3 Simple Ways to Get More Restful Sleep
Even people without insomnia can have trouble getting a good night’s rest. Many things can interfere with restorative sleep — crazy work schedules, anxiety, trouble putting down the smartphone, even what you eat and drink.
The following three simple steps can help you sleep better.
Cut down on caffeine
Caffeine drinkers may find it harder to fall asleep than people who don’t drink caffeine. Once they drift off, their sleep is shorter and lighter. For some, a single cup of coffee in the morning means a sleepless night. That may be because caffeine blocks the effects of adenosine, a neurotransmitter thought to promote sleep. Caffeine can also interrupt sleep by increasing the need to urinate during the night.
People who suffer from insomnia should avoid caffeine as much as possible, since its effects can endure for many hours. Because caffeine withdrawal can cause headaches, irritability, and extreme fatigue, it may be easier to cut back gradually rather than to go cold turkey. Those who can’t or don’t want to give up caffeine should avoid it after 2 p.m., or noon if they are especially caffeine-sensitive.
Stop smoking or chewing tobacco
Nicotine is a central nervous system stimulant that can cause insomnia. This potent drug makes it harder to fall asleep because it speeds your heart rate, raises blood pressure, and stimulates fast brainwave activity that indicates wakefulness. In people addicted to nicotine, a few hours without it is enough to induce withdrawal symptoms; the craving can even wake a smoker at night. People who kick the habit fall asleep more quickly and wake less often during the night. Sleep disturbance and daytime fatigue may occur during the initial withdrawal from nicotine, but even during this period, many former users report improvements in sleep. If you continue to use tobacco, avoid smoking or chewing it for at least one to two hours before bedtime.
Limit alcohol intake
Alcohol depresses the nervous system, so a nightcap may seem to help some people fall asleep. However, alcohol suppresses REM sleep, and the soporific effects disappear after a few hours. Drinkers have frequent awakenings and sometimes frightening dreams. Alcohol may be responsible for up to 10% of chronic insomnia cases. Also, alcohol can worsen snoring and other sleep breathing problems, sometimes to a dangerous extent. Even one drink can make a sleep-deprived person drowsy. In an automobile, the combination significantly increases a person’s chance of having an accident.
You can also improve the amount and quality of your sleep by getting regular physical activity and creating and sticking to a regular sleep schedule and routine.
How to sleep well despite chronic pain
Chronic pain and insomnia are an unhealthy combination. According to the National Sleep Foundation, chronic pain disturbs the slumber of one in five Americans at least a few nights a week. Whether it’s from a bad back, arthritis, or headaches, chronic pain puts you in double jeopardy: the pain robs you of restful sleep and makes you more fatigued, and thus more sensitive to pain.
But you can start to break this vicious circle.
“For chronic pain conditions, what you need is good sleeping habits from the beginning — things that will last,” says Dr. Padma Gulur, a pain medicine specialist at Harvard-affiliated Massachusetts General Hospital. That means relying on the brain’s natural sleep drive as much as possible.
Try “relaxing distraction”
Dr. Gulur recommends “relaxing distraction” to her patients. Some relaxation techniques use basic rhythmic breathing meditation; others focus on guided imagery, in which you imagine being in a calm, peaceful location. Find something that appeals to you and helps you fall asleep. You might look for these exercises on CD or consider group or individual training and sleep education.
Getting back to sleep
For some people, chronic pain not only makes it harder to fall asleep, but can also interrupt sleep. Simply shifting position in bed can trigger pain from a back condition or arthritic knee.
One approach is to take your pain medication right before bed. Check with your doctor to be sure that fits into your treatment plan. If pain does wake you in the middle of the night, first try meditation, visualization, or whatever relaxing distraction you favor. But if it doesn’t work, getting up to read a book in a quiet room with low light can help you to get back to sleep. Avoid loud sounds and bright light (that means TVs, smartphones, tablets, and computers).
Staying on a regular sleep schedule is also important. Go to bed at the same time every night and, no matter how the night goes, rise the next day at the same time and remain awake until your planned sleep time. This helps to set your internal sleep clock and enhances the natural sleep drive.
Copyright © 2014 by Harvard University.
Don’t Lose Your Balance
General physical fitness and targeted exercises to improve balance can prevent falls. But so can activities that hone your cognitive fitness. A sharp mind helps you to think — and stay — on your feet.
We depend on an intricate balance system to keep us upright. The inner ear, which senses head motions, plays an important role. So does the body’s somatosensory system, which relays the feeling of the ground beneath your feet. And, of course, vision tips you off to obstacles around you. The brain takes in all this information, plans movements, and carries them out.
“Balance is a complex system,” says Brad Manor, Ph.D., an instructor of medicine at Harvard Medical School and director of the Mobility and Falls Program, Hebrew Senior Life Program of Boston. “Especially as we get older, cognition becomes a big part of it.” Keeping the mind fit keeps us mentally sharp and helps us to navigate the ever-shifting obstacle course of the world.
Manor and his fellow researchers are conducting studies to evaluate the balance benefits of tai chi, a form of exercise that involves moving gently through a series of poses. Tai chi improves balance because it works with both the mind and body. “Tai chi involves the planned movements,” Manor explains. “It emphasizes being aware of the movements and how they feel.”
Maintaining mental fitness, remaining physically active, and practicing tai chi, qigong, yoga, or another mind-body exercise can help you keep your balance and avoid stumbling. But don’t forget muscle power — the ability to exert force quickly. Rapid, forceful exercises like hopping and side-stepping help to build power. For beginners, classes or trainers are valuable to learn how to safely exercise for power.
One thing is certain. Balance can’t be taken for granted past a certain age; it must be maintained — both in mind and in body.
Special Health Report from Harvard Medical School.
Help Your Loved One With Dementia Overcome Social Isolation
Dementia changes a lot of things, but it doesn't change the need for social interaction.
We'll discuss ways to help your loved one with dementia overcome social isolation at this month's Live Chat with expert David Troxel. Part of the conversation will also focus on how important it is for family caregivers to stay socially active and prevent isolation.
Alzheimer's & Dementia: Overcoming Social Isolation
Live Chat with Expert David Troxel
April 22, 2014 at 5 p.m. EDT
Register Now to Attend
Invite a friend to join us for the Live Chat in the spirit of social encouragement. Forward this email or share on your social media page.
Thanks for sharing the love!
© 2014 Home Instead, Inc. All Rights Reserved.
Salute to Seniors! Set for May 8
Mark your Calendars now for the Annual Salute to Seniors! at the Westchester County Center in White Plains from 9am – 2pm on May 8, 2014. Make it an outing for your senior group, spend the day, have lunch and enjoy all the activities planned. Bring a friend, family member or caregiver!
Elvis Presley and Diana Ross impersonators will entertain the crowd, along with Polynesian and Irish step dancers. Registration is required for a box lunch by calling (914) 813-6416 or (914) 813-6449. Lunch includes a turkey sandwich, apple, cookie and juice. The deadline to place orders is Wednesday, April 23, and the suggested meal contribution is $4.
The Business Expo is always a favorite - where nearly 100 vendors will be on hand with products and services for seniors and caregivers. Representatives from county and state agencies also will be available for questions and information-sharing. Don’t forget to stop by the Health and Wellness Fair for a nutrition assessment, skin and dental care information, tai chi exercise and more.
New this year: TIPS Be among the first to experience the new Telehealth Intervention Program for Seniors (TIPS), an innovative initiative that uses technology to remotely monitor your vital signs. Also receive information about health and wellness programs. TIPS will help you to take control of your health, reduce medical bills and avoid unplanned hospital visits. Advance registration preferred, Call (914) 813-6408 or email email@example.com to sign up .
Are you interested in participating in the Business Expo?
Businesses and non-profit organizations can still sign up for a booth at the Business Expo. For more information, download the application form here or call (914) 747-0519. Sign up now – prices go up after March 28th!
Admission and parking are free at Salute to Seniors!
More information to follow. Hope to see you at Salute!
4 simple ways to boost your energy
Do you sometimes feel like the Energizer Bunny when his battery runs low? You might start the day strong, but by midafternoon, you can’t quite keep going and going.
Fatigue afflicts everyone at one time or another. Assuming your doctor has ruled out serious medical causes, there are a few basic steps you can take to “recharge your batteries.”
1. Pace yourself. If you’re a go-getter, you probably like to keep going — but don’t risk overtaxing yourself. You can pace yourself and still get things done. For example, instead of burning through all your “battery life” in two hours, spread it out among morning tasks, afternoon tasks and evening activities — with rest and meals in between.
2. Take a walk or a nap. There’s nothing more satisfying than a short power nap when you’re pooped out. However, if you have trouble sleeping at night, know that napping can make insomnia worse. If that’s the case for you, get moving instead. Get up and walk around the block, or just get up and move around. If you are not an insomniac, though, enjoy that 20- to 30-minute power nap.
3. Skip most supplements. You may have heard about energy-boosting or “anti-aging” supplements. There is no evidence they work.
- DHEA. There is no evidence that DHEA offers any real benefits, and the side effects remain a question mark. You especially shouldn’t be buying it from ads in the back of a magazine, because you don’t know what’s in it.
- Iron. Iron only improves energy if you are clearly deficient, which a doctor can check with a blood test. Unless you are low in iron, you don’t need to take it — and getting too much iron can be harmful.
- B vitamins. It is true that B vitamins (B1, B2, B6, B12) help the body convert food into the form of energy that cells can burn, but taking more B vitamins doesn’t supercharge your cells. That’s a myth.
4. Fuel up wisely. A sugary roll from the bakery delivers plenty of calories, but your body tends to metabolize them faster, and then you can end up with sinking blood sugar and fatigue. You’ll maintain a steadier energy level by eating lean protein and unrefined carbohydrates. Try low-fat yogurt with a sprinkling of nuts, raisins and honey. Your body will take in the carb-fiber-protein mix more gradually. Don’t skip meals, either. Your body needs a certain number of calories to get through the day’s work. It’s better to space your meals out so your body gets the nourishment it needs all through the day.
Copyright © 2014 by Harvard University.
County Offers Seminar on Tools for Raising Children
The Westchester County Dept. of Senior Programs & Services' Grandparents Coalition and the Kinship Support Program of the Family Service Society of Yonkers are sponsoring a seminar that provides tools to help grandparents and relative caregivers raise children. The session is scheduled for Wednesday, April 23 from 9:30 - 12 noon. Click here for registration details.
5 Ways to De-stress and Help Your Heart
Constant stress — whether from a traffic-choked daily commute, unhappy marriage, or heavy workload — can have real physical effects on the body. It has been linked to a wide range of health issues, including mood, sleep and appetite problems — and yes, even heart disease.
The connection between chronic stress and heart disease isn’t well defined. It has been suggested that stress triggers inflammation, a known instigator of heart disease, but that hasn’t been proven. “I think the conventional opinion is that stress is bad for your heart, but the data are much murkier,” says Dr. Deepak Bhatt, director of the Integrated Interventional Cardiovascular Program at Brigham and Women’s Hospital.
Yet stress may influence heart disease in more subtle ways. “Stress does cause some people to act in ways that increase their risk for heart disease,” Dr. Bhatt says. For example, when stressed, people often eat unhealthy food and don’t have the energy or time to exercise. Stress can also lead us into other heart-damaging behaviors, such as smoking and drinking too much alcohol.
Breaking the connection requires both learning to deal with stress and managing unhealthy habits. These five simple tips can help you do just that.
- Stay positive. Laughter has been found to lower levels of stress hormones, reduce inflammation in the arteries, and increase “good” HDL cholesterol.
- Meditate. This practice of inward-focused thought and deep breathing has been shown to reduce heart disease risk factors such as high blood pressure. Meditation’s close relatives, yoga and prayer, can also relax the mind and body.
- Exercise. Every time you are physically active, whether you take a walk or play tennis, your body releases mood-boosting chemicals called endorphins. Exercising not only melts away stress, it also protects against heart disease by lowering your blood pressure, strengthening your heart muscle, and helping you maintain a healthy weight.
- Unplug. It’s impossible to escape stress when it follows you everywhere. Cut the cord. Avoid emails and TV news. Take time each day — even if it’s for just 10 or 15 minutes — to escape from the world.
- Find ways to take the edge off your stress. Simple things, like a warm bath, listening to music, or spending time on a favorite hobby, can give you a much-needed break from the stressors in your life.
Stress doesn’t have to ruin your life or your health.
Lower stress, lower your blood pressure
You can’t see your blood pressure or feel it, so you may wonder why this simple reading is so important. The answer is that when blood pressure is high your heart is working overtime to pump blood through your body. This extra work can result in a weaker heart muscle and potential organ damage down the road. Your arteries also suffer when your blood pressure is high. The relentless pounding of the blood against the arterial walls causes them to become hard and narrow, potentially setting you up for stroke, kidney failure, and cardiovascular disease.
A healthy lifestyle — not smoking, losing excess weight, eating nutritious foods, and exercising regularly — is the cornerstone for preventing and treating hypertension.
Another important lifestyle change that can help lower blood pressure is managing stress. Too good to be true? No. Your blood pressure comes down when you practice the relaxation response — even when simply breathing deeply for several minutes to calm your body. Regular practice of the relaxation response could help you reap more lasting benefits.
There are many ways to elicit the relaxation response. Techniques include breath focus; body scan; guided imagery; mindfulness meditation, yoga, tai chi, and qi gong; and even repetitive prayer. The trick is to find a method you are comfortable with and to make your stress reduction practice part of your routine.
For some people, medication — in addition to lifestyle changes — is necessary to get blood pressure to a healthy level. Even so, stress management can be a helpful addition. In fact, a randomized, controlled trial of older adults showed that an eight-week program of relaxation response plus other stress management techniques lessened the amount of medication some of the participants needed to control their blood pressure.
Palliative Care & End-of-Life Conference Set for April 3-4
A two-day conference with more than 30 workshops on all aspects of palliative care is being held on April 3 and 4 under the auspices of the Westchester, NYS Southern Region Collaborative for Palliative Care. Click here for details on the conference and click here to register.
Webinar on Disaster Preparedness Planning for Family Caregivers Offered in April
A webinar on Disaster Preparedness Planning for Family Caregivers will be offered on Wednesday, April 16, 2014, from 2:00-3:30 PM EST. Co-sponsored by the US Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR) and Administration for Community Living (ACL), the webinar will provide information to assist family caregivers in planning for emergencies and disasters. Family caregivers have a responsibility of caring for loved ones with health or functional needs, making it important for them to develop a personal preparedness plan as well as a plan for individuals they support. Examples include family caregivers who are responsible for the care of children with developmental disabilities or Autism Spectrum Disorders, older Americans who are medically fragile and persons who have dementia or Alzheimer’s disease. Information provided in this webinar will highlight the unique needs of disaster preparedness planning for these particularly vulnerable populations and considerations for developing and maintaining an emergency plan for both the caregiver and their loved one.
An Introduction to Preparedness Planning for Family Caregivers will be provided by Dr. Cheryl Levine, At-Risk Team Lead, Division for At-Risk Individuals, Behavioral Health and Community Resilience (ABC), ASPR and Greg Link, Aging Services Program Specialist/Team-Lead, Office of Supportive and Caregiver Services, ACL.
The presentations will be:
- Lessons Learned from Hurricane Sandy: Challenges of Sheltering in Place for Parents of Children with Developmental Disabilities or Special Health Care Needs including Autism, Peg Kinsell, Director of Public Policy, Statewide Parent Advocacy Network, New Jersey
- Supporting Older Americans who are Medically Fragile, Della Sanchez, LGSW, AL Cares Coordinator, Support for Caregivers, SARPC/Area Agency on Aging, Mobile, Alabama
- Lessons Learned from 9/11, Katrina and Sandy for Persons with Dementia and Alzheimer’s Disease, Jed Levine, Executive Vice President, Director of Programs and Services, Alzheimer’s Association, New York City Chapter
Facilitated discussion with the panelists will be led by Iris Terashima, developer and trainer for the National Disaster Preparedness Training Center: Natural Disaster Awareness for Caregivers of Senior Citizens.
To participate in the webinar:
Toll Free Number: 888-325-0345
Participant passcode: 813-1392
For security reasons, the passcode will be required to join the conference. Restrictions may exist when accessing freephone/toll free numbers using a mobile telephone.
Live Meeting™ Net Conference Access Information for Participants
Conference number: PW4462938
Audience passcode: 8131392
Participants can join the event directly at:
Exercise is Good for Diabetes
If you have diabetes — or for that matter, nearly any other chronic illness — exercise is one of the most powerful tools that can help you control your weight and blood sugar. And it can help you feel great, too.
The list of exercise benefits is long. Exercise helps control weight, lowers blood pressure, reduces harmful LDL cholesterol and triglycerides, raises healthy HDL cholesterol, strengthens muscles and bones, and reduces anxiety. Exercise can help regulate blood sugar and increase the body’s sensitivity to insulin. Both are important for people with diabetes.
Many studies have documented that exercise is a strong ally in treating diabetes. Here are a few examples:
- All forms of exercise — aerobic, resistance, and a combination of both — have been shown to be equally good at lowering HbA1c values.
- Resistance training and aerobic exercise both helped to lower insulin resistance in previously sedentary older adults at risk for diabetes. Combining the two was better than either one alone.
- People with diabetes who walked at least two hours a week were less likely to die of heart disease than their sedentary counterparts, and those who exercised three to four hours a week cut their risk even more.
- Women with diabetes who spent at least four hours a week doing moderate or vigorous exercise had a 40% lower risk of developing heart disease than those who didn’t exercise.
If you have diabetes, generally it is best to exercise one to three hours after eating, when your blood sugar level is likely to be higher. If you use insulin, be sure to test your blood sugar before exercising. If it is below 100 mg/dL, eat a piece of fruit or have a small snack. This will bump your blood sugar up and help you avoid hypoglycemia. Test again 30 minutes after your snack to be sure your blood sugar level is stable. It’s also a good idea to check your blood sugar after any particularly grueling workout or activity. If you’re taking insulin, your risk of developing hypoglycemia may be highest six to 12 hours after exercising. Experts also caution against exercising if your blood sugar is too high (over 250).
A medical alert bracelet should be part of your workout wardrobe. It should indicate that you have diabetes and whether you take insulin. Also, keep hard candy or glucose tablets with you while exercising in case your blood sugar takes a nosedive.
Copyright © 2014 by Harvard University.
Smart Planning for Eldercare: What All Families Need to Know Now
WJCS geriatric experts Judy Fink, LCSW, ACSW; Jane Slevin, LMFT, and Heidi Weiss, LMSW, MHA, will hold a discussion on Smart Planning for Eldercare: What All Families Need to Know Now, on Sunday, March 20, 2014 at Temple Israel of New Rochelle, 1000 Pinebrook Blvd., New Rochelle. The panel discussion is presented by UJA-Federation of New York New Rochelle Community in collaboration with the Brotherhood of Temple Israel of New Rochelle. Click here to see the flyer for more information.
To reister, contact Susan Scharf Glick at firstname.lastname@example.org or 914-761-5100 x120.
Suggested couvert: $10 and light breakfast will be served .
8 Principles of Low-Glycemic Eating
A low-glycemic diet can help you control your weight by minimizing spikes in your blood sugar and insulin levels. This is particularly important if you have type 2 diabetes or at risk of developing it. Low-glycemic diets have also been linked to reduced risks for cancer, heart disease, and other conditions.
Eight principles of low-glycemic eating
- Eat a lot of non-starchy vegetables, beans, and fruits such as apples, pears, peaches, and berries. Even tropical fruits like bananas, mangoes, and papayas tend to have a lower glycemic index than typical desserts.
- Eat grains in the least-processed state possible: “unbroken,” such as whole-kernel bread, brown rice, and whole barley, millet, and wheat berries; or traditionally processed, such as stone-ground bread, steel-cut oats, and natural granola or muesli breakfast cereals.
- Limit white potatoes and refined-grain products, such as white breads and white pasta, to small side dishes.
- Limit concentrated sweets — including high-calorie foods with a low glycemic index, such as ice cream — to occasional treats. Reduce fruit juice to no more than one-half cup a day. Completely eliminate sugar-sweetened drinks.
- Eat a healthful type of protein, such as beans, fish, or skinless chicken, at most meals.
- Choose foods with healthful fats, such as olive oil, nuts (almonds, walnuts, pecans), and avocados, but stick to moderate amounts. Limit saturated fats from dairy and other animal products. Completely eliminate partially hydrogenated fats (trans fats), which are in fast food and many packaged foods.
- Have three meals and one or two snacks each day, and don’t skip breakfast.
- Eat slowly and stop when full.
Adapted from Ending the Food Fight, by David Ludwig with Suzanne Rostler (Houghton Mifflin, 2008).
Copyright © 2014 by Harvard University.
When To Worry About Worrying
There is no shortage of things to worry about — from personal concerns about job security or health to fears related to larger issues such as political conflicts or natural disasters. Anxiety can be a healthy response to uncertainty and danger, but constant worry and nervousness may be a sign of generalized anxiety disorder.
Do I have generalized anxiety disorder?
You'll need your doctor's help to know for sure, but while other types of anxiety disorders — such as specific phobias or social anxiety disorder — arise from particular situations, generalized anxiety disorder is characterized chiefly by debilitating worry and agitation about nothing in particular, or anything at all.
People with generalized anxiety disorder tend to worry about everyday matters. They can't shake the feeling that something bad will happen and they will not be prepared. They may worry to excess about missing an appointment, losing a job, or having an accident. Some people even worry about worrying too much.
Physical symptoms are common too, and can include a racing heart, dry mouth, upset stomach, muscle tension, sweating, trembling and irritability. These bodily expressions of anxiety can have a negative effect on physical health. For example, people with generalized anxiety disorder are at greater risk for heart attack and other cardiovascular problems.
Symptoms of generalized anxiety disorder
Generalized anxiety disorder is characterized by excessive anxiety and worry that is difficult to control and causes serious distress or interferes with daily activities. For at least six months, these symptoms occur on more days each week than they don't occur, along with at least three of the following:
• restlessness or feeling on edge
• tiring easily
• difficulty concentrating
• muscle tension
• sleep problems
Only your doctor can determine whether you meet the criteria for generalized anxiety disorder. If you think you might have this condition, don't hesitate to talk to your primary care doctor. There are a range of treatments that can ease the very real discomfort of this condition.
Adapted from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).
Copyright © 2014 by Harvard University.
Harvard Health Publications, 10 Shattuck Street, 2nd Floor, Boston, MA 02115, USA
Katie Couric on Caring for Elderly Parents
Find out how the famed journalist is helping her recently widowed mother
By Katie Couric
On a recent Saturday, I stopped into McDonald's to use the ladies' room (not to splurge on fries, I swear!). There, I saw a woman my age with a concerned look on her face, helping an elderly man slowly make his way to the men's room with his walker.
"Is this your father?" I asked gently, as we all headed back to the parking lot. "Yes," she replied. "We're spending the weekend together." She seemed like a loving, dutiful daughter dealing with the inevitable role reversal that comes with age—those moments when it feels like you're taking care of your parents, instead of the other way around.
As a member of the sandwich generation, I can relate. I often feel like the peanut butter between two slices of bread: I'm trying to hold it together for my two teenage daughters, and also meet the needs of my 89-year-old mom, Elinor.
My mother's day-to-day care took on a new urgency after my father passed away last year, a loss that's still very fresh for my siblings—my older sister in Boston, my younger brother in Virginia—and me. My parents cared for each other through Parkinson's, heart disease, bladder cancer. But they went through it together. Now Mom is living alone, in the same house in Virginia where we grew up--the house that used to be full of her children squabbling at the dinner table, practicing the piano, making student council campaign posters, getting suited up to play basketball or cheer on the sidelines. It's full of 55 years' worth of memories, and the thought of leaving it and the life she shared with my dad is understandably overwhelming.
But what if something happens to her and no one's there to help? She has an "I've fallen and I can't get up" necklace, but I've seen it hanging on a picture frame instead of around her neck more than once. What about the hours of loneliness that can't be alleviated with a phone call?
I'm lucky that my siblings and I are in regular communication and we all want to do our part. We have checked out assisted living facilities, but she always comes back saying, "Everyone there is so old!" ("It's like God's waiting room," she usually adds.) She's not interested in a nurse moving in, either. Partly because she's shy by nature, and partly because the idea of having a new person in her home makes her uncomfortable.
We don't want to decide for her, of course. Mom fiercely protects her independence, bristling when people try to help her out of the car, and getting angry when medical professionals direct comments to one of us, as if she's "a potted plant," she says. We do have options: We could work with an occupational therapist to ensure that the house is safe, or bring in someone a couple of hours a day to cook a few meals and do light housekeeping. The most important thing is to keep talking about it as a family, and to keep Mom involved in the discussion.
Whatever we decide, we'll do it together, and I take some comfort in knowing we're not the only baby boomers dealing with these questions. There are no easy answers. Mom sacrificed for us her whole life, and we want to help her age with dignity, as gracefully as possible.
©2014 Hearst Communications, Inc. All Rights Reserved.
WJCS' Ellen Lamanoff A Featured Speaker on Alternative and Holistic Medicine, Feb. 19
WJCS' Ellen Lamanoff, RN, MS, Clinical Specialist Holistic Nursing, will be participating in a discussion on Alternative and Holistic Medicine, sponsored by Aging in Place in White Plains. See below for details.
County Government Issues Generator Safety Information
Westchester County has provided useful information about generator safety. See details at this link.
Smart Planning for Aging Parents Discussion Set for Feb. 13
WJCS' Judy Fink, LCSW, ACSW; Jane Slevin, LMFT, and Heidi Weiss, LMSW, MHA, will be the featured speakers at a discussion on Smart Planning for Aging Parents, sponsored by UJA's Northern Westchester Women's Philanthropy on Thursday, February 13, 2014 at Congregation B'nai Yisrael in Armonk. The event is open to the Westchester community and will cover topics such as comprehensive services and support available to seniors in the county. See below for more details and registration information:
7 ways to snack smarter
Have you upgraded your snacks in the interest of more healthful eating? Perhaps you’ve traded in your afternoon candy bar for an energy bar or have become a fan of baked potato chips or fat-free ice cream. Maybe you’re willing to pay a little extra when the label says “organic” or “natural.”
It’s a great idea to choose snacks wisely. But many foods that seem to be a great nutrition value aren’t. Bran muffins and cereal bars can be packed with unhealthy fats and added sugar. Fat-free foods often contain lots of added salt and sugar.
Here are 7 tips for smarter snacking.
1. Go for the grain. Whole-grain snacks — such as whole-grain low-salt pretzels or tortilla chips and high-fiber, whole-grain cereals — can give you some energy with staying power.
2. Bring back breakfast. Many breakfast foods can be repurposed as a nutritious snack later in the day. How about a slice of whole-grain toast topped with low-sugar jam? Low-sugar granola also makes a quick snack.
3. Try a “hi-low” combination. Combine a small amount of something with healthy fat, like peanut butter, with a larger amount of something very light, like apple slices or celery sticks.
4. Go nuts. Unsalted nuts and seeds make great snacks. Almonds, walnuts, peanuts, roasted pumpkin seeds, cashews, hazelnuts, filberts, and other nuts and seeds contain many beneficial nutrients and are more likely to leave you feeling full (unlike chips or pretzels). Nuts have lots of calories, though, so keep portion sizes small.
5. The combo snack. Try to eat more than one macronutrient (protein, fat, carbohydrate) at each snacking session. For example, have a few nuts (protein and fat) and some grapes (carbohydrates). Try some whole-grain crackers (carbohydrates) with some low-fat cheese (protein and fat). These balanced snacks tend to keep you feeling satisfied.
6. Snack mindfully. Don’t eat your snack while doing something else like surfing the Web, watching TV, or working at your desk. Instead, stop what you’re doing for a few minutes and eat your snack like you would a small meal.
7. You can take it with you. Think ahead and carry a small bag of healthful snacks in your pocket or purse so you won’t turn in desperation to the cookies at the coffee counter or the candy bars in the office vending machine.
For more on creating week-by-week action plans, weight control tips, and recipes, buy the 6-Week Plan for Healthy Eating<http://click.mail.health.harvard.edu/?qs=62b1fc33f5655639d704ec042b08367ddfa40f74e9e37d93895dad527f1cdcafa50696bee6365cce>, a Special Health Report from Harvard Medical School.
8 Aging in Place New Year’s Resolutions
If you haven’t thought about your New Year’s resolutions yet, start now. Think about things you meant to do last year. The things you knew would make your home or your loved one’s home safe. The things you knew would improve yours or your loved ones life. The things you wanted to try. And, in particular, the simple and easy things you knew could make a big difference.
Everyone is busy, but now is a great time to make an aging in place plan for yourself or a loved one that can enrich lives, extend independence and keep everyone safer, healthier and more comfortable. Here are some simple things to promise yourself – and actually do - in the new year.
Install grab bars
Last year you saw these great grab bars but never got around to buying or installing them. This is a simple addition to a bathroom that can help a senior remain independent for much longer. Grab bars in the shower and for assistance getting in and out of the shower will help a senior maintain dignity while being able to get in and out of the shower/tub by himself. Grab bars are easy to install and come in many designs and colors to suit most bathrooms.
Check heating and cooling
It’s been a while since the heating/cooling unit was maintained. You meant to have it checked in time for winter, but you started holiday shopping and completely forgot. Plan on having the heating/cooling unit maintained and inspected for leaks or other wear and tear. Replace the unit if necessary. Regular maintenance of this appliance will help extend its life.
Review your finances
Your finances may have changed since you retired (or your retirement plans have changed since the economy changed) and you feel things are tighter than you planned. It’s been easy to put off evaluating your finances, but the time has come. This year, make sure you do a full review of your finances from income to planned expenses to unexpected expenses. If you can, speak with a financial planner who will be able to evaluate and help you plan for your future needs.
Put down the laptop and take a look around the house. Throw out the throw rugs (or secure them), clean up the power cords and rearrange the furniture to make clear paths for walking. Falls in the home cause a majority of senior injuries and some simple cleaning up can reduce the chances of falling. Other hazards that require attention that you may have been putting off include fixing the loose carpeting, covering slippery surfaces, eliminating clutter on stairs and throughout the home and making sure areas are well-lit.
Call an attorney
It’s weighed on your mind for years, but you still have no official plan in terms of wills, power of attorney, etc. Procrastinating planning your end of life needs (or helping a loved one to plan) is easy since it is a lot of scary talk, but most of us have it floating around in the back of our minds – a worry we just won’t address. Call a lawyer today who can assist you with financial planning, care arrangements, wills and powers of attorneys and take the first step toward your peace of mind.
Get a senior cell phone
A phone that is easy to use, ready in an emergency and affordable? Yes, there are many cell phone models that are designed specifically with seniors in mind. If you didn’t purchase a senior cell phone as a Christmas gift, consider purchasing one for a birthday, mother’s/father’s day or just because. See our list of senior cell phones.
Visit the senior community center
You have wanted to see what is available at the local senior center but haven’t made the trip over to check it out. Pick a day to visit next week and see for yourself. Senior centers offer a safe environment where seniors can participate in physical and intellectual activities. Centers usually have transportation, meals and some have assistance with medication and other needs. The best part about a senior center is the socialization, which can extend and improve quality of life.
Talk to your family
Make a point to speak with your family. It is important that the whole family knows of your plans and wishes. They need to know what they are. You need to ask who is willing to help and everyone can help form a family plan. Communication is key to ensuring your retirement and aging in place needs are met.
Resolutions come and go – most people probably forget they even made any by the time spring is near – but take some time this year to review the things that mean something to you and your family and then make a plan to check those off the list.
Copyright © 2013 AgeInPlace.com, All rights reserved.
Snow Angels Needed to Clean Snow for Senior and Disabled Individuals
The following announcement has been made by Greenburgh Town Supervisor Paul Feiner:
Wanted: Snow angels....to help seniors and disabled residents clear snow from their walkways and driveways.
Some snow angels volunteer their time and help seniors/disabled residents who are on fixed incomes ----expecting no reimbursement.
Other snow angels will help clear driveways, but expect to receive a fee for their services.
If you are interested in being on the list of snow angels - please advise by providing me with your phone number, email address and neighborhoods that you are willing to go to in the event of a snowfall. Please let me know if you expect some payment or if you will provide the service at no cost. Also - can your email address be posted on a website - making it easier for people to reach you in the event of a snowstorm.
If you would like to take advantage of the service, please email me at email@example.com.
I started the snow angel program 22 years ago. Among the benefits of the snow angel program: Some elderly residents worry that if they are snowed in and have a medical emergency it will be difficult to get the help they need. Others were thankful that they have mobility--could get out of the house and be visited by friends. Last year, during winter storms, I left my shovel in the car and helped a few elderly residents clear their driveways. Speaking personally, not only did I feel good about being a snow angel, but I enjoyed the exercise (and rewarded myself with some chocolates after burning some calories!). PAUL FEINER.
Feiner also reminded Greenburgh residents:
DON'T LOSE YOUR STAR PROPERTY TAX BREAKS. NYS REQUIRES EVERY HOMEOWNER WHO RECEIVES BASIC STAR TO REGISTER BY DECEMBER 31, 2013. IF YOU DO NOT REGISTER, YOU WILL LOSE YOUR TAX BREAKS. IF YOU HAVE NOT RECEIVED A LETTER FROM THE STATE,CALL (518) 457- 2036 OR APPLY ON LINE at http://www.tax.ny.gov.
Caregiving Tips from the Pros: 8 Words of Advice
As a family caregiver, you play a vitally important role in the life of your aging loved one—a role that can also be overwhelming, exhausting and sometimes thankless. As our gift to you this season, and as an encouragement for all of the good work you are doing, we asked professional Home Instead® CAREGiversSM to share their best advice with you. Here are eight of our favorites.
1. Take a break without feeling guilty.
Maggie, a Home Instead CAREGiver, says, “The one thing I would advise a family caregiver is to allow themselves respite time, at least a couple times each month, without feeling guilty. A refreshed caregiver is a much better provider of care when they themselves have taken a much needed break.”
2. Helping your loved one look good can help them feel good, too.
CAREGiver Theresa says, “Washing their hair, getting a trim or a haircut can vastly improve how they feel and see themselves. Update their clothes as their size changes or they lose a lot of weight. Purchasing two or three brightly colored, patterned ‘senior bibs’ or ‘painting smocks’ that can be put on and washed every day can also extend the life of their clothes.”
3. Give them the freedom to forget.
CAREGiver Lori says, “Do not assume your family member remembers even the simple parts of life they've always known. Do not assume they like what they've always liked: music, television, current events, travel, past favorite foods, visiting in large groups of people. Do not assume they remember the person in church greeting them, or the neighbor next door, or even you. Allow them the space to remember and forget at their own pace.”
4. Call or visit regularly.
CAREGiver Renee says, “In my years as a caregiver, I have found that most seniors who do not get out much usually experience loneliness. Their phone seldom rings and the television is often left on all day for company. They want to hear the sound of other voices but that doesn't take the place of visiting with other people or spending time out in public.” Renee suggests setting a specific day and time each week to call, to give your loved one something to look forward to. A simple letter or greeting card to let them know they are missed and loved can make their day and remind them that someone cares.
5. Allow them to change and accept when they do.
“Whether it’s a physical incapability or behavioral, realize that it is okay that your loved one is not the person you remember. Step back and realize the only way they can get peace is to let them be.” – Jeannie, Great Lakes Region 2012 CAREGiver of the Year.
6. Never make them feel incapable, or say “no” outright.
Jeannie also advises, “Be considerate about things that may be embarrassing to them (e.g., helping them out of a wheelchair). Be as creative as you can be. If they’re confused about what is going on, ease the confusion by asking questions about their past and suggesting activities like going for a drive and pointing out all their favorite locations. Do what you can to make it feel like they weren’t denied anything.”
7. Be patient and respectful.
Mariana, Central Region 2012 CAREGiver of the Year, says: “Regardless of the reasons they need care, it is important to provide loved ones care in ways that are respectful of their dignity and independence. You need to be patient.”
8. Accept help.
“You need to take care of yourself to take care of someone else. If people offer to help, accept the help.” – Mariana
Mind-Body Medicine and Managing Stress Around the Holidays
The Scarsdale Medical Group in collaboration with Jewish Home Lifecare at Sarah Neuman Center present Mind-Body Medicine and Managing Stress Around the Holidays at the Sarah Neuman Center on Wednesday, December 11, 2013 from 5:30 PM. See flyer below for more details and reservation information.
7 Ways to Investigate Your Loved One’s Needs During a Holiday Visit
As you pile the gifts into the back of the car and check off any last-minute errands from your list before heading home for the holidays, you might also want to prepare to handle any changes you notice in your aging loved ones. Keep your eyes open for these seven common issues that can threaten a senior’s independence.
1. Pain. Does your mother now pull up a stool by the sink to peel the potatoes? Does she wince when she bends down? Does she complain about a bad back? If you notice any red flags, try gently asking her, “How long has your back been hurting you?” Even if she tries to pretend she’s managing fine, consider helping her schedule a doctor’s appointment “just to be sure.”
2. Memory. Does she have trouble recalling events from that morning? Has she told you the same story over and over? You may want to keep a list of concerns to bring up with her primary care physician or neurologist.
3. Depression. If you see any hints of irritability, sadness or sleep difficulties, these could be signs of depression. Depression is common among seniors, and any related concerns should be checked out by a doctor or mental health care professional.
4. Social Engagement. Ask your mother to tell you about her friends. Social seniors generally have a healthier and more optimistic outlook on life. If she doesn’t have a strong social network, look into community activities that she may enjoy or companionship services.
5. Safety. If your mother has more difficulty walking, make sure she has a cane, walker or the proper support; remove throw rugs or other potential tripping hazards; and look into installing grab bars and no-slip strips where needed. If you’re worried about falls or other safety issues, look into getting a medical alert system or hiring a caregiver who can check up on her frequently.
6. Housekeeping. As seniors experience declining health, they may have more trouble keeping up with the housework. If you notice the house looks more unkempt than usual, consider senior care services that include light housekeeping.
7. Medication. Try to notice if your senior loved one is taking the appropriate pills at mealtimes or before bed and if she is keeping the pillbox organized. If she is not reliable with a medication schedule, you may want to look into home care services that provide medication reminders.
How to Address the Issues You Uncover
Even if you meet with some resistance when gently confronting a loved one about potential issues you may observe during your visit, it is in both your and your loved one’s best interest to find a solution that can help keep him or her safe and independent at home.
If you’re unsure about the best way to diplomatically discuss issues with your loved one, download a conversation starter guide. Tthese easy-to-read guides from Home Instead Senior Care and author and communications expert Dr. Jake Harwood include common family situations and sensitive circumstances that often pose communication problems for both older adults and their children or loved ones. Topics include independence, health, end-of-life issues and even romance. These guides also feature conversation tips for both seniors and their family caregivers. A section on advance directives, designed with the assistance of Jo Myers, author and advance planning expert, will help ensure that families are prepared for the inevitable.
40/70 Conversation Topics
The time to start talking with senior parents is sooner rather than later, when a crisis has occurred. But how do you bring up sensitive subjects? These tips and common senior situations are just what you need to get started.
70/40 Conversation Topics
Even seniors who have great relationships with their children can be tongue-tied when it comes to starting conversations about certain sensitive subjects. These tips as well as examples of how to get the conversation going can help.
Want to know how prepared you are to have these important conversations? Visit www.caregiverstress.com.
For any physical or mental health concerns you may have, consulting your aging loved one’s physician might be the best thing to do. It’s better to address a concern early than wait until it becomes a health emergency.
©2013 Home Instead, Inc. All Rights Reserved.
Westchester County Offers Medication Disposal Information
Westchester County has provided residents with information on how to safely dispose of unwanted prescription medications:
Patients Mired in Costly Credit From Doctors -- The New York Times
The following article appeared in The New York Times on October 13. Director of WJCS Geriatric Services Judy Fink advises that seniors should be aware of being offered these medical/dental credit cards.
A Vulnerable Age
Patients Mired in Costly Credit From Doctors
By JESSICA SILVER-GREENBERG
Published: October 13, 2013
The dentist set to work, tapping and probing, then put down his tools and delivered the news. His patient, Patricia Gannon, needed a partial denture. The cost: more than $5,700.
Ms. Gannon, 78, was staggered. She said she could not afford it. And her insurance would pay only a small portion. But she was barely out of the chair, her mouth still sore, when her dentist’s office held out a solution: a special line of credit to help cover her bill. Before she knew it, Ms. Gannon recalled, the office manager was taking down her financial details.
But what seemed like the perfect answer — seemed, in fact, like just what the doctor ordered — has turned into a quagmire. Her new loan ensured that the dentist, Dr. Dan A. Knellinger, would be paid in full upfront. But for Ms. Gannon, the price was steep: an annual interest rate of about 23 percent, with a 33 percent penalty rate kicking in if she missed a payment.
She said that Dr. Knellinger’s office subsequently suggested another form of financing, a medical credit card, to pay for more work. Now, her minimum monthly dental bill, roughly $214 all told, is eating up a third of her Social Security check. If she is late, she faces a penalty of about $50.
“I am worried that I will be paying for this until I die,” says Ms. Gannon, who lives in Dunedin, Fla. Dr. Knellinger, who works out of Palm Harbor, Fla., did not respond to requests for comment.
In dentists’ and doctors’ offices, hearing aid centers and pain clinics, American health care is forging a lucrative alliance with American finance. A growing number of health care professionals are urging patients to pay for treatment not covered by their insurance plans with credit cards and lines of credit that can be arranged quickly in the provider’s office. The cards and loans, which were first marketed about a decade ago for cosmetic surgery and other elective procedures, are now proliferating among older Americans, who often face large out-of-pocket expenses for basic care that is not covered by Medicare or private insurance.
The American Medical Association and the American Dental Association have no formal policy on the cards, but some practitioners refuse to use them, saying they threaten to exploit the traditional relationship between provider and patient. Doctors, dentists and others have a financial incentive to recommend the financing because it encourages patients to opt for procedures and products that they might otherwise forgo because they are not covered by insurance. It also ensures that providers are paid upfront — a fact that financial services companies promote in marketing material to providers.
One of the financing companies, iCare Financial of Atlanta, which offers financing plans through providers’ offices, asks providers on its Web site: “How much money are you losing everyday by not offering iCare to your patients?” Over the last three years, the company’s enrollment has grown 320 percent. Another company posted a video online that shows patients suddenly vanishing outside a medical office because they cannot afford treatment. The company offers a financing plan as a remedy, with the scene on the video shifting to a smiling doctor with dollar signs headed toward him.
A review by The New York Times of dozens of customer contracts for medical cards and lines of credit, as well as of hundreds of court filings in connection with civil lawsuits brought by state authorities and others, shows how perilous such financial arrangements can be for patients — and how advantageous they can be for health care providers.
Many of these cards initially charge no interest for a promotional period, typically six to 18 months, an attractive feature for people worried about whether they can afford care. But if the debt is not paid in full when that time is up, costly rates — usually 25 to 30 percent — kick in, the review by The Times found. If payments are late, patients face additional fees and, in most cases, their rates increase automatically. The higher rates are often retroactive, meaning that they are applied to patients’ original balances, rather than to the amount they still owe.
For patients, the financial consequences can be dire.
Ms. Gannon said she was happy with her dental care, despite the cost, and there was no suggestion that Dr. Knellinger had done anything wrong. But attorneys general in a several states have filed lawsuits claiming that other dentists and professionals have misled patients about the financial terms of the cards, employed high-pressure sales tactics, overcharged for treatments and billed for unauthorized work.
The New York attorney general’s office found that health care providers had pressured patients into getting credit cards from one company, CareCredit, a unit of General Electric, which gave some providers discounts based on the volume of transactions. Patients, the investigation found, were misled about the terms of the credit cards, and in some instances, duped into believing that they were agreeing to a payment plan with dental offices when, in fact, they were being pushed into high-cost credit.
In June, CareCredit reached a pact with Eric T. Schneiderman, the New York attorney general, to improve protections for consumers, and a spokeswoman said the company “does not incentivize providers to have patients open accounts” or give referral fees to providers.
In Ohio, the attorney general has sued the operators of several hearing aid clinics, claiming that they misled customers about using medical credit cards to pay for batteries and warranties.
Cameron P. Kmet, a chiropractor in Anchorage, Alaska, said he had stopped offering medical cards. “One missed payment can really ruin a patient’s life,” he said. Mr. Kmet now runs a company that administers payment plans directly between providers and patients, with annual interest rates around 8 percent.
Regarding medical credit cards, Mr. Kmet said he had urged providers to ask themselves “whether this is something that you would recommend to a family member or friend.” The answer, he said, is usually no.
While medical credit cards resemble other credit cards, there is a critical difference: they are usually marketed by caregivers to patients, often at vulnerable times, such as when those patients are in pain or when their providers have recommended care they cannot readily afford. In addition to G.E., large banks like Wells Fargo and Citibank, as well as several specialized financial services companies, offer credit through practitioners’ offices.
The growth of this form of consumer credit is difficult to quantify because data on medical credit cards specifically, as opposed to credit cards generally, is unavailable. But credit cards of all types are playing a growing role in financing medical care. In 2010, people in the United States charged about $45 billion in health care costs on credit cards, according to the consulting firm McKinsey & Company.
“When the economy got worse, our business got better,” said Katie Kessing, an iCare spokeswoman. In 2010, a little more than a thousand dentists offered the iCare finance plan — a program that requires patients to pay 30 percent down as well as a fee of 15 percent of the total procedure cost. The number of participating providers has since risen to 4,200. Russell A. Salton, the chief executive of Access One MedCard, a credit card company in Charlotte, N.C., said demand for specialized cards — the MedCard has an annual interest rate of 9.25 percent — is driven by providers interested in removing an “obstacle to providing valuable care.” The company says the number of hospitals offering its credit cards has grown about 25 percent a year in recent years.
While neither national medical or dental associations have formal policies, ADA Business Enterprises, a profit-making arm of the American Dental Association that connects dentists and businesses, endorses G.E.’s CareCredit, whose cards are used by more than seven million people nationwide.
“Cardholders tell us they like using CareCredit because it gives them the ability to plan, budget and pay for certain elective health care procedures over time,” said Cristy Williams, the spokeswoman for CareCredit. She said the company had improved consumer protections, going so far as to telephone “senior cardholders with significant first transactions to confirm their understanding of the program and terms.”
She said roughly 80 percent of patients who opted for the deferred interest paid off their debts before they were charged any interest. She and others in the industry said the credit cards and credit lines had helped patients afford otherwise prohibitively expensive care not paid for at all, or in its entirety, by insurance providers.
But state authorities and care advocates in California, Florida, Illinois, Michigan and elsewhere say that older people — many of them grappling with dwindling savings and mounting debt — are running into trouble with medical credit cards and loans.
“The cards prey on seniors’ trust,” said Lisa Landau, who heads the health care unit at the New York attorney general’s office.
Minnesota’s attorney general, Lori Swanson, is investigating the use of medical credit cards, which she said could come with “hidden tripwires and other perils.”
Interviews with patients, along with the review of contracts and lawsuits, show just how significant those perils can be.
Carl Dorsey, 74, recalled his experience at Aspen Dental Management, a nationwide chain that has come under scrutiny for its practices. Mr. Dorsey said that after a dentist at Aspen’s office in Seekonk, Mass., told him that he needed dentures, at a cost of $2,634, he was urged to take out a medical credit card. He was charged the full cost upfront, financial statements reviewed by The Times show. Mr. Dorsey, who made about $800 a month working as a used-car salesman, in addition to receiving Social Security, has since fallen behind on his payments. The lapse set off a penalty interest rate of nearly 30 percent. Mr. Dorsey said he was being pursued by debt collectors.
“This whole ordeal has been devastating,” said Mr. Dorsey, who along with other patients is part of a civil lawsuit filed against Aspen in a federal court in upstate New York. He said he still needed dentures, noting that the ones he received from Aspen were unusable.
Diane Koi-Thompson said that her father, Harold Koi-Than, did not realize that he had signed up for a CareCredit card during a dental visit. She said Mr. Koi-Than, 82, was shocked when a company representative called his home near Niagara Falls, N.Y., saying he had missed a payment. “My dad had no idea he had a credit card, let alone that he was behind on it,” Ms. Koi-Thompson said. She said her father was upset because he is normally meticulous with his finances and thought his memory was failing. Mr. Koi-Than, through a family member, was able to cancel the credit card.
The industry’s growth is being driven by people seeking dental care and devices like hearing aids, which are not covered by Medicare.
Dental care is a large and expensive gulf, according to Tricia Neuman, the director of Medicare policy research at the Kaiser Family Foundation. The new federal health care law, she said, will not change that. “Lack of dental coverage remains a huge concern and expense,” Ms. Neuman said.
Working with care providers, financial services companies have rushed to fill the void. To make medical cards attractive, some companies offer them without checking patients’ credit histories. The cards can be arranged in minutes, with no upfront charges. Such features are attractive selling points.
“Your patient does not require good credit,” First Health Funding of Salt Lake City, Utah says on its Web site. On the site of another lender, the words “No Credit Check” flash in bright letters. First Health Funding did not respond to requests for comment.
Lawyers and others who assist patients say such features make it easy for people who are already on a weak financial footing to take on new debt.
“Ultimately, this credit facilitates a bad financial decision that will haunt a patient because it adds to indebtedness,” said Ellen Cheek, who runs a legal help line for older people through Bay Area Legal Services in Tampa, Fla.
Such critics also say that because there are no industrywide standards for pricing care — costs vary from practice to practice — the cards could encourage providers to charge more for treatment.
Brian Cohen, the lawyer representing Mr. Dorsey, said the cards enabled providers to “bill whatever they want for care, regardless of whether the cost is reasonable.”
State authorities say health care finance in general, and medical credit cards in particular, are a growing worry. In 2010, Aspen Dental, the chain where Mr. Dorsey signed up for a card, reached a settlement with Pennsylvania authorities over claims that, among other things, it had failed to tell patients that missing a payment would mean the rate would rocket from zero to nearly 30 percent. A review of court records and online forums shows hundreds of customer complaints against Aspen, which is based in Syracuse. A civil case brought on behalf of customers is pending in a federal court in upstate New York.
Kasey Pickett, a spokeswoman for Aspen, which is fighting the lawsuit, said the accusations were “entirely without merit.”
Aspen provides mandatory training for office employees who discuss financing with patients, according to Ms. Pickett. “We know that for many patients,” she said, “the availability of third-party financing may be the only way that they are able to afford the care they need.”
Eldercare Boot Camp Scheduled For Nov. 6
Caregiver Conference to Take Place Nov. 2
“Caregiving Across the Lifespan” is the theme of this year’s Caregiver Conference, which will take place Saturday, Nov. 2 from 10 a.m. to 2 p.m. at the Mount Pleasant Community Center, 125 Lozza Drive, Valhalla.
The conference will address the emotional and physical challenges caregivers face in providing for people of all ages. Admission and on-site parking are free.
The keynote speakers will be actors Beth and Nick Wyman. The couple will tell about their journey of caring for a mentally and physically disabled child at their home and an ill parent who lived a distance away. Nick is also president of the Actors’ Equity Association. The conference will also offer attendees free, one-on-one consultations with elder law attorneys, geriatric care managers and social workers.
The event is sponsored by Westchester County’s Department of Senior Programs and Services, the Livable Communities Caregiver Collaborative and the Westchester Public/Private Partnership for Aging Services. Reservations are preferred. To sign up, click firstname.lastname@example.org or call (914) 813-6427.
Transitions in Care Panel Discussion to be Held, Oct. 30
White Plains Hospital and United Hebrew of New Rochelle will hold a panel discussion on Transitions in Care on Wednesday, October 30, 2013 from 6:00 - 7:30 PM at United Hebrew of New Rochelle, 391 Pelham Road, New Rochelle. For more details, click here to see the flyer.
It is just midlife, or is your thyroid slowing down?
Maybe you’re feeling tired and having trouble concentrating — or perhaps you’ve noticed changes in your hair or weight, or just feel blah. You might easily attribute these issues to other health problems, or to simply getting older. But these symptoms can be signs of a sluggish thyroid.
The thyroid is butterfly-shaped gland in the neck. It produces the hormones that regulate metabolism. Low levels of thyroid hormone can cause a range of symptoms including fatigue, constipation, dry skin, brittle nails, hair changes, aches and pains, and feeling down. Untreated, an underactive thyroid (hypothyroidism) can increase the chances of developing high cholesterol, high blood pressure, and heart disease.
Women are more likely than men to have problems with their thyroid, particularly as they get older. In some women, the onset of thyroid trouble is so gradual that it’s hardly noticeable; in others, symptoms come on abruptly over the course of a few weeks or months. These include:
• Fatigue. You may feel unusually tired and have less energy.
• Cold intolerance. You may feel chilly even when others around you are comfortable.
• Appetite loss, weight gain. When metabolism is dragging, you need fewer calories so your appetite may decrease — at the same time, you are using fewer of the calories you do eat, so more are stored as fat.
• Cardiovascular effects. Low levels of thyroid hormone can lead to high blood pressure as well as elevated levels of total and LDL cholesterol. Over time, an underactive thyroid can compromise the ability of the heart to pump blood effectively.
• Mental effects. Hypothyroidism and depression share many of the same symptoms, including trouble concentrating, memory problems, and loss of interest in things that are normally important to you.
• Other signs and symptoms. Hypothyroidism can cause symptoms throughout the body, from constipation to muscle aches and pain around the joints. Skin, hair, and nails may become dry and thin.
If you have any of these symptoms, see your doctor. She or he will examine you for signs of hypothyroidism, and may recommend blood tests to check thyroid function.
Hypothyroidism is usually treated with a daily dose of synthetic thyroid hormone, taken as a pill. This medication works exactly like your body’s natural thyroid hormone. It may take some time to find the right dose for you. Once you do, symptoms usually improve dramatically. Your doctor will check your thyroid function usually once or twice a year to be sure that your dose of medication remains optimal.
Copyright © 2013 by Harvard University.
7 Care Tips for When Someone You Love Is Dying
As your mother, father, grandparent or someone close to you nears the end of life, your loving care matters more than ever. But, as the family caregiver who shared the following story found out, sometimes it’s hard to know how to best navigate those challenging circumstances.
“Looking back, I regret how much I tip-toed around the fact that my mom was dying. When we moved her into a room at the hospice house she said, ‘Well I guess I’ll miss Christmas this year.’ It was early December and we had brought a small tree to decorate her room. My immediate reaction to her gloomy comment was “Aw, no Mom! We’ll bring Christmas to you!’ But the look on her face told me she knew just as well as I did that she wouldn’t make it to Christmas.”
Here are seven tips that may help you and your dying loved one confront the reality of your circumstances and approach the end of life with more restful reassurance.
1. Acknowledge the elephant in the room. The big “Ds,” death and dying, can seem awkward to talk about. Tiptoeing around death can actually add stress. If you don’t know where to start, just follow your loved one’s lead.
2. It’s okay to express your emotions, even your sadness, in front of your loved one. You may feel the urge to pretend that everything is all right, but expressing your feelings gives your loved one freedom to be honest about his or her feelings in front of you. You loved one will likely feel relieved that you understand what’s occurring.
3. Your presence matters. Even if hospitals make you uncomfortable or you’d rather remember your loved one fully functional, showing up probably matters more than your loved one can say.
4. Create meaningful conversation. People at the end of life usually prefer to recall happy memories with those they love and find closure. Try to focus conversation around themes like forgiveness, thankfulness and love between friends or family members and themselves.
5. Listen carefully for any messages your senior loved one would like to convey. Sometimes, people approaching death may try to communicate an important message to those around them, even if they’re unable to speak clearly. If this happens, don’t immediately assume it’s nonsensical babble; try to understand what your loved one is trying to say.
6 .Find out answers to typical end-of-life questions. If your loved one can still think rationally and communicate clearly with you, use the five wishes document to learn about your loved one’s end-of-life preferences. Knowing the answers to questions like “where do you hope to spend your last days?” can help you ensure your loved one remains comfortable until the very end.
7. Be mindful of legal documents. Know what end-of-life legal decisions have already been made, such as a living will or a designated healthcare power of attorney. A living will describes wishes for medical treatment, including the use of life-prolonging treatment at the end of life. A healthcare power of attorney is appointed to act on behalf of your loved one regarding medical treatment decisions. Knowing and respecting these decisions can help you carry out your last one’s wishes with confidence.
With these tips for supportive care, you’ll likely be able to make the most of the time you have left with your loved one, help that person feel as comfortable as possible, and bring the closure needed to move on peacefully.
©2013 Home Instead, Inc. All Rights Reserved.