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... Why might older adults suffer from abdominal pain? Pick the correct answer from the following options: A. Constipation B. Stress C. not enough information D. Hemorrhoids
A

(Question)
The U.S. Congress is one step closer to averting a government shutdown Thursday after the U.S. House easily passed a $1.3 trillion spending plan that would end months of the government operating under short-term spending bills. The measure, approved by a 256-167 vote, now goes to the Senate, which has until midnight Friday to approve it and avert the year's third government closure. The massive bipartisan bill would keep the government funded until the end of September. Lawmakers had just hours to read the nearly 2,200-page bill released Wednesday night. Under Senate rules, a single senator can delay the vote but not stop it entirely. Senator Rand Paul has objected to the short time given to members to read the lengthy legislation. As of Thursday afternoon, the Senate was waiting to see how the vote would proceed, raising the prospect of another brief government shutdown. With midterm elections looming in November, the bill likely marks the final time Capitol Hill will consider major legislation this year. The measure would fulfill President Donald Trump's vow to boost military funding but provides funding for limited parts of his immigration agenda. The bill, which the White House said Trump supports, would give Trump a huge budget increase for the military, including a 2.4 percent pay raise for military personnel. "Today marks the beginning of a new era for the United States military," House Speaker Paul Ryan said in a statement Thursday. "This legislation fulfills our pledge to rebuild the United States military." After extensive negotiations between Republicans and Democrats, the bill also provides $1.6 billion for physical barriers and 150 kilometers (93 miles) of a wall at the U.S.-Mexico border, short of the $25 billion Trump requested for the project he repeatedly touted on the campaign trail while pledging Mexico would pick up the cost. Reading the 2,200 page bill took: Pick the correct answer from the following options: A. each Senate member less than an hour to read B. about an half and hour for the average person to read C. not enough information D. each Senate member over a day to read
(Answer)
D

When I was entering my Sophomore year in High School, we had just moved from a single 4-way stop-sign town, to a bigger city with actual city buses! In order to get to school, I had to ride a city bus for the 1st time, without information/assistance! I barely managed to squeeze in and had to stand on the step of the packed bus on the way to school. BTW, smoking was STILL happening on these buses! I noticed every time we went around a corner, it seemed a bell would ring. I falsely assumed it meant HANG ON! So, when it was time to return home, the bus was not as crowded, and I actually was able to sit down. Again, every time we turned the corner, a bell would ring. So I held on tight! As we neared my bus stop to get off, the bus whizzed past it, without stopping! Panic began to set in quickly. I already had a very strange, long day in a new 3 story school building, and I smelled like cigarette smoke! I quickly moved to the empty seat behind the driver, and told him he didn't stop where I needed to get off. He asked me if I rang the bell. I admitted to him, I had no knowledge of riding on a city bus. He was kind, explained to pull the bell pull 1 block prior to my stop. He explained he would circle back around and I could get off at my stop on the return trip. I was SO relieved! However, now I was 1/2 hour late getting home, especially stressed and tired from the new school and bus fiasco, AND I smelled like cigarette smoke! When I walked into my house, I was immediately confronted on why was I late, why did I smell like smoke, etc.! I burst into tears, and had to tell about my horrible day, but I didn't get into trouble! WHEW! Who did the writer talk to about missing his stop? Pick the correct answer from the following options: A. not enough information B. His best friend C. The bus driver D. His mother
C