Monday, January 31, 2011

The most affordable, healthy foods for adults

Maybe your New Year's resolution for 2011 was to shave off a few pounds, cholesterol points or both -- but one thing is for sure -- gyms across the country never seem quite as populated in February as early January.  Some struggle to workout; others find it difficult to eat well-balanced meals.  The old saying "you are what you eat" carries a certain weight though (no pun intended), because even if we do exercise regularly, if our diets are off kilter then results just won't come.  Dr. Mercola, author of a popular Health Newsletter, said the following about food choice:
When you consider the nutrient value of fresh versus processed-to-death denatured foods and the subsequent health consequences of each choice, it's quite clear that you can eat well and improve your health and still not spend a fortune.
PlanetGreen released a list today of 15 "superfoods" for less than $20, and accompanying recipes.  Some of the more savory choices: Quinoa With Butternut Squash, Sweet Potato Red Curry with Baby Bok Choy and Tofu and Brown Basmati Rice, and Sweet Potato Pancakes.

For Seniors, check out this article with the 100 Best Health Foods for Seniors from  This resource is helpful in that the article lists the best foods for brain health, bone health, eye-sight, and more.  

Friday, January 28, 2011

Who was supposed to be watching Grandma?

There is a popular tune you may have over the last couple of months called “Grandma Got Run Over by A Reindeer” which relates that Grandma -- after drinking too much eggnog -- went out into the winter cold to get her medication and was run over by a reindeer. The question is, “Who was supposed to be watching Grandma?”

Though this little tune is just for fun, it may very well raise alarms to many caregivers of the elderly. Caregivers know that even at a holiday party they cannot let down their diligent watch over their elderly loved one. As far-fetched as it may sound, with all the people and noise, an elderly family member with dementia or Alzheimer’s may be enjoying the family gathering and then suddenly become confused and walk to the door and leave.

For people with loved ones showing early signs of Alzheimer's, disability benefits may be easier to obtain than years past. reported early last year on the Social Security Administration's additions to the Compassionate Allowances list:
Last year, the SSA has added an additional 38 conditions to the Compassionate Allowances list, greatly expanding the number of people who are eligible for the Compassionate Allowances program.  Although most of the conditions on the revised list are rare, of tremendous importance for the aging population is the fact that the SSA has now included Early-Onset Alzheimer’s Disease, Mixed Dementia, and Primary Progressive Aphasia among the new fast-track conditions, meaning that people who are diagnosed with any of these conditions can now receive disability benefits very quickly.
For family caregivers the added stress of the holidays with decorating, shopping, parties and keeping up with all the family traditions is an overwhelming quest. Feelings of isolation, depression and sadness come with this added stress. There are millions of Americans who are caring for elderly frail loved ones and most of these caregivers will go through some of these emotions, especially this time of year.

There are some things you can do as a caregiver to help you and those you care for enjoy the holiday season:

Take care of yourself. Try to eat right, get plenty of sleep and exercise. This will help reduce stress and strengthen your ability to cope with caregiving responsibilities.

Prioritize your responsibilities. Perhaps instead of cooking a large family dinner, have everyone bring his or her favorite dish. Use paper plates. Forfeit the traditional outside light decorating for a lighted wreath on the front door. Choose one or two parties or concerts to attend instead of trying to do it all.

Arrange for help. Call on other family members to help with the caregiving while you do your shopping or go out for the evening. If family is not available, ask your church group or a neighbor if they would donate a few hours.

Use community services. Many senior centers provide meals for the elderly and supervised activities, on-site, at no charge or a minimal charge. For locating senior services in your state, call your state Area Agency on Aging or check the national website at

Use adult day care services. Some assisted living facilities provide day activities and meals for seniors on a day by day basis. Other organizations called "adult day service providers" specialize exclusively in this sort of care support at a reasonable cost. These support services provide respite for caregivers from their caregiving responsibilities as well as social interaction for their elderly family members. There is a cost for adult day services, but the benefit for all is worth it.
For example:
Jean had brought her mother into her home to care for her when mom's Alzheimer’s made it impossible for her to be alone. When the Christmas season approached, Jean realized she had to make some choices. She did not want to give up the traditions she had set with her daughters in shopping and lunches, but it wouldn’t be possible with her caregiving responsibilities. In searching for a solution, Jean visited an adult day services facility near her home. She found she could schedule the days she needed off for her mother to come in. The adult day services company also provided transportation and would pick up mom and bring her home in the evening.
Although Jean's mother was not sure she would like to go at first, she found she enjoyed the programs, meals and conversation with new friends and the activities provided.
The time it gave Jean to have for herself was worth the extra cost for the day care.
Embrace technology. Here is a solution that would have kept “Grandma” from going out in the winter cold and getting run over by a reindeer. Companies that have created monitoring systems, security alarms and other safety equipment are “tweaking” them to adapt to the needs of seniors and their care givers.

Here are a few examples:
  • Ankle or wrist bands that monitor location and alert the provider when a person has gone beyond the designated perimeter, such as out the front door of the house.
  • Motion detectors. Set throughout the home, motion detectors allow someone outside the home to follow a senior as he or she moves through the house.
  • Smart medication dispensers. Live monitoring and dispensing of pills.
  • Emergency response alert. At a touch of a button on a desktop monitor, bracelet or necklace, emergency help is summoned.
Whether providing care in your home or helping senior family members in their own homes, your use of monitoring and “tech” help aids can provide extra safety for your loved ones, and peace of mind for you.

Remember, you are not alone. Join a caregiving help group. Your local senior center may have one or go on the internet to find one. Hearing about other caregivers' problems and solutions and being able to share your own and ask questions is a great way to relieve stress and gain a new perspective. Check out websites like the National Family Caregivers Association at

Work with a Senior Care Professional. Recognize that you are doing the very best you know how. You are not a geriatric health care practitioner, geriatric care manager, home care nurse or aide, hospice provider or family mediation counselor, nor do you have the years of training and experience these professionals have, but you can definitely use their experience. In fact, using a senior care specialist will make caregiving easier for you and more beneficial for your elderly family member.
As an example:
Mark stopped by his father Dan’s home every night after work to help with any errands or things he needed around the house. He began to notice that Dan was not showering, dressing or even fixing meals some days. Another concern was his father's growing confusion and disorientation. A trip to the family doctor only brought more concern to Mark, since the doctor claimed it was just the aging process that caused the confusion.
Wanting a second professional opinion on what was best for his father, Mark hired Shelly -- a Professional Geriatric Care Manger -- to do an assessment. Shelly arranged for Mark and Dan to see a geriatrician, who advised that proper meals and an increase in some vitamins, would help clear up the confusion and disorientation. Shelly arranged for a home care company to come in daily to help with personal needs and prepare meals.
Soon Dan was back to his old self and able to function on his own.
You can find a wide variety of care professionals in your area on the National Care Planning Council website at

One more thing to remember. As a family caregiver, the greatest gift you are giving this holiday season is “Love.”

If you are a caregiver, you may want to check out Evan Farr's chapter "The Role of the Caregiver," from his popular book, The Virginia Nursing Home Survival Guide.

Image: Sura Nualpradid /

Wednesday, January 26, 2011

Depression related to lung-health? COPD may increase depression risk in Seniors

Experts say that over a million people in the United States have chronic obstructive pulmonary disease (COPD). It is a chronic lung condition that includes bronchitis, emphysema or both.

COPD affects the airways and air sacs within the lungs, which makes breathing difficult and can result in a person becoming less active over time. An elderly person who has COPD will easily become depressed, when dealing not only with breathing difficulties but other age related problems.

One example of COPD related depression is Martin, age 72. Martin had lived a busy lifestyle, playing golf, volunteering at the community center and working in his garden. Diagnosed with COPD six months previous, and uncertain how to mange his breathing difficulty and new medications, Martin stopped all his activities. Giving up the things he loved to do and sitting more at home along with improper diet, he became a victim to depression.

Martin’s son Anthony realized that his father could not handle his new situation and depression alone. A trip together to Martin's physician began the steps to dissipating the depression and enabling Martin to return to his social life.

Anthony received instructions about his father’s medications from the doctor and how they were to be used and consequently could help his father with medication reminders.
The most common types of daily COPD medicines are:
  • Inhaler for daily maintenance - Bronchodilators help relax the muscles around the lungs’ breathing tubes. This reduces shortness of breath and makes breathing easier.
  • Steroids – Corticosteroids, taken in pill form or inhaler reduce swelling in breathing tubes to quickly make breathing easier. Not commonly for prolong use.
  • Oxygen Treatment - Severe COPD will reduce your lungs’ ability to put oxygen into your blood to be carried throughout your body. Martin’s oxygen level was measured to determine if he would need prescribed oxygen therapy. Oxygen is usually prescribed if the oxygen in the blood is low during sleep, exercise, or while not active. A respiratory therapist from an oxygen supply company or home health service can help with learning how to use oxygen.
An important factor in Martin’s depression and COPD management was his diet.
“A healthy diet can play an important role in the management and treatment of COPD. Finding the right diet can be tricky for people with chronic obstructive pulmonary disease (COPD), since they need to eat a healthy diet and maintain their optimal weight to keep COPD symptoms in check.”) Krisha McCoy, MS, Lindsey Marcellin, MD, MPH)
Maintaining the right nutrition and taking vitamins not only keeps the body healthy but heals the mind, providing emotional well being. Fad diets or extreme dieting are not appropriate for COPD patients. Extreme weight loss can be as much a hazard as being overweight. A home care nutritionist can help establish a healthy menu and diet plan.

With medication and diet under control the final steps to overcoming Martin’s depression were to return to his daily activities. With COPD, an elderly person is more hesitant to leave home, especially if that person's breathing capacity is not as it used to be. There is a lot of available mobility support for the elderly with small portable oxygen units, walkers, electric scooters and other supportive equipment to help these disabled people move about in the community.
With the help of mobile services and his son at his side to start with, Martin returned to the golf course and community activities. His new diet and return to previous activity helped Martin overcome his symptoms of depression.

Studies show that the intervention of family and friends in helping and supporting elderly people with COPD results in a decrease of depression and a healthier outcome for the patient.
The Oxford Journals Medicine and Ageing states
“It is also worth exploring how family and friends may be involved in supporting the patient and to encourage social interaction. Educating the spouse, family members and friends about depression may help them to understand the consequences of the disease and to develop coping strategies and in turn may reduce the likelihood of isolation. A very recent study that investigated the benefits of emotional support by family and friends and of spiritual beliefs in patients with major depression showed that those with higher perceived emotional support had better outcomes.” (Oxford Journals Medicine Age and Ageing Volume 35, Number 5)
If you are helping an elder parent with COPD related depression there are community and professional services to help you. Start with your parent’s physician. You can also find resources for oxygen therapy, homecare respiratory treatment, home nursing, home medical equipment and mobile services.
The National Care Planning Council promotes eldercare resources and lists eldercare services throughout the United States.

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Tuesday, January 25, 2011

Veterans Benefits: The "second time" help rule

Federal law dictates that no one may help a veteran in the preparation, presentation and prosecution of an initial claim for VA benefits unless that person is accredited. The only exception to this law is that any one person can help any veteran -- one-time only -- with a claim. To help any veteran a second time requires accreditation.

VA recognizes 3 types of individuals for purposes of accreditation.
(1) Accredited attorneys
(2) Accredited agents and
(3) Accredited representatives of service organizations. (Veterans Service Officers)

In order to be accredited to help veterans with new claims, an individual desiring this certification from VA must submit a formal application, must meet certain character requirements and work history requirements and -- except for attorneys -- must pass a comprehensive test relating to veterans claims and benefits. There are also requirements for ongoing continuing education.
Without accreditation no one may help a veteran with a claim more than one time.

What Does It Mean to Help a Veteran with a Claim?
VA interprets its prohibition on preparing, presenting and prosecuting a claim to mean that talking to a veteran or a veteran's qualifying spouse or dependent after that person has indicated an intent to file a specific claim for benefits requires accreditation. Anyone can talk about veterans benefits in general with any veteran and need not be accredited. The point at which discussion narrows down to specific information about the veteran's service record, medical conditions, financial situation including income and assets and other issues relating to a claim specific to a veteran or dependent triggers accreditation. According to VA, discussing the specifics of the claim means that the veteran has expressed an intent to file an application for veterans benefits, and at this point, the consultant helping the veteran must be accredited.

Stated again: An individual cannot advise a veteran or other eligible beneficiary about that person's specific claim for VA benefits unless that individual is accredited.

It does not matter whether physical help with filing the claim is provided or not. The need for accreditation occurs at a much earlier stage than becoming physically involved in the claim. For a better understanding of how VA General Counsel interprets the need for accreditation please go to the VA Office of General Counsel Website -- Frequently Asked Questions about Accreditation at
Working under the Umbrella of an Accredited Attorney or Accredited Claims Agent

Many individuals or organizations who are not accredited and who are promoting and helping veterans obtain their benefits are often attempting to work under someone who is accredited. Most of these individuals are doing it wrong and not complying with the law.

These individuals make sure that the application is done by an accredited attorney or an accredited agent. In some cases, non-accredited individuals will refer veteran households to a local veterans service officer (an accredited representative of a service organization).

Unfortunately, most individuals who are not accredited and who are operating with someone who is accredited are still illegal. This is because the non-accredited individuals become involved in the claim by providing advice after an intent to file and in many cases they help gather documents and other pertinent information. As mentioned above, these activities require accreditation. The only way that a non-accredited individual can operate legally to assist someone who is accredited is to immediately refer a veteran or dependent to an accredited person when first understanding an intent to file a claim. No additional help or advice may be given after the intent to file has been recognized.

Special Salute to Troops from Tim McGraw:

Many accredited attorneys are also not operating legally. Only an accredited attorney -- one-on-one with the client -- may be involved with a claim. Anyone else, inside or outside of the office, cannot assist with the claim except under certain limiting conditions. Specifically, in order to work under an attorney, a non-accredited assistant must either be another attorney in the office, a certified paralegal in the attorney's office or an office law student or an intern. The client must also sign a consent letter allowing this arrangement. This consent must be filed with the original application. No other arrangement is allowed. Please see 38 CFR § 14.629 for an explanation of this requirement.

Charging a Fee for Help with Filing a Claim
Generally, no individual or organization may charge a fee for help with filing an initial application for benefits. There is only one exception to this rule and that is under the third-party exemption in 38 CFR § 14.636 (d). The requirements under this exception are very specific. In our opinion, no one that we know of, who is charging a fee, thinking he or she is operating under this exception, is doing it legally. Here are the ways these people are violating this law. (In most cases those who are operating illegally are engaging in all 4 of these unlawful activities.)
(1) The person paying the fee is not a disinterested third party as required by law.
(2) The person filing the claim is not submitting the fee agreement to VA general counsel as required.
(3) The person filing the claim is not submitting the disclaimer to General Counsel as required.
(4) The fee is contingent upon a percentage of the amount of the approved benefit.
We are seeing various financial arrangements for filing claims that are disguised fees in one way or another. As a general rule, anyone who would directly benefit financially from helping a veteran file a claim -- whether a direct fee is charged or not -- is in essence charging a fee. We know from numerous discussions with representatives, this is the way VA General Counsel treats these arrangements.

If you are working with someone who is not operating legally as outlined above, you should stop using that person's services. If you yourself are operating in a manner that is not in accord with the conditions outlined above, you must stop doing that. You're not legal. Not only could unauthorized individuals get a notice to cease and desist but in some cases there could be fines or legal action involved as well. It's not worth it. For help with accreditation issues you can contact the National Care Planning Council at
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Monday, January 24, 2011

Working with Elder Parents in Planning Financially for their Long Term Care

You may be taking care of elderly parents now or looking at that possibility in the near future. According to a report from USATODAY/ABCNews/Gallup Poll, 41% of baby boomers are helping take care of elderly parents by providing personal help or financial assistance or both.

If financial planning and long term care planning have not been done previous to the need for care, the burden falls on the caregiving family member. Decisions about how care will be paid for, who will be responsible for managing the estate as well as how the long term care will be given can cause stress and contention among family members.

It is best for parents and all family members to be involved in planning for future financial needs.  The financial resources being used today could change drastically with the occurrence of a stroke, illness or onset of dementia. In order to plan financially for long term care, you need to know what the costs are now and what they will be in the future.

Every year MetLife does a survey of long term care costs. Their 2010 survey shows that the average daily rate for private nursing home is $229 which is up from $219 in 2009. Assisted living monthly base rate cost rose to $3,293 in 2010 from $3131 in 2009. Home health aids average $21 an hour.

Planning financial needs can be very difficult, considering you do not know when long term care will be required or how long it will be needed. You can determine what will be needed in certain living situations. Staying in your home for care will require Professional Home Care assistance, travel accommodations to doctor appointments, help with shopping, meals, medical supplies and medication and possibly a 24-hour attendant. Even if a family member is doing most of the care, eventually professional care will be required or a move to a nursing home facility will be necessary.

When evaluating your present income and assets consider how they would work for future needs.
  • What are my care options?
  • What type of long-term care can I afford?
  • Do I have long term care insurance?
  • Are there assets I can sell?
  • If I stay at home how will I pay for care?
  • Do I have to sell the house to pay for other living arrangements?
  • Are there other financing alternatives?
  • Do I have life Insurance or the means to pay for a funeral and burial?
  • Will my spouse be cared for financially?
  • Should I do Medicaid planning?
  • Do I have the legal documents that may be needed?
An article by Thomas Day, Director of the National Care Planning Council, titled “Paying the Cost of Care,” reviews some of the financial options that can be used.
“Tangible assets that might produce enough income to pay for long term care might include investment property such as rentals, commercially leased property, land, a farm, second home or a business..."
"Some individuals are heavy into real estate and short on cash. If the intent was to cash out of the investment at some future point, then a sale is warranted. But, it seems a shame to sacrifice in early years to establish an investment only to throw it away to long term care. It would make more sense to use income from the investments to buy long term care insurance."
Long term care insurance is one option for paying for care. Long term care insurance helps pay for the care you need when you can no longer care for yourself. It can protect your family's financial future and your own investments. There are qualifications that need to be met with health and age. This type of insurance is more expensive the older the person and almost impossible to get if age related illness has already occurred.
Senior Financial Planners, Elder Law Attorneys and Veteran Benefits Consultants can assist you in evaluating your needs and future planning.

Senior Financial Planners are expert in working with seniors and their families to set up long term care plans.  They usually work with an Elder law Attorney and Care Manager (Professional) to give you all options and resources for care.

Elder Law Attorneys help with Medicaid Planning and Asset protection as well as legal documents needed for final requests.

If staying in your home is a desired option, a Reverse Mortgage can supply the funds to pay for home care.
Another option for veterans who served during a time of war is the Aid & Attendance Benefit.  This benefit provides extra income up to $1,949 to help pay for home care, assisted living and medical costs. It will also pay for widows or widowers of the Veteran. To learn more about qualifications for these benefits contact a Veteran Benefit Consultant in your area.

Knowing your needs and financial resources is paramount before making any long term care decisions. Working together, both parents and family members can ease the stress and burden of elder care needs.

Increased awareness of anxiety in elders leads to user-friendly site updates

Stress, anxiety, and fear are normal emotions we all experience at some point, but when does fear cross over the line from “normal” to “excessive?”  NIH realizes the need for more readily available information for older adults on the internet. 

 “It is estimated that anxiety disorders affect between 3 and 14 percent of older adults in a given year,” reported NIH on the prevalence of anxiety in older adults.   And to get the message out, the organization has added a section on anxiety disorders.  View it here

Here is a preview of the cache of information:
Visitors to the website can learn about the risk factors, symptoms and treatments for generalized anxiety disorder, social phobia, panic disorder, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD) and specific phobias such as fear of flying or fear of public speaking. Anxiety disorders can severely affect a person’s life, and they are often overlooked in older adults. - NIA.NIH Press Release
Whether a person is experiencing an anxiety attack or regular levels of anxiety that we all experience as we go through life is a fine and hard-to-distinguish line for some individuals.  The newly provided information is touted as being easily accessible and user-friendly with short, easy-to-ready articles formatted for older adults. 

For a printer-friendly version of this information, click here.

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Friday, January 21, 2011

Long-Term care costs in 2010

 Metlife has conducted a 2010 market survey to determine the long-term care costs across the nation.  Most costs have increased since 2009.  The survey is available here.

Average Base Rate (per month) in Assisted Living: $3293
Average Daily Rate for Private Room in Nursing Home:  $229 
  • National average rates for a private room increased by 4.6%, from $219 daily or $79,935 annually in 2009, to $229 daily or $83,585 annually in 2010.”
  • "National average rates for a private room increased by 4.6%, from $219 daily or $79,935 annually in 2009, to $229 daily or $83,585 annually in 2010. National average rates for a semi-private room increased by 3.5%, from $198 daily or $72,270 annually in 2009 to $205 daily or $74,825 annually in 2010."
  • "The 2010 national average private-pay hourly rates for home health aides and homemaker/companion services remain unchanged from 2009 at $21 and $19 respectively.
Long-Term Care Cost Calculator: To calculate your estimated long-term care costs

Thursday, January 20, 2011

NFL star speaks on Alzheimer's, gets emotional

NFL Superstar Terrell Owens (T.O.) speaking on how Alzheimer's has touched his life personally.

Known for his on-the-field antics, T.O. displays a more emotional side in this clip.  "Estimates vary, but experts suggest that as many as 5.1 million Americans may have Alzheimer’s," according to the National Institute on Aging

Wednesday, January 19, 2011

Could ‘biomarkers’ be the key to predicting Alzheimer’s?

What is a biomarker??  Perhaps a useful tool to diagnose and predict dementia and cognitive decline, studies suggest. AstraZeneca defines the term as “a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacological responses to a therapeutic intervention.”

Because Alzheimer’s disease is complicated to assess or diagnose, researchers have been searching for “biological clues” for years.  

A study aimed at investigating a potential relationship between “plasma beta-amyloid 42 and 42/40 levels and cognitive decline in a large group of community-dwelling older adults without dementia” adds more support for the argument that biomarkers may be a useful tool for doctors.  The biomarkers used by this study: protein framgents.

The study found that older individuals who do not suffer from dementia, but lower levels of “blood plasma and biomarkers beta-amyloid 42/40 (protein fragments),” may be at an increased risk for experiencing cognitive decline. The relationship between cognitive decline and biomarker levels was more profound among less educated participants.  

"[The use of] biomarkers to identify elderly persons at risk of developing dementia could be useful for early prevention, if and when such interventions are available, and treatment," the author of the study explained. 
The study, published in the Journal of the American Medical Association (JAMA) was reported on by Senior Journal today.  That article is available here.  

 What does this mean for the future of biomarker research? 
"Future studies should further explore the use of plasma beta-amyloid as a biomarker, assess the mechanisms by which cognitive reserve modifies this association, and determine whether increasing cognitive reserve through interventions can reduce the risk of Alzheimer disease." 
In a different study, three specific proteins in cerebrospinal fluid were found to potentially “spot” Alzheimer’s disease.  That study appeared in the Archives of Neurology.  The BusinessWeek article that reported on this study is available here.  Of note, the Senior Director of Medical and Scientific Relations at the Alzheimer’s Association had this to say:
"This just reinforces the recommendation by [Alzheimer's working groups] saying that biomarkers can actually be incorporated today into clinical practice in order to add a certain piece to the diagnosis if patients are already presenting with something that looks like Alzheimer's."
Still another study carried out by the Texas Tech University Health Sciences Center and the Texas Alzheimer’s Research Consortium, reported by Ivanhoe Newswire, found that blood serum biomarkers PLUS other clinical information could be used to more accurately classify patients with AD.  Commenting on the importance of such studies, the authors say: "There is clearly a need for reliable and valid diagnostic and prognostic biomarkers of Alzheimer's disease, and in recent years, there has been an explosive increase of effort aimed at identifying such markers."

The Texas Tech study authors appear optimistic:
"With the rapidly evolving technology and the analytic techniques available, Alzheimer's disease researchers now have the tools to simultaneously analyze exponentially more information from a host of modalities, which is likely going to be necessary to understand this very complex disease."
In other Alzheimer's related news, CNN reported that Big Pharma companies are uniting to share data:

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Tuesday, January 18, 2011

Adults are sick almost a month out of the year

Did you know that the average adult will live with a cold for almost a month out of the year? According to Jane Sadler, MD out of Garland, Texas, “the average adult gets three colds per year, each lasting an average of nine days.”

Read’s guide to recovering from your cold here: “Stop a Cold in Its Tracks”

In the article, one doctor suggests drinking plenty of water and juice to alleviate congestion and sore throat. And to reduce inflammation in the throat (the reason we get scratchy voices) gargle some water with a half teaspoon of salt, offers another MD and editor.

Wondering whether you should gear-up and hit the gym to bust through that fever? The health experts say to keep your heart rate below 100, but “light exercise can . . . boost the immune system.”

Because the focus of this blog is on senior and elder issues, it would be a mistake to fail to mention that “of all age groups, individuals older than age 84 have the highest risk of dying from seasonal flu complications; those older than age 74 face the second highest risk.” WebMD, Flu in Older Adults.

From WebMD’s article, Flu in Older Adults, there are certain symptoms to be on the look-out for when assessing whether you have the flu. Among the common symptoms are fever, cough, chest discomfort, and headache. Symptoms that are experienced “sometimes” include a runny or stuffy nose, sore throat, fatigue, and general aches and pains.

Complications that can stem from the flu in senior adults can include pneumonia, worsening of an existing condition, and dehydration. Not only does the Center for Disease Control and Prevention recommend flu vaccinations, but also that older individuals consider the pneumococcal vaccine.

To find out where the flu shot is offered in your area, allows you to enter your zip code to find out. For information regarding who should get the vaccination, the CDC provides guidelines online, available here.

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Monday, January 17, 2011

Why did Obama reverse course on Medicare end-of-life counseling legislation?

Earlier this month, we reported on legislation taking effect in 2011 that would promote end-of-life counseling through Medicare reimbursements to doctors.  Now just days into the new year, the legislation appears to be dead in the water.  ElderLawAnswers has reported that the legislation is being withdrawn:
A provision in the House version of the health reform law would have allowed Medicare to pay for patient discussions with their doctors about how much or little care they want when facing a terminal illness, offering beneficiaries a chance to learn about things like advance directives, palliative care and hospice care.
According to Senior Journal, officials cited a lack of a public commenting period as the purpose behind the reversal.  On the other hand, some critics believe the Obama administration is simply avoiding a touchy subject (i.e. the discussion of “death panels") at a time where every move it makes regarding health reform may have the effect of propagating even more uncertainty.  

 “It remains legal for doctors to talk with patients during the annual Medicare visits [about end-of –life counseling]; it's just that they can't be specifically paid for that discussion,” explained Senior Journal in its recent article.

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Friday, January 14, 2011

New Medicare out-of-pocket home health care expenses for Seniors on the horizon?

The Medicare Payment Advisory Commission suggested Thursday one strategy to cut health care spending; the strategy would force Medicare recipients who receive home health care to pay an out-of-pocket cost.  The proposed cost is not yet certain, though sources suggest the amount may be around $150 for a series of visits.  Medicare home health care costs have steadily increased and have reached a point of about $20 billion per year, according to BusinessWeek.  Home health care can encompass home visits from care workers, nurses, therapists, and other health professionals. 

The strategy may come as unwelcome news for Medicare recipients who receive home health care.  Home health care has been free for patients, but amidst the pressures to control the federal deficit, the advisory panel is re-evaluating aspects of Medicare. 

If this suggestion becomes law, more than 3 million seniors will be affected. 
The rationale for paying for the home health care costs in the past has been based on the fact that it is cheaper to care for a person in their own home as opposed to in a hospital. 

For a description of various types of in-home care providers, describes the similarities and differences between medical professionals, home health aides, and home care aides in this useful article.  The AARP Seniors lobby is one group opposing the proposed strategy outlined above.

Wednesday, January 12, 2011

New tax laws should prompt families to review documents

For the next two years, the federal estate tax will be restored.  The Bush-era tax cuts included a sunset provision that temporarily eradicated the estate tax for 2010.  The tax is back, but the exemption has increased.

It was a surprise to many following this issue when President Obama not only extended the Bush-era tax cuts, but also increased the federal estate tax exemption to $5 million for individuals and $10 million for couples. 

According to a recent Mercury article, entitled, How Restoration of the Federal Estate Tax will Affect You,
some interesting implication are assessed: 
"The new law restores the federal estate tax for the next two years at a 35 percent tax rate, with estates up to $5 million ($10 million for couples) exempt from the tax. Furthermore, the new estate tax is retroactive to Jan. 1, 2010."
 The article further goes on to elaborate:
“This means that heirs of persons dying in 2010 can choose either to follow the 2010 rules (no federal estate tax at all, but with a limited step-up in the cost basis of inherited assets), or to follow the new law with a $5 million exemption and a step-up in cost basis.”
There has been some concern among attorneys as to whether the public will understand the need to properly plan a will or trust in light of these large exemptions.  On the contrary, the new tax laws that are in-flux should, if anything, prompt families to seek an updated assessment of their existing will or trust documents. 

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Tuesday, January 11, 2011

A leading cause of blindness is on the decline

"Age related macular degeneration" (AMD), a disease most prevalent in women over 60, is on the decline according to a study by the Archives of Ophthalmology.  The number of Americans who suffer from age-related macular degeneration is down by nearly a third.

Macular degeneration damages the middle of the retina, making it hard to see small details.  While scientists aren’t certain as to what causes the disease, they often refer to it as “Age Related Macular Degeneration” because people over 60 tend to develop the disease at a higher rate than other age groups. 

“"There have been a number of changes over time that might have a relationship to the findings in this paper. There's been less current smoking in the population. . . . [w]e need to examine these relationships and see if they explain this difference,” said Dr. Ronald Klein, author of the study. 

Risk factors for the disease, according to Google Health, are:

-         Heredity
-         Smoking
-         Diet (high fat)
-         Gender (female)
-         Race (Caucasian)
-         Health (obesity

“No treatment exists for dry macular degeneration. However, a combination of vitamins, antioxidants, and zinc may slow the progression of the disease,” (Source: Google Health)

For more reading on this news, read the CNN article here

Image: Michelle Meiklejohn /

Monday, January 10, 2011

Nursing home patients under 65 on the rise

Undoubtedly a challenging transition at any age, the shift to a nursing home may be even more difficult for the more than 200,000 people living in such facilities under the age of 65. Nursing homes must come to terms with this reality, because this number is on the rise, and the mental health of residents is just as important as their physical needs.

"Young people in nursing homes" are a growing trend, a statistic that has increased 22 percent in just the last eight years, according to AOL (based on a statistical analysis from the Centers for Medicare and Medicaid Services).

A recent AP article tells the story of a 26-year-old young man: A quadriplegic who feels lonely and out of place in his facility, even depressed at times.  “People die around you all the time. It starts to get really depressing because all you’re seeing is negative, negative, negative.”  Despite the fact that around 15% of nursing home residents are under 65, generational gaps make for unique challenges in addition to the already-difficult life circumstances that have led to placement in a nursing facility in the first place. “Nursing homes are not prepared in any way shape or form for young people,” said one social worker who spoke with AOL Health.

An Australian study entitled, Young people with brain injury in nursing homes: not the best option!, concludes that nursing homes are not suited for young people, especially young males. With more media attention and relevant studies, nursing homes that accommodate younger people ought to consider best efforts to instill requisite accommodations for their younger residents.  By taking into account not just the physical and rehabilitative needs, but the equally as important mental needs as well, the quality of life for young residents can be addressed.  

Friday, January 7, 2011

Can seniors delay nursing home reality through strength training?

Over the course of the last several decades, strength training has gone from obsolete to mainstream.  It has gained its due recognition and is now considered an essential element to a well-rounded fitness regimen, along with cardio and stretching.  But is lifting for everyone?

As lifting becomes more mainstream, some senior citizens wonder if it is a safe activity for them.  The short answer is yes.  If exercises are performed properly, lifting can be a safe and beneficial way to decrease the risk of Osteoporosis, a disease that literally means “porous bones." .

On this issue, WebMD cited a study and noted “postmenopausal women who participated in a strength training program for a year saw significant increases in their bone density in the spine and hips, areas affected most by osteoporosis in older women.”
Healing Moves Doctors cited by Natural News say a main reason elders need nursing home care is because of a decline in muscle mass: "Age-related declines in muscle and bone mass … can lead to frailty and fracture -- the primary reason older adults wind up in nursing homes."

For more on weight lifting for women in general, this CNN report discusses the importance of strength training as part of a woman’s exercise routine. 

What steps can you take to start implementing strength training into your daily routine? 

The Livestrong article entitled, Exercise Equipment for Seniors, explains why hydraulic-engineered equipment is best for seniors.  “Treadmills, ellipticals, stair climbers and press machines are all popular among seniors." Most gyms these days have a wide array of machinery.  Before you dive right in though, be sure to consult a personal trainer and your doctor. 

Image: graur razvan ionut /

Thursday, January 6, 2011

Walking speed may be used for predicting health, survival for elderly

Could walking speed analysis, also referred to as "gait speed," be a worthy tool for predicting remaining years of life? Inexpensive and simplistic, gait speed is being touted in a recent study that suggests there is a correlation between gait speed and longevity. The study recently appeared in the Journal of the American Medical Association (JAMA).

Some seniors are accustomed to routine analysis of their blood pressure, BMI, consumption habits, genetic factors, and more. If the study is correct, then some seniors may want to consider monitoring their own walking speed. After all, it’d be a much less intrusive, costly, or bothersome method…with immediate feedback!

The usefulness of assessing gait speed is intuitive in nature: “[L]ife expectancy based on age and sex alone provides limited information because survival is also influenced by health and functional abilities," noted the JAMA study.

The question that comes to mind is: can “health and functional abilities” be accurately measured by gait speed?

The University of Pittsburgh conducted the study “to assess the association of gait speed with survival in older adults and to determine the degree to which gait speed explains variability in survival after accounting for age and sex,” reported by Senior Journal. This was not just a run-of-the-mill study, as it included a combined pool of 9 smaller studies and a whopping 34,485 participants. “Gait speeds of 1.0 meter (3.3 feet)/second or higher consistently demonstrated survival that was longer than expected by age and sex alone."

The most conclusive data corresponded to older individuals, but the researchers are quick to point out that gait speed is connected to likelihood of survival at all ages and in both sexes.

The gist of the study is that gait speeds correlate to survival rates which were longer than otherwise predicted by analysis of merely age and sex as the sole factors.
Image: Idea go /

Wednesday, January 5, 2011

Three Keys To Planning For Long-Term Care

Baby-Boomers and Seniors 2011 Legal Report
I want to dispel two huge myths that routinely produce false security for senior citizens and their adult children: First, a revocable living trust does not protect your assets from nursing home costs or other long-term care expenses. Second, Medicaid is not just for the “poor.”

“Is it time to start thinking about my parent’s long-term care options?”

This question alone may be the most difficult decisions that baby-boomer’s are faced with in 2011. Baby-boomers have been referred to as “the Sandwich Generation” because they often must take on health-related responsibilities for both their own children and their aging parents. Planning for the future should be the #1 New Year’s resolution for baby-boomers and senior citizens.

Key #1: Plan in Advance
The sooner that you or your parents explore and understand the benefits of senior-focused asset protection planning, the better equipped everyone involved will be towards reaching the goal of maintaining your parents’ highest quality of life.
Proper planning can ease anxieties for baby-boomers by removing stressful decision-making and feelings of guilt. Likewise, a senior-focused asset protection plan can ensure that a senior citizen doesn’t feel as if he or she is a “burden” on thefamily.

Key #2: Get on the Same Page
Bringing up the need for long-term planning to an aging parent can be difficult.  But if you understand that the primary goal of this type of planning is maintaining your parents’ highest quality of life for as long as possible, you should be able to effectively communicate that proper advanced planning is in your parents’ best interests.
Just as good parents want what is best for their children, adult children should likewise seek what is best for their parents. The protection, peace of mind, and elimination of uncertainty brought about by proper planning at an early stage is always in the best interests of senior citizens.

Key #3: Select the Right Attorney
Medicaid eligibility rules and veterans’ benefits rules are the most complex areas of law in existence, and it is essential that the attorney your parents work with for their long-term planning has a comprehensive understanding of these laws. The easy way to ensure that an elder law attorney has the requisite knowledge of these laws is to look for the Certified Elder Law Attorney (CELA) designation, which is approved by the American Bar Association.  There are over 5,000 attorneys in the US who practice elder law, but less than 500 of these have passed the full-day exam required to become a CELA.

Tuesday, January 4, 2011

Dolphins and dogs may help soldiers with PTSD decrease heart disease risk

According to, Veterans who struggle with post-traumatic stress disorder (PTSD) may be at an increased risk for heart disease and early death.

“[PTSD] is a disorder that occurs after a life-threatening event, such as personal assault, natural disaster, or military combat…affects can be debilitating with symptoms ranging from severe nightmares and flashbacks to insomnia and increasing social isolation,” explains the PTSD Support reference section on

But perhaps a common misconception  is that veterans who suffer from PTSD only experience mental anguish, anxiety, and depression.  “The disorder may damage blood vessels and increase the risk of dying early,” however, reported after the latest meeting of the American Heart Association.

Just as alarming as the flashbacks and nightmares may be the reported increased risk of heart disease.  “If a vet has PTSD, they need to be under surveillance for cardiovascular disease as they age,” notes Joseph Boscarino in the recent CNN article, an expert on the association between stress and physical manifestations of illness.  According to research, veterans with PTSD tend to have more calcium build-up in their arteries, which can lead to atherosclerosis, a condition of the arteries that has been connected to heart attacks.

The study yielded surprising results.  Of the nearly 300,000 veterans studied, those with PTSD were more than twice as likely to die during the course of the 10-year study.  Specifically, just fewer than 30% of the PTSD diagnosed veterans died during the study, whereas just 8% of the non-PTSD veterans passed during that same time frame.

Non-conventional treatments have been gaining popularity: Dolphins and puppy’s have been used to help soldiers cope with stress.  Check out the CNN video report below entitled, Dolphins help veterans overcome PTSD stress. Such unconventional methods may be successful because stress is known to be a contributing factor to heart disease.

Dolphins are great, but we can’t skip this story about man’s best friend, entitled, Puppies helping veterans.

For an explanation on the treatment options for PTSD, that information is available to vets via the PTSD guides located on the United States Department of Veterans Affairs website.  According to them, “Cognitive behavioral therapy” is a suggested treatment option.

What can veterans do to combat the physical risks of PTSD?  Since heart disease has been indirectly linked to PTSD, vets should understand the risk factors  that can be controlled.  The American Heart Association suggests the following for limiting heart attack and stroke risks:

-         Avoid tobacco
-         Exercise
-         Eat complex carbohydrates, avoid trans fat
-         Maintain a healthy BMI – (check your BMI here, courtesy of the Department of Health and Human Services)
-         Do not drink alcohol excessively

VA Benefits Eligibility: explains, “[e]ligibility for most VA benefits is based on discharge from active military service under other than dishonorable conditions.”  Whether a vet is entitled to benefits is something he or should may consider speaking to a lawyer who specializes Veteran Benefits filing.  For more information in the meantime, you can view the "Veteran's Benefits FAQ" provided by   

Image: Bill Longshaw /

Monday, January 3, 2011

Obama signs bill to benefit 9/11 survivors and first responders; but beware of other settlements

President Obama has signed a bill that will provide benefits for survivors of the September 11th, 2001 terror attacks, including Ground Zero first responders.

In August 2009, the Journal of Occupational & Environmental Medicine published an article entitled,  Multiple Myeloma in World Trade Center Responders: A Case Series.  The study concluded by noting, "[we observed] an unusual number of [Multiple Myleoma] cases in WTC responders under 45 years. This finding underscores the importance of maintaining surveillance for cancer and other emerging diseases in this highly exposed population."

"I believe this is a critical step for those who continue to bear the physical scars of [the 9/11 attacks]" said Obama.  The Act – The James Zadroga 9/11 Health and Compensation Act – is named after a New York police officer who passed away as a result of a disease he contracted from Ground Zero.

Congress passed the Act after some expected bargaining on cost. The final version of the Act will come with a $4.2 to $4.3 billion price tag.  FOX reported that this money will be raised by a fee charged to foreign companies that receive certain contracts from the U.S. government.   

The Bill took a long time…some workers have waited nine years for this assistance.  But there is a small catch to this measure.  The New York Post reports that thousands could potentially lose the benefits from the Act if they choose to become involved in a settlement between the Port Authority and private businesses that were involved with cleanup.  This choice stems from one of the requirements to receive benefits under the Act; recipients can’t accept payments from other sources.

Image: thephotoholic /