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.

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.

Caregivers responsible for the bulk of elder abuse

A new study confirms that financial elder abuse has reached the point of epidemic,with 65% of more than 750 interviews with experts who work with older Americans revealing victims of investment fraud or financial exploitation.

Of those who commit elder financial fraud, family members and caregivers are among the most common offenders, followed by strangers.

“Our new survey shows that financial swindles targeting older Americans are a bigger problem today than ever before and that seniors need more help.” said Don Blandin, president and CEO, Investor Protection Trust. “…Of course, there is no ‘silver bullet’ that will end the financial abuse of America’s seniors. Putting a major dent in the problem will require new and innovative collaborative efforts by many different experts and organizations, both public and private.”

Education is seen as the No. 1 way to combat the problem, through counseling or personal finance management programs tailored to the needs of older Americans. These programs are most effectively delivered through local professionals, protective service workers, law enforcement agencies and health care professionals, as well as senior centers, the study finds.

The magnitude of the problem and lack of effective ways to identify elder financial abuse has led it to become a health issue in addition to a national concern, says Dr. Mark Lachs, Director of Geriatrics, New York-Presbyterian Healthcare System.

“Elder financial abuse is not only about financial exploitation: It is a major public health problem. When older Americans are financially exploited and there are no resources left for their care, these individuals effectively become wards of the state. In these cases, all Americans end up paying.

Read full study...

Top Ten Things a Caregiver Needs from a Health Care Provider

Excellent insight from our friend Gary Barg of Today's Caregiver.

1. Attention: The caregiver's loved one may be the 27th similar case you've seen today; but to the caregiver, this is Mom or Dad, Sister or Lover.

2. Compassion: Be diligent in its application.

3. Time: A few moments of your undivided time is some of the strongest medicine you'll ever administer—and it costs so very little.

4. Respect: The person pushing the wheelchair is also part-time bookkeeper, psychologist, dietitian, insurance and incontinence expert, and a full-time general in the war they are waging with this illness. They not only need your respect, they DESERVE it.

5. Dedication: Be relentless in your devotion to your craft. The caregiver has entrusted you with their most valuable asset—their loved one. You earn that trust with your skill, knowledge base and ability. 

6. Honesty: The caregiver is your partner in this endeavor; they deserve (and can handle) the truth.

7. Prudence: The graceful administration of the truth is a true test of a caring professional.

8. Advocacy: Never accept less than the best your system has to offer their
loved one.

9. Understanding: The caregiver plays a pivotal role in the well-being of your patient; understanding the needs, wishes and fears of the caregiver improves your patient's care.

10. Your well-being: Know your emotional limit and learn when to ask for help. Your loved ones as well as the caregiver's loved one need you to remain well.

Gary Barg
Editor-in-Chief
Today's Caregiver

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.

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.

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...

Buyer Beware - when it comes to care!

When you live in a major metropolitan area like Philadelphia, you find yourself confronted with a number of stories on the local news that give you pause and sometimes make you a little ill. Last night’s broadcasts were no exception. Featured last night as well as this morning, was a most disturbing report. A 56 year old man that was utilizing internet caregiving sites to advertise his babysitting services was arrested for molesting a 2 year old girl that was in his care. Even more disturbing is that fact that this particularly repulsive individual was arrested last year for possession of child pornography. Apparently feeling unencumbered by his arrest record, he posted his listing as a babysitter on numerous sites, some of which tout their ability to provide “background checks” of individuals.

A quick search online will yield quite a few sites that are in the business of matching families in need of care with caregivers that are in need of employment. These sites are not only for the care of the young – they carry profiles of individuals looking to care for seniors as well. In these difficult economic times one of the main “benefits” that these sites highlight is a lower cost of care – you are not paying a home care company’s overhead for the services you need. The theory is that the family will have a more hands-on experience deciding on care as they are handpicking the caregiver from a posting that includes the photo and background information of individuals looking for this type of work.

Several questions immediately come to mind. First - How do you know that the information posted is accurate and that the potential caregiver has had proper training? Secondly - Is the care of your loved one, be it a parent, grandparent or a child something you want to get a “cheap deal” on? Third – finding care for an elderly relative can prove to be a very stressful situation as today’s families are extremely busy and often scattered across the county, making the process even more difficult. Do families really want to handle every aspect of finding and managing a caregiver on their own? Who handles the billing if you need to utilize Medicare or long term care insurance benefits? What happens if the caregiver you find on one of these sites is ill and can’t make it to work? Who will take care of mom if she lives 100 miles away? Many more questions arise but my point is that care for an elderly family member is not a task most people research 5 years in advance. Finding home care is a task undertaken when the need arises – trust in the decision and the individual providing the care is of paramount importance and something that cannot and should not be found as easily as my high school senior finds a potential college roommate on Facebook.

This is one of the many reasons that our company, Aging with Grace, is entrenched within this industry, working only with providers that have proven track records of quality care and service, and giving our members the assurance that their needs will be met. Our mission, for every family, is to guide them toward the best caregiving options to meet their individual needs. Reputable home care companies are in the business to answer my aforementioned questions and to provide and manage quality caregivers so that a family has peace of mind that the needs of their loved will be met. And consider this, the home care company actually meets and interviews the prospective employee.

Howie Kaminsky, Vice President of Home Care Options in Huntingdon Valley, PA, and an Aging with Grace Preferred Provider, shared his hiring process with me. Howie stated that his company “never places advertisements for caregivers; they only hire caregivers from direct referrals from their own dedicated team of employees”. His company also does thorough background checks through state police and FBI records, verification of training and certifications, and complete follow-through on reference checks. Their employees are also bonded and insured, receive on-the-job training and his company promptly reassigns a replacement caregiver in the case of illness or emergency. This well-rounded hiring and management approach is the rule and not the exception found in a top-notch home care agency. These companies also handle every aspect of billing alleviating the additional burden of navigating Medicare or other insurance reimbursement.

Is use of a home care agency more expensive than using the caregiver whose photo you find on one of these “do-it-yourself” websites? Well, certainly, and with good reason. But I find one common thread as I peruse the pages of the satisfaction surveys that Aging with Grace has collected over the past six years from the families that have utilized our Preferred Providers in finding home care. Not one person we surveyed stated that the cost of the care was more important than the quality of care; which is something for families to think about before clicking their mouse on a photograph.

Linda Pancio
Vice President Operations
Aging with Grace

6 Time Management Tips for Caregivers

Caregiver stress is a popular topic these days, and for many caregivers burnout is a very real factor this time of year. I spoke with several people this week who are feeling that they can’t live up to what’s expected of them…that there simply aren’t enough hours in the day to take care of their children, their jobs, their ailing parents, their holiday plans etc.
In order to juggle caregiving responsibilities with all the other demands of daily life, time management strategies can be a life saver. Try these techniques next time you’re feeling overwhelmed:
• Unplug from technology: Laptops and cell phone with Wi-Fi are great, but they make us available to any and all who need us 24/7. Unless that’s part of your job responsibilities, it may be interfering with your ability to relax and enjoy whatever down time you have.
• Make a list: It’s hard to relax when you’re carrying around a mental “To Do” list. Before you go to bed each night, write down all the things you need to take care of the next day. That way you can put them on paper, and let the weight of responsibility go for the night.
• Mono-task instead of multi-task: Our brains can only focus well on one thing at a time. Trying to do too much at one time can cause silly mistakes that take time to correct.
• Start with the most dreaded task on your list: Avoiding an unpleasant task uses up a lot of emotional energy. Attack them first thing instead of worrying about them all day.
• Schedule time to recharge your batteries: Whether its 30 minutes with a cup of coffee and a good book, or 30 minutes at the gym, be sure you give yourself a little “me time” each day.
• Delegate what you can: No one can go it alone. Let your family, friends, and co-workers help when possible.

Is your power of attorney aware of HIPPA regulations?

With the New Year rapidly approaching now is the perfect time to start getting your financial and legal affairs in order. The following information will explain the differences between a Power of Attorney (POA) and a Durable Healthcare Power of Attorney; and how HIPPA affects both.

A power of attorney (POA) and a health care proxy are two of the most important estate planning documents you can have, but in some instances they may be useless if they don't comply with the federal privacy law.

A POA allows someone you designate (your "agent" or "attorney-in-fact") to make decisions for you if you become incapacitated. A health care proxy specifies who will make medical decisions for you. For these documents to be effective, your agents may need to be able to access your medical information. However, medical information is private. The Health Insurance Portability and Accountability Act (HIPAA) protects health care privacy and prevents disclosure of health care information to unauthorized people. HIPAA authorizes the release of medical information only to a patient's "personal representative."

HIPAA can be a problem especially if you have a durable healthcare power (also known as a "springing POA) attorney. A springing POA doesn't go into effect until you become incapacitated. This means your agent doesn't have any authority until you are declared incompetent, but, under HIPAA, the person won't be able to get the medical information necessary to determine incompetence until the agent has authority.

To make sure your agent doesn't get caught in this "Catch-22", your POA and health care proxy should contain a HIPAA clause that explains that the agent is also the personal representative for the purposes of health care disclosures under HIPAA. You should also sign separate HIPAA release forms that explain what medical information can be disclosed, who can make the disclosure, and to whom the disclosure can be made.

Contact your elder law attorney to make sure your POA and health care proxy do not conflict with HIPAA.

Can you prevent Alzheimer's?

If you’re like me, every time you forget your keys or the name of a favorite actor playing in an old movie, you start worrying that you’re starting down the long slide to dementia, if not Alzheimer’s disease.

Alzheimer’s and dementia are actually very different issues. Dementia refers to a set of symptoms that include memory loss, impairment of judgment, and difficulty with language. Alzheimer's is a brain disease that accounts for 60 to70 percent of the cases of dementia, but other disorders such as vascular disease and Parkinson’s can also cause dementia.

Over 5 million Americans suffer from Alzheimer’s. And experts estimate that with our aging population, the number of cases will more than triple to over 16 million by 2050.

It’s not surprising that the main risk factors for Alzheimer’s are the same ones that put you at risk for heart disease and overall poor health. The study named seven main pathways to Alzheimer’s: physical inactivity, depression, smoking, mid-life hypertension, mid-life obesity, low education, and diabetes.

Unfortunately, Alzheimer’s disease is still a mystery to medical science. Although there is clearly some genetic component, researchers do not understand what really causes the disease or even exactly what it is. Amyloid plaques are found in the brains of Alzheimer’s victims. But do the plaques cause the disease, or are they merely a symptom? Doctors are working on tests to predict whether or not you will develop Alzheimer’s, but so far there is nothing definitive.

So if you want to prevent Alzheimer’s, stop smoking, get treatment for depression or anxiety, and engage in some sort of physical activity like walking, biking, dancing, or swimming. Go take an adult education class at your community college, join a bridge club, or start doing crossword puzzles. And if you’re overweight, shed some of those extra pounds.

Aging in Place...still the option of choice.

Retirement communities may have their perks, but Beryl O'Connor says it would be tough to match the birthday surprise she got in her own backyard when she turned 80 this year.

She was tending her garden when two little girls from next door — "my buddies," she calls them — brought her a strawberry shortcake. It underscored why she wants to stay put in the house that she and her husband, who died 18 years ago, purchased in the late 1970s.

"I couldn't just be around old people — that's not my lifestyle," she said. "I'd go out of my mind."

Physically spry and socially active, O'Connor in many respects is the embodiment of "aging in place," growing old in one's own longtime home and remaining engaged in the community rather than moving to a retirement facility.

People have long wondered about the purpose of dreams. But scientists say they now know: they sooth the sting out of troubling memories. And when dreams don’t do their job, horrific memories can take over a person’s life, as they do with PTSD, a new study suggests.

According to surveys, aging in place is the overwhelming preference of Americans over 50. But doing it successfully requires both good fortune and support services — things that O'Connor's pleasant hometown of Verona has become increasingly capable of providing.

About 10 miles northwest of Newark, Verona has roughly 13,300 residents nestled into less than 3 square miles. There's a transportation network that takes older people on shopping trips and to medical appointments, and the town is benefiting from a $100,000 federal grant to put in place an aging-in-place program called Verona LIVE.

Administrated by United Jewish Communities of MetroWest New Jersey, the program strives to educate older people about available services to help them address problems and stay active in the community. Its partners include the health and police departments, the rescue squad, the public and public schools, and religious groups.

Among the support services are a home maintenance program with free safety checks and minor home repairs, access to a social worker and job counselor, a walking club and other social activities. In one program, a group of middle-school girls provided one-on-one computer training to about 20 older adults.

Social worker Connie Pifher, Verona's health coordinator, said a crucial part of the overall initiative is educating older people to plan ahead realistically and constantly reassess their prospects for successfully aging in place.

"There are some people who just can do it, especially if they have family support," said Pifher, "And then you run into people who think they can do it, yet really can't. You need to start educating people before a crisis hits."

There's no question that aging in place has broad appeal. According to an Associated Press - LifeGoesStrong.com poll conducted in October, 52 percent of baby boomers said they were unlikely to move someplace new in retirement. In a 2005 survey by AARP, 89 percent of people age 50 and older said they would prefer to remain in their home indefinitely as they age.

That yearning, coupled with a widespread dread of going to a nursing home, has led to a nationwide surge of programs aimed at helping people stay in their neighborhoods longer.

Verona LIVE is a version of one such concept: the Naturally Occurring Retirement Community, or NORC. That can be either a specific housing complex or a larger neighborhood in which many of the residents have aged in place over a long period of time and need a range of support services in order to continue living in their homes.

Verona is an apt setting. Roughly 20 percent of its residents are over 65, compared with 13 percent for New Jersey as a whole.

Another notable initiative is the "village" concept. Members of these nonprofit entities can access specialized programs and services, such as transportation to stores, home health care, or help with household chores, as well as a network of social activities with other members.

About 65 village organizations have formed in the U.S. in recent years, offering varying services and charging membership fees that generally range between $500 and $700 a year.

Read full article...

Social Security Launches New Spanish Online Services

Michael J. Astrue, Commissioner of Social Security, announced that the agency’s most popular online services, the applications for retirement and Medicare and for Extra Help with Medicare prescription drug costs, are now available in Spanish. The new online services are available at www.segurosocial.gov, the robust Spanish version of Social Security’s award winning website,www.socialsecurity.gov.

“The Spanish online applications for retirement, Medicare, and Extra Help with Medicare prescription drug costs are so easy and can be completed in as little as 15 minutes,” said Commissioner Astrue. “I’m proud that Social Security is a leader in the Federal government in providing service in Spanish, and I thank Don Francisco for volunteering his time to help spread the word about these new online services.”

In addition to the new applications, Social Security has also recently made online estimates of retirement benefits available in Spanish. People interested in planning for retirement can get an immediate, personalized estimate of their Social Security benefit by using the Retirement Estimator at www.segurosocial.gov/calculador. Using people’s actual wages from their Social Security record, the Estimator gives a good idea of what to expect in retirement. Workers can enter in different dates and future wage projections to get estimates for different retirement scenarios, which is why this service is one of the most highly rated electronic services in the public or private sector.

Don Francisco, who will appear in several new public service announcements for Social Security, said, “I have good news to share with the millions of Americans who prefer to conduct business in Spanish. You can now apply online for Social Security retirement and Medicare benefits in Spanish, as well as take advantage of other online services offered in Spanish at www.segurosocial.gov. ¡Es tan fácil!”

Once people complete the online application and “sign” it with the click of a mouse, the application is complete and, in most cases, there are no documents to submit or additional paperwork to fill out. It’s the easiest way to apply, and now it’s available in Spanish.

November is National Family Caregiver’s Month.

WANT TO HONOR VETERANS? HONOR THEIR CAREGIVERS

It’s no coincidence that November marks both Veterans Day and National Family Caregivers month. To truly honor veterans, we must also start honoring their caregivers.

Caregivers of veterans remain a largely invisible group. They are, at best, a footnote in debates about Medicare, veterans benefits, and budgets cuts to local services such as California’s recent decision to cut off Medi-Cal funding for adult day care centers.

Yet caregivers of veterans are not a voiceless bunch. As an advocate for caregivers of the elderly, I hear their stories every day. They speak loud and clear – if we choose to hear them. Take the words of Kathryn M. White, whose husband, a World War II veteran, is now battling Alzheimer’s disease: “I wish none of this ever happened. I wish that I had my wonderful, loving husband back but I know that is not possible.
We were the love of each others’ lives for 24 years and had a great marriage, but that Glenn has gone and I do not know this one.”

She included the following poem, written after assisting her husband through a recent doctor’s visit.

I am not just a Caregiver - I AM the Veteran

I asked the doctor, who was in a bad mood,
After I felt that he was being rude,

“Doctor have you ever put yourself in the shoes of the Vet?”

His answer made me want to shiver.

“Yes, but you’re not a Veteran…you’re just a Caregiver.”

I sat there a moment until I could find my voice.
I had to speak for all of us; he left me no choice.
With tears streaming down my face,
I had one goal: to put him in his place.

“I’m not just a caregiver and this I want you to know.
I’m the veteran and I hope it shows.
Alzheimer’s is taking his mind,
Moreover, I search for the items he can’t find.

“I am his mouth when he can’t speak.
I am his legs when his grow weak.
I am his ears when he can’t hear.
I am the one he counts on being there.

“I am his eyes when he can’t see.
I clean up the messes he makes, even his pee.
I lead him to bathe when he would rather not.
He totally depends on me; I am all he has got.

“I pick him up when he falls,
I lay awake listening for his call.

I pay the bills because he can’t think.
I prepare his meds and hand him a drink.

“We are on a journey into the unknown.
We’ll go together, as one, no, he won’t go alone.
So look into my eyes doctor, see my pain, lest you forget.
I am not just a Caregiver…I am the Vet

-- Patricia Grace, founder and CEO of Aging with Grace,

The best foods to control diabetes in the elderly

Eating healthy is important for everyone, but it's even more important for the nearly 26 million Americans who have diabetes — half of whom are older than 60. A healthy diet, coupled with regular exercise and medicine (if needed) are the keys to keeping your husband's blood sugar under control.

The American Diabetes Association offers a list of 10 superfoods for Type 1 and Type 2 diabetics. These foods contain nutrients that are vitally important to people with diabetes, such as calcium, potassium, magnesium and vitamins A, C and E. They're also high in fiber, which will help your husband feel full longer and keep his glycemic index low so his blood sugar won't spike. And they'll help keep his blood pressure and cholesterol in check, also critical for diabetics.

Beans: Kidney, pinto, navy, black and other types of beans are rich in nutrients and high in soluble fiber, which will keep blood sugar steady and can help lower cholesterol.

Dark green leafy vegetables: Spinach, collard greens, mustard greens, kale and other dark, leafy green veggies are nutrient-dense, low in calories and carbohydrates. A diabetic can't eat too much of these.

Citrus fruits: Grapefruit, oranges and other citrus fruits are rich in vitamin C, which helps heart health. Fiber in whole fruit slows sugar absorption so your husband will get the citrus fruit nutrients without sending his blood sugar soaring.

Sweet potatoes: High in vitamin A and fiber and low in glycemic index, sweet potatoes won't raise your husband's blood sugar at the same level as a regular potato.

Berries: Whole, unsweetened blueberries, strawberries and other berries are full of antioxidants, vitamins and fiber.

Tomatoes: Raw or cooked, this low-calorie food offers vital nutrients such as vitamin C, iron and vitamin E.

Fish with omega-3 fatty acids: Salmon, mackerel, herring, lake trout, sardines and albacore tuna are high in omega 3 fatty acids that help heart health and diabetes. But avoid the breaded and deep-fried variety.

Whole grains: Pearl barley, oatmeal, breads and other whole-grain foods are high in fiber and contain nutrients such as magnesium, chromium, folate and omega 3 fatty acids.

Nuts: An ounce of nuts provides important “healthy fats” along with hunger management. They also contain a nice dose of magnesium and fiber. Nuts are high in calories so a small handful each day is enough.

Fat-free milk and yogurt: These dairy foods provide the calcium and vitamin D your husband needs and can help curb cravings for snacks.

More information

For more details on healthy food choices for diabetics, including free recipes, go to diabetes.org or call (800) 342-2383.

Financial pressures driving some older Americans to drink...

Some older adults may turn to alcohol or cigarettes as a way to cope with financial stress, particularly men and people with less education, a new study suggests.

In the study, researchers surveyed 2,300 older Americans periodically between 1992 and 2006, and found that 16 percent reported growing financial strain over that time, 3 percent reported increases in heavy drinking (more than 30 drinks a month), and 1 percent said they'd started smoking more.

The youngest of the study participants were age 65 when the study began.

Older men who faced increasing financial stress were 30 percent more likely to become heavy drinkers than those who remained financially stable. This increased risk was similar for older adults with lower levels of education compared to those with more education.

Older women and seniors with higher levels of education tended to reduce their drinking when they encountered financial struggles, according to the study published in the November issue of the Journal of Studies on Alcohol and Drugs.

The findings don't actually show that financial problems were the reason for changes in smoking and drinking habits, but it is known that some people use alcohol and tobacco as a way of coping with stress, noted lead researcher Benjamin A. Shaw of the State University of New York at Albany.

"When you have a stressor that's not very controllable, people may focus on something to help control their emotional response to the stressor," he said in a journal news release.

Financial woes may be particularly stressful for older adults, Shaw added.

"They are out of the workforce, and they might feel like they have less time to recover or generally have less control over their financial situation," he explained

What every senior needs to know about hospital observation care.

How do I know the status of my hospitalization stay?

Ask your doctor or other hospital officials if you are in the hospital for observation or as a regular inpatient. If you are an observation patient, ask why. Even if you are admitted as an inpatient, the hospital can switch you to observation status; in that case, the hospital is required to notify you.

You may not be eligible for post hospitalization skilled Medicare benefits.

If you do not have three consecutive days of hospitalization as an inpatient -- excluding the day of discharge -- Medicare will not cover a subsequent stay in a nursing home. For those who do qualify, Medicare pays for up to 100 days of rehabilitation or skilled nursing care.

How long can the hospital keep me for observation?

Medicare expects patients to remain in observation status for no more than 24 to 48 hours. But there are no rules limiting the time; some patients spend several days in observation.

What can I do if the hospital won't change my observation status to inpatient?

"You cannot directly appeal the hospital's determination that you are or were an observation patient," says Ellen Griffith, a Medicare spokeswoman.

If you think you should be considered an inpatient, ask your personal physician to call the hospital and request a change in status, although your doctor cannot mandate this. If that is not successful, there are other steps you can take.

Flu shot hoping to "trick" the oldster's immune system

When it comes to getting flu shots, seniors are exceptional.

Yet despite their unusually high vaccination rates, they also account for an exceptional portion of flu-related hospitalizations: 90 percent, according to the Centers for Disease Control and Prevention (CDC).

It turns out their bodies are sluggish to react to the standard vaccines that easily rev up a younger person's immune system.

So doctors around the country are hoping to coax a better immune reaction from seniors this flu season by offering them a shot that packs four times the amount of dead flu virus to which the body can react.

This high-dose shot, manufactured by French pharmaceutical giant Sanofi Pasteur, has been proved in clinical trials to get a stronger immune response, the CDC said.

Whether a heightened immune response reduces the number of seniors contracting the flu has yet to be proved.

That clinical trial won't be completed until 2014.

But Dr. Larry Bush, an infectious-disease specialist in Atlantis, Fla., gives the shots to patients 65 and older.

So do many private physicians, supermarkets and pharmacies, including Bartell Drugs.

The elderly can choose the standard vaccine or the high-dose one. When his patients ask which he would pick, Bush tells them, "If I were over 65, I would get the high dose," he said.

Bush said that while we can't yet prove it is significantly more effective, it's certainly not less effective. And, Bush said, he's inclined to believe that a proven rise in immune response will translate to fewer cases of the flu.

"It makes sense," said Bush, a staff member at JFK Medical Center in Atlantis, Fla.

Though the CDC at one time advised only select vulnerable populations — including the elderly — to get vaccinated for the flu, that advice changed in 2008. The standing message now is that everyone 6 months and older should get a shot.

It's a message that is particularly important to older people.

"They're at much greater risk of complications and death," said Dr. David Greenberg, Sanofi Pasteur's senior director of scientific and medical affairs. "Influenza, we often say, is not just a bad cold; it's a terrible disease that can lead to hospitalizations and death."

The contagious respiratory virus can bring on a fever, headache, sore throat and runny nose. The flu can make existing chronic medical conditions such as asthma or diabetes worse. It also can cause complications such as sinus infections and bacterial pneumonia.

Flu and pneumonia are the seventh-leading cause of death in the United States among those 65 and older, according to the most recent data from the CDC.

The high-dose vaccine was licensed by the U.S. Food and Drug Administration in time for last flu season. Sanofi Pasteur estimates that 10 percent of the elderly population that was vaccinated last season opted for the high dose. The option is more widely available this year, company officials say.

Like the standard shot, the high-dose version is made of three flu strains deemed most likely to make people ill in that season.

But the high-dose shots pack more antigens, those elements that trigger a body's immune response.

Sanofi's Greenberg said the higher dose of antigens also results in more reactions from the shot.

"The downside is there are slightly more local side effects," Bush said. "A little bit more redness, a little bit more tenderness (around the shot area), a little bit more fever."

But when it comes to serious side effects, the high-dose vaccine is no different from the standard, the CDC said. "Most people had minimal or no adverse events after receiving the Fluzone High-Dose vaccine," it said.

Antidote for the Alzheimer's Epidemic: An Ounce of Will ad a Pound of Pragmatism

Surely, you’ve all read the grim reports about Alzheimer’s disease. The advancing age of the US population will usher forth an Alzheimer’s epidemic in the coming decade. The emotional toll of this epidemic will be immeasurable, and the financial impact could bankrupt the Medicare system.
That dire version of the story might sell newspapers, but it doesn’t really reflect the available options to a nation with a will to fight back. The good news is: we can manage this problem. And no elusive scientific discoveries are required to do so. We merely need to implement the medical knowledge that is already in hand.

This short summary outlines the pragmatic steps necessary to close the gap between the state of current medical knowledge and the lagging standard of care that is routinely practiced in primary care settings. We can avert this looming threat with an ounce of public will and a pound of pragmatism.

Read more...Brain Today

You're never too old to quit

Perhaps you’ve heard of the “damage is done” scenario. An elderly family member started smoking as a young person, maybe a teenager, tucking a pack of cigarettes into his rolled-up shirtsleeve or into her purse. Decades later, despite wall-to-wall anti-smoking ads, despite smoking being outlawed in nearly every public space, perhaps despite family pleas or doctors’ admonitions or even a heart attack, that person remains a smoker.

What’s the point of stopping now, he or she figures, when my body has already suffered the consequences of a lifetime of tobacco addiction? The damage is done, isn’t it?

So while the rate of smoking in those over age 65 is smaller — a bit over 8 percent — than it is in the younger population, more than 22 percent of whom smoke, older smokers are much less likely to try to stop. More than half of smokers ages 18 to 24 have tried to quit, the Centers for Disease Control and Prevention has reported, but only about a quarter of those over age 65 have. In the three decades following the first report by the surgeon general’s report on smoking and health in 1964, smoking rates dropped much more among younger adults than among older ones.

“They’ve been smoking longer, so they might be more nicotine-dependent,” said Bethea Kleykamp, a postdoctoral fellow in nicotine pharmacology at the National Institutes of Health, trying to explain those differences.

But in their article, “The Older Smoker,” recently published in The Journal of the American Medical Association, Dr. Kleykamp and Stephen Heishman, a nicotine researcher at the National Institute on Drug Abuse, argue that the damage isn’t done.

The good news for older smokers is that under the Affordable Care Act, Medicare now covers smoking-cessation counseling for any beneficiary who wants to stop. A quarter of older smokers have already made an attempt. (Previously, Medicare covered such programs only for those who already had a smoking-related disease.)

And Part D drug plans cover medications — patches, gum, pills — in most states. “We know that the best treatment is a combination of pharmacology and counseling,” Dr. Kleykamp said. You’d think that reducing smoking among the elderly population would save Medicare a boatload of money.