Join us at 1 p. Learn more. A woman in Iowa complains when her roommate's husband, who doesn't live in the facility, climbs in his wife's bed to snuggle and, she claims, have sex.
A man likes to fondle fellow residents in his Minnesota dementia-care unit; nobody assesses whether the women invite or welcome the touch or are being assaulted. Remember when roles were reversed when it came to fretting about sex drives? In the wake of several high-profile cases, facilities — eager to avoid liability — have begun to develop guidelines that preserve residents' right to pursue sexual pleasure in privacy, while protecting them from unsafe, unwanted or abusive situations.
Almost half said that developing a policy was "planned" or "uncertain. Many facilities are taking steps to address the issue of residents and their sex lives. She defines sexual expression as anything from compliments to touch to sex. You can no longer jump out of planes, but you can still generate excitement in your life," says geriatric psychiatrist Ken Robbins, a clinical professor at the University of Wisconsin-Madison. Social connections and human touch help ward off the depression and loneliness that old age and institutional living can bring, he adds.
In a place that's not very exciting, he or she may be looking for ways to have fun and have something to look forward to each day. Are people able to consent to sex if they can't balance a checkbook, or if they can barely speak? Or is sex more an impulse akin to eating, a pleasurable appetite that one retains the ability to indulge?
Who gets to decide what's safe and appropriate? Couplings in a nursing home seldom involve just two people. Many simply don't like to think about Mom's sexuality, or family members might disagree about what's best. Informer state representative Henry Rayhons, now 79, was charged with third-degree sexual abuse — for having sex with his wife, Donna Lou. The facility said her Alzheimer's made her incapable of giving consent — a claim echoed by her daughters from a previous marriage.
Donna Lou died the week before her husband was charged. In a statement his family said, "Accusing a spouse of a crime for continuing his relationship with a spouse in a nursing home seems to us to be incredibly illogical and unnatural, as well as incredibly hurtful. Staff members sometimes disapprove or are repelled by the idea of sex among older adults, Doll says.
Administrators often decide it's easier to ignore or actively discourage sexual expression. In a case, a man in a Keystone Communities memory-care unit in Minnesota fondled six women.
Rather than launching an assessment to determine whether any cases were consensual, all kissing, caressing and nudity in public areas was banned. You have to have some way to evaluate each situation. Guidelines are warranted even for behaviors as innocuous as kisses on the cheek. Its pioneering ideas are leading changes like these: A broader definition of "whole person care". Compassionate policies start with acknowledging that older adults still have sexual needs, including the very basic human need for touch.
People who work in the field sometimes call it a "Sandra Day O'Connor case. The spouse is forgotten. Some spouses are relieved — as O'Connor was — that the new attachment brings happiness to the spouse with dementia. Often, however, the new romance leaves the healthy spouse distraught or upsets adult children. Problems occur when the family finds out about the situation unexpectedly, notes Evelyn Tenenbaum, a New York attorney who has written about the issue.
Rhonda Simmonds, a senior vice president at Trilogy Health Services, says counseling can help. Doll adds, "My thinking is that a person with dementia becomes like a new person, and it's unfair to judge them by the old person.Please enter your location to help us display the correct information for your area. All the tests seem to be designed for children.
Thank you for your question. Like you, many are parents who begin connecting the dots after one of their children is diagnosed with autism spectrum disorder ASD. As you discovered, evaluating autism in a previously undiagnosed adult can be challenging.
There are no established diagnostic tests for ASD in adults. Because of these limitations, the evaluation of an adult has to lean heavily on direct observation. This will be in the context of a discussion between the clinician and the patient about current challenges in the areas of social interaction and communication, sensory issues and restricted interests or repetitive behaviors. However, some higher functioning adults on the autism spectrum become very resourceful in developing strategies to compensate for their disabilities.
Clearly, this makes a diagnosis based on observation much more difficult. But diagnosis remains important even when for those who have learned to hide their symptoms because they may still struggle in their everyday lives and interactions. Sometimes this clearly reveals an early development that fits with a diagnosis of ASD.
Often they can answer questions from diagnostic checklists and, so, inform a possible diagnosis. Instead, they began struggling with social withdrawal and related issues in their teens or adulthood. This suggests a cognitive or mental health issue other than ASD. Currently, there are relatively few clinicians who specialize in evaluating and treating adults with autism. Nor do we have established criteria to objectively judge such qualifications.
In my opinion, your best bet may be a developmental pediatrician, child psychiatrist or pediatric neurologist who is both experienced in evaluating autism in children and open to seeing older patients.
So I would recommend talking to the clinician who diagnosed your child. If she or he does not feel qualified to evaluate an adult, he or she may have a respected colleague who would be. Otherwise I would recommend contacting an established and respected autism center in your area. Thanks again for your question. Download our free tool kit for adults who believe they may be on the spectrum and adults who have received a diagnosis.
Send them to GotQuestions AutismSpeaks. Asperger Syndrome Autism Statistics and Facts.
Associated Conditions Sensory Issues. Treatments Access Services Insurance. Autism Response Team. Information by Topic. Resource Guide. Research Programs. Our Grantmaking. Deteccion De Autismo Deteccion Temprana. What Is Autism? Set Your Location. Finding someone qualified to evaluate adults with ASD Currently, there are relatively few clinicians who specialize in evaluating and treating adults with autism.
Got more questions?Readers share their personal experiences. If you have your own to share, please send us a note: hello theatlantic. Note: The kind editors at The Atlantic gave me the option of posting this anonymously. As someone with bipolar I [characterized by at least one manic episodecompared to the lesser bipolar II], I experience manic episodes wherein I feel invincible.
I also have episodes of crippling depression. The most dangerous episodes are mixed, presenting with unbearable sadness combined with intense anger, self-loathing, and frenetic energy. Not only do I desperately want to die, I have the motivation to make that happen. One of the things people are most curious about is ECT electroconvulsive therapy.
Carrie Fisher was candid about her experiences with it, yet for many people ECT remains a mysterious, frightening concept.
But ECT saved my life. Inan overwhelming mixed episode had me fighting for my mind and my life, and I begged my psychiatrist for help. He admitted me to the psych ward. After I settled in, we discussed changing my medication. I had run out of options. He recommended ECT. It was my best shot at taking back control of my bipolar brain. Before I agreed, I did some research. I learned that ECT was still the recommended second line of treatment in the standard medical guide to mental illness the first being the drugs that had failed me.
I considered the list of side effects, including memory loss, impaired thinking, and headaches. When the other option was waiting until I finally snapped and took my own life, these seemed like minor inconveniences. So, I signed up for voluntary brain electrocution. For those unfamiliar with ECT, it goes something like this:. You are given general anesthesia and taken into the treatment room.
You are given a drug that paralyzes your body. The doctor then sends electricity into your brain to disrupt its signals. The procedure itself is thankfully quite brief, and you wake up in recovery with no memory of what happened.
Despite the memory loss that followed my first treatment, that day stands out with startling clarity. The hospital had already been scheduled for demolition, and the interior was aged and neglected. As I rode the rickety elevator to the fourth floor, I struggled to squelch my growing terror.Learn more about how AANE can help.
Many adults with an Asperger profile stumble upon the description of Asperger Syndrome or Autism Spectrum. They may read about it or be told by a family member or friend about the profile. Some may believe that the information matches their history and their current situation and, as a result, may self-diagnose.
Others are not so welcoming of the diagnosis and do not choose to identify with the label. Sometimes family members suspect that their adult child, spouse, or sibling may have an Asperger profile and wonder how to tell them about it. Professionals, even some who have had long-term relationships with their clients, may realize for the first time that the traits their client is exhibiting are best described as an Asperger profile or Autism spectrum difference.
Many individuals choose to conduct their own research through books, the internet, and through support and information organizations like AANE. Independent exploration can provide sufficient answers and confirmation that an Asperger profile accounts for challenges faced and talents possessed. Some individuals do not find that getting an official diagnosis is necessary. There are numerous reasons as to why someone might seek a formal diagnosis.
For some, it can offer a clear avenue for communicating their strengths and struggles to friends and families. For others, it can open the door for needed supports:. Many individuals pursue neuropsychological testing with a neuropsychologist PhD or a psychiatrist MD.
As a result of this testing, it may be determined that the individual has ASD, something related to ASD, or something different. The clinician will usually ask questions about your behavioral history, make behavioral observations, and administer various paper-and-pencil or computer-based tests to evaluate a range of cognitive, linguistic, and communicational abilities.
When you go to see the clinician, be sure to bring with you any previous testing or other written records of past behaviors that stand out in your life. It is also a good idea to bring along a friend or family member who can provide additional perspective.
To apply for SSI there must be written documentation in the record from a medical doctor or Ph. There is no requirement of psychological testing. Specific issues regarding inability to work may be described by other clinicians. Everyone with this profile looks different and therefore the boundaries around this characterization can be challenging to define. Asperger Syndrome was not a formal diagnosis until Asperger Syndrome has since been subsumed under the formal diagnosis of Autism Spectrum Disorder.
We have yet to see how the categories will shift in the future.
This could be because professionals are still learning to recognize the profile as it is expressed in girls and women. Because many adults have adapted strategies to navigate a predominantly neurotypical world, their differences might be less easy to identify than those of children which may result in fewer adults receiving an official diagnosis.
It is never too late for an individual to increase self-awareness in order to capitalize on strengths and work around areas of challenge. What one does with this information at the ages of 20, 50, or 70 may differ, but in all cases it can still offer great value and improve quality of life.
At AANE, our bias is that it is better to know than not to know. This journey can be facilitated through non-judgmental and kind support. AANE is here to help you figure this out.
Contact Adult Services to talk with some via phone, email, or to set up a consultation. That said, many people choose to seek a diagnosis from a professional for many reasons. Below is a guide to help you navigate the current diagnostic landscape. This process can be confusing for anyone, as the designations can change from year to year, and there is on-going debate among professionals and non-professionals regarding the parameters of diagnosis.Dialectical behavior therapy DBT is a specific type of cognitive-behavioral psychotherapy developed in the late s by psychologist Marsha M.
Linehan to help better treat borderline personality disorder. Since its development, it has also been used for the treatment of other kinds of mental health disorders. Dialectical behavior therapy DBT treatment is a type of psychotherapy — or talk therapy — that utilizes a cognitive-behavioral approach. DBT emphasizes the psychosocial aspects of treatment.
The theory behind the approach is that some people are prone to react in a more intense and out-of-the-ordinary manner toward certain emotional situations, primarily those found in romantic, family and friend relationships. People who are sometimes diagnosed with borderline personality disorder experience extreme swings in their emotions, see the world in black-and-white shades, and seem to always be jumping from one crisis to another.
DBT is a method for teaching skills that will help in this task. Self-injurious and suicidal behaviors take first priority, followed by behaviors that may interfere with the therapy process. Quality of life issues and working toward improving life in general may also be discussed.
Both between and during sessions, the therapist actively teaches and reinforces adaptive behaviors, especially as they occur within the therapeutic relationship[…]. The emphasis is on teaching patients how to manage emotional trauma rather than reducing or taking them out of crises […].
Telephone contact with the individual therapist between sessions is part of DBT procedures. Linehan, During individual therapy sessions, the therapist and client work toward learning and improving many basic social skills. The interpersonal response patterns —how you interact with the people around you and in your personal relationships — that are taught in DBT skills training share similarities to those taught in some assertiveness and interpersonal problem-solving classes.
People with borderline personality disorder frequently possess good interpersonal skills. They experience problems, however, in the application of these skills in specific contexts — especially emotionally vulnerable or volatile situations.
An individual may be able to describe effective behavioral sequences when discussing another person encountering a problematic situation, but may be completely incapable of generating or carrying out a similar set of behaviors when analyzing their own personal situation. This module focuses on situations where the objective is to change something e. Most approaches to mental health treatment focus on changing distressing events and circumstances.
They have paid little attention to accepting, finding meaning for, and tolerating distress. This task has generally been tackled by religious and spiritual communities and leaders. Dialectical behavior therapy emphasizes learning to bear pain skillfully. Distress tolerance skills constitute a natural development from mindfulness skills.
They have to do with the ability to accept, in a non-evaluative and nonjudgmental fashion, both oneself and the current situation. Although the stance advocated here is a nonjudgmental one, this does not mean that it is one of approval: acceptance of reality is not approval of reality. Distress tolerance behaviors are concerned with tolerating and surviving crises and with accepting life as it is in the moment.
Four sets of crisis survival strategies are taught: distracting, self-soothing, improving the moment, and thinking of pros and cons. Acceptance skills include radical acceptance, turning the mind toward acceptance, and willingness versus willfulness.
People with borderline personality disorder or who may be suicidal are typically emotionally intense and labile — frequently angry, intensely frustrated, depressedand anxious. This suggests that people grappling with these concerns might benefit from help in learning to regulate their emotions.
McKay, M. New York: New Harbinger Publications.
Van Dijk, S. He is an author, researcher, and expert in mental health online, and has been writing about online behavior, mental health and psychology issues since Grohol has a Master's degree and doctorate in clinical psychology from Nova Southeastern University. Grohol sits on the editorial board of the journal Computers in Human Behavior and is a founding board member of the Society for Participatory Medicine.
You can learn more about Dr.President Obama has been struggling to get things right on national security. The president has not displayed the same kind of poise and confidence as he has with domestic issues. In contrast to the economic stimulus and health care reform, there have been a number of missteps, reversals and intra-party tensions over national security since Obama took office.
Obama, who in February said the trials of Guantanamo detainees were "too important to be held in a flawed military commission system," now says that he will continue to use that system, though in slightly modified fashion.
When Obama announced that he would not release photographs of mistreated detainees, many of his supporters could not help but be disappointed. The most recent controversy has been the battle over a briefing about the CIA's interrogation methods. The controversy has inspired Republicans to argue that Democrats were complicit in the interrogation methods they have been criticizing.
Keep Reading All the stars seem to have aligned for the passage of national health care reform. Victory, supporters say, is inevitable. First, President Obama and Senate Democrats included reconciliation instructions in the budget for health care.
If a deal is not reached by October, congressional Democrats can use a process that prohibits a filibuster and allows passage of the bill with 51 rather than 60 votes in the Senate. And even if opponents of the bill attempted to stage a filibuster, the switch of Sen. Arlen Specter to the Democratic Party, combined with the likely victory of Al Franken as a senator from Minnesota, would provide Democrats with 60 votes to fight it off. When President Obama moved into the White House, press speculation immediately began about what his first days would look like.
Journalists as well as scholars looked to history to speculate about which models of presidential leadership he might follow. As we reach the end of the first days this week, Obama remains much of a mystery. If we are talking grades, the best we can give him at this point is an "incomplete.
Given that the first days is only an artificial marker - it's been used since the presidency of Franklin Delano Roosevelt - it is not surprising that it is too early to reach sweeping conclusions about what this presidency will be. It is worth remembering that Jimmy Carter, whose presidency would become deeply troubled by his second year, ended his first days with high approval ratings and positive media coverage. Sometimes the similarities are striking.
Both aimed high, seeking major legislation to reshape America - Johnson with civil rights and Medicare, Obama with health care and energy legislation.He played the desperate, the drunken, and the deceived, and the trajectory of his life was as tragic as that in any of his films. A car crash in the prime of his career left him in constant pain, and he drank himself to an early death, creating an aesthetic of suffering that has guided the way we think about him today.
But for 12 years, he set Hollywood aflame. From the start, Clift was framed as a rebel and an individual.
When the press talked about Clift, they talked about the skill and the beauty, but they also talked about what an offbeat, weird guy he was.
He insisted on maintaining his residence in New York, spending as little time in Hollywood as possible. When he came to visit storied fan-magazine author Elsa Maxwell at her home, she had her maid darn the elbow in his jacket.
His beat-up car was 10 years old, and his best friends were all outside of the movie business. These anecdotes, and dozens like them, would establish Clift, along with Brando, as the embodiment of 50s youth culture, rebelling against conformity and all that postwar Americans were supposed to embrace.
Yet Clift would come to hate the image that constrained him, just as he hated the suggestion that he was a slob, unfriendly, or loathed in Hollywood: after the story of his bare closet came out in the Saturday Evening Post, he worked arduously to set the record straight, underlining the ways in which publicity takes a kernel of the truth and expands it into legend. They seem to have their stories all written out beforehand.
But he was handsome and beguiling on-screen, creating an appetite for confirmation of that same Clift off the screen. Indeed, it was his apparent lack of romantic attachments that confounded the gossip press the most. He had a close friendship with a woman named Myra Letts, whom the gossip columnists tried arduously to frame as a love interest.
Clift was so protective of Holman that when offered the plum role of the male lead in Sunset Boulevard, he turned it down—reportedly to avoid any suggestion that Libby Holman was his own delusional Norma Desmond, using a handsome young man to pursue her lost stardom. The unspoken truth was that Clift was gay. The revelation of his sexuality did not emerge until the 70s, when two high-profile biographers, one endorsed by his close confidants, revealed as much, rendering him a gay icon within the span of two years.
So finely made.
Oh dear. Have I said something wrong? Benign to most but, in hindsight, highly suggestive. Whatever relationships Clift may have had, he was circumspect. Unlike Rock Hudson, whose affairs were very nearly exposed to the entire nation by Confidential, Clift never made the pages of the scandal rags.
After Eternity he dropped out of Hollywood for several years, and signed a three-year contract with MGM in to make Raintree County, which re-united him with his Place in the Sun co-star Elizabeth Taylor.
Taylor had married British actor Michael Wilding inbut bytheir marriage was in decline. I thought he was dead. What happened next is somewhat fuzzy: one version has Hudson pulling Clift from the car and Taylor cradling him in her arms, at which point Clift started choking and motioning to his throat, where, it soon became clear, two of his teeth had lodged themselves after coming loose during the accident.
Taylor opened his mouth, put her hand down his throat, and pulled out the teeth. True or not, the resilience of the story is a testimony to what people wanted to believe about the bond between the two stars.
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