esl health unit unit five - spring institute esl students...

EESSLL HHeeaalltthh UUnniitt

UUnniitt FFiivvee Taking Medications

Intermediate

Concept by Shelley Reece and Oscar Jimenez with additional activities and

materials by Lisa Minetti, Melissa Halaway and Sharon Nicolary

Made possible by a generous grant from MetLife Foundation.

Additional support provided by Temple University and San Jose State University.

This unit was developed as part of the SHINE-MetLife Foundation Health Literacy

Initiative, as one component of Project SHINE, Center for Intergenerational Learning. For more information about this project, go to www.projectshine.org

ESL Health Unit/Intermediate, Unit Five: Taking Medication

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Acknowledgments

Thematic units were developed by ESL practitioners teaching ESL Health Literacy

classes to elder immigrants at five senior centers in Philadelphia. Each instructor selected

two topics of greatest interest to their class from a list of health literacy topics, identified

by immigrant elders participating in focus groups in Philadelphia and San Jose. SHINE

staff conducted regular curriculum development meetings at which teachers discussed

themes emerging from their classes and methods for encouraging learners to write about

these topics. Many of the lesson activities within the units are based on learner

narratives, in which elder immigrants share their experiences accessing healthcare in the

US.

The project would like to thank the elder immigrants who participated in the ESL Health

Literacy classes and who shared their stories and health concerns with us. Many thanks

to the teachers who taught the classes, participated in the curriculum development

process, formulated the topics upon which the units are based and developed many of the

activities in the units. We would also like to express our gratitude to Gail Weinstein for

her work on the Learners’ Lives as Curriculum framework, which provided the

inspiration for this curriculum development process. Many thanks to Marni Baker Stein,

Hilary Bonta, Melissa Halaway and Sharon Nicolary for their careful work in developing

additional activities and instructional materials, ensuring that activities were at consistent

proficiency levels, and standardizing the format of units.

The initial concept and activities for this unit were developed by Shelley Reece , Jackie

Luttrell and Sun Mi Chung, in collaboration with elder learners at the Norris Square

Senior Center and University Square Senior Residence in Philadelphia. Additional

activities and revision by Marni Baker Stein, author of Talk it Through: Listening,

Speaking and Pronunciation (Houghton Mifflin) and Hilary Bonta of the English

Language Program at the University of Pennsylvania. Patricia Dillon, RN, PhD, of

Temple’s School of Allied Health, provided input on health content.


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Taking Medications A Thematic Unit for Intermediate Level Learners

Table of contents

Lesson One: Managing Your Medications 6-51

Reading and Writing Practice

Goals for this Lesson 6-24

6

Before You Read! 7-13

Health Watch: Tips to Remember and Stay on Your Medications 14-17

Reading One: Lena’s List of Medications 18-19

Reading Two: Youssef’s Problem 20-21

Health Watch: Cutting Costs 22-24 Listening and Speaking Practice


25

Before You Listen! 26-27

Health Watch: A List of Questions for your Pharmacist 28

Listening One: Medications Counseling 29-32

Talk About It! 33-39

Health Watch: Understand Over-the-Counter Drug Labels 40-44 Real Practice


45

Real Practice 46-48

Checklist for Learning 49

Lesson Two: Taking Medications Safely 50-93



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Reading Three: Dangerous Side Effects 55-58

Health Watch: What You Should Know About Drug Interactions 59-62

Grammar Tip: Adjective + Preposition 63-65


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Listening and Speaking Practice


66

Before You Listen! 67

Health Watch: Preventing Falls 68-72

Listening Two: Making Your Home Safe 73-76

Talk About It! 77-79 Real Practice


80

Real Practice 81-92


Lesson Three: Alternative Medicine 94-122



94


Reading Four: Alternative or Conventional? 98-101

Health Watch: Alternative Medical Treatments 99-102 Listening and Speaking Practice


102

Before You Listen! 103-106 Health Watch: Talking with Your Doctor About Alternative Methods 103-106

Listening Three: Seeking Alternative Treatments 107-109

Talk About It! 110-116 Real Practice


117

Real Practice 118-121



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Note to Teachers! The following websites were used in developing this site. You may find them useful references to support your instruction. Resources for Health Topics: � MedicineNet

http://www.medicinenet.com/medications/focus.htm � Food and Drug Administration office of Public Affairs:

http://www.fda.gov/fdac/features/1997/697_old.html � Mayo Clinic.com

http://www.mayoclinic.com/invoke.cfm?id=SA00078 � American Cancer Society

http://www.cancer.org/docroot/ETO/ETO_5.asp?sitearea=ETO

� National Center for Complementary and Alternative Medicine http://nccam.nih.gov/

Resources for Language Topics:

� CyberGrammar Online

http://www.ex.ac.uk/~damyhill/grammar/pronounadv.htm � About.com

http://esl.about.com/library/grammar/blgr_prep9.htm


6


UUnniitt FFiivvee TTaakkiinngg MMeeddiiccaattiioonnss

LLeessssoonn OOnnee MMaannaaggiinngg YYoouurr MMeeddiiccaattiioonnss

RReeaaddiinngg aanndd WWrriittiinngg PPrraaccttiiccee IInntteerrmmeeddiiaattee

Goals for this lesson: Below are some of the goals of this lesson. Which ones are your goals

too? Check (√) them.

� Discuss important questions to ask your doctor and pharmacist � Identify ways to cut costs when purchasing medications � Review indefinite pronouns (someone, anyone, nothing…)


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Lesson One: Managing Your Medications


Before You Read!

In this lesson, you will read about Lena and Youssef’s problems taking their

medications.

Activity One:

Before you read, discuss the following questions with your classmates and

teacher.

1. What kind of medications do you take regularly? Which of these are

prescription medications? Which are over the counter medications?

Prescription medications Over the counter medications


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2. If you take several kinds of medication each day, how do you

remember to take them at the right time? Do you ever forget? What

do you do if you forget to take your medication?

Before we go on: a quick review of indefinite pronouns

IndefinitefPronouns

Indefinite pronouns and adjectives are words used to refer to people or

things non-specifically rather than specifically. Although an indefinite

pronoun may refer to someone or something specific, it refers to them in

general with the notion of all, some, any, or none.

Some common indefinite pronouns are:

Singular:

another both everything nothing

any each neither one

anybody either nobody somebody

anyone everybody none someone

anything everyone no one something


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Plural:

all few more much several

both many most plenty some

Examples:

singular - Somebody was supposed to pick up my prescription.

plural - Many of us are on blood pressure medicine.

Indefinite pronouns can only be classified as pronouns if they are used

alone. If they are used with a noun, then they become indefinite adjectives.

Examples:

pronoun: Both agreed that surgery was the only solution.

adjective: Both doctors agreed that surgery was the only solution.


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"Both" becomes an indefinite adjective in the second

sentence because it modifies the noun "doctors."

pronoun: Several (of the patients) are taking multiple medications.

adjective: I am taking several medications.

"Several" becomes an indefinite adjective in the second

sentence because it modifies the noun “medications"


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Fill in the gaps with somebody, anybody, nobody, something, anything,

nothing, somewhere, anywhere or nowhere.

1. I read __________ about this drug in the newspaper yesterday. They said

it can damage your heart.

2. __________ goes to the Center anymore because they started charging

for classes.

3. I’m not sure where her office is. I think it might be __________ near the

library.

4. __________ could have taken you to the pharmacy. Please ask us if you

need help!

5. __________ scares him. He's very brave.

6. There is __________ to park here. Let's go __________ else to park.

7. Would you like __________ to drink?


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8. Should I be taking __________ for my indigestion?

9. The nurse took him __________ back though that hallway about fifteen

minutes ago.

10. She doesn’t take __________ for her diabetes. She tries to manage it by

watching her diet and exercising.

11. She needs __________ to talk to. She's very lonely.

12. He is very stubborn. He got angry with his doctor and says he won’t see

him __________.

13. There isn't __________ you can do to help him. __________ can help

him.

14. We do not need __________ to help us with the house. We can do it

ourselves.


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15. __________ is ringing the bell. Go and see who it is.

16. __________ phoned while we were out, but they did not leave a

message.

17. __________ told me that __________ is going to the party .

18. They are looking for __________ that is in a nicer neighborhood. They

want to find a quiet place to lead a quiet life.

19. I will live __________ as long as it is close to my daughter

20. Is there __________ at home who can help you with this?


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Health Watch: Tips to Remember and Stay on Your Medications

The first step to staying on your medication is to understand what you are

taking and why.

• Ask your doctor what you are being treated for and how each

medicine helps.

• Know the side effects of any medications you are taking. You can find

this out by asking your doctor or pharmacist.

• Ask your doctor how your medicine works with your other

medications and the foods you eat. For example: Some medicines

work best if you take them with food, and others work best if you take

them at bedtime.

• Ask your doctor what to do if you miss a dose of medicine or have

problems with side effects. It is important that you keep your doctor

informed of how the medicine is working for you. It may be useful to

ask your doctor for help in completing a chart on all of your

medicines that includes the name of the medication, what the

medication is being taken for, when to take it, what side effects to

watch for, and whom to call if you should have a problem.

Remembering to take your medicine is important. Some ways to help


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yourself remember to take your medicine could be:

• Daily reminders are often helpful when scheduling your medication

doses. Try to time taking your medicine around activities that you do

daily such as setting your alarm clock, brushing your teeth, eating

your meals, going to work, or doing other daily activities. Once you

have the routine down it will become a habit (for example, taking

your daily meds before you brush your teeth by putting the

prescription bottle next to your toothbrush).

• Setting your watch alarm to go off when it's time to take your

medicine.

• Placing a reminder card in a visible place.

• Having a family member or a friend remind you.

• Use a medication box that will hold your entire day's supply of

medicine. This will let you know if you missed a dose of medicine.


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If you have tried these tricks and still have trouble remembering your

medicine, talk to your doctor or pharmacist. It may be possible to simplify

your medication schedule or to put your medicine in special containers

called blister packs to help you.

Your Pharmacist Can Help Too

One of the most important services a pharmacist can offer is to talk to you

about your medicines. A pharmacist can help you understand how and when

to take your medicines, what side effects you might expect, or what

interactions may occur. A pharmacist can answer your questions privately in

the pharmacy or over the telephone.

Here are some other ways your pharmacist can help:

• Many pharmacists keep track of medicines on their computer. If you

buy your medicines at one store and tell your pharmacist all the over-

the-counter and prescription medicines or dietary supplements you

take, your pharmacist can help make sure your medicines don't

interact harmfully with one another.

• Ask your pharmacist to place your prescription medicines in easy-to-


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open containers if you have a hard time taking off child-proof caps

and do not have young children living in or visiting your home.

(Remember to keep all medicines out of the sight and reach of

children.)

• Your pharmacist may be able to print labels on prescription medicine

containers in larger type, if reading the medicine label is hard for you.

• Your pharmacist may be able to give you written information to help

you learn more about your medicines. This information may be

available in large type or in a language other than English. Your

pharmacist can help keep track of your medicines.

Information adapted from MedicineNet.com


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Reading One - Lena’s List of Medications

Next read Lena’s story and answer the questions that follow with your

classmates and teacher. As you are discussing your answers, notice how

and when you use indefinite articles and make sure to try to use them

correctly!

My name is Lena and I am 75 years old. Every time I go to the doctor he

puts me on something new. You can look at my medicine chest and see all

of the bottles. I got something for my eyes, blood pressure, I hurt my foot

and he gave me a pain killer. I started to get nervous and he gave me these

Paxil pills. I know he is a good doctor and he is trying to help, but it is

really hard for me to remember when to take what pills – there are so many

and sometimes I forget, did I take that pill or not today? And sometimes I

can’t even get the caps off the bottles. So I just stopped taking all of it – its

crazy all of these drugs anyway!

This story was generated by the course developer for instructional purposes.


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Questions:

1. What is Lena’s problem?

2. What has Lena decided to do about her problem?

3. Do you think this is a good solution?

4. If you were Lena, what would you do to solve this problem?


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Reading Two - Youssef’s Problem

Next read Youssef’s story and answer the questions that follow with your

classmates and teacher. Again, as you answer, notice how and when you

use indefinite articles and make sure to try to use them correctly!

My name is Youssef. The last time I counted, I think I was on six

different prescription medications plus I take an over the counter medication

to help me sleep and sometimes I take Tylenol when I get a headache. I

know that I’ve got to take my blood pressure medicine and I got one to help

me lower my cholesterol, but the rest of them I’m not sure about – and they

are really expensive – so, I only buy the ones I need the most. Also, the

directions are complicated and I have trouble reading the labels. When I am

at my doctor’s office I ask the nurse to explain but sometimes by the time I

get home I forget. Luckily, my neighbor is on some of the same medications

so he tells me what to do when I have a problem. He’s a big help.



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Questions:

1. What is Youssef’s problem?

2. What is Youssef’s solution to his problem?

3. Do you think this is a good solution?

4. If you were Youssef, what would you do to solve this problem?


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Health Watch: Cutting Costs

The cost of medications is a serious concern for older people, most of whom

must pay for drugs out of pocket. Even those who have insurance to

supplement Medicare must often pay a percentage of the cost of their

medicines.

For a new prescription, don't buy a whole bottle but ask for just a few pills.

You may have side effects from the medication and have to switch. If you

buy just a few, you won't be stuck with a costly bottle of medicine you can't

take.

For ongoing conditions, buy medications in the largest quantities you can.

Do this only if you know your body tolerates them well, since it's not usually

possible to return medications.

Call around for the lowest price. Pharmacy prices can vary greatly. If you

find a drug cheaper elsewhere, ask your regular pharmacist if he or she can

match the price.

Other ways to make your prescription dollars go further include:

• Ask for a senior citizen discount.

• Ask for a generic equivalent. These non-brand substitutes are tested to

be sure they are chemically identical to the original, and they deliver

the same amount of the drug to the body in the same amount of time.


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LLiisstteenniinngg aanndd SSppeeaakkiinngg PPrraaccttiiccee

IInntteerrmmeeddiiaattee

Goals for this lesson: Below are some of the goals of this lesson. Which ones are your goals too?

Check (√) them.

� Learn ways to remember and stay on your medications. � Discuss important questions to ask your doctor and pharmacist � Review adverbs of frequency (often, frequently, never…) � Read and understand prescription and over-the-counter medication

labels


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Before You Listen!

Activity One:

The National Council on Patient Information and Education

www.talkaboutrx.org suggests that before you leave the doctor's office with

a new prescription, you should ask the list of questions below. Read through

the list with your classmates and teachers and then discuss the questions that

follow:

• What is the name of the medicine and what is it supposed to do? Is

there a less expensive alternative?

• How and when do I take the medicine and for how long?

• Whether to take it with water, food, or with a special medicine, or at

the same time as other medicines.

• Can it be taken with over-the-counter medicines? If so, when?

• What to do if you miss or forget a dose.

• Whether you take it before, during, or after meals.


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• The timing between each dose. For example, does "four times a day"

mean you have to take it in the middle of the night?

• What your doctor means by "as needed."

• Are there any other special instructions to follow?

• What foods, drinks, other medicines, dietary supplements, or activities

should I avoid while taking this medicine?

• Will any tests or monitoring be required while I am taking this

medicine? Do I need to report back to the doctor?

• What are the possible side effects and what do I do if they occur?

• When should I expect the medicine to start working, and how will I

know if it is working?

• Will this new prescription work safely with the other prescription and

over-the-counter medicines or dietary supplements I am taking?

Questions:

1. When you leave the doctor’s office with a prescription for a new

medication, do you usually feel like you know enough about that

medication, what it does, how and when to take it…?

2. Think about the list above. When you talk to your doctor about a new

medication, do you usually ask these questions? Would you feel

comfortable asking these questions? Why or why not?


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Health Watch: A list of Questions for Your Pharmacist

The National Council on Patient Information and Education also suggests

that at the pharmacy, or wherever you get your medicines, you should ask

the following questions about your prescriptions:

• Do you have a patient profile form for me to fill out? Does it include

space for my over-the-counter drugs and my dietary supplements?

• Is there written information about my medicine? Ask the pharmacist if

it's available in large print or in a language other than English if you

need it.

• What is the most important thing I should know about this medicine?

Ask the pharmacist any questions that may not have been answered by

your doctor.

• Can I get a refill? If so, when?

• How and where should I store this medicine?

Information adapted from MedicineNet.com


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Listening One: Medications Counseling

**Note to teacher: Do not pass out the written message in the box below. Record it onto a cassette (if possible with someone to play the second role in the dialogue) and have students listen to the recording. Play once or twice before they begin to listen for specific information.

Now you will listen to conversation between Ramone and a pharmacist who

works at his medical center. Ramone has many questions about the

medications he is taking. Listen to suggestions that pharmacist gives

Ramone and then discuss the questions that follow with your classmates and

teacher.

Ramone: My doctor has me on so many medications right now. For me they all look alike. I’m so frustrated I’m thinking about stopping a couple of my medications because I don’t think I need them anymore.

Pharmacist: Ramone, really you should take your medicines for the

whole time they are prescribed, even if you feel better. If you think you no longer need a prescription medicine you are taking, ask your doctor to check how well it is working, whether you still need to take it, and, if so, whether there is anything you can do (like lowering fats in your diet or exercising more) to cut back or, in time, stop needing the medicine. Don't stop taking the medicine on your own without first talking with your doctor.

And, Ramone, its not so hard to figure out a system for being able to you’re your medications apart is it? You could organize them by size, shape, color, or maybe by the container they come in. There are special containers with different colored caps and different sections for


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organizing your medications – maybe we could get you some of those to help you out?

Ramone: That sounds great…but what about at night. Many of my

medications need to be taken during the night. I get out of bed and I am groggy, I can’t see and I am supposed to take pills like this?

Pharmacist: Do you have children or pets living with you at home? Ramone: No. Pharmacist: Then I suggest you place the pills you will need during the night on your bedside table. Turn on the light and make sure you're taking the right medicine at the right time. You could set a loud alarm to wake yourself up at the right time – something you can’t ignore! Ramone: And what about when I travel? I am flying out to see my daughter’s family in a couple of weeks and I am worried about taking my medications while I am there. Pharmacist: Oh I know. Taking your medication is even harder when you are traveling. Make sure before you go that you ask your doctor how to adjust your medicine schedule to account for changes in time, routine, and diet. Bring the phone numbers of your doctors and pharmacy with you in case you need to get a refill. Since you are flying, my suggestion is to make sure you take all of your medicines with you on the plane; do not pack them in your checked luggage. And always keep your medicines out of heat and direct sunlight. Ramone: Actually, what I really hate the most about taking my pills is swallowing them. I have always had a hard time swallowing pills but it seems to get worse as I get older. Sometimes I try to break them so they are smaller or I try to chew them but I can’t always do it and this also gets me off schedule.


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Pharmacist: Never break or chew tablets without first asking a health professional about it. Not being able to swallow pills is a really common problem. Let’s take a look at your prescriptions and see if maybe there is a liquid medicine you could use or maybe you can crush your tablets.

And, you know, if you think your schedule for your medications is too complicated, and you can’t keep up with it, talk about it with your doctor. He may have another medicine or ideas that better fits your lifestyle. For example, if taking medicine four times a day is a problem for you, maybe the doctor can give you a medicine you only need to take once or twice a day. The most important thing is you tell your doctor about how you are feeling - that way he can help you come up with a system that works for you!


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Activity One:

Ramone tells his pharmacist about several problems he is experiencing with

taking his medications. In the box below, write down the advice the

pharmacist gives Ramone about each problem/question.

Ramone’s Problem/Question The Pharmacist’s Advice

I’m so frustrated I’m thinking about

stopping a couple of my medications

because I don’t think I need them

anymore.

Many of my medications need to be

taken during the night. I get out of

bed and I am groggy, I can’t see and

I am supposed to take pills like this?

I am flying out to see my daughter’s

family in a couple of weeks and I am

worried about taking my medications

there.

I have always had a hard time

swallowing pills but it seems to get

worse as I get older. Sometimes I try

to break them so they are smaller or I

try to chew them but I can’t always

do it and this also gets me off

schedule.


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Talk About It!

Before we begin, let’s review how to use adverbs of frequency when

speaking and writing English.

Adverbs of Frequency

Adverbs of Frequency answer the question "How often?" or "How

frequently?" They tell us how often somebody does something.

Adverbs of frequency come before the main verb (except the main verb "to

be"):

• We usually go shopping on Saturday.

• I have often forgotten to take my medicine.

• She is always late.

Occasionally, sometimes, often, frequently and usually can also go at the

beginning or end of a sentence:

• Sometimes I have problems swallowing my medication.

• I have problems understanding the labels occasionally.


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Rarely and seldom can also go at the end of a sentence (often with "very"):

• I talk to the doctor about my medications rarely.

• John goes to the pharmacy very seldom.

Adverbs of frequency express a continuum of meaning with “always”

meaning 100% of the time, never meaning 0% of the time and all of the

other adverbs falling in between:


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Now check your understanding by filling in the gaps with the

correct adverb of frequency (there may be more than one

correct answer.)

1. My sister and I (30%) __________ go to the doctor

together.

2. Andrea (90%) __________ keeps her medications

organized in color-coded containers.

3. I (20%) __________take the time to organize my

medications.

4. I have (0%) __________ asked my pharmacists for help managing my

medications.

5. Eleanor (40%) _________ forgets to take her medication.

100% always

usually

frequently

often

50% sometimes

occasionally

rarely

seldom

hardly ever

0%

never


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Activity One:

Read the following medication labels and answer the questions that follow

with your classmates and teacher.

PRESCRIPTION LABEL ONE:

________________________________

CVS Pharmacy PH: 215-662-0333

3915 Walnut Street, Philadelphia, PA 19104

RX: 376083 Prescriber: Dr. Judy Summers

Take one tablet twice a day.

ADALET 10 MG TABLETS

QTY 30

1 Refill

Rph. Larry Gross

Date Filled: 4/23/04

Take with food.

May cause disorientation or dizziness. Avoid

driving or operating machinery while taking this

medication.

_________________________________________


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If you were prescribed this medication,

1. How many pills should you take every day?

2. How often should you take it?

3. Can you take it on an empty stomach?

4. What are the side effects?

5. What is the name of the pharmacist?

6. What is the prescription number?


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PRESCRIPTION LABEL TWO:

__________________________________________

CVS Pharmacy PH: 215-662-0333

3915 Walnut Street, Philadelphia, PA 19104

RX: 376083 Prescriber: Dr. Judy Summers

Take two tablets per day, one in AM and one in PM.

LOZOL 5 MG TABLETS

QTY 25

2 Refills

Rph. Larry Gross

Date Filled: 4/23/04

May be taken with or without food.

May cause headache.

May cause skin rash.

_______________________________________________


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If you were prescribed this medication,

1. How many pills should you take every day?

2. What is the name of the medication?

3. What is the name of the pharmacist?

4. What are the side effects?

5. What is the prescription number?

6. How many refills do you have?


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Health Watch: Understand Over-the-Counter Drug Labels

• Reading the product label is the most important part of taking care of

yourself or your family when using over-the-counter (OTC) medicines

(those that are available without a prescription). This is especially true

because you probably take OTC medicines without first seeing a

doctor.


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Activity Two:

Discuss the following statements with your classmates and teacher. For

each one, fill in the gap with an adverb of frequency and explain why.

I ____________ ask my doctor:

• The name of the medicine she is prescribing and what it is supposed

to do

• If there is a generic equivalent that I can buy that might be cheaper.

• How and when I should take the medicine, how much to take, and for

how long.

• What food, drinks, other medicines, or activities I should avoid while

taking the medicine.

• If the medicine will interfere with other medicines I take

• What side effects the medicine may have and what to do if they occur

• If there is written information in my native language that I can take

home.


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I __________:

• Throw away expired medicines.

• Keep medicines in their original containers or in containers with

sections for daily doses (see box below).

• Stop taking medicines your doctor has prescribed when I feel better.

• Drink alcohol while on a medicine.

• Share medications with others


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RReeaall PPrraaccttiiccee IInntteerrmmeeddiiaattee

Goals for this lesson: Below are some of the goals of this lesson. Which ones are your goals too?

Check (√) them.


labels


42


Real Practice!

One easy way to help you and your doctor better manage your medical

treatment is to keep an accurate, up-to-date Medicine log. Fill in the log

with each medication you take, your reason for taking it, the doctor who

prescribed the medication and any information about how long you have

taken the medication and any side effects you have experienced. Make

copies to keep at home for easy access in case of an emergency as well as to

bring to your doctor’s appointment.


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Medicine Log

Prescription Medicine Log

(make copies as needed.)

Medicine

Name/Dose Color/Shape

Reason

For

Taking

Prescribed

By

Date

Started/Stopped

Side

Effects/notes

(sample:)

Precose

50mg 3 x

day

White/round Diabetes Dr.Johnson 5/98 to present Take at each

start of meal

1.

2.

3.

4.

5.

6.


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Over-The-Counter Medicine Log

(make copies as needed.) List Vitamins, Minerals, Herbs, too.

Name/Dose Reason For

Taking How Often

Side

Effects/Notes

(sample:) Tums

500mg Get Calcium

1 tablet 2x

Daily None

1.

2.

3.

4.

5.

© copyright 2001

Seniors Health@Home Online

American Institute for Preventive Medicine


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A Thematic Unit for Intermediate Level ESL Teachers

Intermediate Level, Unit Five: Taking Medication Lesson One: Managing Your Medications

Checklist for Learning

Vocabulary Log: In the space below, write down all of the new words you learned during this

lesson that you want to remember. Try to separate your list of words into nouns

(person, place or thing), adjectives (describing words) and verbs (action

words). For extra practice use them in sentences of your own.

New words I learned during this lesson:

Nouns:

Adjectives:

Verbs:

What can you do?

Below are some of the language goals you worked on during this lesson. Check

(√) what you learned from this lesson. Add more ideas if you wish.

I learned to…


labels � _________________________________________________________ ___


46



LLeessssoonn TTwwoo TTaakkiinngg MMeeddiiccaattiioonnss SSaaffeellyy




� Learn how to prevent dangerous drug interactions � Practice commonly used preposition clusters � Review using prepositions to describe place and movement


47

Lesson Two: Taking Medications Safely


Before You Read!

In this lesson, you will read about Supark and some problems he had with

drug interactions.

Activity One:

Before you read, discuss the following questions with your classmates and

teacher.

1. What is a drug interaction?

2. Do you know an elderly person who suffered from a drug interaction

or a serious fall? If so, describe what happened.

Before we go on: a quick review of common preposition clusters.


48

A preposition cluster is a combination of a noun + preposition or an

adjective plus preposition.

Prepositions + Noun Clusters

FOR

Use “for” preceeded by the following nouns: check, demand, need, and

reason.

Examples: He gave me a check for $40.

There’s a huge demand for the flu shot this season.

There is a real need for affordable medication in the

United States.

I have a reason for keeping a medication logbook.

IN

Use “in” preceded by the following nouns: rise, increase, fall, and decrease.

Examples: There has been a rise in prices recently.

We have seen many decreases in heart disease in our

family since people stopped smoking.


49

OF

Use “of” preceded by the following nouns: cause and photograph.

Examples: She is the cause of all his problems.

He took a photograph of the mountains.

TO

Use “to” preceded by the following nouns: damage, invited, reaction, and

solution.

Examples: I did a lot of damage to my lungs by smoking for 30

years.

We were invited to their wedding.

Her reaction to the new medication made me anxious.

The pharmacist provided the solution to my problem

understanding directions by finding someone who can

translate the instructions.

WITH

Use “with” preceded by the following nouns: relationship, connection, and

contact.

Examples: My relationship with my doctor is sometimes difficult..


50

His connections with the Spanish-speaking community

are very limited.

It helps to have contact with other Hispanic patients to

understand our culture.

BETWEEN

Use “between” preceded by the following nouns: connection, relationship,

contact, and difference.

Examples: There is no connection between going outside in the

winter and getting sick.

The relationship between the two friends was very

strong.

There is little contact between the two parents.

There is no difference between generic and name-brand

drugs.


51

Now read about Supark.

Reading Three - Dangerous Side Effects

My name is Supark and I am from Thailand. Because I have several

chronic conditions, I am always on medication so I have to be careful about

drug interactions. About two years ago, I had an accident in my home. I

was walking across the living room to turn on the television and I tripped

over a stool. Even though the stool has always been there, I didn’t see it and

I fell. I was injured and I couldn’t move. My wife had to call “911” and an

ambulance came to take me to the emergency room. I felt stupid and

embarrassed.

The doctor in the emergency room asked me questions about my

medications. I told him that I take pills for high blood pressure and heart

problems, painkillers for my knee and on that day I had taken a Benedryl

tablet to help with my springtime allergies. I learned from him that anyone

taking more than four medications is at risk of falling and that some of my

pills could make me dizzy. After that I spoke with my regular doctor about

my medications and we worked out a new plan. The doctor also sent a

social worker to our house who looked at our rooms and showed us ways we

can prevent falling accidents. At first I thought it was strange for someone

to come into our house and do this, but Wendy was very friendly and


52

helpful. Now I am much more careful about walking in the house and I am

careful reading the warning labels and talking to my doctor and pharmacist

before I begin taking any medication.


Activity One:

1. How did Supark fall?

2. Why does the doctor think Supark fell?

3. What did Supark’s doctor do to help him with this problem?

4. Who is Wendy and why did she come to Supark’s house?


53

Activity Two:

Finish these sentences supplying the correct proposition (there may be more

than one correct answer):

1. The cause _________ (preposition) Supark’s accident was a drug

interaction.

2. Supark had taken a Benedryl tablet ________ (preposition) his

springtime allergies.

3. Supark’s doctor told him not to take Benedryl __________

(preposition) the other drugs he is also taking.

4. He said there is a big connection _______________ (preposition) the

number of medications you take and falling.

5. Supark’s meeting __________ (preposition) the social worker was

useful because it helped him to make his home a safer place.

6. Because of his fall, Supark realized that there is a very important

reason _________ (preposition) read the warning labels on

medications.

7. He now talks _________ (preposition) his doctor or pharmacist before

taking any new medication.


54

Now read the following Health Watch article and answer the questions that

follow.


55

Health Watch: What You Should Know About Drug Interactions

As you learned in the last lesson, it is also more important than ever to know

about the medicines you take. If you take several different medicines, see

more than one doctor, or have certain health conditions, you and your

doctors need to be aware of all the medicines you take. Doing so will help

you to avoid potential problems such as drug interactions.

Drug interactions may make your drug less effective, cause unexpected side

effects, or increase the action of a particular drug. Some drug interactions

can even be harmful to you. Reading the label every time you use a

nonprescription or prescription drug and taking the time to learn about drug

interactions may be critical to your health. You can lower your risk of

harmful drug interactions and side effects with a little bit of knowledge and

common sense. Drug interactions fall into three broad categories:

1. Drug-drug interactions occur when two or more drugs react with each

other. This drug-drug interaction may cause you to experience an

unexpected side effect. For example, mixing a drug you take to help

you sleep (a sedative) and a drug you take for allergies (an

antihistamine) can slow your reactions and make driving a car or

operating machinery dangerous.

2. Drug-food/beverage interactions result from drugs reacting with foods

or beverages. For example, mixing alcohol with some drugs may

cause you to feel tired or slow your reactions.

3. Drug-condition interactions may occur when an existing medical

condition makes certain drugs potentially harmful. For example, if


56

Activity Three:

Answer the following questions about drug interactions. Be careful about

using prepositions as you discuss your answers with your classmates and

teachers.

1. What are the causes of drug interactions?

2. What are possible solutions to this problem?

3. Do you fall into a risk category for possible interactions? If so, talk

about what you will do to make sure this doesn’t happen.


57

Now let’s review more preposition clusters.

Adjective + Preposition Clusters

ABOUT

Use the adjective 'about' after angry, annoyed, and furious, excited, worried,

upset, and sorry. Use the verb 'to be' with these expressions.

Examples: I'm really worried about the increasing costs of my

prescription medicines!

AT

Use the adjective 'at' after good, excellent, bad, and terrible.

Example: My pharmacist is very good at explaining everything I need

to know about taking my prescription medicines.

AT / BY

Use the adjective 'at' or 'by' after surprised and amazed.

Example: I was amazed at how many different medicines my neighbor

takes for her heart condition.


58

FOR

Use the adjective ‘for’ after famous, responsible, sorry and to feel sorry.

Example: He's famous for winning the Tour de France after beating

cancer. At first people felt sorry for him but now that he’s

responsible for 6 U.S victories in bicyling, people admire

him.

FROM

Use the adjective 'from' after different (from something or someone).

Example: His drinking habits are very different from before. He’s

stopped drinking beer now that he regularly takes

medication.

Above adapted from http://esl.about.com/library/grammar


59

Activity Four:

Now read the Marielena’s story and fill-in the blanks with the proper

preposition

I am an anxious person and lately I’ve been worrying a lot ____________

the number of medications my husband and I need to keep track of. His

eyesight isn’t very good so I’ve been responsible ________ reading all of

the labels and making sure he takes the right pill at the right time. I get

angry _________ all of the medications we need to take. He has heart

disease and several complications from diabetes. I have osteoporosis and

arthritis. Our lives are very different ___________ before when we had

more extra money to spend on fun things like going out to dinner. Now we

spend so much money or our medication. I am amazed ______ how much

our bill is at the pharmacy. And I am always worried ___________ the

possibility of some kind of bad side effect. So I have to read all of the

instructions for both our medicines. I think my pharmacist feels sorry

_________ me because he is wonderful ______ giving me advice and

making sure I understand all of the instructions. Sometimes he even asks

someone to explain things to me in Spanish.


60




LLiisstteenniinngg aanndd SSppeeaakkiinngg PPrraaccttiiccee IInntteerrmmeeddiiaattee



� Know the risk factors and prevention tips for falling � Learn tips for making your home a safer place to live


61

Lesson Two: Taking Medications Safely


Before You Listen!

Before you listen, read through the following Health Watch article. Discuss

any words you do not know with your classmates and teacher and answer

the questions that follow.


62

Health Watch: Preventing Falls

Everyone knows an older adult who has suffered from a fall. Some people

believe that falling is a normal part of aging or that people fall because they are

old. However, there are certain risk factors which increase an older person’s

chances of falling. If you know these factors, you can work towards preventing a

serious fall.

Factor #1: Osteoporosis

Osteoporosis is a condition where bones become weaker. Caused by hormonal

changes, to little calcium and vitamin D, and a decrease in physical activity,

osteoporosis often causes fractures in older adults, especially among women.

What you can do:

� Eat or drink sufficient calcium. Postmenopausal women need 1,500 mg of

calcium daily. Calcium-rich foods include milk, yogurt, cheese, fish and

shellfish, selected vegetables such as broccoli, soybeans, collards and turnip

greens, tofu and almonds.

� Get sufficient vitamin D in order to help the body absorb calcium.

� Regularly do weight-bearing exercises.


63

Factor #2: Lack of Physical Activity

If you do not exercise regularly your body loses muscle tone, strength, bone mass

and flexibility. This causes falls and increases injury due to falls.

What you can do:

� Exercise every other day for about 15 minutes to increase muscle and bone

strength, and to improve balance and flexibility.

� Be careful when doing daily activities such as reaching and bending

properly. Take time to recover balance when rising from a chair or bed.

Learn the proper way to fall, and how to recover after a fall.

� Wear supportive shoes with low heels or rubber soles.

Factor #3: Vision Problems

Age-related vision problems such as cataracts and glaucoma can increase the risk

of falling. People with problems seeing have difficulties moving safely.

What you can do:

� Have regular checkups by an ophthalmologist (eye doctor).

� Use color strips to identify balance-aiding objects in the home (e.g., grab

bars and handrails) and first and last steps to identify change of level.

� Clean eye glasses often to improve visibility.


64

Factor #4: Medications

Many medications can cause falls by reducing mental alertness, by causing you to

lose your balance and by causing drops in systolic blood pressure while standing.

The more medications you are taking at one time, the greater your risk of falling.

What you can do:

� Know the common side effects of all the medications you take.

� Talk with your physician or pharmacist about ways to reduce your chances

of falling by using the lowest effective dosage, and the need for walking

aids while taking medications that affect balance.

� Remove all out-of-date medications and those medications you no longer

use from your home.

� Have your doctor or pharmacist review all of the current medications you

are taking to look for possible dangerous interactions.

� Limit the amount of alcohol you drink as it may interact with medications.

Factor #5: Environmental Hazards

At least one-third of all falls in the elderly in are because of hazards in the home.

The most common hazard for falls is tripping over objects on the floor. Other

hazards are poor lighting, loose rugs, lack of grab bars or poorly located/mounted

grab bars, and unsteady furniture.


65

What you can do:

� Walk though your home to look for possible problems that may lead to

falling.

� Consider a home visit by a occupational therapist or social worker who is

trained to identify risk factors and recommend solutions.

Outdoors

� Repair cracks and uneven edges of sidewalks and driveways.

� Install handrails on stairs and steps.

� Remove high doorway thresholds.

� Trim shrubbery along the pathway to the home.

� Keep walk areas clear of clutter, rocks and tools.

� Keep walk areas clear of snow and ice.

� Install bright lighting by doorways and along walkways leading to doors.

All Living Spaces

� Use a bright color strip to warn of uneven surfaces or sudden steps up or

down.

� Secure rugs with nonskid tape as well as carpet edges.

� Avoid throw rugs.

� Have at least one phone in each level of the home and post emergency

numbers at each phone.


66

� Reduce clutter.

� Make sure lighting is bright enough for you to see.

� Put nightlights or motion-sensitive lighting throughout home.

� Install electronic emergency response system if needed.

Adapted from report by K.R. Tremblay Jr., Colorado State University Cooperative Extension housing specialist and professor,

design and merchandising; C.E. Barber, Colorado State University professor, human development and family studies. 5/96.

Revised 3/01.

1. What factors increase your risk of falling? Fill in the chart below in

your own words with your classmates and instructor and discuss – are

you or someone you know at risk of falling?

Risk Factor Solutions to Problem Osteoporosis

Getting no exercise

Can’t see very well

Taking multiple medications

Dangers in the home


67

Listening Two: Making Your Home Safe

**Note to teacher: Do not pass out the written message in the box below. Record it onto a cassette (if possible with someone to play the second role in the dialogue) and have students listen to the recording. Play once or twice before they begin to listen for specific information. Listen to the news broadcast’s healthy lifestyles reporter discuss ways to

make homes more safe.

Reporter: Good evening John. Tonight we have a special segment for viewers who are worried about falling. An injury from a fall can limit a person's ability to lead an active, independent life. This is especially true for older people who are at greater risk of falling and hurting themselves. But these falls don’t have to happen. Many falls can be prevented by making simple changes in the home or personal practices. For example:

First think about the bathroom - with tile and slippery wet surfaces this room can be especially dangerous. Steps you can take to make it safer include changing to a toilet that is taller and easier to sit on, installing grab bars in the bath and/or shower and making sure to use non-skid mats and special decals in the tub or shower that help you to keep your balance. Also use nightlights and make sure that you dry wet floors before you walk on them.

Now let’s turn to the bedroom. Some people are surprised at how many things you can do to improve safety in this room. In your bedroom you should have a telephone and a lamp next to your bed. You should also have the bed adjusted to a height that is easy for you to get in and out of. And, as in the bathroom, make sure to use nightlights in case you need to get up quickly in the middle of the night.

If your home has stairs and hallways, make sure that you always pick up clutter. Even a newspaper left on a step can cause an accident. And, since these areas are sometimes dark, make sure you have enough light to see clearly. If you have carpets in these areas, make sure that they are secured to the floor. Also consider installing hand rails on both sides of stairways and make sure all hand rails are steady.


68

In living areas such as the living room, dining room and family room, remove cords from walking paths, arrange furniture to provide for clear pathways, adjust couch / chair height for ease of standing up and provide adequate lighting.

Activity One:

Listen and check the tips that you hear the reporter say.

□ Install grab bars in the shower

□ Dry wet floors before you walk on them

□ Leave the lights on when you go to bed

□ Pick up clutter

□ Remove carpets from your home

□ Remove cords from walking paths


69

Activity Two:

Listen again and try to list all of the tips the reporter gives for each of the

rooms listed below.

Bathroom:

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

Bedroom:

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________


70

Stairs and Hallways:

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

Living Areas:

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________


71

Talk About It!

Remember Supark from Reading One of this lesson? Let’s talk about

Supark’s risk for falling before his accident and some of the ways he can

make improvements. Before you begin, review the meanings of the following

prepositions of position and direction with your classmates and teacher.

Prepositions of Position

Prepositions of Direction

At the back of

at the bottom of

at the top of

behind

beneath

between

in the corner of

in the middle of

next to

to the left of

on the other side of

to the right of

on the side of

on top of

opposite

across

between

into

out of

past

round

through

towards

List from http://esl.about.com/library/grammar/blgr_prep9.htm


72

Activity One:

Work with a partner to think about the falling hazards in Supark’s living

room and make suggestions about how he could make his home safer. As

you discuss your solutions, remember to use correct prepositions to describe

the changes you think Supark should make to his living room.

Supark’s Living Room

Supark lives in a small apartment. In his living room there is a large sofa,

two end tables, a large chair, a coffee table, a television, a fan, and a

bookcase. There is a broken lamp on one of the end tables.

The sofa is old and comfortable but sits very low to the ground and so is

difficult to get in and out of. The two end tables are to the left and to the

right of the sofa.

The coffee table is in front of the sofa - very close to the sofa - and is

covered with magazines. There are also stacks of magazines beneath the

coffee table, on the floor in front of the television and on top of the

bookcase. The book case is full of books and is a little unsteady


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There is a cord on the floor connecting the fan to an outlet in the wall. The

only way to turn the fan on and off is by unplugging it. The plug is behind

the chair.

In the middle of the room, between the sofa and the television there is a

throw rug that Supark uses to cover the hardwood floors.

1. What are the falling hazards?

2. What changes do you think Supark should make to his living room to

make his home safer?

Activity Two:

Now write a description of a room in your house in the space below. Be

careful to use the correct prepositions. When you have finished the

description of your room, share it with your partner and discuss any falling

hazards.


74







� Learn how to prevent dangerous drug interactions � Practice commonly used preposition clusters � Review using prepositions to describe place and movement


75

Lesson Two: Taking Medications Safely Real Practice

Checking Your Home

Carefully walk through your home with the checklist below. Answer each

item and take notes on any concerns that you have. Report the results to

your class and discuss any actions you have taken or need to take.

This checklist is a series of questions, which look at safety in and around

your home. If you answer 'no' to any of the questions, the checklist suggests

action you can take to make your home safer. Most changes are easy and

inexpensive. Many of the items you may need such as paint, handrails, slip-

resistant strips and lighting are available from hardware or department

stores. Sales assistants or local service organizations will usually be able to

help arrange someone to install the items where necessary.

It's up to you to take steps to prevent a fall.


76

Checklist Suggestions

FLOORS - Answer YES or NO

1. Do your carpets and mats lie flat

without wrinkles or curled edges?

Y/N

2. Do loose mats have a slip-resistant

backing?

Y/N

3. Do you clean up spills as soon as

they occur?

Y/N

4. Are floors free of clutter?

Y/N

5. Are all cords safely away from

walkways?

Y/N

6. Are floor surfaces non slip?

Y/N

FLOORS

- You are less likely to slip on

surfaces such as carpet or unglazed

tiles. These surfaces are preferable to

polished floors which can be very

slippery.

- There are also paint on non-slip

products.

- Remove all loose mats or ensure

they are firmly secured and have

non-slip underlay.

- Make sure your carpets are in good

condition.

- Always wipe up spills as soon as

they occur. Some floor surfaces are

particularly slippery when wet.


77

LIGHTING - Answer YES or NO

1. Are your lights bright enough for

you to see clearly?

Y/N

2. Are stairs and steps well lit?

Y/N

3. Are light switches easy to reach

and near each doorway?

Y/N

4. Can you easily switch on a light

from your bed?

Y/N

5. Is there good lighting where you

keep medicines?

Y/N

LIGHTING

- We recommend 75 watt globes in

all rooms, passageways and

stairwells. (Note that some light

fittings take a maximum of 60 watts).

- Nightlights are an inexpensive way

to provide light to dark passageways

at night.

- Consider installing movement

activated or photo electric lights to

illuminate passageways.

- Have extra lights installed or place

lamps in dark areas.

- Allow time for your eyes to adjust

when going to and from light and

dark areas.


78

STAIRS, STEPS and LADDERS-

Answer YES or NO

1. Are you able to see the edges of

the steps clearly?

Y/N

2. Are stairs and steps well lit?

Y/N

3. Is there a light switch at top and

bottom of steps?

Y/N

4. Are non-skid treads or paint used

on the edges of each step?

Y/N

5. Are coverings on steps in good

condition?

Y/N

6. Do the steps have a sturdy

handrail?

Y/N

STAIRS, STEPS and LADDERS

- Stairs may need extra lighting.

- Lights which turn on automatically

are recommended.

- Make sure there are handrails on at

least one side of all stairways.

- Handrails on both sides of steps are

preferable where possible.

- Move frequently used items to

reduce the need for ladders.

- Have someone with you if it is

necessary to use a ladder.

- Ensure your stepladder is in good

condition. Ladders with handrails are

recommended.


79

7. Is your stepladder or stepstool

short and sturdy with anti-slip feet?

Y/N

BATHROOM AND TOILET -

Answer YES or NO

1. Do you use slip-resistant mats in

the bathroom?

Y/N

2. Is the soap, shampoo and towel

within easy reach so you don't have

to bend or reach too far?

Y/N

3. Are you able to get out of the bath

or shower without holding onto taps

or towel rails?

Y/N

4. Do you have handrails in the bath

and shower?

BATHROOM AND TOILET

- Wet areas are more likely to be

slippery and therefore hazardous.

Take extra care when on a wet

surface.

- Non-slip flooring is recommended

for bathrooms.

- Paint on or self adhesive non-slip

strips are advisable in the shower and

bath.

- Handrails are recommended in all

positions around the bath and toilet

where you need something to hold

on to.


80

Y/N

5. Are you able to easily get on and

off the toilet seat?

Y/N

6. Are you able to walk directly into

your shower without stepping over a

raised edge?

Y/N

KITCHEN - Answer YES or NO

1. Can you easily reach kitchen items

you use regularly without climbing,

bending or upsetting your balance?

Y/N

2. Is there good lighting over work

areas?

- Occupational Therapists from your

local Hospital can advise you on

hand rails and other equipment for

modifications to your bathroom to

ensure your maximum safety and

independence.

KITCHEN

- Arrange your kitchen so the most

frequently used items are easy to

reach.

- Counters and tables should be

sturdy enough to support your weight

if you lean on them.

- Range hoods, vents or exhaust fans


81

Y/N

3. Do you mop up spills

immediately?

Y/N

4. Is there good ventilation to reduce

the risk of eyeglasses fogging?

Y/N

LIVING ROOM - Answer YES or

NO

1. Can you get out of your lounge

chair easily?

Y/N

2. Are all cords, furniture and clutter

kept away from walkways?

Y/N

3. Is your furniture placed so that

you don't have to stretch or lean too

can be installed to provide better

ventilation when cooking.

- If possible install a wall oven in

preference to a low oven.

- Use a broad based, sturdy and

secure stepladder if it is absolutely

necessary to reach high places.

LIVING ROOM

- Higher chairs and chairs with solid

armrests are easier to get in and out

of.

- Keep telephone and electrical cords

clear of walkways.

- Fans and heaters should not be

placed in walkways or in the middle

of the room.


82

far to open windows?

Y/N

BEDROOM - Answer YES or NO

1. Can you turn on a light before you

get out of bed?

Y/N

2. Can you easily get in and out of

your bed?

Y/N

3. Do you have a telephone in the

bedroom?

Y/N

4. Is your electric blanket cord safely

secured so you don't trip? Is the

control easy to reach from the bed?

- Remove loose rugs or apply slip-

resistant backing or secure by other

means.

BEDROOM

- Have a light within reach of your

bed. Consider a touch lamp or night

lamp.

- Keep a flashlight next to your bed

at night.

- Keep floors clear in bedroom.

- Secure loose telephone and

electrical cords in the bedroom and

out of walkways.

- Ensure your eyeglasses are easy to

reach if you need them when you get

out of bed.


83

Y/N

5. Is your bedspread made without a

looped fringe?

Y/N

6. If you use walking aids, are they

easy to reach before you get out of

bed?

Y/N

CLOTHING AND FOOTWEAR -

Answer YES or NO

1. Do you wear shoes with non-slip

soles?

Y/N

2. Do your shoes have rounded broad

heels?

- Beds should be at a good height for

easy movement on or off.

- A firm mattress provides support.

This will make getting into and out

of bed easier.

- Get out of bed slowly - sit up

before you stand up.

- If you are having difficulty getting

in to or out of your bed, talk with an

- Occupational Therapist or

Community Nurse.

CLOTHING AND FOOTWEAR

- Shoes and slippers should have

non-slip soles with patterned tread

and rounded, broad heels.

- Avoid wearing socks only, loose

fitting slippers, leather or other


84

Y/N

3. Do you wear street shoes rather

than slippers outside the house?

Y/N

4. Does your clothing fit securely

with no dangling cords or hems?

Y/N

OUTSIDE YOUR HOUSE -

Answer YES or NO

1. Are the edges of steps clearly

marked?

Y/N

2. Do step edges have an adhesive

non-slip strip?

Y/N

3. Do steps have a sturdy, easy-to-

grip handrail?

Y/N

slippery soles and high heels.

- Clothing should be short enough to

avoid tripping

- Sit down rather than stand on one

leg when dressing.

OUTSIDE YOUR HOUSE

- Make sure all outside steps are

highly visible by painting the front

edge of the step a - contrasting color

or by putting on non-skid treads.

- Paths need to be even and

unbroken.

- Keep paths free of moss and leaves,

and take extra care in wet conditions.

- Walk carefully near pets or small


85

4. Are the paths around the house in

good repair?

Y/N

5. Are the paths and entrances well

lit at night?

Y/N

6. Is the garden kept free of hazards

(i.e. tools, hoses)?

Y/N

7. Are your garage floors free from

grease and oil?

Y/N

8. Are the public areas around your

house in good repair?

Y/N

animals, their movement is

unpredictable.

- Store garden tools safely.

- Many falls result from the use of

ladders. Be extremely careful. If you

cannot get someone else to assist you

ensure you comply with all safety

instructions.


86

ACTIONS NEEDED

1.

2.

3.

4.

5.

6.

7.

8.

9.

Checklist and suggestions from the NSW Multicultural Health Communication Service, Sydney Australia


87



Intermediate Level, Unit Five: Taking Medications Lesson Two: Taking Medications Safely







Nouns:

Adjectives:

Verbs:

What can you do?



I learned to…

� Know the warning signs of poor nutritional health and what you can do to improve your diet.

� Understan d the difference between count and non-count nouns � Be able to use the phrases “used to”, “be used to” and “get used to” to

compare the past to the present. � ___________________________________________________________ � ___________________________________________________________


88



LLeessssoonn TThhrreeee

AAlltteerrnnaattiivvee MMeeddiicciinnee


Goals for this lesson:

Below are some of the goals of this lesson. Which ones are your goals


� Learn about different types of alternative medicines and practices. � Discuss effective strategies for talking to your doctor about

alternative medicine.


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Lesson Three: Alternative Medicine

Reading and Writing Practice Before You Read! In this lesson, we will read about and discuss alternative medicines and

medical treatments. Before we read a story about Ching Yi’s experience

with Chinese herbal medicine, review the following definitions and answer

the questions with a partner.

Definitions

Alternative Medicine – Healthcare practices and approaches used instead of

conventional methods. For example, chiropractic care, acupuncture,

meditation, yoga, spiritual healing and Chinese herbal medicine (for

descriptions of these and other types of alternative medical treatments see

the Health Watch box below on page).

Conventional Medicine – Medicine and medical approaches practiced by

holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees and

by their allied health professionals, such as physical therapists,

psychologists, and registered nurses. Other terms for conventional medicine

include: western, mainstream, orthodox, and regular medicine; and

biomedicine. Some conventional medical practitioners are also practitioners

of alternative medicine.


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Questions:

1. Have you or someone you known received any kind of alternative

medical treatment? If so describe.

2. Do you believe in the power of something other than medical science

(medications, operations, etc.) to heal the human body?

3. Are alternative medical treatments common in your culture or a

culture you are familiar with? If yes, please describe.

Reading Four - Alternative or Conventional? Now read about Ching-Yi and her conflict with traditional Chinese medicine

and conventional medicine and answer the questions that follow with your

classmates and instructor.

My name is Ching-Yi and I am from Taiwan. About 6 months ago I

was diagnosed with cancer. My oncologist was very nice and spent a lot of

time talking to me about treatment. He said I would need to have surgery

and then begin chemotherapy. But when I told him I also wanted to talk to

my Chinese Doctor in Chinatown about possible herbal treatments, he

became upset. He told me that I could get sicker if I wasted my time with

these treatments. So I talked to my family doctor and he suggested I see

someone new, Dr. Laurence.


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I called Dr. Laurence first to see how she felt about traditional

Chinese medicine. She said it was fine as long as I continued my treatment

with her. I liked her even more after I went to visit her. She had done some

research and said that Chinese medicine can help reduce my nausea during

my chemotherapy treatment. She encouraged me to go, but she said that I

must report everything I take and do to her and that I need to check-in with

her before trying some new treatment or herb that might interfere with other

drugs. I feel worried and anxious about my cancer, but I am glad that I am

able to use both Western and Chinese medicine to help fight it.


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Health Watch: Alternative Medical Treatments

Traditional Chinese Medicine: Originating in China thousands of years ago,

this system is based on the theory that illness results from the improper flow

of the life force (qi) through the body. Various practices are used to preserve

and restore health, including herbal remedies, massage, meditation, and

acupuncture.

Acupuncture is one of the most widely accepted alternative medicine

techniques in the Western world. Licensed practitioners do not necessarily

have a medical degree, although some medical doctors, often pain

specialists, are trained and licensed to perform acupuncture. Acupuncture

involves stimulating specific points on the body, usually by inserting very

fine needles into the skin and underlying tissues. Sometimes, additional

stimulation is added with a very low voltage electrical current. The

procedure is not painful but may cause a tingling sensation. (A variation of

acupuncture, called acupressure, uses massage instead of needles.)

Ayurveda: Ayurveda is the traditional medical system of India, originating

more than 4,000 years ago. It is based on the theory that illness results from

the imbalance of the body's life force, or prana. Ayurveda uses herbs,

massage, yoga, and internal cleansing to restore balance within the body and with nature.

Homeopathy: Homeopathy, which was developed in Germany in the late

1700s, is based on the principle that "like cures like". In other words, a

substance that in large doses causes illness is believed to cure the same

illness if given in small doses. The remedies used in homeopathy are

derived from naturally occurring substances, such as plant extracts and


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Questions:

1. How did Ching-Yi’s first oncologist feel about Chinese herbal medicine?

Why do you think he feels this way?

2. How does Dr. Laurence feel about Chinese herbal medicine?

3. If you were diagnosed with a serious illness, would you seek help from

an alternative medicine practitioner? Do you think your doctor would

support you if you decided to receive some sort of alternative medical

treatment?


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LLiisstteenniinngg aanndd SSppeeaakkiinngg PPrraaccttiiccee IInntteerrmmeeddiiaattee


Below are some of the goals of this lesson. Which ones are your goals too?

Check (√) them.




95

Lesson Three: Alternative Medicine

Listening and Speaking Practice Before You Listen! Activity One:

Read through the following HealthWatch box and discuss the questions that

follow with your classmates and instructor.

Health Watch: Talking with Your Doctor About Alternative

Methods

Many patients are reluctant to discuss complementary or alternative methods

with their doctor. It’s true that many doctors may not know about the uses,

risks, and potential benefits of these treatments. However, this doesn’t have

to stop you. The following are several things you can do to communicate

effectively with your doctor.

� Gather as much information as possible on your own. Look for

information from reputable, credible sources on the potential benefits

and risks of the treatment you are thinking about.

� When you share this information with your doctor, do it in a non-


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confrontational manner. Let him or her know that you are thinking

about an alternative or complementary treatment and that you want to

make sure it will not interfere with your regular medical treatment.

� Make a list of questions and bring it along with any information you

want to talk about. Ask your doctor to be a supportive partner in your

education and treatment process.

� You might bring a friend or family member with you to the doctor’s

office to support you. He or she can also help you talk with your doctor

and relieve some of the stress of having to make decisions alone.

� Listen to what the doctor has to say, and try to understand his or her

point of view. If the treatment you are thinking about will cause

problems with your medical treatment, discuss safer choices together.

Don’t delay or skip regular treatment. If you are thinking about stopping

or not taking conventional treatment, please discuss this decision with

your doctor.

� If you are taking dietary supplements as part o f your treatment,

make a complete list of what you are taking and the amount. Many

supplements can interact in potentially harmful ways with other

medicines, so talk with your doctor and pharmacist about your

supplements. Report any changes to your health care team.


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� If you are pregnant or breastfeeding, ask about the risks and effects of

complementary or alternative methods. Never give herbal medicines to

children.

Many insurance companies are starting to cover some of the more widely

accepted complementary methods of treatment. Many major insurers,

including Blue Cross and Medicare, cover one or more complementary

methods of treatment. The ones most often covered are acupuncture and

chiropractic therapy. Contact your insurance company to find out what, if

any, services are covered by your plan.

If possible, you might want to get a recommendation or referral from your

doctor for the complementary therapy you are thinking about. Many

insurance companies require that the method be shown to be reasonable and

medically necessary, and it may help later on to have your doctor’s

recommendation. Insurance companies usually will not cover methods that

have not been proven to be effective.

Adapted from information from the American Cancer Society


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Questions:

1. If you are planning to talk to your doctor about seeking alternative

treatment for an illness or condition, what should you do to prepare?

2. Why is it important to give your doctor complete information about the

kinds of alternative treatments you are using (herbal remedies,

acupuncture…)?

3. Does health insurance pay for alternative treatments?


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Listening Three: Seeking Alternative Treatments

**Note to teacher: Do not pass out the written message in the box below. Record it onto a cassette (if possible with someone to play the second role in the dialogue) and have students listen to the recording. Play once or twice before they begin to listen for specific information.

Now you will listen to conversation between Sylvie and her doctor. Sylvie is

interested in seeking alternative medical treatment for her breast cancer.

She is anxious to get her doctor’s opinion about these types of treatments.

Listen to the advice Sylvie’s doctor gives her and then discuss the questions

that follow with your classmates and teacher.

Doctor Edwards: Do you have any questions Sylvie? Sylvie: Well…yes. My neighbor recommended that I try

acupuncture and herbal medicine to help me recover from surgery and chemotherapy…what do you think?

Doctor Edwards: Um…I know that many cancer patients are experimenting with these treatments but… (Sylvie interrupts) Sylvie: I know, I know…you’re probably going to say it’s a bad idea, but, I’ve done some research. Look at this brochure I brought from the Holistic Medical Center. Look what it says here (she reads):

Acupuncture and herbal medicine can be utilized before, during and after surgery, chemotherapy and radiation. It is very effective in reducing the side effects of these treatments.

Sylvie: I went to talk to them and I met a Dr. Lin. He said

that he could help me heal faster after surgery. He said that he had treatments that could help me with nausea during chemotherapy and even give me a better chance to beat the cancer.


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Doctor Edwards: Sylvie, listen, I’m not going to say it’s a bad idea.

I happen to know Dr. Lin very well. I took an acupuncture certification course last year and he was my teacher.

Sylvie: Really? You do acupuncture? Doctor Edwards: I’m learning about it. Look, I have no problem

with you seeking alternative treatment, especially with Dr. Lin. The Holistic Medical Center has a wonderful reputation and I have had many patients who have gone there.

Sylvie: So you think I should do it? Doctor Edwards: I won’t tell you what to do Sylvie. If you would

like to start complementing your care here with acupuncture or herbal therapies, which is up to you, but I do have some ground rules. Please let me know what you are planning to do before you do it. If you decide to start an herbal remedy, I want to discuss this with you. After you see Dr. Lin I’ll need you to make a complete list of his recommendations, which therapies he suggests, what you are taking and the amount...

Sylvie: Why? Are some of the herbal remedies dangerous? Doctor Edwards: Many supplements can interact in potentially

harmful ways with other medicines, so we’ll need to talk regularly and you need to be sure to tell us right away is you feel like you are having any unusual side effects.

Sylvie: Thanks doctor. I am so happy – and surprised that you are being so supportive about this.


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Doctor Edwards: Actually, Sylvie - there are many complementary treatment methods you can use safely. I’ve got patients who are doing aromatherapy, biofeedback, massage therapy, meditation, tai chi, yoga…these are very useful to help control some of their symptoms and improve the quality of their lives. But remember Sylvie; these treatments do not cure the cancer. Unfortunately, there are no silver bullets.

Questions:

1. What reasons does Sylvie give for wanting to seek alternative treatments

at the Holistic Center?

2. Does Dr. Edwards think it is a good idea for Sylvie to use acupuncture

and herbal remedies to complement her conventional medical treatments?

What makes you think so?

3. What does Dr. Edwards mean when he says, “But remember Sylvie, these

treatments do not cure the cancer. Unfortunately, there are no silver bullets.”


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Talk About It!

Before we begin, let’s review how to agree and disagree appropriately when

arguing your opinion in English.

Agreeing

In agreeing with a negative opinion in English, you may wish to qualify your

agreement with an expression of regret, etc.

That movie was terrible!

Yes, I am afraid it was.

I have to agree that it was.

I must say I thought it was too...

In other cases, you can be as enthusiastic as you like in emphasizing your

agreement.

*It was an interesting lesson, wasn’t it? – Yes, it was superb/absolutely

splendid!

*She is an amazing doctor. – Yes, definitely/quite/absolutely/I absolutely

agree/I couldn’t agree more/I quite agree/ I agree entirely.

*Alternative medicine isn’t for everybody. – Definitely not/It certainly

isn’t/You are absolutely right/ I agree completely/Exactly.


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You can show that you agree strongly with someone’s description of

something by repeating the adjective they have used and using "very" or

“extremely” in front of it. You can also use “indeed” after the adjective.

*It was very interesting, wasn’t it? – Very interesting indeed.

*The information on herbal medicine was helpful wasn’t it? – Oh, extremely

helpful.

Other ways of expressing agreement are:

*That’s just what I was thinking.

*You know, that’s exactly what I think.

*That’s a good point.

Qualified agreement

In discussion and argument, there is often a need to agree with one aspect of

a speaker’s view, and to disagree with another. Here are some of the

methods you might use to express this sort of qualified agreement:

*Certainly it’s true that …, but on the other hand…

*I can see that…. But surely…

*I am in total agreement with you about… but we also have to consider….

*Agreed, BUT if we accept… then it must also be true that…


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Corroboration

We can also agree, and add a further point to corroborate or confirm the

argument

*Yes, and in fact….

*Yes, and what is more…

*I agree, and in fact one might go so far as to say…

*Absolutely. Actually, I would go further, and say…

Disagreement

In English it is very important to be very polite when disagreeing with

someone – even someone you know quite well. Look at the responses to the

following statement about alternative medicine.

Alternative medicine is usually a waste of time.

-I am afraid I disagree with you: some alternative medical practices are

very effective, I think.

Or

- It can be, but sometimes it works very well.

Or

-Do you think so? Actually, I think it is very effective.


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The commonest ways to express disagreement are as follows:

*I’m not sure I agree.

*Well, you have a point there, but…

*Perhaps, but I don’t think that…

*I see what you mean, but…

*I am afraid I can’t agree with you there...

Strong disagreement

If you know someone very well you can disagree more directly using

expressions like these:

*You can’t be serious! You’ve got to be kidding!

*Come off it!

*Don’t be silly!

*No, that’s not right.

*I disagree…

*No, you’re wrong…

Note: You should be very careful when using these expressions, in order to

avoid offending people.


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Activity One:

Note to teacher: write the following controversial statements regarding the topic of alternative medicine on the blackboard:

• Western doctors don’t care about their patients. They just care about money!

• Alternative medicine is a waste of time. Anyone who believes in that stuff is crazy.

• Big drug companies are really bad for society. They take all of our money and they don’t give anything back.

Each learner should be given the chance to express their opinion on the given statements giving reasons/examples why they agree or disagree with it. The activity should be carried out in a circle and learners should link their opinion to the preceding one.

Activity Two:

Work with a partner to role play each of the following situations (take turns

playing the different roles). As you do, be sure to use appropriate phrases

as you agree/disagree with each other.


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Situation One:

Roles:

Doctor Martinez: You have been Marcia’s doctor for twelve years. You

have been treating her high blood pressure for six. Recently, Marcia told

you that she is going to stop taking her blood pressure medicine and start an

alternative therapy that includes herbal remedies, acupuncture and

therapeutic massage. You think that alternative medicine is a waste of time

and money. You are trying to convince Marcia not to do it.

Marcia: You do not like taking drugs. Your sister-in-law told you about a

therapy that she read about on the Internet. It is a combination of Chinese

herbal remedies and acupuncture guaranteed to lower high blood pressure.

You are convinced that this therapy will help you to feel better because you

will be able to stop taking your high blood pressure medications.

Situation:

Doctor Martinez: So…Marcia, how are you feeling? How is that new

medicine working that you are taking for high blood pressure?

Marcia: …

Play out the rest of the conversation…


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Situation Two:

Roles:

Ravi: You have been doing yoga for thirty years. You believe that yoga is

a wonderful way to exercise, and you also believe that it is extremely good

for your health because it gives you energy and helps your body fight against

disease. In your experience, you have seen many people who have

improved their health. These people have reduced pain and reduced the

symptoms of chronic diseases like high blood pressure through practicing

yoga.

Sam (Ravi’s co-worker): You recently saw a show about yoga on

television. You think people who practice yoga are crazy. You don’t

believe that standing in one place and stretching can help anyone’s health.

You believe the only way to treat poor health is by going to the doctor.

Situation:

Bob: Oh my god…I saw the funniest thing on television yesterday. It was

yoga class. The instructor was talking about how yoga can reduce stress,

help lower high blood pressure, and fight disease. Those people must be

crazy…

Ravi… Play out the rest of the conversation…


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Below are some of the goals of this lesson. Which ones are your goals too?

Check (√) them.




110

Lesson Three: Alternative Medicine Real Practice! Are you currently complementing your health care with alternative

treatments – or are you thinking about doing so? If yes, here is a checklist

of questions to ask about selecting a practitioner for alternative or

complementary treatments:

Questions to ask when selecting a practitioner:

� Ask what training or other qualifications the practitioner has. Ask

about her education, additional training, licenses, and certifications. If

you contacted a professional organization, see if the practitioner's

qualifications meet the standards for training and licensing for that

profession.

� Ask if it is possible to have a brief consultation in person or by phone

with the practitioner. This will give you a chance to speak with the

practitioner directly. The consultation may or may not involve a

charge.

� Ask if there are diseases/health conditions in which the practitioner

specializes and how frequently he treats patients with problems

similar to yours.

� Ask if the practitioner believes the therapy can effectively address

your complaint and if there is any scientific research supporting the

treatment's use for your condition.


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� Ask how many patients the practitioner typically sees in a day, and

how much time she spends with each patient.

� Ask whether there is a brochure or Web site to tell you more about the

practice.

� Ask about charges and payment options. How much do treatments

cost? If you have insurance, does the practitioner accept your

insurance or participate in your insurer's network? Even with

insurance, you may be responsible for a percentage of the cost.

� Ask about the hours appointments are offered. How long is the wait

for an appointment? Consider whether this will be convenient for your

schedule.

� Ask about office location. If you are concerned, ask about public

transportation and parking. If you need a building with an elevator or

a wheelchair ramp, ask about them.

� Ask what will be involved in the first visit or assessment.

Once you have gathered the information, assess the answers and determine

which practitioner was best able to respond to your questions and best suits

your needs.


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Questions to ask at your first visit:

The first visit is very important. Come prepared to answer questions about

your health history, such as surgeries, injuries, and major illnesses, as well

as prescriptions, vitamins, and other supplements you take. Not only will the

practitioner wish to gather information from you, but you will want to ask

questions, too. Write down ahead of time the questions you want to ask, or

take a family member or friend with you to help you remember the questions

and answers.

What benefits can I expect from this therapy?

� What are the risks associated with this therapy?

� Do the benefits outweigh the risks for my disease or condition?

� What side effects can be expected?

� Will the therapy interfere with any of my daily activities?

� How long will I need to undergo treatment? How often will my

progress or plan of treatment be assessed?

� Will I need to buy any equipment or supplies?

� Could the therapy interact with conventional treatments?

� Are there any conditions for which this treatment should not be used?


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How do I know if the practitioner I have selected is right for me?

After your first visit with a practitioner, evaluate the visit. Ask yourself:

� Was the practitioner easy to talk to? Did the practitioner make me

feel comfortable?

� Was I comfortable asking questions? Did the practitioner appear

willing to answer them, and were they answered to my

satisfaction?

� Was the practitioner open to how both the alternative therapy and

conventional medicine might work together for my benefit?

� Did the practitioner get to know me and ask me about my

condition?

� Did the practitioner seem knowledgeable about my specific health

condition?

� Does the treatment recommended seem reasonable and acceptable

to me?

� Was the practitioner clear about the time and costs associated with

treatment?


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Intermediate Level, Unit Five: Taking Medications Lesson Three: Alternative Medicine







Nouns:

Adjectives:

Verbs:

What can you do?



I learned to…

� Know the warning signs of poor nutritional health and what you can do to improve your diet.

� Understand the difference between count and non-count nouns � Be able to use the phrases “used to”, “be used to” and “get used to” to

compare the past to the present. � ___________________________________________________________ � ___________________________________________________________

esl health unit unit five - spring institute esl students...

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