How to reach 100...

Your chances of reaching age 100 could be better than you think – especially if you get some additional sleep and improve your diet.

New research from UnitedHealth looks at centenarians and baby boomers, asking the former about the “secrets of aging success” and evaluating whether the latter are taking the necessary steps to celebrate a 100^th birthday.

The primary findings: Many boomers are embracing lifestyles that could lead to a long and rewarding life – with two exceptions. More than seven in 10 centenarians – 71% – say they get eight hours or more of sleep each night. By contrast, only 38% of boomers say they get the same amount of rest. And when it comes to eating right, more than eight in 10 centenarians say they regularly consume a balanced meal, compared with just over two-thirds (68%) of baby boomers.

The report – “100@100 Survey” – begins with some startling numbers. As of late 2010, the U.S. had an estimated 72,000 centenarians, according to the Census Bureau. By the year 2050, that number – with the aging of the baby-boom generation – is expected to reach more than 600,000. Meanwhile, an estimated 10,000 boomers each and every day – for the next decade – will turn 65.

How to reach 100? Centenarians point to social connections, exercise and spiritual activity as some of the keys to successful aging. Among surveyed centenarians, almost nine in 10 – fully 89% – say they communicate with a family member or friend every day; about two thirds (67%) pray, meditate or engage in some form of spiritual activity; and just over half (51%) say they exercise almost daily.
In each of these areas, baby boomers, as it turns out, match up fairly well. The same percentage of boomers as centenarians – 89% – say they’re in touch with friends or family members on a regular basis. Sixty percent of surveyed baby-boomers say spiritual activity is an important part of their lives, and almost six in 10 boomers (59%) exercise regularly.

Again, sleep and diet are the two areas where baby boomers come up short. Not surprisingly, the one area where boomers are more active is the workplace. Three-quarters (76%) of surveyed baby boomers say they work at a job or hobby almost every day; that compares with 16% of centenarians

Sunshine Vitamin D

Vitamin D got its nickname, "the sunshine vitamin," because sun exposure helps promote vitamin D production in the body. This essential nutrient is also found naturally in a few foods such as oily fish (mackerel, salmon) and is used to fortify milk, baby formula, cereal, and juice. But changing lifestyles and diets mean that many of us are lacking in vitamin D. In fact, it's estimated that about 75 percent of American teens and adults don't get enough vitamin D, and studies suggest that this may play a role in several chronic diseases, including arthritis.
Arthritis and Vitamin D: What the Research Says - research has found that vitamin D may play a significant role in joint health, and that low levels may increase the risk of rheumatologic conditions such as arthritis. Several studies have found low blood levels of vitamin D in patients with osteoarthritis of the hip and knee. In another study of more than 2,000 people, researchers found that vitamin D deficiency was strongly associated with disabling symptoms among those with rheumatoid arthritis. While it may be true that people with arthritis don't get as much sun exposure — exposure to the sun helps promote vitamin D production in the body — the study authors adjusted for that and still found that being vitamin D deficient was linked to arthritis pain.

Getting Enough Vitamin D - in addition to helping prevent arthritis, getting enough vitamin D may also lower the risk for other autoimmune diseases, cancer, heart disease, type 2 diabetes, bone fractures, depression, and even the flu. If vitamin D has the potential to improve your arthritis symptoms and your overall health, you want to know that you're getting enough.

Consider these strategies to keep your vitamin D levels optimal:

• Spend some time in the sun. Dermatologists will tell you to slather on sunscreen any time you're outside to avoid skin cancer — and rightfully so since skin cancer can be deadly. Nevertheless, sun exposure is a good way to build up your levels of vitamin D. Luckily, it takes just a few minutes of sun exposure for your body to use the sun's rays to make vitamin D. Be sure to apply or reapply sunscreen after getting some brief exposure to sunshine each day.
• Consider a daily supplement. In addition to soaking up some sun, it's probably a good idea to take a vitamin D supplement to be sure you're getting enough, especially if you live in northern states where the sun's rays may not be strong enough for your body to make enough vitamin D in the winter. Doctors recommend taking 800 to 1,000 international units, or IU, of vitamin D a day. (Some multivitamins include 1,000 IU of vitamin D, so check the label.) If you buy the supplement separately from your multivitamin, be sure to choose vitamin D3, a natural form of vitamin D that lasts longer in your body, advises Dr. Dean.
• Get tested. Symptoms of vitamin D deficiency include chronic pain, frequent infections, gastrointestinal problems, depression, and weak bones. If you think you may be deficient, or if you're thinking about taking more than 1,000 IU of vitamin D a day, have your doctor test your blood levels, Dean suggests. Then you'll be able to take a safe and effective dose.

Although vitamin D is found in some foods, it can be hard to get it from your diet. Fatty fish such as salmon, tuna, and mackerel contain vitamin D, but they may also contain mercury and shouldn't be eaten in large quantities. Foods that are fortified, such as milk, have the synthetic form of vitamin D and don't offer as many long-term benefits.

 

Focus on getting a healthy amount of sun exposure and consider taking a supplement that contains vitamin D3 to help with arthritis symptoms.

Support groups provide a non-threatening environment to ask questions.

Even though millions of people have diabetes, when you’re the one receiving the diagnosis you can feel very alone. Joining a diabetes support group, either in person or online, can help you see the many resources available to you, and that you’re far from alone in your battle to control diabetes.


When you meet other people who have diabetes and share your common experiences in a diabetes support group, it can be comforting as well as educational, says Ruth S. Pupo, RD, a diabetes educator at the East Los Angeles Center for Diabetes at White Memorial Medical Center.


The Benefits of Group Support


Participating in a diabetes support group can provide social support as well as ideas and strategies for better diabetes management and more effective diabetes care. By joining a diabetes support group, you can:


Get solutions to common diabetes care problems. People in support groups often have good suggestions for diabetes care issues, like counting carbohydrates and eating without raising blood sugar levels. Someone in your group might know of a great place to buy fresher foods or great gyms for exercise. People with the same health issues as you can often be invaluable resources.


Find out about the latest in diabetes management and treatment. Diabetes research is ongoing, and at a diabetes support group meeting you will often hear about the latest developments. Pupo says professionals as well as people with diabetes and their family members attend her support group meetings, and the professionals can help sort out the rumors that may start when a member hears of a new treatment or drug.


Ask questions you may hesitate to ask your healthcare provider. “I can’t stress enough that it’s a nonthreatening environment,” Pupo says. The people there feel comfortable asking questions they may be afraid to ask their doctor or diabetes educator for fear of looking stupid. 


Explore topics or issues you might not have thought of. People in your support group may bring up an issue or problem they're dealing with — something you realize you hadn’t thought about but probably should, Pupo says. It could be anything from managing your co-workers’ attitudes toward your condition to how to handle holiday meals.

Forget someone's name? Don't panic...

It's common for seniors to struggle to recall a word that's on the tip of their tongue, a new study shows.
University of Michigan researchers found that this type of memory lapse occurred in 61 percent of 105 healthy, highly educated older adults aged 65 to 92.

The participants filled out a checklist of the memory errors they made in the previous 24 hours and underwent several other tests. About half of them reported making errors that may be related to absentmindedness, such as forgetting where they placed an item or having to reread a sentence because they forgot what it said.

The study was published online in the journal Aging, Neuropsychology, and Cognition.
The findings may help brain-training programs target memory problems that older people experience in daily life, rather than those that occur in laboratory tests, said senior study author and psychology professor Cindy Lustig.

"We wanted to identify which errors still occur despite changes people might be making in their environment and routine. That's where it may be especially important to change the person," she said in a university news release.

Lustig stressed that occasionally forgetting a name or word does not meant that an elderly person is in the early stages of Alzheimer's disease or another type of dementia. "Everybody forgets," she said.
"However, our findings suggest that certain types of memory errors may be especially important to monitor for increases, which then should be discussed with a clinician."

Financial elder abuse on the rise

Senior citizens have been getting swindled out of billions of dollars a year, and the trend is only getting worse, studies show.

The majority, or 84%, of experts who deal with financial fraud of elders -- including financial planners, medical professionals and social workers -- have noticed an increase in financial abuses this year, according to a survey released this week by nonprofit organization Investor Protection Trust.

About 58% of the 762 respondents reported that they encountered investment fraud or financial exploitation of seniors "quite often" or "somewhat often." And 96% of experts said elderly fraud is a serious problem.

Meanwhile, research from insurance provider MetLife has found that Americans over the age of 60 lost about $2.9 billion to financial abuse in 2010 -- up 12% from the $2.6 billion lost in 2008.

About half of that fraud was perpetrated by complete strangers, while family, friends and neighbors accounted for about 34% of financial abuse, according to the report. In many cases, fraudsters stole seniors' Medicare or Medicaid benefits -- resulting in losses of $38 million in 2010.

Best money moves for seniors -

The increase in financial abuse of the elderly prompted the Consumer Financial Protection Bureau, the government's new consumer watchdog, to launch an inquiry into the issue on Thursday.

The CFPB's director, Richard Cordray, said that at his former post as Attorney General of Ohio, he saw many instances of financial abuse against seniors -- including fraudulent lottery or sweepstakes scams where criminals stole the last of their money.

"Many seniors have routines, and their predictable patterns make them easier targets for predators," he said in a speech in Washington, D.C., a day before World Elder Abuse Awareness Day. "They can be lonely or overly trusting, and we now have many methods by which perfect strangers can communicate with them, often anonymously or posing as someone they are not."

The MetLife study also found that elderly women are nearly twice as likely to be victims as men. The majority of victims were between 80 and 89 years old, lived alone and were dependent on some sort of help around the home or with their health care.

Caregivers are often in a position where they can easily take advantage of seniors, especially if they have access to their finances, said Cordray.
Most elderly victims of financial abuse don't report fraud because they are either too ashamed, don't realize they are being duped until it's too late to get their money back, or their adult children fail to recognize the problem in time to intervene, the IPT survey found.

To learn more about the problem and to determine whether action needs to be taken, the CFPB is seeking comments from the public about whether seniors are getting effective financial education or counseling and whether there are adequate resources available for seniors to determine the legitimacy of a financial planner or advisor. The agency is also asking for examples of any abusive and deceptive practices currently targeting seniors, and veterans and military retirees in particular

Never too late to quit...

There's yet more evidence that smoking cuts life expectancy, with a new study that finds the habit increases the risk of early death from all causes among older smokers.

There was good news, though: Quitting, even late in life, helps reduce the risk.

One expert not connected with the study agreed with that finding.

"Smoking cessation is important to improve life quality, and will have a benefit whenever it is done -- although the sooner the better," said Dr. Michael Niederman, chairman of the department of medicine at Winthrop-University Hospital in Mineola, N.Y.

Proving that it's always a good idea to quit, former smokers had 34 percent higher odds for death than that of those who never smoked -- still an increase in risk, but much lower than that of current smokers.

The team also found that survival seemed to rise along with the amount of time since a person quit smoking, even at an older age.

The study was published June 11 in the journal Archives of Internal Medicine.

Another expert said that although the findings were "not surprising," there are lessons to be learned from the data.

"In my experience, individuals who have smoked for several decades are less interested in quitting and are less likely to be encouraged to quit by their health-care providers," said Patricia Folan, director of the Center for Tobacco Control at the North Shore-LIJ Health System in Great Neck, N.Y. "There seems to be the sense that if they have made this far -- 60, 70, 80 -- they do not need to quit."

But the new data suggests otherwise, and the findings "may provide incentive for older smokers to quit and encourage providers to target this group of smokers for cessation efforts," Folan said.

"Most smokers grossly underestimate their own risks. Many older smokers misbelieve that they are too old to quit or too old to benefit from quitting," he said. "Simple, direct, strong and evidence-based warning is needed."

More information

The American Lung Association has more about smoking and older adults.

The Secret Gift

by Stephen Gilbert

This is a Hopi symbol called “The Man in aMaze.” I love this symbol in light of the my work.

Technically this image is not a “maze.” It is a labyrinth. The difference is that a maze is a puzzle designed to trick and be deceiving. There are dead ends and wrong turns. But a labyrinth is not a puzzle. As one moves through a labyrinth all one must do is keep moving, and the destination will always be reached. There are no dead ends or wrong turns. In a metaphorical sense, a labyrinth is a journey whose end is certain. There is one way in, and one way out.

As a person that assists others in planning and funding their end-of-life events, I find this image and the notion of a labyrinth compelling.

As human beings we are all on our journey. Each of them is different, yet occasionally our journeys cross paths. Relationships are formed, and they become part of our journey. Dreams sometimes motivate us along them way. Risks are taken, or not. Sometimes we fail at what we set out to do; other times we succeed. Yet, it is all the same journey, and if we but keep moving, the end is certain.

I have met many people in the work I do that say something like this: “I don’t want to be a burden on my family, just cremate me and dump me out,” or “I don’t want a fuss made over me, just get it over with.”

 
Let be clear here. Whatever is done after your death is not about you. It is solely for those that remain after your death. What might they need? How will they manage this time? You certainly get to make the decision about what you want to happen, but will the decision be based upon what they will need the most, or upon your desire to avoid being a burden?

Here’s a thought. They love you. Just like you love them. When you go, they will grieve, and you don’t really have a say in that. It will be a burden, it is painful, and it is a part of their journey through the labyrinth of their life. No one likes this part, but everyone will go through it.

I know that the statements I refer to above come from a place of love, but sometimes the expectation of future pain skews our decision-making and planning.

So. The crucial questions in planning are these: 

What can I do to make this time in the lives of my family and friends as meaningful as possible.  

1. What will they want or need to do when I die?  
2. What parts can I take care of now so they won’t have to manage it during a difficult emotional time for them.  
3. How do I want to be remembered? What is my legacy?  
4. What can I do now that will demonstrate my love for them after I am gone?

The answers to these questions become a way to impact each of your loved one’s journey in a loving and significant way. The answers don’t avoid the hard reality of your death and their grief, but they open the door to your love touching them even after your death. The answers become a part of their labyrinth.

And these are the questions I encourage people to engage when we discuss the events following their death. It is a difficult conversation. No one really like considering these things. But by avoiding it, you ignore the opportunity to extend your love to them in a uniquely powerful and important way. I like to call it the “Secret Gift.” It gets unwrapped only after you are gone. Love never dies.

-----

Read my blog at stevegilbertsblog.blogspot.com. I welcome comments about this article or anything on my blog. I work with folks all over the country, helping them with end-of-life planning. You can email me at: segilbert.fia@gmail.com.

The downside of aging in place...loneliness.

A new study makes a case for seniors to consider moving into congregate senior housing.

Many seniors prefer to age in place and remain in their own homes, but the benefits they might gain by saving money or maintaining a familiar setting can be lost through loneliness, which speeds up the aging process, according to a recent Cornell study published in Psychology and Aging.

The social pain of loneliness produces changes in the body that mimic the aging process and increase the risk of heart disease, according to the study, and while heart functions change as a normal aspect of aging, loneliness accelerates the process. 

Researchers measured cardiovascular reactivity and recovery in 91 young adults (aged 18 to 30) and 91 older adults (aged 65 to 80) who gave a speech and did mental arithmetic in a lab setting. They assessed each person’s level of loneliness before the tasks, and took systolic and diastolic blood pressure measurements before, during, and after the tasks.

“The most striking thing we found was that the cardiovascular response of the lonely young adults to the social stressor task looked more like that of the nonlonely older adults,” said lead author Anthony Ong, associate professor of human development in Cornell’s College of Human Ecology in a statement.

Older adults had a higher resting blood pressure and a greater cardiovascular stress reactivity, along with a longer recovery time, compared to younger adults. The study found that loneliness increased each of these measures, with an even more negative impact in older adults. In fact, the recovery time after the tasks was, on average, “so delayed [that] they did not return to baseline levels during the two-hour-long follow-up period.” 

“I think it’s helpful to distinguish the emotional pangs that are associated with acute loneliness from the more chronic feelings of distress that accompany perceived deficits in the quality of our social relationships,” Ong said. ”Viewed from this perspective, acute loneliness may be seen as adaptive, signaling us to repair social connections. However, it is the persistence of loneliness over time that may set the stage for health problems in later life…one of the most important and life-affirming messages of this research is the reminder that we all desire and need meaningful social connections.”

Wake up people...

Financial problems in the U.S. stemming from the aging baby boomer generation are only going to get worse, says NPR in its Family Matters series, and government entitlement programs won’t be able to sustainably provide care for the growing senior population.

Roughly 78 million boomers (a staggering number) are entering their retirement years, and while they’re “young” seniors now, their health likely won’t last—and neither will their resources.

For individuals, families, local government officials and federal taxpayers, this demographic shift will drain dollars and attention, and force extremely difficult decisions about living arrangements, as well as end-of-life care.
The government is running short of funds for existing programs. Medicare’s trustees recently said the program that provides medical care to the elderly will remain solvent only until 2024. The Social Security system already is paying out more than it is taking in.

More than 50 million Americans reside in multigenerational homes. And in many of these households, middle-aged “children” are caring for elderly parents, as well as providing shelter for their own grown children. In many cases, family members are making big financial sacrifices to help each other.
But the squeeze may get even tighter for future households because boomers generally had fewer children, and more divorces, compared with the World War II generation. A Pew Research Center analysis of census data found that the boomer generation “offers its elderly parents about 50 percent more grown children with whom they can share a household.”

Providing aging Americans with long-term care “is a bona fide need and growing concern,” said David Walker, a former U.S. comptroller general and an expert on federal spending. “But we have to recognize that the U.S. government has overpromised in the area of health care. We can’t make more entitlement promises.”

About 20% of older people are now living with another generation, according to the Pew Research Center, and that number is expected to keep rising. But doubling up to save on living costs “may fall far short of the trillions of dollars that would be needed to hire all of the care needed to cope with all of the long-lived elderly,” NPR says.

Older employees working longer to pay for eldercare

Older adults are increasingly providing care for elderly parents or others, according to a May fact sheet from the Boston College Center on Aging and Work. Over the past 20 years, there has been a gradual, moderate increase in the number of those providing elder care, with one in seven older workers having responsibility for a child and an adult, the report states. 

Between 1989 and 1999 the percentage of older adults providing this care rose from 36% to 44% and the number continued to rise over the past 10 years as well, including financial assistance provided to children and grandchildren. 

Because of this financial responsibility, the Boston College research states, many older adults want to remain in the workforce longer so that they can continue to provide this support. It has some bearing on their work schedules as well as their vacation time. Many postpone retirement, but many others stop work earlier or cut back on hours in order to fulfill caregiving responsibilities. 

“Increasing numbers of older adults are involved in caregiving and financial support of their parents, spouses, adult children and grandchildren,” the report states. “Many older adults today find that they need to continue to work in order to help family members financially, while others need flexibility in their work schedules to meet caregiving demands.”

Read full report...

Think you have retirement healthcare cost covered? Think again.

A 65-year-old couple retiring in 2012 is estimated to need $240,000 to cover medical expenses throughout retirement, according to the latest retiree health care costs estimate calculated by Fidelity Investments. This represents a 4% increase from last year, when the estimate was $230,000.

For many Americans, health care likely will be among their largest expenses in retirement. The estimate, calculated by Fidelity's benefits consulting business, does not include any costs associated with nursing-home care and applies to retirees with traditional Medicare insurance coverage.

The estimate has increased an average of 6% annually since Fidelity's initial calculation of $160,000 in 2002, with the exception of 2011 when the estimate declined $20,000. That one and only decrease in the history of the estimate was due to a one-time adjustment driven by Medicare changes that reduced out-of-pocket expenses for prescription drugs for many seniors. This year, health care expenses are rising once again.

"Today's workers must understand that the cost of health care is expected to continue rising significantly in future years," says Brad Kimler, executive vice president of Fidelity's Benefits Consulting business.

"Medical inflation is outpacing salary increases and cost of living adjustments for many people. Until that situation changes, it is critical that individuals include health care costs in their retirement savings strategies today so they can be prepared to pay their medical bills throughout retirement," Kimler says.

Fidelity compared Social Security's average cost of living adjustment (2.3% against an assumed average annual increase of health care costs for retirees nationally (6%). The comparison found that 65-year-old couples retiring this year with a $75,000 household income should expect that 35% of their annual benefit (about $10,476) could be needed for health care expenses today. In 15 years or by 2027, their allocation of Social Security benefits going to health care expenses is likely to almost double to 61% of a $41,205 annual Social Security payment, or about $25,000 a year.

"Retirees relying entirely on Social Security to fund their health care costs will be faced with difficult challenges in the future," says Kimler. "Today's workers should plan to supplement their retirement income to cover their medical expenses. It is never too late to begin utilizing all retirement savings vehicles available, including any 401(k) accounts, IRAs and health savings accounts, to help build a more secure retirement."

Smart phones improve patient health

A remote rehab program helped stroke patients improve lower-body function, researchers say.  It increased the likelihood that patients would stick to an exercise regimen and improved their ability to complete tasks such as preparing meals and bathing.

Researchers, lead by Neale Chumbler, Ph.D., at the Richard Roudebush VA Medical Center in Indianapolis, developed the home telerehabilitation program STeleR (short for stroke telerehab).
The study, which will be published in the August issue of the journal Stroke, involved 52 patients from VA medical centers in Atlanta, Durham, N.C., and Tampa, Fla., who had had an ischemic or hemorrhagic stroke within the previous two years.  

The study compared those undergoing usual care with the group in telerehab, which consisted of three home visits, five telephone calls, and an in-home messaging device resembling a clock radio to instruct patients in exercises and adaptive strategies.

The treatment started with a home visit from a team member with a camcorder who filmed the patient's physical function and discussed the home environment, the Indiana University School of Medicine reports. Each week a teletherapist monitored and responded to information provided on the device by the patient. The therapist phoned the patients bi-weekly. The in-home treatment lasted three months, but most of the functional improvements remained at six months.

Chumbler said STeleR could be a good option for people who live in rural areas or those who have difficulty lining up transportation for routine therapy.
It's just one of a number of ways in which technology is being used to treat stroke, including providing specialty care remotely using a robot. Researchers in the UK have developed an iPad app to present information visually to help patients and families decide whether to receive or refuse thrombolysis, a time-sensitive, life-and-death decision.