Welcome ...

All too many times overwhelmed caregivers are physically and emotionally depleted and need to take time to rest and care for themselves. Believing in a holistic approach to caregiver stress and a strong commitment to helping our members find the right solutions, we created this blog to help you connect with others who, like you, may be facing the same eldercare issues and challenges. Feel free to comment, ask questions, and submit articles. Please forward the blog link to your family and friends. They'll be glad you did.

Warm regards,

Patricia Grace
founder & CEO
Aging with Grace

Wednesday, July 25, 2012

Music lessons provide a lifetime of benefits

It turns out mom was right. Music lessons are good for you, and those benefits may last a lifetime. 

A recent study conducted by Brenda Hanna-Pladdy, a clinical neuropsychologist in Emory University School of Medicine's Department of Neurology, offers additional evidence that musical instrumental training, when compared to other activities, may reduce the effects of memory decline and cognitive aging.

This is the second study published by Hanna-Pladdy, which confirms and refines findings from an original study published in Neuropsychology in 2011 that revealed that musicians with at least 10 years of instrumental musical training remained cognitively sharp in advanced age. The findings were published in the July issue of Frontiers in Human Neuroscience. 
"The study confirms that musical activity preserves cognition as we age, by comparing variability in cognitive outcomes of older adults active in musical instrumental and other leisure activities," says Hanna-Pladdy. "A range of cognitive benefits, including memory, was sustained for musicians between the ages of 60-80 if they played for at least 10 years throughout their life, confirming that maintenance of advantages is not reliant on continued activity. In other words, you don't use it or lose it. Nonetheless, the study highlighted the critical importance of the timing of musical activity, which may optimize cognitive benefits."
The cognitive enhancements in older musicians included a range of verbal and nonverbal functions, as well as memory, which is the hallmark of Alzhemier's pathology. The study evaluated the timing of musical engagement to determine whether there is a critical period of musical training for optimal cognitive advantages in advanced age. While years of playing music were the best indication of enhanced cognition in advanced age, the results revealed different sensitive periods for cognitive development across the lifespan. Early age of acquisition, before age nine, predicted verbal working memory functions such as remembering and reorganizing digits in your head, consistent with early sensitive periods in brain development.  Sustained musical activity in advanced age predicted other non-verbal abilities involving visuospatial judgment, suggesting it is never too late to be musically active.     
Continued musical activity in advanced age also appeared to buffer lower educational levels. 
"This is an exciting finding in light of recent evidence suggesting that high educational levels are likely to yield cognitive reserve that may potentially delay the onset of Alzheimer's symptoms or cognitive decline," says Hanna-Pladdy. "This also highlights the promising role of musical activity as a form of cognitive enrichment across the lifespan, and it raises the question of whether musical training should eventually be considered an alternative form of educational training."

Monday, July 23, 2012

For many, retirement is a thing of the past

Retirement and old age is typically associated with stability and relaxation. But after the mortgage meltdown, many seniors have found just the opposite. According to a report released Thursday by the AARP, Americans over 50 are facing unprecedented financial hardship.

In the first study to look at how the crisis affected people older than 50, researcher Lori Trawinski found that between 2007 and 2011, the rate of serious delinquencies actually grew faster among that group than younger homeowners. Overall, the study found that about 3.5 million loans (16 percent) held by people age 50 or older were underwater, 600,000 were in foreclosure, and another 625,000 were 90 or more days delinquent. That’s in addition to the 1.5 million older Americans who lost their homes during these five years.

Though the AARP didn’t do a geographic analysis of the data, many retirees live in epicenters of the collapse—Florida, Arizona, and Nevada, for example, and were vulnerable to the housing price collapse that decimated house prices nationally. More broadly though, the finances of older Americans are not as robust as in the past, says Debra Whitman, AARP executive vice president for policy. They are living longer and running through their retirement money, and many deal with huge unexpected health care costs. Some were also targeted by predatory lenders – purchasing a home with an adjustable-rate mortgage, or taking out a second mortgage on their current home. A study last year from the University of Michigan Law School found that those 65 and older are the fastest-growing segment of the U.S. population filing for bankruptcy and that older Americans carry 50 percent more credit card debt than younger debtors.

Especially surprising is the number of people older than age 75 who have home loan trouble. The foreclosure rate in this group grew from about .4 percent to about 3.2 percent in the five years covered by the research—a 700-percent increase. And since 1989, the proportion of those older than age 75 who carry mortgage debt has quadrupled from 6 to 24 percent—an unusual trend for a group who traditionally have paid off their mortgages by that age.

The challenges seniors face to dig themselves out of a mortgage hole are much greater than for younger people. Whitman cites a recent national study showing that two-thirds of people ages 75 and older have no money in their retirement accounts. And unlike younger people, they can’t hope for future high-earning working years to rebuild their lost savings.

Worse, they’re headed into a period of life when they’ve traditionally used the equity in their house to finance high medical costs or the price of an assisted-living facility. “When they lose their house, it’s the last piece of equity they were going to rely on for the rest of their life,” Whitman says.

Tuesday, July 17, 2012

Retired boomers "surprised" at the cost of healthcare

A new survey, conducted by Bankers Life and Casualty Company Center for a Secure Retirement, asked 300 retirees between ages 55 to 75 with an annual household income between $25,000 and $75,000, a variety of open-ended questions about what they have learned since they stopped working and what challenges they have faced.

Many retirees say their health itself had become a challenge.  While some felt their health had improved since leaving the workforce, nearly one in five (18 percent) said they had dealt with unexpected health issues.

The high costs of medical expenses were also a big issue.  When asked what costs more in retirement than they thought it would, more than half (55 percent) of respondents indicated that healthcare is costing them more than anticipated.  And if given the opportunity to go back in time, retirees say they would make saving for their healthcare costs a much bigger priority.

While many have experienced increased costs in every aspect of life, here’s a look at the top five expenses that were higher than expected among America’s retirees:

  •   Healthcare – 55%
  •   Groceries – 41%
  •   Car/Transportation – 38%
  •   Prescription Drugs – 33%
  •   Utilities – 22%

Retirees polled had many goals beyond the stereotypical ideas of retiring to Florida, seeing their grandchildren and traveling the world.  When asked what goal they hope to accomplish in the next three years, more than one in three (36 percent) have a personal goal that focuses on their health and wellness.  While some people wanted to travel, many retirees wanted to be in better health (21 percent) or lose weight and be more physically fit (15 percent).

“Many times when people think about retirement planning, they only think about money,” said Chris Campbell, vice president of marketing and business development at Bankers Life and Casualty Company, a national life and health insurer.  “While that is important, don’t over look your health.  Living a healthy lifestyle keeps healthcare costs down and the ability to fully enjoy your retirement years.”

Here’s a look at the top five goals today’s retirees hope to accomplish in the next three years:
  1.  Travel 
  2.  Maintain or Improve Health
  3. Lose Weight/Get Physically Fit
  4.  Home Improvements
  5.  Spend More Time with Family

The Bankers Life and Casualty Company Center for a Secure Retirement’s survey series Listening to Middle-Income Americans was conducted in April 2012 by the independent research firm The Blackstone Group. Excerpts from the report can be viewed at www.CenterForASecureRetirement.com

A nationwide sample of 300 retirees ages 55 to 75 who have an annual household income of between $25,000 and $75,000 participated in the Internet-based survey.  Significant sub-sample differences were tested at the 95% confidence levels.

The Bankers Life and Casualty Company Center for a Secure Retirement studies and consumer awareness campaigns provide insight and practical advice for how everyday Americans can achieve financial security during retirement.

Established in 1879 in Chicago, Bankers Life and Casualty Company focuses on the insurance needs of the retirement market.

Monday, July 16, 2012

After the heart attack...

If your parent has recently been hospitalized for a heart attack, the future may seem very uncertain. Now is the time to organize medical care and figure outhow to make the transition from hospital tohome as smooth as possible.

Ask your parent's physician (s) the following:
How serious was the heart attack?
Some heart attacks are worse than others. Knowing how badly your parent's heart was damaged will give you a clearer sense of his prognosis and timeline for recovery. The extent of damage will also determine any complications your parent might have.
What complications should we watch for?
If your parent suffered a very mild heart attack, you might not need to worry about complications at all. But if the attack was more severe, your parent could develop complications, such as an arrhythmia, congestive heart failure, or stroke. Ask the doctor about your parent's risk for these complications and how to recognize them if they develop.
How much care will my parent need -- and for how long?
If your parent will need more care than you can provide, now is the time to make plans. The doctors and nurses should be able to give you an idea of how badly and how long your parent will be disabled.
When can my parent resume normal activities?
How much and what type of activities your parent can do will depend on the condition of his heart. In most cases, heart attack survivors can get back to normal activities within a few months; others may need to take it easy for a longer period of time. Depending on his state's laws, your parent may be able to start driving within a couple of weeks. The doctor can help you and your parent set a realistic timetable for recovery.

What exercises should my parent do?
Physical activity strengthens the heart muscle and is important for overall health. Exercise can help your parent reduce his cholesterol level, lose weight, and lower his blood pressure. But it's important not to overdo it, especially soon after a heart attack. Ask the doctor if your parent could benefit from a cardiac rehabilitation program, in which an exercise specialist will help him develop a program he can continue on his own.

What kinds of dietary restrictions are necessary?
You probably already realize that your parent will need to make changes to his diet, but the thought of implementing those changes may daunt you. The doctors and nurses can help you figure out the best diet for your parent. Ask what foods are good for heart health, what foods he should limit, and how to control portion size. If you need more help, ask for a referral to a nutritionist who specializes in cardiac patients.

What medications will my parent need to take -- and what are the likely side effects?
The doctor has probably prescribed a bewildering array of different medications for your parent. Make sure you understand each medication and its potential side effects.

 For each medication, ask:
  • What does it do?
  • How often should my parent take it?
  • Should my parent take this medication with food?
  • Is there anything my parent should not eat or drink with this medication?
  • What side effects might we expect?
  • What doctors should my parent see?
If your parent's heart attack was fairly mild, he may be able to continue to see only his primary care physician. But if his heart was badly damaged, he'll probably need to see a cardiologist as well. Ask what doctors he'll need to visit and whether your insurance will cover those appointments.
What's my parent 's risk for another heart attack, and what signs should we watch for?
Most heart attack survivors are at a higher risk for a second attack. Ask the doctor how you can tell the difference between angina and a heart attack. Be aware that the second heart attack may not exhibit the same symptoms as the first. With that in mind, ask the doctor for a list of signs to watch for and what to do if you see them, including where you should seek emergency care.

Saturday, July 14, 2012

10 Questons to Ask Before Hiring a Caregiver

A troubling new national study finds many agencies recruit random strangers off Craigslist and place them in the homes of vulnerable elderly people with dementia, don’t do national criminal background checks or drug testing, lie about testing the qualifications of caregivers and don’t require any experience or provide real training.

The study conducted by Lee Lindquist, M.D., an associate professor of medicine at Northwestern University Feinberg School of Medicine, was published in the July 13 issue of the Journal of American Geriatrics Society.

For the study, researchers posed as consumers and surveyed 180 agencies around the country about their hiring methods, screening measures, training practices, skill competencies assessments and supervision. Without a federal background check someone could move from Pennsylania to Ohio and could have been convicted of abusing an elder adult or theft or rape and the agency would never know.

The following highlights some of the study's findings:
  1. Only 55 percent of the agencies did a federal background check.
  2. Only one-third of agencies interviewed said they did drug testing.
  3. Few agencies (only one-third) test for caregiver skill competency. A common method of assessing skill competencies was “client feedback,” which was explained as expecting the senior or family member to alert the agency that their caregiver was doing a skill incorrectly.
  4. Inconsistent supervision of the caregiver.
Agencies should send a supervisor to do a home visit to check on the caregivers more frequently initially and then at least once a month. But this only occurred with 30 percent of the agencies.
“Amazingly, some agencies considered supervision to be asking the caregiver how things were going over the phone or when the employee stopped in to get their paycheck,” Lindquist said.

With seniors wishing to remain in their own homes, paid caregivers fill an important role. “The public should demand higher standards, but in the short term, seniors and their families need to be aware what explicitly to look for when hiring a paid caregiver through an agency,” Lindquist said.

  •  How do you recruit caregivers, and what are your hiring requirements?
  • What types of screenings are performed on caregivers before you hire them? Criminal background check—federal or state? Drug screening? Other?
  • Are they certified in CPR or do they have any health-related training?
  • Are the caregivers insured and bonded through your agency?
  • What competencies are expected of the caregiver you send to the home? (These could include lifting and transfers, homemaking skills, personal care skills such as bathing, dressing, toileting, training in behavioral management and cognitive support.)
  • How do you assess what the caregiver is capable of doing?
  • What is your policy on providing a substitute caregiver if a regular caregiver cannot provide the contracted services?
  • If there is dissatisfaction with a particular caregiver, will a substitute be provided?
  • Does the agency provide a supervisor to evaluate the quality of home care on a regular basis? How frequently?
  • Does supervision occur over the telephone, through progress reports or in-person at the home of the older adult?
Remember an educated consumer is generally a satisfied consumer.

Wednesday, July 11, 2012

Obamacare offers choice...support kids or aging parents

What will we do?
While most Americans wait to find out how Obamacare will affect their own health care situation, Martha R Gore, Watch Dog Politics Examiner, Examiner.com, speculates that those who are most likely to bear the brunt of the legislation are the demographic who care for aging parents as well as adult children
Medicare cuts could pose a conflict for those “middleagers,” writes Gore as they choose between health care costs for themselves and their parents while weighing the option of a multigenerational household to help keep costs down. 
The follow is a sample of cuts to Medicare:
  • Home health care
  • Diagnostic imaging like MRIs, CT scans
  • Ambulances
  • Diagnostics labs
  • Durable medical equipment
  • Power wheelchairs unless rented for previously rented for 13 months
  • Long term hospitals, nursing homes and inpatient rehab facilities
  • Dialysis treatment
  • Inpatient psychiatric hospitals
  • Hospice
  • Hospitals that treat low income seniors
According to an article in NPR the number of elderly Americans needing expensive care is going to surge as more Baby Boomers retire and begin to depend upon Medicare to meet their health needs. This is the age group born between 1946 and 1964 and many of them are expected to live to live 85 years or older. Today there are 6 million Americans in that age group.
As more cuts to Medicare are made it may mean many Americans that are still supporting children may be expected to shoulder more of the cost of taking care of the health and medical needs of elderly parents.
In some cases, this may require that the aging parent move into the family dwelling in order to cope with the financial challenges. The Pew Research Center reports that this is already happening with about 20% of older people living with another generation. However doubling up to split living costs may fall short of what is needed to care for an aging parent. Three generations in one household may become the rule rather than the exception.

Tuesday, July 10, 2012

Sunglassess...more than a fashion statement

We all know the importance of using sunscreen to protect our skin from the sun’s harmful rays, but what about protection for our eyes?
July is UV Safety Month and eye doctors across the nation are urging Americans to protect their eyes and their children’s eyes by wearing sunglasses and wide-brimmed hats.
Recent studies have shown that prolonged exposure to the sun’s invisible, high energy ultraviolet rays without protection may cause eye conditions that can lead to vision loss, such as cataracts and age-related macular degeneration. During the summer months the level of ultraviolet radiation is three times greater than in the winter.

Sunglasses and a wide-brimmed hat are the best defense system for your eyes against sunlight and harmful UV rays. To be effective, both must be worn every time you’re outside for prolonged periods of time, even when it’s overcast.

But what type of sunglasses should you buy? The most important thing is to purchase sunglasses that block 99 to 100 percent of UV-A and UV-B ray. Don’t be misled by the color of the lens or the price tag dangling from the frame. 

The ability to block UV light is not dependent on the darkness of the lens. UV protection can come from adding chemicals to the lens material during manufacturing or from a chemical coating applied to the lens surface. And as for the cost, many $10 sunglasses provide equal or greater protection than a $100 pair. With expensive sunglasses, you’re paying for style, frame quality and options such as scratch-resistant coatings, and not necessarily protective UV ray blocking ability.

In addition to the damage caused by repeated sun exposure overtime, you need to protect your eyes from acute damage caused by a single day in the sun. Excessive exposure to ultraviolet light reflected off sand, snow or pavement can burn the eye’s surface. Similar to sunburns, eye surface burns usually disappear within a couple of days, but may lead to further complications later in life.

Friday, July 06, 2012

Are calcium supplements safe?

New research is prompting questions about the safety of the calcium supplements that so many women age 50 and older take to strengthen their bones. One recent study suggests these pills raise a person's risk for a heart attack, and another new study—scheduled to be presented next month—is expected to raise more safety questions, continuing the debate that erupted this summer.
The controversy began in July when the British Medical Journal published a study that raised troubling questions about the calcium supplements taken by millions of Americans to ward off the bone thinning that comes as we age.

This latest research may call into question the popular practice of getting calcium from pills, but it has not suggested any heart risk from calcium in the diet. Researchers say that may be because food doesn't cause the same temporary, short-term boost in blood calcium as supplements. The authors say this boost produces calcium deposits that may harden the blood vessels or make the blood more likely to clot.

But U.S. doctors widely recommend calcium supplements, especially to postmenopausal women at risk for osteoporosis—thinning and fractured bones—and some say the evidence linking the pills to heart risk is not yet persuasive enough to change that policy. "I don't think it's enough to tell our patients to stop using calcium," says Lynne Braun, a researcher and nurse practitioner who counsels patients on cardiovascular risk at the Heart Center for Women at Rush University Medical Center in Chicago. "I personally use calcium supplementation. Would I stop based on this [study]? The answer is no."

Braun says the new study suffers from the usual shortcomings of meta-analysis, a statistical method that pools data from a variety of studies that haven't necessarily gathered information on the same questions or in the same ways.

Where's the vitamin D?

Others argue that the recent analysis is all but irrelevant, since it excluded patients also taking vitamin D, which may protect the heart by helping the body absorb calcium, and which is nearly always prescribed along with calcium supplements. "The field has moved on from the calcium-alone issue to the combination of calcium and vitamin D, because they work in concert to protect bones," says Bess Dawson-Hughes, M.D., director of the USDA Nutrition Center at Tufts University in Boston.
The Women's Health Initiative, a national study involving 36,000 participants, looked at women taking both calcium and vitamin D, and in 2006 reported no overall cardiovascular effects from the supplements.

What are the benefits?

Despite the widespread use of calcium supplements for bone health, there remains some debate about just how useful they are in preventing fractures. A 2006 report on data from the Women's Health Initiative found no statistically significant reduction in fractures among healthy postmenopausal women taking calcium and vitamin D, although women over age 60 who closely followed their supplement regimens did suffer fewer hip breaks. Meanwhile, this 2006 report suggested the pills might promote kidney stones, which can be quite painful.

On the other hand, says Weinerman, even the potential risk of kidney stones, to say nothing of cardiovascular risk, argues for greater caution against the overuse of calcium pills. Though the average American diet is deficient in calcium, he says he often sees patients whose eating habits, combined with excessive supplementation, give them more calcium than they need (about 1,200 mg daily for people 50 and above, according to Institute of Medicine guidelines). "That doesn't make any sense."

Monday, July 02, 2012

Mom, what's wrong with Nana?

Alzheimer's can be baffling to anyone, but for young children and even teens it can be especially hard to grasp all that's happening to someone who has played a central role in their lives. But because Alzheimer's can have a profound impact on family life, it’s important to talk with your children about the disease as soon as possible and help them to understand how this disease will probably have to change the relationship they’ve previously shared with that loved one.
You should expect that your children will have a strong reaction to the news of their loved one's Alzheimer's diagnosis. "Both the five-year-old and the fifteen-year-old are going to be alarmed and stressed, and as grandpa or grandma drifts away they're going to face feelings of bereavement," says Richard Powers, MD, associate professor of neurology and pathology at the University of Alabama at Birmingham School of Medicine and spokesman for the Alzheimer's Foundation of America. "It's important to explain that while grandpa may not remember your name, he still loves you as much as the first day he laid eyes on you, and you need to reach out to the part of the person that's still intact."

To choose the right words to explain a loved one’s Alzheimer diagnosis to a child, first consider their age and modify the conversation to make it age-appropriate. The following tips can help you to do just that:
  • Younger children - when talking to a younger child about a loved one's diagnosis, you won't necessarily want to use the term Alzheimer's disease. "I recommend parents say something like, 'Grandpa is having problems with his memory or he is unable to think as well as he used to think, so sometimes we'll have to help him with his thinking or his remembering,'" says Barry J. Jacobs, PsyD, a psychologist, faculty member of the Crozer-Keystone Family Medicine Residency Program in Springfield, Pa., and author of The Emotional Survival Guide for Caregivers. You should mention that the person with Alzheimer’s will get sicker over time. Then, if your child seems to have a good grasp of what's already been explained, you could prepare him for some of the changes he will see in the person with Alzheimer's by going over symptoms and how to handle them appropriately.
  • Teenagers - will be capable of understanding more than young children, so you should share details of both the progression of Alzheimer's disease and the treatment options available. "For teenagers, we developed a more sophisticated program that actually gets into the brain pathology," says Dr. Powers. "Often, teenagers will end up playing a role in caring for grandpa or grandma, so it is important for them to know as much as possible up front."
Reassure children that Alzheimer's disease is not infectious as you answer their questions and acknowledge their feelings. Make sure they understand that the dementia patient still loves them and wants to see them, but don't force them to visit if they are very resistant or uncomfortable with the situation.

There are a number of emotions children and teens might experience after hearing of their loved one's Alzheimer's diagnosis, including:
  • Sadness and a sense of loss
  • Confusion or fear about behavioral changes
  • Worry that Alzheimer's is contagious, or that their parents might develop the disease
  • Anger or frustration because they have to repeat questions when interacting with the dementia patient or help with caregiving tasks
  • Remorse over their anger or frustration
  • Embarrassment and not wanting to have friends over if the Alzheimer’s patient lives at home with them
These emotions can also be expressed in ways that are less obvious. The child or teenager might act out by:
  • Complaining of vague physical discomfort, like a stomachache
  • Performing poorly at school
  • Spending more time away from home
  • Refusing to invite friends over
Parents should respond with unconditional love and support, allowing their children to work through their feelings and answering all of their questions as honestly as possible. Family-related activities like sorting through old photographs or making a family tree also might help by reinforcing the child's connection to their loved one.
Above all, don't force kids to do things they are not comfortable doing. This could include being present for medical exams, participating in daily care (like toileting), or making visits to a nursing home rather than visiting the person with Alzheimer's at a more neutral or familiar location.
Hearing of a loved one's Alzheimer's diagnosis is tough. Explaining it to kids can be challenging for you as well. But following these tips, and customizing them to your specific situation, can be a great step in the right direction. Opening the lines of communication will ease the transition for everyone, no matter

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