself to express them appropriately as they occur.

45. Express your anger directly with clarity. Indirect or covert anger only prolongs distress and distrust.

46. When asked, always tell the whole truth to yourself and to others.

47. Respect your own ideas, and have respect for other people's feelings, ideas, and choices.

48. Exercise, walk, stretch, move about. Staying physically fit keeps you mentally fit, emotionally calm, and at peace.

49. Eat healthy foods and chew well. Don't eat just because you are bored, unhappy, or angry.

50. Experience and express joy at being alive, at having choices, and at the opportunity to explore loving relationships.