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Understanding the Types of Rehab for Stroke Therapy

February 15, 2019

A breakdown of the various offerings and where insurance fits in
By Lisa Fields

After a stroke, only about 10 percent of people recover almost completely without intervention. For everyone else, therapy is a crucial part of the recovery process. Whether you need physical, occupational and/or speech therapy following a stroke depends on your needs, but the goal is the same: to help you regain control of your body and be independent once again. The therapy you receive should be tailor-made to suit your lifestyle.

“Is the goal returning to driving or returning to work, or (is the person) a retiree who needs to take care of their own bodily functions and participate in playing with a grandchild?” says Glen Gillen, professor and director of programs in occupational therapy at Columbia University in New York and a fellow of the American Occupational Therapy Association.

Kinds of Rehabilitation Facilities

Most stroke patients stay in the hospital for five to six days. Their therapy needs are assessed within the first two days, and therapy may begin on the second. Some patients are sent home from the hospital right away. They may receive outpatient therapy sessions three times a week or get therapy at home from visiting nurses or therapists.

“If they’re higher-functioning, they can potentially go to outpatient therapy, if they have the means to get there,” Gillen says. “That is a challenge for many.”

Many stroke patients are discharged from the hospital to inpatient rehabilitation facilities, where they receive therapy at an intensity that’s best for their needs, based on the severity of the disability. Some go to acute inpatient rehab facilities, which offer the most intense therapy for the most responsive patients. Those with a greater degree of impairment may be sent to “subacute rehab” facilities, where the therapy isn’t as intense as acute rehab.

At acute rehab facilities, “people are guaranteed a minimum of three hours of therapy a day, and a physician visits six days a week,” says Dr. Alexander Dromerick, professor of rehabilitation medicine and neurology and chairman of rehabilitation medicine at Georgetown University Medical Center in Washington, D.C. “(At a subacute facility), they may get a few minutes a day, up to two hours a day, of therapy, and a physician visits every few weeks. They’re very different levels of intensity of care.”

Patients who are making great strides in a subacute facility might be moved to an acute facility for more intense therapy. Those who don’t have the endurance to tolerate an acute facility’s therapy, might be transferred to a subacute facility. “A subacute unit can be a way station back to the community,” Dromerick says, “or it can be a way station to go to a nursing home for the long term.”

Types of Therapy for Stroke Patients

Stroke patients often need physical therapy to strengthen their muscles, retrain their sense of balance and coordination and relearn certain movements. They may need occupational therapy to ensure they can do the tasks associated with daily living, like getting dressed, feeding themselves, showering or relearning skills necessary to return to work. Speech therapy also might be required to relearn how to speak or swallow food.

“Sometimes occupational therapists and physical therapists work together, but occupational therapists focus more on mobility activities that have to do with returning to work or returning to their role in their family or community,” says Carolee Winstein, professor of biokinesiology and physical therapy and director of the Motor Behavior and Neurorehabilitation Laboratory at the University of Southern California. “Physical therapists work on fundamental skills that are needed to be functional in their particular life, whatever it is. We work a lot on mobility. We teach people a lot about the importance of remaining physically active.”

Physical therapists help patients overcome physical challenges — this includes when a stroke has weakened or partially paralyzed one side of the body. Medical professionals refer to that side as “paretic.”

“If they’re having trouble reaching and grasping with their paretic side, I have them do it with their less paretic side to remind them what it should feel like,” Winstein says. “A lot of motor skills are implicit — we don’t think; we do it automatically.”

Occupational and speech therapists also address cognitive challenges.

“We consider most tasks physical, like dressing yourself, (but) all tasks that we do across the day have a cognitive component,” Gillen says. “With getting dressed, it’s the sequence of the clothing: which goes on what body part, which goes on first. If cognition is involved after a stroke, it’s a time-consuming process. We know it will take much longer, much more repetition of practice to get them there.”

Insurance Plans Could Limit Therapy

Health insurance may limit how much therapy a person can receive during a single calendar year or during his or her lifetime. If a person can afford to pay out of pocket, he or she may continue therapy without interruption. Otherwise, many therapists offer plans that patients can follow at home or at a fitness center either on their own or with the help of a family member, friend or personal trainer.

“You can keep working on the stroke problems indefinitely,” Dromerick says.

Therapists hope to get stroke patients functioning independently again, even after their sessions are complete.

“They may need a cane and a brace, but (we teach) them how to navigate with their disability so their disability does not become a barrier in their participation of being active,” Winstein says. “If there are certain things they can’t do, we show them what they can do and get them to work on those things.”

To learn more about stroke rehab and recovery, check out the American Stroke Association’s website.

By Lisa Fields
Lisa Fields is a writer who covers psychology and health matters as they relate to the workplace. She publishes frequently in WebMD and Reader’s Digest.

Losing Herself in Art and Finding Joy

February 12, 2019

A lifetime of challenges has never slowed the author's spirited mother
By Donna Trump

Part of the Vitality Arts Special Report

My mother, Anne Pols, celebrated her 87th birthday in November. In that same month, she also made her art show debut, exhibiting a half-dozen freehand colored pencil drawings at the Long Island Museum in Stony Brook, N.Y.

She and six other residents of her assisted living program at Jefferson’s Ferry contributed 25 pieces to a show called “Through Our Eyes.” The accomplishment is particularly sweet for my mother for several reasons. She has lived with a physical disability for most of her life. She took up drawing at 86. And six months prior to the show, she lost, in a single instant, most of the vision in her left eye.

One of my sisters said that days after the eye failed, my mother told her she was working on regaining her appetite. “Well, you’ve been though a lot in the last few days,” my sister said. To which our mother replied, “That’s history.”

She returned to her art classes a few weeks later.

Through Her Eyes

In our youth, my three sisters and I were never far from seeing a somewhat terrifying childhood through our mother’s eyes. At six, she nearly died from a ruptured appendix. In the hospital, she was forced to lay on her belly for a month to allow infected fluids to drain from the open surgical incision. A well-meaning relative doused the wound with perfume to diminish the odor. “That hurt,” our mom told us with a whistle.

At nine, she suffered a stroke — likely a burst aneurysm. There were no CAT scans or MRIs then, so the diagnoses ranged, she told us, from cerebral palsy to polio to some kind of infectious disease. In any case, she lost the use of the right side of her body and her speech as well. Her Irish immigrant family didn’t have much, so she was treated at public hospitals. She recalled for us the times she was paraded, naked or partly clothed, across a stage for a roomful of doctors-in-training. “I’d rather do that than go to the dentist any day,” she’d tell us.

When she was 12, her mother died of her own cerebral hemorrhage. Her father followed her mother to his grave within months, succumbing either “to the drink” or tuberculosis or a broken heart, depending on the telling. It didn’t matter why, we learned. What did matter was that her beloved Aunt Mary (barely a decade older than my mother at the time) and Uncle Bill took my mother and her siblings in after they were orphaned. These fine people supported my mother through years of physical therapy and multiple orthopedic surgeries in her teens, and, in fact, for the rest of their also tragically brief lives.

Mild but persistent right-sided weakness and a tendency of her right arm to tighten in spasticity kept my mother from nothing but learning to drive. An occasional word-finding problem showed up most often in calling her four sons-in-law by the wrong names, errors over which she was frequently the first to laugh out loud.

Learning to Draw

At the exhibit, my mother’s drawings are small in scale but realistic, colorful and expertly shaded. In some, she uses a brush to wash over the pencil for a watercolor effect. The subject is generally still life: a cornucopia, a parrot, a bowl of fruit, daffodils.

The daffodil drawing was one of my mother’s first, and when I saw it, it took my breath away. Not only was it was expertly drawn, it reminded my sisters and me of one of my father’s favorite poems. He was the love of her life but is gone nearly six years now, yet another in a series of losses which our mother appears, most times, to take in stride.

My mother started Saturday morning art classes about a year ago, with an accomplished Long Island artist she knows only as Jill. The class is one of many offered by the fine recreational therapy staff at my mother’s assisted living home. She enrolled in part because there wasn’t a lot of other programming on weekends: “It was something to do on a Saturday morning,” she said, adding, “something I was interested in.”

Although she writes with her weaker right hand (assisting with a steadying grip on the wrist with her left hand) she draws with the left. “It’s easier to control,” she said.

The class started with simple coloring of already-drawn designs, which my mother enjoyed, but soon prompted her to tell Jill, “Let me see if I can copy that.” She did. “Then I colored it and watercolored it, too,” she said with satisfaction.

Jill is a constant source of expertise, support and encouragement. “She taught me all about the shading,” my mother said. “That’s what makes it 3-D.”

I do not recall one incident in my mother’s life up to now where she made art for its own sake. She cooked just about every meal we ate, crocheted hats and blankets and sewed some of our clothes — surely artistic endeavors — but always in service to her family.

Not this time. Not with this pursuit of drawing. One of my favorite things about the exhibit was watching my mother, now unable to stand or walk independently and so using a wheelchair for mobility, crane her neck upwards toward exhibit attendees (mostly strangers) to respond to their comments and questions. Her face is animated. She laughs often. Her hands fly up in enthusiasm. She is an artist discussing her work, her process. Her self.

Self and Others

Contrary to much of today’s advice about being one’s own biggest advocate, my sisters and I were raised (in a fairytale compared to our mother’s childhood) with the understanding that “Self-praise is no praise at all.”

I hope it was not only me, among the four of us sisters, whose ego was periodically trimmed by our mother’s quick-tempered, “Who the hell do you think you are?” Let’s just say there wasn’t much discussion about self-actualization.

And yet, the image of her animation at the exhibit stays with me. What is it in drawing that gives her this joy?

In our daily phone calls what I hear most is how time flies — how, in fact, she loses her self — when she’s drawing. “I look up and two hours have passed,” she says. “It relaxes me. It’s like meditation.”

When pressed, she offers just a touch more: “I think that something special came out of me when I started those classes.” I ask her if she feels in any way that she has found herself through this art. “I know who I am,” she informs me, somewhat curtly. “I don’t need to find myself.”

As to the question of what might have come of it all had she started earlier, she is adamant: “I never think about that. My life went the way it did and it was full of love, consideration and respect.”

And now, Saturday morning art classes with Jill.

Donna Trump’s work has been published in december magazine (forthcoming in November 2018), Ploughshares and Mid-American Review, among others. She has received several Pushcart Prize nominations.  Honors include a Loft Mentorship, mentorship with Benjamin Percy, a MN Emerging Writer grant and the selection of her story “Portage” by judge Anne Tyler for first prize in a 2018 contest sponsored by december.

Do You Really Need All of Those Pills?

February 8, 2019

A medication review with your doctor could reduce the number you take
By Kelly K. James

Taking more medications than you used to? You’re not alone; as you get older, you’re more likely to take prescription medicine.

According to the Centers for Disease Control, 72 percent of adults ages 45-64 had taken at least one prescription drug in the last 30 days in 2011-2014; 39 percent had taken three or more in the last 30 days and 20 percent had taken five or more. For adults ages 65 and over, the figures are even higher: 92 percent have taken at least one prescription drug in the last 30 days; 68 percent, three or more and 42 percent have taken five or more.

The average number of prescription drugs taken has risen, too. One 2015 study found that the median number of prescription drugs taken by people 65 and over doubled from two to four and that nearly 40 percent of people were taking five or more prescription medications. (The study authors attribute some of this increase to more prescriptions being written for cardioprotective and antidepressant medications.)

Most people 65 and older would like to reduce the number of medications they take, according to a recent study of nearly 2,000 Medicare recipients published in October, 2018. More than 90 percent were willing to stop taking one or more of their medications if their doctor said it was possible, and two-thirds wanted to reduce the number they were taking.

So why are more of us taking more prescription drugs? “I think the issue is that a lot of times people see more than one specialist, and they may be given more than one medicine [by each specialist],” says geriatrician Dr. Lee A. Lindquist, associate professor of medicine at the Northwestern University Feinberg School of Medicine in Chicago. “And people think medicines will make them feel better, so there’s a push to prescribe … (but) “deprescribing is a very hot topic among geriatricians because of issues including side effects and drug interactions. The fewer medications someone is on, the better.”

Reasons Why Medication Needs Change

Changes in your health and lifestyle may eliminate the need for some medications. For example, “some people may have had stressful full-time jobs when they were in their 40s, 50s, and 60s, and may have had conditions like high blood pressure or gastroesophageal reflux disease,” says Dr. Lindquist. But post-retirement, these kind of stress-induced conditions may disappear or no longer require treatment.

A change in your weight or exercise habits could also mean that your medication needs change. For example, working out regularly can help you maintain healthier blood sugar levels if you have diabetes, and allow you to reduce or eliminate diabetic medications. “Exercise may be even more beneficial than medications,” Lindquist says. “The more exercise you do, the more you can cut back…during retirement, when you’re taking better care of yourself or when you lose weight or are exercising more, you may not need the medication because your lifestyle has changed.”

The Right Time for a Medication Review

Scheduling a medication review lets you make sure that every medication you’re taking has a purpose, and that every medication is still appropriate. It’s smart to have one review annually, along with one during a health care transition, like when you’re going from the hospital to a rehabilitation center, or coming home after surgery. “A lot of times medications will be added during the transition — that’s where a lot of unnecessary medications get added on,” Lindquist says.

Age-related changes in your body that affect drug metabolism can also impact how you react to certain drugs, which is another good reason for an occasional medication review. Some drugs are fine to take in earlier adulthood, but as you get older, they can last longer and/or have a more pronounced effect. Even an over-the-counter medication like Benadryl can be over-sedating for someone in their 60s or 70s, says Lindquist.

A medication review also is a good time to talk about when and how you’re taking your medications. Some people take medications five or six times a day when it may be possible to combine them, while others need to be taken on their own.

Talk to Your Pharmacist and Doctor

Your pharmacist is a good place to start, Lindquist says. “Pharmacists know medicines and what medicines are used for. They’re great at guiding people to have better conversations with their doctors,” she says.

Since your doctor might not ask you about your medications, you should feel free to bring it up on your own. “Many times when a physician sees a patient who’s looking good and is on a list of medications, he or she doesn’t want to rock the boat, so it’s fair for the patient to be proactive and say, ‘can I stop this medication?’” Lindquist explains.

Bring your list of current prescriptions to every doctor’s visit (along with any over-the-counter supplements you may take). At your medication review, ask if the medications you’re taking are necessary for you and what their risks are. Also ask if there are other options for the drugs you’re taking; this includes taking a different drug or other ways you can manage your symptoms. However, do not stop any prescribed medication — even if it’s producing side effects — without talking to your doctor first.

If you’re concerned about the number of medicines you take, don’t be afraid to bring it up with your physician, adds Lindquist. “Medications should support your health, instead of interrupting your life,” she says.

How to Safely Dispose of Unneeded Medications

If you have medications you no longer need, get rid of them as soon as possible to ensure that they won’t be accidentally taken or misused by other people. However, it’s important to dispose of the medications in a safe way to protect people and to ensure they won’t end up polluting the environment. The Food and Drug Administration (FDA) has these guidelines for safely disposing of prescription and over-the-counter drugs:

  • Best option: take-back programs and sites. The U.S. Drug Enforcement Administration (DEA) periodically hosts National Prescription Drug Take-Back events. Also, many pharmacies and health care organizations have secured medication disposal containers where you can simply bring your drugs in and drop them in a bin. To find a site near you, check out this DEA webpage.
  • Second-best option: throwing them in your household trash. If there are no take-back programs or drop-off locations near you, you can dispose of medications in your trash. The FDA recommends you first mix different medications together and place them in a container, like a sealed plastic bag.
  • Flush only if instructed to do so. A small number of medications specify that you should flush them down the toilet if you have no take-back option available. These drugs are especially harmful if taken the wrong way or by someone other than who received a prescription. This is the reason flushing is recommended over putting them in the trash. However, a take-back program/site is the safest option.

Kelly K. James is a health, wellness and fitness writer and ACE-certified personal trainer based in Downers Grove, Ill.

Committing to Memory

February 8, 2019

More than 5 million Americans are living with Alzheimer’s disease. Is it time for you to talk to your doctor about Alzheimer’s?

If there’s one thing that worries seniors, it’s the prospect of developing signs of dementia. These fears prompt many to visit websites that claim to provide online tests for Alzheimer’s disease.

While these Internet tests may do a good job of presenting their material in an understandable and usable way, research reveals them to be ineffective for diagnosing Alzheimer’s. According to a study presented at a recent Alzheimer’s Association International Conference, online Alzheimer tests are inaccurate, unscientific and unethical.  Don’t waste your time or money on online tests that may only make you more anxious about your memory issues!

A battery of tests and expert interpretation are required to make an accurate diagnosis. If you have concerns about your memory, it may be time to talk to your doctor about Alzheimer’s testing. Your doctor can tell you for sure whether your memory issues are related to Alzheimer’s or dementia.  And if you do have Alzheimer’s, there may be medications that can slow the progression of the disease. 

For more information about Alzheimer’s, visit the Alzheimer’s Association website  or tap into our additional Senior Experience here.  

How to Recharge Your Job or Career in 2019

February 6, 2019

A noted life and career coach offers her five-step plan
By Allison Task

Would you like to make 2019 a remarkable year for you?

A new year has begun. It’s is as exciting and fresh as the first day of school and a brand new lunchbox. You’re past those school days, of course, but you aren’t past embracing the new and possibilities to recharge your job or career this year.

As a career and life coach, I help people set — and more importantly — achieve life-changing goals. It’s what I do: identify what isn’t working, clarify what could be better and help people pursue a life they’d rather lead. I’d love to help you make 2019 a remarkable year.

Ready?

What you’ll need:

A 2018 calendar, filled out (or your memories of 2018 fresh in your mind)

A 2019 calendar, fresh and new

Blank paper (or a Word doc if you’re more of a  computer person)

What you’ll get: A remarkable year.

There are five parts to this exercise — reflection, selection, envisioning, planning and sharing. Here’s how it works:

Reflection

For this part, pull out that 2018 calendar if you have it or rely on your memory.

Write down the names of the months on three pieces of paper. Put four months down on a page, in separate quadrants. January, February, March, April on one, May, June July, August on another and September, October, November and December on the last page.

Now, review 2018 month by month. Let’s start with the trips you’ve taken. Where did you go, in which month? Short trips, overnights and longer trips. Write them down on the calendar.

Next: were there any landmark events for you? A new job, a promotion, weddings, graduations, births and deaths? What big events happened in your life, and the life of loved ones?

Sit with this for a while, as you start remembering one thing, which leads to another. As you start filling up the months, you may realize that you need more pages. Enjoy the memory trip.

You’re ready for phase two.

Selection

Once you’ve got a thick set of memories from 2018, take out another piece of paper. On one side, write “coming” and on the other side write “leaving.”

Imagine that you are packing your bag for 2019, and you can choose five things that come with you, and five things you’d like to leave behind. Maybe you hired a terrible contractor last year; leave him or her in the past. More importantly, what incredible things happened? New relationships or experiences that you could pick as the “best of” 2018?

Keep that list of five things you treasured from 2018 and want to bring with you and five things you’d prefer to leave behind.

Envisioning

You’ve just taken stock of 2018 and my guess is that it was more extensive and powerful than you may had remembered. So many things happened. And 2019 will be the same. Right now, you can choose those things.

Look at your top five treasures from 2018. If you were to elevate these, build on the joy they delivered and create even more joy, how could you do that? How could you plan that into the coming year? If you improved your health, how could you celebrate that or take that to the next level? If you became closer to an old friend, is there a new old friend you’d like to connect with this year?

Write it down. Acknowledge and elevate your top achievements from 2018.

Is there something missing that you’d like to be sure to add to this year? Think about what that would be

Maybe you’d like to start meditating more, or get off medications that you think are slowing you down.

Maybe you’d like to travel more, or nest more. This is your life; your choice.

Write it down. Add new goals for 2019.

Next, look at the four seasons and the month at the center of each: February, May, July and October. When you think of these seasons, what do you love most? Is it apple picking in October, and the beach in July? How can you embrace the upcoming season with a new or well-loved experience or person you’d like to have in the center of the season? What is the treasure you’d like to look forward to?

Write it down. Make sure to add your favorite parts of the year to 2019.

Planning

Now take out that 2019 calendar. What is already in place? Have you booked any travel already? When is your birthday? Any upcoming weddings, graduations or other events? Put those on the calendar.

Your 2019 treasure map is starting to take shape.

And now (drumroll please)… add in those extras: those bigger dreams and seasonal joys. Add in the items you identified in the “envisioning” phase. If you can dream it, you can build it. You’ve dreamt it, so put it on the calendar.

Have fun with this. You may find there’s too much to do in one year; some items may need to wait until 2020. Others that seemed important may not seem as urgent now that you’ve raised your game, so they can be replaced.

Sharing

Onto Sharing. This is where the rubber meets the road. It’s time to share your dreams and your calendar with your friends and family members. Make a list of the top five items you want to do this year (that you’ve always done) and top five new objectives (that you’ve never done). Identify something, each month that you are looking forward to doing.

On the first of the month, announce the thing that you’re excited about. You may be telling your loved ones, but what you’re REALLY doing is telling yourself, reminding yourself how sweet your life is, and then sucking every last bit of sweet off your finger tips.

You have now created a treasure map for 2019 of the things you’d most like to do. Pursue that treasure. You’ve created a powerful vision. It can be as remarkable as you let it be.

Allison Task, is a Montclair, N.J. life and career coach whose business is Allison Task Career & Life Coaching. She is a author of Personal (R)evolution: How to Be Happy, Change Your Life and Do That Thing You’ve Always Wanted to Do.

Should You Adopt an 80-Year-Old?

February 1, 2019

Five programs that provide assistance for struggling older adults
By Lisa Fields

Everyone of a certain age remembers Sally Struthers’ Save the Children TV commercials, encouraging viewers to improve the life of an impoverished child in a developing nation by sponsoring him or her for the price of a cup of coffee a day. Many organizations still let people sponsor underprivileged children. But if you’d rather sponsor a struggling older adult with limited resources, there are a number of programs available.

“Lots of older adults are barely making ends meet,” says Homa Rostami, board member of the California-based Adopt an Elder Foundation. “They fought in wars and are kind of forgotten. They might just need a [little] more a month.”

Programs for older adults in need can provide tangible results. If you’re hoping to make a difference in the lives of adults across the country or around the world, consider programs like these:

Unbound

This Kansas-based nonprofit can pair you with a 60-plus adult needing assistance who lives in a developing nation in Asia, Africa or Latin America, to help him or her age with dignity. Many older adults spent decades performing manual labor. Now, their health is declining, their mobility is limited and they may not have many social services available to them. Sponsors donate $36 per month, which provides older adults with food, medical care, support groups and recreational activities. Donors receive photos of, and letters from, their beneficiaries. More than half of donors are over 50.

“We often hear that our elders in the developing world and their sponsors are able to bond over similar challenges, such as illness, losing a spouse of other family member or children moving away,” says Andrew Kling, Unbound’s community outreach director. “Both the families we serve and our sponsors frequently tell us that the letters and photos they receive become cherished possessions.”

The program serves more than 31,000 elders from 18 countries and has allowed people to sponsor older adults since 1984.

Adopt an Elder

It isn’t safe for every older adult to continue living independently, but some can’t afford to move to assisted-living facilities. This nonprofit provides financial aid to older adults in Northern California, supplementing their incomes by $350 per month so they can live in facilities providing the appropriate level of care. This provides a needed financial boost since many people come up a few hundred dollars short of what they would need to stay in assisted living facilities.

Many are introduced to the program by their doctors or social workers if the professional is concerned that the older adult is no longer able to safely live alone. (The program itself isn’t involved with moving people directly into facilities.)

Donors typically provide $25 per month to the program. You won’t be paired with one individual, but you can interact with beneficiaries by distributing holiday gifts with volunteers in December. Beneficiaries appreciate the help they receive, which allows them to enter assisted-living communities for life.

“They always talk about the social engagement, having someone to talk to,” Rostami says. “They say, ‘It’s nice that I’m not alone anymore.’”

This year, the program has helped 72 older adults remain in assisted living facilities. The nonprofit has existed since 2001.

Adopt A Senior

Here, you can develop relationships with long-term-care facility residents, some of whom who have few or no visitors.

People donate $50 annually through this New Jersey-based nonprofit to provide every resident of five long-term-care facilities in New York and New Jersey with personalized birthday gifts, holiday gifts and two seasonal gifts. Volunteers visit the facilities monthly for birthday celebrations, games and conversations, which help ease residents’ loneliness. You can meet the person you’re paired with if you choose to hand-deliver gifts with volunteers during these events. Some people stay in touch by phone or letter.

“They consider us their ‘family,’ and we feel the same about them,” says Annye Cohen, Adopt A Senior’s president and co-founder. “Our motto is: Seniors should never be forgotten, and we strive to do that each and every day.”

The program serves 1,300 older adults. Since 2014, it has distributed more than 9,000 gifts.

Adopt a Native Elder

Many older adults in remote areas of the Navajo Reservation in Utah and Arizona live below the poverty line. This nonprofit provides assistance beyond what the reservation’s elder care programs can address.

Donors provide $200 annually, covering the cost of a year’s worth of food for an older adult. The program also provides Navajo elders with medicine, clothing, firewood and other essentials. Once you sign on through this Utah-based nonprofit, you’ll receive a photo of the elder you’re paired with, along with his or her contact information, and you’ll be encouraged to stay in touch.

“Friendships that last a lifetime may develop between the elders and people who adopt them,” says Linda Myers, founder and executive director of Adopt a Native Elder.

Since 1991, the program has helped more than 2,000 Navajo elders. Today, over 560 older adults are enrolled in the program.

Be a Santa To a Senior

With this program, you can deliver holiday gifts to older adults across the U.S. and Canada who are identified as at-risk for loneliness, which helps them feel like they’re a part of a meaningful community.

Those who are identified as potentially lonely by local organizations request simple necessities like blankets, gloves and personal care items. Once you receive someone’s wish list, you shop, then return with the requested gifts.

This Nebraska-based program extends to more than 200 Home Instead Senior Care franchises. Some locations organize delivery events, so if you want to meet the person whom you’ve shopped for, you may be able to connect face-to-face.

“One recipient last year said, ‘I haven’t received a gift in over 10 years, and it made me feel so good to open a gift and to just have something new,’” says Jeff Huber, president and CEO of Home Instead Senior Care. “We hope that these small moments help to alleviate feelings of loneliness, so seniors are not only happier, but healthier each holiday season.”

Since 2003, more than 700,000 older adults have received gifts, and more than 1.2 million gifts have been given through the program.

By Lisa Fields

Lisa Fields is a writer who covers psychology and health matters as they relate to the workplace. She publishes frequently in WebMD and Reader’s Digest.

“Cash-ing” it in With Pet Visits!

January 30, 2019

Katherine Kimes visits residents at Westminster Place, the personal care community at our Oakmont campus, every Tuesday with her therapy dog, Cash. Cash is an energetic poodle who makes his way around the community with three goals: to make our residents smile, to visit as many folks as he can and to find treats wherever they are hiding, which is usually in resident Bill Waddell’s pocket!


Photo caption: Katherine with Cash and Bill. 

Cash is a smart dog. When making rounds, he recognizes Bill’s door and knows that when he enters, a treat is waiting for him! Volunteers like Katherine and Cash gives our residents the chance to spend time with a pet, something they may have done prior to moving to their new Presbyterian SeniorCare Network home.

No bones about it, pet visits enrich the aging experience!

It’s Quality, Not Quantity, of Life That Matters

January 29, 2019

Frank talk about aging from Dr. Ezekiel Emanuel, a Longevity Innovator
By The Milken Institute Center for the Future of Aging

(Advances in science and public health are increasing longevity and enhancing the quality of life for people around the world. In this series of interviews with the Milken Institute Center for the Future of Aging, 14 visionaries are revealing exciting trends and insights regarding healthy longevity, sharing their vision for a better future. The Longevity Innovators interviews highlight new discoveries in biomedical and psychosocial science, as well as strategies to promote prevention and wellness for older adults. This is the tenth in the series.)

From spearheading the Affordable Care Act to opposing the legalization of euthanasia, Dr. Ezekiel Emanuel continues to make his mark on health care. Emanuel, vice provost of global initiatives and chair of the department of medical ethics and health policy at the University of Pennsylvania, is a globally renowned oncologist and bioethicist, and author and contributor to numerous media outlets. In an interview with the Milken Institute Center for the Future of Aging, Emanuel explains the urgent need to improve quality of life and why we are getting further from an honest conversation about aging.

The Milken Institute Center for the Future of Aging: In your attention-getting piece in The Atlantic, you identified the age of 75 as a personal cut-off point for health interventions. You state: “Once I have lived to 75, my approach to my health care will completely change. I won’t actively end my life. But I won’t try to prolong it, either.” With what’s known about the distinction between chronological and biological age, why 75?

Dr. Ezekiel Emanuel: I think there are five or six different criteria. The first thing almost all of us will say is “I really care about quality of life, not quantity of life.” The question then becomes: when does quality of life begin to deteriorate?

Whether it’s cognitive or physical, 75 is a very important threshold. As we get older, our cognitive abilities decline — there’s a natural slowing down of the brain, a natural decrease in processing speed, a natural decrease in creativity. So, if you are interested in mental acuity, 75 is where you see a dramatic slowdown.

Similarly, you have a lot of physical decline and an increase in physical morbidity the older you become. For example, the inability to climb stairs or the inability to walk a quarter of a mile, these things begin to increase.

And if you look at the rates for Alzheimer’s and other dementias, they are relatively low pre-75, higher at 75 and then dramatically increase after 75. So, by 80, between a third and a half of people have dementia of some kind.

And finally, I would say if you look at the world’s literature on creativity and productivity and generating and thinking new thoughts, it’s very hard to find anyone after 75 who has done anything positive. I can think of four people in all of history where we see good evidence of their creativity, productivity and generation of thought post-75. You have Michelangelo, Benjamin Franklin, Goethe, and Verdi. What ends up happening in life is that you switch from being engaged with life to being much more passive.

Are we too focused on living longer?

Yes, and I think we delude ourselves about the wonderfulness of living long, and I think the advertising industry and others want us to be somewhat deluded.

Right after I published that article in The Atlantic, there was a big advertising campaign by AARP about how the beat goes on forever and so can my life. Then they show these very vigorous people, not very old, hiking in what looks like Montana. Around the same time, The New York Times wrote a big article on people in their 80s doing things like driving motorcycles and snorkeling. Those people exist, those activities exist, but they don’t show you the flip side.

In these ads, you didn’t have the full picture of just how many people are in nursing homes, people who were just sitting around in vegetative states or people who are unable to leave their houses. So, you get a much-distorted view of what it’s like to age.

If you read the literature of what’s happening in Japan, you get a lot of people who are lonely, their spouses died off, their friends have died off, their kids are off doing their kid things and they are left very much alone. That doesn’t seem to be a wonderful life.

So I think we need a much more accurate view of what it is to live a long life into your 80s and 90s.

I would say that for many, maybe even the majority of people, it isn’t so wonderful. Almost anyone you ask will say, ‘Yes, you’re right. I don’t want to just record the number of years, I want to have a high quality of life.’ But, in the end, the average lifespan in the U.S. has gone up another three months. What does that tell you? Well, we’re just counting numbers, we’re not counting quality. The average lifespan is not a quality measure.

Regardless of age, what health characteristics should people consider as they make care and treatment decisions and weigh age-prolonging options?

First, I think the most important thing is for people to consider, well before they get close to the end of life, or well before they even get to 70 or 75, is how they want their life to go. It’s the kind of thing you should consider when you’re 20, 30, 40, 50.

Henry David Thoreau talks about sucking the marrow out of life, and I think that’s what people ought to do — to stop worrying about ‘Am I going to make it to 80 or a 120’ I think when you start thinking that you’ll make it to 100, that may be a recognition that my previous or current life wasn’t that valuable or meaningful, and I sort of squandered it.

Be focused more on living a rich life rather than trying to get to 120 — that might be more valuable in my opinion.

How should public and private payers evaluate the returns on their investment in treatment and care?

An evaluation on care that does not prolong life over disease symptoms is hard to measure, and that could be very helpful to people at the end of life. We don’t want to waste money, so the return is either prolonging life, reducing symptoms, increasing convenience or reducing costs. We need to see those things from our medical interventions.

There is a growing effort for communities to be more age-friendly and celebrate the value and potential of older adults. Do you think these efforts are misguided?

The reality for all older adults paints the full picture of aging. Most people who age will tell you that growing old is not for sissies. It’s hard. The face falls, the body begins to fall apart and the mind slows down. It’s not an ageist view. That’s just what happens when the body begins to age and deteriorate.

That’s also the way people’s mental capacity works — processing speed declines, memory capacity declines and the ability to find creative solutions to problems declines.

Yes, we’ve got a spectrum of people, of course, but it is true of the average, it’s true of the median, and it’s true of everyone that it’s going to happen at slightly different rates. I don’t think that’s ageist. It’s an easy charge for people to make when they’re trying to preempt a serious discussion about meaningful aging.

As a society, are we getting closer to or further from an honest conversation about aging?

I think in general we’re getting further away from honest conversations about everything in our society, because we’re unwilling to look at the facts and too willing to dismiss people with ad hominems and overall charges like ageism or discrimination.

By The Milken Institute Center for the Future of Aging

The Milken Institute Center for the Future of Aging aims to improve lives and strengthen societies by promoting healthy, productive and purposeful aging.

5 Hidden Causes of Heart Disease

January 25, 2019

What can increase your risk and how to prevent it
By Frieda Wiley, PharmD

Heart disease kills about 610,000 people in the United States each year — 1 in every 4 deaths — more than any other disease, according the Centers for Disease Control and Prevention. It’s commonly known that exercise and eating a healthful diet are keys to keeping your heart in tip top shape. But there are seemingly unrelated conditions and lifestyle habits that can lead to heart disease.

Here are five lesser-known causes of heart disease that you can do something about: Sleep apnea; stress, anxiety and loneliness; sitting all day, influenza and dental disease.

  1. Sleep Apnea

“Sleep apnea is very common, especially as we get older, and it puts enormous stress on the heart,” says Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver.

People who have sleep apnea tend to also have other conditions that are associated with the disease, such as high blood pressure, atrial fibrillation (a kind of irregular heartbeat) or pulmonary hypertension, which Freeman defines as high blood pressure on the right side of the heart.

Symptoms of sleep apnea include daytime sleepiness, memory problems and irritability. Being overweight or obese and even structural features, such as having a big chin or tongue, may also make you more likely to develop sleep apnea, according to the American Lung Association.

Premenopausal women are less likely to have sleep apnea than men, but postmenopausal women and men of any age share similar risks. After reaching adulthood, sleep apnea becomes more common with age until you reach 60, when the chances of developing it begin to taper off.

One way to treat sleep apnea is to use a continuous positive airway pressure (CPAP) machine at night. However, Dr. Mark Peterman, a cardiologist at Texas Health in Plano, says that many people find the machine uncomfortable to use. Other treatment options, depending on the severity of the problem, include weight loss, oral appliances (similar to a mouth guard), nasal decongestants and surgery.

  1. Stress, Anxiety and Loneliness

Stress can have powerful effects on the body that wreak havoc on your health. Some stresses, such as learning a new language or skill, can be positive. But Freeman says the majority of stress people experience, like worrying about children or finances, tend to have negative effects on the body.

While it might be difficult to see the connection, the lack of social interaction and fulfilling relationships also impacts heart health.

“It might sound strange to hear a heart doctor talk about love, but people need what we call social support and connection,” Freeman says. “People don’t talk about it much, but people who lack social support or are lonely are at higher risk for heart disease and depression.”

The American Heart Association says that, while stress can harm the heart, researchers still haven’t quite figured out the role stress plays in causing heart disease. Even for those who manage stress well, keeping up with life in our increasingly fast-paced world can still take its toll.

“Treating stress with medication can be difficult, so it usually requires counseling and lifestyle changes,” Peterman says.

  1. Sitting All Day

We hear a lot about how important exercise is to keep your body and mind in shape. Studies also show that sitting the majority of the day increases your chance of developing heart disease.

In a 2014 study of how a sedentary lifestyle affects blood pressure, researchers found a strong association between a sedentary lifestyle and an increase in blood pressure. This finding was independent of time spent in moderate to vigorous exercise. A 2015 study came up with similar findings: Sitting down the majority of the day can increase your risk for heart disease, stroke and even diabetes — even if you exercise an hour a day.

Luckily, this heart risk factor is easily remedied with increasing physical activity. If you’re having trouble getting started, Peterman suggests technological devices like Fitbits to help you become more aware of your daily movement and motivate you to exercise.

  1. Influenza

If you think the only consequences of getting the flu are having body aches, a runny nose and fever for a week or two, think again. The flu can increase the risk for heart problems stemming from the inflammation it causes.

Peterman says the flu has been linked to increased risk of heart trouble between the months of October and February. One study published in the 2016 found that people who had the flu were six times more likely to have a heart attack within the first seven days of their condition being confirmed with laboratory testing.

Sounds like your doctor may have more than one reason for recommending you get a flu shot.

  1. Dental Disease

Dental health is important for more reasons than a great smile; it can also work wonders for your heart.

Mouth issues like cavities and gum disease can trigger chronic inflammation, which Peterman warns can speed up hardening of the arteries, or atherosclerosis, causing the risk of heart problems to soar.

But not to worry. This problem is easily remedied by maintaining good brushing and flossing habits along with regular trips to the dentist.

How to Reduce Body Inflammation

Freeman says these five hidden causes of heart disease lead to inflammation in the body, which is the root of other common diseases, including cancer, diabetes and arthritis. Luckily, there are four key practices you can adopt to put your body in anti-inflammatory mode and strengthen your heart in the process:

  • Eat a predominantly plant-based diet; limit your consumption of animal-based products.
  • Get at least 30 minutes of brisk activity each day.
  • Make time for a little stress relief each day. Prayer, yoga, meditation or anything else that helps you become more mindful and live in the moment helps.
  • Build a strong social network so you feel connected, supported and loved.

“Switching the body into an anti-inflammatory healing environment is what we’re trying to do to get people to heal,” Freeman says.

Hopefully these extra tips will help you take a load off your heart — and your life.

By Frieda Wiley, PharmD

Frieda Wiley, PharmD, CGP, RPh, is a board-certified geriatric pharmacist and freelance medical writer based in the Piney Woods of East Texas. She enjoys using her background in patient care to empower people with more knowledge about living well.@frieda_wiley

A Nursing Career Inspired by MASH

January 24, 2019

We love when our team members share their stories, especially when a childhood dream becomes reality!

Read about Chris Plyler, a RN Neighborhood Manager at Oakwood Heights, our Oil City campus, and how her favorite TV show led her into nursing.  

“I always wanted to be a nurse. As a young child, the television show MASH was big. At the same time, my uncle went into the Marines—the perfect storm happened! I connected with Margaret Houlihan, “Hot Lips.” So my story begins. I would play hospital and I was always the nurse. If you watched the show, “Hot Lips” was tough. In the scary times, she took control, orchestrated the work in the OR and worked hours upon hours. She took time to hold the hands of the wounded. The expectation of myself is to be strong as needed, but gentle at the same time. My experiences are vast from starting at a nursing home as a CNA to being a nurse in a 1000 bed hospital ICU, then making the circle back home to Oakwood Heights. I get to hold hands and make memories with some of the most beautiful people in the world. I feel as part this team, I make a difference.”

Like Chris, do you have a story about Presbyterian SeniorCare Network that you would like to share? We would love to hear it! Click here to visit our web page. Once there, please click on the button, Share My Story.

Once you have submitted your story, you will automatically be entered into a random drawing to win a $50 Visa gift card! Winners will be pulled the first Monday of every month.

 
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