More Can Do Conversations

Subnitted by: Dr. Wayne T. Phillips

This is the second post on my recent conversations about ‘Usual’ vs ‘Successful’ Aging with a group of older adults. I was comparing what ‘usually’ happens with strength to what can happen … and what actually does happen with many members of STRIVE who strength train with us on a regular basis. As I said in my previous post, I received a lot of good feedback from this event so I decided to share it here. It makes for ‘Successful Reading!’

Of course the conversation in this group turned, as it always does, to the ubiquitous question of weight loss. “Ok so what about weight loss?” somebody asked “is strength training good for that too?”

Here’s what ‘usually’ happens: We gain about one pound of body fat per year from the age of 30. By the time we hit 70 we have gained about 15% body fat more than our 30 year old fat mass. So far so not good!

Here’s what can happen: The good part comes when we think about how strength training fuels energy expenditure. First of all strength training increases the amount of muscle you have (muscle ‘mass’) and so gives your metabolism (your body’s energy expenditure) a permanent ‘boost’. This makes it easier to lose body fat. Strength training also makes it easier to perform aerobic exercise (another way to increase energy expenditure) because of increased strength and endurance. All this can happen with an appropriately designed program of strength training. Of course you are also expending energy while actually doing the strength training! The importance of strength training in weight management has recently been confirmed by The American College of Sports Medicine. This world wide organization recommended including strength training as an important part of a weight management program. Here’s what they say
… the inclusion of resistance training in weight loss programs has clear advantages. Resistance training is a potent stimulus to increase fat-free mass (FFM), muscular strength, and power and thus may be an important component of a successful weight loss program by helping to preserve FFM while maximizing fat loss.

Sounds good to me!

Lastly, a number of women asked whether strength training can stop or slow bone loss.
Here’s what ‘usually’ happens: The average woman loses about 1% of bone mass each year and after menopause this rate can almost double during the first 5 menopausal years. By age 60 some 20% or more of pre-menopausal bone mass may be lost.

Here’s what can happen: An appropriately designed strength training program can actually reverse this process! Studies have shown that a regularly attended strength training program can slow, reduce or even reverse bone loss. Studies as short as 16 weeks have been shown to increase bone strength and reduce the risk for fractures among older women. But here’s the thing. You have to be working at more than 70% of your maximal strength for these exercises. Not that working at lower levels won’t do any good. It will. But just using those thin rubber bands or those small dumbbells won’t cut it for bone strength. Your muscles will get stronger with this form of exercise, and you will gain some valuable functional benefits, you have to gradually build up the amount of weight you lift to strengthen your bones. This is more achievable than you may think. STRIVE members safely and regularly work at these levels with no problems.

The bottom line from this conversation is that the many benefits of strength training can not only make you stronger but also can help you to “Activate your Aging”

- GET STRONG –

Dr. Wayne Phillips, FACSM, Intrinsic Coach® is Co-Founder and Research Director of The STRIVE Wellness Corporation and an internationally recognized expert on aging and wellness. He is currently the author of two blogs focused on older adults: one relating mainly to strength, independence and quality of life @ http://strivealive.wordpress.com/ and one relating mainly to health related behavior change @ http://telosity.wordpress.com/. A brief bio of Dr. Phillips may be found @ http://strivealive.wordpress.com/about/

The truth about older drivers...

The truth about older drivers...

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I think my (fill in the blank) has Alzheimer’s! What do I do?

Submitted by: Laura Bramly

More and more people are coming forward to say that one of their family members or friends may be showing signs of memory loss. I get this question all the time: What do I do now? Where do I go? Who do I talk to?

There are so many diseases in the world, some easy to diagnose and some more difficult, but everyone knows that the first stop is the doctor. With memory loss, it’s different. For some reason (probably due to the stigma of losing memory) no one knows where to turn or what to do next. Here are three steps that you can take with your loved one who may be showing signs of memory loss: Diagnose. Manage. Live.

One proviso: Alzheimer’s disease is a type of dementia. There are some 70 or more types of dementia, with Alzheimer’s being the most prevalent, along with Vascular Dementia (caused by a stroke) and Lewy Body Dementia. People can have two or more types of dementia at one time. Even when considering Alzheimer’s alone, no two people with Alzheimer’s will present exactly the same symptoms or maintain the same capabilities. Each person is different. So, even though there are three steps to take with a person who may have dementia, the exact path that each person takes will differ.

In talking about the three steps, I alternate between talking about the caregiver and the person with dementia in the third or first person to cover both bases; perhaps “you” are the caregiver who is reading this blog, or perhaps “you” are the person with symptoms of memory loss. I strongly believe and recommend that all steps should be taken in partnership between the caregiver/family member and the person with memory loss.

Step One: Diagnose
Memory loss should be treated like any other illness for which a diagnosis can mean the difference between suffering in silence and receiving a treatment that can have a real impact. Memory loss is not a direct ticket to the nursing home, as it can result from such treatable medical conditions as depression and anxiety disorders, thyroid disease, B12 deficiency, elevated homocysteine levels, dehydration, infection, brain tumor and others.

If possible, see a doctor who is a neurologist, or who specializes in geriatrics (if the person experiencing memory loss is a senior). If you see your primary care physician, make sure that you go to your appointment well-armed with information about diagnosing the cause of memory loss. If the only test your loved one receives is a memory test, ask for further testing. Such conditions as brain tumors can not be diagnosed by a memory test! Most importantly, ensure that you feel comfortable conversing with the doctor, that you don’t feel as if you are getting brushed off, and that you are receiving thoughtful and knowledgeable answers. If you don’t feel this, find another doctor.

Step Two: Manage
If the diagnosis for memory loss is Alzheimer’s disease or another form of dementia, then it’s time to understand how to slow the progression and how the disease may impact the rest of the person’s life. Talk to the doctor about drugs that are available to slow the progression of the disease. Put together a program of exercise, healthy eating, brain activity and socialization. Studies have shown that all of these factors can contribute to slowing the progression of the disease.

It’s also time to understand how the disease may unfold and affect the person with dementia over the years (again, understanding that no two people have the same experience with dementia). For example, the early stage of dementia is a good time to get financial affairs in order and determine what care options are available so that a plan can be implemented “when the time comes.” Now is the time to have thoughtful discussions with family and friends about what the future may bring, so that family members are not forced into making reactive and upsetting decisions about these important issues. It’s also a nice time to put together family history scrapbooks, make videos, reconnect with long lost family and friends.

Step Three: Live!
Dementia is not a death sentence. Well, OK, it can be. We will all die sometime, but people with dementia know more or less when they will die and what it might look like. So, in the years that are left, it’s time to live. Yes, driving will become unworkable at some point. People with early-onset dementia may lose their jobs. Activities that were once easy, requiring no thought, may become more difficult or indeed, impossible. However, that does NOT mean that a person with dementia must resign themselves to a life of watching the TV alone in their house with a caregiver, or to mindless activity in a nursing home. In fact, don’t, just DON’T!

While it’s hard enough for people without a life-threatening disease to find purpose in life, many people with dementia find new purpose in their lives when they know life is limited. It’s time to ask one’s self: How am I going to use these last years of my life so that I can have the greatest impact on my family, my community, my country, my world? People with dementia are in demand as bloggers and speakers, so that they can pass along their experiences and recommendations to a public hungry for more information about dementia. There is no one who can comfort a newly-diagnosed person more than a person who already has the disease and who can pass along reassurance and counsel. A person with dementia might also find new purpose in volunteering for other causes, or in travel, or in taking up a new hobby. Anything one can do to keep the brain and body active is essential to slowing the progression of the disease, even when one reaches the later stages of the disease.

The person with dementia and their family may find that many of their friends stop calling to invite them out; dementia still has a terrible and unfounded stigma that makes even “good” friends reluctant to maintain former relationships. Through your local Alzheimer’s Association support groups or through your faith community or senior’s centre, find other families dealing with the disease and with whom a social group could be formed. Just because a person has dementia doesn’t mean that they don’t enjoy going out for a beer on Friday night!

In later blogs I will endeavour to break down these three steps into more detail. In the meantime, I welcome comments and emails to laura@eldercareread.com

Loneliness...an elder ill that can't be treated with medication

Loneliness...an elder ill that can't be treated with medication

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Deeds, Not Words, Made Dad’s Love Obvious We don’t have to hear “I love you” to know we’re loved

By Rita Files

I overheard a conversation the other day where one woman was complaining to another about how she never heard her father tell her he loved her. “He never once said ‘I love you,’ and I do everything for him now.” Hearing this, I began to reflect on my experience with my own dad and came to the realization that I never heard those words from him either. Yet I always knew I was loved.

My Dad was the epitome of a brawly Irish man—big and tough looking, the type you wouldn’t want to have mad at you for any reason. Yet this same man would cry like a baby during Shirley Temple movies. He was a man of few words who had mastered the art of communicating through body language. With a smile, a chuckle, or the shake of his head, I knew if he approved of something or not. I knew he was proud of me when he would say with a tear in his eye, “You’re a good kid, Re Re.” And with a simple “You’re something else, Re Re,” his love was apparent.

Dad grew up during the tough times of World Wars I and II and the Great Depression. Instead of enjoying his teen years the way I did, he was busy working to support his family. When he wasn’t working, he was learning sign language so he could volunteer to help deaf children. Every year, he played Santa at their Christmas party. He also made sure that a neighbor who suffered with profound Down Syndrome always had a ride to church and doctor visits. My dad’s way of saying “I love you” was by doing, helping, and giving to others. He didn’t talk the talk, he walked the walk.

Not everyone is able to express their love with words. My dad did it with deeds. Knowing you are loved is what is most important as you go through life. In other words, I always knew that my dad loved me.

Union Plus Eldercare Services for Labor Union Members

Union Plus Eldercare Services for Labor Union Members

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The new 'female problem': Caregiver stress

The new 'female problem': Caregiver stress

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Reverse Mortgage Basics

Submitted by: Onisha Williams

“If it weren’t for junk mail, the paper industry would have gone out of style with the walkman” ~ Onisha Williams

You’ve seen commercials, heard radio ads, and it is officially the soft murmur topic at every country club, senior center, and park bench in America – The Reverse Mortgage! If you are over 62 and creatively inclined, I am certain that you could create a collage worthy of Braque with the postcards and mailers that you receive from mortgage companies touting any number of jazzy slogans!

I like to keep it plain; we can get fancy another day!

The reality is that no matter how simple someone makes this program sound, it is a dynamic financial product that requires a full understanding of the features and consequence by potential borrowers and their caregivers. There is no “one size fits all” philosophy – good or bad - behind using a Reverse Mortgage. I find that every individual situation is unique for a myriad of reasons, usually surrounding property value, health, family involvement, asset positioning, and the person’s overall estate plan.

With that being said, let’s review the basics of the Reverse Mortgage!

Types – Proprietary and Government Insured. The spectrum of proprietary products is long and wide, although they mirror the Government insured, FHA, products in many ways they have many variants. This is a review of the FHA Home Equity Conversion Mortgage (HECM).

Qualification
• The youngest person on title must be at least 62 years old.
• The property must be a primary residence.
• HECM Counseling Certificate must be obtained.
• A satisfactory FHA approved appraisal to confirm value.
• Title Insurance to verify chain of ownership and release of liens

Use – The program can be used to purchase a new primary residence or to refinance the home you currently live in.

Features – No repayment while at least one borrower occupies the property. Funds borrowed are available in a lump sum, equity line of credit, fixed payments for a limited amount of time, fixed payments for the life of the loan, or a combination of the aforementioned options.

Requirements – At least one borrower must live in the home, retain home owners insurance at all times, timely pay property taxes, and maintain the physical integrity of the property.

Repayment – The loan becomes due to be paid in full if any of the requirements are no longer met, this also includes if at least one borrower does not live in the home for 12 consecutive or the death of the last borrower living in the home. Repayment is usually done through the sale of the property either by the borrower or their heirs. The amount due will include the amount of money borrowed, accumulated interest & service fees, monthly mortgage insurance premiums, and upfront settlement costs that were financed into the loan. Any remaining equity belongs to the borrower or their estate.

I know it seems simple enough, but these are the highlights – explore these resources and continue to follow my Reverse Mortgage Posts!

YOUR BEST INTEREST AT HEART

By Elizabeth Foster, Social Security District Manager in South Philadelphia

So, you think you might qualify for benefits but aren’t sure who to ask, where to start, or how to begin. Should you be applying for Social Security or Supplemental Security Income? Medicare or Medicaid? What’s the difference? For someone not familiar with such benefits, it can all seem confusing.
That’s why we’d like to show you the BEST way to get the process started.

Just visit Social Security’s Benefit Eligibility Screening Tool (BEST). BEST will help you determine whether you may be eligible for different types of benefits, including:

Social Security Disability;
Social Security Retirement;
Social Security Survivors;
Medicare;
Special Veterans Benefits; and
Supplemental Security Income (SSI).

BEST also links users to an additional website that can help you determine whether you may qualify for the Medicare Prescription Drug Plan through Medicare and for extra help with your prescription drug costs through Social Security.

At the BEST website, you’ll be asked some basic questions about your situation. It will take about five to 10 minutes to complete the questions. No one will see the answers you give and the session will not be recorded. It is a confidential way for you to plug in your situation and get quick answers regarding the benefits you may be eligible to apply for.

Why not get started now? Just visit www.Govbenefits.gov and answer a few simple questions to find out whether you might be eligible for benefits. You can also visit www.socialsecurity.gov for additional information about Social Security.

The Road Less Travelled; the Inpatient Geriatric-Psychiatric Option.

Submitted by: Jason Young, MS

When a geriatric patient begins to experience a substantial decrease in appetite and sleep, this can quickly become a life threatening situation. For example, someone diagnosed with Major Depression showing a sudden decrease in appetite may benefit greatly from an evaluation of their antidepressant medications. Often, specialists are able to prescribe medications that have strong appetite stimulating properties in addition to their psychotropic effects.

The person diagnosed with Alzheimer’s disease doing fairly well for a few years may begin to become more agitated and uncooperative with care, sometimes refusing medications. If the complete refusal of medications continues for long, numerous complications can occur. Many times, adjustments can be made to memory enhancing meds and anti-psychotics that can be of great help. Other times there is untreated depression and / or anxiety that can be addressed accordingly.

The aforementioned examples certainly do not encompass the hundreds of differing treatment scenarios that occur. Though by considering the positive results that can be reached in a short amount of time within an intensive psychiatric program, one can conceptualize how such an approach may be able to help their loved one. Acute intensive psychiatric treatment should be thought of as the option to take when ones primary physician and / or psychiatrist has been unable to stabilize the patient on an outpatient basis. The only reason to seek treatment at an inpatient unit is to allow a specialist the opportunity to evaluate the patient for needed changes to their medications. This is certainly not the only advantage of entering such a facility, though it is the primary goal that should never be lost sight of. Great things happen in these facilities. All caregivers of elderly persons with cognitive problems should become more knowledgeable on where their loved one could obtain such help should it ever be needed.

Jason has 10 years experience with serving seniors in several capacities. He currently works as a geriatric clinician, marketer, and speaker for a health care company and geriatric inpatient psychiatric unit. Jason has a Bachelors Degree in Social Work and a Masters in Community Agency Counseling. For more of his articles, please visit http://jasonyoung99.wordpress.com

Can Do Conversations

Submitted by: Wayne T. Phillips

I was talking the other day about some interesting statistics relating to strength and aging – and some highly encouraging research ‘responses’ to these numbers. I had been speaking to an audience of older adults on ‘Usual’ vs ‘Successful’ Aging and comparing what ‘usually’ happens with strength to what can happen … and what actually does happen with many members of STRIVE who strength train with us on a regular basis. I received a lot of good feedback from this conversation so I decided to share it here over the next few posts. Trust me – it makes ‘Successful Reading’! Read the full article

Compliments of Aging with Grace

At no time is your role as caregiver more important than when you are faced with the responsibility of speaking on behalf of the person you are caring for. By preparing in advance, you can significantly ease the stress and ensure that you and your loved one have a voice when it counts the most. Keeping important documents and information in one place is the most important step in the preparation process.

Aging with Grace now offers caregivers the ability to download or view a complimentary copy of our Caregiver Survival Kit. Click the image in the sidebar to view and/or download this handy booklet.

Loneliness…an elder ill that can’t be treated with medicine.

Submitted by: Patricia Grace

Families often do not recognize the insidious impact of loneliness on their elderly loved ones. With new studies providing increased documentation of the correlation between loneliness and dementia I hope more family members will take notice of the importance of daily interaction and socialization for our elders.

Over the course of my career I have spoken with many families that only focus on the safety of a loved one with the goal of keeping that older person their home. Although most of us would agree that staying in our home is our preference, we must factor in the need for regular socialization & interaction for people of all ages.

A great option for keeping an aging parent in their home is Adult Day Care or Home Care. Both options provide the opportunity to stay in at home with regular social interaction. The following article by Kathleen Fackelmann from USA TODAY focuses on this issue.

Wayne T. Phillips, PhD., FACSM joins our Panel of Experts

Dr. Phillips, known for his humorous and provocative speaking style, eliciting ‘new thinking’ from audiences about wellness and active lifestyle issues for older adults, is the Founder and Owner of AgeWELL Initiatives, LLC (www.agewellinitiatives.com). He is also a Founding Partner of The STRIVE Wellness Corporation (www.strivealive.com), two companies whose mission is to improve the functional independence and quality of life of older adults. Learn more about Dr. Phillips

New addition to our Panel of Experts

Laura Bramly is a communications consultant specializing in education programs about dementia. She is author of ElderCareRead Life Scenes 1, a book for people with moderate to advanced dementia to read and enjoy. Learn more about Laura

Daily Money Management: Who, What, and Why?

Submitted by: Sheri Samotin

Daily Money Management is a relatively new field that deploys personal finance expertise to clients who have difficulty in managing their personal monetary affairs. The services meet a continuum of needs, from organizing and keeping track of medical and insurance papers, assisting with check writing and maintaining bank accounts, and advocating for payment of medical, disability, and long term care claims. Some Daily Money Managers (DMMs) will also arrange for in-home care and medical appointments and provide information regarding community resources available to meet other needs.

Most DMMs work mainly with seniors, although the services are available to anyone. Seniors who work with a DMM usually do so due to a physical change precipitated by the aging process, such as limited vision, arthritis or other conditions which limit the ability to write, dementia or a simple loss of the ability to follow through on tasks. Some others are so active in their retirement that travel and social activities make it difficult to keep up with paperwork, and they prefer to let someone else handle things for them. Often, the adult child will seek the assistance of a DMM on behalf of their aging parent if the child does not feel they have the time or ability to maintain their parent’s affairs.

A DMM does not take the place of other trusted professionals such as attorneys, accountants, geriatric care managers, or financial advisors. The work of the DMM complements the work of these other professionals by facilitating the completion of the day-to-day tasks rather than determining long-term plans. However, a good DMM should be able to recognize potential issues and refer you to professionals qualified to provide the other services you may need.

If you are interested in hiring a DMM for yourself or your aging relative, you should try to get a referral from someone you know and trust. In addition to your friends and relatives, other good sources for referrals are doctors, lawyers, accountants, residential community directors, home care providers, and geriatric care managers. There is also a national association of DMMs called the American Association of Daily Money Managers (AADMM). You can visit their website at www.aadmm.com to search for a member in your area.

Since the type of activities DMMs handle for their clients is highly personal and confidential, it is important that they are insured or bonded. A professional DMM will always be willing to have his or her work reviewed by your lawyer, accountant, or family member. It’s also a good sign if the DMM is a member of the AADMM, the local Chamber of Commerce, and active in local community organizations. Often, the DMM will be able to provide references that you can call.

Most DMMs charge for their service on an hourly basis, with rates varying with geographic areas. In addition to the hourly rates, most DMMs charge for their travel time and for out-of-pocket expenses. Each DMM sets his or her own fees and billing arrangements. Be sure to ask, in advance, so that there are no misunderstandings. It is best to have a written agreement with your DMM that outlines the scope of services to be provided, the fees to be charged, and the payment arrangements.

Hiring a DMM may be the perfect solution for you and your family. It is especially appropriate for long-distance caregivers who simply can’t be there to manage the business of life. A professional DMM will provide peace of mind for you or your care recipient, and allows seniors to maintain their independence and dignity.

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What's Everyone Talking About ?

They're talking about significant savings on prescription costs with the Aging with Grace FREE Discount Prescription Drug Card! We have teamed up with Silver Planet to co-brand a prescription drug card to provide our users with real value in today's world of costly prescriptions and health care supplies.

Even if you have prescription insurance, this card could save you money if the cost of the drug with the card is less than your co-pay. If you use Medicare prescription plans, you can save on many drugs that are not covered under Medicare or if the prices are less with the card than with the insurance. Click on the Locator, enter your zip code to find your local stores that carry the drug, and then compare prices with the card. Or, just present the card when you make your purchase and see if the price is less with the card.