Posted by: Bob Stott

Last week, an article of mine went live on the Therapy Times site, entitled "Dying with Dignity", focusing on palliative care professionals and respiratory therapists coming together to aid the terminal patient. While I didn't face the usual struggles I come across when writing an article – wading through PR fluff or "reliable" sources who pack up and leave for Indonesia (oh, it happens) – I still ran into a bit of a writing wall.

With a lot of articles in which I spotlight therapists combating some tragic or debilitating trauma, I do my best to show both sides of the story: the tragedy but at the same time, the silver lining where therapists' efforts are making real differences. End-of-life therapy took me somewhere else entirely. On a topic like this, it was hard to locate that time-honored silver lining.

Also, covering a subject so intertwined with personal spiritual beliefs, I was having some minor troubles trying to walk a politically correct tight rope. Myself an agnostic and out-of-practice Catholic, I didn't want to validate or discount anyone's spiritual perspective on the proper management of end-of-life therapy. While illness and dying are a normal part of life, everyone, even therapists and palliative care workers, seem to have different ideas of where one's own spirituality fits into the process.

The Joint Commission has an accreditation standard that includes the patient's right to spiritual care and support, and although clinicians may recognize the need to provide spiritual care, many are understandably uncomfortable asking questions about spirituality or religion, for fear of superimposing their own ideas on the patient. From my research, it's clear, even today, that the relationship between spirituality and the patient's coping abilities is relatively new in the therapeutic literature. The number of studies addressing spirituality has tripled in the past five years alone.

Unwilling to make a spiritual stand myself, I decided to focus on the medicine of end-of-life field. Going into a topic like this, you have a misconception that the elephant in the room will be the removal of ventilator from the patient, the allowance of the patient to die – that very Grey's Anatomy-esque drama. But the entire road to this point can be a gauntlet, from dealing with hostile family situation to juggling demands for more aggressive preventative treatments.

Choosing to embrace palliative care over aggressive treatments is not giving up, and it's not giving in. A patient's decision to change the focus of their treatment from "cure" to "comfort" is about weighing quality of living versus quantity of life. It is about clarifying choices and the goals of the individual and family. As the patient juggles the aspects of palliative care – holistic care, pain management, home versus hospice care, spiritual issues, and familial support – experts say its crucial that healthcare professionals remain supportive of these decisions.

Its been an interesting article, seeing this hot topic from a lot of different angles, and coming to terms with my own ideas of mortality and end-of-life has been a real eye-opener. By all means, if you'd like, read my article and let me know your own unique perspective about patient management in end-of-life care.

Posted by: Bob Stott

As I finish up another intense air drum solo (to a standing ovation, I might add from the spider plant and the collection of multi-colored highlighters) to the wicked drumbeat from "Thanks for the Memories" courtesy of Fallout Boy, I could not help but notice the accelerated heartbeat and the tiniest bit of perspiration, the standard package deal that comes from flailing your arms in front of you for even a few seconds at a time. While my wild moves might not solidify my standing at the office as a balanced and reserved individual, new research says that I might be doing the best possible thing for someone who spends a majority of their day in a stationary position.

A study published in the journal Science has revealed that fidgeters – my people, the ones who cannot seem to stop their incessant foot-tapping, thumb twiddling, head bobbing, or incoherent humming to no audible song – are thinner, on average, than non-fidgeters.

The study found that sedentary (the statues of the workplace) burn at least 350 fewer calories compared to even a low-level fidgeter (the fairly infrequent foot tapper). The study suggests that sedentary people prefer to sit still due to a genetic predisposition, while many fidgeters are afflicted with opposing genetic tendencies that require freedom of movement and activities that match the amount of food intake.

While full-blown fidgeters are known to be an annoyance in the workplace, as much they were in school with the pencil tapping on the desk, many of the fidget behaviors either go unnoticed or are of no bother to anyone. The study suggests that an easy way for obese people to lose weight is to simply speed up their metabolism a little each day – essentially, just fidget more.

For those not predisposed to move while working (some find it a distraction to their workflow as opposed to the focusing element that fidgeters feel it induces), there are a few simple ways to incorporate more motion into routine activities, even without the full-blown air instrumental solo. The trick is to maintain a 'motion-minded' perspective. Putting a post-it on the side of your computer that reads simply 'Move' can usually provide sufficient motivation for a few seconds of activity. Recommended methods of the new 'fidget diet' are:

• Tap your feet

• Swing your legs

• Drum your fingers

• Stand up and stretch at intervals

• Move your head from side to side

• Change your position every ten minutes

• Wriggle and fidget

• Pace up and down

• Don't use the internal phone – go in person

• Use the bathroom on a different floor

• Park in the far corner of the parking lot

• Stand up while you're on the phone

• Clench and release your muscles

Posted by: Haley Jestice

"Do children fill a marriage with happiness?" According to Daniel Gilbert, author and psychology professor at Harvard, "no" or at least, not while they are still living at home.

Gilbert recently presented his views at the "Happiness and Its Causes" conference in Sydney, Australia. As reported by the Associated Press, he told the audience that based on statistics "married people are in almost every way happier than unmarried people – whether they are single, divorced [or] cohabiting."

Given this fact, it's assumed that children only add to an already opulent married life. However, Gilbert proposes that the opposite is true.

When the stork comes bearing the gift of a child, the married couple's happiness often diminishes, according to Gilbert. He says, "People are extremely happy before they have children and then their happiness goes down, and it takes another big hit when kids reach adolescence,"Gilbert told delegates, presumably as half of them exchanged gleeful high-fives and the other half didn't hear a word he said since they were too busy texting the nanny: "Fish stix in freezer, no TV 4 Billy 2nite."

Following the onset of sleepless nights in a "love nest" that now provides a sanctuary for posterity – consisting of a multitude of diapers, onesies, band aids, strollers, toys, formula, "sippy-cups," Cheerios, and a mesmerizing DVD-collection of Bob the Builder, Blue's Clues, Barney & Friends, The Wiggles, Dora the Explorer, and more – wouldn't every married couple exude elation?

"The psychologists tell us that we like things more when we pay for them," said Gilbert. "What does that sound like? It sounds like children. We pay for them in time, attention, blood, sweat and tears – what kind of idiots would we be to devote all of that to the rearing of our young if they'd didn't bring us some happiness?"

So, it seems that Gilbert is suggesting happiness takes a backseat for a while, perhaps, he is suggesting it exist as a memory or a hope for the future: "remember, how – before we had kids – when we . . . "; "Maybe, after school starts, when the kids are gone ...".

Now, this blog is just to stimulate reader's thoughts on happiness in life such as: What creates happiness? How do people stay happy?

As I was writing an article on the topic of depression for an upcoming newsletter, I probed therapists to find out answers to the following questions: "Are there ever times when a patient seems unhappy or unmotivated? How do you approach them?" And, later, I searched the Internet for related content and came across information about Daniel Gilbert. I became intrigued by Gilbert's view of happiness.

Now, I'm curious to find out what other people think of his opinion. He suggests that a married couple's idea of "happiness" prior to children isn't satisfied with children. But, here's another perspective: perhaps, children bring a new meaning to what "happiness" truly is in life, and maybe children challenge parents to reach for a new level emotional stability since they are dependent on them, and further maybe children allow parents to experience happiness in a new way – life through their child's eyes.

What are your thoughts on happiness?