Experts say meditation can work as well as medications for some people
By Patricia Corrigan

You’ve probably figured out that taking a few deep breaths in a stressful situation can calm you down. And you may know that practicing meditation on a regular basis helps many people cultivate serenity. But did you know that some studies show meditation can alleviate pain?

“We have pretty strong evidence that mindfulness meditation is helpful for chronic pain conditions,” says Wen Chen, chief of the basic and mechanistic research branch at the National Center for Complementary and Integrative Health’s Division of Extramural Research in Bethesda, Md. The center is part of the National Institutes of Health.

“We experience pain where the body is injured, but we also experience the psychological and social aspects of pain. Mindfulness meditation works on the psychological aspect,” Chen says.

“Meditation is an ancient practice, and we know very little about how it works,” she adds. “We do know that it’s low risk, it’s not invasive and you can do it on your own. Lots of people find it beneficial.”

And it appears that an increasing number of Americans are finding meditation beneficial for a variety of different reasons. In 2012, only 4.1% of adults in the U.S. practiced meditation, but by 2017, the number had increased to 14.2%.

Wen Chen

A government-sponsored site with an overview of mindfulness meditation reports that research about the practice’s ability to reduce pain “has produced mixed results,” but in some studies, “scientists suggest that meditation activates certain areas of the brain in response to pain.”

Reducing Pain Through Mindfulness Meditation

An estimated 11.2% of the U.S. adult population suffers from chronic pain, according to a research post Chen published three years ago.

“Prescription opioid medications present serious risks, both medically and socially,” she wrote, and she cited a study that provides “compelling evidence for the existence of a non-opioid process in the brain to reduce pain through mindfulness meditation.”

“With mindfulness meditation, you accept the (pain) message, and gradually, your body and brain stop sending it. It’s like turning down the volume control.”

So what is mindfulness meditation? One evidence-based form, known as mindfulness-based stress reduction (MBSR), is an eight-week program developed by Jon Kabat-Zinn at the University of Massachusetts Medical Center in the 1970s.

A teacher-certification program has placed its instructors in almost every state, but you also can learn the method through Kabat-Zinn’s MP3s and CDs. Plus, some pain-management programs offer mindfulness-based stress reduction training, so check with your doctor.

“MBSR has a breathing component where you focus on your breathing as you meditate. That aspect of slow breathing is very helpful,” Chen says, “and quite a few researchers point toward the breathing component as quite important to relieve pain. Just twenty minutes of mindful breathing can often do the trick.”

She adds that in addition to looking at MBSR, researchers also are evaluating mindfulness-based cognitive therapy, a modified form of psychotherapy, and progressive relaxation techniques for pain management.

Other Benefits of Meditation for Pain Control

Danny Penman

Danny Penman, a journalist in Bristol, England with a Ph.D. in biochemistry, teaches and writes about meditation. He is the co-author with Vidyamala Burch of the book Mindfulness for Health: A Practical Guide to Relieving Pain, Reducing Stress and Restoring Wellbeing, published in the U.S. as You Are Not Your Pain.

The British Medical Association honored the book with first place in the organization’s 2014 Medical Book Awards competition. In 2013, a clinical trial conducted at the University of Manchester in England showed that the eight-week program outlined in the book is “highly effective at reducing anxiety, stress and depression.”

Other clinical trials have shown that mindfulness is “at least as effective as the main prescription painkillers,” Penman says.

Powerful painkillers do dull the sensation of pain, but the medications also lose their effectiveness over time and have addictive qualities. According to the National Institute on Drug Abuse, roughly 21% to 29% of patients prescribed opioids for chronic pain misuse them and between 8% and 12% develop an opioid use disorder. About 80% of people who use heroin first misused prescription opioids.

“We all have to come to terms at some point with illness or suffering, and I believe that in the longer run, mindfulness is at least one of the answers,” Penman says. Pain, he adds, is a message, and the body and the brain keep sending that message.

“With mindfulness meditation, you accept the message, and gradually, your body and brain stop sending it. It’s like turning down the volume control,” he says.

Professional Reassurance: ‘You Can’t Fail at Meditation’

While still in school, Penman started meditating as a means of stress reduction. In 2006, he was in a paragliding accident.

“Once my pain was under control, I started meditating seriously, and after a couple of weeks, I was able to reduce my painkiller intake by two-thirds,” he says. He later trained as a meditation teacher specializing in pain relief.

Many of us know people who say they have tried meditation, but failed. Penman says that’s not possible.

“You can’t fail at meditation. Ironically, the moment you think you’ve failed is a moment of mindfulness because you have come back into the present moment and are no longer wrapped up in your other thoughts,” he says.

Some people who think they have failed “build a catastrophe around it, letting in fears and anxieties that can amplify their pain,” Penman says.

“Meditation is like physical exercise,” he continues. “The more you do it, the more you begin to relax, and the easier gets. You may still have doubts or fears, but it gets easier each time you do the basic practice and focus on your breath. The more you meditate, the more you will benefit.”

Whether you’re just starting or giving mindfulness meditation another go to help cope with pain, once you understand what to do, you need to set aside only 10 or 20 minutes each day for the practice.

Over time, it will become a comfortable habit, so Penman suggests you simply begin. He says, “The hardest thing in the world is taking that first breath.”

By Patricia Corrigan

Patricia Corrigan is a professional journalist, with decades of experience as a reporter and columnist at a metropolitan daily newspaper, and a book author. She now enjoys a lively freelance career, writing for numerous print and on-line publications. Read more from Patricia on her blog.

Experts say meditation can work as well as medications for some people
By Patricia Corrigan

You’ve probably figured out that taking a few deep breaths in a stressful situation can calm you down. And you may know that practicing meditation on a regular basis helps many people cultivate serenity. But did you know that some studies show meditation can alleviate pain?

“We have pretty strong evidence that mindfulness meditation is helpful for chronic pain conditions,” says Wen Chen, chief of the basic and mechanistic research branch at the National Center for Complementary and Integrative Health’s Division of Extramural Research in Bethesda, Md. The center is part of the National Institutes of Health.

“We experience pain where the body is injured, but we also experience the psychological and social aspects of pain. Mindfulness meditation works on the psychological aspect,” Chen says.

“Meditation is an ancient practice, and we know very little about how it works,” she adds. “We do know that it’s low risk, it’s not invasive and you can do it on your own. Lots of people find it beneficial.”

And it appears that an increasing number of Americans are finding meditation beneficial for a variety of different reasons. In 2012, only 4.1% of adults in the U.S. practiced meditation, but by 2017, the number had increased to 14.2%.

Wen Chen

A government-sponsored site with an overview of mindfulness meditation reports that research about the practice’s ability to reduce pain “has produced mixed results,” but in some studies, “scientists suggest that meditation activates certain areas of the brain in response to pain.”

Reducing Pain Through Mindfulness Meditation

An estimated 11.2% of the U.S. adult population suffers from chronic pain, according to a research post Chen published three years ago.

“Prescription opioid medications present serious risks, both medically and socially,” she wrote, and she cited a study that provides “compelling evidence for the existence of a non-opioid process in the brain to reduce pain through mindfulness meditation.”

“With mindfulness meditation, you accept the (pain) message, and gradually, your body and brain stop sending it. It’s like turning down the volume control.”

So what is mindfulness meditation? One evidence-based form, known as mindfulness-based stress reduction (MBSR), is an eight-week program developed by Jon Kabat-Zinn at the University of Massachusetts Medical Center in the 1970s.

A teacher-certification program has placed its instructors in almost every state, but you also can learn the method through Kabat-Zinn’s MP3s and CDs. Plus, some pain-management programs offer mindfulness-based stress reduction training, so check with your doctor.

“MBSR has a breathing component where you focus on your breathing as you meditate. That aspect of slow breathing is very helpful,” Chen says, “and quite a few researchers point toward the breathing component as quite important to relieve pain. Just twenty minutes of mindful breathing can often do the trick.”

She adds that in addition to looking at MBSR, researchers also are evaluating mindfulness-based cognitive therapy, a modified form of psychotherapy, and progressive relaxation techniques for pain management.

Other Benefits of Meditation for Pain Control

Danny Penman

Danny Penman, a journalist in Bristol, England with a Ph.D. in biochemistry, teaches and writes about meditation. He is the co-author with Vidyamala Burch of the book Mindfulness for Health: A Practical Guide to Relieving Pain, Reducing Stress and Restoring Wellbeing, published in the U.S. as You Are Not Your Pain.

The British Medical Association honored the book with first place in the organization’s 2014 Medical Book Awards competition. In 2013, a clinical trial conducted at the University of Manchester in England showed that the eight-week program outlined in the book is “highly effective at reducing anxiety, stress and depression.”

Other clinical trials have shown that mindfulness is “at least as effective as the main prescription painkillers,” Penman says.

Powerful painkillers do dull the sensation of pain, but the medications also lose their effectiveness over time and have addictive qualities. According to the National Institute on Drug Abuse, roughly 21% to 29% of patients prescribed opioids for chronic pain misuse them and between 8% and 12% develop an opioid use disorder. About 80% of people who use heroin first misused prescription opioids.

“We all have to come to terms at some point with illness or suffering, and I believe that in the longer run, mindfulness is at least one of the answers,” Penman says. Pain, he adds, is a message, and the body and the brain keep sending that message.

“With mindfulness meditation, you accept the message, and gradually, your body and brain stop sending it. It’s like turning down the volume control,” he says.

Professional Reassurance: ‘You Can’t Fail at Meditation’

While still in school, Penman started meditating as a means of stress reduction. In 2006, he was in a paragliding accident.

“Once my pain was under control, I started meditating seriously, and after a couple of weeks, I was able to reduce my painkiller intake by two-thirds,” he says. He later trained as a meditation teacher specializing in pain relief.

Many of us know people who say they have tried meditation, but failed. Penman says that’s not possible.

“You can’t fail at meditation. Ironically, the moment you think you’ve failed is a moment of mindfulness because you have come back into the present moment and are no longer wrapped up in your other thoughts,” he says.

Some people who think they have failed “build a catastrophe around it, letting in fears and anxieties that can amplify their pain,” Penman says.

“Meditation is like physical exercise,” he continues. “The more you do it, the more you begin to relax, and the easier gets. You may still have doubts or fears, but it gets easier each time you do the basic practice and focus on your breath. The more you meditate, the more you will benefit.”

Whether you’re just starting or giving mindfulness meditation another go to help cope with pain, once you understand what to do, you need to set aside only 10 or 20 minutes each day for the practice.

Over time, it will become a comfortable habit, so Penman suggests you simply begin. He says, “The hardest thing in the world is taking that first breath.”

By Patricia Corrigan

Patricia Corrigan is a professional journalist, with decades of experience as a reporter and columnist at a metropolitan daily newspaper, and a book author. She now enjoys a lively freelance career, writing for numerous print and on-line publications. Read more from Patricia on her blog.

Charity raters generally haven't evaluated this key measure — until now
By Richard Eisenberg

One frustrating thing for people eager to give wisely to charities: finding ones that truly make an impact. The big charity raters have done a great job sizing up nonprofits for overhead costs, transparency and executive pay. Impact, however, wasn’t part of their scoring — it was too hard to assess.

Recently, though, a new charity rater known as ImpactMatters has stepped into the breach for prospective donors by rating nonprofits on the amount of good achieved per dollar spent. It doesn’t review all charities or even all types of charities, as I’ll explain, but does an impressive job for the ones it does analyze, with star ratings.

And the nonprofit Open990.org is making it easier to compare charities head-to-head for things like their salaries and expenses and revenue.

Both sites are free and I think could be quite useful when choosing where to make your charitable contributions before the end of 2019.

How ImpactMatters Rates Charities

ImpactMatters, which is funded by several foundations and private donors, rates nonprofits that directly deliver services. Specifically, it focuses on these eight areas: homelessness, health, clean water, veterans, poverty, hunger, climate change and education.

Of the 1,077 nonprofits ImpactMatters has rated, 59% have 5 stars, 28% have 4 stars and 13% have lower scores.

It doesn’t rate nonprofits that operate through advocacy or by trying to change people’s minds (too hard to measure, though some in the nonprofit sector criticize ImpactMatters for not rating these types). Nor does ImpactMatters rate what are called “donor-use” membership-based charities, such as religious organizations, community associations or institutions like museums.

“We have three principles when rating charities for impact,” says ImpactMatters co-founder and executive director Elijah Goldberg. “Outcomes — what changes as a result of their work have been meaningful? What would have happened without the program? And, the most neglected principle in some ways: comparing the outcomes to the costs.”

Most nonprofits are doing something good and improving lives in some way, Goldberg says. “The question is: Do you give money to one of them or to another that is doing something similarly, but more efficiently?”

Of the 1,077 nonprofits ImpactMatters has rated on its scale of five stars (best) to 1 star (worst), 59% have 5 stars, 28% have 4 stars and 13% have lower scores. That’s a far smaller group than the estimated 1.9 million nonprofits, but it’s a decent number for direct-service ones of all sizes.

So how exactly does this rater determine whether a charity is making an impact?

“In our first iteration, we did impact audits. That meant a lot of contact with the nonprofits,” says Goldberg. “We discovered that took a lot of time.” Now, the rater does its exhaustive analysis without direct interactions, but  gives the charity an opportunity to review the rating.

4 Ways to Use ImpactMatters

There are four ways you can use ImpactMatters.

• You can search for a particular charity you’re interested in to see if there’s a rating.
• You can review the site’s Toplists, which show all the ratings for a particular type of charity.
• You can look at the 5-Star Nonprofits list, which includes Veterans of Foreign Wars of the United States; Sightsavers (helping cure blindness) and Fellowship Deliverance Ministries (providing homeless shelters).
• You can look at any of its 44 local giving guides  which shows the best-rated groups in particular metro areas, from Atlanta to Washington, D.C.

The Charity Navigator website, which has traditionally rated charities on financial measures, now also offers information about impact. It does this by including ratings from places like ImpactMatters and GlobalGiving, a crowdfunding platform for grassroots charitable projects.

How Open990.org Can Help You Research Charities

If you’d like to research charities based on how well they’re run and enjoy perusing data, check out Open990.org. Heather Kugelmass says she co-founded it with David Borenstein, Charity Navigator’s former director of data science, to “democratize access to nonprofit data.”

The site pulls together in one place data the financial information forms charities file with the Internal Revenue Service, known as Form 990. Then, Open990.org turns the forms into profiles for laypeople. “We highlight what people are most interested in,” Kugelmass says.

So, if you want to bore down into how a particular charity is run and not get bored doing it, you can see how its programs have changed over time as well as how its expenses and revenues have evolved.

You can search by the organization’s name or geographic location or cause area (such as: Education). You can search based on size, if you especially want to donate to either a large charity or a smaller one. And you can search by things like expenses or highest-paid individual at the nonprofit.

If You Want to Donate to Local Charities

Some people prefer donating to small nonprofits where they live because they like to see the effects of their contributions in person. If you’re one of them, you’ll want to do your own impact assessment by visiting local charities and asking their executives questions whose answers satisfy you.

Danielle Holly, CEO of Common Impact (a group that connects corporate employees to community nonprofits), says donations to small, local nonprofits are “especially meaningful” to those organizations. That’s because these types of charities, Holly says, are less likely than national and global ones to get large corporate or foundation sponsorship.

Charity-rating sites like Guidestar and Charity Navigator may be able to help you ensure that these groups are well-managed and efficient.

By Richard Eisenberg

Richard Eisenberg is the Senior Web Editor of the Money & Security and Work & Purpose channels of Next Avenue and Managing Editor for the site. He is the author of How to Avoid a Mid-Life Financial Crisis and has been a personal finance editor at Money, Yahoo, Good Housekeeping, and CBS MoneyWatch. Follow him on Twitter.

One frustrating thing for people eager to give wisely to charities: finding ones that truly make an impact. The big charity raters have done a great job sizing up nonprofits for overhead costs, transparency and executive pay. Impact, however, wasn’t part of their scoring — it was too hard to assess.

Recently, though, a new charity rater known as ImpactMatters has stepped into the breach for prospective donors by rating nonprofits on the amount of good achieved per dollar spent. It doesn’t review all charities or even all types of charities, as I’ll explain, but does an impressive job for the ones it does analyze, with star ratings.

And the nonprofit Open990.org is making it easier to compare charities head-to-head for things like their salaries and expenses and revenue.

Both sites are free and I think could be quite useful when choosing where to make your charitable contributions before the end of 2019.

How ImpactMatters Rates Charities

ImpactMatters, which is funded by several foundations and private donors, rates nonprofits that directly deliver services. Specifically, it focuses on these eight areas: homelessness, health, clean water, veterans, poverty, hunger, climate change and education.

Of the 1,077 nonprofits ImpactMatters has rated, 59% have 5 stars, 28% have 4 stars and 13% have lower scores.

It doesn’t rate nonprofits that operate through advocacy or by trying to change people’s minds (too hard to measure, though some in the nonprofit sector criticize ImpactMatters for not rating these types). Nor does ImpactMatters rate what are called “donor-use” membership-based charities, such as religious organizations, community associations or institutions like museums.

“We have three principles when rating charities for impact,” says ImpactMatters co-founder and executive director Elijah Goldberg. “Outcomes — what changes as a result of their work have been meaningful? What would have happened without the program? And, the most neglected principle in some ways: comparing the outcomes to the costs.”

Most nonprofits are doing something good and improving lives in some way, Goldberg says. “The question is: Do you give money to one of them or to another that is doing something similarly, but more efficiently?”

Of the 1,077 nonprofits ImpactMatters has rated on its scale of five stars (best) to 1 star (worst), 59% have 5 stars, 28% have 4 stars and 13% have lower scores. That’s a far smaller group than the estimated 1.9 million nonprofits, but it’s a decent number for direct-service ones of all sizes.

So how exactly does this rater determine whether a charity is making an impact?

“In our first iteration, we did impact audits. That meant a lot of contact with the nonprofits,” says Goldberg. “We discovered that took a lot of time.” Now, the rater does its exhaustive analysis without direct interactions, but  gives the charity an opportunity to review the rating.

4 Ways to Use ImpactMatters

There are four ways you can use ImpactMatters.

• You can search for a particular charity you’re interested in to see if there’s a rating.
• You can review the site’s Toplists, which show all the ratings for a particular type of charity.
• You can look at the 5-Star Nonprofits list, which includes Veterans of Foreign Wars of the United States; Sightsavers (helping cure blindness) and Fellowship Deliverance Ministries (providing homeless shelters).
• You can look at any of its 44 local giving guides  which shows the best-rated groups in particular metro areas, from Atlanta to Washington, D.C.

The Charity Navigator website, which has traditionally rated charities on financial measures, now also offers information about impact. It does this by including ratings from places like ImpactMatters and GlobalGiving, a crowdfunding platform for grassroots charitable projects.

How Open990.org Can Help You Research Charities

If you’d like to research charities based on how well they’re run and enjoy perusing data, check out Open990.org. Heather Kugelmass says she co-founded it with David Borenstein, Charity Navigator’s former director of data science, to “democratize access to nonprofit data.”

The site pulls together in one place data the financial information forms charities file with the Internal Revenue Service, known as Form 990. Then, Open990.org turns the forms into profiles for laypeople. “We highlight what people are most interested in,” Kugelmass says.

So, if you want to bore down into how a particular charity is run and not get bored doing it, you can see how its programs have changed over time as well as how its expenses and revenues have evolved.

You can search by the organization’s name or geographic location or cause area (such as: Education). You can search based on size, if you especially want to donate to either a large charity or a smaller one. And you can search by things like expenses or highest-paid individual at the nonprofit.

If You Want to Donate to Local Charities

Some people prefer donating to small nonprofits where they live because they like to see the effects of their contributions in person. If you’re one of them, you’ll want to do your own impact assessment by visiting local charities and asking their executives questions whose answers satisfy you.

Danielle Holly, CEO of Common Impact (a group that connects corporate employees to community nonprofits), says donations to small, local nonprofits are “especially meaningful” to those organizations. That’s because these types of charities, Holly says, are less likely than national and global ones to get large corporate or foundation sponsorship.

Charity-rating sites like Guidestar and Charity Navigator may be able to help you ensure that these groups are well-managed and efficient.

By Richard Eisenberg

Richard Eisenberg is the Senior Web Editor of the Money & Security and Work & Purpose channels of Next Avenue and Managing Editor for the site. He is the author of How to Avoid a Mid-Life Financial Crisis and has been a personal finance editor at Money, Yahoo, Good Housekeeping, and CBS MoneyWatch. Follow him on Twitter.

Charity raters generally haven't evaluated this key measure — until now
By Richard Eisenberg

One frustrating thing for people eager to give wisely to charities: finding ones that truly make an impact. The big charity raters have done a great job sizing up nonprofits for overhead costs, transparency and executive pay. Impact, however, wasn’t part of their scoring — it was too hard to assess.

Recently, though, a new charity rater known as ImpactMatters has stepped into the breach for prospective donors by rating nonprofits on the amount of good achieved per dollar spent. It doesn’t review all charities or even all types of charities, as I’ll explain, but does an impressive job for the ones it does analyze, with star ratings.

And the nonprofit Open990.org is making it easier to compare charities head-to-head for things like their salaries and expenses and revenue.

Both sites are free and I think could be quite useful when choosing where to make your charitable contributions before the end of 2019.

How ImpactMatters Rates Charities

ImpactMatters, which is funded by several foundations and private donors, rates nonprofits that directly deliver services. Specifically, it focuses on these eight areas: homelessness, health, clean water, veterans, poverty, hunger, climate change and education.

Of the 1,077 nonprofits ImpactMatters has rated, 59% have 5 stars, 28% have 4 stars and 13% have lower scores.

It doesn’t rate nonprofits that operate through advocacy or by trying to change people’s minds (too hard to measure, though some in the nonprofit sector criticize ImpactMatters for not rating these types). Nor does ImpactMatters rate what are called “donor-use” membership-based charities, such as religious organizations, community associations or institutions like museums.

“We have three principles when rating charities for impact,” says ImpactMatters co-founder and executive director Elijah Goldberg. “Outcomes — what changes as a result of their work have been meaningful? What would have happened without the program? And, the most neglected principle in some ways: comparing the outcomes to the costs.”

Most nonprofits are doing something good and improving lives in some way, Goldberg says. “The question is: Do you give money to one of them or to another that is doing something similarly, but more efficiently?”

Of the 1,077 nonprofits ImpactMatters has rated on its scale of five stars (best) to 1 star (worst), 59% have 5 stars, 28% have 4 stars and 13% have lower scores. That’s a far smaller group than the estimated 1.9 million nonprofits, but it’s a decent number for direct-service ones of all sizes.

So how exactly does this rater determine whether a charity is making an impact?

“In our first iteration, we did impact audits. That meant a lot of contact with the nonprofits,” says Goldberg. “We discovered that took a lot of time.” Now, the rater does its exhaustive analysis without direct interactions, but  gives the charity an opportunity to review the rating.

4 Ways to Use ImpactMatters

There are four ways you can use ImpactMatters.

• You can search for a particular charity you’re interested in to see if there’s a rating.
• You can review the site’s Toplists, which show all the ratings for a particular type of charity.
• You can look at the 5-Star Nonprofits list, which includes Veterans of Foreign Wars of the United States; Sightsavers (helping cure blindness) and Fellowship Deliverance Ministries (providing homeless shelters).
• You can look at any of its 44 local giving guides  which shows the best-rated groups in particular metro areas, from Atlanta to Washington, D.C.

The Charity Navigator website, which has traditionally rated charities on financial measures, now also offers information about impact. It does this by including ratings from places like ImpactMatters and GlobalGiving, a crowdfunding platform for grassroots charitable projects.

How Open990.org Can Help You Research Charities

If you’d like to research charities based on how well they’re run and enjoy perusing data, check out Open990.org. Heather Kugelmass says she co-founded it with David Borenstein, Charity Navigator’s former director of data science, to “democratize access to nonprofit data.”

The site pulls together in one place data the financial information forms charities file with the Internal Revenue Service, known as Form 990. Then, Open990.org turns the forms into profiles for laypeople. “We highlight what people are most interested in,” Kugelmass says.

So, if you want to bore down into how a particular charity is run and not get bored doing it, you can see how its programs have changed over time as well as how its expenses and revenues have evolved.

You can search by the organization’s name or geographic location or cause area (such as: Education). You can search based on size, if you especially want to donate to either a large charity or a smaller one. And you can search by things like expenses or highest-paid individual at the nonprofit.

If You Want to Donate to Local Charities

Some people prefer donating to small nonprofits where they live because they like to see the effects of their contributions in person. If you’re one of them, you’ll want to do your own impact assessment by visiting local charities and asking their executives questions whose answers satisfy you.

Danielle Holly, CEO of Common Impact (a group that connects corporate employees to community nonprofits), says donations to small, local nonprofits are “especially meaningful” to those organizations. That’s because these types of charities, Holly says, are less likely than national and global ones to get large corporate or foundation sponsorship.

Charity-rating sites like Guidestar and Charity Navigator may be able to help you ensure that these groups are well-managed and efficient.

By Richard Eisenberg

Richard Eisenberg is the Senior Web Editor of the Money & Security and Work & Purpose channels of Next Avenue and Managing Editor for the site. He is the author of How to Avoid a Mid-Life Financial Crisis and has been a personal finance editor at Money, Yahoo, Good Housekeeping, and CBS MoneyWatch. Follow him on Twitter.

One frustrating thing for people eager to give wisely to charities: finding ones that truly make an impact. The big charity raters have done a great job sizing up nonprofits for overhead costs, transparency and executive pay. Impact, however, wasn’t part of their scoring — it was too hard to assess.

Recently, though, a new charity rater known as ImpactMatters has stepped into the breach for prospective donors by rating nonprofits on the amount of good achieved per dollar spent. It doesn’t review all charities or even all types of charities, as I’ll explain, but does an impressive job for the ones it does analyze, with star ratings.

And the nonprofit Open990.org is making it easier to compare charities head-to-head for things like their salaries and expenses and revenue.

Both sites are free and I think could be quite useful when choosing where to make your charitable contributions before the end of 2019.

How ImpactMatters Rates Charities

ImpactMatters, which is funded by several foundations and private donors, rates nonprofits that directly deliver services. Specifically, it focuses on these eight areas: homelessness, health, clean water, veterans, poverty, hunger, climate change and education.

Of the 1,077 nonprofits ImpactMatters has rated, 59% have 5 stars, 28% have 4 stars and 13% have lower scores.

It doesn’t rate nonprofits that operate through advocacy or by trying to change people’s minds (too hard to measure, though some in the nonprofit sector criticize ImpactMatters for not rating these types). Nor does ImpactMatters rate what are called “donor-use” membership-based charities, such as religious organizations, community associations or institutions like museums.

“We have three principles when rating charities for impact,” says ImpactMatters co-founder and executive director Elijah Goldberg. “Outcomes — what changes as a result of their work have been meaningful? What would have happened without the program? And, the most neglected principle in some ways: comparing the outcomes to the costs.”

Most nonprofits are doing something good and improving lives in some way, Goldberg says. “The question is: Do you give money to one of them or to another that is doing something similarly, but more efficiently?”

Of the 1,077 nonprofits ImpactMatters has rated on its scale of five stars (best) to 1 star (worst), 59% have 5 stars, 28% have 4 stars and 13% have lower scores. That’s a far smaller group than the estimated 1.9 million nonprofits, but it’s a decent number for direct-service ones of all sizes.

So how exactly does this rater determine whether a charity is making an impact?

“In our first iteration, we did impact audits. That meant a lot of contact with the nonprofits,” says Goldberg. “We discovered that took a lot of time.” Now, the rater does its exhaustive analysis without direct interactions, but  gives the charity an opportunity to review the rating.

4 Ways to Use ImpactMatters

There are four ways you can use ImpactMatters.

• You can search for a particular charity you’re interested in to see if there’s a rating.
• You can review the site’s Toplists, which show all the ratings for a particular type of charity.
• You can look at the 5-Star Nonprofits list, which includes Veterans of Foreign Wars of the United States; Sightsavers (helping cure blindness) and Fellowship Deliverance Ministries (providing homeless shelters).
• You can look at any of its 44 local giving guides  which shows the best-rated groups in particular metro areas, from Atlanta to Washington, D.C.

The Charity Navigator website, which has traditionally rated charities on financial measures, now also offers information about impact. It does this by including ratings from places like ImpactMatters and GlobalGiving, a crowdfunding platform for grassroots charitable projects.

How Open990.org Can Help You Research Charities

If you’d like to research charities based on how well they’re run and enjoy perusing data, check out Open990.org. Heather Kugelmass says she co-founded it with David Borenstein, Charity Navigator’s former director of data science, to “democratize access to nonprofit data.”

The site pulls together in one place data the financial information forms charities file with the Internal Revenue Service, known as Form 990. Then, Open990.org turns the forms into profiles for laypeople. “We highlight what people are most interested in,” Kugelmass says.

So, if you want to bore down into how a particular charity is run and not get bored doing it, you can see how its programs have changed over time as well as how its expenses and revenues have evolved.

You can search by the organization’s name or geographic location or cause area (such as: Education). You can search based on size, if you especially want to donate to either a large charity or a smaller one. And you can search by things like expenses or highest-paid individual at the nonprofit.

If You Want to Donate to Local Charities

Some people prefer donating to small nonprofits where they live because they like to see the effects of their contributions in person. If you’re one of them, you’ll want to do your own impact assessment by visiting local charities and asking their executives questions whose answers satisfy you.

Danielle Holly, CEO of Common Impact (a group that connects corporate employees to community nonprofits), says donations to small, local nonprofits are “especially meaningful” to those organizations. That’s because these types of charities, Holly says, are less likely than national and global ones to get large corporate or foundation sponsorship.

Charity-rating sites like Guidestar and Charity Navigator may be able to help you ensure that these groups are well-managed and efficient.

By Richard Eisenberg

Richard Eisenberg is the Senior Web Editor of the Money & Security and Work & Purpose channels of Next Avenue and Managing Editor for the site. He is the author of How to Avoid a Mid-Life Financial Crisis and has been a personal finance editor at Money, Yahoo, Good Housekeeping, and CBS MoneyWatch. Follow him on Twitter.

Start slowly, create categories and seek help if you need it
By Rachel Hartman

Organizing. and getting rid of, extra belongings can make it easier to downsize, clean a home and entertain guests.

But what should be done with a stack of boxes containing memorabilia stashed in a closet? Or a basement filled with items that represent the past 30 years?

“Clutter is real, and stuff follows us to the end,” says Felice Cohen, author and professional organizer based in New York City who teaches online organization classes to older adults.

“Sentimental clutter is the hardest clutter to part with.”

Sorting through last week’s coupons can be much easier than tackling a bin filled with memories from the past.

“As someone at the beginning of decluttering our large home in preparation for retirement, or at least moving into an apartment, we, like many friends, are dealing with the added, painful issues of what to keep from the home of close relatives who have passed away,” says Joel Poznansky, 61, who lives in Bethesda, Md. “There are questions about items — like overly revealing love letters or divorce papers that raise significant issues — fraught with overwhelming emotions.”

Those emotionally charged items can be tough to evaluate rationally. “Sentimental clutter is the hardest clutter to part with,” Cohen explains.

Strategies for Successful Decluttering

While not painless, approaching a stash or houseful of sentimental things with the following strategies may make the process manageable:

1. Group the memorabilia. “Memorabilia is very overwhelming to deal with, both from a volume and emotional perspective,” says Lisa Dooley, an organizing coach and author of More Space, More Time, More Joy!

To simplify decluttering, gather all keepsakes and mementos and put them in one spot. In addition to the easy-to-find items, empty drawers, closets and other storage areas. “Believe it or not, dealing with it piecemeal is even more time consuming, because we have no idea where it will pop up next,” Dooley explains.

2. Start with what’s easy. After putting it in a pile, don’t tackle everything in one day. Start slowly, such as setting a timer for 15 minutes or half an hour. Take a break and head back to the pile the following day.

You’ll likely spot items that you don’t use or value, such as a broken lamp from your first marriage or stained clothing you don’t remember purchasing. Deal with those first. “If it’s been damaged by water, heat or animals, it is beyond saving,” Dooley notes. “Throw it out now and move on to what you can work with.“

3. Create categories. It’s not unusual for a home’s memorabilia pile to span multiple generations, including everything from antiques to handmade blankets, children’s artwork and an assortment of grammar school yearbooks. Sort the belongings into groups, such as collections, pictures and old documents.

“Classifying items by type provides structure, which decreases the likelihood of becoming too emotionally overwhelmed,” says Sheri McGregor, a life coach and author of Done With the Crying: Help and Healing for Mothers of Estranged Adult Children.

Then, focus your attention on one group at a time. “Going through old photographs is one decluttering category,” McGregor says. “Sorting through a son or daughter’s school mementos is another. So is deciding about heirlooms such as family china or jewelry.”

4. Redirect items. If you come across items you don’t want to keep in the family, selling is an option. But don’t count on receiving a windfall.

“Many of the collectibles gathered over a lifetime may not have much resale value anymore,” says Luis Perez, CEO of Remoov, a San Francisco-based company that helps people declutter. “Baseball cards post-1960s have little to no value at all.”

For belongings you think your children or grandchildren would appreciate, consider giving them as gifts now or marking them to be passed on later. Also, keep in mind that while collections or college textbooks might have personal meaning to you, others might not be interested. “A library card or a playbill from a play you love can mean nothing to your children,” Poznansky says.

If family members aren’t interested, you can try to donate the wares to a secondhand store. Or create a new keepsake, such as a quilt made with T-shirts from places you visited or a collage of old photographs.

5. Set parameters. “If you’re moving to a smaller place, make a comparison to your current situation,” McGregor says. Then, aim to declutter as much as you need to fit the new place, such as 40 % or half of the boxes.

A friend or relative might be able to help you evaluate what to keep and what to pass on. If you’re struggling to downsize, a professional organizer could provide support.

“Some organizers specialize in photo and memorabilia management,” Dooley says. Others focus on the mental health and emotional journey of parting with things and serve as a bit of a life coach.

6. Enjoy the process. “Don’t look at it like decluttering and getting rid of your past, but as a journey through a long life,” Cohen says. Hold your wedding dress in your hands or flip through a photo album and take the time to remember what life was like then.

“Sometimes you just need to remember, to share a story one more time, to be able to part with something,” explains Cohen.

If you’re not ready to get rid of something now, and space isn’t a concern, put it aside for a year. Then revisit the item to see if you’re at a point where you can let it go.

And hold on to special discoveries you come across. “Keep toys you remember your children particularly enjoying — or that you would enjoy playing with with your grandchildren,” Poznansky says.

By Rachel Hartman

Rachel Hartman is a freelance writer specializing in finance, business, lifestyle and travel topics. She has written for Parenting, Yahoo Finance and MSN Money, among other outlets.

Start slowly, create categories and seek help if you need it
By Rachel Hartman

Organizing. and getting rid of, extra belongings can make it easier to downsize, clean a home and entertain guests.

But what should be done with a stack of boxes containing memorabilia stashed in a closet? Or a basement filled with items that represent the past 30 years?

“Clutter is real, and stuff follows us to the end,” says Felice Cohen, author and professional organizer based in New York City who teaches online organization classes to older adults.

“Sentimental clutter is the hardest clutter to part with.”

Sorting through last week’s coupons can be much easier than tackling a bin filled with memories from the past.

“As someone at the beginning of decluttering our large home in preparation for retirement, or at least moving into an apartment, we, like many friends, are dealing with the added, painful issues of what to keep from the home of close relatives who have passed away,” says Joel Poznansky, 61, who lives in Bethesda, Md. “There are questions about items — like overly revealing love letters or divorce papers that raise significant issues — fraught with overwhelming emotions.”

Those emotionally charged items can be tough to evaluate rationally. “Sentimental clutter is the hardest clutter to part with,” Cohen explains.

Strategies for Successful Decluttering

While not painless, approaching a stash or houseful of sentimental things with the following strategies may make the process manageable:

1. Group the memorabilia. “Memorabilia is very overwhelming to deal with, both from a volume and emotional perspective,” says Lisa Dooley, an organizing coach and author of More Space, More Time, More Joy!

To simplify decluttering, gather all keepsakes and mementos and put them in one spot. In addition to the easy-to-find items, empty drawers, closets and other storage areas. “Believe it or not, dealing with it piecemeal is even more time consuming, because we have no idea where it will pop up next,” Dooley explains.

2. Start with what’s easy. After putting it in a pile, don’t tackle everything in one day. Start slowly, such as setting a timer for 15 minutes or half an hour. Take a break and head back to the pile the following day.

You’ll likely spot items that you don’t use or value, such as a broken lamp from your first marriage or stained clothing you don’t remember purchasing. Deal with those first. “If it’s been damaged by water, heat or animals, it is beyond saving,” Dooley notes. “Throw it out now and move on to what you can work with.“

3. Create categories. It’s not unusual for a home’s memorabilia pile to span multiple generations, including everything from antiques to handmade blankets, children’s artwork and an assortment of grammar school yearbooks. Sort the belongings into groups, such as collections, pictures and old documents.

“Classifying items by type provides structure, which decreases the likelihood of becoming too emotionally overwhelmed,” says Sheri McGregor, a life coach and author of Done With the Crying: Help and Healing for Mothers of Estranged Adult Children.

Then, focus your attention on one group at a time. “Going through old photographs is one decluttering category,” McGregor says. “Sorting through a son or daughter’s school mementos is another. So is deciding about heirlooms such as family china or jewelry.”

4. Redirect items. If you come across items you don’t want to keep in the family, selling is an option. But don’t count on receiving a windfall.

“Many of the collectibles gathered over a lifetime may not have much resale value anymore,” says Luis Perez, CEO of Remoov, a San Francisco-based company that helps people declutter. “Baseball cards post-1960s have little to no value at all.”

For belongings you think your children or grandchildren would appreciate, consider giving them as gifts now or marking them to be passed on later. Also, keep in mind that while collections or college textbooks might have personal meaning to you, others might not be interested. “A library card or a playbill from a play you love can mean nothing to your children,” Poznansky says.

If family members aren’t interested, you can try to donate the wares to a secondhand store. Or create a new keepsake, such as a quilt made with T-shirts from places you visited or a collage of old photographs.

5. Set parameters. “If you’re moving to a smaller place, make a comparison to your current situation,” McGregor says. Then, aim to declutter as much as you need to fit the new place, such as 40 % or half of the boxes.

A friend or relative might be able to help you evaluate what to keep and what to pass on. If you’re struggling to downsize, a professional organizer could provide support.

“Some organizers specialize in photo and memorabilia management,” Dooley says. Others focus on the mental health and emotional journey of parting with things and serve as a bit of a life coach.

6. Enjoy the process. “Don’t look at it like decluttering and getting rid of your past, but as a journey through a long life,” Cohen says. Hold your wedding dress in your hands or flip through a photo album and take the time to remember what life was like then.

“Sometimes you just need to remember, to share a story one more time, to be able to part with something,” explains Cohen.

If you’re not ready to get rid of something now, and space isn’t a concern, put it aside for a year. Then revisit the item to see if you’re at a point where you can let it go.

And hold on to special discoveries you come across. “Keep toys you remember your children particularly enjoying — or that you would enjoy playing with with your grandchildren,” Poznansky says.

By Rachel Hartman

Rachel Hartman is a freelance writer specializing in finance, business, lifestyle and travel topics. She has written for Parenting, Yahoo Finance and MSN Money, among other outlets.

by Taylor McMahon, nurse navigator and educator, Oakmont campus

I take my roles as nurse navigator and educator very seriously. I promote quality of life for our residents, and that comes in many variations, but mostly through early identification of individuals at the highest risk for readmission, those who need help with medication management and those who need education about their condition. My dual role is an essential piece to getting our residents back to their home, feeling in control and staying out of the hospital.

Patients with COPD have a higher risk of returning to the hospital. So when I had a short-term rehabilitation patient with COPD who did not understand her medications or why adhering to a medication routine was essential, I got to put my navigator and educator skills to good use.

I sat with her and we talked about her current knowledge of COPD. I’ve discovered that I am most successful when I understand what the patient understands about their condition. It is important to explore knowledge gaps so that education can be tailored to each patient.

In this patient’s case, we discovered that she was not using her inhalers the correct way, and was only using them on days she didn’t feel well.

After using the teach back method, she was able to demonstrate the correct way to use her inhalers, and understand the “why” of adhering to a medication routine.

She could tell me why she needed to take her medications exactly as the doctor ordered, and how those medications were helping her lungs. She felt empowered and was much more willing to take the steps to manage her condition. All it took was getting to know her and assessing her base of knowledge.

As part of the navigator role, I follow an extensive evidenced-based checklist to ensure that we do everything we can for a safe discharge. Making the follow-up doctor appointment, medication reconciliation, follow-up phone calls and talking to the home health provider for a smooth hand-off are just a few of the steps I take.

As I was helping my patient prepare for discharge, I was so proud when she told me that I gave her back control of her life. The role of navigator and educator has made such a difference at The Willows, our skilled nursing center. This is my “why.”

by Taylor McMahon, nurse navigator and educator, Oakmont campus

I take my roles as nurse navigator and educator very seriously. I promote quality of life for our residents, and that comes in many variations, but mostly through early identification of individuals at the highest risk for readmission, those who need help with medication management and those who need education about their condition. My dual role is an essential piece to getting our residents back to their home, feeling in control and staying out of the hospital.

Patients with COPD have a higher risk of returning to the hospital. So when I had a short-term rehabilitation patient with COPD who did not understand her medications or why adhering to a medication routine was essential, I got to put my navigator and educator skills to good use.

I sat with her and we talked about her current knowledge of COPD. I’ve discovered that I am most successful when I understand what the patient understands about their condition. It is important to explore knowledge gaps so that education can be tailored to each patient.

In this patient’s case, we discovered that she was not using her inhalers the correct way, and was only using them on days she didn’t feel well.

After using the teach back method, she was able to demonstrate the correct way to use her inhalers, and understand the “why” of adhering to a medication routine.

She could tell me why she needed to take her medications exactly as the doctor ordered, and how those medications were helping her lungs. She felt empowered and was much more willing to take the steps to manage her condition. All it took was getting to know her and assessing her base of knowledge.

As part of the navigator role, I follow an extensive evidenced-based checklist to ensure that we do everything we can for a safe discharge. Making the follow-up doctor appointment, medication reconciliation, follow-up phone calls and talking to the home health provider for a smooth hand-off are just a few of the steps I take.

As I was helping my patient prepare for discharge, I was so proud when she told me that I gave her back control of her life. The role of navigator and educator has made such a difference at The Willows, our skilled nursing center. This is my “why.”

From travel 'deals' to puppies to gift cards, watch your wallet!
By Michele Wojciechowski

It’s the most wonderful time of the year — unless you get scammed.

“In this season of generosity, people let down their guards and tend not to be as skeptical as they would be the rest of the year,” says Christopher Elliott,  founder of the consumer-advice nonprofit Elliott Advocacy and author of How to be the World’s Smartest Traveler.

With that in mind, here’s a guide to some scams that proliferate around the holidays and how to avoid getting fleeced by them:

Vacation-Booking Scams

Booking places to stay during the holidays or for a vacation gift can be convenient when done online. But before you do, be sure it’s the real deal.

“If you book now, I can get you a reduced rate. But you have to book now!”

“Scammers know that this is a great time to rip people off with fake vacations. This is their busiest time of year,” notes Elliott.

In fact, the Better Business Bureau (BBB) just released an eye-opening study of rental scams involving vacation properties.

The report says: “BBB has received numerous reports of people who arrive at a vacation property with their families and luggage after having made advance payments only to discover that the location doesn’t exist or is not available for rent, leaving people stranded with nowhere to stay and finding their money has disappeared.”

Elliott says crooks often demand victims wire money before their trip. “Never wire money,” he cautions. “When you pay with a credit card, you’re protected under the Fair Credit Billing Act. So, you can dispute a charge and get your money back. But if you pay with anything other than a credit card you will have fewer protections. Wiring money is the worst because once that money goes somewhere, there’s no way to send it back.”

Vacation scammers also like to use tactics to rope you in. For example, they’ll use the scarcity ploy: “If you book now, I can get you a reduced rate. But you have to book now!” Or: “If you don’t send that money now, this deal will be gone. I’m just looking out for you.”

When searching for online travel deals, stick with legitimate, trustworthy brands, Elliott advises, like Priceline, Expedia, Orbitz or Kayak. “Or go directly to your airline or hotel website,” he adds. “If you see a site that has a deal that’s too good to be true and it’s a site you don’t recognize, go look somewhere else.”

Timeshare Scams

Many legitimate companies sell timeshares, where you lock in the right to use the same accommodation year after year, often for holiday vacations. But many timeshare companies are run by crooks.

The timeshare scam usually works like this: The scammer invites victims to a presentation at a mall or a pop-up store on the premise of traveling for less money. The attendees write checks and then the fraudsters disappear.

“If they’re engaging in high-pressure sales tactics or they won’t let you take the contract home to read through it — those are the tell-tale signs of a scam,” says Elliott.

Another timeshare scam: companies that claim they have people who’ll buy or rent the owners’ units, take the owners’ cash (perhaps $2,500 or more) and then fail to make good on their promise.

These types of scams are so prevalent, sometimes the Federal Trade Commission (FTC) gets involved.

In October 2019, the FTC announced it was mailing more than 8,000 refund checks totaling $2.7 million to people scammed by Pro Timeshare Resales into paying an upfront fee to resell their timeshares. The company was forced to surrender assets and banned from reselling timeshares.

Puppy Scams

Another prevalent scam this time of year involves puppies bought online, says Katherine Hutt, national spokeswoman for the BBB. Frequently, they’re meant to be holiday gifts to family members.

“According to the BBB Scam Tracker Risk Report, pets are the number one online purchase that turns out to be fake,” says Hutt. “Scammers create websites filled with adorable photos and offer great prices, but then keep adding charges such as extra shipping fees, ‘required’ vet visits and shots. Each request for more money makes it seem as if your new family member is that much closer to coming home, but, in reality, the puppy never existed in the first place.”

The BBB gives the following tips to avoid puppy scams:

• If possible, try to pick up the puppy in person. Puppy scams depend on buyers trusting that the animals will be delivered to them.
• Be careful about buying a puppy from anyone you don’t know, and be especially skeptical if the price is much lower than normal.
• Avoid wiring money or using prepaid cards or gift cards to pay for transporting animals. Instead pay by credit card in case you need to challenge the purchase later.

Gift Card Scams

The BBB also sees crooks stealing the value of gift cards during the holidays.

“Scammers can copy the numbers off unsold cards — even those displayed in a store — and, once you purchase the card, they can download the cash value before you even realize it’s gone,” says Hutt.

Another gift card scam to beware of: discounted gift cards advertised on social media or in text messages. These cards could be fake or could be real cards that are either stolen or worthless, Hutt says.

If you buy a gift card in a store, the BBB advises, make sure it’s not damaged and that the PIN isn’t exposed. Also, register the card if the retailer allows.

By Michele Wojciechowski

Michele "Wojo" Wojciechowski is an award-winning writer who lives in Baltimore, Md. She's the author of the humor book Next Time I Move, They'll Carry Me Out in a Box. Reach her at www.WojosWorld.com.@TheMicheleWojo

From travel 'deals' to puppies to gift cards, watch your wallet!
By Michele Wojciechowski

It’s the most wonderful time of the year — unless you get scammed.

“In this season of generosity, people let down their guards and tend not to be as skeptical as they would be the rest of the year,” says Christopher Elliott,  founder of the consumer-advice nonprofit Elliott Advocacy and author of How to be the World’s Smartest Traveler.

With that in mind, here’s a guide to some scams that proliferate around the holidays and how to avoid getting fleeced by them:

Vacation-Booking Scams

Booking places to stay during the holidays or for a vacation gift can be convenient when done online. But before you do, be sure it’s the real deal.

“If you book now, I can get you a reduced rate. But you have to book now!”

“Scammers know that this is a great time to rip people off with fake vacations. This is their busiest time of year,” notes Elliott.

In fact, the Better Business Bureau (BBB) just released an eye-opening study of rental scams involving vacation properties.

The report says: “BBB has received numerous reports of people who arrive at a vacation property with their families and luggage after having made advance payments only to discover that the location doesn’t exist or is not available for rent, leaving people stranded with nowhere to stay and finding their money has disappeared.”

Elliott says crooks often demand victims wire money before their trip. “Never wire money,” he cautions. “When you pay with a credit card, you’re protected under the Fair Credit Billing Act. So, you can dispute a charge and get your money back. But if you pay with anything other than a credit card you will have fewer protections. Wiring money is the worst because once that money goes somewhere, there’s no way to send it back.”

Vacation scammers also like to use tactics to rope you in. For example, they’ll use the scarcity ploy: “If you book now, I can get you a reduced rate. But you have to book now!” Or: “If you don’t send that money now, this deal will be gone. I’m just looking out for you.”

When searching for online travel deals, stick with legitimate, trustworthy brands, Elliott advises, like Priceline, Expedia, Orbitz or Kayak. “Or go directly to your airline or hotel website,” he adds. “If you see a site that has a deal that’s too good to be true and it’s a site you don’t recognize, go look somewhere else.”

Timeshare Scams

Many legitimate companies sell timeshares, where you lock in the right to use the same accommodation year after year, often for holiday vacations. But many timeshare companies are run by crooks.

The timeshare scam usually works like this: The scammer invites victims to a presentation at a mall or a pop-up store on the premise of traveling for less money. The attendees write checks and then the fraudsters disappear.

“If they’re engaging in high-pressure sales tactics or they won’t let you take the contract home to read through it — those are the tell-tale signs of a scam,” says Elliott.

Another timeshare scam: companies that claim they have people who’ll buy or rent the owners’ units, take the owners’ cash (perhaps $2,500 or more) and then fail to make good on their promise.

These types of scams are so prevalent, sometimes the Federal Trade Commission (FTC) gets involved.

In October 2019, the FTC announced it was mailing more than 8,000 refund checks totaling $2.7 million to people scammed by Pro Timeshare Resales into paying an upfront fee to resell their timeshares. The company was forced to surrender assets and banned from reselling timeshares.

Puppy Scams

Another prevalent scam this time of year involves puppies bought online, says Katherine Hutt, national spokeswoman for the BBB. Frequently, they’re meant to be holiday gifts to family members.

“According to the BBB Scam Tracker Risk Report, pets are the number one online purchase that turns out to be fake,” says Hutt. “Scammers create websites filled with adorable photos and offer great prices, but then keep adding charges such as extra shipping fees, ‘required’ vet visits and shots. Each request for more money makes it seem as if your new family member is that much closer to coming home, but, in reality, the puppy never existed in the first place.”

The BBB gives the following tips to avoid puppy scams:

• If possible, try to pick up the puppy in person. Puppy scams depend on buyers trusting that the animals will be delivered to them.
• Be careful about buying a puppy from anyone you don’t know, and be especially skeptical if the price is much lower than normal.
• Avoid wiring money or using prepaid cards or gift cards to pay for transporting animals. Instead pay by credit card in case you need to challenge the purchase later.

Gift Card Scams

The BBB also sees crooks stealing the value of gift cards during the holidays.

“Scammers can copy the numbers off unsold cards — even those displayed in a store — and, once you purchase the card, they can download the cash value before you even realize it’s gone,” says Hutt.

Another gift card scam to beware of: discounted gift cards advertised on social media or in text messages. These cards could be fake or could be real cards that are either stolen or worthless, Hutt says.

If you buy a gift card in a store, the BBB advises, make sure it’s not damaged and that the PIN isn’t exposed. Also, register the card if the retailer allows.

By Michele Wojciechowski

Michele "Wojo" Wojciechowski is an award-winning writer who lives in Baltimore, Md. She's the author of the humor book Next Time I Move, They'll Carry Me Out in a Box. Reach her at www.WojosWorld.com.@TheMicheleWojo

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.

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.

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.

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.

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.

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
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:

• Oakmont area: 4^th Tuesday of every month from 3 p.m. to 4:30 p.m. at Woodside Place of Oakmont.
• Washington area: 2nd Wednesday of every month from 10:30 a.m. to 11:30 a.m. at the Hillsview Chapel at the Presbyterian SeniorCare Network Washington campus
• Erie area: last Thursday of every month from 3:00 pm to 4:30 pm at the Lincoln Community Library.

We hope you'll join us! 

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:

• Oakmont area: 4^th Tuesday of every month from 3 p.m. to 4:30 p.m. at Woodside Place of Oakmont.
• Washington area: 2nd Wednesday of every month from 10:30 a.m. to 11:30 a.m. at the Hillsview Chapel at the Presbyterian SeniorCare Network Washington campus
• Erie area: last Thursday of every month from 3:00 pm to 4:30 pm at the Lincoln Community Library.

We hope you'll join us!