Q: 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... Question: What is probably the best way to treat constipation in the elderly? === The answer to the above question is

A: not enough information


Q: 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. Question: What is probably true of Paul? === The answer to the above question is

A: He believes in supporting the military


Q: Thanks for the A2A Josh: Tough one to reduce to just a single incident but I’ll try. I grew up in North Central Indiana, about 50 miles south of South Bend. It was common to have frequent snow accumulation in the winter and blustery, freezing temps. It seems like this was particularly true during my childhood in the 70’s and 80’s. My family was blue collar through and through. We lived in the heartland in a town of just a few hundred with a sawmill and an on again off again gas station as our only two businesses. My dad worked in a factory for roughly 45 years. He apparently started that job right out of high school. My mom was an incredibly hard worker and Still is to this day. She did factory work, restaurant management and everything in between. It was this Protestant work ethic that led to one of the frequent tasks that my brother and I had to do which was not fun but ultimately was a very good deed. As I said, winters were often snowy and harsh. So my mom would make my brother and me shovel driveways and sidewalks for a couple of elderly residents. We did this of course, after we did our own driveway. Some people had motorized snowblowers but we did not. Standard snow shovels were our tools. I remember us whining about the chore, wishing we could just play in the snow or get out of it altogether. I don’t remember being overly conscious of the relief this provided for our elderly neighbors. I just remember that Mom would be disappointed if we didn’t do a good job. Later in life I would have great appreciation for the things required of me by my parents. Factory work and summer farm jobs helped us learn the value of hard work and would set us on a road to appreciation of future job opportunities that were less taxing. I still remember hating shoveling snow. But I’m forever grateful that I did it. Question: What is probably true about his dad? === The answer to the above question is

A: He works very hard all his life


Q: WHITE HOUSE — An audio recording was released Monday depicting children desperately crying and begging for their parents after being separated from them by U.S. immigration authorities at its southwestern border, sparking new outrage against the Trump administration and its new "zero-tolerance policy" towards illegal immigrants. The nearly eight-minute long recording was released by ProPublica, an independent, investigative news site. ProPublica says an unidentified whistleblower passed on the recording to a civil rights attorney, who gave it to the website. Among the disturbing sounds heard on the recording was a child identified by ProPublica as a six-year-old girl from El Salvador begging authorities in Spanish to call her aunt to pick her up from the detention center. At one point in the audio, a man identified as a Border Patrol agent said in Spanish over the cries of scores of children: "Well, we have an orchestra here. What's missing is a conductor." President Donald Trump defended his administration's policy of forcibly separating children from parents at the U.S. border with Mexico on Monday, saying “The United States will not be a migrant camp and it will not be a refugee holding facility." Trump, speaking in the White House East Room during a National Space Council meeting, warned that “what’s happening in Europe … we can’t allow that to happen to the United States – not on my watch.” Earlier in the day, on the Twitter social media platform, the president inaccurately linked migration in Germany to a rising crime rate. (Actually, the latest German government statistics show reported crimes at the lowest level in 30 years.) Nearly 2,000 children were sent to mass detention centers or foster care from mid-April to the end of May, according to government officials. The regular White House briefing was delayed several times Monday amid the furor as officials huddled with Trump in the West Wing. Press Secretary Sarah Huckabee Sanders finally introduced Department of Homeland Security Secretary Kirstjen... Question: How long were the immigrants held for? === The answer to the above question is

A:
weeks