*Question*
Constipation is not a glamorous topic, but it's certainly important, especially in older adults. As anyone who has experienced occasional or even chronic constipation can tell you, it can really put a damper on quality of life and well-being. Constipation can also cause more substantial problems, such as: * Severe abdominal pain, which can lead to emergency room visits * Hemorrhoids, which can bleed or be painful * Increased irritability, agitation, or even aggression, in people with Alzheimer's disease or other forms of dementia * Stress and/or pain that can contribute to delirium (a state of new or worse confusion that often happens when older adults are hospitalized) * Fecal incontinence, which can be caused or worsened by having a hard lump of stool lodged in the lower bowel * Avoidance of needed pain medication, due to fear of constipation Fortunately, it's usually possible to help older adults effectively manage and prevent constipation. This helps maintain well-being and quality of life, and can also improve difficult behaviors related to dementia. The trouble is that constipation is often either overlooked or sub-optimally managed by busy healthcare providers who aren't trained in geriatrics. They are often focused on more "serious" health issues. Also, since many laxatives are available over-the-counter, some providers may assume that people will treat themselves if necessary. Personally, I don't like this hands-off approach to constipation. Although several useful laxatives are indeed available over-the-counter (OTC), I've found that the average person doesn't know enough to correctly choose among them. Also, although in geriatrics we often do end up recommending or prescribing laxatives, it's vital to start by figuring out what is likely to be causing or worsening an older person's constipation. For instance, many medications can make constipation worse, so we usually make an attempt to identify and perhaps deprescribe those. In short, if you're an older adult, or if you're helping an older... According to the above context, choose the correct option to answer the following question. Question: Who is often focused on more serious health issues? Options: A. Adults B. People with constipation C. not enough information D. Healthcare providers
**Answer**
D

*Question*
For those of us who struggle with thoughts about our size and shape, sometimes we don't like our bodies and our behaviour very much. It seems like an impossible task to transform our self loathing into self-love, but it is possible with these five simple steps. I started to write some examples of the self loathing dialogue I occasionally have in my head and I found I couldn't do it. It felt as wrong as criticising my closest friend. I guess it goes to prove that the shift from loathing to love is not always huge and momentous, but subtle and gradual. When I look in the mirror and see a part of my body I don't like, I run through these five steps in my head. This following example is the kind of internal conversation I might have about my belly. 1. POSITIVE INTENT (THE GIFT) Recognise the gift your body is giving you. My belly fat is protecting and cushioning my intestines and reproductive system. By having a higher body fat percentage my hormones are functioning as they should, enabling me to have a normal transition through perimenopause. I fit my skin and the wrinkly empty skin folds are gone. 2. FORGIVENESS Acknowledge the way you have treated your body in the past. I am sorry that I have been either starving you or stuffing you with toxic food and that I have accused you of betraying me. I now realise that my body is a reflection of my thoughts and beliefs so I was hating myself. Please forgive me for treating you so badly. 3. GRATITUDE Notice the miracles your body performs even though you have abused it. I am so thankful that even though I have treated you so badly you are still healthy and functioning. I am amazed at your ability to heal a lifetime of digestive and hormonal issues within a short amount of time. Thank you for your forgiveness and that's it's not too late to take great care of you. According to the above context, choose the correct option to answer the following question. Question: What are the steps to go from self loathing to self love? Options: A. functioning, hormonal issues, forgiveness B. positive intent, forgiveness, gratitude C. criticism, negative beliefs, betrayal D. not enough information
**Answer**
B

*Question*
Relatives of a dying lady I was caring for kicking and screaming not to give their Mum pain relief because they were so terrified / knew it would probably be the thing to end her life. She had a horrible aggressive cancer that ravaged her whole body and needed very regular doses of strong pain relief which - as she had a terminal illness and was receiving end of life care - did not have an upper limit so to speak. She had pain relief as and when needed to make her comfortable and that often results in people ultimately overdosing. Mum had Alzheimer's and was howling and writhing in agony so we were giving her pain relief but daughters knew it would probably result in her death - which they were right about possibly happening and in their grief and panic, started trying to prevent us from doing anything. Didn't want us getting near her at all and we had to go through an awful scenario of trying to explain what we had to do for Mum and why and when they still wouldn't have it or allow us near, we had to do what nobody wants and go against their wishes by administering the pain relief anyway. One daughter screamed the place down, threatened to have me arrested and struck off / said she would go to the papers and tell them about how we killed her Mum and in the end she had to be removed from the bedroom. Her Mum was given the pain relief, immediately relaxed and fell asleep then died peacefully in her sleep about 15 mins later. The saddest thing is her daughter wasn't able to be there and see her Mum dropping off so peacefully and her last memory will forever be of her screaming and thrashing about as she (daughter) was physically removed from the room. Tragic. According to the above context, choose the correct option to answer the following question. Question: What drug was the Mum given Options: A. A nasid B. An opiod C. not enough information D. Fentanyl
**Answer**
C