Dementia in general...

Dementia in general, and Alzheimer's disease in particular, count among the most frightening prospects of our senescence. My patients routinely convey this worry to me. I'm right there with them. And most of us know—first hand, through our social networks, or via media portrayals—how devastating it is for patient and family alike to deal with a condition that leaves intact the appearance of health, while destroying its inner essence.

And so most people are eager to know what they can do prevent dementia. There is abiding interest in brain-specific "superfoods," cognition-enhancing supplements, and pharmacotherapeutic advances. There is as well a booming market in mental calisthenics, from crossword puzzles to Sudoku, which purportedly keep the brain in fighting trim.

There certainly is some evidence to support a "use it or lose it" approach to brain health. A lifetime of cognitive activity, which I suppose in the vernacular would be "thinking," is associated with a lower risk of developing dementia. It is less clear that any specific approach is protective, or that mental gymnastics provide much defense once cognitive decline has begun. Much of this thinking about thinking remains wishful, and a work in progress.

But there are three areas where our knowledge about how best to mind our brains, and protect them, is quite well established.

1. The ankle bone is connected to the shin bone.

This expression we all know was never really just about our legs—it was about holism. Our bodies are healthy, or they are not; the status of any part affects the whole. The brain is a vital organ, vitally dependent on the health of the whole. A healthy brain requires a healthy vascular system, to deliver an appropriate blood supply. It requires healthy kidneys and a healthy liver to ensure that blood is free of toxins. It requires a strong heart to pump that blood under suitable pressure. And so on.

The notion that there are super foods or super supplements specific to the health of the brain is thus more about marketing than science. What is good for health overall is good for the health of the brain. And conversely, what is harmful to the body is harmful to the mind.

2. Mind the heart, mind the brain.

While there are aspects to Alzheimer's disease that are unique, overwhelmingly it and other common dementia's appear to be variants of cardiovascular disease. There may be genes that predispose someone to Alzheimer's, but it is garden-variety cardiac risk factors that tend to result in those genes being expressed as the condition itself.

Studies associate dementia with high blood pressure and dyslipidemia (high levels of the "bad" cholesterol variants). In particular, there appears to be a strong association between Alzheimer's and insulin resistance, a state associated with obesity and diabetes risk. Some experts have argued this link is so strong that Alzheimer's should be considered "type 3 diabetes."

3. Move the body, take the mind along.

Since Alzheimer's and related dementia's have much in common with cardiovascular disease, we have long had cause to believe that physical activity was protective. We have more cause now.

Hot off the presses is a study in the journal Stroke, indicating that routine physical activity protects brain function, prevents dementia, and preserves functional independent in older adults.

The study, followed over 600 adults in countries throughout Europe. Cognitive function was assessed along with lifestyle factors, including physical activity level. MRI scans were used to evaluate brain status directly. The punch line is that routine physical activity was associated with a reduction in the risk of dementia of any kind by about half. The effects were robust and independent of age and education, along with a number of other factors.

So, while mental calisthenics may protect the brain, conventional calisthenics almost certainly do. Exercise is a mind game.

Study after study after study after study that has shown an elimination of up to 80 percent of all chronic disease with the application of lifestyle as medicine has not carved out an exception for Alzheimer's. The evidence that we can alter gene expression with the power of lifestyle almost certainly pertains to Alzheimer's as it does to cancer. By minding our bodies, we can mind our minds too. We can best mind both by minding the short list of what matters most to health.

There is some evidence to support what most of us have heard about "brain foods." Fish consumption appears to protect brain function, most likely by contributing omega-3 fatty acids to the diet. An omega-3 oil supplement, 1 to 2 grams daily, is an alternative. Antioxidants in food appear to be protective as well, contributing to the reputations of blueberries, red wine, and green tea. But while an inventory of potential brain foods can be assembled, the evidence is much stronger for the importance of the overall dietary pattern.

Similarly, exercising the brain may be a good idea. But the preservation of good ideas may owe as much or more to exercising the body.

Alzheimer's remains scary. But we all have far more potential to prevent it than most of us exercise—by exercising, among other things. So take your head in your hands, and get in the game. Because it turns out that health promotion is a mind game too.

We're back...

We have been offline since Monday but promise to be up and running by November 5. Please keep all of those affected by the storm in your thoughts and prayers!

Sandy's on the way. Are you prepared?

No part of the country is immune from the effects of Mother Nature.

You don't have to become a survivalist, do you know what you would need if there is an evacuation and you 10 minutes or two days to prepare for an evacuation? The value of preparation, which includes having a plan A, B, C, D and E can be the difference between life and death for you and your pets. The devastating tornado that wiped out communities in and around Joplin, Mo., in 2011 offers another shocking reality check. When disaster strikes, you must be your own first responder. The right tools and the right plan can make a big difference.

Here are 10 tips to help kick-start your emergency plans.

1. Create an emergency contact list. Start with friends or family members who live nearby and can reach you or your pets quickly. Make sure they have keys, necessary codes or other information to access your home, grab the pets and evacuate. For every Plan A, have a Plan E. Most Plan A's don't happen, so Plan C has to be just as good.

2. Make an emergency kit. Fill a backpack with at least two weeks' worth of food for your pets and plan for at least a gallon of water per day, per pet. If your animal eats wet food, then it will consume less water.

3. Try camping, or at least learn a few skills. Hotels frequently change their policies during emergencies, so have a camping kit to set up wherever it is save, dry and unaffected by the current disaster event. If you lack that wilderness gene, stop by an outdoor shop for primers on purifying water or other survival skills. While you are there, stock up on a few tools, plates and a utility knife.

4. Practice makes perfect. Take a weekend and rehearse your emergency evacuation plan. It should include finding alternate exit routes for your neighborhood, just in case a downed tree or other issue creates an obstacle.

5. Take a certification course. For the best experience in planning for a disaster, learn from the experts. Sign up for a FEMA certification course or join your county emergency response team. It's one way to guarantee that you have first-hand info.

6. Invest in sturdy pet carriers. Whether your pet goes to a relative or an emergency shelter, it needs a safe place to stay, says Toni McNulty, team lead for animals in disaster with HumanityRoad.org @Redcrossdog on Twitter, a nonprofit organization that uses social media to fill the communications gap between those affected by disaster and those responding to disaster. Try a collapsible crate that is large enough to hold food and water bowls, and allows your pet to stand and turn around. "Get it ahead of time and let your pet get used to it. Mark with contact information. If your pet winds up in an emergency shelter, that contact information is necessary." It also helps to include a few favorite toys or bedding.

7. Stock the basics in an emergency bag. Be sure to include a leash (for dogs and cats), a collar with identification information, a harness and a muzzle, even if your pet is the sweetest in the land. "If an animal rescue person tries to pick up your pet, you don't want your pet biting," McNulty says. "Pets pick up stress, just like people in an emergency, and they can behave in a way that they normally don't."

8. Carry copies of documentation. Grab a waterproof container and use it to hold copies of your pet's vital information, McNulty says. The container should hold pictures of your pet, as well as a list of medications, allergies, vaccination records, a rabies certificate, and disaster contacts — inside and outside of the disaster area. When Johnnie Richey was killed in the Joplin tornado, his 9-year-old cocker spaniel was eventually reunited with the owner's sister, Kerri Simms. "Even though her brother is gone, she could retrieve his pet and have a little bit of her brother through that pet," McNulty says. "That's why it's so important that you have pictures and out-of-area contacts."

9. Carry photos that show you with your pet. To alleviate any confusion when it's time to recover your pet from an emergency facility, be sure to carry photos that show you and your pet together. McNulty says to attach those photos as proof of ownership on your pet's crate.

10. Don't wait for the second or third warning. If you live in an area that's known for weather emergencies, act as soon as you hear a warning, McNulty says. "When pets sense urgency, they hide and you lose valuable time trying to find them," she says. Keep leashes, collars and crates ready at a moment's notice, particularly if you live in a mobile home or vulnerable structure.

It also helps to bookmark a few key websites and Twitter addresses. Here are a few worth noting:
FEMA: For information regarding pets, check out the FEMA.org site before and during an emergency. (@FEMA on Twitter)

Pet-friendly lodging: In addition to checking HumanityRoad.org for frequent updates, McNulty often recommends Petswelcome.com and BringFido.com because these sites list hotels that accept multiple pets, exotic animals, birds and gerbils. But keep in mind that rules may change during emergencies.

The Red Cross: Although the Red Cross does not accept pets during emergencies, it's important to bookmark the site for evacuation information regarding your area.

Falls could indicate early onset Alzheimer's

Compared with older people with no signs of Alzheimer's, those whose brains show early signs of the disease are twice as likely to experience a fall, researchers have found.

In the new study, investigators looked at brain scans of 125 older adults who were participating in a study of memory and aging. The seniors were also asked to keep track of how many times they fell over the course of eight months.

An increased risk of falls was noted among individuals whose scans showed early signs of Alzheimer's. The study authors suggested that falls could indicate the need for an evaluation for the memory-robbing disease.

"To our knowledge, this is the first study to identify a risk of increased falls related to a diagnosis of preclinical Alzheimer's disease," study author Susan Stark, an assistant professor of occupational therapy and neurology at Washington University in St. Louis, said in a news release from the Alzheimer's Association International Conference.

"This finding is consistent with previous studies of mobility problems among persons with very early symptomatic Alzheimer's or mild cognitive impairment. It suggests that higher rates of falls can occur very early in the disease process," Stark added.

The study, which was slated for presentation Sunday at the Alzheimer's Association International Conference in Paris, found that of the 125 adults studied, 48 people experienced at least one fall.

The brain scans of the participants showed that higher levels of an imaging agent that binds to the abnormal protein growth that is a signature of Alzheimer's disease, was associated with a 2.7 times higher risk of a fall for each unit of increase on the scan.

The researchers noted that Alzheimer's has been linked to balance and gait disorders, as well as problems with visual and spatial perception, which could put people with the disease at higher risk for falls. Based on their findings, they added, these symptoms may appear before other more obvious signs of the disease, such as memory loss and impaired thinking.

"Growing scientific evidence suggests that 'silent' biological changes may be occurring in the brain a decade or more before we can see the outward symptoms of Alzheimer's," Maria Carrillo, Alzheimer's Association senior director of medical and scientific relations, said in the news release. "According to this study, a fall by an older adult who otherwise has a low risk of falling may signal a need for diagnostic evaluation for Alzheimer's."

The study authors concluded that additional research is needed to improve early detection and intervention in Alzheimer's disease. Lowering the risk of falls, they added, could also have an economic impact since these incidents contribute to higher rates of disability among older adults, premature placements in nursing homes and more than $19 billion in direct medical costs in 2000 alone.

Insomnia Major Driver of Costly Workplace Accidents & Errors

A national study led by Harvard Medical School researchers found that insomnia was associated with a much higher percentage of workplace accidents and errors than any other chronic condition. These errors were also more costly. Researchers estimate that insomnia costs employers $31.1 billion annually.

Researchers conducted a cross-sectional survey of commercially insured individuals. Participants were asked about nineteen chronic conditions including diabetes, arthritis, and depression. Researchers looked into medical and pharmaceutical claims to confirm these conditions, and those that reported insomnia were then screened to ensure that their insomnia was not caused by other chronic conditions. Participants were also asked if they caused damage, work disruption, or mistakes that cost their company $500 or more.

Those who suffered insomnia were responsible for 7.2 percent of all costly workplace accidents or errors, which is a 40 percent higher risk than workers with any other condition. These mistakes were also associated with higher costs. 23.7 percent of all costs spent on workplace accidents or errors were generated by individuals with insomnia.  Insomnia related errors cost on average $32,062, while non-insomnia errors cost $21,914 on average. This difference was even seen when researchers controlled for educational level, age, and other demographic factors.

To learn more about this read Time Magazine article.

Medicare open enrollment starts today...

Medicare open enrollment is just around the corner Oct. 15 - Dec. 7. Whether you’re a person with Medicare, a caregiver, or professional helping clients to review their coverage options, we’ve got some helpful tips for you to keep in mind this season.

Tips for Consumers

1. Start early - Yes, open enrollment runs until Dec. 7. But the best time to start thinking about whether you want to change your drug or health coverage is now. If your circumstances have changed—for example, you’re taking different medications, or you’ve heard that your plan is changing—it’s important to have time to review all your options. And if you need personalized assistance, it’s easier to schedule an appointment now than if you wait until after Thanksgiving.

2. Pay attention to your mail - This is the time of year that you’ll start to get a lot of information.
Your Part D or Medicare Advantage plan sends out an Annual Notice of Coverage in September, which explains any changes happening to your plan and/or to your benefits in 2013.
If you get help paying for your Medicare, such as through the Medicare Part D Low Income Subsidy (Extra Help) or Medicare Savings Programs, you may receive mail from Social Security or Medicare asking you to verify your income or informing you of changes to your subsidy. You may also get a letter if your plan is ending service in your area, or has not met quality standards for three years. Save all of these letters, and have them on hand as you discuss your options with an SGIA (Strategic Growth Insurance Associates) counselor.

3. Review, review, review - Many people are happy with their current coverage, and would rather not check what other options are available to them. But this is a very important step, and can save you money. What should you look for? We like to remind people of the 4 Cs:

• Cost - How much have you spent in premiums, deductibles, and co-payments in 2012? How will these amounts change in 2013??
• Coverage - Does your plan cover all of the medications you believe you will need in 2013?? Do you want to get your health care and drug coverage through one single plan? If so, you should review your Medicare Advantage options.
• Convenience - To what extent will your plan restrict access to certain medications you need in 2013, such as through prior authorization or quantity limits? Can you use the plan at the pharmacy of your choice? Can you get your prescriptions through the mail if you prefer to?
• Customer service - Is your plan responsive when you have a question?

It's that time of year...get your flu shot

Just as they do every year, the CDC strongly recommends a seasonal flu shot to almost everyone, but it's especially important for seniors who are more vulnerable. The flu puts more than 200,000 people in the hospital each year and kills around 24,000 — 90 percent of whom are seniors.

This year, all seniors 65 and older have two flu vaccine options from which to choose. A traditional flu shot, or a shot of Fluzone High-Dose. The high-dose vaccine contains four times the amount of antigen (the part of the vaccine that prompts the body to make antibody) as a regular flu shot does, which creates a stronger immune response for better protection.

And if you're under age 65, your two options are a regular flu shot, or a shot of Fluzone Intradermal. The intradermal vaccine uses a shorter, thinner needle to inject the vaccine just under the skin, rather than in the muscle like other flu shots. If you're squeamish about needles, this is a nice option.

You also need to be aware that if you're allergic to chicken eggs or if you have had a severe reaction to a flu vaccine in the past you should not get vaccinated without consulting your doctor first.

To locate a vaccination site that offers regular, high-dose and intradermal flu shots, ask your doctor or pharmacist, or check the online flu-shot locator at flu.gov. Most chains like CVS, Walgreens, Safeway, Kmart, Walmart, Rite Aid and Kroger offer all types of shots.

The importance of a special needs trust

The following is an excerpt from an excellent article that appears in the NY Times, October 5, 2012.

An estimated 6.9 million non elderly disabled people receive Social Security payments under the Supplemental Security Income program, according to federal government figures.

 For every one of those people, many of whom draw from multiple sources of government aid, there are often several family members helping to sort out the financial details of that relative’s care. They navigate a confounding thicket of tasks and rules. On one side, there is the bureaucracy that government program administrators may erect at any moment. On the other, there are specialized trust accounts and estate planning issues to consider. Even sophisticated investors and ace budget masters find themselves lost when encountering all of this for the first time.

 There are few well-marked road maps for these people, as there are for those trying to invest their 401(k) money or refinance a mortgage. But there are a growing number of financial advisers and other professionals who themselves have special needs children or siblings. Because they’ve been there, they know the practical steps that most families need to take.  

Read full article... 

Eeking out a living on social security

For the millions of Americans who rely solely—or heavily—on Social Security as income, life is tough, according to a New York Times article published this week. As retirees weigh the most basic living expenses including food, housing and medical needs, many are finding there is simply no leeway in the budget. It can lead to choices impacting where seniors are living and what they are doing with their home equity.

The reality is, most have few other options with nearly three quarters of unmarried people receiving at least half their income from the program, and nearly a quarter of married couples receiving 90% or more, NY Times reports.

For some, it works, but for many it presents a struggle as rent or housing, medical bills and food take top priorities for spending.

“It gets hard for a lot of people to imagine getting along on just the Social Security check, but obviously millions of people are doing it,” said David Certner, legislative policy director for AARP. “They’re really living month to month and relying on that check. Some people have a paid-off home, but they’re still dealing with upkeep, insurance, taxes, plus utilities and health care.”

With an average monthly payment of $1,200 per individual (the actual amount is determined from one’s earnings record), nobody is getting rich on Social Security; that’s $14,400 a year, not much above the federal individual poverty line of $10,890, and payments aren’t adjusted by regional differences in the cost of living.

Modest as that average income is, someone would need about $300,000 to buy an equivalent annuity with a built-in cost-of-living increase, Mr. Certner said. Few retirees have savings like that.

 Read the full Times article. 

Who determines when the elderly stop driving...families or doctors?

Families may have to watch for dings in the car and plead with an older driver to give up the keys — but there’s new evidence that doctors could have more of an influence on one of the most wrenching decisions facing a rapidly aging population.

A recent study in the New England Journal of Medicine found that when doctors warn patients, and tell driving authorities, that the older folks may be medically unfit to be on the road, there’s a drop in serious crash injuries among those drivers.

The study, could not tell if the improvement was because those patients drove less, or drove more carefully once the doctors pointed out the risk.

But as the number of older drivers surges, it raises the question of how families and doctors could be working together to determine if and when age-related health problems — from arthritis to frailty to Alzheimer’s disease — are bad enough to impair driving.

Often, families are making that tough choice between safety and independence on their own.

By one U.S. estimate, about 600,000 older drivers a year quit because of health conditions. The problem: There are no clear-cut guidelines to tell who really needs to — and given the lack of transportation options in much of the country, quitting too soon can be detrimental for someone who might have functioned well for several more years.

Doctors aren’t trained to evaluate driving ability, and the study couldn’t tell if some drivers were targeted needlessly, noted Dr. Matthew Rizzo of the University of Iowa. Yet he called the research valuable.

“The message from this paper is that doctors have some wisdom in knowing when to restrict drivers,” said Rizzo. His own research shows some cognitive tests might help them better identify who’s at risk, such as by measuring “useful field of view,” essentially how much your brain gleans at a glance — important for safety in intersections.

Today, the American Medical Association recommends that doctors administer a few simple tests in advising older drivers. Among them:

—Walk 10 feet down the hallway, turn around and come back. Taking longer than 9 seconds is linked to driving problems.

—On a page with the letters A to L and the numbers 1 to 13 randomly arranged, see how quickly and accurately you draw a line from 1 to A, then to 2, then to B and so on. This so-called trail-making test measures memory, spatial processing and other brain skills, and doing poorly has been linked to at-fault crashes.

—Check if people can turn their necks far enough to change lanes, and have the strength to slam on brakes.

Dr. Gary Kennedy, geriatric psychiatry chief at New York’s Montefiore Medical Center, often adds another question: Are his patients allowed to drive their grandchildren?

“If the answer to that is no, that’s telling me the people who know the patient best have made a decision that they’re not safe,” said Kennedy, who offers “to be the bad cop” for families or primary care physicians having trouble delivering the news.

There are no statistics on how often doctors do these kinds of assessment.

“It’s this touchy subject that nobody wants to talk about,” said Dr. Marian Betz of the University of Colorado, whose surveys show most senior drivers don’t think their doctors know whether they drive. She is testing if an advance directive would help get older adults talking with their doctors about how to keep watch on their driving fitness before trouble arises.

More objective measures are needed — and to help find them, hundreds of older drivers are letting scientists install video cameras, GPS systems and other gadgets in their cars as part of massive studies of everyday driving behavior.

Identifying who needs to quit should be a last resort, said Jon Antin of the Virginia Tech Transportation Institute. He helps oversee data collection for a study that’s enrolling 3,000 participants, including hundreds of seniors, in Florida, Indiana, New York, North Carolina, Pennsylvania and Washington. The drivers undergo a battery of medical checks before their driving patterns are recorded for 12 to 24 months.

For now, advocacy groups like the Alzheimer’s Association and KeepingUs Safe offer programs to help family’s spot signs of driving problems and determine how to talk about it. 

Founded in 2008, Keeping Us Safe is an organization that serves older drivers and their families across both the United States and Canada. "Beyond Driving with Dignity is a workbook to help your family make driving-related decisions that are in the best interest of the older driver", says founder & President Matt Gurwell.

Alzheimer's disease promotes isolation

Patients with Alzheimer’s disease, the most common form of dementia, and their caregivers say the illness leaves them feeling isolated and apart from family, friends and life’s typical connections, a report shows.

About a quarter of people with dementia hide or conceal their diagnosis because of the stigma surrounding the disease and 40 percent say they are excluded from everyday life, according to the World Alzheimer Report 2012 released today by London-based Alzheimer’s Disease International.

About 36 million people worldwide are living with dementia and the numbers will more than triple to 115 million by 2050, according to the report. The global cost of the disease is estimated at $604 billion. More education is needed about dementia, especially as seemingly healthy people are diagnosed earlier with the disease, said Beth Kallmyer, vice president of constituent services at the Alzheimer’s Association in Chicago.

Travels with Scooter

Sometimes, traveling with a mobility scooter may not seem to be worth the effort. With the amount of care that goes into ensuring its functionality after long distances, many users of disability scooters have started looking for ways to rent a mobility device instead while being abroad.

Like renting a car, mobility scooter rentals vary depending on the model and make, insurance, and duration of use. There may also be the expense of renting an actual car for a traveling partner to assist with transporting the mobility scooter or wheelchair across longer distances. Fortunately, many places offer handicap passes to be placed on the car so that drivers can obtain prime parking spots near entrances and doorways.

It hasn’t always been easy to travel with disability scooters, especially with air transportation. Special requests have to be made long in advance to ensure that the plane holds enough space to store the device carefully. This also means extra handling fees are needed to dispatch special crews to manage the device with special attention. Even then, there are no guarantees that the mobility scooter will arrive unscathed.

To avoid the matter entirely, people have turned to renting at the place of destination. Even though most people are very attached to their own mobility scooter and have difficulty adjusting to a different one, many users have found it worth it to skirt the issue and simply rent upon arrival. While there aren’t many places that offer this yet, especially at international locations, it is slowly catching on as more and more people use disability scooters as their primary means of getting around.

Because of the lack of mobility rental locations, however, many users must still resort to finding ways to transport their scooter or electric wheelchair. Often time, this means settling for places that can be reached by car. The user’s travel partner will likely be in charge of loading and unloading the scooter at different destinations.  So while traveling by car is certainly the most convenient form of transportation for mobility scooter users, it can be limiting.

 All the same, users of disability scooters should not stop traveling because of their mobility device. Renting a scooter at the point of destination is steadily becoming commonplace, allowing mobility users to enjoy the same destinations and sites as anyone. When traveling by air, airports will often accommodate by using a manual wheelchair to move the user through security checkpoints and directly to the boarding gate. Once there, an airline agent will assist the user to their seat and provide assistance in flight and upon disembarking. In the airport at the destination, users can then seek out a mobility scooter for rent.

Renting a mobility scooter may take some adjustments, but for some it could be worth it to be able to travel without the hassle of transporting their own mobility scooter.  And because companies have to apply with federal regulations on mobility scooters, it’s a safe bet that a rental won’t look or feel any different from personal ones. Above all, it allows users of disability scooters to travel more efficiently and experience the same comforts as anyone while wandering the world.

Paul Stiner is the staff writer of AllMobilityScooters.com – a one stop resource for the mobility-challenged and all things mobility aid-related from Medicare assistance to parts and repair.

Activities for Aging in Place

written by Sarah Jennings, guest blogger

The most difficult part of post-employment life is the loneliness. Even if you don’t live alone, you probably crave the company of more than just one person. Even if you were not particularly buddy-buddy with anyone at your workplace, work offered a variety of people to interact with. Meeting people can be difficult if you don’t have anywhere to start. Luckily, no one at this age has to start with a blank slate. There are a few different places you can draw from to find people to associate with.

Old Friends

Maybe you haven’t talked to the boys from the office, or the girls from your old book club for years, but people you were close to in your younger life are great to catch up with. You can compare lives, brag on grandchildren, and talk about the other people you used to know. This will also give you some perspective about where you are in life and what you want to do while you still can.

Church

The best way to find people to spend time with is to draw on your resources. If you attend church or any other weekly function, reach out and talk to new people. There are probably plenty of people you’ve known for years but never really gotten to know. Invite some of them to lunch or to try a yoga class with you or something.

Finding people isn’t the only difficult part though.  What are things you can actually do with limited funds and possibly mobility? Well, there’s actually a lot.

Community classes

Life is a never-ending parade of lessons. We never stop learning. So look into the offerings of your community to see what learning opportunities there are. The local recreation center probably offers a yoga class or another stretch-based exercise option. This is a great way for you to stay fit, learn something new, and meet people.

A local university or art studio might offer pottery or sculpture as a community class. These can be either low-cost or free depending on your location. Learning a new art style not only broadens your mind, but keeps you sharp. Adding skills to your repertoire as you get older keeps your mind strong and reminds you that you are still fully functional even though some days you may not feel like it.

Senior Centers

Senior Centers in your area probably offer a plethora of activities for both residents and non-residents. Senior centers are all about community so there is probably an easy way for you to get involved. By doing this, you can be a part of game tournaments, physical activities, and events such as shows, dances, and movie showings. These activities will also all be people-centered, so you are sure to make some new acquaintances.

It is important to get out in nature, as tempting as it might be to stay cooped up at home all day. Whether it’s just feeding the birds and reading a book in the park or going for a hike, find ways to get outside and enjoy the world. Have you always had a passion for photography? Utilize it now. Getting outside can be as simple as eating lunch on your porch or as involved as maintaining a garden.

Life after retirement can be full of time, and there are plenty of ways to fill the hours. Whether you are as active as ever or need to slow down a bit, you can find ways to fulfill lifelong dreams and satisfy curiosities. By utilizing your resources and accessing your goals from younger days, you can be sure to have a fulfilling retirement.

Sarah Jennings has been taking care of others her whole life. In 2005, she moved her mother into her family home. She uses her personal experience to share with others about caring for the elderly. She currently writes for Brookedale Senior Living.

Are you over indulging your grandchildren?

Americans are lavishing their kid's kids with money and gifts, even to the point of jeopardizing their own safety net.

New York Times columnist Kelly Greene offers insight into gifting responsibly.

Read article...

Great Activities for Limited-Mobility Seniors

Guest blogger - Ken Stanfield

If you have an elderly loved one and children of your own, sometimes the age gap between the two generations can be difficult to bridge. It can be especially tricky when your aging loved one has limited mobility and your child seems to go full speed all day long. What do you do to foster closer relationships between children and their aging relatives? Not everything will work for every situation, but here are a few ideas for you to draw inspiration from.
Memory Activities
Some of the most rewarding activities for seniors and children to do together are memory related. Even if seniors have difficulty with short term memory, many retain a good deal of their long-term memory and thus remember stories, dates, and people from their younger years that may be of interest to their grandchildren. Memory activities are mutually beneficial; the seniors have the opportunity to share their history and feel important and useful, and the children not only get to see their grandparents in a different light, but also gain more of a sense of who they are and what their heritage is. Some examples of memory activities include

·         Telling stories: Provide a list of questions about your elderly loved one’s life for your child to ask their grandparent and keep a recorder on hand to preserve their answers. They can also look at photo albums together and talk about who is in the pictures and the circumstances in which they were taken.

·          Making a memory book: Have grandparent and grandchild sort photos and place them in an album, along with the stories that go with them. This can help work fine motor skills for your elderly loved one and produces a priceless piece of family history.

Playing Games
Games are easy and fun activities for homebound seniors to enjoy with their young relatives. These include things like board games, card games, bingo, etc. If your child has never (or rarely) played checkers or chess, playing with Grandpa can be a good learning experience and a treasured time spent together. If your child knows a game his grandparent does not, he might be able to teach Grandpa a thing or two as well. For example, WiiFit games like bowling or tennis can be a fun alternative to shake things up a little bit; these games can be played with simple arm motions and are therefore feasible even for those with limited mobility.

Teaching a Skill or a Hobby
Along those lines, having the grandparent teach her grandchild a skill or hobby can be another great bonding experience. Perhaps the two could crochet or knit together, or your mother can supervise your child in the kitchen while she cooks. Passing on these skills will ensure that your parent’s special talents will be preserved in some way.

Reading
Reading together is one of the classic activities to do with elderly relatives, who may have vision problems that keep them from reading very often on their own. You might see if you can round up books that your elderly relative enjoyed when he or she was young so your child can enjoy it as well.

Watching a Movie
Many kids have not seen some of the classic films or TV shows that were popular when your parents were young; these may include Casablanca, Red Skelton, Mr. Smith Goes to Washington, Abbot and Costello, I Love Lucy, The Andy Griffith Show, and others. It’s worth introducing your children to some of the classics that multiple generations can enjoy together.

Arts and Crafts
Even if your child or their grandparent isn’t particularly “crafty,” art and craft projects can be a fun way to spend time together. If the final product doesn’t turn out very well, you can always just laugh about how terrible it looks afterward. Ideas for arts and crafts include

·         Drawing or painting

·         Sculpting with clay

·         Folding origami

·         Tying fleece blankets

·         Weaving hats on a circular loom for charity

·         Seasonal crafts

Limited mobility doesn’t mean limited relationships or limited fun. With a little creativity and effort, your child and their grandparents can have a good time and develop a treasured relationship in the process.

Ken Stanfield is a writer and blogger who spends his time researching and writing about health care, geriatric healthcare needs (including medical walkers), and humanitarianism.

 

Retirement Savings Goals by Age

For those of you wondering if you’re saving enough money for retirement, here are some new savings guidelines to ponder.

Fidelity Investments has recommended that most workers should strive to save at least eight times their final salary before they retire to adequately prepare for retirement. (Saving that amount puts you on track to replace 85 percent of your salary, Fidelity says.)

Now, the investment firm is suggesting earlier milestones to help you get to that eight times goal by the time you’re 67.

Namely, Fidelity suggests workers should aim to save about one times their salary at age 35, three times at age 45 and five times at age 55.

So if you’re 45 and you’re making $50,000 a year, you should have put away $150,000.
“We believe these savings targets offer a rule of thumb to help employees get engaged in retirement planning by making it simpler and more achievable, but we recognize many individuals may need more than eight times their ending salary in retirement based on their lifestyle,” James M. MacDonald, president of workplace investing at Fidelity, said in a news release.

The company’s savings guideline is based on an employee in a workplace retirement plan, like a 401(k), beginning at age 25, working and saving continuously until age 67 and living until age 92. The goal would include savings in all retirement accounts, like 401(k)’s and I.R.A.’s, as well as other savings.

The calculation includes several assumptions, like a lifetime average annual portfolio growth rate of 5.5 percent and income growth of 1.5 percent a year over inflation with no breaks in employment.
So, all of you out there who are 35, 45 and 55(ish), are you anywhere near those targets? How did you do it?

Will you outlive your money?

Retirement used to last less than 20 years on average for Americans, but new projections are forecasting a much lengthier time period—up to 30 years for some Americans.

With the expanded time frame, the aging population will need to adjust their long-term financial plans accordingly so it can continue to fund housing and health care costs.The increase is attributed to longer life expectancy along with some seniors’ decision to enter retirement in their early 60s.

“Now we have more of a 30-year retirement period we are looking at,” said Shawn Britt of Nationwide. “People are living longer and there was a time that we projected a 20-year retirement period where people would retire at 65, the husband would die by 85. Most Americans are now retiring at 62.”

The 30-year retirement period shows a sizable increase from the U.S. Census Bureau’s 2000 average retirement period of 18.7 years.

Because of the rise in number of years spent in retirement could also mean an increase in the amount of costs seniors acquire, it is important for those in the industry to plan for this new, longer retirement.

“As people age into their 80s, it increases the amount of money they need to survive,” said Britt. “This isn’t something people are aware of. The aging of America really has an impact on how we have to plan.”

Today, when couples reach age 65, there is a 50% chance one spouse will live to age 92 and a 25% chance one spouse will live to age 97, Britt says, citing research from Senior Capital Services.

While life expectancy for both men and women has increased, women have a longer life expectancy than men, and should be realize they will most likely face greater costs than their husband, according to Britt.

It’s important that people understand what they’re really facing. They need to understand that women are going to live longer than men, and their health care costs will be more. 

Can you avoid developing osteoarthritis?

Nearly 27 million Americans have osteoarthritis, the most common form of arthritis. And while some of the risk factors for this condition can't be changed — for example, your age, sex, and genetic makeup — you can control others.

Osteoarthritis Risk Factors:

• Age - is the number one risk factor for getting osteoarthritis. Research shows that, in younger people, cartilage in joints is stimulated to grow thicker and stronger with use, but with age, that ability is lost. The tendons and muscles that support your joints also weaken with age, which increases wear and tear on the joints over time. Osteoarthritis is rarely diagnosed in people under the age of 40, and is commonly diagnosed in people over the age of 60.
• Sex - if you are female, your chances of getting osteoarthritis are higher. Women are at higher risk for osteoarthritis in all joints, and this increased risk begins at around the age of 60. Researchers suspect this is partly due to the hormonal changes associated with menopause, though this risk factor is not yet completely understood.
• Genes - you are born with are believed to play a significant role in hip and hand osteoarthritis, where heredity is involved in about 50 percent of osteoarthritis cases. Osteoarthritis of the knee is less often inherited, probably less than 30 percent of the time. People who are born with certain types of knee abnormalities, have a very high risk of getting osteoarthritis.
• Researchers are studying biomarkers, substances in the blood of people with osteoarthritis that can be found on a blood test and serve as an early warning sign that the person may develop osteoarthritis. This way, you can work with your doctor to start treating your osteoarthritis at an earlier stage.
• Weight - how much you weigh is the biggest controllable risk factor for osteoarthritis. "Being overweight makes joint pain of all sorts much harder to cope with and may aggravate wear in knee joints," warns Edwards. Carrying too much weight is generally worse for people with knee arthritis than with hip arthritis, and worse for women than for men. Being just 10 pounds overweight will increase the stress on your knees with every step you take. Women who are overweight have four times the risk of osteoarthritis as women who are of normal weight.
• Damage - to the ligaments that support your joints causes the joints to be less protected from stress. A broken bone can change the structure of a joint and lead to abnormal stress. Someone who has already had a joint injury should avoid strain through strenuous exercise, which can further aggravate the problem. Certain diseases can cause joint damage that can increase the risk for osteoarthritis. These include joint infections, gout, rheumatoid arthritis, and Paget's disease.

Certain occupations or activities in which the joint is stressed repeatedly over a long time can also be risk factors for osteoarthritis. Farmers, for instance, have a high risk of hip osteoarthritis, while miners have a high risk of knee and spine osteoarthritis. A recent study also found that military personnel are at higher risk of osteoarthritis, especially those serving in the Army — who must meet high physical demands on a regular basis.

The bottom line: As with most diseases, prevention and early treatment offer the best chance of success against osteoarthritis. Get your weight down to a normal range through diet and exercises that are right for you.

Trouble on the horizon for LTC...

Low interest rates and policyholders' unwillingness to drop coverage are two of the key reasons the long-term care insurance market is in trouble, an expert recently asserted. Long-term care insurance carriers used to operate under the assumption that a reliable number of policyholders would drop their coverage before they reaped their claim, Howard Gleckman, a journalist and Urban Institute fellow, writes in Forbes magazine. But as interest rates plunged in the economic downturn, more policyholders have not cashed in. Additionally, not enough consumers are buying the policies, he says.

In this environment, LTC insurance carriers have had to either exit the market or increase premiums substantially. Genworth increased premiums this year and decreased product offerings, while Prudential has decided to offer only group long-term care policies.

“Overall, though, the decline of the private LTC market is a huge problem, especially since it is coming just as Washington is seeking ways to reduce Medicaid, the most important payer of long-term care costs,” Gleckman wrote.

An aspirin a day may keep cancer at bay...

People who take a low-dose aspirin daily may not only be helping their hearts, but also reducing their odds of dying from cancer, according to American Cancer Society researchers.

The lower risk of dying from cancer associated with aspirin, however, may not be as great as previously thought, say the authors of the large new study.

And aspirin's possible side effects -- notably the higher risk of bleeding episodes -- need to be taken into account when considering its use, they added.

"Expert committees that develop clinical guidelines will consider the totality of evidence about aspirin's risks and benefits when guidelines for aspirin use are next updated," said lead researcher Eric Jacobs, the society's strategic director of pharmaco-epidemiology.

Jacobs said, until there are new guidelines, he doesn't recommend taking aspirin for cancer prevention.

"Although recent evidence about aspirin use and cancer is encouraging, it is still premature to recommend people start taking aspirin specifically to prevent cancer," he said.

Even low-dose aspirin can substantially increase the risk of serious gastrointestinal bleeding, Jacobs pointed out.

"Decisions about aspirin use should be made by balancing the risks against the benefits in the context of each individual's medical history. Any decision about daily aspirin use should be made only in consultation with a health care professional," he added.

The study was published in the online issue of the Journal of the National Cancer Institute.

To look at the potential effect of daily aspirin use on cancer deaths, Jacobs' team used data from the Cancer Prevention Study II Nutrition Cohort, part of a larger long-term study on the effects of lifestyle factors on mortality.

This study included more than 100,000 men and women without a history of cancer, some of whom were taking aspirin daily. Of the study participants, 5,138 eventually died from cancer.

Aspirin use was associated with an up to 16 percent lower risk of dying from cancer, which, however, was less than seen in another recent study, the researchers noted. In that analysis of randomized trials (where people were randomly assigned to either take aspirin or not take aspirin), aspirin use reduced cancer deaths by 37 percent during five years of follow-up and 15 percent during 10 years of follow-up, the authors noted in the report.

Nevertheless, "even a relatively modest benefit with respect to overall cancer mortality could still meaningfully influence the balances of risk and benefits of prophylactic [preventative] aspirin use," Jacobs' team concluded.

A limitation of the study is that it was an observational study, not a randomized trial. This could mean that the reduction in cancer deaths tied to aspirin use may be over- or under-estimated, the researchers noted.

Dr. John Baron, a professor of medicine at the University of North Carolina at Chapel Hill School of Medicine, who authored an accompanying journal editorial, said, "It's a remarkable idea that something that's in medicine cabinets around the world, and has been around for more than a century, can prevent cancer."

However, Baron is not recommending that people start taking aspirin to cut their odds for malignancy.

Why it works against cancer isn't known, Baron said, and he noted that the effect of aspirin is seen over time. For example, aspirin might start preventing colon cancer after a person had taken it for about 10 years.

During that time, however, that person might have gastrointestinal or brain bleeding caused by aspirin. So those risks and benefits need to be balanced, he noted.

The question is no longer whether aspirin prevents cancer, according to Baron, but rather whether the risks associated with aspirin are overshadowed by its benefits, he suggested. "But even the most pessimistic study shows a meaningful reduction," he added.

But while the new study found an association between aspirin use and reduced cancer risk, because it is not a randomized, controlled trial -- the "gold standard" for research -- it did not prove a cause-and-effect relationship.