January 3, 2013 by admin
The most important safety measure that can
be taken is to ensure that you are able to communicate during extreme weather.
Emergency response systems have self-contained
back-up power good for about 72 hours leaving time to contact the monitoring
center for assistance. If you have phone service through your cable company and
the power fails the response system fails with it.
Many seniors have cell phones today. They
are not dependent upon an immediate power supply if they are kept fully
charged. However, it does not take much for the battery to run down.
During the last power outage I was able to
maintain 3 cell phones fully charged with a battery pack I purchased from Sam’s Club for $59.
Whatever power supply you choose should have a USB port to charge things like cell phones and
laptops. If the power supply is always plugged in it should be ready for use
during the next power outage. I was without power for 7 days and the battery
pack had more than ample power for 3 cell phones and two computers. Peace of
mind for only $59.
Category Emergency Preparedness | Tags: aide,Alzheimer’s,assisted,Avon,Berlin,bonded,Branford,Bristol,call,Canton,care,certified,companion,Connecticut,Connecticut care health home alzheimers disease nurse aide newington new haven hartford east galstonbury waterbury meriden west manchester britain vernon avon,Cromwell,dementia,disease,east,emergency,Enfield,Farmington,Granby,Guilford,Hamden,Hartford,haven,health,home,Insurance,Kensington,Litchfield,live ins,living,Lyme,manager,Manchester,Meriden,Middletown,new,Newington,north,nurse,on,Orange,Plainville,response,Rockville,Saybrook,Simsbury,south,Southbury,Southington,state,system,Tolland,Vernon,Wallingford,Waterbury,west,wide,Windsor,Woodbridge | No Comments
January 3, 2013 by admin
We are living in the “New Normal”, a time
when 100 year storms come back to back. If this is the new norm then we need to
be better prepared for the next event. It is not a matter of “if” the next big
storm will hit, it is a matter of when it will hit.
We are very dependent on electrical power
for all of our needs. When the power fails many of us lose phone service,
lights, refrigeration and, worst of all, heat.
With winter weather fast
approaching there are a number of things you
can do to be prepared.
The CDC has a
really neat checklist of how to heat your home safely during winter weather.
However, it is not really focused on seniors.
Many seniors have downsized into apartment
buildings with elevators. There are no fireplaces or storage for kerosene
heaters. Most apartments do not have back-up generators.
It is important for seniors to be aware of
weather reports and take heed of early advisories and warnings. When a big
storm hits rescuers might not be able to get to you.
The best thing to do is to know where your
town’s shelters are and get there whenever they open. If transportation is an
issue contact your local police department for assistance. For emergency shelter
information contact info line at 211.
Category Emergency Preparedness | Tags: aide,Alzheimer’s,Ansonia,assisted,Avon,Berlin,Bloomfield,bonded,Branford,Canton,care,caregiver,certified,companion,Connecticut,Cromwell,dementia,Derby,east,emergency,Enfield,falls,Farmington,Granby,Guilford,Hamden,Hartford,haven,health,home,Insurance,Kensington,Litchfield,live-in,living,Lyme,Madison,Manchester,Meriden,Middlebury,Middletown,new,Newington,north,nurse,Nutrition,Orange,Plainville,response,Rockville,Rocky Hill,Saybrook,Simsbury,south,Southbury,Southington,Stafford Springs,Suffield,system,Tolland,Unionville,Vernon,Wallingford,Waterbury,Watertown,west,Wethersfield,Windsor,Woodbridge | No Comments
January 3, 2013 by admin
There are many reasons that people have for
not eating healthy. Here are a few ideas to help you overcome the obstacles to
1. Say “no” to eating alone. Being with others
stimulates your mind and helps you to enjoy your meal. Make a date to share
lunch or dinner with family and friends on a rotating basis. Adult Day Care Centers
provide companionship and healthy meals. Senior meal programs are a great way
to meet others and get a nutrition meal at the same time. The Newington Senior
Center has a nutritious meal program. You can find out more by calling them at
2. Loss of
appetite can be another excuse. Check with your doctor to see if this may be
related to any medications you are taking. Changes in a medication dosage may
be able to help. Try natural flavor enhancers such as garlic, onions, ginger
and other spices to boost your appetite.
3. Difficulty chewing can be an obstacle to healthy eating. Consult your dentist to make sure
that there are no oral problems. Try making smoothies with fruit, yogurt and
protein powder. Eat steamed vegetables and soft foods like couscous, rice and
4. Eating the same foods over and over is
bound to get boring. Start by making variety a priority. Read cooking
magazines, buy spices you haven’t tried before and chat with friends about what
5. If you can’t shop or cook for yourself there
are a number of possibilities depending on your living situation, finances and needs. Take
advantage of home delivery such as Pea Pod. Ask family, friends or neighbors if
they will shop for you. If you live alone consider sharing your home with a
housemate willing to shop and cook for you. Hire a homemaker to shop and cook
for you. You may also contact your local “Meals on Wheels” for nutritious meals
delivered to your door.
Category Nutrition | Tags: aide,Alzheimer’s,Alzheimers memory loss home care health nurse aide CNA homemaker companion live in connecticut hartford new haven emergency response system,assisted,Avon,Berlin,Branford,Bristol,care,certified,companion,Connecticut care health home alzheimers disease nurse aide newington new haven hartford east galstonbury waterbury meriden west manchester britain vernon avon,Cromwell,disease,east,Enfield,Farmington,Granby,Guilford,Hamden,Hartford,haven,health,home,home health assisted living food nutrition homemaker companion nurse aide live in hartford newington hamden new haven north south west east connecticut windsor manchester middletown waterbury enfield ,Kensington,living,long term care home health alzheimers connecticut newington hartford new haven east west north health aides registered nurse homemakers live ins respite hamden wallingford vernon wethersfield,Manchester,new,Newington,north,nurse,Orange,Plainville,Rockville,Simsbury,south,Southbury,Southington,Tolland,Vernon,Wallingford,Waterbury,west,Windsor,Woodbridge | No Comments
January 3, 2013 by admin
Often we have a tendency to approach our
daily dietary needs with a lack luster attitude. We are fearful of moving
outside of our comfort zone when it comes to trying new foods. Frequently we
feel that “well, I didn’t like it as a kid so I won’t like it now”, forgetting
that over the years our taste buds change.
Good nutrition is important at any age. Eating
well will help you to feel better every day and may even help prevent heart
disease, osteoporosis, diabetes and some cancers.
As we get older we need fewer calories but
the same amount, or even higher amounts, of certain vitamins and minerals. This
can make meal planning a daunting task.
A major key to healthy eating is planning your
meals accordingly. Start with planning for three meals a day. Skipping a meal,
especially breakfast, will make it difficult for you to get all of
your daily nutritional requirements.
1. Try one different
food each month. You might just find a new favorite.
2. Keep a list of
menu items for when you are out of ideas.
3. Swap ideas
with family and friends to add variety.
4. Start your day
with 100% juice.
Category Nutrition | Tags: aide,Alzheimer’s,Alzheimers memory loss home care health nurse aide CNA homemaker companion live in connecticut hartford new haven emergency response system,assisted,Avon,Branford,Bristol,care,certified,companion,Connecticut care health home alzheimers disease nurse aide newington new haven hartford east galstonbury waterbury meriden west manchester britain vernon avon,Cromwell,disease,east,Enfield,Farmington,Granby,Guilford,Hamden,Hartford,haven,health,home,home health assisted living food nutrition homemaker companion nurse aide live in hartford newington hamden new haven north south west east connecticut windsor manchester middletown waterbury enfield ,Kensington,living,Manchester,Meriden,Middletown,new,Newington,north,nurse,Orange,Plainville,Rockville,Simsbury,south,Southbury,Southington,Tolland,Vernon,Wallingford,Waterbury,west,Windsor,Woodbridge | No Comments
August 2, 2012 by admin
Dementia is really a group of symptoms that include memory
loss, personality changes and impaired intellectual functioning. These symptoms
may be a result of either disease or trauma to the brain. The symptoms are
those not a part of normal aging and are severe enough to impact daily living,
a person’s independence and family relationships. There are many different
forms of dementia but Alzheimer’s disease and Vascular Dementia are most
common. Alzheimer’s disease is the most common type accounting for two thirds
of all diagnosed cases. If the diagnosis is Alzheimer’s disease there are
medications that can slow the appearance of more severe symptoms of dementia.
The most common signs and symptoms of dementia include
memory loss, impaired judgment, and inappropriate behavior. Other symptoms may
include decreasing communication skills, increased problems with ambulation and
poor personal hygiene. The person with dementia may repeatedly ask the same questions
or may easily become confused in familiar places. This person may also be found
wearing the same clothes day after day. He/she may appear unkempt and
disheveled. He/she may have difficulty following simple directions.
I know, I know, a strong case could be made that I have had
it for years and it just has never been diagnosed. For instance, since youth I
have had difficulty following directions. That has not improved the slightest
over the years. I misplace car keys, glasses and baseball caps; glasses found
on my head and baseball cap in my hand. So, do I have dementia? I say “not
yet”, of course, my wife would disagree.
Even though you may have some of the symptoms you may not
have dementia either. Dementia can be caused by a large number of conditions
such as stroke, drug interactions and urinary tract infections. When symptoms
appear suddenly it is important to see your physician as soon as possible. Prompt
diagnosis and early intervention can control, or even eliminate symptoms all
together. Exercising your mind helps you stay active. Find a cause and get
involved, there are plenty of them out there. July 4th 2012,
Independence Day, is right around the corner. I felt that this would be the
perfect opportunity to discuss independence and the fear and frustration that
comes from having one’s independence threatened. How many conflicts have
occurred worldwide all in the name of freedom and independence? Why is it so
difficult for caregivers to understand the negative response from a memory
impaired person when he/she feels threatened? I suppose it is because
caregivers are convinced that they are acting in the person’s best interest.
But are they really?
Dan Fisher RN, BSN
A & D
Home Health Solutions
Category Cognitive Impairment | Tags: aide,Alzheimer’s,assisted,Avon,Berlin,Branford,Bristol,care,certified,companion,Cromwell,disease,east,Enfield,Farmington,Granby,Guilford,Hamden,Hartford,haven,health,home,Kensington,living,Manchester,Meriden,Middletown,new,Newington,north,nurse,Orange,Plainville,Rockville,Simsbury,south,Southbury,Southington,Tolland,Vernon,Wallingford,Waterbury,west,Windsor,Woodbridge | 1 Comment
February 7, 2012 by admin
The Department of Veterans Affairs provides three types of long term care services for veterans.
The first type is benefits from the VA healthcare system. This benefit is focused on those with service connected disabilities, who are receiving VA Pension or are considered low income. Services may include free medical care, free prescription drugs, orthotics and prosthetics, home renovation grants for disabilities, home care, assisted living and nursing home care. Availability of these services is dependent on the local medical centers funds, the nature of the disability and whether the veteran is considered low income.
The second type of benefit is state veterans homes. The majority of these homes offer nursing care but some may offer assisted living care as well. Veteran’s homes are supported with a combination of state and federal funds. These homes are generally available to veterans and their spouses. There may be a waiting list in some states.
The third type of benefit is disability income for active duty veterans. The first of these disability incomes is called compensation. It is designed to award a veteran a certain amount of money to compensate for potential loss of income in the private sector. In order to qualify for this benefit a veteran needs to have evidence of a service related disability. Some veterans may have record of being exposed to extreme cold, non-disabling injuries, tropical diseases or other incidents of exposure, while on active duty, which years later may be the cause of medical conditions. These veterans could apply to see if they could receive a benefit. Some veterans may be receiving Compensation but their condition has worsened and they can reapply for a larger amount based on a higher disability rating.
The second disability income benefit is called pension. Pension is also called “Veterans Aid and Attendance Benefit”. It is available to all active duty veterans who served at least 90 days during a period of war. Applicants younger than age 60 must be totally disabled or a patient in a nursing home. Proof of disability is not required for applicants 65 years of age and older.
The purpose of this benefit is to provide supplemental income to disabled or older veterans who have low income. If the veteran’s income exceeds the pension amount, then there is no award. However, income can be adjusted for unreimbursed medical expenses, and this allows veterans with incomes larger than the pension amount to qualify for a monthly benefit. There is also an asset test to qualify for Pension. The primary residence, most personal property and automobiles are exempt from this asset test.
Category Uncategorized | Tags: aide,Alzheimer’s,Avon,Branford,care,caregiver,Clinton,companion,Connecticut,Cromwell,disease,east,Enfield,Farmington,Glastonbury,Granby,Guilford,Hartford,haven,health,home,homemaker,live-in,Madison,Management,Manchester,Meriden,Middletown,New Haven,Newington,north,nurse,Orange,Rocky Hill,Saybrook,south,Southbury,Southington,Tolland,Vernon,Waterbury,west,Wethersfield,Windsor,Woodbridge | No Comments
September 26, 2011 by admin
Two-way personal emergency response (PERS) systems have been around for quite a number of years now. They continue to be an important tool to keep one aging safely in place. I am sure that you have seen the television commercials where a lady is lying on the floor yelling “Help me. I’ve fallen and I can’t get up.” Unfortunately this is an all too common occurrence. The longer a person lies on the floor without assistance the more difficult full recovery will be. One push of the button and you are in contact with trained responders. The commercial aired quite heavily on many television stations making it well known within the healthcare industry. It also created a sort of tunnel vision for seniors and providers alike.
Just last week a client was telling me what she thought of our PERS system. She loves it and feels that it saved her life. This is the story I received form her. She was having difficulty breathing and was sitting on the edge of her bed. She decided to call her doctor. (I’m thinking, PUSH THE BUTTON). Her doctor was off so she spoke with the covering physician. He told her to wait 35 minutes and if she didn’t feel better dial 911. (In my head I’m screaming, PUSH THE #*!! BUTTON). My client decided that 35 minutes just did not seem right so, thankfully, she pushed the button. Oh yea, before she pushed the button she walked to the front door and unlocked it even though the responders have access to the key. She was in even more respiratory trouble by the time she reached her bedside. The responders arrived within minutes and transported her to the emergency room. She was admitted to the medical intensive care unit and treated for congestive heart failure.
As you can see the PERS units are useful for more than just falls. Chronic illnesses can bring on acute symptoms that require immediate medical attention. They may be used in case of fire or police emergencies. They may be used for medication reminders and regular welfare checks. Monitoring companies are staffed with specially trained responders 24 hours a day, 365 days a year. So, if you have these concerns with yourself or a loved one call us for more information. Mention code WB-101 to receive the exclusive discount of $27.95 per month
Dan Fisher RN, BSN
A & D Home Health Solutions, Inc
Visit our website: www.adhomehealthsolutions.com
Category Uncategorized | Tags: aide,Avon,Branford,caregivers,certified,chronic,Clinton,companions,Connecticut,disease,east,emergency,Enfield Tolland,Granby,Guilford,Hamden,Hartford,haven,health,home,homemakers,Lyme,Manchester,new,north,nurses,Orange,personal,response,Rockville,Say brook,south,systems,Vernon,veterans,west,Windsor,Woodbridge | No Comments
August 26, 2011 by admin
I am often called in to assist clients after they have gone into crisis mode. The crisis may be a result of medication mismanagement, a fall resulting in injury or driving to the barber shop down the street and ending up in another state. The ability to manage the daily household operations can deteriorate slowly over time. Family members may miss simple signs and symptoms of this inability to cope with the activities of daily living. The following list will help to identify the need for professional help for your aging relatives.
1. Medication bottles that have not been refilled in the last two or three months.
2. Medication bottles that are filled too frequently.
3. Cluttered pathways.
4. Increasing short term memory loss.
5. Wearing the same clothes for weeks on end.
6. Windows and blinds shut and locked tight at all times.
7. Stoves cluttered and unusable.
8. Washer and dryer cluttered and unusable.
9. Decreasing personal hygiene.
10. Unopened mail.
11. Utility shut off notices.
12. Empty cupboards.
13. Empty refrigerator.
14. Cancelled medical appointments.
15. Cancelled hair appointments.
16. Phone calls to friends and relatives in the middle of the night.
17. Paranoia about friends and relatives stealing from them.
18. Inoperable bathroom facilities.
19. Thick blankets placed over the windows and blinds.
20. Going out of the house without weather appropriate attire or wearing nothing at all.
Having been a homecare nurse for the past 20 years I have seen all of these symptoms and many more. There are many options to assist individuals to remain as independent as possible in their own home. Knowing when to call in a professional care manager can be the difference between aging in place successfully and having to move to a skilled nursing facility.
Dan Fisher RN, BSN, CEO
Case Management Services
Category Uncategorized | Tags: aide,Alzheimer’s,Avon,Branford,care,caregiver,Clinton,companion,Connecticut,Cromwell,disease,east,Enfield,Farmington,Glastonbury,Granby,Guilford,Hartford,haven,health,home,homemaker,live-in,Madison,Management,Manchester,Meriden,Middletown,New Haven,Newington,north,nurse,Orange,Rocky Hill,Saybrook,south,Southbury,Southington,Tolland,Vernon,Waterbury,west,Wethersfield,Windsor,Woodbridge | 3 Comments
August 11, 2011 by admin
Generally, elderly parents want to remain living in their own home. However, remaining in
the home becomes a concern when children see their parents slowing down,
perhaps even having trouble with handling stairs and doing general daily
activities. Yet, with parents’ mental and physical health currently not
creating problems, there seems to be no imminent need to search out support
services or other accommodations for aging parents.
This is now the time to evaluate the home to make it safe and secure for your loved
ones — now and in the near future — in anticipation of aging disabilities
that may occur. Help and support are available. The nation as a whole is more
aware of elderly needs and services and products are becoming available at an
The Bureau of Labor Statistics states, “Employment of
personal and home care aides is projected to grow by 51 percent between 2006
and 2016, which is much faster than the average for all occupations. The
expected growth is due, in large part, to the projected rise in the number of
elderly people, an age group that often has mounting health problems and that
needs some assistance with daily activities.” Bureau of labor
Statistics-Occupational Outlook Handbook, 2008-09 Edition
This growing need for aides and services also encompasses
- home remodeling
services — making a home more serviceable to the elderly;
- safety alert
systems and technology;
- motion sensors
to monitor movement;
services — using home-based computer systems for the doctors office or a
nurse to monitor vital signs and
- even a pill
dispenser that notifies when it is time to take medication.
Where do you begin to make sure your elderly family member is safe and managing well
in his or her home?
Visit often and at different times of the day and night. Make note of daily
activities that appear challenging and where changes might be made to add
safety and convenience. Remove rugs that slide — causing a fall — and move
furniture with sharp edges. Set the water heater at a lower temperature. This
will protect their older sensitive skin from scalds and burns. Be sure smoke
detectors and carbon monoxide detectors are in place.
Bathrooms are a hazard area for the elderly. Grab bars by the toilet and shower are a
must to help prevent falls. There are easy to install bars at your local
hardware store if you want to do the work yourself. Another item that is good
to have is a shower stool or chair.
If you are not sure of what needs to be done, consider hiring a professional.
There are companies that specialize in home remodeling and accommodation for
seniors. Michelle Graham of Accessible Design by Studio G4 says about
senior home remodel projects,
“The main thing we incorporate in all of our projects is a
careful study of needs and potential needs that may develop throughout a
Keep in mind what future home adjustments might be needed for
your parents to “age in place” in their home.
Home safety or medical alert companies provide GPS-based bracelets
or pendants to track the elderly at home who tend to wander. Or the companies
may provide alarm devices such as pendants or bracelets which allow the elderly
to alert someone if there has been a fall or a sudden health-related attack. In
the event an alarm has been triggered, a 24 hour monitoring service will alert
the family or medical emergency services or call a neighbor depending on
previous instructions. In addition there are companies that will install motion
sensors in the home to monitor the elderly on a 24 hour basis.
Don’t forget your parents’ community as a valuable resource for helping them stay in their home. Take Margaret Muller as an example. At 82 years of age, Margaret lives alone in her small home. She manages very well with the help of her local Senior Center. The Center’s “Senior Companion” program sees that Margaret is taken to the store for groceries and other needs and checks in with her often to see how she is doing. Once a day, the Senior Center delivers a hot healthy meal to her door. Having these services and visits gives Margaret the help she needs and peace of mind that she is not alone.
Neighbors, local church groups, senior centers and city centers are some places to look
for assistance. Most of the time there is little or no cost for these services.
Your state aging services unit is a valuable community resource. The National Area
on Aging website www.aoa.gov states:
“AoA, through the Older Americans Act and other legislation, supports programs that help older adults maintain their
independence and dignity in their homes and communities. In addition AoA
provides funding for a range of supports to family caregivers.”
Some of the programs the site lists are:
“Supportive Services and Senior Centers
National Family Caregiver Support Program
Grants for Native Americans
Nursing Home Diversion Grants
Aging & Disability Resource Centers
Evidence-Based Disease Prevention
Long-Term Care Planning
Alzheimer’s Disease Grants
Naturally Occurring Retirement Communities”
A few thoughts on hiring home care aides or live-in care givers.
The classifieds are filled with people looking for work as aides to the elderly.
Many of these aides are well-qualified, honest people who will do a good job;
but, of course, there will be some not so reputable. If you are looking to hire
someone, be sure you interview and check references and qualifications. You
will be responsible for scheduling that person and doing payroll and taxes as
well. Be very sure you hire someone trustworthy, as the elderly seem to trust
these helpers more than they should and therefore can easily be taken advantage
A professional home care service will eliminate your employment concerns.
Professionally-provided aides are usually bonded and service is guaranteed.
Home care companies take care of the scheduling and payment of their employees.
Home care companies cater to the elderly in their homes by offering a variety
of services. Please take the time to visit our website for further information.
A & D Home Health Solutions
These providers represent a rapidly growing trend to allow people
needing help with long term care to remain in their home or in the community
instead of going to a care facility. The services offered may include:
- grooming and dressing
- recreational activities
- incontinent care
- handyman services
- teeth brushing
- medication reminders
- bathing or showering
- light housekeeping
- meal preparation
- respite for family caregivers
- errands and shopping
- reading email or letters
- overseeing home deliveries
- dealing with vendors
- transportation services
- changing linens
- laundry and ironing
- organizing closets
- care of house plants
- 24-hour emergency response
- family counseling
- phone call checks
- and much more.
Day, Director of the National Care Planning Council states,
“Care in the home provided by a spouse or a child is the
most common form of long-term care in this country. About 73% of all long term
care is provided in the home environment typically by family caregivers.”
As their caregiver, you can make the difference in the quality of
life for your aging parents and if staying in their home is a possibility, you
have the resources to make it happen.
Dan Fisher RN, BSN
A & D Home Health Solutions, Inc
Category Uncategorized | Tags: aide,Alzheimer’s,Bloomfield,Branford,care,Clinton,companion,Cromwell,disease,east,Enfield,Glastonbury,Granby,Guilford,Hartford,haven,health,home,homemaker,in,live,Lyme,Madison,Manchester,memory,Meriden,Middletown,Milford,new,Newington,north,nurse,Orange,Portland,Rocky Hill,Saybrook,Simsbury,south,Stafford Springs,Stratford,Suffield,Tolland,Trumbull,Vernon,Wallingford,Waterbury,west,Wethersfield,Willington,Windsor,Woodbridge | 27 Comments
August 2, 2011 by admin
Homecare nurses see a multitude of urinary tract infections every year. The occurrence of these infections is most notable within the first 7 to 10 days after discharge from a hospital or skilled nursing facility. While anyone can get a urinary tract infection some are more prone to them. Women get this infection more often than men. Senior women frequently have depressed immune systems which make them quite vulnerable.
Symptoms of urinary tract infections include:
• Increased frequency of going to the bathroom
• Increased urgency to make it to the bathroom
• Cloudy or blood tinged urine
• A foul odor from the urine
• Increasing confusion in seniors
• Frequently a senior will display a subnormal temperature.
• Low grade temperature
Seniors may not exhibit any signs or symptoms in the earlier stages of the infection. They may only have increased confusion, general feelings of discomfort and new incontinence.
Prevention includes drinking plenty of fluids, cranberry juice and cranberry products appear to reduce the incidence of infections. When you feel the urge to urinate do not delay.
Contact your physician immediately when one or more of these symptoms are displayed. Depending on the Take any medications prescribed by your physician exactly as directed. Even if you are feeling better and all signs and symptoms are absent continue taking the full course of medications.
Dan Fisher RN, BSN
Category Uncategorized | Tags: aide,Alzheimer’s,Avon,Berlin,Branford,Bristol,care,companion,Cromwell,disease,Durham,east,emergency,Enfield,Farmington,Granby,Hamden,Hartford,haven,health,home,infection,Kensington,live-in,maker,Manchester,Meriden,Middletown,Milford,new,New Britain,north,nurse,Orange,Plainville,Plantsville,response,Rockville,Simsbury,south,Southbury,Southington,system,Tolland,tract,urinary,Vernon,Wallingford,Waterbury,west,Windsor,Windsor locks | 4 Comments