By R. Keldron. Houghton College.
Try and ensure that you have no urinary infections buy 100 mg voveran sr overnight delivery, which can make your bladder problems worse if left untreated discount voveran sr 100mg fast delivery. The following advice can help reduce the risk of ‘accidents’ during intercourse: • Reduce your intake of fluids for an hour or two beforehand. If the woman has problems with spasticity in her legs, then such a position is likely to reduce the possibility of annoying cramps and rigidity. Sometimes lubrication can be helped by direct stimulation of the genital area; or try to set up an environment which is relaxing and conducive to sexual thoughts and experiences. As far as additional lubrication is concerned, K-Y Jelly or a similar water-soluble substance can be very helpful. Substances like Vaseline are not recommended because they do not dissolve in water, and they are likely to leave residues which could give rise to infections. Spasticity Check with your doctor that the general control of your spasticity is as good as it can be. Try and keep your muscles as well toned as possible through regular exercises (see Chapter 8), and use appropriate drugs such as baclofen as necessary to give additional control. There are also certain positions for sexual activity that appear to make the muscular spasms less likely, although it is important that you explore other possibilities than those mentioned below, for you may find another position that suits you both very well. For a man who may have difficulty with spasms or rigidity in his legs, then sitting in an appropriate chair (without arms) would allow his partner to sit on his penis either facing him or with her back to him. For a woman, lying on her side may help, perhaps with a towel or other material between your legs for more comfort. Another possibility is to lie on your back towards the edge of your bed with the lower part of your legs hanging loosely off the bed. Fatigue As with other symptoms associated with MS, it is important to discuss this with your doctor who will assess the best means of managing it. Although there are one or two drugs which may help (for example amantadine or pemoline) and which – if prescribed for you – might be taken a few minutes before sexual activity, currently the best help is through various appropriate lifestyle changes. The use of various techniques to assist with fatigue is discussed in more detail in Chapter 7.
In addition to a home care equipment ordered by a physician buy voveran sr 100 mg with visa, including hospital benefit purchase voveran sr 100 mg without a prescription, Medicare has a home hospice benefit that is re- beds, wheelchairs, commodes, pumps, tube feeds, and imbursed separately. A include skilled nursing, skilled therapy, home health It is important to be aware of exclusions in Medicare aide services, and social services (Table 12. However, coverage, including homemaker services, long-term care the beneficiary must be in need of nursing, physical nursing, home-delivered meals, transportation that is therapy, or speech therapy to be reimbursed for other nonemergent, all bathroom equipment, and patient care services such as occupational therapy, personal care, or for those who do not require skilled nursing services. To bill for services, a physi- management of the patient’s plan of care; and patient cian must do at least 30 min or more of documented work education. Skilled therapy includes restorative therapy, per patient within a calendar month. The work can which is based on the expectation that the patient will include development or revision of care plans, review of improve in a reasonable amount of time, and mainte- care plans, review of studies and test results, communica- nance therapy, which consists of activities that the bene- tion with home health agency personnel, coordinating care with consultants, and arranging other services (including by telephone). To qualify for Medicare Home Care benefits, a patient must meet the following criteria: Medicaid A normal inability to leave home Medically contraindicated to leave home Medicaid funding for home care services is provided Leaving home requires a considerable and taxing effort jointly by the federal and state governments. The regula- Inability to leave home except with the aid of supportive devices, tions are federal, but eligibility is determined on a state- special transportation, or the assistance of another person by-state basis. Coverage is designed for those who not Leaves home only infrequently or for short duration of time, or for only meet state income eligibility guidelines but also are the purpose of receiving medical treatment blind or disabled. The majority of states cover nursing Source: From the Health Care Financing Administration. Coverage for diagnostics, In a randomized controlled trial with 1-year follow-up, medication, transportation, adult day care, social work, veterans 70 or older were screened by a physician assis- personal care, and physical, speech, or occupational tant or registered nurse for medical, functional, and social therapy varies from state to state. The results included the discovery of four home health services fall into three main categories: the new or suboptimally treated problems in each patient, traditional home health benefit, which is a mandatory on average, and an improvement in immunization rate benefit provided by all states, and two optional pro- and IADL scores.
See The Psychopathology of Everyday Group therapy Life purchase 100mg voveran sr visa, 107 Perceptual disturbances generic voveran sr 100 mg on-line, 9 Psychosexual development, 71–76, Personality Projections in the Draw- 85–86 ing of the Human Figure, 117 anal phase, 72–73, 173–174 Personality traits, defenses and, genital phase, 75, 136 21, 45 latency phase, 75, 80, 98 Perspective, 309. See also Formal oral phase, 72 analysis phallic phase, 73–75 Pervasive Developmental Dis- Psychosocial personality develop- order, 84 ment, 77, 171–175, 178, 189 empathy and, 257 autonomy vs. See also Formal Presenting problem, interpreting analysis art and, 47 Primordial images, 5 Quadrant of regression. See Regres- Projection, 19 sion, quadrant of Projective drawing, 14 Qualitative analysis. See Formal Projective identification, 280 analysis Projective testing, 103, 106–111. See also Formal Sexual abuse, 4, 11 analysis 8CRT and, 158 Rapprochement, 52 conversion and, 25–30, 45–46 Reaction formation, 27, 72, 73, 75 individual therapy case study, 203 Redrawing, 300. See also Structural regression and, 42–43 analysis Sexualized symbols, 40–42 Regression, quadrant of, 110–111 Shading, 298 Reich, Wilhelm, 45 body parts, 308 (see also Formal Reinforcement of body parts, 308. See also For- latency phase and, 75 mal analysis repetition and, 107 Shoulders, 304. See also Formal analysis Size, 296 Rorschach test, 105, 136 gender and, 299 Rubin, Jay, 19 tree, 312 (see also Formal Rumination, 9 analysis) See also Structural analysis Schemata, 54, 60 Smiley face, 308. See also Formal Schizophrenia, 12, 13 analysis collecting and, 95–96 Social history, interpreting art and, developmental stages and, 49–50 47 directives and, 173 Stick man, 307. See also Formal four stages of progression, 98 analysis here-and-now interaction and, Storytelling, mutual, 8 249 individual therapy case study, paranoid, individual therapy case 230–241 study, 216–228 Structural analysis, 108 regression and, 38–43, 46–47 8CRT and, 151, 153–156, 161– Self-disclosure. See Directives, 163 insight and self-disclosure; in case study, 218–221 Directives, group therapy DAP and, 108–110, 112–114, Self-portrait, 12–13 116, 120–121, 123 Sentence completion tasks, 263 HTP and, 110–111, 125, 140– Sex organs, 308. See also Breasts; 142, 146, 149, 150 Formal analysis Sublimation, 19 342 Index latency phase and, 75 Transparencies, 300.
