Category / Nutrition Diet

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.

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

Simple Steps to Keep the Deadly C. Diff Infection at Bay

January 22, 2019

The contagious bacterial infection can be more serious for older adults
By Mark Ray

When you were a child, did you worry about monsters hiding under your bed or lurking behind your closet door? It turns out one monster — clostridium difficile, or C. diff — may actually be closer at hand, at least in hospitals and nursing homes.

Transmitted via fecal matter, the C. diff bacterial infection can cause severe diarrhea, nausea, fever, dehydration, abdominal pain, kidney failure and even death. Older adults are more vulnerable to it because of naturally weaker immune systems, more likelihood of underlying health issues and more time spent in health care settings.

  1. diff is resistant to some antibiotics, but there are some shown to work against it. In serious and recurrent C. diff cases, patients may undergo a fecal transplant or surgery to remove a portion of the colon.
  2. diff spores adhere to every imaginable surface, including toilet seats, faucet handles, doorknobs, linens, bedrails, nurse call buttons, chair arms, ceiling vents and even floors. A 2017 study in the United Kingdom detected it in floor corners in 86 percent of hospital rooms that had undergone routine cleaning.

Since its spores resist standard cleaning methods and alcohol-based hand wipes, C. diff is tough to eradicate. “We know those spores can last nine months or more in a room,” says Dr. Kate Mullane, an infectious disease specialist at The University of Chicago Medicine. “It takes a high concentration of bleach to kill the spores: a cup of bleach in a gallon of water.”

And killing the spores is critically important because C. diff itself is a killer. The most common microbial cause of health care-associated infections in the United States today, it causes nearly half a million infections and 15,000 deaths annually — almost as many deaths as drunk driving and HIV/AIDS combined,  according to the U.S. Centers for Disease Control and Prevention (CDC). Eighty percent of C. diff deaths occur among people 65 and older, and one in 11 patients in that age group dies within 30 days of diagnosis.

A two-pronged approach can keep this microscopic, but deadly killer, at bay. Prong one is antibiotic stewardship; prong two is infection control.

Antibiotic Stewardship

You’ve doubtless heard the world uses far too many antibiotics, wasting money and contributing to the growing problem of antimicrobial resistance. The Pew Charitable Trusts reported that 30 percent of outpatient antibiotic prescriptions in the U.S. are unnecessary (antibiotics prescribed for a viral infection, for example).

Doctors are getting more judicious in their use of antibiotics, but Mullane says patients should still talk with their doctors about the drugs they’re prescribing. If you can avoid antibiotics, or at least broad-spectrum antibiotics, you will be less vulnerable to C. diff. This is because, along with the bad bacteria the drugs are after, antibiotics also kill much of the good bacteria in our intestines. This leaves C. diff an opportunity to overwhelm the gut and cause illness.

  1. Diff Infection Control

Given C. diff’s persistence in health care environments, it’s also important to prevent transmission between patients, health care workers and visitors — including people who aren’t symptomatic.

“We know at any one time, about 5 percent of the population is colonized with C. diff,” Mullane says. “They may not be sick with it, but they’re at least carrying it.”

The easiest way to stop transmission is with proper handwashing, according to Anna Barker., a researcher in the medical scientist training program at the University of Wisconsin-Madison. “Even with hospital-grade hand sanitizer, which in many cases is pretty similar to what you would buy out in the community, you do still need to use soap and water,” she says.

“It’s not only the soap and water (that gets rid of the germs), it’s the friction and having your hands under the tap water, which you just don’t get when you use (hand sanitizer) gel,” Barker says. A good rule of thumb to make sure you get rid of the germs: Wash your hands for as long as it takes to sing Happy Birthday to You.

But hand hygiene is just the beginning. In the April 2018 issue of the journal Clinical Infectious Diseases, Barker and two colleagues reported their research on the effectiveness of nine discrete C. diff hospital interventions, including everything from patient hand hygiene to terminal cleaning (deep cleaning of a room after a patient is discharged).

Using computer models, Barker and her colleagues found that daily room cleaning with a sporicidal cleaner plus screening for C. diff at the time of admission reduces hospital-associated infections by roughly 82 percent and asymptomatic colonization by about 91 percent.

“When hospitals try to combat their C. diff rates, they’ll end up doing lots of things at once,” Barker says. “This paper showed you can get a considerable reduction in C. diff with only those two interventions.”

What Patients Can Do

While patients don’t have much control over infection-control practices in a hospital or clinic, they can take two concrete actions.

The first is to ask health care providers if they’ve remembered to wash their hands.

“That’s easier said than done given everything we know about power dynamics and the patient-doctor relationship, but I think that really has a potential to make a big impact,” Barker says.

The other action, perhaps surprisingly, is to reduce the clutter in hospital patient rooms.

“One of the things we hear from the cleaning staff is that it’s very difficult to clean a patient’s room effectively if there are newspapers everywhere or books or food or other items throughout the room,” Barker says. “They can’t, at least at our institution, move the patient’s things for them.”

While decluttering your hospital room may not be quite as simple as switching on the lights to banish an under-bed monster, it can go a long way toward keeping you safe from C. diff.

Mark Ray is a freelance writer who has written for Scouting, Eagles’ Call, Presbyterians Today, Kentucky Homes & Gardens and other publications. He has also written, edited and/or contributed to a dozen books for the Boy Scouts and the Presbyterian and United Methodist churches.

8 Reasons You’re Losing Sleep

January 8, 2019

Avoid these culprits to get a better night's rest
By Sheryl Kraft

E-READERS

As if there weren’t enough things keeping you tossing and turning each night, here’s a new one: Using short-wave, blue light-emitting e-readers, like the iPad, iPhone, Nook Color, Kindle and Kindle Fire before bedtime can make it harder to fall asleep, according to a December 2014 study at Brigham and Women’s Hospital in Boston.

“When blue light hits the optic nerve, it tells the brain to stop producing melatonin,” which is “the key that starts the engine for sleep,” says Michael Breus, diplomate of the American Board of Sleep Medicine and fellow of the American Academy of Sleep Medicine. “This is especially problematic, since as you get older, the ability to produce melatonin becomes even more compromised.”

Fixes: Open up a real book instead. (Remember those?) If giving up your e-reader is impossible, look for screens and glasses that can block the sleep-stealing blue light on websites like Lowbluelights.com.(MORE: 6 Habits That Ruin a Great Night’s Sleep)

BEING OVERWEIGHT

Carry extra pounds, especially in the neck and trunk section, and it’s more likely you’ll suffer from sleep apnea, which causes your airway to become blocked or obstructed during sleep, robbing you of quality deep sleep. The condition affects 90 percent of obese men, though it’s not purely a man’s disease. The Cleveland Clinic reports that after menopause, it’s just as likely to affect women. Even more disturbing, it goes undiagnosed in as many as 80 percent of those who get a lousy night’s sleep.

“Sleep apnea can mask itself as fatigue, trouble with concentration, dry mouth or even depression,” Breus states.

Unfortunately, the relationship between sleep apnea and obesity is a bit of a chicken-egg scenario. Do sufferers have problems because they’re obese, or is their obesity stoked by their compromised sleep? No one knows for sure, but what is known is this: Poor sleep makes people less motivated to increase physical activity, which can lead to more weight gain. Additionally, reduced sleep is associated with elevated levels of the hormone leptin, which helps regulate appetite.

Fixes: Among the various treatments for sleep apnea is a continuous positive airway pressure (CPAP) machine, which delivers air pressure via a mask that sits over your nose or mouth while you sleep. Other treatment options include losing weight, oral appliances (that resemble mouthguards), and Inspire Upper Airway Stimulation (USA) therapy, a new FDA-approved implantable device.(MORE: A Good Night’s Sleep Could Ward Off Alzheimer’s)

MEDICATIONS

Many popular over-the-counter pain medications, like Excedrin and Bayer Back and Body, may contain caffeine, which helps the medication get absorbed more quickly, but can cut into your sleep, according to Breus (who suggests always checking the label first). If you’re feeling under the weather, beware of nasal decongestants and daytime cold or flu medicines, as well, which can contain pseudoephedrine; you’ll feel jittery instead of tired.

Diuretics, water pills for heart disease and high blood pressure, and ADD medications like Adderall and Ritalin can also disrupt sleep, says Dr. Hrayr Attarian, a neurologist at Northwestern Memorial Hospital in Chicago, Ill. Other culprits include steroids and some medications for depression or asthma. “As with any new medication, always check with your doctor first,” Attarian says.

Fixes: If your meds are causing sleep problems, “First, I’d suggest talking to your physician to see if your medication can be changed or the dose adjusted,” Attarian says. “If that doesn’t work, you can go to a sleep clinic to discuss treatment options that may or may not include sleep aids. Taking a sleeping pill is not always the right thing right away, especially if you are taking other medications to manage health conditions.”

(MORE: 6 Foods and Medications That Don’t Mix)

A WARM BATH

Body temperature naturally begins to drop before bedtime, preparing us for sleep. Although a warm bath can relax and calm you, taking one too close to bedtime will not give your body enough of a chance to cool sufficiently to bring on slumber.

Fixes: To reap the full benefits of your bath, the National Sleep Foundation recommends finishing up your soak at least an hour before climbing into bed. While you’re at it, keep your room cool. “We sleep better in cool rooms,” says Dr. Patrick D. Lyden, chairman of the Department of Neurology at Cedars-Sinai Medical Center in Los Angeles, Calif..(MORE: Can’t Sleep at Night? Look at Your Day)

THE WRONG FOODS

If you like to snack before bed, watch what you eat. Loading up on foods that contain excessive salt or fat can stimulate brain waves, bringing on nightmares instead of sweet dreams, says the National Sleep Foundation. Choose foods that contain tryptophan (an amino acid linked to sleep quality), whole-grain carbs (which help boost serotonin production) and certain minerals (like calcium and magnesium, which can have a calming effect). Examples include half a banana and a handful of almonds, whole-grain crackers and peanut butter, a mug of warm milk, or half a turkey sandwich on whole-wheat bread.

Fix: In general, stick to a routine of eating early in the evening and try to avoid sugar at night. “Late meals are more likely to make it harder to sleep; snacking in the middle of the night can worsen insomnia,” says Dr. Andrew J. Westwood, a member of the American Academy of Neurology and American Academy of Sleep Medicine. Additionally, eating too much can make you feel physically uncomfortable when you lie down, and may cause heartburn, contributing to wakefulness.(MORE: 6 Healthy Foods to Put in Your Grocery Cart)

CLUTTER

The ideal bedroom should be simply furnished and decorated, so there’s not much to distract you from the primary reason you’re in there — to sleep. Excess clutter and mess can often cause anxiety, and remind you of all your unfinished business, making it harder to fall — and remain — asleep.

(MORE: Take the 30-Day Declutter Challenge)

EXERCISE

Sure, being physically active can make you tired, promote sleep and improve the quality of your rest, but exercising vigorously too close to bedtime can rev you up instead. “Aerobic exercise can raise your core body temperature long after you’ve finished,” says sleep specialist Rubin Naiman.

Fixes: Naiman suggests completing exercise at least three hours prior to bedtime. However, gentle exercise like yoga, he says, can be helpful to promote relaxation and sleepiness.(MORE: The Best Exercise to Protect Your Bones)

STRESS

When you’re stressed, your body secretes cortisol, a hormone produced by the adrenal gland. This can disrupt the body’s natural rhythm, says Naiman. “Cortisol is naturally produced in the morning. It peaks at around 8 a.m., when it can be helpful to naturally energize us,” he explains. “But at the wrong time—like nighttime—it can make us hyper-aroused and disrupt our sleep.”

Fixes: In addition to yoga for relaxation, a new study in adults over 55 finds that practicing a popular form of meditation known as mindfulness meditation can reap improvements in sleep quality and reduce insomnia and fatigue. Mindfulness meditation can also help reduce stress, according to a 2009 Massachusetts General Hospital study. Visit Mindful.org to learn some basics.(MORE: 6 Health Risks of Poor Sleep)

If meditation is not your thing, there’s always a good old-fashioned belly laugh; laughter actually induces physical changes in your body, says the Mayo Clinic. It cools your stress response and can increase positive thoughts, which, in turn, causes your body to release neuropeptides to help fight stress.

By Sheryl Kraft

Sheryl Kraft is a freelance journalist, essayist and writer of non-fiction based in Fairfield County, Conn. Her writing covers all areas, with a concentration in health, wellness and fitness.@sherylkraft

The Best Way to Improve Brain Health

November 8, 2018

The first in a series of interviews with Longevity Innovators
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 a series of interviews with the Milken Institute Center for the Future of Aging, 14 visionaries will be 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 first in the series.)

Renowned neurosurgeon Dr. Keith Black (chair of the department of neurosurgery and director of the Maxine Dunitz Neurosurgical Institute at Cedars-Sinai Medical Center in Los Angeles) has pioneered advances in our understanding and treatment of brain cancers and complex neurological conditions. Black is also a research scientist studying targeted drug delivery, cancer stem cells and Alzheimer’s detection through retinal imaging, among many other areas. In an interview with the Milken Institute Center for the Future of Aging, Black talks about the importance of developing a test for early onset Alzheimer’s and his goal to inspire the next generation.

Dr. Keith Black

What is the most important thing that people should know about improving brain health?

People need to know how important lifestyle is to sustain health. Lifestyle, diet, exercise, moderating stress, making sure you get a good eight hours of sleep when you can, making sure you keep your brain engaged particularly in novel activities — all of these matter. You have to remember the brain is a living organism very much like a muscle — the more you use it, the stronger it becomes.

We need to treat our brains better. For example, try to avoid excessive alcohol and make sure that you screen yourself for diseases like diabetes and hypertension that can be devastating to the brain.

What will be the benefits of having a reliable test for early onset Alzheimer’s?

I think there’s a huge misconception that if you get Alzheimer’s or if you’re going to get Alzheimer’s, there’s nothing that you can do about it. And I think the science shows that that perception is incorrect.

We know two things now that address your question. The first is that Alzheimer’s starts about two decades before a person develops symptoms. During that period of 20 years, you’re losing brain cells, and you’re losing brain connectivity. If you can detect the disease at the very start, particularly before you lose enough brain cells to become symptomatic, we may have the ability to stop the process or at least slow it down and prevent an individual from becoming symptomatic.

If people are developing Alzheimer’s in their 50s and 60s, they are going to become symptomatic in their 70s and 80s. If you can slow the overall process and have people become symptomatic in their late 90s or 100s, you have the ability to essentially prevent the disease from being symptomatic in most of our lifetimes. That’s really the major reason to move towards early detection, because preventing brain loss is a lot easier than restoring brain cells once they’ve died.

The other reason people should be interested is that even though we don’t have a pill that can stop the progression, we know that Alzheimer’s also has a lifestyle component. The scientific evidence shows that lifestyle habits such as a Mediterranean diet, exercise, sleep, meditation and other types of mindfulness modify stress levels. We’re seeing that potentially even micronutrients like the omega-3 fish oils may be very important in slowing the progression of Alzheimer’s disease.

What’s your take on Pfizer ending research to find new drugs aimed at treating Alzheimer’s and Parkinson’s diseases? How do you think it will impact ongoing research?

I think a lot of the trials that have failed for Alzheimer’s disease, including the Pfizer trial, could’ve been better designed and better developed. I think we have a lot to learn from the failure of those trials.

For example, how do we get the drugs into the brain more effectively? How can we better select the right population of patients to treat? I think addressing those potential reasons for the failures of those drugs will lead to successful therapies and hopefully successful approvals.

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.

Reinvent Yourself!

May 4, 2018

Engage at Every Age - even after retirement! If you are missing your 9 am to 5 pm lifestyle or are searching for a new “normal” after retirement, look for ways to find inspiration – a second career, helping others, discovering new interests – the possibilities are endless!

Click here to check out ways to reinvent yourself!

May is Older Americans Month!

May 1, 2018

Throughout the month of May, Presbyterian SeniorCare Network will be embracing the Engage at Every Age theme and will utilize the power of Facebook to publicize our inspiring resident and team member stories. We’ll keep the buzz going all month, so be sure to check Facebook often and be sure to share our posts with your friends and family!

Each May, the Administration for Community Living leads our nation’s celebration of Older Americans Month. The theme for 2018 is Engage at Every Age. This powerful theme emphasizes that you are never too old (or young) to take part in activities that can enrich your physical, mental, and emotional well-being. Participating in activities that promote mental and physical wellness, offering your wisdom and experience to the next generation, seeking the mentorship of someone with more life experience than you—those are just a few examples of what being engaged can mean.

No matter where you are in your life, there is no better time than now to start!

Tell Your Doctor What’s on Your Bucket List

April 16, 2018

It'll help direct your health where you want it to go


By Grace Birnstengel for Next Avenue


Your doctor can’t read your mind. A doctor assumes everyone wants to live and continue to live the best, healthiest, happiest life possible — but that means something different for everyone. If your doctor knows about your long-term goals and “bucket list” items, however, that can be used to direct your health plan and goals.

Dr. VJ Periyakoil, an internist, geriatrician and palliative care professional at Stanford Health Care wrote a piece for the New York Times about how she regularly asks her patients about their bucket lists.

“I started doing this to forge a personal connection and get a quick glimpse into what matters most to each of them,” she wrote.

In Periyakoil’s experience, most patients have bucket lists already — whether it’s burgeoning in the back of their mind or a concrete list pinned to a bulletin board.

Why a Bucket List Is Useful

What Periyakoil does with this information comes in two parts.

First, she uses the bucket list items as incentive for more healthy behaviors. “For example, I found that saying, ‘I don’t think your half-marathon is happening anytime soon if you don’t quit smoking’ got my patient’s attention much faster than making obvious and boring statements like, ‘Smoking is bad for you,’” she wrote.

But more importantly, the bucket list goals guide Periyakoil toward or away from certain medical decisions or recommendations.

She used the example of a patient diagnosed with a serious case of gallbladder cancer. When asked about his bucket list, the patient assumed he’d take his family on a trip to Maui the following year — after his radiation appointments. Periyakoil, knowing how the treatments would affect his ability to travel, suggested going to Maui while he still could and starting the treatments after the trip.

“If I had not asked about his bucket list, he would have stoically undergone the radiation and chemotherapy, and the Maui trip would have remained a sunny fantasy,” she wrote.

Making it Work

Periyakoil co-published a study in the Journal of Palliative Medicine to discover more about what’s on Americans’ bucket lists. The study suggested six prevailing themes of bucket list items: a desire to travel, personal goals (such as running a marathon or writing a book), life milestones (like marriage or children), quality time with friends and family, financial stability and daring activities (like surfing and bungee jumping).

These themes resonate with the experiences of Next Avenue readers and writers as well. We have stories about older adults setting out to conquer the largest and longest recreational bicycle touring ride in the world, learning to tap dance at 85 and skydiving with an early-onset diagnosis of Alzheimer’s.

Some of these common bucket-list items might not seem relevant to your health and therefore irrelevant to bring up in a doctor appointment. But Periyakoil rejects this notion.

“Many [people] — especially those who are not in perfect health — may underestimate the extensive coordination required to make their bucket list wishes possible,” Periyakoil said.

Your bucket list items may be completely in reach, and if your doctor is up-to-date on your goals, he or she can better advise you on how to best achieve them and when — taking into account health obstacles that may affect you in the process and avoiding treatments that could get in the way.

© Next Avenue - 2018. All rights reserved.

7 New Year's Resolutions for Your Mental Health

December 29, 2017

Resolve to focus on taking care of yourself, beginning now


By Patricia Corrigan for Next Avenue


Eating less and exercising more are likely on many a to-do list for 2017. But in between meals and after working out, we all can identify ways to improve our mental health as well. Below are seven new year’s resolutions I’ve devised to help me take better care of myself in 2017. What are yours?

1. Adjust the settings. While fixing my leaky faucet, the plumber blurted out: “I’ve lost my passion for this work. I’ve been at it for so long, and the passion just isn’t there anymore.”

We commiserated, and before he left, we had concluded that at some level, every job is just a job. We also spoke about how important it is to balance work with leisure time. And we agreed it’s important to evaluate our work lives from time to time. Even if we can’t make dramatic changes, we can tweak this or adjust that, in the hope of finding more satisfaction on the job.

I did, and it worked. I enjoy writing about the arts more than stories with political angles, and said so often — to all the wrong people. One day, I simply called the editor. “Arts stories and profiles — assign those to me,” I said. Inspired by my own moxie, I added, “Also, I am not accepting any more assignments about cancer. Just because I’ve had it doesn’t mean I want to write about it. I don’t.” The editor learned something new — and so did I. Life is too short to be subtle!

2. Embrace green therapy. Looking at nature — at the edge of the continent, in a state park or in your own backyard — beats looking out a window any day. Stand in the sun. Let the wind mess up your hair. Breathe deep.

Letting your mind play outside for a while is good for you. David Strayer, a cognitive psychologist at the University of Utah, told National Geographic in January 2016 that our brains are not “tireless three-pound machines.” They get fatigued, he said, but when we slow down and take in beautiful natural surroundings, “not only do we feel restored, but our mental performance improves too.”

Strayer promotes three-day getaways in nature, but even shorter visits can refresh your mind and your spirit. Grab a jacket and go.

At least once a week, I drive three miles to the Pacific Ocean. Regardless of the varying hues of the water — metallic green, slate gray, shining silver — the waves are relentless. I watch until the sight and sound lull my busy mind and wash away any heightened sense of false significance I may have about present circumstances, allowing my “three-pound machine” to take a break.

3. Take a time out. When the battery in my bathroom clock died, I took a good look at the clock. It was decades old, and the white plastic frame had yellowed badly. Impulsively, I threw it out. Along with the clock, I discarded the notion that my every moment must be tracked, relieving the stress that builds when I think I don’t have time or won’t have time — even when I do.

Four months later, I still glance at the clock’s former spot on the bathroom wall. The inexpensive framed print of the Golden Gate Bridge that hangs there now does not tell me the time, but it reminds me that I do not need to rush while showering, putting on makeup or filling my pill organizer.  

That makes for a more peaceful morning and helps me start the day with a softer focus. How do I stay on schedule when I must? I set my bedroom clock 12 minutes fast.

4. Downsize emotional reactions. Looking at the big picture is important — except when that’s too overwhelming. One day long ago, I cried in a therapist’s office, mourning the death of a friend and obsessing about a crisis at work.

“You’re looking at your life on a giant IMAX screen,” the therapist said, handing me more tissues. “Bring it down to a TV set in the living room. Sit with that a few minutes. Now, imagine how everything that’s going on would look when viewed on a small black and white TV on your kitchen counter. Is that more manageable?”

It was. To this day, after that first emotional rush of an upsetting moment, I try to remember to adjust the perspective to lessen the emotional intensity.

5. Rethink the closet. When I open the closet door, I see clothes I wear, clothes I once wore and clothes I will never wear. I see boxes I never open, full of stuff I can’t seem to part with. I see bags filled with gifts I bought too far in advance. Worse, I see bags full of bags, just in case I need more bags.

This is a not a closet that simply stores clothing. It has evolved into a storage locker, housing memories in a holding pattern and silly stuff, all stashed among too many pairs of black pants. What if I tossed the spare bags, pared down the sentimental items and donated the clothing I never wear?

For one thing, I would feel better organized and experience a victory over stuff — always a good feeling.

That victory may even extend to making peace with losses we all suffer in the course of a life. Patty de Vries, director of the Stanford Health Promotion Network, told U.S. News & World Report late last year that some people “collect clutter to make up for some sense of loss in other areas of their lives.” I need to remember that clutter does not minimize losses, and then fill a bag or two — I have plenty of those — with donations.

6. Find more teachers. When people come along who know more than I do, especially about things I want to know, I do whatever it takes to learn what they have to teach.

Sometimes great wisdom is revealed in a quick conversation with a stranger on a bus or in the waiting room at the dentist’s office. Other times, a casual encounter leads to a decades-long relationship. That’s what happened when I met Ross.

A close friend of my boss, he was artistic director of a dance company and a choreographer. When I learned that, I knew he had much to teach me about creativity and vulnerability. But Ross also was an introverted loner who was not inclined to make time to get close to anybody new.

After meeting him a time or two at the office, I pestered him for attention. The day he asked me — somewhat testily — what I was doing in his life, I replied, “Learning things from you that no one else has taught me.” We were close until he died, some 22 years ago. I continue to talk to strangers, looking for new teachers.

7. Take the short view. Worrying about what may or may not come to pass may help me prepare for an uncertain future, but it also propels me into a time beyond my control.

“There is no broom big enough to sweep up debris accumulating in the future,” a wise friend once told me.” When I start imagining the worst that could happen, I visit there for a while and then make myself return to the present.

Do I have clothes to wear? This month’s rent money? Food in the fridge? Family and friends to call on for help? If so, I am OK just now. If not, I can devise a strategy to improve the situation — and then I can head outdoors for some free green therapy. (See resolution No. 2.)

 

© Twin Cities Public Television - 2017. All rights reserved.

3 Recipes to Capture the Flavors of Fall

October 30, 2017

These easy, tasty recipes will warm your body and soul


By Meggan Hill for Next Avenue


Just as autumn has a traditional color palette, classic tastes are also associated with the season: rich pumpkin, tart cranberry, comforting apple and distinctive cinnamon, nutmeg and ginger.

The three recipes below wrap fall’s flavors in wonderfully-scented, warming-to-the-soul baked treats.

Enjoy!

Double Ginger Cookies

Ingredients

2 ¼ c. flour
2 tsp. ground ginger
1 tsp. baking soda
¾ tsp. ground cinnamon
½ tsp. ground cloves
¼ tsp. salt
¾ c. butter
1 c. + 2 T. sugar
1 egg
2 T. crystallized ginger, finely chopped
¼ c. molasses
1 T. water

INSTRUCTIONS

Preheat oven to 350°F. Sift together flour, ginger, baking soda, cinnamon, cloves, and salt.

In a large bowl, cream butter with 1 c. sugar. Add egg and mix until uniformly combined. Stir in crystallized ginger, molasses, and water.

Add the sifted dry ingredients in 3 batches, mixing well after each addition.

Using wet hands, form rounded tablespoon-sized balls of dough. Roll each ball in the remaining 2 T. sugar and lay on ungreased baking sheets about 2” apart. Press down each to flatten slightly.

Bake for 8-10 minutes, rotating the baking sheet halfway through baking. Allow the cookies to cool on the baking sheet slightly, about 5 minutes, before removing to a wire rack to cool completely. Fall is the perfect time to whip up some delicious goodies that capture the flavors of the season.

Cranberry Bread

Ingredients

2 ¼ c. flour
¾ c. sugar
1 ½ tsp. baking powder
½ tsp. baking soda
½ tsp. salt
½ c. dried cranberries
¾ c. + 1 T. half-and-half, divided
½ c. butter, melted and cooled
2 eggs
2 tsp. orange zest
¼ c. orange juice
1 oz. white chocolate, chopped
¼ c. powdered sugar

INSTRUCTIONS

Preheat oven to 350°F. Coat the bottom of a 9” x 5” bread pan with nonstick cooking spray.

In a large bowl, whisk together flour, sugar, baking powder, baking soda, and salt. Stir in cranberries.

In a small bowl, combine ¾ c. half-and-half, butter, eggs, orange zest, and orange juice. Add to dry ingredients in 3 parts, stirring after each addition until ingredients are just moistened. Pour batter into prepared pan.

Bake 60 minutes or until a toothpick inserted comes out clean with just a few crumbs attached. Cool in pan for 10 minutes. Run a sharp knife around the inside of the pan to loosen and invert onto a cooling rack set over a baking sheet.

Meanwhile, combine white chocolate, the remaining 1 T. half-and-half, and ¼ c. powdered sugar in a small bowl. Microwave on high for 30 seconds and stir, heating a little longer if required to melt. Whisk in powdered sugar until smooth.

Pour over cooling cake, letting excess glaze fall through the cooling rack to the baking sheet below. Cool completely.(MORE: Top Chefs’ Tips for the Late Summer Harvest)

Old Fashioned Apple Crisp

Ingredients

½ c. flour
1 c. old-fashioned or quick-cooking rolled oats
½ c. firmly packed brown sugar
¼ tsp. salt
1 tsp. ground cinnamon, divided
½ c. unsalted butter, chilled and cut into ¼” cubes
½ c. walnuts, finely chopped
¾ c. sugar
¼ tsp. freshly grated nutmeg
6 c. Granny Smith apples, peeled, cored, halved, and sliced ¼” thick

Vanilla ice cream or sweetened whipped cream, for serving, optional

INSTRUCTIONS

Adjust an oven rack to the lower-middle position. Preheat oven to 350°F. Coat a 2 quart or 9” x 13” baking dish with nonstick cooking spray

To make the topping, combine flour, oatmeal, brown sugar, salt, and ½ tsp. cinnamon in a medium bowl. Using a pastry blender, a knife, or your fingers, cut or rub butter cubes into the flour mixture until crumbly.

Add the walnuts and stir to combine. Cover and refrigerate while preparing the filling.

To make the filling, combine sugar, nutmeg, and ½ tsp. cinnamon. In a large bowl, toss sugar mixture with apple slices until evenly coated.

Spread the apple slices evenly in the bottom of the prepared baking dish and cover with the topping.

Bake until the topping is crisp and golden brown, about 1 hour. Serve with vanilla ice cream or sweetened whipped cream, if desired.

© Twin Cities Public Television - 2017. All rights reserved.

 
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