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June 26, 1998     Cape Gazette
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June 26, 1998

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34 - CAPE GAZETTE, Friday, June 26 - July 2, 1998 HEALTH & FITNESS Mid-Sussex Medical Center offers care to veterans By Kerry Kester Health-care services for veterans in Sus- sex County are now easier to access. Mid- Sussex Medical Center celebrated its grand opening Monday, June 22, with free health screenings for veterans. Prior to the center's opening, veterans had to go to the Veterans Affairs (VA) hos- pital in Elsmere to receive health care. Now, through a partnership with Nanticoke Memorial Hospital, veterans may receive primary care and assistance with prescrip- tions at the clinic located in Millsboro. Of the 15,000 veterans in the area, 1,400 are now registered with the Sussex clinic. In addition to providing primary care ser- vices, the clinic also offers limited x-ray services, electrocardiograms, nutrition counseling and blood tests. ,'We think much of the primary care will be provided here," said Barbara Nowell, staff assistant to the director at the Elsmere facility. Pri- mary care and preventive care are key fac- tors to providing the best health-care ser- vices to the veterans, she said. Nowell said recent misinformation on the Internet claimed that veterans not enrolled by Oct. 1 would lose their eligibility status. There is no deadline for enrolling, she said. The legislation pertaining to enrollment will be fully in place by Oct. 1, but the VA, nationwide, is now accepting applications for enrollment. "Any honorably discharged veteran is entitled to VA services," said Nowell. Cost to veterans for the health-care ser- vices vary, depending on how they meet el- igibility criteria and their economic needs. "The care could be free, or they could have a copay," said Nowell. The same would hold true for prescriptions, she said. "The key thing that many of the veterans appreciate is getting their prescriptions han- dled locally," said Dr. Anthony Policastro, Nanticoke Memorial Hospital's senior vice president of medical affairs. Previously, he said, the veterans would have to travel to the Elsmere facility to get prescriptions filled. Since many of the patients are older, the traveling was often a burden. There are 172 VA hospitals nationwide. Nowell said recent legislation now allows for preventive health care to be a key com- ponent of the health services VA clinics and hospitals may offer. De Jesus provides primary care Dr. Victor de Jesus is now accepting pa- tients at the VA clinic. De Jesus is board certified in internal medi- cine and will serve many of the clinic's patients as a primary care physician. One of his particular areas of interest in medi- cine is geriatrics. While in his residency at the University of Connecti- cut, de Jesus worked with DE JESUS some exceptionally well- trained specialists in the field of geriatrics. Although geriatric medicine includes an array of health-care issues associated with aging, one of the more common problems found in older patients, he said, is dementia. What many geriatric specialists and other physicians are now concentrating on is managing the disorder that causes mental functions to break down. New drugs now on the market help mini- mize the problems, he said. "A good num- ber of people with dementia have reversible Repeat after me,  said Clyde Bragg, R.N., staff nurse for the Department of Veterans Affairs, Medical Regional Office Center. "Ouch." With humor and warmth, Bragg conducted health screenings for veterans during the Mid-Sussex Medical Center grand opening Monday, June 22. Shown with Bragg, right, is Charles Grant, a World War II veteran who served in the U.S. Army's 45th Division in Central Europe. During the open house, 30 people received health screenings, 20 applied for Veterans Affairs (VA) health benefits and 67 had pictures taken for their VA identification eards causes," said de Jesus. For example, some- times the disorder is caused by too many or too few of the hormones produced by the thyroid. Too little B12 or folic acid can al- so cause symptoms of dementia. Addition- ally, said de Jesus, a tertiary type of syphilis or ministrokes can affect brain functions, New medications often are effective treatments for some of the causes of demen- tia. Other treatments may include decreas- ing pressure on the brain through surgically implanting a shunt or, as is often the case with tertiary syphilis patients, directing penicillin into the spine, he said. In addition to treating dementia, de Jesus Continued on page 36 Mental health care: confidentiality key This is the first of a two-part se- ries about the two reasons why people seek mental-health coun- seling - off the record. Part I: Confidentiality People coping with mental or emotional problems are stopped from seeking help by two consid- erations: lack of insurance cOver- age and lack of confidentiality. Even those with the best insur- ance coverage are often stopped by the lack of confidentiality built into the corporate health-care sys- tem. In theory, there are no distinc- tions between those who suffer from life-threatening illness of any kind, physical or mental. But it's no secret that in our culture there is a definite prejudice against the mentally ill. If Aunt Flo is diagnosed with cancer, heart disease or diabetes, she is respectfully treated with hu- mane care. If, instead, she suffers from a biochemical imbalance that pre- disposes her to psychological problems or addiction, she is like- ly to become thebrunt of jokes, derision and haphazard care, if she can get any care at all. One reason people pay thera- pists directly is to avoid being stigmatized. Another reason is to pay less than if they'd used their insurance company as a third-par- ty payer. Where confidentiality is con- cerned, the stakes are incredibly high for people who suffer mental or emotional problems. Even though you may-be doing an out- standing job, you may be "down- sized" if an employee finds out you've been seeing a psychologist or psychiatrist. It's illegal to fire a person for any illness, but employers who know nothing about mental condi- tions may get rid of those they suspect are unstable, even when there is no evidence of instability except visits to a therapist. The same employer is likely to be sympathetic to employees suf- fering from physical ailments, but the myth persists that psychologi- cal difficulties are due to instabili- ty and "weak characters." If you visit a mental-health pro- fessional using your health insur- ance for full ol; partial payment, the therapist is the only one sworn to maintain confidentiality. How- ever, your records will be mailed, faxed or e-mailed to your health- care provider and may be read by a number of people with no reason to keep your records in confi- dence. Individuals have even been shunned and ostracized by whole communities due merely because of rumors of mental or emotional problems. Mental-health professionals are ethically, morally and legally bound to maintain confidentiality. However, managed-care compa- ny, police, paramedics, case man- agers, secretaries and others privy to records are under no such re- straints. That is why people "in the know" often bypass their insur- ance providers when seeking mental-health care. They see private practitioners and pay out-of-pocket; they do not want a quasi-public record of their visits to a psychologist or psychia- trist. They do not want their records read and speculated on by a vari- ety of others who are not obliged to maintain confidentiality. Recent scientific research indi- cates that illnesses such as schizo- phrenia, addiction, bipolar disor- der and clinical depression are ge- netically determined and/or physi- cally based. But there is still no universal agreement about this and ancient superstitions, fueled by lack of information, persist. As for personality disorders, there is some evidence that these have roots in the person's first two years of life. But again, lack of ac- curate information and an abun- dance of rumor and myth persists. Emotional problems, if treated in a timely manner, can be pre- vented from triggering worse problems later. Lingering emo- tional problems can eventually weaken the immune system and bring on severe depression or oth- er long-term maladies. One common example is grief. A person who has lost a loved one, ignores the mourning process or has no idea how to get through it, may repress emotions that initi- ate serious illnesses. Emotional problems suffered by a child who is afraid to reveal them can also fester into serious illnesses in that individual's fu- ture. The reasons for addressing mental or emotional problems are many, but superstitions and mythologies act to suppress men- tal-health care. And the corporate health-care system does not pro- tect confidentiality, leading to the possibility of dire consequences for those who seek help through HMOs or other insurers. That is why many people now bypass their health insurance when seeking help. Another rea- son is cost, which will be ad- dressed in next week's article. HEALTH TOPICS Carolyn Gover Carolyn Gover is in private practice with Gover Counseling Services in Rehoboth Beach. For more information, call 226-0744 or 888-285-4645.