Passover was a dreaded holiday for me as a teenager growing up in Allentown, Pennsylvania. It was a time when my uncle, who thought of himself as a “lay Rabbi,” rose at the head of the table and straightened himself out as if he was the Chief Rabbi in the grandest synagogue in Europe. He ceremoniously opened the Haggadah, the text recited at the Seder on the first two nights of the Jewish Passover.

As he began reciting in Hebrew the narrative of the Jewish exodus from Egypt, my aunt looked adoringly at him. At the other end of the table, my mother rolled her eyes, my father grumbled curses under his breath, and I pretended the conflict and anger I saw didn’t exist. In this week’s three-part series, I’ll share some of my thoughts on the nature of family conflicts occurring at holiday gatherings.

Family Conflict and Reduced Inhibition and Expectations

Family gatherings during holidays are supposed to be happy events where we shove personal issues to the side, forgive past wrongs, and the “good” of the family is most important. The expectation is what happened in the past is irrelevant now, and the joy of the moment; Passover, Easter, or other holidays will sooth over unskillful behaviors as warm milk does to an upset stomach. Neither anecdotes are always successful.

Our Present is Based on Our Past

We don’t live in a vacuum where our lives were immaculately conceived. You don’t need to believe in Freudian psychology to understand what a person does in the present carries with them their past.

I’m sure my uncle’s love of the family during the Passover Seder was genuine. For a brief time, he was able to reinterpret or ignore how his past behaviors hurt the family. Unfortunately, those on the receiving end couldn’t forget. Regardless of how genuine his love, my parents couldn’t go beyond his past.

Upcoming Holidays

We would like to think the joy of a holiday or it’s greater meaning will overshadow “petty” disagreements. In the 1960′s many sociologists wrote about the role of rising expectations in social turmoil. They believed inequities and injustices weren’t as important in creating conflicts as was the belief things could be changed.

It may be prudent as you approach the new holiday season to adjust your expectations of what’s possible during your family gathering. You may not have a “want to-be” Rabbi in your family, but don’t expect your cousin’s irksome behaviors that irritated you forever to vanish because you wish they will.

In the next part of this three-part series, I’ll talk about why family truths are always relative. In the final part, I’ll suggest some attitudinal adjustments that worked in my counseling and coaching of families dealing with crises.

One of the most persistent and potentially dangerous problems that disabled seniors with late stage Dementia have to live with are multiple UTI bacteria which permanently exist in their urinary tract. Here is my personal experience as a Caregiver.

There can be several reasons why this happens. With our mom, the reason had been partially due to kidney stones. And her weakened immune system had not been strong enough to render these residing organisms completely harmless even with the aid of antibiotics. So, these bacteria ended up ever present in certain localized areas in the body.

This situation is especially true for, what I consider, “special needs” seniors with two or more other physical ailments. These types of people are essentially confined to the bed. They have to be turned and fed by g-tube. And most often Nursing Homes are not the ideal place for them. The majority of them do not talk. They have contractures and they are incontinent. More important, they are totally dependent on the care of a live-in primary caregiver. It is for these reasons that they are considered “special needs”.

The goal then becomes not to get rid of the infections, but to manage and control their severity. If these germs are not treated and/or properly managed, they can cause some real damage like kidney failure or death.

Understand, however, that many bacteria reside in the body with symbiotic relationships. It is when certain ones unintentionally are allowed to compromise their unique living arrangements that they then can create damage.

First, what are UTI? According to The National Kidney and Urologic Diseases Information Clearinghouse, it is an infection in the urinary tract. 1 in 5 women will experience UTIs in her lifetime. These infections are caused by microbes which are organisms too small to be seen without a microscope. This includes fungi, viruses, and bacteria. However, bacteria are the most common cause of UTIs. There are basically three kinds of UTIs:

* Urethritis is an infection in the urethra.

* Cystitis is an infection in the bladder.

* Pyelonephritis is an infection in the kidneys

So, what are some of the names of the bacteria which can cause so much damage in the body? Three of the most recognized are: (a) Escherichia coli, (b) Klebsiella pneumoniae, (c) Streptococcus epidermidis.

Managing them can be tricky and a real inconvenience. Every time my mom had urine samples done at the hospital or clinic, two of these bacteria are always more prominent in my mom’s urine than some others: Escherichia coli and Klebsiella. Her doctors had decided years ago to keep her on a low dose maintenance of antibiotics at home to control them.

They also become resistant to certain antibiotics. Whenever these germs occasionally did manage to progress to a more dangerous level-for whatever reasons-they required us to take our mother to the hospital for a few rounds of intravenous antibiotics. That usually stabilized any potential harm.

At home, however, we eventually had learned how to manage these infections in our mom by way of monitoring, early detection, proper hydration and vitamin intake. These routines should be performed daily to ascertain that the level of bacteria growth in her system remains low.

MONITORING THE URINE:

(1) Visually check the adult underwear throughout the day. Whenever it becomes full and ready to be discarded, always check the color, odor and volume of the urine.

(2) Make a note of it in a daily care journal. Usually, foul smelling urine, bad color and/or low urine volume mean that the status of severity has increased.

(3) Remember. All three of these areas of concern (color, odor and volume) might not progress at the same rate. Only one area might be noticeably dominant.

(4) Always consider these three areas in relationship to each other. Check the urine often.

When the odor is noticeably foul and/or strong, chances are likely that the infection has multiplied to a dangerous level.

Lemon yellow is the normal color of urine. Light, medium or dark tea colors signifies guarded caution. Rust or Red colors means full alert-SOME APPROPRIATE AND TIMELY ACTION MUST BE TAKEN!!

The volume of urine is important as well. Water in; water out! If there is not sufficient amount of urine in the adult underwear, it might mean that your senior could be withholding voiding for fear of pain which means the infection has elevated. It could also mean possible blockage-especially if the senior has kidney stones. You may need to call your doctor if that condition continues-especially if it is accompanied by higher body temperatures or other related symptoms.

EARLY DETECTION IS KEY:

(1) When looking at the color of the urine in a soiled adult underwear, make note of first signs of discoloration and odor.

(2) Journalize the advent of the change and watch its progress.

(3) Choke off the growth, if possible. Sometimes simply giving the patient more water or some kind of acidic juice can slow the growth of the germ.

(4) Continue to maintain daily ingestion of maintenance antibiotic. Your daily recordings is your early detection tool.

PROPER HYDRATION:

(a) The Institute of Medicine determined that an adequate intake (AI) for men is roughly 3 liters (about 13 cups) of total beverages a day. The (AI) for women is 2.2 liters (about 9 cups) of total beverages a day. So how much water is enough to employ as a tool to control constant UTIs in the urine.

(b) Too much water can cause hyponatremia. It is a condition where more than normal amounts of sodium is flushed out of the system from drinking too much water. Marathon runners can experience this condition when drinking excessive amounts of H20.

(c) We discussed with our mom’s urologist about finding a workable consumption of water to help treat UTIs and to help flush out Kidney stones. Water can be a useful tool in managing UTIs. Remember: Each doctor often has a different opinion. At home, we had been following different doctors’ advice for years and found that every one of them has a different opinion to offer.

(d) Ultimately it depends on the caregiver to take notes, closely monitor his love one’s water-infection relationship and act accordingly. It has been my experience to hear doctors tell us one way and then blame us if it doesn’t ‘pan out”.

(e) The key to this water technique of controlling UTIs is to make scheduled visits to the doctor and/or clinic and have complete blood work done. Lab reports will show current changes in the levels of sodium or potassium in the bloodstream. Thus, water can indeed be a useful flushing technique in controlling the growth of permanently residing or recurrent infections in the urinary tract.

VITAMIN INTAKE:

(1) Vitamin C is a good source of ascorbic acid. When the urinary tract is coated with a sufficient amount of acid, germs find a difficult time sticking to the surface. Vitamin C can limit bacteria growth.

(2) Cranberry juice is often praised by doctors and nurses as the number one juice which inhibits the growth of UTIs. What they fail to also mention is that if your ailing senior has kidney stones, cranberry juice often exacerbate the condition as it creates stones as well. Remember: Cranberry juice is not the only juice that contains ascorbic acid. Lime, lemon or a simple vitamin C tab can be an adequate substitute for Cranberry juice.

(3) Make sure that vitamin C is a daily part of your Senior’s diet.

So yes. These diseases can be a menace! Everyone’s body is different. However chronic or ever present UTIs can be managed with a plan that should be collaborated between the primary caregiver and the doctor. Talk with him or her about a water and low dose antibiotic regimen. It worked for my mom.

Bardhaman district is one of the fastest productive industrial districts of India which is known for its natural resources. The district covers over 7,000 km and is situated in a favourable position as it is flanked by five other districts of West Bengal namely Birbhum, Murshidabad, Nadia, Hooghly and Bankura. In the northwest region the district meets the state of Jharkhand.

Interestingly, the headquarters of the district also share the same name I.e. Bardhaman city. It is commonly believed that the district got its new name after the Jain spiritual leader, Mahavir Bardhaman, visited this place. Mahavir Bardhaman, the 24th Jain Tirthankar, lived in a small village of Ajahapur near Memari Railway Station which presently falls under NH2.

During the 16th century, the place gained immense prominence when the Mughal leader Sufi pir Baharam settled in the outskirts of the town of Sharifabad. Baharam arrived and settled here in a bid to escape from the atrocities laid upon him by his rivalries, Abul Fazal and Faizi. During the Gupta period, the place was better known as Sharifabad and was an important agricultural and administrative centre. Even during the British rule, it became a hub of many patriotic activities.

Owing to its wonderful location, the district is always hustled with a lot of commercial and tourist activities. It can be said that the district is quite well planned in comparison of other districts of West Bengal. It consists of six subdivisions namely Asansol, Kalna, Durgapur, Katwa, Sadar – south and Sadar – north.The National Highway 60 or NH 60 connects the district to the surrounding regions and rest of the state. The other two National Highways namely NH 60 and NH 28 also cover a wide area across the district. All major townships including Durgapur, Asansol, Raniganj, Andal, etc. are connected to major roads. The railway network of the Bardhaman district is connected to two major branch lines. One connects to Katwa and the other connects to Howrah.

Over the past decade Bardhaman has flourished both in agricultural and technological terms. The eastern region is blessed with the rich alluvial soil due to the presence of River Bhagirathi. On the other hand, the western soil is loaded with mineral resources. Various industries based on iron, steel and cement have been established in the townships of Durgapr, Asansol, Rajganj, Murnur Kulti etc. It is to be noted that a major portion of Bardhaman overview is dependent on its growth which took place amid 1955-1965. Today, the region is better known as a rising industrial belt owing to the industrialised zones of the Durgapur and Asansol Subdivisions.