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The Linkage Between Trust and Communication

Posted by Tahira Wright. She is a blogger and has her own website at www.happilydivorcedandafter.com where she discusses relationship issues, insights on trending news and celebrity insights and her journey in becoming a happily divorcee. Her style is reality-based with a quirky and comedic twist.

Posted by Tahira Wright. She is a blogger and has her own website at www.happilydivorcedandafter.com where she discusses relationship issues, insights on trending news and celebrity insights and her journey in becoming a happily divorcee. Her style is reality-based with a quirky and comedic twist.

Many times when entering in a relationship or friendship there is initial acceptance of a certain level of trust. What increases your level of comfort with someone? Is it time that has elapsed since initially engaged with that person or the depth of your communication?

When reflecting over obstacles faced in my relationships, I cannot help but to say to myself, now had we communicated our thoughts better this issue would of been a moot topic. In my opinion, trust and communication are directly correlated. Between two people of the opposite sex, this becomes a challenge. When speaking to my girlfriends we have very descriptive conversations, share our emotions whether it is the way our feet felt in our brand new pumps when we hit the town last night or how we are excited in meeting a new guy. Men on the other hand tend to be more reserved, keep it simple share on a need to know basis. If you want to know how there day was, you have to pry it out by asking specific questions. “What type of feedback did you receive from your manager on the presentation you were up all night preparing for?” Not just how did it go. On the other hand, when a man asks a woman how her day went, we as women will start to tell a story. We discuss  how our boss looked at us, what they were wearing and want it to be interpreted by our mate.  But men don’t want to hear all that. They just want to know it went well and as a result there will be a peaceful evening.

The imbalance in my opinion can create trust issues if the man and woman aren’t understanding of the communication expectations from each other. What communication feedback do I as a woman want and need in a relationship? When initiating the possibility of a relationship: communicate expectations upfront. When you are dating: still communicate updated expectations. When exclusively dating or married: still communicate updated expectations. When I refer to expectations not I want to get married in so many months. Gees relax men! Some men hear expectations and think us women are trying to race them to the altar or give them a long list of rules. No not the case at all. In my opinion for most women, we want to hear what type of woman our potential mate likes and explain what keeps us attracted. What thrives you and goals do you have are the questions we want answered. Now these expectations change. So it is important for both mates to stay updated. Only difference is that maybe the communication will need to be more direct and less colorful when speaking to a man. For the man he will need to step up his convo and be a bit more descriptive.

When there are too many unknown variables….alternative conclusions and assumptions are made. Expectations are not met and trust begins to erode as opposed to increasing. Hence, in my opinion communication and trust are intertwined together.

What Are Your Thoughts? Do You Think Communication Fosters Trust?

 

State Health, Emergency Officials Urge Californians to Prepare for Excessive Heat

SACRAMENTO – In response to forecasts for excessive heat through Monday throughout much of California, state emergency and public health officials are urging Californians to drink plenty of water, wear lightweight, loose-fitting clothing and take other actions that will reduce their risk of death or heat-related illness.

This warming trend has prompted the issue of Excessive Heat Warnings by the National Weather Service (NWS) through Monday for parts of Imperial, Kern, Los Angeles, Riverside, San Bernardino, San Diego, San Luis Obispo, Santa Barbara and Ventura counties and Special Weather Statements for most of the Sacramento and San Joaquin Valley and foothills, as well as the east Bay Area.

“Prolonged exposure to excessive temperatures can be extremely dangerous, if not deadly, particularly for infants, small children seniors and those with health problems,” said Dr. Ron Chapman, director of the California Department of Public Health.  “Last year was the hottest year on record in the United States.  Heat waves in California are projected to occur earlier in the season, be more intense and last longer.”

He noted that at on average heat-related emergencies cause 56 deaths in Californians each year and prompt 3,800 people to seek treatment at hospital emergency rooms for heat-related symptoms, with approximately 500 cases per year requiring hospitalization.   At least 136 Californians died due to illnesses prompted by the 13-day heat wave that struck the state in July 2006.

“Cal EMA and its partner agencies have been preparing for excessive heat in many areas of the state this summer and fall by reviewing internal procedures, updating cooling center data bases, identifying state fairgrounds and facilities that serve as cooling centers and taking other actions to help cities and counties throughout the state ensure the safety of their residents, but it’s important that every Californian who is able do the simple, but important things that can make the difference between life and death,” said California Emergency Management Agency (Cal EMA Secretary Mark Ghilarducci.

Key actions residents and visitors of California can take to reduce their risk of heat-related death and injury include:

  • Monitoring local media for the latest weather forecasts and information from local officials
  • Learning the signs of heat-related illness
  • Staying out of the sun
  • Drink plenty of liquids and reducing physical activity
  • Using air conditioning and fans or getting to a location that is air conditioned such as the mall, the theater or a designated cooling center
  • Using cool compresses, misting and baths to lower body temperatures
  • Wearing lightweight, loose fitting clothing.
  • Taking shelter and breaks periodically, as well as staying hydrated, if you must work outside.

The recommendations from state emergency and health officials come as state agencies implement the “Heat Alert” phase of the state’s Contingency Plan for Excessive Heat Emergencies. 

Actions taken by Cal EMA and other state agencies as part of the implementation of “Heat Alert” phase activities include:

  • Coordination calls among Cal EMA, key state agencies and the potentially affected operational areas and regions with weather and power updates.
  • Coordination by Cal EMA with the California Independent System Operator and the California Utilities Emergency Association for power updates.
  • Dissemination of information related to the warming trend to key partners
  • Coordination by Cal EMA of information requirements and needs with the Access and Functional Needs Community, the Department of Developmental Services, the Department of Aging and Department of Rehabilitation
  • Dissemination of safety tips and resource information to the public via the Heat Portal of the Cal EMA website
  • Coordination with state and regional public information officers by Cal EMA and outreach by Cal EMA to media partners
  • Coordination by CDPH regarding the excessive heat event with local public health and other officials.

Additional information on preparing for heat-related emergencies is available at:

Unwanted Medical Treatment: A Painful Nightmare We Cannot Afford

By Mickey MacIntyre and Sean Crowley

Imagine your 90-year-old mother has Alzheimer’s disease and is near death. But before she became mentally incompetent, she gave you power of attorney to sign a Do Not Resuscitate (DNR) order so medical personnel would honor her wishes to die peacefully, without aggressive medical interventions in her final days.

Then your worst nightmare unfolds: your mother goes into cardiac arrest, and is subjected to the very treatment she had been determined to avoid: aggressive, traumatic Cardio Pulmonary Resuscitation, and other extreme measures, including having a hole cut in her throat, being injected with paralyzing drugs, having tubes forced down her throat and into her stomach, and having air forced into her lungs.

Two days after this aggressive, traumatic resuscitation, you are in the indescribably horrifying situation of having to direct that your mother’s ventilator be removed so she can finally die and her suffering end. But she lingers on in a slow decline for another five days while you maintain a heartbreaking, bedside vigil each day and night until she finally passes away. Then to add insult to injury, the hospital hands you a bill for this unwanted medical treatment totaling thousands of dollars.

Sound preposterous? Unfortunately, it’s not. It is Sharon Hallada’s real life, front page news nightmare.  It prompted the leading national organization dedicated to ensuring that medical professionals honor patients’ end-of-life choices, Compassion & Choices, to help Sharon file a lawsuit against a hospital and a nursing home in Lakeland, Florida, for failing to honor her mother’s wishes, despite the fact that they had been clearly and legally specified in the DNR. Sharon sued on behalf of her deceased mother, Marjorie Mangiaruca, to ensure no else’s parent has to endure this kind of traumatic experience.

In fact, medical professionals override or ignore many patients’ decisions in the weeks and months before their deaths. It happens for a variety of reasons and can lead to invasive and fruitless testing, needless suffering, unrelenting pain and a prolonging of the period before death. Patients are tethered to monitors and machines despite their determination to reject treatment and desire to die at home in the embrace of loved ones.

A recent study published in Journal of the American Medical Association found that between 2000 and 2009 treatment in intensive care units in the last month of life increased from 24 percent to 29 percent. The accompanying editorial concluded, “The focus appears to be on providing curative care in the acute hospital regardless of likelihood of benefit or preferences of patients. If programs aimed at reducing unnecessary care are to be successful, patients’ goals of care must be elicited and treatment options such as palliative and hospice care offered earlier in the process than is the current norm.”

To stop this disturbing trend, policy makers can and should provide both the carrot and the stick to ensure that patients’ wishes are honored: financial incentives for honoring advance directives and financial disincentives for disregarding patients’ expressed wishes.

The Centers for Medicare and Medicaid Services (CMS) should deny payment to providers when there is clear evidence that patients were subjected to  treatments they didn’t want — just as current policies deny payment when patients receive unnecessary treatment.

The Justice Department is investigating hospitals and doctors’ groups for unnecessary treatment and taking legal action against the perpetrators when they find evidence of such treatment. The same diligence should be trained on unwanted medical treatment. It is always unnecessary and should never be considered acceptable.

Compassion & Choices recently recommended CMS initiate several steps to improve the quality of conversations among health care professionals, patients and families about end-of-life decisions, including:

1.      Reimbursing medical providers for participation in advanced care planning with patients and their families well in advance of illness or before facing end of life;

2.      Providing financial incentives and training to encourage medical providers to offer all the information and counseling necessary for a patient’s decision making when they secure informed consent;

3.      Ensuring that the full range of medical care and treatment decisions, including curative care, palliative care and medical assistance in dying, are freely available to patients without institutional or reimbursement barriers.

The explosion of the aging population coupled with the nation’s financial and moral commitment to providing health care to an ever-increasing number of Americans reveals that the scourge of unwanted medical treatment must be an urgent priority for our nation.

Mickey MacIntyre is the Chief Program Officer for the nation’s leading end-of-life choice advocacy group, Compassion & Choices. He recently testified before the Institute of Medicine’s Committee on Transforming End-of-Life Care.

Sean Crowley is Media Relations Manager for Compassion & Choices and a former press secretary for U.S. Rep. Sander Levin, the ranking member of the House Appropriations Committee, which has jurisdiction over federal health care programs.