Vaccines for Children: List By Age, Benefits, Safety
Are You Deciding Or Sliding In Your Love Life?
The longer a couple stays together, the more their joint identity grows. Staying together because of this can be problematic in the long run.
Source: Alex Green / Pexels
Are you actively deciding to move on to the next romantic stage of your love life, or are you simply slip-sliding along the route to what may seem like the next logical step?
After we decide to commit ourselves to someone, our decision-making process may change course.
What Is Commitment?Commitment is based on both the individual's particular personality traits as well as the interdependence of the individuals on one another. Put simply, people who need other people and feel needed by those people are more likely to commit to each other than those who don't.
Suddenly, Rapunzel and her prince falling in love at first sight seems to make a lot more sense: Rapunzel needed her freedom, and every fairytale prince needs a romantic partner who just happens to be a helpless maiden.
But how do we know if our love will last the test of time?
According to science, relationships last when (1) people need or depend on each other and (2) the other options for potential mates aren't particularly appealing.
In 1980, researcher C.E. Rusbult added the idea of romantic investment to this equation.
The decision to stay in a relationship is also a result of the resources that could be lost if the relationship ends. This includes money, possessions, and emotional investments—in particular, how much you allowed that person to get to know you and your vulnerabilities.
In other words, there are times when we want to stay in a relationship simply because we have given so much of ourselves to it.
This is staying in a relationship for the sake of the relationship. Not because you love your partner.
However, the longer a couple stays together, the more their joint identity grows. At some point, it may start to feel as if staying with a partner is about your identity as a couple, rather than staying together because you love each other.
How Does a Relationship Best Survive?A long-term relationship is likely to continue if (1) both individuals are happy within it and (2) the available options for alternative partners aren't super-appealing.
Research also shows that choosing pro-relationship strategies can increase the likelihood of a long-term relationship succeeding over time.
What is a pro-relationship strategy?
Couples who live together before they marry tend to have:
Researchers Stanley, Whitton, and Markman (2004) found that men who lived with their wives before they were married reported significantly less dedication to their wives than men who did not live with their wives before they were married. In 2005, Manning and Smock found that more than 50 percent of couples who live together report "drifting or sliding" into cohabitation, rather than having a conversation for the specific purpose of approaching the question of whether the couple feels that they are ready to live together.
The issue that comes up with sliding into decisions such as living together, having sex, having children, or even entering an emotionally volatile relationship is that there is a reduction in future options that is not being considered.
If a couple slides into sex, have they considered whether there is an expectation that neither will have sex with other people moving forward?
If you slide into the idea of having a child, has either person contemplated the possibility that if the relationship does not work out the possibility of ending up as a single parent may be lurking around the corner?
ConclusionThe question being raised is akin to a game of Chutes & Ladders. In this childhood game, you can get ahead by climbing a ladder that leads you on a path to a better future. On the other hand, if you happen to land on a chute—or, as in relationships, if you happen to slide into an important decision—you may miss the opportunity to separate your in-the-moment romantic notions from what is logically and rationally best for you both in the long run.
IU Health Hospital Horror Stories: Lack Of Space Leaves Patients On Cots In Hallways
Patients at IU Health's Bloomington hospital have been complaining about long wait times in the emergency room since shortly after the facility opened in 2021.
After Brown County resident Sarah Noggle recently rushed her husband, David Noggle, 78, to the IU Health Bloomington Hospital emergency room with severe abdominal pain, he spent the night on a cot, suffering in a hospital hallway.
Bloomington resident Norman Holy, 82, said when he recently went to the hospital with chest pain, he had to wait about 24 hours, mostly in a small room near the emergency room, before he was offered an actual hospital room. Holy, who is in a wheelchair, said he could not reach the call button in his initial room, and it took two hours for him to alert anyone to get him some water.
Bloomington resident Jack King, 87, said he has, on multiple trips to the hospital, waited for hours, in pain, in hallways or small rooms before being offered a hospital room. On his most recent trip, he waited hours to be diagnosed with broken ribs.
Soon after Indiana University Health opened its new $557-million hospital on Bloomington's east side, patients began complaining about long wait times in the emergency room and even longer wait times to get an actual patient room. Patients have reported often they suffered in pain, alone, in hallways, while worrying about when they would get care.
Nearly all of the patients said they eventually received good care and they were grateful for the nurses and doctors.
"I have nothing bad to say about the nurses and the doctor," Sarah Noggle said.
But Noggle, Holy, King and others questioned why the hospital does not have enough rooms and/or enough staff to handle the patient load, even outside of a medical crisis such as a pandemic.
"If the person or people involved in running this hospital are in over their heads would they please admit it and stand down, deferring to someone who is capable," Noggle wrote in a letter to The Herald-Times.
IU Health chief medical officer: "All-too-common experience"IU Health Chief Medical Officer Dr. John Sparzo said, "We are aware that this is unfortunately an all-too-common experience."
Dr. John Sparzo
He said hospital leaders have been meeting weekly and are implementing measures to reduce the overcrowding.
"We take it very seriously," he said.
Sparzo said many hospitals across the country are — and have been — dealing with the issue, and IU Health shared a letter in which medical groups including the American Medical Association and American Nurses Association told President Joe Biden in late 2022 that overcrowding was at a "crisis point" and "further spiraling the stress and burnout driving the current exodus" of health care professionals.
The letter quoted an unnamed physician who said, "We have patients who unfortunately have died in our waiting room while awaiting treatment."
The letter described emergency rooms as "gridlocked and overwhelmed," because the pandemic worsened the decades-old overcrowding problem, in part because of post-pandemic pent-up demand. The overcrowding, the health experts said, is not a result of "operational issues or inefficiency" but stems from "misaligned economic drivers and broader health system dysfunction."
The letter read that sometimes the overcrowding requires ambulances to wait with patients in the back, which means "the ambulances are stuck at hospitals and unable to respond to new emergencies."
The American College of Healthcare Executives said a lack of nurses — and hospitals' higher costs related to hiring travel nurses — is contributing to the overcrowding, because hospitals can fill beds only if they have the staff to oversee the patients.
And while IU Health Bloomington in 2022 lost money for the first time in more than a decade, primarily related to higher drug and labor costs, Sparzo said the current overcrowding problem is caused by lack of space — not lack of staff.
Sparzo said when IU Health Bloomington patients have to wait in hallways, that means the hospital already has filled other spaces it has designated as overflow areas, including rooms that otherwise are reserved for patients who are recovering from surgeries.
Given the facility's space constraints, he said, hospital leadership has focused on reducing the average length of stay per patient, which increases how frequently beds are available.
Sparzo said the Bloomington facility has reduced the average length of stay by 8% since early last year, to about 4.7 days. That has allowed the hospital to take care of 900 more patients in the first four months of this year.
He emphasized that despite the shorter stays, patient outcomes have not worsened: The number of patients who are readmitted to the hospital within 30 days of their release has remained steady.
'The hallways were full': Patient waits overnight emergency surgerySarah Noggle said her husband is a contractor and usually handles even moderate pain without complaint. So when he asked to go to the hospital because of abdominal pains, she knew his condition was serious.
She said a doctor in the ER saw him relatively quickly, but then David Noggle waited in the ER waiting room for about four hours before he was offered a cot and wheeled into a hallway.
"He was given medication, but he was in real pain," his wife said.
She said by the time she left her husband that evening, she saw at least two dozen patients on cots in hallways. The patients had small blankets but were still in their street clothes.
"The hallways were full," she said.
She returned the next morning at about 7 a.M. To check on her husband.
"He was still in the hallway," Noggle said.
She got very worried when she heard her husband say he was in so much pain that he thought about how to get to the roof to jump.
About four hours later, he was wheeled into surgery, she said. The physician told them David Noggle's gangrenous gallbladder was the worst he had ever seen.
Long waits for chest pains and broken ribsHoly, a retired chemist and graduate of Purdue University, said he retired in Bloomington because of the university's cultural offerings, especially music and opera. He also figured the local hospital would have fewer problems attracting enough staff to serve its community.
But when he went to the hospital with chest pains in mid-March, he was told initially no rooms were available. Staff placed him on a cot in a "cubby" near the ER, "kind of off the beaten track," he said.
He stayed in that cubby overnight, mostly not sleeping, because he had trouble breathing, he said, and he felt congestion in his chest.
He was offered a hospital room the next morning but declined. He went to Monroe Hospital instead and got a room immediately. He spent several days there and said he received good care, before returning to Bell Trace, a senior living community where he lives with his wife, Judy.
Holy, too, wrote about his experience in a letter to the H-T. He said he hears similar stories from other patients.
"I wouldn't have written the letter if my experience was exceptional," he said. "It's not exceptional. It's very common."
King said during his most recent hospital visit, he was placed in an examination room fairly quickly, but it took hours for him to be seen by a doctor.
King said while he was waiting, he flagged down some of the people who were moving up and down the hallway, just to make sure they had not forgotten about him.
"I was not unattended but it was a slower process than anyone would have wished it to have been," he said.
After staff determined he had broken ribs, they told him the condition is tough to treat and it would be best if he rested, took pain medication as necessary and followed up with his family physician.
He said that for three days after, he slept in a recliner, only fitfully.
"I don't feel OK," King said last week, "but I certainly feel a lot better."
Doctor: Hospital closure, retirees create unique challenges for IU Health BloomingtonSparzo said while many hospitals in the country deal with overcrowding, IU Health Bloomington is dealing with some unique challenges.
Health care systems that have designed hospitals in the last few years have generally expected the number of patients to decline, in part because procedures such as knee replacements, for which people used to stay in the hospital, now are completed in surgical centers.
Indeed, Brian Shockney, now a senior vice president with IU Health, said in 2021 that he expected the new Bloomington facility to require fewer beds because of demographic trends and changing preferences for where patients receive care, with smaller generations post baby boomers likely needing less care and more people preferring to get care at home.
IU Health: New Bloomington hospital to improve care, cut costs through flexibility, privacy
However, Sparzo said, Monroe County is seeing a greater-than-expected influx of retirees who are 65 and older, which is boosting demand for health care, including hospital stays. In addition, he said, the Bloomington facility used to be able to transfer patients to its Bedford hospital, but that happens only rarely today, primarily because of the closure of a rival hospital in that community.
Sparzo also said the Bloomington hospital's physician group, Southern Indiana Physicians, has successfully recruited specialists that can now offer services locally for which the health system previously sent patients to Indianapolis. That, too, is increasing the local patient volume.
He said the hospital is weighing all kinds of solutions to the overcrowding problem, though he said he does not have a definitive answer as to whether the health system will consider constructing additional rooms on the Bloomington hospital campus.
The new hospital has 364 individual rooms, while the former hospital had 371 rooms. Shockney said when the new hospital opened, the private rooms would aid healing in part because they offered patients more privacy and reduced the risk of infections.
Increasing the number of patients per room is not an option, Sparzo said, because the hospital is licensed only for 364 individual rooms.
He said additional solutions the hospital is implementing or considering include:
Sending patients who are stable and getting better — or at least not worse — home to receive care, with support from nurses, physicians and even meals.
Coordinating with leaders from Monroe Hospital to make sure all hospital beds in the community are fully used.
"It's a tough thing to fix," Sparzo said.
Noggle said her husband's experience made her question what she will do the next time her husband needs urgent medical care.
"I thought I was going to a good hospital," she said. "It would take a lot for me to go back there, even though the care was excellent."
Tips to avoid long wait times in hospitalsSparzo said emergency rooms typically are least busy in the morning and busiest from 4 p.M. To midnight. Staff try to release patients early in the day to make sure more beds are clean and available for the patient surge in the afternoon.
When you should go to the emergency room for medical treatment.
Sparzo suggested patients and their loved ones do the following to avoid waiting for long periods:
Say something: Patients and their advocates should feel free to tell caregivers about what the patient needs.
Request a transfer: IU Health Bloomington will transfer patients, at no cost, to other nearby hospitals, including Monroe Hospital or IU Health's Paoli facility.
Patients should pick the right venue for care. A significant percentage of patients who come to the ER can get proper care in a different setting, including urgent care clinics or from a family doctor, Sparzo said. Patients who suffer from medical conditions that are life-threatening or could result in permanent disability — heavy bleeding, chest pain, severe burns or seizures — should come to the ER. However, people with conditions that aren't life-threatening but need urgent attention — flu-like symptoms, ear aches, fractures — can seek care at an urgent care facility.
Boris Ladwig can be reached at bladwig@heraldt.Com.
This article originally appeared on The Herald-Times: Bloomington IU Health hospital patients say they wait hours in hallways
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Judi Dench, 89, Might Retire From Acting Amid Health Battle
Judi Dench is a Hollywood icon, but the 89-year-old recently revealed that she may be done acting.
This week at London's Chelsea Flower Show, Judi was asked if she had any movies coming up. Her response? "No, no. I can't even see!" she said, according to Deadline.
In 2012, Judi was diagnosed with macular degeneration, which has interfered with her vision over the years.
"You find a way of just getting about and getting over the things that you find very difficult," she told audiences during a Vision Foundation talk in 2021, per People. "I've had to find another way of learning lines and things, which is having great friends of mine repeat them to me over and over and over again."
"I have to learn through repetition, and I just hope that people won't notice too much if all the lines are completely hopeless," she added.
But Judi said it's "difficult" to memorize the lines if she has longer parts. "You just deal with it," she told The Mirror in 2023. "I have so many friends who will teach me the script. I have a photographic memory."
Judi isn't happy about her "ghastly" condition, adding that it's "terrible to be so dependent on people." But she has no plans to retire anytime soon, saying she wants to "work as much as I can."
After all this, it's understandable to have questions about macular degeneration and Judi Dench's health. Here's what you need to know.
What is causing Judi Dench's blindness?Age-related macular degeneration is an eye disease that can blur your central vision, according to the National Eye Institute (NEI), and is the leading cause of vision loss for older adults. While it doesn't cause complete blindness, it can make it harder to see faces, read, drive, cook, or fix things around your house, the NEI says.
The condition doesn't cause any early symptoms, but as it progresses, it can cause mild blurriness or trouble seeing in low lighting. In the latest phase, many people may notice that straight lines look wavy or crooked, and they may notice a blurry area near the center of their vision, the NEI says.
Why does macular degeneration happen?According to the American Academy of Ophthalmology (AAO), people are more likely to develop macular degeneration if they:
How is macular degeneration treated?There is no cure for macular degeneration, but it can be treated with certain medications or surgery, according to the AAO.
Eye-healthy foods like dark leafy greens, yellow fruits and vegetables, and fish have also been shown to be beneficial for people with age-related macular degeneration, the organization says.
Is Judi Dench still performing?As of now, Judi doesn't have any movies coming down the pipeline. But who knows what this Hollywood legend has in store.
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