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Navigating Holiday Travel

Navigating Holiday Travel

by | Dec 3, 2020 | Being Well

It’s that time of year again! The trees are changing colors, the weather is getting colder, and the days are getting shorter. While some things are expected and familiar to us all, other things are new – Holidays during a Pandemic.

After 8 months of lockdown and social distancing, many of us find ourselves eager to see loved ones. While spending time with loved ones can be a great stress-reliever, navigating the holidays during a pandemic can also be a source of stress. So that begs the question: to travel or not to travel?

The absolute safest way to celebrate this Holiday season is to stay home and celebrate with your household family members. Virtual gatherings, over Zoom or Facetime, are encouraged to stay connected and safe this season. Given the new statewide “Two-Week Freeze” announced by Governor Brown, limiting gatherings to no more than 6 people from no more than 2 households, now is the perfect time for virtual gatherings!

For those that are traveling and will be spending time with friends and family outside of their homes, here are some tips to enjoy the holidays safely:

  • Wear a face mask at all times (except for when eating)
  • Always maintain social distance of 6ft or more
  • Try to have gatherings in an outdoor location, but remember to dress warm and wear a face mask if social distancing cannot be maintained
  • When sharing a meal, consider individual plates of food versus buffet-style dining
  • Consider driving with household members to the gathering, versus flying when possible
  • Make a plan to quarantine before and after the gathering, to reduce transmission of COVID-19
  • Get your flu shot before traveling and meeting up with friends and family for holiday gatherings
    • While the flu shot will not directly protect against COVID-19, it has many other benefits to keep you safe and healthy, reducing illness
  • Stay home if you are feeling sick, have recently tested positive for COVID-19, or are a known contact to someone who recently tested positive for COVID-19
  • If flying, consider purchasing traveler’s insurance and pack for a two-week trip in the case you should have to quarantine at your destination

Deciding to cancel your trip is difficult, but also something to be on our minds. Traveling during a pandemic requires all of us to call on the power of our inner-planners! Check out this infographic below for tips on delaying or canceling trips:

Remember, you can still partake in the holidays and make it special, while still staying safe! Now’s the perfect chance to get the WHOLE family together (virtually) and finally take that large family photo you’ve been wanting. Is it the same? Of course not. But will it be a holiday season you’ll ever forget? Of course not- it will be one to remember!

AUTHOR: Morganne Skinner, RN, BSN, Public Health Nurse at Tillamook County Community Health Center

For more local health and wellness information, follow Tillamook County Wellness on Facebook, Instagram and Twitter.

Seeking Help in Times of Stress

Seeking Help in Times of Stress

by | Nov 25, 2020 | Being Well

We’ve been sharing ways to cope well during stressful and uncertain times. This Wellness Wednesday tribute goes out to another partner organization that provides vital services to those who are struggling to cope right now. Just like with other prevention measures, it is better to seek and get help early, even if we don’t think we are “that bad off.” This week’s shout out goes to the Rinehart Clinic in Wheeler.

What are common issues for which people are seeking help right now?

It is well-known that the pandemic has widely resulted in anxiety, depression, and an increased use of alcohol and drugs across the world. People may be seeking help for anxiety or depression, but they may also be seeking treatment for other symptoms related to stress, trauma, or anxiety that may masquerade as separate ailments. These symptoms could include increased irritability/anger, new or increased pain (migraines, new back pain, etc.), changes in sleep patterns (not sleeping or sleeping too much), increased distractibility, inability to stay on task. People may also be struggling ​more with relationship issues, prolonged isolation-related distress, feeling exhausted by parenting while working-from home, and feeling overwhelmed in general.

What are some of the specific services your organization provides that help individuals with these concerns?             

Rinehart Clinic offers a full scope of health services including: medication, acupuncture, individual psychotherapy, Mindfulness Meditation classes, SMART Recovery meetings, recovery groups, and a variety of online classes and programs that offer social connections to others in the community.

As part of our team-based care, we conduct regular screenings ​and interventions for depression and substance use, as well as a variety of social determinants that may impact the health of our patients. Interventions may include a brief meeting with a mental health or behavioral health provider, connection to needed resources, and sometimes a referral to an outside specialist.

What are some common outcomes for people who receive these services?   

Patients have experienced a reduction in symptoms,  increased coping ability, decreased sense of isolation, and an overall increased feeling of well-being.

Are these services covered by insurance and/or do you offer a sliding scale for payment?     

Rinehart Clinic accepts most major insurance plans, including Oregon Health Plan, and we offer a sliding fee scale based on income. Our community wellness classes and group meetings are held free of charge.

Rinehart Clinic takes a team-based approach to primary care, so providers work together to offer​ care for the whole person. Patients can access mental health or behavioral health services through their primary care provider, or if they prefer, they can access these services directly by contacting our behavioral health providers.

To learn more, contact us at 1-800-368-5182 or www.rinehartclinic.org.

Stress Coping Strategies During and After the Pandemic

Stress Coping Strategies During and After the Pandemic

by | Nov 25, 2020 | Being Well

You are not alone if you have been feeling more stressed than usual. This additional stress is likely a result of the COVID-19 pandemic. One way to cope with stress is to utilize stress coping strategies. These strategies can be used as a tool to manage current and future stress that you may encounter.

Here are five coping strategies that may help you manage stress:

Journal writing: Journal writing can help to reduce stress levels. This coping strategy can be done in many ways, such as: recording daily events, creative writing, gratitude journaling, goal tracking, or journal prompts. If you are looking to learn about other ways that you can document what you are experiencing during this time, I encourage you to read this New York Times article.

Physical activity: Physical activity helps your body release endorphins which can make you feel good. Individuals of all ages can benefit from physical activity. To ensure physical activity will be sustainable in your life, choose exercises that you enjoy. If you are looking for some ideas on how to be active, I would recommend visiting Tillamook County Wellness.

Breathing Exercises: Breathing exercises are a good way to lower stress. These exercises are great because you can do them almost anywhere. To learn more about breathing exercises, I recommend reading this Washington Post article.

Do something you enjoy: Take time each day to do something that you enjoy. Try scheduling enjoyable activities the same way as you would schedule an appointment. If you are interested in learning about hobbies that lower stress, I recommend starting with this list for inspiration.

Have a conversation: Having conversations with others can allow you to get emotional support. You can connect with anyone that you trust, such as family members, friends, or a faith leader. If you do not feel comfortable opening up to someone you know, you may want to consider speaking with a health professional. A health professional is trained to help a person improve physical or/and mental health. Examples of these professionals include: physician, nurse, and counselor. If you would like to learn more about health services in Tillamook County check out the Best of Health & Wellness Guide. Another way to get emotional support is through a support group. These groups are facilitated by either peers or health professionals. These groups allow participants to participate in whatever way they feel comfortable. Support groups are ideal for people who want to talk with individuals that have similar lived experiences. One support group that I would like to highlight is the Tillamook Family Counseling Center’s COVID-19 support group. If you would like to learn more about the group call (503)842-8201.

I hope you have found this article helpful. If you would like to learn more about stress coping strategies be sure to follow the Tillamook County Wellness’s #COPEWELL campaign by following Tillamook County Wellness on Facebook.

AUTHOR: Janeane Krongos, Prevention Specialist at Tillamook Family Counseling Center

For more local health and wellness information, follow Tillamook County Wellness on Facebook, Instagram and Twitter.

Getting the Help We Need

Getting the Help We Need

by | Nov 18, 2020 | Being Well

We’ve been sharing ways to cope well during stressful and uncertain times. For the next few weeks, our Wellness Wednesday tributes go out to partner organizations who provide vital services to those struggling to cope. It’s important to reach out and get help even if a person doesn’t think they are “that bad off,” as we so often hear. Just like with other prevention measures, it is better to seek and get help early. This week’s shout out goes to Tillamook County Community Health Centers (TCCHC) and their behavioral health providers who responded to our interview.

What are the more common issues for which people are seeking help right now?

We are noticing an increase in Depression, Anxiety, Mood disorders, PTSD, and Substance Use Disorders. There is also an increase in difficulty managing chronic conditions such as health conditions like hypertension and diabetes as well as insomnia and other sleep issues, fatigue, chronic pain, stress, migraines and headaches. People are also struggling with weight concerns and behavioral challenges for children which can include ADHD.

What are some common warning signs for these conditions and how common are they? 

Warning signs can include insomnia and other sleep issues, emotional dysregulation, difficulty concentrating, increased disassociation, difficulty with organization, no or low motivation, lack of interest in pleasurable activities, irritability, increased risky behaviors, increased use of alcohol, drugs, gambling, food, etc.

Statistics cited by the National Institute for Mental Health for these conditions include:

Anxiety: 19.1% of the US adult population (23.4% are female, and 14.3% are male).  31.9% of the US adolescent population ages 13-18 (38.0% female, and 26.1% male)

Depression: 7.1% of the US adult population (8.7% female, 5.3% male). 13.3% of the US adolescent population ages 12-17 (20.0% female, 6.8% male).

Suicide: 10th leading cause of death overall in the US in 2018.  2nd leading cause of death among individuals ages 10-34, and 4th among individuals ages 35-54.

Post-Traumatic Stress Disorder (PTSD): 3.6% of the US adult population (5.2% female, 1.8% male), 5.3% in ages 45-59.  5.0% of the US adolescent population (8.0% female, 2.3% male), 7.0% for ages 17-18.

Substance use: (2018) 60.2% of the US population ages 12 and older (this includes alcohol, drugs, and tobacco). Highest use is 39% among ages 18-25.

(https://www.nimh.nih.gov/health/statistics/index.shtml)

During a study in June 2020, U.S. adults reported considerably elevated adverse mental health conditions associated with COVID-19. Younger adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers reported having experienced disproportionately worse mental health outcomes, increased substance use, and elevated suicidal ideation. (CDC, https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm)

Nearly half of Americans report the coronavirus crisis is harming their mental health, according to a Kaiser Family Foundation poll. A federal emergency hotline for people in emotional distress registered a more than 1,000 percent increase in April compared with the same time last year. Last month, roughly 20,000 people texted that hotline, run by the Substance Abuse and Mental Health Services Administration. (Washington Post, https://www.washingtonpost.com/health/2020/05/04/mental-health-coronavirus/)

Online therapy company Talkspace reported a 65 percent jump in clients since mid-February. Text messages and transcribed therapy sessions collected anonymously by the company show coronavirus-related anxiety dominating patients’ concerns. (Washington Post, https://www.washingtonpost.com/health/2020/05/04/mental-health-coronavirus/)

What are some of the specific services your organization provides that help individuals with these concerns?             

As behavioral health clinicians who are integrated into primary care our focus is to work with patients around improving health outcomes.  Patients are referred to behavioral health via their primary care provider, and our sessions are generally 30 minutes in length with periodic follow ups as needed or recommended.  We do refer patients to other services as needed; this can include linking with Tillamook Family Counseling Center or a private therapist. Behavioral health is intended to be a short-term consultative service, it is not intended to be long-term intensive psychotherapy.

We engage patients using motivational interviewing, cognitive behavioral therapy, focused acceptance and commitment therapy, behavior activation, and many other tools.

We have a medication assisted treatment (MAT) program for individuals with opioid use disorder; this means we have providers who can prescribe suboxone to treat opioid use disorder.  Individuals must be a patient of the clinic or be willing to establish care, they must have an assessment by the behavioral health provider before they are determined eligible for the program.  MAT participants are then seen by the prescribing provider and behavioral health clinician on a pre-determined schedule to monitor effectiveness, and address any challenges the individual may be experiencing, along with working on their individual goals.

Psychiatry services are available in our clinic; your primary care provider can consult with the psychiatrist, and if needed, the psychiatrist can provide direct services for patients (such as evaluation, follow up, medication starts or changes, and then facilitate return to your primary care provider for ongoing management). Currently this service is only available for patients of the Health Center.

What are common outcomes for people who receive these services?   

We have seen improvements in diabetes management (reduction in a1c’s), improvement in blood pressure control, medication adherence, improved nutrition, improve sleep, and improvements in depression, anxiety, weight management, and stress.

In our MAT program we have seen a reduction in use of opioids and other substances, increased education about overdose and the use of Narcan, and we have seen patients meet their goals, such as getting stable housing, stable employment, improved relationships, etc.

Are these services covered by insurance and/or do you offer a sliding scale for payment?     

TCCHC accepts all forms of insurance, including Oregon Health Plan (OHP), private insurance, and self-payments. We have a sliding fee scale and will not refuse services based on the inability to pay.

What else should people know about your services?

We are a team-based clinic that will assist you in accessing needed resources and services.  We can collaborate with other treatment facilities, and community agencies to help coordinate the care you need.

Individuals may contact us at 503-842-3900 or 800-528-2938.  TTY at 800-735-2900.

 

Caring for Our Veterans

Caring for Our Veterans

by | Nov 12, 2020 | Being Well

The COVID-19 pandemic has been difficult for almost everyone to navigate. Certain populations, such as veterans, may face even greater challenges under stressful circumstances. According to the National Center for PTSD, “the COVID-19 pandemic creates stressors like fear about getting sick, concern for loved ones, isolation, job loss and new childcare and family demands.” They note that many of the ways people normally cope, like eating out or going to the movies, are not an option. Without the usual coping mechanisms, it is critical that our veterans know about local care options and resources available to them.

We asked our veterans’ services advocates to share how local veterans are coping with the anxiety, uncertainty and stress of the pandemic, as well as other local and national events that are impacting people’s sense of safety and well-being.

Are you seeing any trends with veterans needing or seeking additional services during the pandemic?

The VA shut down community-based out-patient clinics for several months, only accepting urgent/emergency care, so a lot of routine healthcare was put off. This is causing delays in getting routine exams and health screenings, many of which also require transportation to Portland.  During the pandemic, there have been more interactions with veterans seeking mental health support. Stress, uncertainty and civil unrest can impact individuals with PTSD, increasing paranoia, anxiety and depression. Treatment for these conditions are often being provided through telehealth.

For many years, veterans were required to receive their healthcare at a VA clinic or hospital, which we do not have in Tillamook County. Now, under the Mission Act (formerly called the Choice Act), veterans can access local care with prior approval. Going through that approval process is a service provided by our Tillamook County Veterans Services office, located at the County Courthouse in Tillamook.

Are there common triggers or events that contribute to increased need for mental health services?

Current civil unrest is putting veterans on edge. There has also been a rise in homelessness and substance use. Like many people, veterans have been impacted by unemployment during the pandemic.  According to an article published in the Military Times, 54% of female vets have sought mental health support, compared to 31% of male veterans. It is thought that female vets are likely balancing more family responsibilities due to pandemic-related distance learning.

Job loss is a concern for veterans, whose unemployment rate was 3.5% prior to the pandemic. That rate is now at 6.4%, which is still lower than for non-military peers at 7.2%. Military training and experience may contribute to increased adaptability and a more resilient perspective during the pandemic.

What services, resources or connections does our county veterans services office provide?

The top priority for veterans services is mental health support and eliminating suicide. All Tillamook County Veteran’s Services office staff attended a recent suicide prevention training called “QPR.” Most of the time when a veteran is in a mental health crisis, they are immediately taken to Portland for specialty care.

What are some common outcomes for people who receive these services?

While outcomes differ from vet to vet, many of them are able to completely avert such a crisis. Often, they may get their medications adjusted and they are always provided follow up care to help them manage and avoid future occurrences.

How are these services covered?

Many people assume the VA is a type of insurance, but it is actually a healthcare provider. The VA contracts with other entities (Tri West in Tillamook County) to provide insurance benefits for eligible vets, under a tiered, income-based system. For example, if a veteran has a service-connected disability, they are fully eligible, while someone who is working may have coverage under their job and may be able to use their veterans benefit as a secondary insurance. Retirees on Medicare are also able to use their VA-sponsored “Tri Care for Life” benefits as secondary insurance.

The key is for veterans to get enrolled, which they can do through our local veteran’s services office.

Is there anything else we should share about veterans’ healthcare services?

When veterans go to the Emergency Department, they visit will only be covered through the VA if they are notified within 72 hours of the admission. A medical staff personnel, family member or the veteran themselves must contact the VA Notification Hotline at (844) 724-7842.

The local office also refers veterans to other services such as, CARE, Inc., Helping Hands and Habitat for Humanity’s Ramps and Rails program. They also coordinate with the PUD Light Brigade for utility vouchers and holiday baskets.

To learn more, call or visit Tillamook County Veterans Services Office, 201 Laurel Ave (Basement, Room 12), Tillamook, OR 97141, (503) 842-4358 during regular office hours. A Veterans Services Facebook page is coming soon!

To celebrate and honor our veterans, join the Veteran’s Day outreach event, Wednesday, November 11th, 10-4 pm at the Air Museum. Free admission to veterans.

AUTHOR: Michelle Jenck, Director of Community Well-Being, Adventist Health

For more local health and wellness information, follow Tillamook County Wellness on Facebook, Instagram and Twitter.

Finding Hope Through Service

Finding Hope Through Service

by | Nov 5, 2020 | Being Well

For many Oregonians, the week following Labor Day 2020 will be remembered for quite some time. The wildfires that swept across our state left devastation for families, businesses, and entire communities – many of which are still working to recover and rebuild today.

Like so many others, Tillamook County’s Director of Community Development Sarah Absher knows it is no secret that Tillamook is a generous community. A handful of locals quickly organized a dessert auction through Facebook to raise money for fire relief on Sunday, and Sarah was stationed at the Tillamook Nazarene Church on Saturday to welcome and receive desserts. As someone who is ready to dive into any project that may need help, Sarah ended up joining the Open Table event that was occurring at the same time at the Nazarene Church. As she helped serve meals to community members in need, she was acutely aware of the increasing number of community residents impacted by hunger, but she also felt gratitude and hope in the volunteers who work so passionately to fill that void.  Although this was not her initial plan for where the weekend was headed, she was touched by the experience and gave her email to the volunteer coordinator with plans to return.

On Sunday, Sarah woke up bright and early to bake a few goodies for the PNW Fire Relief Auction, an event quickly organized by Jesse Boroughs, Nichole Crossley and Kourtnie Zwald. The event was set to last 2-3 hours but ended up going for over 6 hours on Facebook with auction items being sold every 3 minutes – by the end, the community had raised over $22,000. This event demonstrated the amazing power that a community has when it comes together to support a cause. As Sarah pointed out, “It is easy to think that our actions as one individual are not enough to change the world, but each and every one of us has a unique set of skills that we can bring to the table.” She continued with the wildfires specifically, “I have no experience fighting fires, but I do have experience running an auction and I’m a halfway decent baker.” Although many of us may have felt helpless as we watched the smoke settle over the horizon, no act of service is too small to be left unappreciated. We may find that serving others not only lifts up those around us, but it also just might be the medicine our souls need to find the goodness in the world that still exists.

For Sarah, this weekend of service lifted a burden from her chest and restored a feeling of hope. “I am speechless and humbled, and thankful that my path crossed with so many wonderful humans over the course of the weekend. What it also reminded me is that we are all special, gifted people in our own ways, and that it takes all of us working together to overcome the challenges we face.”

AUTHOR: Ariel Slifka, TCW AmeriCorps VISTA

For more local health and wellness information, follow Tillamook County Wellness on Facebook, Instagram and Twitter.