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Category "Local Health"

21Mar

UBC researchers create robot to help sooth pain of NICU babies

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UBC researcher Liisa Holsti, with a therapeutic robot that simulates human skin-to-skin contact and helps to reduce pain for babies, in the neonatal intensive-care unit at B.C. Women’s Hospital in Vancouver on March 22.


NICK PROCAYLO / PNG

Nothing soothes a newborn’s pain like the tender touch of a loving parent, but researchers at the University of B.C. hope their new robot might help sometimes.

“Calmer” was created to mimic hand-hugging, a treatment in which a premature baby’s head, hands and legs are gently held in a curled position to help manage pain from medical procedures. Lead inventor Liisa Holsti developed the robot with colleagues at UBC and said it mimics some of the therapeutic aspects of skin-to-skin holding.

The white-metal device is about the size of a standard pillow. On top of it rests a silicon mat wrapped in Gore-Tex fabric, meant to feel like a parent’s soft touch. When the robot is turned on, its platform gently rocks up-and-down while playing the sound of a beating heart, both programmed to match the rate of a parent’s own breaths and heartbeat.

“The type of pain that these babies have actually changes their brain development and so what we’re trying to do is protect the brain of premature babies,” said Holsti, an associate professor at the department of occupational science and therapy.

Holsti was also lead scientist for the robot’s first randomized controlled trial to evaluate whether it reduced pain in premature babies at B.C. Women’s Hospital’s neonatal intensive care unit (NICU).

The 49 premature babies in the study had just undergone a routine, medically ordered blood test, so the study caused them no additional pain. Half were hand-hugged, the other half were placed on the robot.

The researchers then looked at how the babies’ faces and hands changed, as well as their heart rates and brain-oxygen levels.

“We found no difference between the robot treatment and the human-touch treatment,” Holsti said.

Holsti stressed that the robot isn’t a replacement for human touch, but could be helpful in many cases. Her hope is that it could eventually be available for all premature babies.

“There are times when it’s very busy in an NICU and nurses may not be able to be there all the time when a lab tech comes to take the blood, and so our goal would be that Calmer would be available when parents can’t do skin-to-skin holding or nurses have to be doing other things,” she said.

“It’s an additive to care. It’s not meant to replace human beings,” she said.

Lauren Mathany, 34, a new Vancouver mother who works in public health, said that while “Calmer” wasn’t yet being used when her twin girls Hazel and Isla were born four months’ premature, she can see how it could have helped. It would have comforted the twins — now healthy, happy and close to 11 months old — and given some reassurance to Mathany and her husband, who works in construction, she said.


Lauren Mathany with twin sisters Hazel, left, and Isla is enthusiastic about a therapeutic robot that simulates human skin-to-skin contact, helping reduce pain for babies in the neonatal intensive-care unit at B.C. Women’s Hospital.

NICK PROCAYLO /

PNG

“I think it would have been great,” Mathany said.

During the four months the girls were in the NICU, Mathany and her husband gave the girls plenty of hand-hugging and hours of skin-to-skin contact every day. They would sing and talk to them too.

But the new parents couldn’t be at the NICU around the clock and needed to rest so they could take proper care of themselves and the girls, she said.

“If the Calmer was available to them, we’d know that during medical procedures, blood work, etc., that there was something there to make them feel safe and reassured, and feel that we were still with them, even though we couldn’t be, physically,” she said.

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20Mar

FDA issues device warning; Health Canada in monitoring mode

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Health Canada and the U.S. Food and Drug Administration are near opposites in their responses to rising evidence of patient harms caused by some medical devices.

A new B.C. study has added to the mounting evidence about potential complications from the plastic-like coatings on devices such as catheters, guide wires and stents that are inserted through blood vessels during minimally invasive medical procedures.

Such devices are coated so they can slide through vessels with less friction and less damage to tissues. But the Vancouver study of 110 patients who died within 90 days of having procedures with coated devices showed that 23 per cent had polymer fragments scattered in different parts of their bodies. Three deaths were judged to be definitively caused by the dislodged material.

Hydrophilic polymer embolism is the term used by experts to describe the recently recognized phenomenon in which the foreign material separates from device surface and travels through the bloodstream to various organs in the body.

The FDA issued a safety bulletin in 2015 which said there were 500 reports of coating delamination in just two years. There were also 11 device recalls and nine U.S. deaths associated with the peeling or flaking from guide wires used during cardiac angiograms or angioplasties. Last year, the FDA followed up with additional recommendations.

Health Canada, by contrast, has taken a monitoring position.

Eric Morrissette, the department’s chief media relations officer, said in an email: “The department reviews data associated with the delamination of coatings to ensure that such devices do not shed material. In addition, the labelling of these devices sold in Canada must contain warnings to inspect the devices for any signs of damage (kinked or weakened segments, or delamination of coatings).

“Health Canada’s position is that the benefits of these products continue to outweigh the risks. This balancing of benefits and risks is a key part of any assessment for a medical device or drug in Canada.”

The Canadian agency is aware of the FDA notices, Morrissette said, but has not issued its own. 

“Should new evidence come to light related to the safety of these devices, Health Canada will take appropriate action,” he said.

Devices inserted through blood vessels for so-called endovascular procedures in B.C. include those made by companies like Bard, Cook, Boston Scientific, Gore and Canadian Hospital Specialties. Some manufacturers were repeatedly contacted by Postmedia for responses to the latest study. All declined to comment.

Dr. Dave Wood, a Vancouver interventional cardiologist and director of the Vancouver General Hospital cardiac catheterization laboratory, said the study “absolutely” poses some “intriguing hypotheses” that need further investigation.

“To be truthful, it wasn’t on my radar. But it is now. And I’m not trying to belittle the study, but we have clinical trial data on these devices showing they are generally safe and effective.”

Wood said he’s not aware of any occasion when coatings has come off devices he’s used. Patients undergoing endovascular procedures are cautioned about the small risk of heart attacks and strokes after such procedures. The fact that coating debris has been found to have caused three deaths is not going to change the general information he gives patients during the informed consent process although he acknowledged patients may now ask about it because of news coverage.


Dr. John Maguire, a VGH neuropathologist.

Arlen Redekop /

PNG

He said he’s anxious to collaborate on further research and has already reached out to the study leader Dr. John Maguire, a neuropathologist.

In 2017, Dr. Rashi Mehta and Dr. Rupal Mehta, U.S. experts, gave an update for physicians about the significant complications that can ensue from device delamination. 

This week, Rupal Mehta said there has been enormous pushback from physicians and medical device industry personnel who insist complications are too rare to worry about.

Dr. Harry Vinters, a professor and anatomical pathologist at Ronald Reagan UCLA Medical Center who has collaborated on research into the coating problem, praised the Vancouver researchers.

“Their study is especially intriguing in that it utilizes what could be considered old technology — careful tissue analysis of autopsy specimens — to derive extremely important new information that has a direct impact on outcomes in a select group of patients. Indeed, the autopsy is about the only way this data could have been derived, and Dr. Maguire and his colleagues are to be congratulated for the care with which the study was performed and the data analyzed.”

Vinters said despite the latest research, it is still impossible to quantify the degree of risk.

“Autopsy studies are not population-based studies, they look at highly selected individuals.”

Asked if interventional cardiologists and other specialists using such devices should give patients specific information about such risks during the informed consent process, he said:

“Generally, consents given by both anesthesiologists and surgeons are all-encompassing and include warnings about possible negative outcomes.” 

Christopher Thrall, spokesman for the Canadian Patient Safety Institute, said studies like the one in Vancouver are important and while the agency doesn’t have any statistics on delaminations on device coatings, Canadian patients are generally vulnerable to adverse events in the hospital because of such things as faulty devices, medications, mistakes and falls. For instance:

• Every 17 minutes someone dies in a Canadian hospital from complication of treatment. That’s about 31,000 people a year.

• There are hundreds of thousands of preventable patient safety incidents each year. One out of 18 hospital visits results in preventable harm.

• Over 40 per cent of complex surgical patients suffer harm. Patients who suffer harm are four times more likely to die in hospital than those who don’t.

Thrall said the Institute for Safe Medication Practices Canada, Health Standards Organization, and the Canadian Patient Safety Institute are working together to support a Health Canada initiative that requires health care institutions to identify and report on serious adverse drug reactions and medical device incidents.

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20Mar

BC to launch measles catch-up campaign with shots at schools, clinics

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19Mar

Coroners: Carfentanil detected in 13 of 90 overdose deaths in January

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A Vancouver RCMP officer opens a printer ink bottle containing the opioid carfentanil imported from China. Drug dealers have been cutting carfentanil and its weaker cousin, fentanyl, into heroin and other illicit drugs to boost profit margins.


Submitted / RCMP

B.C.’s coroners say there were 90 suspected illicit-drug overdose deaths in the province in January, including more than a dozen in which they detected carfentanil.

The synthetic opioid carfentanil, which began showing up in B.C.’s street-drug supply in late 2016, turned up in 13 illicit-drug overdose deaths in January, according to a B.C. Coroners Service update released Tuesday. Carfentanil was detected in 35 deaths in all of 2018 and 71 deaths in the last seven months of 2017. Carfentanil is many orders of magnitude more potent, and dangerous, than fentanyl.

Fentanyl and analogs were detected in about 87 per cent of overdose deaths last year, up from 82 per cent in 2017, the service said.

Coroners also updated the total number of illicit-drug overdose deaths in 2018 to 1,510, up from the 1,489 deaths it reported last month (the numbers change as toxicology reports are completed and investigations are concluded). Overdoses killed 1,486 in 2017 and 991 in 2016.

The coroners said 90 people died of an illicit-drug overdose in B.C. in January, down from 130 deaths in January 2018, and below the 116 deaths in December 2018.

The coroners service says no one died at a supervised consumption or drug-overdose prevention site.

Most of the deaths in January were in the Vancouver Coastal Health (29) and Fraser Health (27) regions, and 88 per cent occurred indoors, including 62 per cent in private residences and 26 per cent in other residences such as social housing or hotels.

People aged 30 to 59 accounted for 76 per cent of those who died, and 83 per cent were male.

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13Mar

Private medical clinics get year-long reprieve as Victoria delays medicare amendment

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Dr Brian Day says Day said the fact that the cabinet order was passed was proof the medicare amendment was unnecessary in the first place.


Nick Procaylo / PNG

Private diagnostic and surgical clinics have won another reprieve, this time from their nemesis — the provincial government, which would prefer to see them shut down.

It means that doctors providing care to patients seeking expedited treatment at private clinics across B.C. can continue doing so for at least for another year, as long as they don’t double bill both the government and patients.

The government has put off bringing into force a Medicare Protection Act amendment that would have harshly penalized doctors who provided expedited care to patients in private clinics. The decision was in the form of an NDP cabinet order and there was no press release announcing the decision.

The amendment — which allowed for fines and even criminal fraud charges — were supposed to take effect last October and could have forced dozens of clinics to close.

But surgery clinics won an injunction in November that effectively ordered the government not to enforce the amendment until after the marathon trial over medicare that began three years ago, initiated by lead plaintiff Dr. Brian Day, is over sometime this year or next.

The government tried, but was denied, to get leave to appeal the injunction two months ago.

Since the injunction dealt only with private surgery clinics, it left diagnostic clinics offering private MRI, CT and PET scan imaging out. The government had said that on April 1, diagnostic clinics would have to comply with the act.

Dennis Hummerston, senior director of Canada Diagnostic Centre, said diagnostic clinics were planning their own injunction application but then got word about the cabinet order.

The amendment is now scheduled to take effect on March 31, 2020, which means private facilities have at least another year in business. The clinics have always disputed the rationale for “draconian” fines and penalties and maintained the legislation would force them out of business.

Hummerston said he’s not aware of any clinics that have gone out of business but said some have lost administrative staff, technologists and radiologists due to the legal uncertainty.

Stephen May, a spokesman for the Ministry of Health, said the government changed the date when the Act will take effect because of the medicare trial and the injunction.

“Consistent with the court’s decision to grant an injunction in a similar case, section 18.1 of the Medicare Protection Act will not come in to force until March 31, 2020 — after the expected completion of the Cambie Surgeries trial. This decision respects the court’s prior decision. … (But) we are committed to stop extra billing.”

May said the government has put an additional $11 million into magnetic resonance imaging in the public system to reach a total of 225,000 MRIs in 2018-19.

“This is approximately 35,000 more MRI exams than the previous year. We are ahead of these targets with hundreds of more operating hours added across the province and more MRI machines running 24/7 than ever,” he said.

Day said the fact that the cabinet order was passed was proof the amendment was unnecessary in the first place.

“The action confirms that there is, and never has been, any health-related rationale for pursuing these amendments. They were merely aimed at prohibiting patients from accessing private options to care for themselves, especially when the actions were taken during the course of a trial aimed at discovering the legality of those prohibitions. It is a perfect example of ideology taking precedence over reason and logic, not to mention ideology trumping the rights of suffering patients.”

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13Mar

Grand Chief Stewart Phillip: ‘I want my son’s death to be meaningful’

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“There’s no way to describe the enormous shock a parent experiences when you get a phone call informing you … You lose your ability to stand, and you sink into the closest chair. Your heart stops and you just can’t believe it. This terrible wave of shock goes through your entire body.”

Grand Chief Stewart Phillip took that terrible call last August from his wife, Joan. She was nearly hysterical.

“The minute I heard her, I thought, ‘Oh, no. Oh, no.’ She kept saying over and over, ‘He’s gone. He’s gone.’”

It was Aug. 7, 2018, the day after Kenny Phillip’s 42nd birthday. Their oldest son had died alone in a hotel room of a carfentanil overdose in Grand Prairie, Alta.

“I don’t think he knew that he had taken carfentanil,” his father told me. “But nobody was more well-versed in addictions and the variety of drugs available than he was.

“Having gone through so many treatment programs, he had high level of expertise. He knew everything about his addictions, the pattern and so forth. Yet he still was vulnerable to the powerful call of the addiction.”

Kenny struggled with addiction to drugs and alcohol since he was a teenager, and had been to at least half a dozen treatment programs. Still, his father said, “You’re never ready for that phone call.”

His son followed the usual cycle. Bouts of drug and alcohol use punctuated by detox, treatment and periods of recovery. His longest recovery period lasted nearly three years. But this time, his parents were optimistic that it was different.

He had graduated from the Round Lake Treatment Centre. He was working as an apprentice mechanic. He loved it. He had been obsessed with cars since he was a kid. One of the people who worked with him in Penticton described Kenny to me as “a helluva guy.”

After he died, a former co-worker designed a logo with two crossed wrenches, Kenny’s initials with the years 1976 and 2018, and had decals made up so that his friends could honour him by sticking them on their toolboxes.

Phillip says something happened when Kenny went up to northwestern Alberta, triggering his addiction. And given Grande Prairie’s reputation as a crossroads for drugs, he wouldn’t have had to go far to find them.

Northwest of Edmonton, Grande Prairie has had several recent large drug busts. In January, RCMP seized four kilos of crystal methamphetamine, 2.2 kilos of cocaine, 200 grams of heroin, about 5,500 oxycodone tablets and about 950 fentanyl tablets.

A few months earlier, guns, ammunition as well as meth, cocaine, heroin and magic mushrooms were seized in a follow-up to a July raid.

“I have first-hand knowledge,” Phillip said. “I started drinking when I was 15, and was 40-something when I sobered up. It was the hardest thing that I ever did, and I was an alcoholic not strung out on crystal meth and some of the street drugs.

“But I know that at the end of the day, it’s up to the person. The individual.”

Seven years into marriage with, at the time, three children — two daughters and Kenny — Phillip’s wife told him she was finished with the fighting, picking him up when he was drunk, and buying liquor for him. But if he wanted to carry on, he was free to go.

“I thought, ‘Free at last,’” Phillip recalled. “I lasted a month. I was downtown drinking with all my so-called buddies talking about my newfound freedom. One evening in a Chinese restaurant — nobody else was there — I put in an order and was staring at the tabletop. I just broke down. I started crying and then howling.

“The howling was coming from the soul. I was scared stiff.”

At that moment, he realized his stark choice.

“If kept going, I was going to die at my own hand. But to contemplate stopping … which at the time was like contemplating to stop breathing or stop eating because it was such an integral part of who I was.”

What had kept Phillip from suicide, he told the Georgia Strait in May 2018, was the thought of his son. “I thought he would have to grow up with that stigma.”

With the help of Joan and Emery Gabriel, a drug and alcohol counsellor and the only sober friend Phillip had, he got into treatment at the Nechako Centre and has never relapsed.

Every day, Phillip thanks the Creator for sobriety because abstinence has enabled him to take on the work he has done and continues to do as president of the Union of B.C. Indian Chiefs, grand chief of the Okanagan Nation, and as a board member for Round Lake Treatment Centre.

Phillip grieves for the “incredible, amazing young man who touched so many different lives” and for the choice Kenny made last August, knowing full well the risk he was taking in the midst of the opioid overdose crisis.

He speaks openly, and urges others to as well, because those who have died need champions to bring about change.

“I want my son’s death to be meaningful,” Phillip said. “The path forward has to be an abundance of resources to help those who are struggling with addictions. … More treatment centres, more programs, and a greater commitment from governments and society to pick up the responsibility for it.”

So far, governmental response has been “minimalist,” said Phillip.

“This notion of harm reduction is just kicking the issue down the road. It’s not dealing with getting people from an addictive state to where they are clean and sober. That’s what we need to do.”

As for cannabis legalization, Phillip said, “I just shake my head when I think of where we are at and the direction we are going.”

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11Mar

Whooping cough case confirmed in Duncan

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A Vancouver Island Health Authority office in Victoria.


Times Colonist

A case of whooping cough has been reported in Duncan, making it the second confirmed case on southern Vancouver Island in recent days.

After a laboratory confirmed that a Duncan adult had a case of pertussis, a letter was sent out by Island Health on March 8, agency spokesperson Jennifer Parisi said Sunday.

The letter went to areas where there might have been exposure. People were asked to watch for early signs of whooping cough and to follow up with their health care provider if they have any symptoms.

In that case, “There are no high-risk contacts and no further follow up is required by public health or the communicable disease team so there is no concern there,” she said.

It is not out of the ordinary to have two cases of whooping cough in the region, Parisi said.

Island Health sent another letter out this past week, informing the Mount Douglas Secondary community that a case of whooping cough had been confirmed at the school.

The pertussis bacteria can be spread through coughing, sneezing, sharing drinks or cigarettes, and kissing.

Small babies can be especially vulnerable to pertussis, said Parisi, who recommends that vaccination records be checked to ensure everyone is up to date.

Cold-like symptoms appear and the illness can advance to a severe cough with a whooping sound. Gagging and vomiting are also possible. Island Health said symptoms can continue for several weeks.

Antibiotics are used to treat whooping cough.


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9Mar

No place to go for homeless hospital patients after release: advocate

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The Fraser Health Authority says it is investigating after Chilliwack Mayor Ken Popove raised concerns about a 76-year-old woman who was discharged from Surrey Memorial Hospital and sent by taxi to the Chilliwack Salvation Army shelter, despite mobility and incontinence issues.

On Thursday, the mayor requested a meeting with Fraser Health CEO Dr. Victoria Lee to discuss “why vulnerable people are being sent to Chilliwack homeless shelters from another community.”

He cited the case of an elderly woman who had no family in Chilliwack, but arrived at the local shelter from the Surrey hospital in early February. Shelter staff were not prepared to care for her medical needs, which included severe incontinence.


Chilliwack Mayor Ken Popove has taken issue with a Fraser Health decision to send vulnerable hospital patients to the Chilliwack homeless shelter.

Submitted photo /

PNG

“Constantly cleaning up fecal matter … is a serious concern for both staff and shelter clients,” said Popove in a letter to Lee.

Fraser Health spokesman Dixon Tam said Fraser Health makes “every effort” to find homeless patients a place to go when they are clinically stable and ready to leave the hospital, but “finding suitable housing is a challenge across our region.”

Tam said: “We are committed to continue to work closely with B.C. Housing and our municipal partners to develop more options. At the same time, we need to be careful not to use hospital beds as an alternative to stable housing.”

Abbotsford homeless advocate Jesse Wegenast said he wasn’t surprised to read the Chilliwack mayor’s account in the newspaper, “but only because it’s such a common practice.”

Wegenast’s organization, The 5 and 2 Ministries, opened a winter homeless shelter in Abbotsford on Nov. 1. The next day, he received a call from a Vancouver General Hospital administrator asking if he had space for an 81-year-old patient.

Wegenast said he often says no to accepting patients because the shelter is not open 24 hours and people must leave during the day. He’s had requests to take people with severe mobility issues, as well as those who need help with toileting or washing.

“The people who work at shelters are often very compassionate, and if the hospital says, ‘Well, we’re not keeping them,’ they feel obligated to help,” said Wegenast.


Abbotsford pastor and homeless advocate Jesse Wegenast.

Ward Perrin /

PROVINCE

The pastor said he’s rarely seen people in shelters receive home care or followup care, and it’s also difficult for them to get prescriptions filled.

Wegenast helped a low-income senior on Friday who recently had half of his foot amputated. The man lives in an apartment and was receiving home care to help with dressing changes, but he’d been unable to get antibiotics for five days since being released from hospital.

“When you have people exiting acute care at the hospital and there’s no one to follow that up, it’s bad for that person’s health, and it’s also bad for public health in general,” he said.

Unlike Wegenast, Warren Macintyre was surprised to read about the Chilliwack woman’s situation because it confirmed that the experience he’d had with Fraser Health was not uncommon.

“I really had no idea this kind of thing was going on,” he said.

Three weeks ago, a close family member was admitted to Surrey Memorial after suffering from alcohol withdrawal, said Macintyre. He was placed on life support in the intensive care unit for about 10 days. When he was stable, he planned to enter a treatment program in Abbotsford, but there weren’t any beds available until March 14.

“We were told the plan was to keep him in hospital until then, but I got a call Wednesday telling me he’d been discharged,” said Macintyre.

Surrey Memorial had sent his relative to the treatment centre, where staff repeated they had no space, so he was returned to the hospital. The man, who had been staying at the Maple Ridge Salvation Army before his hospital admission, took a cab to a friend’s house.

His family is hoping he’ll be able to stay sober until he can get into treatment March 14.

“I told the hospital, if he goes back on the booze, he’ll be right back here,” said Macintyre.

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9Mar

Canine counsellor Mac hits paws after 13 tail-blazing years of helping

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Mac enjoys his cake at his retirement party at the University of the Fraser Valley last week.


University of the Fraser Valley

After 13 years, Mac the golden retriever will no longer wear the blue-and-yellow vest that identified him as a working dog.

The canine counsellor — the Pacific Assistance Dog Society’s (PADS) longest-serving member — retired last week after a career that saw him become the first registered therapy dog in the world to work with a counsellor in a non-residential setting.

He was also the first to work full time in a hospice and the first to work as a therapy dog with students at the University of the Fraser Valley.

“He’s a trailblazer — or maybe we should say a tail-blazer,” said his owner Dawn Holt, a clinical counsellor who works in UFV’s counselling department. “I think some of those firsts are due to him doing it for so long.”

In addition to supporting students, Mac has helped dozens of people across B.C. through traumatic events, including some of the province’s biggest disasters. He received an “Above and Beyond” award for selflessness in service after the 2017 wildfires. He’s also supported police, consoling officers during funerals, and calmed victims in crisis.


Mac hard at work at UFV.

Submitted photo – University of the Fraser Valley /

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Mac has always had a “calm, mellow, gentle, sweet nature,” said Holt. From his puppy days, he’s been able to detect stress and sadness. “In a room full of people, he’ll go to the person who needs him the most.”

PADS trainers noticed this trait when Mac was young and began to train him as a therapy dog. A volunteer with PADS at the time, Holt began her career as a clinical counsellor at the same time Mac did. The two have always been partners, working in hospice, at UFV and in private practice.

But while Mac is officially retired, he won’t disappear from campus or from his patients’ lives. He can still be seen at the university, albeit without his recognizable vest. Instead, he now wears a UFV T-shirt.

“He doesn’t have that mantle of responsibility anymore,” said Holt.

Students have been surprised to discover that without his vest, Mac is a little more goofy. He’s now allowed to roll around on the campus lawns and sniff bushes.

“I guess he’s been wanting to sniff those bushes for the last 13 years,” quipped Holt. “He knows the difference between the vest, which he wore when he was working, and the T-shirt. He knows the T-shirt is somewhere between full-on work and relaxing at home.”

Holt explained a therapy dog works in two ways. First, they create a physiological response in patients, offering unconditional friendship, which can slow breathing, calm the body and reduce stress hormones. They also work to “build a bridge” between counsellor and patient, calming fears and building trust so the counsellor can do her work.

Mac doesn’t take his work home with him. A good therapy dog can “shake off” a heavy session, literally shaking his coat like he’s just gotten out of a lake.

“I’m so proud of him and the work he’s done,” said Holt.


Mac as a puppy. The 15-year-old golden retriever is the Pacific Assistance Dog Society’s longest-serving member.

Submitted photo – University of the Fraser Valley /

PNG

 


Mac receives a hug from Margaret Trudeau. Over the course of his career, the canine counsellor made 1,792 drop-in visits, participated in 6,187 counselling sessions, and appeared in over 12,000 meet and greets at gyms, arenas, and events.

Submitted photo – University of the Fraser Valley /

PNG

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9Mar

Tidying up: The psychology of clutter and why we’re now cleaning it up

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When Shelley Davies arrives at a client’s door with her big black eyeglasses and calm, focused demeanour, she could be mistaken for any professional making a house call: A physician, tutor, stylist, therapist or, perhaps, exorcist. She is, in a way, all of these things.

The founder of Details Modern Order, Davies makes house calls that can feel as personal as a doctor’s consultation, as consoling as a therapy appointment and as cleansing as an exorcism. Her goal? A cure for our modern malaise: clutter.

“The words I have heard over and over again are ‘I’m drowning,’ or ‘I’m suffocating,’” says Davies.

The feeling of being overwhelmed comes, says Davies, because “when people are surrounded by too much clutter they feel stuck.”

Our clutter problem has become something of a 21st-century obsession. The Netflix show Tidying up with Marie Kondo, replete with its soothing, almost holy rituals of holding and letting go, has cashed in on the anguish and helplessness that we who live cluttered lives feel.

In the era of fast fashion, easy credit and urban density, many of us simply have too much stuff and nowhere to put it. The never-ending stream of clothing, dollar-store gizmos, seasonal decor, gifts, paperwork, sentimental items, unfinished projects and overloaded Billy bookcases is just too much.

Unlike hoarding, which has been classified as a psychiatric disorder since 2013 but affects just two to six per cent of the population, the emotional consequences of clutter have not benefited from wide psychological study.

Perhaps they should. According to the Professional Organizers of Canada, 83 per cent of Canadians indicate they are extremely disorganized and 91 per cent of Canadians feel clutter negatively affects their lives. According to Planet Storage, the average Canadian spends 12 weeks a year looking for stuff they can’t find.

Decluttering expert Shelley Davies checks out Vanda Borean's clean, organized closet in her Vancouver home. ‘When people are surrounded by too much clutter they feel stuck,’ says Davies.


Decluttering expert Shelley Davies checks out Vanda Borean’s clean, organized closet in her Vancouver home. ‘When people are surrounded by too much clutter they feel stuck,’ says Davies.

Arlen Redekop /

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In a recent paper published in Current Psychology, authors Joseph Ferrari et al. suggest clutter may have significant downsides: “Clutter might undermine the comfortable, everyday experience of feeling at home people take for granted, since disorganization of one’s possessions may erode an ability to find things, move safely throughout their home, and use spaces as intended.”

Sheila Woody, a psychologist who specializes in hoarding disorders at UBC, says that although clutter is not a mental illness, it can affect mental health. “It’s stressful to be in a cluttered environment,” says Woody.

According to Psychology Today, clutter causes stress in part because of its excessive visual stimuli. It also signals to our brains that our work is never done and creates guilt, anxiety and the feeling of being overwhelmed.

Dr. Joti Samra, a clinical psychologist who works with compulsive hoarders, says, “Clutter itself, the tendency to collect and keep, is a normal human attribute with an evolutionary reason.”

That evolutionary reason may go back to “our cave-person days,” says Samra, “when resources were scarce.”  Collecting, storing, even hoarding, might have helped us survive between harvests and hunts.

Samra believes that in North America’s wealthy consumer society, basic needs are not just met but exceeded for most of us, so “when the attribute no longer serves a need, it becomes a stressor.”

Japanese organizational expert Marie Kondo, who has helped spark worldwide interest in decluttering your home, mainly through her Netflix series.


Japanese organizational expert Marie Kondo, who has helped spark worldwide interest in decluttering your home, mainly through her Netflix series.

Seth Wenig /

Associated Press files

Enter Davies, who sees herself an “organizing coach.” In her work, Davies sees what happens when clutter encroaches not just on our homes, but on our mental and emotional well-being.

After discovering a gift for creating calm out of chaos 15 years ago, Davies is booked solid.

“Organizing is on the top five of everybody’s New Year’s resolutions,” says Davies. “Every year for the past 12 years (with the exception of this year), O magazine’s March issue has been on organizing.”

Marie Kondo’s bestselling books and Netflix show have brought even more attention to clutter, although some experts, like Sheila Woody, take exception to the singularity of her method.

“One of the things that concerns me about the Marie Kondo phenomenon is that it tells people what kind of person they should be, it tells them what makes them a good person. It says this is how you have to live. Not everyone has the same aesthetic or the same values.”

(Woody points out that Kondo’s “spark joy” test, in which you keep only those things that make you happy, won’t work with hoarders and people who love stuff, as “so many things bring them joy.”)

In order to declutter successfully, a person needs skills that may not be innate to their personality. They must be able to prioritize, make choices and take action, and may have to reflect on other values, such as an item’s necessity, the size of a space, or lifestyle in combination with whether or not the objects bring them joy. 

‘It was life changing,’ Vanda Borean says getting the clutter — the excess stuff — out of her life. ‘I didn't realize how much heaviness was coming from holding on to these items.’


‘It was life changing,’ Vanda Borean says getting the clutter — the excess stuff — out of her life. ‘I didn’t realize how much heaviness was coming from holding on to these items.’

Arlen Redekop /

PNG

It’s OK to ask for help

Vanda Borean, 52, reached out to Davies when she renovated the modest Vancouver home she shares with her dog. Borean’s contractor had made an abrupt change in the work schedule and she was ordered to remove all her possessions within two weeks.

Although she describes herself as a fairly tidy person, Borean had accumulated a lot of stuff over the years. She had married and later separated. She had left a corporate career to become the owner of Rackets and Runners, a sporting goods store. Her small home was stuffed with books she had read and loved, books she hadn’t yet read, clothing that didn’t fit or she hoped would one day fit, suits that reflected her prior corporate career, and mementoes from her travels that were tucked away in shoeboxes she never opened.

Borean was blessed and cursed with a basement — she’d just toss stuff down there. (Garages serve a similar function when it comes to clutter — 25 per cent of Canadians with two-car garages use them just to store stuff.)

Not only was Borean unaware of how much all that stuff was weighing her down, she didn’t realize the process of decluttering was about much more than just getting rid of things. “It was life changing,” says Borean. “I didn’t realize how much heaviness was coming from holding on to these items.”

Borean was guarded at first. “It’s like letting someone into your deepest, darkest secrets. Behind the curtain.”

But she felt a “lifting” as she and Davies went through each room, asking what she was holding on to, and why.

Clutter affects us negatively, says Davies, because of the emotions we attach to things. When we allow it to accumulate “we stop living in real time.”

She defines clutter, in part, as “delayed decision-making.”

“The stuff that surrounds us is actually in control of how we are living our lives. It creates feelings of guilt, embarrassment, disappointment.”

An untouched guitar can represent an aspiration, but it can also represent a broken dream. “Does having that guitar mean you are a musician? Or does it mean you feel badly because you don’t ever play it?”

Davies holds no judgment about how much stuff someone has, or why they have it, but she sees people judge themselves.

“Having a clutter-filled home, to many, is an embarrassment. It shows failure in many people’s minds. Shame is a byproduct of feeling like they have lost control of their lives, their stuff. Lack of control leads to lack of confidence. All this can make people feel like they have failed,” says Davies. “But at the end of the day, it’s just stuff.”

Being non-judgmental is part of the gig. “If someone says they want to keep their 100 pairs of shoes, no problem. But we are going to put them away so they are respected, so you can see them, so you can access them to make it work in your life.”

Vanda Borean (left) teamed up with decluttering expert Shelley Davies to reorganize Borean’s Vancouver home.


Vanda Borean (left) teamed up with decluttering expert Shelley Davies to reorganize Borean’s Vancouver home.

Arlen Redekop /

PNG

Balancing beauty and function

Davies says the problem can’t be dealt with in a day or resolved with a few baskets from Ikea or a new storage system.

“The goal isn’t just to move stuff around,” says Davies. Some people are “filers,” others are “pilers,” some have what she calls “square, organizing brains” and want to see order and systems, others have “round,” more artistic, creative ways of organizing.

The method Davies uses takes four steps, whether you are attacking a junk drawer, a room or a whole house.

Step 1 is to define how you want to use the space: A bedroom in a small home might need to have a dressing area, a bed, a desk, a book shelf. Or, says Davies, a client might envision a completely minimalistic “Zen” space — but if the client has a huge treadmill acting as a clothes hanger they don’t want to move, then a conversation has to happen.

Step 2 is to minimize what is in the space. “We need to go through all the parts of the room and the stuff, touch it and make decisions about it.”

Davies calls this part of the process getting your space “down to its true inventory.” That means moving things out, selling, consigning, garbage — whatever it takes. 

Her criteria goes beyond “spark joy.”

“I prefer to use the beauty and function test,” says Davies. “Your home is really important to how your life unfolds. If you use something and love it, we are going to hold on to it. But we are looking to find a home for it for two reasons: So you know where it is and you can retrieve it easily.”

Step 3 is about finding a home for everything that the client has decided to keep — what Davies calls “creating systems of flow,” so when she leaves it doesn’t all fall apart.

In Step 4 Davies works with clients to “make it beautiful.”

“My goal isn’t to tell you to get rid of everything but to make sure you are surrounding yourself with, and organizing, what you really want in your life.”

Borean says the psychological and emotional impact of letting go of the clutter was “cathartic, empowering and liberating.”

“The relinquishing of these things was, in a way, a coming to terms with my past and saying it’s OK,” says Borean. “You’ve done some incredible things, you’ve made some mistakes, and you are ready to embark on the next stage of your life.”

Borean’s experience is a testament to what Davies has learned during 15 years of detailing Vancouver homes: Decluttering is about much more than tidying up, says Davies. “It’s about removing what doesn’t make you happy, and giving space for the things that do.”

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8 Tidy Tips

Organization tips from Shelley Davies:

1. Commit to a new lifestyle.

2. Remember: baby steps with attainable goals.

3. Prioritize the areas that you want to conquer first.

4. Schedule daily/weekly/monthly organizing tasks.

5. Get your whole family on board.

6. Don’t be afraid to ask for help or hire help.

7. Don’t give up — the situation didn’t happen overnight.

8. Pat yourself on the back, do a dance, reward yourself on your successes.

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