Affording the best is not the
question* **finding the best is.
A first...
Apartment living in a
Skilled Nursing facility
For the discriminating person
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NURSING HOME page 59
cational Service, spoke on out-
reach and advocacy programs of-
fered through the Jewish
community. She informed the
nursing-home professionals of
services they can request for the
Jews living in their facilities. For
instance, Project Outreach brings
(among other things) religious
services and holiday parties to
people who cannot access them
on their own.
"I would appreciate it. If you
are in nursing homes in Detroit
or in Wayne County and have a
Jewish resident, please contact
me," Ms. Bender said.
Carol Rosenberg, administra-
tor of Fleischman Residence in
West Bloomfield, delivered the
final address.
"The only portable support
that stays with you until you die
— what is it?" she asked. "Your
religion."
At Fleischman and other
homes affiliated with the JHA,
Ms. Rosenberg has befriended el-
derly residents who can't re-
member faces of family members
and days of the week.
But they remember the words
and melodies of Jewish songs.
Ms. Rosenberg encouraged the
professionals in nursing homes
outside of the Jewish communi-
ty to probe their Jewish residents'
backgrounds. Understand, she
advised, what that person expe-
rienced in his or her younger
years. Is that person a Holocaust
survivor? Was he a religious Jew?
Was she involved in Jewish char-
ities?
"It doesn't matter if you are not
Jewish," Ms. Rosenberg told
members of the audience. "It
doesn't matter who is giving the
care ... Just so long as the care is
being given." ❑
Incontinence:
Dealing With It
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E
ver since the birth of her
second child, Karen Smith
has suffered from an em-
barrassing problem.
Whenever she sneezes, coughs,
or laughs, she spontaneously los-
es urine.
"I had extreme leakage from
my bladder," recalled Smith, who
asked that her real name not be
used. "My bladder was so bad
that if I sneezed, I lost it all."
Smith suffers from urinary in-
continence, a condition that may
affect as many as 10 million to 12
million Americans.
"The statistics are absolutely
staggering," said Dee Hartmann,
a physical therapist with Healthy
Expectations in Naperville, Ill.,
who specializes in gynecological
physical therapy. "The incidence
is much higher than we think."
"There are two ways you lose
urine," according to Dr. Gary
Christensen, a gynecologist who
treats urinary incontinence.
"Urgency incontinence occurs
when a person has a sudden,
overwhelming need to go. With
urge incontinence, a person may
begin to leak urine as they are
rushing through the bathroom
door."
. The second type of urine loss
occurs due to mechanical stress
on the bladder; and is known as
stress incontinence.
"Stress incontinence is relat-
ed to anatomical problems," Dr.
Christensen explained. "Cough-
ing, sneezing, anything that caus-
es abdominal pressure will cause
a loss of urine."
Dr. Christensen describes ur-
gency incontinence as an active
contraction of the bladder, stress
incontinence is more like a pitch-
er being spilled. Exercise can ex-
acerbate both types.
"Bouncing around causes blad-
der contractions," he said. "You
can't always tell by listening to
(the patients') stories which type
it is."
To further complicate matters,
some individuals may experience
both types of incontinence. This
is known as mixed incontinence.
Urinary incontinence can have
devastating psychological and so-
cial consequences for the suffer-
er.
The incontinent person may
quit exercising and avoid going
out in public for fear of having an
accident.
"They feel. isolated. They feel
doomed," Dr. Christensen said.
"A lot of people probably would
stay home," Smith said. "Me, I'd
just put on three pads and go out
anyway."
But it did keep Smith from do-
ing things like dancing at a par-
tY.
"It really messes you up so-
cially," she admitted.
Stress incontinence most com-
monly occurs after childbirth or
menopause.
"A lot of incontinence can be
blamed on changes due to child-
birth," Dr. Christensen said.
Muscles of the pelvic floor,
which normally support the blad-
der, become relaxed, allowing the
bladder to sag.
The healthy bladder also is
supported from above by con-
nective tissue, according to Ms.
Hartmann.
C/\