Ice Bucket Challenge

Blog post by Liz Fischer, August 2014

It’s the current rage for a good cause, it’s a very creative way of raising money for ALS–the Ice Bucket Challenge. One can hardly look at Facebook without seeing another person dumping a bucket ice Bucket Challengeof ice water over their heads and challenging at least two others to do the same or donate $100 to ALS.  Between July 29 and Aug. 19, the association received $22.9 million in donations, according to a press release. Over the same period last year, it raised $1.9 million. That’s an increase of more than 1100%.

The Hillsboro Home Instead Senior Care joined in the fun in honor of our clients who have ALS and challenged the Home Instead Senior Care Tigard, East Portland and Bend to take the plunge too.

You can watch our video on YouTube.

When parents can’t manage their money

Blog post by Liz Fischer, August, 2014

A good friend who is a Financial Advisor emailed me this article he saw on CNBC by Keeley Holland. I found it very interesting and related a lot to Home Instead Senior Care’s 40/70 materials. Have you had the talk with your parents? If not contact our office to get some very good materials that will lead you step by step through the important questions you should discuss now or attend our 40/70 seminar at Jennings McCall retirement community October 11 from 10-12. Please call our office at 503-530-1527 for more information.

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caregivercouple

Maybe your mother is suddenly having trouble balancing her checkbook, or your father can’t seem to pay his bills on time. Perhaps a parent has called you to brag about a hot new stock someone’s nephew encouraged them to buy.

There comes a time in many people’s lives when managing their money is out of their reach. If it’s happening in your family, experts say you need to act—now.

The big question in many families is how.

First, recognize that this is a surprisingly common situation. One study by researchers at the Federal Reserve, Harvard, New York University and the University of Singapore, found that financial decision-making abilities peak around age 53. It goes downhill from there. The study also pointed out that about half of all adults between the ages of 80 and 89 either suffer from dementia or have a diagnosis of cognitive impairment without dementia.

Some elderly people suffer from physical ailments that impede either their cognitive abilities or their physical ability to manage their finances. Connie Stone’s grandmother gradually lost her eyesight, and that naturally made it much harder for her to keep a handle on her checkbook.

Whatever the cause, when elderly people lose a handle on their finances, the risk of financial missteps – or worse – increases rapidly. A study by MetLife found that losses by victims of elder financial abuse come to at least $2.6 billion every year.

“The best thing would be in advance of all this to have a conversation with the parents,” said Stone, co–founder of Stepping Stone Financial. “It can make a big difference down the line.”

There are several typical warning signs when people start to lose the ability to manage their money, experts say. And it pays to be watchful: Parents aren’t likely to recognize their own declining abilities.

In a study of financial knowledge by FINRA, the Financial Industry Regulatory Authority, people who reported being more confident in their financial decision making than they were five years ago had slightly lower cognition scores than those who said their confidence was unchanged. In the Fed’s Older Adult Survey, 96 percent of respondents age 70 or older said they were just as confident or more confident in their decision-making than five years earlier.

If an elderly person suddenly changes investment strategies—if a normally cautious investor suddenly gets excited about a new, high-risk security, for example—that is often a red flag.

Getting behind on bills is another potential warning sign, especially if it’s someone who has been very organized in the past. Calls from creditors may be a signal that someone can no longer keep track of bills or is facing some other financial challenge worth surfacing.

If someone has always been careful about filing and record-keeping and now the papers are piling up, that may indicate a problem. The same goes for a sudden rash of expensive purchases that seem out of character.

Watch out as well for an onslaught of charitable solicitations, experts say, or a bunch of expensive purchases.

Barry Glassman, president of Glassman Wealth Services, said he has brought in a client’s son or daughter (with the client’s permission) on at least two occasions when he became concerned about slipping cognition and questionable transactions. “As soon as the son stepped in we were able to see that there was a financial predator.”

Often, the best way to approach the issue of personal financial management with an elderly parent is indirectly, experts say.

“You have to get them in to see third-party objective people,” Yankee said. “Have them go in and talk about the importance of having it so that they are being taken care of.”

That third party could be a respected family friend, an accountant, a lawyer or a financial advisor. Yankee actually makes it a practice to create that third-party option for clients, having them sign a form identifying people Yankee and his colleagues can contact if they have concerns about the client’s health or well-being. He started with clients turning 80, but has now signed the form with clients as young as 62.

Janet Stanzak, founder of Financial Empowerment, a financial advisory firm, suggests an open-ended question to get a discussion going. “Find a track where we are asking questions that open the door for them to start the conversation,” she said. She suggests questions like, “I noticed you opened a new account. How is that working for you?”

Another option is to try and make a money management task a joint effort. Suggest that you balance your parent’s checkbook while they find a place for the two of you to go out to lunch, for example. That will also give you a glimpse of your parent’s finances.

However you approach this issue, remember that for the aging parent it is a scary one. Giving up control of one’s money can be even more painful and challenging than handing over the car keys. It’s essential to handle the conversation in a way that maintains everyone’s dignity.

But even though the discussion may be especially fraught, it’s incredibly important.

Yankee said he intends to have it as soon as it’s practical in his own family.

“I’m in my 40s. I’m obviously not going to have that conversation with my kids yet. But when my kids are of an age to be responsible, where I might make them my health-care proxy, in their late 20s or so, I would have that conversation,” he said. “You’re never as sharp again as you are today.”

Four Vaccines Urged for Seniors

Blog post by Mike Brunt, August 2014

I’ve been there as my boys get their vaccinations and always feel for them as the sight of the needle scares them more than the actual vaccination. I look forward to the time when they’re all caught up and only need booster shots occasionally. Reading this article in our Certified Senior Advisor newsletter reminded me that children are not the only ones that need to have vaccinations, it’s very important for seniors too!

In the 1920s, the respiratory disease diphtheria was one of parents’ biggest fears for their vaccinationchildren. In the United States, an estimated 100,000-200,000 cases of diphtheria per year caused 13,000-15,000 deaths, mainly children, in that decade (Wikipedia). Today, diphtheria vaccines have largely eradicated the disease from the United States. In fact, if diphtheria is remembered at all today, it’s because of the celebrated story of a relay by sled dogs and their mushers to deliver diphtheria antitoxin 674 miles away to Nome, Alaska, to prevent a predicted epidemic. The initial relay in 1925 became today’s Iditarod Trail Sled Dog Race.

Don’t Get Sick While AbroadIn addition to the four recommended vaccinations, international travelers may need to get additional vaccinations for diseases specific to the country you are visiting. The Centers for Disease Control provides information about which vaccines tourists need—by country as well as type of travel (cruise ship, mission/disaster relief, etc.).

For example, the CDC recommends Bahamas-bound cruise-ship passengers receive routine vaccines, such as measles-mumps-rubella, Tdap, varicella (chickenpox), polio and your yearly flu shot, as well as vaccines pertinent to the Bahamas: hepatitis A and typhoid to prevent diseases procured from eating and drinking contaminated food or water.

The CDC’s Travel Health Notices list warnings for various countries and their danger level: for example: Ebola in Guinea, posted March 26, 2014; measles in the Philippines, March 18, 2014; various health issues for the World Cup in Brazil, March 11, 2014; cholera in Cuba, February 27, 2014.

 

Today, vaccines have curbed the development of many diseases that were once considered fatal, especially in older adults. While some vaccines have side effects, health experts say that the benefits typically outweigh the possible complications of certain illnesses in seniors. Except for people with certain health problems, such as cardiovascular disease, lung disease, diabetes, kidney problems or a condition that weakens the immune system, getting vaccinated is a safer choice than risking illness to obtain immune protection. Consult with your healthcare provider to discuss the advantages and disadvantages of each vaccine for you.

Vaccines work by exposing you to dead or weakened disease-causing microorganisms, which causes your body’s immune system to produce antibodies that fight the microorganisms, helping to make you immune to a specific disease. Most vaccines are given through a simple injection, usually in your arm, although some are administered by mouth or nasal spray.

Experts recommend four vaccinations for seniors: flu, pneumonia, shingles and a combined tetanus-diptheria-pertussis.

Flu

The most prevalent vaccine is for influenza, commonly called the flu, a contagious illness caused by viruses. Older people are at the highest risk of developing serious flu complications that require hospitalization; in some cases, the flu can be fatal. Ninety percent of flu-related deaths and more than half of flu-related hospitalizations occur in people age 65 and older. As you age, your immune system weakens, which makes you more susceptible to the flu.

Health experts recommend that those 50 or older should receive one dose of influenza vaccine every year, preferably in October or November, before the winter flu season starts. Flu season usually peaks in January or February, but it can occur as late as May. Early immunization is most effective, but it is not too late to get the vaccine in December, January or later. Flu vaccines are needed every year because immunity is short-lived and vaccine manufacturers make updates every year to combat current strains of the virus.

If you get the flu vaccine, you are 60 percent less likely to need treatment for the flu by a healthcare provider. Vaccination may also reduce illness, antibiotic use, time lost from work, hospitalizations and deaths.

Although the flu vaccine is meant to protect you for one flu season, evidence supports that immunity declines more quickly in older people. Therefore, another flu vaccine option is available—one that contains a higher dose of antigen, the part of the vaccine that prompts the body to make an antibody. Designed specifically for people 65 and older, this alternative is intended to create a stronger immune response.

For those worried about the possible dangers, seasonal flu vaccines have a good safety track record (vaccines.gov). The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) closely monitor their safety. As with any drug, mild side effects, such as soreness, headaches and fever, are common. Less common and more serious are severe reactions such as difficulty breathing, hives or facial swelling; for these, seek medical attention immediately.

Shingles

Shingles is an extremely painful and contagious blistering rash, which is activated by the varicella zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays in the body in a dormant state but can reactivate years later, for reasons not fully known. At least 1 million people a year in the United States get shingles.

The zoster vaccine, which scientists developed in 2006, is not guaranteed to prevent shingles, but it can decrease your risk by about 50 percent, or at least minimize its severity. Vaccines.gov recommends that anyone 60 years of age or older get the shingles vaccine, regardless of whether they recall having had chickenpox or not. Studies show that more than 99 percent of Americans ages 40 and older have had chickenpox, even if they don’t remember. Shingles is far more common in people 50 years of age and older than in younger people, and increasing age can result in more severe effects.

A shingles rash usually appears on one side of the face or body and lasts from two to four weeks. Its main symptom is pain, which can be severe. Other symptoms include fever, headache, chills and upset stomach. Very rarely, a shingles infection can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis) or death.

For approximately 20 percent of people, severe pain, called post-herpetic neuralgia (PHN), can continue long after the shingles rash clears up. Its repercussions are more widespread in seniors, affecting up to half of untreated people who are 60 years of age and older. Although the pain from PHN may be debilitating, it usually resolves in a few weeks or months.

While any vaccine can carry risks, no serious problems have been identified with the shingles vaccine. Mild reactions can include headache and redness, soreness, swelling or itching at the site of the injection.

Pneumonia

Infection from pneumococcal bacteria is one of the leading causes of death in the United States from a vaccine-preventable disease. Seniors, especially, are susceptible to pneumonia, which is responsible each year for 60,000 deaths among those over 65. The CDC recommends that people age 65 and older receive a one-time dose of pneumococcal vaccine; those who were vaccinated more than five years ago and were younger than 65 at the time should get a one-time repeat vaccination.

Pneumococcal infections, which include pneumonia, blood infections (bacteremia), brain infections (pneumoccocal meningitis) and middle-ear infections, are spread through respiratory secretions, like coughing and sneezing. The disease comes from a type of bacteria called Streptococcus pneumoniae (pneumococcus) found in many people’s noses and throats.

Pneumonia symptoms include fever, cough, shortness of breath and chest pain. In addition to redness, pain and swelling at the injection site, vaccine side effects may include mild fever, fatigue, headache, chills or muscle pain.

Tetanus-Diphtheria-Pertussis

Tetanus, diphtheria and pertussis, all caused by bacteria, can be very serious, for adolescents as well as adults. Before vaccines, the United States saw as many as 200,000 diptheria and pertussis cases annually and hundreds of tetanus infections. Since vaccination began, tetanus and diphtheria have dropped by about 99 percent and pertussis by roughly 80 percent (CDC). The Tdap vaccination covers all three diseases.

The tetanus bacteria enters the body when cuts, scratches or wounds come into contact with contaminated soil, dust or manure. Tetanus, also known as lockjaw, affects the nervous system, causing painful muscle tightening and stiffness, usually all over the body. In some cases, you can’t open your mouth, swallow or even breathe. It can be deadly, particularly for older people, killing approximately one out of five people who are infected. Because the immunity from past tetanus shots eventually fades, ask your doctor if you are due for another vaccination.

Diphtheria is a respiratory bacterial infection that spreads from person to person through coughing or sneezing. If left untreated, it can cause airway obstruction, coma and death. Although both tetanus and diphtheria are rare in the United States today, people who become infected often have severe complications.

Pertussis, also known as whooping cough, produces severe coughing spells, which can cause difficulty breathing, vomiting and disturbed sleep. The illness can also lead to weight loss, incontinence and rib fractures from coughing. Up to 2 percent of adolescents and 5 percent of adults with pertussis are hospitalized or have complications, which could include pneumonia or death. Seniors are increasingly getting pertussis, possibly due to dwindling immunity.

You should get the Tdap vaccination as a one-time booster, regardless of when you received your last tetanus-diphtheria vaccine. Side effects include redness or swelling at the injection site, headache, fatigue, fever, nausea, vomiting, diarrhea and stomach ache.

Sources

Centers for Disease Control and Prevention
“Senior Immunizations,” 
John Muir Health
Vaccines.gov
“Vaccines for Seniors,” 
Everyday Health

Dental Health and Aging: The Connection to Overall Health

Blog post by Mike Brunt, August 2014
We all know to do regular checkups with our doctors, how many of us plan annual dental exams too? I found this article from our Certified Senior Advisor newsletter on dental health very informative and am glad I’ve been seeing my dentist regularly. Have you?
Researchers are discovering that a healthy mouth is associated with more than just looking and feeling good – it can have a significant impact on our overall health. 
A hundred years ago people wouldn’t have expected to live well into their seventies, eighties, and nineties, much less with most of their natural teeth intact. Today, however, people are living longer and thanks to advances in dentistry, they are also retaining more teeth. Researchers are discovering that a healthy mouth is associated with more than just looking or feeling good—it can have a significant impact on our overall health. Poor dental hygiene can cause mouth pain, swelling, and fever, and it has even been linked to malnutrition and dehydration in older adults. Perhaps most surprising is the link between oral health and serious medical conditions such as heart disease. As we age, dental issues become more common, and make routine dental care even more important.
Mouth Issues Increase as We Age 
People are reaching old age with more of their natural teeth intact than those of previous generations. This is due to advancements in dentistry including anesthesia, public health campaigns, and a change in the cultural valuation of a healthy mouth (Kiyak and Reichmuth 2005). Despite these advances, older adults are still more at risk for periodontal (gum) disease, tooth loss, the use of dentures, and xerostomia—dry mouth (American Dental Association 2013). Among adults age sixty-five and over, about 65 percent have moderate to severe periodontal disease, 43 percent have lost six or more teeth, and a little over 18 percent have lost all of their teeth (Centers for Disease Control NOHSS; Eke et al. 2012). Seniors are also at a higher risk of developing xerostomia, in part due to their higher use of prescriptions drugs, which can cause the condition (Ettinger 1992). Dry mouth is associated with sore throat, hoarse voice, trouble swallowing, and even tooth loss.
The risk of developing diabetes, Alzheimer’s disease, or dementia increases with age and those with these conditions tend to have poorer oral health. Diabetics— and especially those who are not properly managing the disease—are more likely to have periodontal disease (Soskolne and Klinger 2001). Alzheimer’s disease or dementia can put individuals at a greater risk of mouth issues if the decline in mental functioning inhibits or prevents proper oral hygiene or access to dental care.
The Effects of Oral Health on Other Medical Conditions 
Heart disease is the leading cause of death for persons aged sixty-five and over (Centers for Disease Control 2013). Researchers have found links between periodontal disease, heart disease, and stroke. The number one cause of heart attack and stroke is atherosclerosis, or hardening of the arteries due to plaque buildup. The plaque that builds up in the arteries is different than the plaque that builds up on teeth, so researchers were puzzled when they found the association between heart attack, stroke, and the frequency of dental cleanings. The current hypothesis is that the inflammation caused by gum disease bacteria leads to inflammation in other parts of the body, including the blood cells in the arteries, thus leading to an increased risk of a blood clot (Beck et al. 2005; Pussinen et al. 2004). Researchers are also investigating the proteins produced by gum disease as a possible cause of artery hardening. These proteins might eventually end up in the bloodstream and latch onto existing plaques, making them even larger (Paoletti et al. 2004; Scannapieco et al. 2003).
Older adults who are in hospitals or nursing homes are at risk of developing pneumonia. Poor oral health has been linked to respiratory infections including pneumonia. The mouth harbors billions of bacteria, and when pneumonia-causing bacteria like Staphylococcus aureus are left unchecked, they can lead to infection. Proper dental care has been shown to decrease the number of organisms in the mouth that cause pneumonia (Adachi et al. 2007). Diabetes is a risk factor for developing mouth problems because the disease makes it more difficult to fight infections like the ones that cause periodontal disease. This relationship is fairly well established. However, researchers are beginning to explore the relationship in the opposite direction (American Diabetes Association 2013). For example, studies are examining the link between gum disease and the onset or aggravation of diabetes and the relationship between gum disease and hyperglycemia (high blood sugar). Some small, sample-size studies have found insulin resistance in those individuals with periodontal disease (Kuo et al. 2008).
Barriers to Oral Care
The American Dental Association (ADA) recommends the following to maintain a healthy mouth:
  • proper nutrition
  • brushing twice a day with fluoride toothpaste
  • flossing at least once a day
  • regularly replacing toothbrushes
  • regular dentist visits
However, there are some significant barriers that seniors face in adhering to the ADA’s recommendations.
Perhaps the most important barrier is the acceptance of poor oral health as a normal product of aging. Studies have demonstrated that despite having mouth issues (and dental insurance in many cases), many older people will not seek dental care because of a general acceptance of their condition as a fact of life (Kiyak 1987; Abrams, Ayers, and Lloyd 1992).
Paying for routine dental exams, or for more extensive dental services like root canals or dentures, can be difficult for seniors. Medicare does not cover dental care, except under very rare circumstances. Medicaid dental coverage varies by state with some states providing no coverage at all while most others provide only emergency dental care. According to Oral Health America’s “State of Decay” report (2013), only 30 percent of older adults have dental insurance.
Living in a long-term care setting can make it difficult for older adults to obtain needed dental care. Although licensed nursing homes are federally required to provide access to dental care, many seniors in institutionalized settings are not receiving it. Assisted living facilities may be required to provide dental care by the state in which they operate. Staff in long-term care settings has little to no oral health training and few dentists are willing to provide care in these situations. Staff are usually focused on health-related tasks other than dental care.
When nursing staff does provide dental care, it is often not sufficient. For example, the use of lemon glycerin swabs in place of brushing and flossing is a common practice despite the fact that they are so acidic they can destroy tooth enamel. Another popular replacement for brushing is foam swabs, but these, too, are not good replacements because they don’t control plaque (Coleman 2002). Another issue in long-term care settings includes declines in the ability to perform activities of daily living. For example, declines in mental functioning might make it difficult to remember to brush and floss, or to physically complete the tasks without assistance. Those with dementia might become confused, and in turn become combative when staff try to assist them in oral care.
Oral Health Improvement
How can advisors help seniors improve their oral health? The first is to promote the idea that older age does not have to equal poor dental health. Adhering to a regular mouth care routine including regular dentist visits can help to maintain oral health, regardless of age. For those who are diabetic, maintaining proper insulin levels is key to avoiding dental complications. Another strategy would be to encourage seniors to buy dental insurance since Medicare and Medicaid won’t pay for it. This website can be used to locate dentists in your state, financing options, transportation and more:
http://www.toothwisdom.org/care.Finally, the long-term care industry should adopt policies and procedures that will promote clients’ oral health. Certified nursing assistants should receive additional training on how to provide routine dental care and be able to spot oral health problems. Dental care should be included in staff members’ daily routine. For residents with dementia, caregivers can ease the confusion and resistance to routine care by holding the toothbrush with the resident, placing their hand over the resident’s hand, distracting the resident by playing music or watching television, and so on (see Chalmers, 2000 for more techniques).

Oral health can have a profound effect not just on how we feel about ourselves, but our general health too. People are now reaching older ages with better mouth health than ever before, a trend that will hopefully continue. • Lori Moore, Ph.D.

Lori Moore, Ph.D., is a Research Associate at Florida State University’s Claude Pepper Center. Her research interests include healthy aging and long-term care settings. She has published in peer-reviewed journals and presented her research at several academic conferences. She can be reached at ldmoore@fsu.edu. 

Dental Health and Aging: The Connection to Overall Health was recently published in the Spring 2014 edition of the CSA Journal.

Bone Up on Facts about Osteoporosis

Blog post by Mike Brunt, August 2014

I saw this article on Osteoporosis in our Certified Senior Advisor newsletter and thought you would find it interesting too.  Osteoporosis can lead to debilitating fractures, chronic pain and the inability to perform everyday activities, including walking, maintaining your household and even dressing and bathing. Fortunately, with the right diet, exercise, supplements or medication, you can either prevent osteoporosis or lessen the effects

Osteoporosis is more than deteriorating and weak bones. It can lead to debilitating fractures, chronic pain and the inability to perform everyday actions, including walking, maintaining your household and even dressing and bathing. Those who suffer from it can testify:

“I have had three vertabrae fractures in the last two years. I’m still in considerable pain and Bonescannot do the simplest of tasks. Vacuuming, window cleaning or anything to do with lifting, even a casserole dish, brings on severe pain. I went a whole year in severe pain, could not do much, struggled at work. . . . I could not open heavy doors, open filing cabinets, open car doors, etc., but tried to continue working. I’m part time, so on days off, I just collapsed and rested. It totally changes your life, and I don’t think people really understand it. . . . I’m only 58 but feel like a very very old lady” (from the community forums of theNational Osteoporosis Foundation).

Supplementing with Calcium and Vitamin DWomen age 51 and older and men age 71 and older require 1,200 mg daily of calcium, which includes calcium from food and supplements (National Osteoporosis Foundation). To determine how much calcium is in a particular food, check the food label’s nutrition facts panel for the percentage of daily value (DV) of calcium. This amount is based on 1,000 mg of calcium per day. For example, 30 percent DV of calcium equals 300 mg.Because your body can only absorb 500 mg of calcium at a time, supplements should be taken in divided doses during the day. Work with your doctor to make sure you get enough calcium, but not too much.Not only does vitamin D help protect your bones, but your body requires it to absorb calcium. Vitamin D is now being recognized as a key player in osteoporosis, so make sure you’re getting enough—either through vitamin D2 (ergocalciferol) or vitamin D3 (cholecalciferol). Women and men over 50 need 800 to 1,000 IU daily. Although we absorb vitamin D through sunlight or by ingesting foods such as mackerel, these sources are likely not enough. For example, people everywhere are getting much less vitamin D through sunlight because we increasingly use sunscreen, and people living in northern climates don’t have access to sufficient sunlight, especially in the winter. 

Osteoporosis causes bones to gradually thin and weaken, leaving them susceptible to fractures. In the United States, the condition causes about 2 million fractures each year (figures from the National Osteoporosis Foundation). Although the condition affects all bones, those in the spine, hip and wrist are most vulnerable. Many osteoporosis fractures—about 300,000 every year—are hip fractures, which, in the elderly, can be particularly dangerous because immobility during the healing process can lead to blood clots or pneumonia, both of which can be fatal.

In addition, 1 in 4 hip-fracture patients over 50 die within a year after the fracture, often from related complications such as a pulmonary embolism or pneumonia. Plus, 1 in 5 of those who could care for themselves prior to the broken bone requires nursing home care afterward. Only one-third of patients with hip fractures return to their previous levels of functioning.

Mostly Women Affected

Women are more susceptible than men. Of the estimated 10 million Americans with osteoporosis, about 8 million are women. Approximately 1 in 2 women over age 50 will break a bone because of osteoporosis. A woman’s risk of breaking a hip is equal to her combined risk of breast, uterine and ovarian cancer.

Women are more vulnerable to osteoporosis because they have smaller, thinner bones than men and because the estrogen hormone decreases sharply when women reach menopause, which can cause bone loss.

Women who are at higher risk for developing bone loss are thin or have a small frame, smoke, drink more than moderately, live a sedentary lifestyle, have a family history of hip fracture, have had their ovaries removed and are Caucasian or Asian.

Although women are more susceptible, men are not immune to the condition. Up to 1 in 4 men over age 50 will break a bone due to osteoporosis. In fact, men older than 50 are more likely to break a bone due to osteoporosis than they are to get prostate cancer. Each year, roughly 80,000 men will break a hip. As a result of problems related to the break, men are more likely than women to die within a year after breaking a hip.

Many of the factors that put women at risk for osteoporosis apply to men, as well as low testosterone levels.

Causes of Osteoporosis

Although the exact cause of osteoporosis is unknown, the process starts early in life when bone is continuously replaced. Bone loss—where bone breaks down faster than it builds up—usually begins somewhere in your mid-30s. When bones begin to lose calcium—the mineral that makes them hard—faster than they can replace it, the bones begin to thin.

For women, bone density loss speeds up during the first five to seven years after menopause, caused by a sharp decline in the body’s production of estrogen, which scientists believe helps keep calcium in the bones.

The good news is that the right diet, exercise, supplements or medication can help prevent osteoporosis or lessen its effects. If you haven’t yet been diagnosed with osteoporosis, have your doctor order a bone density test, which shows the amount of bone in the hip, spine or other bones. Doctors routinely recommend this test for men age 50 and older and postmenopausal women.

Eating the Right Foods

The two most important nutrients for bone health are calcium and vitamin D (National Osteoporosis Foundation). Each day, we lose calcium through our skin, nails, hair, sweat, urine and feces, but our bodies cannot produce new calcium. When we don’t get enough calcium for our body’s needs, our bones must provide it, leading to low bone density and even broken bones.

Experts recommend a well-balanced diet with plenty of dairy, fish, fruits and vegetables. The foods with the most calcium are:

  • Dairy products such as low-fat and non-fat milk, yogurt and cheese
  • Canned sardines and salmon (with bones)
  • Green vegetables, including collard greens, turnip greens, kale, okra, Chinese cabbage, dandelion greens, mustard greens and broccoli

For seniors who are lactose-intolerant, many plant-based whole foods contain calcium. They include tofu, tapioca, collard greens figs, white beans, spinach, almonds and sesame seeds

To maintain healthy bones, experts recommend limiting the intake of sodium and alcohol, or avoiding them all together.

The best foods for vitamin D are fatty fish such as salmon, mackerel, tuna and sardines. Calcium and vitamin D are sometimes added to juices, breakfast foods, soy milk, rice milk, cereals, snacks and breads. If you’re not getting enough calcium and vitamin D from food, you can take supplements. In particular, it’s difficult to get enough vitamin D without using supplements (see sidebar).

Exercise for Bone Health

Exercise not only prevents osteoporosis by strengthening bones but can also help maintain bone mass if you already have osteoporosis. Through exercise, you build and maintain your bones’ thickness (bone mass density). Before beginning any exercise program, talk to your doctor. This is especially important if you know you have bone loss or osteoporosis.

WebMD recommends three types of exercise for osteoporosis:

Weight-bearing:
Exercises that support your body’s weight include walking, hiking, dancing and stair climbing. Walking as little as three to five miles a week can help build bone health.

Resistance: Working against the weight of another object strengthens muscle and builds bone. This type of exercise includes free weights or weight machines, resistance tubing and water exercises. For best results, do resistance exercises two or three times a week. You can make the exercise more challenging by gradually adding weight or repetitions. Work different muscle groups, including arms, chest, shoulders, legs, stomach, and back, but allow for recovery by avoiding resistance training on the same muscle group two days in a row.

Flexibility: Having flexible joints helps prevent injury. To flex joints and elongate muscles, stretch regularly or do t’ai chi or yoga.

Drug Therapies

Although estrogen was once considered the standard osteoporosis treatment for postmenopausal women, new options are now available for men and women who are wary of estrogen’s risks, such as breast cancer. Most osteoporosis medications slow down the rate at which the body reabsorbs bone, and one drug can help the body make new bone (from University of Maryland Medical Center). Your doctor can advise you about which of the following medications may be right for you.

  • Bisphosphonates, including alendronate (Fosamax), ibandronate (Boniva), risedronate (Actonel) and zoledronic acid (Reclast), are a class of drugs that has been shown to boost bone density, slow or stop bone loss and reduce the risk of fractures. Patients must take medications first thing in the morning before eating and stand upright for at least 30 minutes. The exception is Reclast, which patients receive intravenously (IV) once a year.
  • Raloxifene (Evista) has estrogen-like effects on bone (prevents bone loss) but does not increase the risk for breast cancer.
  • Calcitonin (Miacalcin) does not improve bone density as well as the bisphosphonates do, but it does slow bone loss, reduce spinal fractures and ease pain associated with bone fractures. This option is an alternative for women who cannot take estrogen or bisphosphonates.
  • Parathyroid hormone (Forteo), an injectable medication, can increase bone production when used in low doses.

Sources
“Learn about Osteoporosis,” National Osteoporosis Foundation
“Osteoporosis,” University of Maryland Medical Center
“Understanding Osteoporosis — the Basics,” WebMd

Heat Takes a Toll on Seniors

Experts Encourage Families to Keep a Close Eye on Older Loved Ones During Heat Wave

Nobody likes extreme and prolonged heat, but such conditions can be very dangerous and heatpotentially deadly for seniors.

According to the National Oceanic and Atmospheric Administration (NOAA), heat is the number one weather-related killer in the United States. On average, excessive heat claims more lives each year than tornadoes, hurricanes, floods and lightning combined (http://www.noaawatch.gov/themes/heat.php).

“The elderly are often the most vulnerable to severe heat,” said Mike Brunt, local owner of Home Instead Senior Care® franchise office serving Hillsboro, Forest Grove, Beaverton and Tigard. “Their bodies do not adjust as well as young people to sudden changes in temperature, they are more likely to have a chronic medical condition that changes normal body responses to heat and they are often on a prescription medicine that impairs the body’s ability to regulate its temperature or that inhibits perspiration,” he continued.

Following are tips from the local Home Instead Senior Careoffice, to help seniors combat the heat:

  • Keep a glass of water in every room to quickly and easily access fluids. Drink plenty of fluids, even if you don’t feel thirsty.
  • Go through the closet and remove all heavy materials, long sleeves and dark colors. Instead look for short sleeves, lightweight rayons or cottons, and light-colored clothing that reflect the heat.
  • Stay out of the sun during the hottest times of the day. Sunburn makes the job of heat dissipation that much more difficult.
  • Save household chores, particularly washing and drying clothes and operating the dishwasher, for evenings when the weather is cooler.
  • Relax indoors during high heat times – between 3 and 5 p.m. in the afternoon.
  • Keep shades down and blinds pulled during the heat of the day.
  • Keep the house tightly closed, so it is more energy efficient.
  • Take cool showers or baths to cool down.
  • Eat lots of fruits and vegetables. Foods with a lot of protein increase metabolic heat production which can, in turn, increase water loss.
  • If increased use of a central air conditioning system causes higher utility bills that are a problem for your budget, consider purchasing a fan or small window unit that can cool down a home at a lower cost. However, do not rely on a fan as the primary cooling device during an extreme heat event.
  • Seek medical care immediately if your senior shows symptoms of heat-related illness like muscle cramps, headaches, nausea or vomiting.

For more information about the heat, visit the National Weather Service Web site at http://www.noaa.gov and the Federal Emergency Management Agency Web site at www.fema.gov. Or, to learn more about Home Instead Senior Care, log on to www.homeinstead.com

Elder Safe Program

BLOG post by Liz Fischer, June 2014

We have recently attended a couple of forums on elder abuse and were astonished at how many seniors have been physically, mentally or financially abused.

Elder mistreatment (i.e. elder abuseabuse and neglect) is defined as intentional actions that cause harm or create a serious risk of harm (whether or not harm is intended) to a vulnerable elder by a caregiver or other person who stands in a trust relationship to the elder

Unfortunately, we simply do not know for certain how many people are suffering from elder abuse and neglect. It appears that female elders are abused at a higher rate than males and that the older one is, the more likely one is to be abused.

Signs of elder abuse may be missed by professionals working with older Americans because of lack of training on detecting abuse. The elderly may be reluctant to report abuse themselves because of fear of retaliation, lack of physical and/or cognitive ability to report, or because they don’t want to get the abuser (90% of whom are family members) in trouble.

The Washington County Sheriff Department has an Elder Safe  program that helps victims aged 65 and older after a crime is reported to police and continues to help them through the criminal justice system.

Based at the Sheriff’s Office, Elder Safe collaborates with the District Attorney’s Office and the Disability, Aging & Veteran Services and city police departments to coordinate services.

Volunteer victim advocates provide crime victims with emotional support and information relating to the criminal justice system and their case. Assistance tailored to the unique circumstance of each victim may include personal support, court advocacy, or help filling out forms. Program staff and volunteers understand the needs of victims for information, validation, restitution, testimony, and support as their cases travel through the criminal justice system.

Learn more about the Washington County Elder Safe Program

Learn more about the National Center of Elder Abuse Administration on Aging

Help Me Home Program

Blog post by Liz Fischer, June 2014

Did you know Washington County Sheriff’s office now offers a Help Me Home program?  It is sheriffdesigned to help at risk or endangered residents living in Washington County who may become lost and have difficulty communicating vital information about themselves.

Often these individuals have left the safety of their homes without the knowledge of their caregiver. Help Me Home is a voluntary enrollment program for adults and children who may become lost due to a disability. Those who are registered in this program have their identification photo and pertinent information placed in a database that deputies and law enforcement personnel can access via laptops in their patrol cruisers. Registrant information is kept confidential.

When a deputy or police officer finds your loved one alone, they can quickly query the database using personal identifiers. With a match in the database caregivers will be contacted immediately to let them know their love done has been located.

For detailed application information and forms go to the Help Me HOme website at: www.co.washington.or.us/helpmehome or contact Marcia Langer at 503-846-6048 or marcia_langer@co.washington.or.us.

Octogenarian’s Dance Performance Amazing

BLOG post by Mike Brunt, June 2014

I always enjoy seeing seniors do the unexpected and know you’ll enjoy this too.

When the 80-year old woman appeared on the stage of “Britain’s Got Talent,” there were moredancers than a few skeptical glances from the judges and the crowd. But once Paddy and her younger cohort, Nico, got a few minutes into their salsa routine, the crowd was in disbelief at the daring and thrilling moves made by this octogenarian

Watch the amazing dance routine.

YOUR MONEY–Living Within Your Means—and Assets

BLOG post by Mike Brunt, June 2014

I saw this article in our Certified Senior Adviser newsletter and thought you would find the information useful too. We all think about retirement and saving enough money to retire comfortably. This article provides some good information on planning for retirement and living within your means.

Living on your retirement savings can be a constant balancing act: between maintaining your Senior Calculatorstandard of living and making sure you don’t outlive your savings. How do you know if you’re withdrawing too much from your financial portfolio and threatening your ability to enjoy life as you age? Or maybe you’re taking out too little, refraining from the kind of activities you desire, such as traveling, only to end up with more than adequate assets when you die. There are no easy answers to this dilemma, although retirement experts offer a few suggestions.

The 4 Percent Rule

The traditional standard for how much money you should withdraw each year after retirement is the 4 percent rule, in which you withdraw a fixed amount from your portfolio on a periodic basis. Typically this is adjusted for inflation annually, so the amount grows over time while remaining constant in real terms. In other words, you maintain the same lifestyle from year to year.

Don’t Forget Required WithdrawalsThe IRS requires owners of retirement-plan assets, such as traditional IRAs, to take withdrawals each year after turning 70½. Roth IRAs do not require withdrawals until after the death of the owner.The purpose of the required minimum distribution (RMD) is to spread out your IRA’s taxable distributions over your life expectancy rather than accumulating funds to leave as an inheritance. The IRS allows you to withdraw more than the minimum required amount. Be aware that your withdrawals will be included in your taxable income except for any part that was previously taxed or that can be received tax-free (such as qualified distributions from designated Roth accounts).IRS Publication 590 explains the percentage that you’re required to pull out each year, but the math can be difficult. Free online calculators can help you figure out RMD:

Financial Industry Regulatory Authority;
T. Rowe PriceBankrate.

Under this formula, retirees add up their retirement savings, such as 401(k)s and IRAs, and then withdraw 4 percent of the portfolio’s overall value in the first year of retirement. The next year, the retiree takes out another 4 percent plus the rate of inflation, and so on. Although it’s called the 4 percent rule, the typical withdrawal range is between 4 and 5 percent.

A similar method is to base withdrawals on the value of the financial market. One expert found that withdrawing at a rate around 5.5 percent when markets are strong and reducing the withdrawal amounts when times are tough is a better standard than withdrawing at a fixed rate.

Annuities offer another simple way to withdraw retirement funds because you’re promised the same income payments for life. However, most annuities aren’t inflation adjusted, which means your payments won’t keep up with inflation. Plus, if you die early, you may forfeit any money left in the annuity. One other drawback to an annuity is that your money is tied up in investments, preventing access to emergency cash.

Newer Models

Another fixed approach is to base your retirement withdrawals on your life expectancy. The Social Security Administration provides tables that give averages. Of course, you need to keep in mind your health and your genetic disposition toward life-threatening diseases such as cancer.

In its simplest form, to figure out how much you could withdraw each year, divide your savings/investments by your remaining years. For example, if your life expectancy is 20 more years, you could withdraw one-twentieth every year. However, if your assets keep growing, you might have more left than you planned, and that money may have been better used when you were younger and more active

Market Watch advocates a slightly different approach. The “Safety First Withdrawal Idea” focuses first on what you need to maintain your standard of living during retirement and then matches your financial resources to your required expenses. The basic idea is to use conservative investments to preserve your standard of living, such as U.S. Treasury Inflation Protected Securities (TIPS), lifetime annuities from blue-chip issuers and federally insured savings accounts. Social Security is a key part of this type of safety-first portfolio, because the retirement benefits are guaranteed and predictable. Once you’ve created an income plan from your conservative investments, you can invest your remaining money in riskier funds. If you get good returns, you can spend that money on more frivolous purchases.

More Flexible Approaches

J.P. Morgan Asset Management recommends a more flexible approach to retirement withdrawal strategies. Rather than sticking to one formula, the asset manager suggests reacting to changes in wealth, age and income streams by periodically adjusting withdrawal rates and portfolio asset allocations (Investment News). For example, as a retiree gets older or has maintained her assets, she could raise her withdrawal rates.

To figure out the ideal withdrawal rates for each age, J.P. Morgan’s model weighs five factors: the individual’s preference for timing and amount of withdrawals, lifetime income, current age and life expectancy, the predictability of the market and extreme events, and the retiree’s need to spend the money.

The website Can I Retire Yet recommends a withdrawal system that sells in response to your own “routine income” needs rather than in response to market events.” The “total return approach” or “active safe withdrawals” concept means selling some of your most appreciated assets once or twice a year, when the money is needed.

“This is where asset allocation comes into play,” writes Darrow Kirkpatrick. “For me, it makes no sense to live off your conservative cash and bond buckets when stock markets are up. That’s like dipping into the storehouse when there is fresh, healthy grain available in the fields. Much better to be selling volatile equity assets when they are in favor, and to preserve your safe ‘buckets’ for the bad times.

“When those bad times come, as they inevitably will, then the flexible withdrawal approach begins dipping into the safe cash and bond buckets that have been set aside.” He says new research suggests that it may be better to spend bonds first, which goes against traditional advice, producing a rising equity allocation for the long term. In fact, continuing low interest rates mean retirees are no longer depending on bonds, as they once were.

Kiplinger.com dubs a similar approach in “lifestyle-driven investing.” Erin Botsford, a financial planner in Frisco, Tex., and author of The Big Retirement Risk, urges clients to divide their expenses into four categories: needs, wants, likes and wishes.

Then she recommends relying on “lifestyle investments”—those that produce income, either now or in the future, and are safe, predictable or guaranteed—to cover basic needs. “Food and shelter take a higher priority than vacations and luxury cars,” she says. “Shouldn’t your investment plan reflect this reality?”

If your current savings aren’t enough to support your projected retirement lifestyle, you may have to forgo some of your wants, likes or wishes, or be willing to save more or work longer to afford them, she says.

In the end, most of us will borrow bits of different withdrawal systems to create what works best for us and adjust our retirement plans and withdrawals according to our own set of circumstances—whether it’s poor or good health, still-dependent adult children or the urgent need to live in a warm climate.

Calculators and Simulations

You can plug your figures into various retirement withdrawal calculators and simulations. Here are a few:

Vanguard’s tool determines how much you can withdraw each month based on how much you’ve saved, your asset allocation (whether conservative, moderate or aggressive), how long you expect to spend in retirement and which withdrawal method you plan to use.

Once you plug in those figures and answers, its interactive tool shows how much money you could have withdrawn from your portfolio during the time the returns were calculated, using the dollar-adjusted withdrawal method. In general, Vanguard suggests making withdrawals at rates no greater than 3 percent to 5 percent at the outset of your retirement, depending on your withdrawal method.

E*Trade Easy Retirement Calculator asks for your expected age of retirement, how much you’ll get in Social Security, your assets (savings and investments), your investment status (conservative to aggressive) and an estimate of how much you’ll have when you retire. After you input your retirement monthly expenses (mortgage, healthcare, home expenses, etc.), the tool produces a retirement plan comparing how much you’ll need versus how much you’ll have.

Monte Carlo Retirement Calculator factors in market volatility, running random iterations, so you can see your chances of meeting your goal. To determine your goal, provide your desired annual withdrawal amount and the number of years you want the account to last. The outcome, which is slightly different each time you perform the exercise, shows your chances of failure and success.

Sources

“4% withdrawal rate in retirement unrealistic in real world, researchers say,” February 2014 Investment News
“Easy Retirement Calculator,” 
E-Trade
“Monte Carlo Retirement Calculator,” 
Money Chimp
“New Strategies to Ease Into a Secure Retirement,” March 2012 
Kiplinger.com
“Retirement Withdrawal Strategies,” December 2013 
Can I Retire Yet
“The ‘Safety First’ Guide To Retirement Withdrawals,” September 2013, 
Forbes Next Avenue

Four Vaccines Urged for Seniors

Blog post by Mike Brunt, June 2014

I saw this article and thought it would be good information to pass on to you. We all thought vaccineswe were done with vaccines once we reached adulthood. It’s important to check with your doctors to ensure you’re still up to date with important shots so you can proactively avoid some of the diseases that can be so detrimental to senior’s health.

In the 1920s, the respiratory disease diphtheria was one of parents’ biggest fears for their children. In the United States, an estimated 100,000-200,000 cases of diphtheria per year caused 13,000-15,000 deaths, mainly children, in that decade (Wikipedia). Today, diphtheria vaccines have largely eradicated the disease from the United States. In fact, if diphtheria is remembered at all today, it’s because of the celebrated story of a relay by sled dogs and their mushers to deliver diphtheria antitoxin 674 miles away to Nome, Alaska, to prevent a predicted epidemic. The initial relay in 1925 became today’s Iditarod Trail Sled Dog Race.

Today, vaccines have curbed the development of many diseases that were once considered fatal, especially in older adults. While some vaccines have side effects, health experts say that the benefits typically outweigh the possible complications of certain illnesses in seniors. Except for people with certain health problems, such as cardiovascular disease, lung disease, diabetes, kidney problems or a condition that weakens the immune system, getting vaccinated is a safer choice than risking illness to obtain immune protection. Consult with your healthcare provider to discuss the advantages and disadvantages of each vaccine for you.

Vaccines work by exposing you to dead or weakened disease-causing microorganisms, which causes your body’s immune system to produce antibodies that fight the microorganisms, helping to make you immune to a specific disease. Most vaccines are given through a simple injection, usually in your arm, although some are administered by mouth or nasal spray.

Experts recommend four vaccinations for seniors: flu, pneumonia, shingles and a combined tetanus-diptheria-pertussis.

Flu

The most prevalent vaccine is for influenza, commonly called the flu, a contagious illness caused by viruses. Older people are at the highest risk of developing serious flu complications that require hospitalization; in some cases, the flu can be fatal. Ninety percent of flu-related deaths and more than half of flu-related hospitalizations occur in people age 65 and older. As you age, your immune system weakens, which makes you more susceptible to the flu.

Health experts recommend that those 50 or older should receive one dose of influenza vaccine every year, preferably in October or November, before the winter flu season starts. Flu season usually peaks in January or February, but it can occur as late as May. Early immunization is most effective, but it is not too late to get the vaccine in December, January or later. Flu vaccines are needed every year because immunity is short-lived and vaccine manufacturers make updates every year to combat current strains of the virus.

If you get the flu vaccine, you are 60 percent less likely to need treatment for the flu by a healthcare provider. Vaccination may also reduce illness, antibiotic use, time lost from work, hospitalizations and deaths.

Although the flu vaccine is meant to protect you for one flu season, evidence supports that immunity declines more quickly in older people. Therefore, another flu vaccine option is available—one that contains a higher dose of antigen, the part of the vaccine that prompts the body to make an antibody. Designed specifically for people 65 and older, this alternative is intended to create a stronger immune response.

For those worried about the possible dangers, seasonal flu vaccines have a good safety track record (vaccines.gov). The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) closely monitor their safety. As with any drug, mild side effects, such as soreness, headaches and fever, are common. Less common and more serious are severe reactions such as difficulty breathing, hives or facial swelling; for these, seek medical attention immediately.

Shingles

Shingles is an extremely painful and contagious blistering rash, which is activated by the varicella zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays in the body in a dormant state but can reactivate years later, for reasons not fully known. At least 1 million people a year in the United States get shingles.

The zoster vaccine, which scientists developed in 2006, is not guaranteed to prevent shingles, but it can decrease your risk by about 50 percent, or at least minimize its severity. Vaccines.gov recommends that anyone 60 years of age or older get the shingles vaccine, regardless of whether they recall having had chickenpox or not. Studies show that more than 99 percent of Americans ages 40 and older have had chickenpox, even if they don’t remember. Shingles is far more common in people 50 years of age and older than in younger people, and increasing age can result in more severe effects.

A shingles rash usually appears on one side of the face or body and lasts from two to four weeks. Its main symptom is pain, which can be severe. Other symptoms include fever, headache, chills and upset stomach. Very rarely, a shingles infection can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis) or death.

For approximately 20 percent of people, severe pain, called post-herpetic neuralgia (PHN), can continue long after the shingles rash clears up. Its repercussions are more widespread in seniors, affecting up to half of untreated people who are 60 years of age and older. Although the pain from PHN may be debilitating, it usually resolves in a few weeks or months.

While any vaccine can carry risks, no serious problems have been identified with the shingles vaccine. Mild reactions can include headache and redness, soreness, swelling or itching at the site of the injection.

Pneumonia

Infection from pneumococcal bacteria is one of the leading causes of death in the United States from a vaccine-preventable disease. Seniors, especially, are susceptible to pneumonia, which is responsible each year for 60,000 deaths among those over 65. The CDC recommends that people age 65 and older receive a one-time dose of pneumococcal vaccine; those who were vaccinated more than five years ago and were younger than 65 at the time should get a one-time repeat vaccination.

Pneumococcal infections, which include pneumonia, blood infections (bacteremia), brain infections (pneumoccocal meningitis) and middle-ear infections, are spread through respiratory secretions, like coughing and sneezing. The disease comes from a type of bacteria called Streptococcus pneumoniae (pneumococcus) found in many people’s noses and throats.

Pneumonia symptoms include fever, cough, shortness of breath and chest pain. In addition to redness, pain and swelling at the injection site, vaccine side effects may include mild fever, fatigue, headache, chills or muscle pain.

Tetanus-Diphtheria-Pertussis

Tetanus, diphtheria and pertussis, all caused by bacteria, can be very serious, for adolescents as well as adults. Before vaccines, the United States saw as many as 200,000 diptheria and pertussis cases annually and hundreds of tetanus infections. Since vaccination began, tetanus and diphtheria have dropped by about 99 percent and pertussis by roughly 80 percent (CDC). The Tdap vaccination covers all three diseases.

The tetanus bacteria enters the body when cuts, scratches or wounds come into contact with contaminated soil, dust or manure. Tetanus, also known as lockjaw, affects the nervous system, causing painful muscle tightening and stiffness, usually all over the body. In some cases, you can’t open your mouth, swallow or even breathe. It can be deadly, particularly for older people, killing approximately one out of five people who are infected. Because the immunity from past tetanus shots eventually fades, ask your doctor if you are due for another vaccination.

Diphtheria is a respiratory bacterial infection that spreads from person to person through coughing or sneezing. If left untreated, it can cause airway obstruction, coma and death. Although both tetanus and diphtheria are rare in the United States today, people who become infected often have severe complications.

Pertussis, also known as whooping cough, produces severe coughing spells, which can cause difficulty breathing, vomiting and disturbed sleep. The illness can also lead to weight loss, incontinence and rib fractures from coughing. Up to 2 percent of adolescents and 5 percent of adults with pertussis are hospitalized or have complications, which could include pneumonia or death. Seniors are increasingly getting pertussis, possibly due to dwindling immunity.

You should get the Tdap vaccination as a one-time booster, regardless of when you received your last tetanus-diphtheria vaccine. Side effects include redness or swelling at the injection site, headache, fatigue, fever, nausea, vomiting, diarrhea and stomach ache.

Sources

Centers for Disease Control and Prevention
“Senior Immunizations,” 
John Muir Health
Vaccines.gov
“Vaccines for Seniors,” 
Everyday Health

‘There is No Cure for Aging’ — So Embrace It

Blog post by Mike Brunt

We saw this advertisement from Age UK that brought a smile to our face, we hope you enjoy it adtoo.

A TV ad is circulating an important message: “Aging isn’t an illness, but a way of life.”

Age UK’s “Love Later Life” ad aims to reshape society’s view on aging. The video features a poem by Roger McGough that encourages people to seize the day and enjoy the adventure of aging.

Older Adults and Technology Use

Blog post by Mike Brunt

We often read articles on seniors that we like to share. This one looks at how seniors are using technology and the beneficial outcomes of that adoption.woman-using-laptop

Pew Internet Research Project study on seniors and the internet looked at how older adults are using technology in their lives. Technology adoption among seniors has been increasing slowly but surely. According to the report, 77% of seniors have a cell phone, 59% use the internet, and almost half have broadband at home.

This article examines how seniors face hurdles to to adopting new technology, how once they join the online world digital technology becomes an integral part of their daily lives, what devices they’re using and how they’re being used and how social media can help seniors stay connected to friends and family.

What is your Aging IQ?

There are a lot of stereotypes about seniors, are they true? How would you answer the following questions?bikers

Do you think that getting older means giving up on exercise? Actually, physical activity at any age can help make your heart, lungs, and muscles stronger.

Do you think that older adults are bad drivers? Not really. Older adults really tend to be safe drivers who engage in less risky behaviors behind the wheel.

Do you think older adults have nothing left to learn? As a matter of fact, there is no age limit on learning new skills or improving your existing ones.

The National Institute on Aging’s quiz, What’s Your Aging IQ? Can be answered on-line or is available as a free booklet (even bulk copies) to help start conversations about aging and challenge aging stereotypes.

Elder Abuse Forum May 16

Research shows that as many as five million older adults are victims of elder abuse each year and that financial exploitation costs seniors an estimated $3 billion writingannually. To address this growing problem, Washington County Disability, Aging and Veteran Services (DAVS) is hosting an Elder Abuse Forum. This community event takes place on Friday, May 16, from 1-4 p.m., at theHillsboro Civic Center.

Topics include identifying and reporting elder abuse as well as financial scams and how to avoid them.

The forum is appropriate for all community members, including caregivers, law enforcement, social service providers and others who routinely come in contact with older adults.

For more information about this event, please contact Randy Mifflin at 503-846-3084 or visit the Home Instead Senior Care website for other extremely informational articles, resources and videos including a downloadable Senior Fraud Protection Kit.

Why I’m Grateful For My Caregiver

TY CGThis is an amazing and inspirational video done by the Alzheimer’s Association, “Why I’m Grateful For My Caregiver.”  It brought such a smile to our face, and we know you’ll enjoy it too. You may not hear it as much as you should but you are appreciated! Thank you to all caregivers!

Guide to Preventing Falls: A Free Online Program

Are you a caregiver for a friend or family member who depends on your care and assistance to remain living in her or his own home? Are you a caregiver for a spouse or loved one who lives with you?senior walking

Pew Research Center (2013) reports the 39% of U.S. adults provide care for a loved one and many navigate care with the help of technology. Caregivers are reported to be “online health information consumers” who are more likely than non-caregivers to go online to look for health information.

B-Better: Caregiver Guide to Preventing Dependent’s Falls is a FREE online course available through Oregon State University’s – Professional and Continuing Education. The course is designed for anyone who provides in-home care to a more dependent adult; or anyone looking to learn how to help her or himself or older adults reduce their risk of slips, trips and unexpected falls at home.  The B-Better Online Module is divided into four sections that you can complete at your own pace. The course is available at: B Better: Caregiver Guide to Preventing Dependent’s Falls.

For additional information, please contact Deborah.John@oregonstate.edu. This project was funded by Clackamas County 2013 HEAL Community Grant award to OSU Extension Family & Community Health program in Clackamas County, a key partner in engAGE in Community for Age-Friendly Clackamas County.

Hearthstone WWII Veteran and Daughter take “Trip of a Lifetime” to Washington, D.C.

Blog Post by Jean Blackburn

I was privileged to interview Penny Holcomb (whom many of us know and love at Penny and DadHearthstone of Murrayhill) and her father, Murray Hale, about their inspiring Honor Flight trip to Washington, D.C., in September of this year. Their four-day trip — with 50 Oregon World War II Veterans and an equal number of guardians, plus team leaders and trip leaders — included two days touring the WWII and other war memorials in our nation’s capitol. The trip was organized by Honor Flight of Eastern Oregon and Honor Flight Portland Oregon, which are two regional hubs of the national, non-profit organization called Honor Flight Network.

Honor Flight Network and its regional hubs are dedicated to transporting as many United States military Veterans as possible to see “their memorials” in Washington, D.C. The trips are at no cost to the Veterans (guardians pay their own way). Currently these organizations are reaching out to WWII Veterans, most of whom are over the age of 90 and dying at the rate of more than 600 each day, but they also accept applications from terminally ill Veterans of other wars.

One of the remarkable aspects of Honor Flight trips is their emphasis on fulfilling the needs and requests of the Veterans. Trip leaders make it clear to guardians that these trips are for the Veterans, and that the Veterans are to be honored in every way. Guardians are instructed to “make sure your Veteran does not pay for anything” on the trip, and trained on measures to ensure the health, safety and well-being of each Veteran.

According to Murray and Penny, every last detail of their Honor Flight trip was perfectly planned, organized, and fulfilled.  All accommodations – including the flights, hotel, food and ground transportation — were top-notch. After a full day of travel from Portland to D.C., the Honor Flight group of more than 100 settled in at the Crowne Plaza Hotel in Alexandria, Virginia (which was, to quote Penny, “the nicest hotel I’ve ever stayed in”).

The next two days were spent traveling by tour bus to the numerous national war memorials. The days were full (wake up calls at 5 a.m. — which Murray said, “brought back memories of being in the military and experiencing reveille,” aka bugle calls). In addition to the WWII Memorial and the Tomb of the Unknowns, one of the most emotional destinations was the Iwo Jima Memorial commemorating the raising of the American flag at Suribachi, Japan. Three of the Honor Flight’s 50 Veterans had fought in The Battle of IwoJima VetsIwo Jima on February 19, 1944.

Murray informed me that, coincidentally, February 19, 1944, was also the day when his Army battalion had “their most perfect day of the war.”  On that day General MacArthur ordered 100 men from the 511th Parachute Infantry Regiment of the 11th Airborne Division to rescue 2,000 civilians held captive in an internment camp in Los Banos, Luzon (MacArthur had reason to believe they were to be killed at the end of the war). Murray is very proud of the men who parachuted in to rescue the 2,000 civilians — all of whom were saved but for one Filipino scout. Although he was in the hospital at the time of the rescue (Murray was awarded three Purple Hearts for his war injuries), he was extremely proud of what his battalion accomplished that day.

When I asked Murray to share his favorite parts of the trip, there was no hesitation: “The best part was to share this experience with my daughter. The connection we have because of this trip is so powerful.”

Murray went on to say that the trip was profoundly meaningful in other ways, as well, including the reception the 50 Veterans received from the public. He explained that everywhere they went adults and children alike expressed their gratitude for the Veterans’ service with cheers, applause, handshakes and salutes. He found this to be surprising, and deeply moving. Penny said the public reception affected her the same way. She recalled an instance when her dad was approached by a mother whose son was fighting in Afghanistan. The mother took Murray’s hand, thanking him for serving our country; Murray replied by thanking her for her son’s service. Both were choking back tears during the encounter.

Another highlight for Murray was meeting “the highest ranking woman in the U.S. Army,” 4-star General Ann Dunwoody, at the WWII Memorial. Fortunately Penny was able to capture a photo of their chance encounter.Lady Vet

Murray and Penny both agree that the Honor Flight program for military Veterans is a “big thing,” and that WWII Veterans need to take advantage of this opportunity. They have found many WWII Veterans who resist applying for various reasons — minimizing their war contributions, apprehensive due to physical limitations, anxious about taking a cross-country trip. They emphasized that the tour group had three nurses and a physician traveling with them, and that Veterans are always encouraged to use wheelchairs when they get off the bus. The organizers make sure there is plenty of food and water available, and take great care to ensure quick access to toilet facilities. They do everything possible to meet the specific needs of each Veteran.

Both Murray and Penny ended our conversation by saying, “It was the trip of a lifetime,” and urging all WWII Veterans to submit their applications to the Honor Flight organization. To learn more about the Honor Flight Network and its regional hubs, go to www.HonorFlight.org.  (Be sure to use the “org” suffix, as there are confusingly similar websites that do not represent the official Honor Flight Network.)

Be A Santa To A Senior

King City Regal Courier Article on Home Instead’s Holiday Giving Program – Barbara Sherman, November 28

Each year, the Home Instead Senior Care®  partners with local stores, businesses, nonprofits and other organizations in the community to deliver gifts to lonely and financially challenged seniors through the Be a Santa to a Senior® program. There are many seniors who would not receive gifts during the holiday season if it were not for this program. Volunteers and gift donations needed.BASTAS

This year we are partnering with The Meals on Wheels People in Tigard and in Forest Grove to deliver gifts to seniors in each community.

How it works:

  • Remove an ornament from the wreath (gift ideas are printed on each ornament)
  • Purchase the gift(s) listed.
  • Bring the ornament and gift back to participating store and give to store employee or place in the bin under the wreath

Home Instead Senior Care employees will then wrap the gifts and the Meals on Wheels drivers will deliver them the week of December 16th.

Read a story about how gift giving touched the lives of a senior from one Home Instead franchise

In 2006, Be a Santa to a Senior volunteers visited a local nursing facility and distributed gifts to a number of residents, including one 87-year-old woman whom we’ll call Mary. She was pleased to receive her gift and thanked us profusely, but it wasn’t until we returned to give Mary another gift in 2007 that we recognized the true value of Be a Santa to a Senior.

When we entered Mary’s room for our second visit, we noticed that the only card on her bulletin board was the Be a Santa to a Senior card from the previous year. As we spoke with her caregivers we found out that our Christmas card and gift were the only items she had received throughout the year. Mary re-read the card regularly to help keep that memory alive.

Please help us spread holiday cheer to lonely or financially-challenged seniors in our area through the Be a Santa to a Senior program.  In Forest Grove  the giving wreath is at Bi-Mart (3225 Pacific Ave. Forest Grove), in Tigard the giving wreath is at McCann’s Pharmacy (15685 Sw 116th Ave, Tigard)

7 Ways to Investigate Your Loved One’s Needs During a Holiday Visit

Blog post by Mike Brunt

The holidays are a fun time of year but they may be stressful too, especially if you’re visiting aging parents or relatives. This article offers very good advice on what to look for with your aging loved ones that may indicate they need additional help.caregivercouple

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 CAREGiverSM from the Home Instead Senior Care® network 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.

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.

If you get the sense that your loved one needs more assistance with tasks of daily living, look into local in-home care services. The Home Instead Senior Care network offers free care consultations that allow you and your family to sit down and discuss care options with a home care professional, without you having to pay for the consultation or committing to services.Get in touch with your local office to schedule your free consultation