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Pass Along Traditions With a Family Cookbook

December 10, 2019

Compiling cherished recipes can be a true labor of love.
By Brette Sember


Nearly everyone can share a favorite food memory; whether it’s all of the components of the family’s traditional Thanksgiving meal or Grandma’s molasses cookie recipe or Dad’s famous waffles. Gathering these beloved memories together can be a true labor of love.

A family cookbook preserves special family recipes, passing them down to future generations. Family cookbooks are popular for family reunions, weddings, and holidays.

Virginie Martocq, owner of HeritageCookbook.com, says they are also common “when someone in the family has passed, as a way to remember all the times that were shared at that person’s table.” Cookbooks are also made as graduation presents or for children setting out on their own; “it feels like bringing home with them,” Martocq says.

“The cookbook is really family history — it’s not all  about the food itself.”

Interested in creating your own family cookbook?  Here are some suggestions:

Getting Started

Creating a family cookbook is a real project and for success, treat it seriously. Chip Lowell co-owns The Family Cookbook Project and says the first step is choosing a “go-getter” as the editor who will get the project going, ask for submissions, choose recipes and get the book published.

Next, determine the number of recipes you’re aiming for. Lowell says 100 to 150 is a good number. Set a deadline for submissions. Invite family to participate and send deadline reminders.

Michelle Clark, 59, of Wellfleet, Mass., created a family cookbook as a wedding gift for her brother and sister-in-law and invited the wedding guests to contribute recipes. She set a deadline, but had to extend it by a month for procrastinators.

Choosing the Recipes

Deciding which recipes to include can be challenging. Lowell says, “Family favorites that folks always ask about are typically the first choice.”

Food historian Sarah Wassberg Johnson suggests prioritizing recipes from deceased or older family members. “There’s nothing sadder than a ‘famous’ family recipe that dies when the person who made it does,” she says.

She also recommends including recipes family members make frequently, as well as those that are featured at special meals like holidays.

“Cookie or other dessert recipes are especially good, because people are more likely to follow an exact recipe when it comes to the science of baked goods,” Wassberg Johnson says. “The ones to avoid are the super-fancy or trendy recipes that you only made once or twice or are very complicated.”

Martocq notes that most family cookbooks are heavy on baked goods, but says that’s not a bad thing. “A family cookbook should really be a reflection of the foods you love best, so it’s not important for it to be well-rounded,” she says.

Duplicate recipes can pose a challenge. Clark had several people send in duplicates and she had to decide which person to credit.  “I usually gave credit to whoever had fewer recipes,” she says. Another option is to list everyone who submitted the recipe.

Sharing Stories of the Recipes

A simple way to organize your book is by food type, but don’t be afraid to get creative.

Ellen Hester, 73, of Monroe, Ga., began her family cookbook when her daughter requested recipes from her childhood. Hester gathered recipes and started to write the stories that went with them. “The stories began flowing, and I recognized a pattern,” she says.

Hester told the stories in chronological order, which coincided with the places they lived.  She named each story after where they lived at the time: “Table in Cairo,” “Table in Albany,” “Table in Monroe.”  She placed the recipes in a separate section (sorted by type) and cross-referenced their pages whenever she mentioned a recipe in a story.

Other Things to Include

“The cookbook is really family history — it’s not all about the food itself,” says Lowell. So, view the project as capturing family history. He suggests adding “personal notes about the recipes and why they are important to the people who contributed them.”

Johnson recommends including photos, “especially photos of previous generations, which can put a face to the recipes.” Another idea is to include photos of heirloom recipe cards, so Grandma’s handwriting is preserved.

Creating a memorable cover will help make the book special. Hester has an artist friend who “volunteered to paint my hands tying an apron to be the cookbook cover. It was truly the icing on the cake,” she says.

Selecting Your Medium

A family cookbook can be digital, print or both. Lowell believes, “having a physical cookbook makes the family history come alive so much more than just a database of the same content.”

Clark created print and online versions. “We did not include pictures in order to save money on printing, but there are many photos in the online version. Everyone in the family loves it and continues to use it and they’re continuing to share new recipes in the online format.”  Seeing new recipes accumulate online has Clark thinking about doing a second print volume.

Pricing depends on your method. A digital version (Word document, PDF or blog) is free if you make it yourself, or low cost if you use a cookbook site.

Lowell says the price for print books depends on the number ordered. His average customer orders 29 books of about 160 pages, for $17 per book.

If you want to DIY a print book, print the pages out at home or at a copy shop and get the book stapled with a cardstock or laminated cover. Lowell recommends a spiral coil binding. “It’s inexpensive, the book opens and lies flat on the counter,” he says.

There are also options for heirloom books — hardcover bound books with glossy pages. Johnson prefers erring on the side of usefulness instead so people will actually cook from the book, instead of letting it sit on a shelf.

Working out the number of copies to print can be tricky. Lowell recommends ordering 10% more than you think, since people will see the finished product and want one. Hester originally had 20 copies made, but ended up ordering 100 more because friends wanted them.

Family Cookbook Mistakes to Avoid

There are bound to be a few hiccups along the way. Lowell says it’s unrealistic to assume everyone in the family is going to want to participate. Put the call out and then work with the recipes you receive.

Don’t be a perfectionist. he says. “Family cookbooks are living documents that are currently evolving just like the families themselves,”  notes Lowell. You can always create another volume later.

A common problem with older recipes is deciphering vague descriptions or measurements (such as a pinch of this or that). Martocq advises that “To really capture the spirit of Grandma’s recipe, you should leave the wording as she would have. But maybe in the prep instructions, or in notes, you can add a little more information about what works in your experience. Recipes are living things, so adding your comments just gives it more layers.”

By Brette Sember

Brette Sember is the author of many books about divorce, child custody, business, health, food, and travel. She writes online content and does indexing and editing.

Ways to Be Grateful Every Day

December 6, 2019

Celebrating what you have, and not envying what you lack, is the key
By Julie Pfitzinger

Thanksgiving is the day meant to serve as a reminder to be thankful for everything we have and to be grateful to the individuals who bring love, friendship and fulfillment to our lives.

Kristi Nelson

Kristi Nelson, the executive director of A Network for Grateful Living, believes gratitude should be part of every day.  As she says, even though we have abundance in many areas of our lives, we live in a society that focuses on scarcity.

“Society feeds a sense of lack,” says Nelson, 59, who lives in Western Massachusetts. “There is this prevalence of imagery and messages that ‘everyone has what you don’t have.’”

During the holidays, social media has the tendency to feed this monster more than ever. “The message is ‘other people are having the kind of Thanksgiving [or other holiday] I wish I was having,'” she says. “This really causes low-grade suffering among people.”

The Work of Brother David

A Network for Grateful Living is a global organization with a host of online resources fully devoted to gratitude; its vision is “a peaceful, thriving and sustainable world, held as sacred by all.” Several thousand people visit its website each day, representing more than 240 countries and territories.

The co-founder, and now senior adviser, of A Network for Grateful Living is Brother David Steindl-Rast, OSB, who has received worldwide recognition for his work on behalf of peace, justice and living gratefully.

As Nelson explains: “It’s not happiness that makes us grateful, it’s gratefulness that makes us happy.”

Brother David, now 93, was one of the key figures in the House of Prayer movement which began in the 1970s, composed of a group of more than 200,000 individuals from religious orders in the United States and Canada. He’s the author of several books including Belonging to the Universe and A Listening Heart and continues to travel around the world giving lectures.

On the Grateful Living site, there are multiple articles by Brother David, including this popular one called “The ABCs of Grateful Living: A Practice” in which he goes through the alphabet one letter at a time, tying a word that comes to mind to the topic of gratitude: A is for Amazement, B is for Beauty … and P is for Potholes. He writes, “Potholes in the road give me the opportunity to slow down. That is a great gift.”

The Difference Between Gratitude and Gratefulness

Nelson, a Stage 4 cancer survivor for more than 25 years, has spent a large portion of her life, in both a personal and a professional capacity, celebrating the practice of grateful living.

One of the topics she frequently addresses is the difference between “gratitude” and “gratefulness.”

“Gratitude is something we experience as a happy response when something goes our way,” Nelson says. “But really, that can be a fleeting transaction.”

“When you are grateful,” she continues, “you embody gratitude. And when you choose to live in a state of being grateful, you become more cognizant, you celebrate what you have and not what you lack.”

As Nelson explains: “It’s not happiness that makes us grateful, it’s gratefulness that makes us happy.”

Gratitude Through Challenges

Growing older can bring its share of changes and challenges, making it even easier to focus on what we might be lacking. One place where this may be noticed daily is a loss of the good health we used to have. But here, too, is an opportunity for grateful living.

“Sometimes we become so focused on the ills of the body that we define ourselves by what isn’t working, instead of what is,” Nelson says. “And what’s wrong will always be dwarfed by what is right.”

Another challenge is the loss of a loved one. Nelson lost her mother earlier this year, after tending to her in hospice for six months. While living through the pain of her mother’s death, Nelson sees a path to live the rest of her life with love and honor for her mom.

“There is a purposeful way to be in relationship with loss,” she says. “We can say to ourselves, ‘I am still alive, I have opportunities.’”

Moreover, Nelson believes that living gratefully is the best possible way for us to honor those we have loved.

“They want us to experience joy. They want us to live — what would they have given for another day, another hour?” she says. “We have that time.”

Reflecting on What Makes Us Grateful

Nelson suggests that making time for daily reflection can lead us to be grateful for the experiences of our past. It just depends on the questions we ask ourselves.

“Think back about the times where you’ve made the best of a difficult situation. Think about the times you have shown courage, and the times you’ve shown gratitude — for what, to whom?” she says.

But there are also many opportunities for grateful living right now, Nelson says, which require us to truly be present, not dwelling on how our lives will change as we age.

“A source of great suffering can occur when we live the limitations now that aren’t ours to live,” Nelson explains. “One day, our lives will become smaller and more limited. This should compel us to do the things now that we want to be able to do. Live how we want to live. Participate in the activities that we want to do.”

She adds, “It’s never too late to live gratefully.”

Giving Thanks in an Authentic Way

However you will be celebrating Thanksgiving this year, Nelson encourages you to “fill your day with things that make you grateful and express (to others) how grateful you are.”

A simple way to do this is to spend the week of Thanksgiving writing two cards a day, sending them to people in your life for whom you are grateful. (A Network for Grateful Living offers e-cards on its site.)

“Express your thanks. Be a wellspring of gratitude,” Nelson says. “This can really create a ripple effect because when others are inspired by our actions, they may take action, too.”

By Julie Pfitzinger

Julie Pfitzinger is the editor for Next Avenue’s lifestyle coverage across the Living and Technology channels. Her journalism career has included feature writing for the Star-Tribune, as well as several local parenting and lifestyle publications, all in the Twin Cities area. Julie also served as managing editor for nine local community lifestyle magazines. She joined Next Avenue in October 2017. Reach her by email her at jpfitzinger@nextavenue.org.

Detective Work Serves as Bridge to Care

December 3, 2019

by Pam Policz, nurse navigator, Washington campus

I am a detective. I get to dig deep to learn about each individual. I love learning about my patients and what they hope to get out of their stay with us.

This is my dream job. I get to spend time with our short-term rehabilitation patients to learn more about their healthcare needs and goals. It’s gratifying to become a consistent support and player in their overall care plan.

Helping individuals navigate their care options isn’t just about nursing, or the medical part of the journey. We have a whole team – everyone from dietitians to housekeepers – who play a role in the care experience. I am so honored to be part of the care team, and wouldn’t be able to do my work without my teammates, who make up the backbone of my work.

Together with my team, we build the bridge between healthcare and hospitality, ensuring that the needs of the whole person are met. And that can be anything from helping them to understand their medication to checking in with them to see when they want their room cleaned. It’s everything that we do as a team.

Building the “bridge” is the best part of my work. Once I receive a new patient, I start examining the newcomer’s history, lab results and what brought them to short-term rehab.

I live for the moments I get to spend with each patient. When someone is with us for a short stay, it is often because something has changed in their life. Maybe they’ve just had open heart surgery and need to recover, or maybe they are learning how to manage their COPD.

Regardless, it is my job to get to know them so that we can individualize their care and educate them on their condition so that they can go home feeling empowered.

It is my personal mission to help our patients recover. I help them understand what it takes to get better, show them that I am invested in their care. And when their eyes light up just knowing that they have a support system, I know I’ve done my job well and that I am a visible difference in their lives.

Detecting Early Onset Alzheimer’s Disease in Innovative Ways

November 25, 2019

Thanks to new funding, research on biomarkers and blood tests moves forward
By George Lorenzo

The progression and symptoms of early-onset Alzheimer’s Disease, typically identified in patients in their 40s or 50s, can vary dramatically depending on the individual. According to the Alzheimer’s Association, “getting an accurate diagnosis of early-onset Alzheimer’s can be a long and frustrating process. Symptoms may be incorrectly attributed to stress or there may be conflicting diagnoses from different health care professionals.”

The Alzheimer’s Drug Discovery Foundation (ADDF) is working to eliminate such conflicts through its $50 million Diagnostics Accelerator program. It’s aimed at supporting the development of “novel biomarkers” for the early detection of Alzheimer’s and related dementias.

“The health of small blood vessels is an increasingly recognized component of dementia and AD.”

“We want to accelerate the science,” says Dr. Howard Fillit, founding executive director and chief science officer of ADDF. That means providing funding to support innovative research to quicken the process of developing and implementing clinical trials required for regulatory approval of Alzheimer’s diagnostic tools and programs.

Developing Biomarkers

The onset of Alzheimer’s, in general, is currently diagnosed through: mental and neuropsychological tests performed by primary care doctors and/or neurologists, along with a review of a patient’s medical history; genetic testing that identifies the APOE e4 gene associated with early-onset Alzheimer’s; a PET scan or invasive spinal tap that may reveal the presence of amyloid plaques and/or tau tangles in the brain and a CT or MRI that can identify vascular dementia.

All of these solutions are relatively expensive (excluding mental testing), time-consuming, challenging to take advantage of, and, in some cases, not administered properly nor proven to yield 100% valid results in diagnosing Alzheimer’s.

“We must now develop inexpensive and noninvasive biomarkers, preferably blood tests, that will help diagnose Alzheimer’s disease and track the effectiveness of treatments,” wrote Fillit in a recent article published in Scientific American.

4 First Round Award Winners

ADDF’s first round of award recipients, announced on May 30, 2019, allocated approximately $3.5 million to two Alzheimer’s diagnosis blood tests and two retinal imaging R & D programs. The four — Saliha Mussaoui, Amoneta Diagnostics, based in France; Kaj Blennow, University of Gothenberg, Sweden; Tom MacGillivray, University of Edinburgh, Scotland and  Peter van Wijngaarden, the Centre for Eye Research in Australia  — were chosen out of 300 applicants from 30 countries.

Creating a Blood Test to Identify Early-Onset Alzheimer’s

Amoneta is an affiliate of Firalis, a life sciences biotechnology company created by Dr. Huseyin Firat. Since 2014, Amoneta has conducted research and development for ultimately creating a valid blood test that can identify mild cognitive impairment (MCI) and early-onset Alzheimer’s.

The test, called MemoryLINC, is based on finding difficult-to-monitor and characterize lncRNAs (long noncoding ribonucleic acids) in blood panels. These lncRNAs regulate gene expression and diverse biological functions. “It is increasingly recognized that lncRNAs is tightly related to the pathogenesis and prevention and cure of AD (Alzheimer’s Disease),” notes a January 2019 study published in Pathology – Research & Practice.

Fillit says Amoneta has data indicating that certain RNAs are elevated in blood samples of people with Alzheimer’s that are relevant to learning and memory and the disease itself.

The MemoryLINC Project has reached its final clinical validation phase comprised of 800 subjects at 13 European clinical sites in France, Switzerland, Belgium and Turkey. Firat says “the MemoryLINC study is the most important clinical study ever done in this domain.”

Tau-related Research

The ADDF funding for Blennow’s project intends to develop brain-specific, tau-related blood tests to identify and monitor neurodegeneration. Tau is a protein contained in nerve cells. It resides in cerebrospinal fluid in the brain and spinal cord and can be gauged through an invasive and highly uncomfortable spinal tap. The aggregation and collapse of tau into tangles that elevate and spread throughout the brain is symptomatic of Alzheimer’s.

“Measuring tau in blood can be very useful,” Fillit explains. “But the problem is that tau is present in the blood in such low quantities as it relates to [Alzheimer’s] that, so far, we haven’t been able to measure it effectively.” Blennow, however, has discovered how to measure brain-specific tau fragments in blood.

Over the next two years, Blennow’s team will evaluate the presence of different levels of tau in blood samples. Many of these samples will be identified from a Swedish BioFINDER cohort at Lund University, which includes 600 cognitively healthy individuals, 500 patients with subjective cognitive dysfunction or mild cognitive impairment, and 100 patients with Alzheimer’s.

“This is an exploratory project aiming to develop a novel analytical method to establish robust blood biomarkers for tau,” Blennow explains.

Looking Behind the Retina

The other two ADDF-funded awardees are conducting research on imaging techniques and processes that can identify the possible unhealthy accumulation of amyloid plaques behind the retina, which is another symptom of Alzheimer’s. The Alzheimer’s Association’s “2019 Alzheimer’s Disease Facts and Figures” report noted that recent research has shown that the accumulation of amyloid in the brain “were significantly increased starting 22 years before symptoms were expected to develop.”

In addition to focusing on amyloid buildup, MacGillivray’s project is looking closely at vascular changes in the small blood vessels in the back of the retina, both of which can be seen with Optical Coherence Tomography (OCT) machines that are commonly utilized by ophthalmologists.

MacGillivray says the health of small blood vessels is an increasingly recognized component of dementia and Alzheimer’s. “We think we see differences in how wide or how narrow these blood vessels are, and also the number of blood vessels that fill the tissue space,” he notes.

“We are seeing potentially a dying lack of blood vessels or a less optimum range of blood vessels delivering oxygen and nutrients to vascular tissue, and this is then replicated in the brain,” says MacGillivray. “We have a quick and non-invasive way to see if blood vessels are changing [by utilizing relatively inexpensive OCT imagery scans] and degrading in a detrimental way inside the brain without having to go through expensive techniques such as MRIs and PETS.”

‘A Wealth of Information’

“Imagine a world where people who may have memory problems are referred by their primary care doctor to the ophthalmologist around the corner,” Fillit says. The ophthalmologist uses the OCT machine to see if there is an amyloid plaque buildup in the back of the eye. It could tell you whether a person is “cooking” Alzheimer’s or not, notes Fillit.

These same principles apply to Wijngaarden’s project, but with different mechanisms and equipment. This one also deals with looking behind the retina for amyloid plaques, but utilizes a sophisticated camera technology, called hyperspectral imaging. That technology can capture images behind the retina revealing different colors of light that correlate to early-onset Alzheimer’s based on amyloid plaque buildup.

“We can get a wealth of information about the structure of the back of the eye,” Wijngaarden says.

To support his research and ultimately incorporate it into everyday clinical practice, Wijngaarden has developed a low-cost portable camera for hyperspectral imaging of the retina. It’s being tested for use in routine eye exams where the camera will identify amyloid plaque buildup years before a patient might show signs of cognitive decline.

The Future

“What we want to do with the digital accelerator is advance these technologies, measuring things like function, cognition and a whole variety of other variables,” Fillit says.

How long will it take for such innovative technologies to possibly get government approval through clinical trials and validation and ultimately reach patients at their next doctor visit? Amoneta estimates that its blood test could be launched for use in clinics in the U.S. and Europe by 2021. The three other awardees all agree that it should take three to five years for their technologies to possibly become common practice in clinics.

By George Lorenzo

George Lorenzo is an independent writer and publisher from Ann Arbor, Michigan. He writes about aging at OldAnima.

Get by with a little help from Presbyterian SeniorCare Network

November 20, 2019

Get by with a little help from Presbyterian SeniorCare Network
Alzheimer’s support services are available across our Network

Alzheimer's disease is life-changing for both those who are diagnosed and those close to them. Having a helping hand when you need it is key to keeping yourself, and your loved one living with dementia, healthy and happy. When you need a little help or an ear to listen, support services are available.

Support groups

Often times, caregivers say they are looking for support from people who "really understand because they've been there." An Alzheimer's Support Group offers just that – a place for caregivers, family and friends of persons with dementia to meet and develop a support system.

Support groups offer a place to:

  • Exchange information on caregiving problems and solutions
  • Talk through challenges and ways of coping
  • Share feelings, needs and concerns

Presbyterian SeniorCare Network, in affiliation with the Alzheimer’s Association, holds support group meetings in various locations:

We hope you'll join us! 

7 Tips for Being a Successful Snowbird

November 12, 2019

Wintering in warmer climates is not the same as a vacation
By Bart Astor

In the next few months, thousands of northerners — so-called “snowbirds” — will escape their snowy, cold climates to spend the winter in warm, sunny spots in the southern or western part of the United States. My wife and I will be among them. We’ve been swapping our Virginia home for one in Florida for the past four winters and boy, have we made a lot of snowbirding mistakes.

Let me tell you seven lessons we’ve learned. If you’ll be a snowbird this winter, maybe they’ll help you avoid our goofs.

  1. Choose a place that reflects your lifestyle. Often, snowbirds choose areas based on where they’ve vacationed. But here’s the thing: Spending a few months somewhere and living your daily life there is not a vacation. That’s why your snowbird location needs to reflect the kinds of activities and lifestyle you most enjoy doing regularly.

Before you leave home, create automatic payments with your creditors, set up electronic bill pay with your bank and, if your bank doesn’t have a branch where you’ll be, open a checking account near your winter home.

If you’re an active, Type A personality, you won’t be content with a laid-back beach community for long. So, you might want to rethink that isolated beach house and choose an area where you can keep active, go to different restaurants, hang out with others and live a lifestyle similar to the one you have up north.

  1. Don’t go all in the first year. Start your snowbirding experience by renting a place just for a month or two before committing for the full winter. You really won’t know if you love it until you live it and won’t know if you’ve chosen the right place until you’ve spent several weeks or more there. If you’re not happy, try a new area next year.

Once you’re sure you’ve found the right spot, book the whole winter. If you can, talk with the landlord and book the following year before you leave. Good rentals go quickly.

  1. Go electronic with all your bills. Years ago, it was difficult to keep up with the business of your life when you were away from home. You had to rely on the mail to receive and pay bills and get checks, plus keep up with the myriad things you had to do. Technology, however, has made it so much easier.

So, before you leave home for the winter, create automatic payments with your regular creditors, set up electronic bill pay with your bank and, if your regular bank doesn’t have a branch where you’ll be, open a checking account near your winter home. Then, set up the ability to electronically transfer funds back and forth between your banks.

  1. Make new friends! One of the difficult things about being away from home for months at a time is the growing distance you’ll feel with friends and family. You try to stay current — FaceTiming, texting or calling frequently — but it’s not the same. You can’t get together for hours at a time over dinner, for instance.

Fortunately, when you join a new community as a snowbird, you’re likely to find many there just like you. Introduce yourself.

  1. Don’t overbook visitors. Friends and family from up north may want to visit, since you’ll be basking in the sun while they’d be shoveling snow. Just don’t overdo extending open invitations.

We love when our pals and loved ones come to visit. But being a frequent host takes a lot of time and energy. So, schedule those visits in moderation. Otherwise, your winter home will turn into a bed and breakfast (without the income)! Also, try to limit the length of stay for your houseguests. As Ben Franklin said: “Guests, like fish, begin to smell after three days.”

  1. Make your snowbirding home a second home. If you buy a place rather than renting one, it’s quite a bit easier to keep clothes and other necessities there so you don’t have to lug them all back and forth. But even if you’re renting, it’s possible to store some items either in the residence itself (with the landlord’s permission) or in a nearby storage unit. Doing so will make traveling to and from much easier. And having your belongings with you will add to the feeling of your snowbird home feeling like “home.”
  2. Take your time traveling back and forth. For many people driving to their snowbird location, the trip takes two days, maybe three. What’s your hurry? You’ll be there for three or four months. Why not turn your travel into enjoyable road trips of four or five days or longer?

Stop to see places that are “almost” along the way. Visit friends or family you typically only see rarely. Stop in the fun city or national park that you’ve been meaning to see for years. This will make the journey fun and easier on the body.

By Bart Astor

Bart Astor, an expert in life transitions and elder care, is the author of the book AARP Roadmap for the Rest of Your Life: Smart Choices About Money, Health, Work, Lifestyle and Pursuing Your Dreams and Baby Boomer’s Guide to Caring for Aging Parents. His website is BartAstor.com and he can be reached at Bart@BartAstor.com.@bartastor

6 Early Signs of Alzheimer’s Disease

November 4, 2019

Some believe that severe memory loss is a normal part of aging. This is not true. How can you tell the difference between age-related changes and Alzheimer’s disease? Here are six early signs to watch for—and what may just be age-related changes.

  1. Forgetfulness: Is recently learned information, such as today’s weather forecast, more frequently forgotten? Do you or a loved one forget important dates, locations or ask the same questions repeatedly? Age-Related: Sometimes forgetting dates or appointments but remembering them later.
  2. Problem Solving Challenges: Is following a plan or working with numbers more difficult? Is it often harder to make decisions or concentrate on doing familiar, everyday tasks, like driving to work? Age-Related: Making occasional planning or mathematical errors.
  3. Confusion with Time or Place: Do you or a loved one permanently lose track of the date or even forget where you are or how you got there? Age-Related: Losing track of the day of the week but remembering it soon.
  4. Vision Issues: Has judging distance, reading or recognizing color become an issue? Age-Related: Other visual changes, such as those related to cataracts.
  5. Trouble with Words: Is it harder to carry on conversations or find the right words for common topics when speaking or writing? Age-Related: Occasionally searching for the rights words.
  6. Personality Changes: Have you or a loved one started to avoid social activities or hobbies? Do you sometimes feel confused, suspicious, depressed or fearful? Age-Related: Sometimes avoiding social situations or wanting to do things your own way.

SOURCE: Alzheimer's Association

My Second Act: Starting a Newsletter

October 30, 2019

Financial journalist Vera Gibbons on her risks and rewards launching it
By Kerry Hannon

It’s 7 a.m., and, like clockwork, the Nonpolitical News digital newsletter lands in my email inbox. I’m a subscriber.

After slogging through my daily morning news reading — mostly from national media outlets and my Twitter feed — this free newsletter is a breath of fresh air. It’s filled with short, breezy news highlights and stuffed with links to “some need-to-know news, some nice-to-know and some ‘who knew?” as Vera Gibbons, the second-act founder and editor of NonPoliticalNews.com (NoPo) described it to me in an interview.

The 52-year-old TV financial journalist launched NoPo newsletter —“for those who are sick and tired of the political headlines” she told me — last year because she felt she needed to make a career switch.

“There came a point when the political climate became so relevant, and that’s all anybody was covering (on TV). My air time got slashed by fifty percent. I was at a crossroads,” she said. “I don’t talk politics. They really only wanted political people on air either pro or con. It was, ‘Well, I’m going to have to do something different, if I want to keep working. I’ve been in the news business forever. So, it was a logical next step for me.”

I know news. I love the news. To transfer my skills over was a slam dunk. It was an easy transition.

Gibbons is a former financial contributor to CBS’ The Early Show and has worked as a correspondent for CNBC’s High Net Worth and MSNBC. She still appears on national news networks and writes freelance articles.

Risks and Rewards of a Midlife Career Change

Gibbons told me she’s well aware of the risks and challenges of a midlife career change. But she was frustrated by the changing news business and looking for a way to remain relevant in a field she’s passionate about.

Each of the newsletter’s sections — Consumer/Personal Finance, Health/Wellness, Fashion/Beauty and Fitness/Diet — has five to seven links to the latest news ranging from, say, Walmart unveiling a rewards credit card to how to find the perfect workout for your personality.

Gibbons is fortunate. She’s a saver and built up enough of a financial cushion to take a leap of faith and self-fund her venture. Meantime, she has enough freelance business on the side to help pay some bills while building the newsletter to the point where she can pay herself.

Here are excerpts from my conversation with Vera Gibbons about starting a newsletter business as a second act in midlife:

Kerry Hannon: There seems to be plenty of competition in the newsletter arena, particularly The Skimm, the current-events newsletter for millennial women. Who is your target audience?

Vera Gibbons: My audience, which is now twenty-five thousand subscribers from New York to Dubai to Hong Kong and Los Angeles, is more for my age — for Skimm parents, if you will. They are smart, educated, sophisticated and many are news junkies like me.

Another differentiator: They’re explaining the news; I’m exposing it — all the stuff that isn’t getting covered due to the heavy political coverage.

I often say about second acts that you’re not reinventing yourself, but often redeploying skills from your previous career. How is that true with your experience?

That is so true for me. I know news. I love the news. To transfer my skills over was a slam dunk. It was an easy transition.

Who do you consider your competitors?

There are lots of other newsletters out there. We are the only ones doing nonpolitical news only. I do like Morning Brew and read that regularly just to see what they’re up to. I also read Market Snacks, but they, like the others, are explainers. Then there are explainers like The New York Times, CNN, Huff Po;  but they only use their own stories, of course.

What have you learned trying to start a newsletter in midlife? What’s been your biggest challenge?

I’ve learned the importance of having a team as dedicated as you are to the service.

The biggest challenge has been finding the right people to have on my team. You really need people as devoted and committed as you are. We only have news junkies helping us out who are crazy and spirited and love news as much as I do.

They’re volunteering their time at this stage. They provide a lot of the stories over the course of the day. I get up between 4 a.m. and 5 a.m. to curate what they have given me, and I turn the TV on to see if there’s anything that’s more relevant.

I’m trying not to bite off more than I can chew. Now people are saying ‘You need a podcast.’ I’m focused on doing one thing, and doing it very well.

And what have been the rewards of becoming an entrepreneur in midlife?

At this stage in my career, I know the news business and have a network of people who trust my judgment. I have television news show bookers and producers and anchors opening the newsletter every single day. They know I’m a reliable source. The biggest reward is seeing the growth of the product.

Getting the thumbs up from subscribers means the world to me.

What’s your advice to others who want to launch a start up at this stage in their lives?

Go slowly. You have to test the waters and see if there’s a market.

I started on Facebook, posting items as updates. It was almost a hobby at first. And I kept getting more and more Likes, and people saying I should really do more with it.

I began solo, but currently have a team of six, who all work remotely. I work out of my home office, on the Upper East Side of Manhattan.

What’s a ballpark figure for what you’ve invested in your venture?

I’ve invested probably fifty thousand dollars of my own money and have been bootstrapping up to this point.

The legal fees are the most expensive. Trademark searches alone were about ten thousand dollars. My next big expense is my techie, who is on retainer. He handles delivery issues, website, design, promotions and hosting.

I do have venture capital firms calling and have met with potential investors. But for now, I would like to focus on the growth of newsletter. Taking on investors is a different ballpark. Now I have control of the content and can put in the stories I want.

When do you expect to be able to pay yourself?

Hopefully in 2020.

By Kerry Hannon

Kerry Hannon is the author of Never Too Old to Get Rich: The Entrepreneur's Guide to Starting a Business Mid-Life. She  has covered personal finance, retirement and careers for The New York Times, Forbes, Money, U.S. News & World Report and USA Today, among other publications. She is the author of a dozen books including Money Confidence: Really Smart Financial Moves for Newly Single Women and What's Next? Finding Your Passion and Your Dream Job in Your Forties, Fifties and Beyond. Her website is kerryhannon.com. Follow her on Twitter @kerryhannon.

How to Find a Good Estate Planner

October 25, 2019

If you've put off getting a will drafted, here's help in hiring a pro
By Elizabeth Alterman


Estate planning is a critical part of financial planning, but something many Americans procrastinate about. Yet drafting a will and a health care proxy or power of attorney, maybe creating a trust, and maximizing your loved ones’ inheritances by minimizing taxes are all important matters you don’t want to leave to chance.

Taking care of these key tasks properly limits the potential for family turmoil and possible legal battles should you become incapacitated, as well as after your death. An estate planner can help you prevent crucial missteps and assist you in adjusting your plans as your circumstances, and laws, change.

Here are a few tips for finding one:

Look For a Specialist

Not all attorneys specialize in estate planning. So, you’ll want to find one whose primary focus is estate and trust law in your state.

If you don’t know where to begin the search, ask around, says Paul T. Joseph, an estate planning attorney, Certified Public Accountant (CPA) and founder of Joseph & Joseph Tax & Payroll in Williamston, Mich.

“You need to determine if the attorney typically deals with estates that are similar to your unique situation.”

“Talk to family members and friends to see if they can recommend anyone with whom they’ve worked,” advises Joseph. “Speak with other professionals that you work with to see if they have anyone they can recommend.”

You can also look at the National Association of Estate Planners & Councils’ website and the American Academy of Estate Planning Attorneys site to find an accredited estate planner in your area.

Once you’ve found a few possibilities, don’t hesitate to ask the estate planner for references. Speak to those clients to get a feel of what it will be like to work with this pro, as well as the quality of the planner’s work.

Ask About the Attorney’s Experience

Once you’ve narrowed down your list, inquire about the exact nature of the attorney’s trusts-and-estates experience.

“You need to determine if the attorney typically deals with estates that are similar to your unique situation,” says David Reischer, estate planning attorney and CEO of Legal Advice.com. “Some attorneys manage complex business estates, while others cater to small businesses and families.”If you have an aging parent, you may want to hire an estate planner who focuses on elder law.”

Experience is critically important.

“I recommend a three-year minimum in estate planning,” says Jessica Campbell, a CPA and financial adviser at the personal finance website, End Thrive. “That knowledge and specialized experience comes with being well-versed and up-to-date with the laws of your state. Otherwise, your estate plan could be deemed invalid by the court.”

Ask What, and How, the Estate Planner Charges

The amount you’ll spend depends on the complexity of your needs, your location and your attorney’s experience level. Fees for wills can range from about $100 for a simple will to several hundreds for an in-depth will, notes Joseph.

Add on a trust, and the cost tends to get much steeper. A trust can help save on estate taxes, avoid probate (proving in court that a will is valid), save on time and court fees and put conditions on the disposition of your assets after you die.

“Often, having a will and trust drafted can cost several thousand dollars,” says Joseph. “I have seen fees in the neighborhood of fifteen hundred dollars all the way up to ten thousand dollars or even more, depending on the complexity of the documents.”

If you need an estate-planning attorney to draft a power of attorney (authorizing someone to make financial or legal decisions for you when you can’t) and other advance directives, that might cost about $1,100 or so alone. When combined with a will, a single person might figure on paying closer to  $2,600, says Eric R. Goldberg of NJ Elder Law Center at Mandelbaum Salsburg in Roseland, N.J.

When interviewing potential candidates, ask them what they’d charge you and how you’d be charged. (Some offer a free consultation for this first visit; others will charge you, but then apply that amount toward your total cost if you choose to hire them.)

Many estate-planning attorneys charge a flat fee. “For a will, the range could be as low as a hundred dollars to several hundred dollars,” says Joseph.

If you meet with a flat-fee attorney, find out exactly what the cost includes and ask if it’s based on a set number of visits or just a certain time period. Additionally, determine which documents are covered by the fee and whether the fee includes the cost of any future updates.

Some estate-planning attorneys charge by the hour. As a rule of thumb, these lawyers typically have hourly fees of $250 to $550.

If you’ll use one who charges this way, ask approximately how long the process will take, so you have an idea of the total cost from the outset.

Neither option is necessarily better than the other. But, says attorney Steven M. Zelinger of Philadelphia, “Most estate planning can and should be done on a flat-fee basis with the understanding that updates are needed over the years as your situation — or even the law — changes.”

You might be able to save some money by using a junior lawyer at the firm. “Typically, junior lawyers in a large firm charge less than the senior lawyers,” says Joseph. And, Goldberg notes, “all junior attorneys are supervised by partners.”

But, Joseph advises, “depending on the complexity of your estate, you may be better served by hiring someone who has substantial experience, even though it may cost you more.”

Recognize This Is an Ongoing Relationship

While interviewing estate planners, be certain that you’ll feel comfortable with the person you choose, says Campbell.

“Since you’ll be sharing personal details of your life and your concerns with your estate planner, you’ll want to feel comfortable and listened to,” she notes. “A good estate planner should pay attention to even the smallest details and ask questions about your situation to tailor a plan unique to you and your needs.”

Ask About Support Staff and Succession Planning

As you’re selecting your estate planner, inquire about the practice’s support staff, too. Is there a highly skilled team to ensure the quick turnaround of documents and timely communication with you as well as your loved ones?

Zelinger also stresses the importance of looking ahead. “I think it’s a good idea to ask about the age and succession plan of the lawyer,” he says. “I am on the younger side (42), so I will be around for many years. But what if I die or retire early?”

Some people prefer a larger firm, knowing that no matter what happens to their particular lawyer, someone will be there to take over, if necessary.

By Elizabeth Alterman

Elizabeth Alterman is a freelance writer with more than 20 years' experience in digital and print media. Her writing has appeared on Forbes, The New York Times, Newsweek, Mashable, The Muse.com and Realtor.com.

Staying Mobile in the Hospital Helps to Get Better and Get Out

October 22, 2019

It’s counterintuitive to some, but activity is proven to make all the difference
By Edie Grossfield

Part of the Age-Friendly Health Care Special Report

(Editor’s note: This story is part of a series for The John A. Hartford Foundation.)

In her work as the chief nursing officer for Anne Arundel Medical Center in Annapolis, Md., Barbara Jacobs recently found herself dodging a lot of patients walking in the corridor as she made her way down the hall.

“There were so many people up and moving, and that was a good problem to have,” she recalls. Jacobs is pleased that the hospital’s initiative of the past two years to keep patients — especially older ones — mobile during their time there is working.

Because staying mobile helps maintain muscle function and overall healing, it also reduces the risk of falls.

Like many hospitals around the country, Anne Arundel is recognizing the important role mobility plays in healing, reducing the risk of medical complications and ensuring that older patients will be able to return home after they’re discharged, rather than having to go a nursing home or rehabilitation facility.

Immobility Leads to Problems

“One of the things that is absolute is when a person becomes immobile, the loss of muscle tone is very, very quick — the actual loss of muscle mass is quick,” Jacobs says. “So, when a person comes into the hospital and becomes immobile, it’s significant — even if you’re young, you will go out feeling weak.”

And weakening muscles is just one of the negatives of being in a hospital bed for days.

“When we lay in a bed, our lungs are laying back against the back of our body,” Jacobs explains. “For maximum performance of our lungs, you’re supposed to be standing or sitting, where gravity is helping open our lungs. So, we’re more prone to developing pneumonia (and other respiratory illnesses) because our lungs are not in the position that they should be if we leave you in bed all day long.”

Immobility during a hospital stay is connected to a number of other problems, including frailty, falls and even death, “even after controlling for illness severity and comorbidity,” according to a 2018 article in the journal Gerontology and Geriatric Medicine.

Hospitalized older adults who remain mostly in bed are 34 times more likely to die and six times more likely to end up in nursing homes after their hospital stays than those who move around at least twice per day, according to research that included nearly 500 people age 70 and older.

Mobility Priority at Anne Arundel

In 2017, Anne Arundel Medical Center began its new mobility practices in the hospital’s geriatrics unit, which is an Acute Care for the Elderly (ACE) unit. Anne Arundel’s ACE unit is part of the hospital’s “age-friendly” initiative, with the goal of aligning care to what matters most to each patient.

Patients of all ages, inside and outside the ACE unit, who are able to get out of bed and move are encouraged to do so — ideally at least three times per day.

“It depends on the patient, obviously,” Jacobs says. “There are times when the person is too sick to get up. But for most people, they should be getting up and mobilizing as far as they can every day.”

That means doing some walking, even if it’s only a short distance.

“If the farthest you can get is walking from your bed to the door, great,” Jacobs says. “If you only go from the bed to the door two times today, but the next day you go fifty feet, that’s great.”

To help get patients moving, Anne Arundel has people called “mobility quality technicians,” whose main job is to ensure that patients who are able to move do so daily.

Movement and Socialization With ACErcise

The ACE unit also launched “ACErcise,” a group exercise program that Jacobs says is popular with patients. The groups do chair exercises and walk to and from their hospital rooms. Other hospitals around the country with ACE units have similar programs.

“Part of what makes it great is the socialization of being together,” Jacobs says. “Then, we had some (patients) who said, ‘Can we just eat together?’ So, after ACErcise, we put up a table and they can eat together.”

This emphasis on mobility has been important to patient Cline Warren’s recovery, says his wife Martha Warren. The couple live in southern Anne Arundel County. Cline Warren, 91, who has dementia, was brought into the hospital after he accidentally ingested a caustic substance.

“He’s much better,” Martha Warren says, adding that along with the exercise, the socialization aspects have been especially helpful. “It certainly contributes to being less bored — you know, being in your room alone. And (it helps to) be able to focus on other patients or the activity director.”

Patients ‘MOVE’

At St. Mary Mercy Livonia, a hospital in the Detroit suburb of Livonia, hospitalized patients have been staying active through “Mobility Optimizes Virtually Everything,” or MOVE, since 2017.

“As I was researching this topic prior to implementation of MOVE, I found out that every day a person spends in the hospital bed can take up to four days to regain their strength,” said program manager Belinda Dokic, adding that the hospital implemented MOVE because “mobility can also be a medicine.”

As part of MOVE, each patient receives “personalized mobility goals,” which nurses and aides review daily with patients.

MOVE began in St. Mary Mercy’s observation unit. This included adding full-time ambulation aides who were trained by the hospital’s physical therapists on how to safely move patients to avoid falls and injuries. Toward the end of 2018, the hospital added MOVE to its medical/surgical unit.

The goal of MOVE is to walk patients twice per day. Patients who are unable to walk are encouraged and helped to at least move from their bed to a chair for some period of time during the day.

“Any movement is good.” Dokic says. “Even if the patient is laying in bed and we (adjust) the bed for them to sit up and eat (a meal) that way, or we move them from bed to chair or even help them walk from a chair to the shower — all of this is considered movement.”

Mobility Helps With Fall Prevention, Too

Because staying mobile helps maintain muscle function and overall healing, it also reduces the risk of falls. This is something Dokic has seen at St. Mary Mercy, where the patient falls rate in the two units with the MOVE program decreased from 2.7% to zero from the last quarter of 2017 to the first quarter of 2018.

For some, more movement brings concern of more risk of falls, but a study led by Johns Hopkins Hospital researchers in 2016 found that increasing patient mobility did not increase the number of patient falls with injuries.

St. Mary Mercy carefully trains its ambulation aides, Dokic says. “I think it was four hours of training, where they were shown how exactly to move the patients without putting them at risk to have a fall,” she says.

Patient and Family Buy-In

Nurses and other staff working on mobility programs occasionally encounter concerned family members who believe their parent or other loved one shouldn’t be moving around while in the hospital.

“The family member might say, ‘Well mom’s been sick. Just let her rest in bed,’” Jacobs says. “But we’re actually not helping mom if we just let her rest in bed the whole time. So we have to actually say to the families, ‘No, this is an important part of your mother’s healing, that we get up and ambulate with your mom.’”

Staff also encounter patients who would rather not get up, understandably, because they don’t feel well. In that case, Jacobs says, it’s important to remind patients and families that remaining immobile could lead to a longer hospital stay, or worse.

“There’s a question we ask everybody every day (in the ACE unit), and that’s ‘What is it that really matters to you?’ This is part of our age-friendly work,” Jacobs says. “And the majority of patients answer that they want to get home. Well, the best thing we can do to get you home is to keep you moving. So, if that’s your plan, let us help get you there.”

By Edie Grossfield

Edie is Next Avenue’s health and caregiving editor. In this role, she reports on the information people need to make sound decisions about caregiving, their health and the health of their loved ones. She has been a journalist for more than 20 years, reporting and editing for newspapers and magazines. Edie has a master’s degree in journalism from the University of Wisconsin-Madison. Reach her by email at egrossfield@nextavenue.org.

 
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