Transcript Hidden & Social Disabilities / Addictions

Hidden & Social
Disabilities / Addictions
KNR 270
Carter, Van Andel, & Robb, 2003
Definitions
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Hidden
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People don’t know or believe person has disability
Sometimes blamed for their disability
Social
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Array of nonspecific characteristics that affect
personal lives & social relationships
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Carter, Van Andel, & Robb, 2003
HIV/AIDS, Eating Disorders, Addictions
Questions to Consider
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What limitations might the person
experience?
How will these limitations affect recreation
performance?
What accommodations are available to
reduce or eliminate these barriers?
General Recreation vs.
Therapeutic Recreation
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Intervention
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Intervene once a condition is present
Prevention
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Prevent condition before it happens, correct at
early stages, or prevent it from getting worse
Promote healthy behaviors
HIV/AIDS
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HIV (161, 976 Americans)
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AIDS (344,178 Americans)
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Human immunodeficiency virus
Virus that causes AIDS
Acquired immunodeficiency syndrome
Transmitted through blood-to-blood & sexual contact
 Sexual intercourse
 Sharing needles or injection equipment
 HIV infected women to babies before or during birth,
or through breast feeding
Lifespan illness
Lots of stigma & discrimination
Acquired HIV/AIDS Stages
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Stage 1(HIV infection)
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Most people don’t know they are infected
Asymptomatic (symptom-free)
Has begun to attack white blood cells
Results in antibodies that can be detected by
blood test
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2 weeks to 3 months after infection
Acquired HIV/AIDS Stages
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Stage 2 (HIV disease)
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Experience rapid weight loss, diarrhea, fevers of
unknown origin, chronic fatigue, shortness of
breath, night sweats, skin rashes, coughing,
susceptibility to infections, white coating on
tongue, swollen lymph glands, extreme tiredness
Acquired HIV/AIDS Stages
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Stage 3 (AIDS)
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Disintegration of immune system, presence of
opportunistic diseases, pneumonia, Kaposis
sarcoma (cancer)
Loss of vision, decreased cognitive abilities,
dementia, seizures, psychological problems
Death
Considerations /
Accommodations
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Access to refrigerator to store food supplements or
medications
Access to restroom
Accommodations for vision impairments (remember
Disability Concerns tour)
Accessibility (e.g., ramps, parking, etc.)
Rest breaks
Provide written instructions
Support groups/activities
Make people feel welcomed and supported
Include family and friends in activities
Related Considerations /
Accommodations
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Reduce stress or teach stress management
Confidentiality
Others????
Universal precautions
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Likely to continue participating in sport &
recreation for health benefits
Not all will disclose their status
Also for Hepatitis B virus (causes liver disease)
Preplanning is key
Universal Precautions
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Use for all participants regardless of health
status
Applies to blood or other body fluids with
visible blood
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Includes semen & vaginal secretions,
cerebrospinal fluid
Does not include feces, nasal secretions, sputum,
saliva, sweat, tears, urine, or vomitus unless
contains visible blood
Treat all blood /fluids as if hazardous
Universal Precautions
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Use protective barriers
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Disposable gloves, gowns, protective eye ware
Waste Management
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Clean blood spills using bleach & water solution
(1:10)
Do not pick up broken glass with bare hands
Store towels & clothes in biohazard bags for
cleaning or dispose of properly
Dispose of protective barriers properly
Universal Precautions
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Wash hands immediately with soap and hot
water
Report potential exposure to supervisor
immediately
Seek medical attention as necessary
Pre-Event Planning
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Cover all wounds with air-tight dressing to
withstand rigors of play
Have equipped first aid kits
All staff trained in universal precautions
During Event
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Participants should bring open wounds to attention
of staff
Staff should remain alert for bleeding & call attention
to participant
Remove bleeding participants from event
Participants should not return until bleeding is
controlled, cleaned, treated, and securely bandaged
Change clothes
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DeRosa, 2003
Eating Disorders
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More than 5 million Americans affected
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Females & males
Athletes: gymnasts, figure skaters, wrestlers
Types?
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Anorexia nervosa
Binge-eating
Compulsive eating disorder
Bulimia nervosa
Obesity
Anorexia Nervosa
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Willful periods of dieting that can lead to
starvation
90% are females
Prevalence rate 12-18 y/o = 1/250
Self esteem directly connected to body shape
and weight
Weight loss is viewed as achievement or
indication of self-discipline
Anorexia Nervosa
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4 criteria
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Refusal to gain or maintain body weight at or
above normal, 15% below ideal weight
Intense fear of weight gain
Disturbance in body perception (feels fat even
though emaciated)
In females, absence of at least 3 menstrual cycles
Binge-Eating
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Recurrent, out-of-control episodes of eating
large amounts of food
Eat whether hungry or not
Eat past being comfortably full
Can lead to obesity or bulimia nervosa
High risk for depression or anxiety disorders
Compulsive Eating Disorder
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Incapable of controlling how much or how
often eat
Eat fast
Eat nearly nonstop throughout the day
Over-indulge in sugary foods to elevate mood
If not eat foods crave, may have severe
withdrawal symptoms
Bulimia Nervosa
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Frequent periods of overeating
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Followed by
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3,500-5,000 calories in 1 sitting
Self-induce vomiting
Use of diuretics, laxatives, or enemas
Fasting
Compulsive exercise
15-20% of college age women
Bulimia Nervosa
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4 criteria
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Recurrent binge eating
Inappropriate compensatory behavior
Minimum of 2 binge-eating episodes a week for at
least 3 months
Inappropriate evaluation of self by shape & weight
Obesity
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Are at greater risk for
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High blood pressure
Stroke
High cholesterol
Heart disease
Diabetes
Gallbladder disease
Upper respiratory problems
Arthritis
Related Considerations /
Accommodations
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Expressive, creative, and experiential activities
Wellness programs
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Relaxation
Stress management
Nutritional education
Lifetime healthy patterns of exercise
Observe for unusual rituals around food or
excessive exercise
Role model desired relationships between food,
exercise, and leisure
Related Considerations /
Accommodations
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Leader should be nonjudgmental and supportive
Sets expectations
Discussions about weight, diet, and appearance is
minimized
Assist to increase self esteem
Go Girls program (National Eating Disorders
Association)
National Eating Disorders Awareness Week
Others????
Addictions
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Alcohol
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Drugs
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Gambling
Alcohol and Drug Use
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Alcohol most commonly consumed substance for users 12 and
over
 Nearly 15 million Americans abuse alcohol or are alcoholic
 9.1% of Americans addicted to alcohol and drugs
Are primary contributors to homelessness, criminality, spread of
HIV, child abuse, & development of antisocial personality
disorders, depression or anxiety disorders
Contribute to more deaths, disabilities, & illnesses than any other
preventable health condition
 ¼ highway accidents
 40% of traffic fatalities
Use often occurs during leisure
Terms
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Dependence
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Cluster of cognitive, behavioral, & physiological
symptoms that indicate continual use, resulting in
tolerance, withdrawal, & compulsive substancetaking behavior.
Use continues despite knowledge of effects on
daily functions & decline in functions like work
Tolerance
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Need for increased amounts to achieve
intoxication
Terms
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Withdrawal
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Behavior change resulting from substance decline in body
Often results in consumption to relieve or avoid unpleasant
physiological & cognitive effects
Abuse
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Results from repeated use
Causes failure in role obligations, multiple legal, social, and
interpersonal problems, & potential for physically harmful
situations
Less likely to have signs of tolerance or withdrawal from
not using
Terms
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Addiction
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Continued involvement associated with acquiring,
using, & recovering from substance’s effects
Tendency to revert to use after attempts to quit or
withdraw
Final step in progression from drug use through
tolerance to abuse then dependency and
eventually addiction
Alcohol Questions
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I drink to relieve feelings of stress when I’m
under pressure.
Whenever I have a reason to celebrate – for
example, a job promotion, birthday, or
anniversary – drinking is one of the first
things I make a point of doing.
I sometimes drink heavily after a
disappointment or rough day.
Alcohol Questions
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I experience memory blackouts during or after
drinking.
I sometimes stay drunk for more than a few days at
a time.
I use alcohol to build my self-confidence.
I have missed school due to alcohol.
Do you feel more at ease on a date when you are
drinking?
I drink to get drunk.
I drink to get together with my friends.
Binge Drinking
National Institute on Alcohol Abuse & Alcholism
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Men: 5 drinks in a 2-hour period
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Women: 4 drinks in a 2-hour period
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Can lead to alcohol poisoning
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Excessive vomiting
Passing out
ISU Drinking Statistics
2006 ISU Core Alcohol and Drug Survey
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ISU
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81.4% consumed alcohol
in past 30 days
38% consumed alcohol
at least 3 times or more a
week
9.2 drinks was average
per week
28.2% reported being
hurt or injured as a result
of drinking in their
lifetime
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Nationwide
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71.4%
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23.5%
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5.8 drinks
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15.6%
Alcohol
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Also tend to be dependent on or abuse other
substances
Initial mood & behavioral changes with a blood
alcohol level of .05%
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Equivalent to 150 lb. person consuming 2 drinks in
succession
Can lead to
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Cirrhosis of liver, heart disease, sexual dysfunction,
irreversible brain & nervous system damage,
gastrointestinal irritations, and FAS for infants of mothers
who drink
4 Symptoms of Alcoholism
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Craving
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Loss of control
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Inability to limit drinking on any given occasion
Physical dependence
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Strong need or compulsion to drink
Withdrawal symptoms, such as nausea, sweating,
shakiness, and anxiety, occur when alcohol use is stopped
after a period of heavy drinking
Tolerance
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Need to drink greater amounts in order to “get high”
Drug Addiction
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2003 National Survey on Drug Use and Health
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6.8 million addicted to drugs
 4.2 million used marijuana
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Average age of first use is 14
1.5 million used cocaine
1.5 million used pain relievers
Drug use can change brain metabolism and activity
Includes use of illegal drugs and the illegal use of
prescription drugs
Drug Use at ISU
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20.1% are current marijuana smokers
16.0% used other drugs in the past year
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Amphetamines, cocaine
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ISU Alcohol and Drug Survey Results, 2004
Drugs
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Amphetamines
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Chronic use results in mood changes,
malnutrition, hostility & aggressiveness,
hallucinations, suicidal ideation, heart problems,
social isolation
Caffeine
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Increased amounts associated with cardiac
arrhythmia & exacerbation of anxiety symptoms
Drugs
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Cannabis
 Marijuana
 Most widely used illicit substance in world
 Can lead to impaired memory, learning problems, problems with
judgment, & motor performance, emphysema, weight gain
 45% of teenagers try before finish HS
Cocaine
 Crack is highly concentrated form of cocaine, 10 times more
powerful
 Rush-crash cycle
 Can lead to depression, seizures, respiratory problems, cardiac
failure, strokes
 Adults age 26 and older have highest user rate
Drugs
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Hallucinogens
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LSD, mescaline, etc.
Use can impair thinking processes & memory,
abnormal perceptions
Inhalants
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Gasoline, glue, paint, paint thinner, etc.
Use can lead to memory loss, fatigue, depression,
brain damage, coma
Often first drug young children use (17% of 10th
graders)
Drugs
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Nicotine
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Smokers are more likely to be heavy drinkers &
Illicit drug users
May forgo social & recreation activities because
they occur in smoke-free setting
Can lead to coronary heart disease, cancer,
chronic obstructive pulmonary disease (COPD)
Drugs
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Opioids
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Narcotics like heroin, morphine
Can develop tremors, seizures, impaired memory,
collapsed veins, liver diseases, unconsciousness,
coma, death
Phencyclidine (PCP)
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Angel dust
Can lead to loss of coordination, memory loss,
apathy, hallucinations, seizures, respiratory
depression
Drugs
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Sedatives
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Sleeping pills, for anxiety
Can impair motor function, memory,
concentration, judgment, delusions, tremors,
depression, suicidal attempts
Polysubstance dependence
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Use 3 or more substances (excluding caffeine &
nicotine) but do not rely on one as a dominant
drug
Drugs
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Other
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Steroids (anabolic)
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Can cause liver tumors, cancer, high blood pressure,
shrinking testicles and breast development in males,
growth of facial hair and menstrual changes in females
Over-the-counter drugs
Prescription medications
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OxyContin, Demerol, Vicodin, Valium, Xanax, Ritaline
Can lead to paranoia, irregular heart beat, high body
temperatures
Drugs
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Methamphetamine
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Speed, meth, crystal
Can lead to psychotic behavior, hallucinations, stroke
Nearly 12 million Americans have tried
Club drugs
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Used by teens & young adults at all night dance parties
Ecstasy (MDMA)
Can be added unobtrusively to beverages to intoxicate or
for sexual assaults
Related Considerations /
Accommodations
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Fitness programs
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Nutrition
Cardio
Stress management
Coping skills program
Leisure education
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Healthy activities
Resources
New leisure partners
Participating without using
Related Considerations /
Accommodations
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Adventure/challenge experiences
Do not serve or include alcohol in events
Role model
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Don’t talk about how you partied over the
weekend
Do not use beer sponsors
Others???
Gambling Questions
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Have you ever lost time from work/school due
to gambling?
Have you ever felt remorse after gambling?
Have you ever gambled to get money t pay
debts or solve financial difficulties?
After losing, do you feel you must return as
soon as possible to win back your losses?
After winning, do you have a strong urge to
return and win more?
Gambling
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Readily available
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For most it is harmless form of entertainment
4-6% become pathological gamblers
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Legalized gambling is one of the fastest growing industries
in the US
Adolescents have a high risk of becoming gamblers
As gambling increases, people spend less time with
family, may steal money from family, may have
problems at work or steal from work
Custer’s 6 Types of Gamblers
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Professional gamblers
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Antisocial gamblers
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Make their living by gambling, are not addicted
Uses gambling as a way to get money by illegal
means (playing with marked cards, etc.)
Casual social gamblers
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Used as recreation, entertainment, distraction
Does not interfere with family, social, or other
obligations
Custer’s 6 Types of Gamblers
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Serious social gamblers
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Relief and escape gamblers
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Major source of entertainment
Compared to a “golf nut”
Relief from anxiety, depression, anger, boredom,
loneliness
Compulsive gamblers
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Most important thing in their life
Progression of Gambling
Addiction
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Winning phase
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Experience big win or series of wins
Results in unreasonable optimism that winning
will continue
Leads to great excitement
Increase amounts of bets
Progression of Gambling
Addiction
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Losing phase
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Start gambling alone, thinking constantly about
gambling, borrow money
Start lying to family & friends
Begin to “chase” their losses
Depression phase
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Marked increase in time gambling
Leads to remorse, alienating family & friends
Suicidal thoughts, arrest, divorce, emotional
breakdown
Pathological Gambling
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Persistent, maladaptive gambling that
disrupts personal, family, work, or education
pursuits
May be preoccupied with gambling
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Reliving past experiences
Planning nest gambling venture
Thinking about ways to get money with which to
gamble
Could include gambling online
Pathological Gambling expressed
in 5 or more of following
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Needs to put increasing amounts of money
into play to get desired excitement
Has repeatedly tried (and failed) to control or
stop gambling
Feels restless or irritable when trying to
control gambling
Uses gambling to escape from problems
Often tries to recoup loses
Pathological Gambling expressed
in 5 or more of following (cont)
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Lies to cover up extent of gambling
Has stolen to finance gambling
Has jeopardized a job or important
relationship
Has had to rely on other for money to relieve
the consequences of gambling
Is preoccupied with gambling
Related Considerations /
Accommodations
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Consider when appropriate to use games of
chance in programs
Stress management
Other????