Wednesday, August 23, 2017

Mental Health and Depression

Depression is a medical condition that affects individuals and those who share their lives. Everyone knows what it is like to feel sad, down or “blue” from time to time. In fact, transitory feelings of sadness or discouragement are perfectly normal, especially during particularly difficult times. But, when these feelings continue for more than a few weeks and are accompanied by certain other physical and mental symptoms, doctors call the condition depression. According to the National Institute of Mental Health, depression is the leading cause of disability worldwide. Depression, if left untreated, can lead to suicide. Fortunately, depression can be treated effectively with therapy and/or medication. Depression screening provides awareness about depression and enables people with depression to seek necessary treatment. Anyone, regardless of age, gender, race, or socioeconomic status, can suffer from depression. It is estimated that 19 million Americans suffer from depression every year. Depression is not a weakness or a character flaw—it is a real medical illness. But the good news is that with proper treatment, patients can improve. People who have depression are not just moody or having "the blues" for a few days. They have long periods of feeling very sad and lose interest in social and daily activities. Depression changes the way a person feels, thinks, and behaves. The causes of depression are not always clear. It may be caused by an event or for no apparent reason at all. Genes may also play a role. The symptoms of depression may differ from person to person. Some symptoms may include a persistent sad mood, lack of pleasure in activities, change in sleep or eating habits, or a feeling of worthlessness. There are several signs and symptoms that help a healthcare professional or doctor determine if a person has depression. The following is a depression risk questionnaire. Have you noticed any of these signs of depression?  Change in sleeping pattern (too much, too little, or disturbances)  Change in weight or appetite  Speaking and/or moving with unusual speed or slowness  Loss of interest or pleasure in usual activities  Withdrawal from family and friends  Fatigue or loss of energy  Diminished ability to think or concentrate, slowed thinking or indecisiveness  Feelings of worthlessness, self-reproach or guilt  Thoughts of death, suicide or wishes to be dead You should seek professional help if you or someone you know has had some of the symptoms continually or most of the time for more than two weeks. You don't need to have all these signs and symptoms to have depression. Symptoms will also vary from person to person. For instance, compared with depressed men, depressed women are more likely to experience guilt, weight gain, anxiety, eating disorders, or increased sleep. Depressed older adults tend to experience persistent sadness or "empty" moods. It is important to remember that depression is a medical condition like any other. And, just as there are treatments for conditions like diabetes or heart disease, there are treatment options available for depression. Remember—depression is more than just feeling down. It is a real medical condition that can be effectively treated, but first you must seek help. The diagnosis and treatment of any medical illness or condition, including depression and other psychiatric disorders, can only be performed by a physician or qualified mental health professional. Unfortunately, many fail to recognize the illness and get the treatment that would alleviate their suffering. They or their loved ones fail to notice a pattern and instead may attribute the physical symptoms to "the flu," the sleeping and eating problems to "stress," and the emotional problems to lack of sleep or improper eating. But if people looked at all of these symptoms together and noticed that they occur over long periods of time, they might recognize them as signs of depression. The term "depression" can be confusing since it's often used to describe normal emotional reactions. At the same time, the illness may be hard to recognize because its symptoms may be so easily attributed to other causes. People tend to deny the existence of depression by saying things like, "She has a right to be depressed! Look at what she's gone through." This attitude fails to recognize that people can go through tremendous hardships and stress without developing depression, and that those who suffer from depression can and should seek treatment. For many victims of depression, these mental and physical feelings seem to follow them night and day, appear to have no end, and are not alleviated by happy events or good news. Some people are so disabled by feelings of despair that they cannot even build up the energy to call a doctor. If someone else calls for them, they may refuse to go because they are so hopeless that they think there's no point to it. Family, friends, and co-workers offer advice, help, and comfort. But over time, they become frustrated with victims of depression because their efforts are to no avail. The person won't follow advice, refuses help, and denies the comfort. But persistence can pay off. Remember the person suffering from depression is not alone – more than one out of six individuals suffer from depression in their lifetime. I hope by providing some of this information, it makes it a little easier to discuss with your medical professional.

Caregiver Pain

New research shows that nearly all unpaid caregivers suffer from some form of chronic pain. While the issue of long term pain and the resulting risk of injury for informal caregivers certainly isn't a new one, the study shows just how prevalent this problem has become. According to this research, 94% of unpaid caregivers experience chronic pain that affects the muscles, ligaments and tendons, and bones. The vast majority of study respondents complained of lasting lower back pain (76%), while knee, wrist and shoulder pain were also cited as frequent areas of concern. Perhaps most troubling is the impact chronic pain is having on caregivers and care recipients alike. Over 78% of informal caregivers said that chronic pain has adversely affected their ability to provide care. As a result, 66% also said their overall quality of life has suffered. The research study points out that the complaints of chronic pain from an estimated 42.1 million unpaid caregivers actually mirrors what is reported by professional caregivers. However, informal caregivers often times do not have access to the training and resources available to their professional counterparts. Informal caregivers provide almost half a trillion dollars’ worth of support to individuals with disabilities each year. These caregivers - usually family members - often perform physically-demanding tasks with little or no training, which can result in muscle strains and chronic pain. With very little data on the physical impact of informal caregiving, new research is identifying which tasks caregivers say are the most physically demanding and where they experience the most body pain. The good news is that the results of this study are being used to identify tasks and situations that may be considered "high risk". The hope is that in the coming years, protocol developed using this research will help lower the risk of chronic pain and injury among caregivers of all types.

Tuesday, August 1, 2017

Food Nutrition Survey - Fresh out of the garden class

A statewide survey was conducted by New York State Office of the Aging and New York State Department of Health to assess the extent of nutritional health risks among older New Yorkers. The “New York State Elderly Nutrition Survey” results show that one out of every four elderly New Yorkers living at home is nutritionally at risk. The survey found that 25 percent or approximately 728,000 New Yorkers aged 60 or older were at risk of malnutrition based on one of the following three factors: • Presence of 2 or more warnings signs of poor nutritional health • 'Food insecurity' including going without meals and inadequate income to buy food as well as other necessities; and/or, • Being homebound and unable to prepare nutritious meals. The survey uses ten warning signs to determine the risk of poor nutritional health. As shown below, each warning sign, if answered "yes," receives a weighted score of 1 to 4 reflecting the importance of the warning sign. These scores are summed; and, a score of 6 or more indicates high nutritional risk. ___Has 3 or more drinks of beer, liquor or wine almost every day (weighting of 2) ___Eats fewer than 2 meals per day (weighting of 3) ___Doesn’t always have enough money to buy the food he/she needs (weighting of 4) ___Has tooth or mouth problems that make it hard for him/her to eat (weighting of 2) ___Without wanting to, he/she has lost or gained 10 pounds in the last 6 months (weighting of 2) ___Is not always physically able to shop, cook and/or feed himself/herself (weighting of 2) ___Takes 3 or more different prescribed or over-the-counter drugs a day (weighting of 1) ___Has an illness or condition that made him/her change foods he/she likes (weighting of 2) ___Eats few fruits or vegetables, or milk products (weighting of 2) ___Eats alone most of the time (weighting of 1) The Elderly Nutrition Survey found 18.5 percent or 539,000 elderly New Yorkers were at high nutritional risk and should consult a qualified professional. The prevalence of individual warning signs ranged from a low of 3 percent who had "3 or more drinks ... every day" to 42 percent who said they eat "alone most of the time." It is recommended that elderly persons at high nutritional risk consult their doctor, dietitian or other qualified health or social service professional. Food insecurity (including going without meals and inadequate income to buy food as well as other necessities) is a serious concern for the elderly. Because of low incomes often coupled with frailty, the elderly may skip meals, may not be able to shop for food or to prepare meals, or may be forced to choose between buying food and paying for other necessities such as medicine, housing and utilities. The Elderly Nutrition Survey found that a total of 11.4 percent or 332,000 elderly New Yorkers experienced at least one of the three food insecurities, ranging from 4 percent who skipped one or more meals to 7 percent who had to choose between buying food and other necessities during the past six months. Elderly persons most at-risk nutritionally are often those, who because of physical incapacity from chronic health problems or following acute hospital stays, are unable to shop, prepare meals or feed themselves. In many cases, family or other informal caregivers provide the assistance the elderly person requires. When such care giving is inadequate or simply not available, the elderly person is determined to need nutritional assistance, which may include nutrition counseling, shopping assistance and the delivery of hot meals to the older person's home. You may be interested in attending one or more free workshops/presentations related to nutrition. Fat Facts is being offered on Monday, August 21st at 10:30am. You will learn about fats – which are the healthiest and which to limit in your diet. You’ll learn tips for adding healthy fats to your meals without sacrificing taste. Information will be presented by Jennifer Johnson, Health Promotion Coordinator, BlueCross BlueShield of Western New York. Good Bugs for Good Health is being offered on Monday, September 18th at 10:30am. Learn how bacteria affects your gut and the digestive and immune systems, as well as the difference between probiotics and prebiotics. This presentation is also by Jennifer Johnson. Fun Facts and Good Bugs for Good Health are both free to attend. Presentations will take place at The Dale Association, 33 Ontario Street, Lockport. Please call 433-1886 to reserve your seat. Fresh Out of the Garden Cooking Class is being offered on Thursday, August 10th at 10:00am. It is sure to be a fun morning of cooking with fresh in-season ingredients. Four different recipes will be made that include fruits and vegetables of the summer season. Bring containers to take home leftovers and be prepared for fun, laughter, and delicious tastings. The cost for this session is $20 for members or $30 for non-members. Please call 433-1886 or register in person at The Dale Association, 33 Ontario St, Lockport.

Summer Safety

The pleasures of summer include longer, warmer and sunnier days, celebrations with family and friends, and backyard BBQs. Summer can also bring with it additional safety challenges. Summer Safety – something we should all be thinking about. Limit your exposure to the sun. Place comfortable lawn chairs in shaded areas. Stay indoors between 10:00 a.m. and 2:00 p.m. when the sun’s rays are the strongest. During the summer heat it is especially important to drink lots of fluids. Drink a glass of water hourly, or keep a cool glass of water within arm’s reach as a reminder to drink. Provide non-alcoholic beer or lemonade for backyard BBQs. Gardening can be a pleasurable and relaxing activity but can also pose risks. Keep an eye on sharp gardening shears or tools and closely monitor their use. Use fertilizers that are not harmful if swallowed accidentally and ensure that the plants in the garden are not poisonous. As our bodies age, skin and fat tissue, the body's insulators, tend to thin. Because of that change, seniors regulate temperature less efficiently, putting them at greater risk than others from heat-related health problems. Signs of dehydration or heat exhaustion are less pronounced in seniors, who: • Tend to perspire less than younger people—so their bodies don’t shed heat as easily as they once did. • May lose some of their sense of thirst and not feel thirsty until severe dehydration has set in. • May take high blood pressure and heart disease medications that remove salt and fluids from the body. These medications, coupled with heat, can cause a senior to become dehydrated—leading to confusion, organ damage and even death. The following tips can help seniors beat the heat. • Slow down. Strenuous activity in extremely hot weather adds strain to the heart. If you must be active, choose the coolest part of the day. • Take regular breaks when engaging in physical activity on warm days. If you think that you, or someone else, show signs of heat-related illness, stop your activity, find a cool place, drink fluids and apply cool compresses. • Stay cool. If you don’t have air conditioning, spend time at an air-conditioned shopping center, senior center, library, movie theater, restaurant or place of worship. • Plan outdoor activities in the cooler early morning or evening hours • Stay in the shade. A covered porch or under a tree are good choices. • Wear a wide-brimmed hat and umbrella to protected yourself from sun overexposure • Use U/V skin protection • Stay cool in your home. If you must be at home without air conditioning: • Stay in the coolest part of the house—usually the lowest floor. • Close curtains or shades on sunny windows to keep out heat and light. • Use portable and ceiling fans, and/or battery-operated hand-held fans and misters. • Install outdoor awnings or sun screens. • Use wet washcloths or ice cubes wrapped in a washcloth to pat your wrists, face and back of the neck. • Take cool baths or showers. • Stay hydrated. Carry water or juice with you and drink continuously even if you do not feel thirsty. Avoid alcohol and caffeine, which dehydrate the body. • Eat small meals and eat more often. Avoid foods that are high in protein, which increase metabolic heat. Sandwiches, salads, fresh fruit and vegetables are good choices. • Avoid using salt tablets unless directed to do so by a physician. • Dress for the heat. Wear lightweight, light-colored clothing. Light colors will reflect away some of the sun's energy. Wear a hat or use an umbrella as well. • Discuss with your doctor how medications and/or chronic conditions may affect your body's ability to manage heat. • Take the heat seriously. Rapid heartbeat, dizziness, diarrhea, nausea, headache, chest pain, fatigue, clammy skin, mental changes or breathing problems are warning signs that you should seek immediate medical attention. Heat related illnesses can get serious quickly. For more information, a lively discussion of important summer safety tips, and learning how to avoid common health problems associated with the warmer weather the public is invited to a free presentation on Monday, August 7, 2017 at 10:30am at The Dale Association, 33 Ontario Street, Lockport. Denise DiPaola, RN, BSN/ Community Outreach Worker with GuildCare will present.

Wellness Presentations

Wellness means different things to different people. The focus of wellness tends to focus on physical health – it is that and so much more. The most important element of improving older adults’ health is to promote their participation in wellness activities. Some activities are coming up that help adults be well: Nutrition and Diabetes: How do your food choices affect blood sugar control? If you are living with diabetes or pre-diabetes, you are invited to a presentation that will discuss ways to eat well and stay healthy, including meal planning, smart snacking and the impact of carbohydrates. The mini-workshop is Monday, July 17th at 10:30 am at The Dale Association, 33 Ontario St, Lockport. The presentation is free and is presented by Rachel Ceness, RD, Blue Cross Blue Shield of Western New York. Please reserve your seat by calling 433-1886. Healthy Summer Snacks and Drinks: Learn how to cut back on sodium, sugar and fat with easy ingredient swaps and food demonstration. The presentation is on Wednesday, July 19th at 12:00noon. It is free and being presented by Marla Guarino, RDN, SNAP-Ed Nutritionist, Cornell Cooperative Extension. Reservations can be made by calling 433-1886. The presentation will also take place at 33 Ontario St, Lockport, NY 14094. Video Re-broadcasting: By popular demand, a video re-broadcasting of the guest speakers from our recent Health and Wellness Expo will be shown on Thursday, August 24th between 9:00am and 2:00pm in The Dale Association lounge, 33 Ontario St, Lockport. Each presentation lasts approximately 20 minutes. Topics and speakers are as follows: Dr. Susan Mason – “Tools to Sharpen Your Brain” Dr. Roger Schneider – “T’ai Chi for Your Health” Steve Giroux, PhD – “A Pharmacist’s Best Advice” Marla Guarino, RD, CDN – “My Plate Meal Planning” Chair Exercise Class has been expanded: Chair exercise is designed for people of all abilities and those with mobility limitations or arthritis. The class is now being offered an additional day each week, by popular demand. On Tuesdays and Thursdays it starts at 10:30am. NEW – it is now offered on Wednesdays at 9:30am. To enroll, please call 433-1886. The class takes place at The Dale Association, 33 Ontario St, Lockport; new people are welcome to join at any time.

Elder Justice

As Americans live longer and technology becomes increasingly more sophisticated, older Americans can be vulnerable to scam artists and others seeking to exploit them for financial gain. They also can be vulnerable to abuse and neglect. The negative effects of abuse, neglect, and exploitation on the independence, well-being, and health of seniors are extensive. Elder abuse increases the risk of premature death and causes unnecessary illness, injury, and suffering and can threaten the economic security of older Americans. And it impacts elders across all economic, racial and ethnic lines, regardless of where they live—at home, with families, in assisted living, and nursing homes. People living with dementia are at higher risk for abuse, neglect, and exploitation. Cognitive impairment reduces financial capacity, increasing the risk of financial exploitation. Elder abuse carries both a human cost and an economic cost. It undermines our public investments in long-term services and supports. The costs of elder abuse are borne by public programs of the federal government and the states, private businesses and most importantly, by families and individuals. The Elder Justice Act, enacted as part of the Affordable Care Act, recognizes the nation’s need to address this issue. Since 2012, the federal Elder Justice Coordinating Council, authorized by the Elder Justice Act, has brought together federal agencies to build the federal capacity to address elder abuse. Elder abuse includes physical, emotional and sexual abuse; financial exploitation; and neglect (including self-neglect). It is found in all communities and is not limited to individuals of any particular race, ethnic or cultural background or socio-economic status. Because it often is hidden and unrecognized, and because the definition of elder abuse varies from state to state, both the incidence and prevalence of elder abuse have been difficult to articulate with great confidence on the national level. In 1995, New York State legislation established the Elder Abuse Education and Outreach Program to provide education and outreach to the general public, including older persons and their families and caregivers in order to identify and prevent elder abuse, neglect, and exploitation. The program includes elder abuse education and outreach programs designed to support a statewide effort to increase awareness and prevention of elder abuse. As the population of older Americans grows, so does the hidden problem of elder abuse, exploitation and neglect. We should continue to develop public-private partnerships, as well as partnerships with state and local-level entities, to stem the tide of elder abuse, neglect and exploitation.

Preventing Scams

It is estimated senior citizens are robbed of roughly $3 billion a year in financial scams. The “grandparent scam” or “grandchild in need scam” is on the rise. The scam begins with something most grandparents don't get enough of - a phone call from a grandchild - or so the caller says. It almost always ends with a desperate plea for money. Scammers call senior citizens, impersonating a grandchild in distress, begging for cash. According to a convicted scammer when asked how a typical call would go, he said, "You just say, 'Hey, how are you, hi grandma, hi grandpa... I'm in a little bit of trouble right now. If I tell you, just keep it between us, I'm on vacation, I got into a little accident, and I was arrested for a DUI (or some other type of trouble).' You tell them, ‘Things got out of control, and I need you to send me the money’." It triggers something emotional, it causes you to act. It works because grandparents want to help. "I was upset, sort of frantic and, of course, sort of shocked," according to one grandmother who was scammed. Even when she said the voice on the other end didn’t sound like her grandchild, the scammer had an answer for that, “I have a cold.” The grandmother said, "I felt there was a desperation and an urgency in his voice, partly because he said 'love you'." "I just wanted him to be home with his family," she added. "That's all I wanted." So she immediately sent almost $18,000 to a bank account, thinking it was going to a lawyer. But her grandson wasn't in jail. Her money was gone. The grandmother said, "You are blinded by emotion. Totally blinded. You don't think rationally when this happens. You know, your family comes first." According to the scammed grandmother, “It's not simply the loss of the money. We feel stupid, we feel gullible, and we have nightmares about it.” It's hard to tell how many senior citizens have been scammed like this, because there is no national database to track the grandparent scam and many grandparents are too embarrassed to report it to police. It's also very hard to catch these criminals, especially when they're operating outside the U.S. Also, their tactics can be highly sophisticated, such as disguising their phone numbers with a familiar number. To guard against this kind of act, people should ask a question that only your grandchild would know, such as the name of your pet, and confide in someone -- even though the person on the other end of the line will beg you to keep it a secret. And report it. To file a complaint with The Federal Trade Commission, go to www.ftc.gov where you can fill out an online complaint form. You can also call the FTC at 1-877-382-4357 to report a complaint. Another scam designed to separate the trusting individual with their money is aggressive and threatening phone calls by criminals impersonating IRS agents. Scammers make unsolicited calls claiming to be IRS officials. They demand that the victim pay a bogus tax bill. They con the victim into sending cash, usually through a prepaid debit card or wire transfer. They may also leave “urgent” callback requests through phone robo-calls or via phishing email. Many phone scams use threats to intimidate and bully a victim into paying. They may even threaten to arrest, deport or revoke the license of their victim if they don’t get the money. Some schemes may even say you are entitled to a huge refund. They all add up to trouble. Scammers often alter the caller ID numbers to make it look like the IRS or another agency is calling. The callers use IRS titles and fake badge numbers to appear legitimate. They may use the victim’s name, address and other personal information to make the call sound official. Scam artists are sophisticated and often prey on trusting victims. Be very careful and do not give out information to anybody who initiates a call. I hope this information makes you pause and not become a victim of a scam.

Wednesday, June 28, 2017

Driving and Independence

A new study found that older adults who are able to continue driving safely are less likely to enter long-term care than those who have given up driving or who have never driven. The study included 1,593 older adults, ages 65 to 84, and was conducted over a 10-year period. While driving itself did not produce this effect, the independence driving represents enables older adults to delay entry into a long-term care community. Non-drivers were four times more likely to enter long-term care than drivers, and the risk doubled for non-drivers without any other drivers in the home. Although the slower driving habits of some seniors often steam impatient younger motorists, researchers at Johns Hopkins School of Medicine have found that elders who stay behind the wheel are less likely to enter nursing homes or assisted living centers than those who have never driven or who have given up driving altogether. “We are not recommending continuation of driving for seniors who are a threat to themselves or others on the road,” said the study’s lead author. “Instead, we hope that understanding the very real health impact that losing the ability to drive has on seniors will encourage families to plan contingencies to assist elderly members with transportation issues.” The researchers also pointed out that losing the ability to drive poses an especially significant hardship to seniors living in isolated rural areas or any place without good, accessible public transportation for the elderly. “We set out to learn whether or not the loss of driving ability played a measurable role in an older person’s eventual need for long-term care,” according to John Hopkins School of Medicine. “The independence that accompanies a driver’s license and car has long been linked anecdotally to a better quality of life for seniors.” This probably isn’t so much about the process of driving but rather the larger issue of mobility as it relates to a person’s independence. When someone becomes a shut-in due to the loss of their primary transportation, the likelihood that they will require living assistance categorically increases. Non-drivers across the entire age group studied had four times the risk of long-term care entry compared to drivers, and the absence of other drivers in the home doubled the risk of entering long-term care. Nine percent of those studied entered long-term care for three months or more. By the end of the study, 29 percent of men and 58 percent of women had no other drivers in the household, and 22 percent of people who were driving at the beginning of the study reported that they stopped driving during the study. These findings point to the importance of research into how to keep seniors driving and independent as long as is safely possible.

Mobility and Gardening

This week I am combining suggestions for people with limited mobility and/or vision impairment and one of my favorite hobbies – gardening! The timing for this topic is fitting – with the official start of summer this week. When you think about moving around in your yard, do you think how limited mobility can make it difficult to enjoy your garden? Do you have physical impairments or does someone with physical limitations live in your house or visit frequently? Another factor that may be keeping you from enjoying your garden may be problems with vision or hearing. Even minor sensory problems multiply problems of movement, as do problems of balance in such disorders as inner-ear disturbances or diabetes. Don’t focus on being able to pronounce the next word, just work on understanding its meaning. Proprioception is the technical name for the collection of senses and brain functions that tell you where you are spatially at any given moment. Certain conditions can damage or destroy the nerves of proprioception in the legs and feet, so that a person has to rely on visual orientation only. A person who has problems with proprioception is likely to sway or wobble especially in bad light. Enjoying a garden means different things to different people. Some want just to look to take in the beauty and some want to dig in the dirt. The best way to make gardening easier is to move the plants closer to the gardener by constructing raised beds. There are two measurements to consider – height and width. Two feet is a good height. Topping the retaining wall with a foot wide (or wider) stone or concrete seat offers a convenient place to sit or lean, or to keep tools handy. The bed should also be no wider than is convenient for you to reach; perhaps 2-3 feet wide if it’s only accessible from one side or 3-4 feet wide if it’s accessible from both sides. Rounded corners eliminate sharp edges. Another way to bring the plants closer to the gardener is to plant in containers. Plants grown in pots generally need to be watered more often than plants grown in the ground, so make sure there’s a faucet or other water source convenient to where the pots will be set. Select low maintenance plants that do not need frequent deadheading or complicated pruning. Many plants are identified as “low maintenance” at the nursery. Easy to handle tools are also available to make your gardening easier. Look for tools with long handles, which increases your reach, and those with cushioned or oversized grips, which are more comfortable to handle. Make sure the tools you select aren’t too heavy, since it can be awkward to use. For even slightly limited mobility, transitions can be tricky. Some front walks are too narrow to accommodate a quad cane or walker and the uneven grass strip can be treacherous. A person with a leg brace, or even a cane, needs a hard surface that is wide enough to walk in a straight line, with additional space for changing or reversing direction. A 4-foot walk that’s ample for the agile is tight for someone with a cane walking alone. Consider a 6-foot minimum for high use walks, so a helper can walk on the same surface, if necessary. Steps and sloped paths should have graspable railings or other firm handholds at crucial spots. Make sure the steps and stairs are well lighted. Make sure the light source is well above or below eye level. Blinding lights can be hazardous, because as one gets older, your eye’s response to changes in light slows with age. There are 10 million blind and visually impaired people in the United States. 5.5 million people over the age of 65 are blind or visually impaired. Gardening may seem like an activity for only the sighted, but it doesn’t have to be. Gardens can be a haven of sound, fragrance and textures. According to American Foundation for the Blind, by continuing to garden, people who have experienced vision loss gain self-confidence and that self-confidence bleeds over to other areas of their life. If you continue to garden, you set aside limitations set upon yourself. Longtime advocate for those with disabilities say that growing plants provides inspiration and that vision loss is simply not enough reason to hang up the watering can and trowel. Some safety tips for people with visual limitations include: Clear plants hanging over paths Carefully coil hoses and store them out of the way Use labels or tags with large, readable letters or Braille or colored stakes to identify different plants Use tools with bright colors to make them easier to find Use an apron or tool belt to store tools while in the garden Avoid spraying pesticides Avoid thorny plants Making the garden lower maintenance in general can help the vision impaired gardener say independent. Simple enjoyment is a good reason for making your garden accessible for those with limitations. Even if you don’t want to or can’t completely re-landscape your garden, you should be able to make a least some of your outdoor space easily accessible to someone who has trouble walking, bending or kneeling.

Tuesday, May 16, 2017

Older Americans Month

May is Older Americans Month. The 2017 Older Americans Month theme is “Age Out Loud”. The Administration for Community Living (ACL) of the U. S. Department of Health and Human Services, declares May Older Americans Month. The theme is intended to give aging a new voice – one that reflects what today’s older adults have to say about aging. President Lyndon B. Johnson signed the Older Americans Act into law in 1965. Since that time, the act has provided a nationwide aging services network that helps older adults live with dignity in the communities of their choice for as long as possible. These services include home delivered and congregate meals, caregiver support, community based assistance, preventive health services, elder abuse prevention, and much more. Older adults are a growing and increasingly vital part of our country. The contributions they make to our communities are varied, deeply rooted, and include influential roles in the nation’s economy, politics, and the arts. The theme for this year gives us an opportunity to shine a light on many important issues and trends. More than ever before, older Americans are working longer, trying new things and engaging in their communities. They are taking charge, striving for wellness, focusing on independence, and advocating for themselves and others. They expect to live their life to the fullest. What it means to age has changed and Older Americans Month is a perfect opportunity to recognize and celebrate what getting older looks like today. While The Dale Association provides social and supportive services for older adults year round, Older Americans Month offers an opportunity to focus on how older adults in our community are leading and inspiring others, how we can support and learn from them, and how we might follow their examples. It’s also an occasion to highlight how older adults are engaging with and making a difference in those communities. Throughout the month, The Dale Association will be conducting activities and proving tips on how to access programs and resources designed to maximize the independence of older adults in our community. The annual observance offers the opportunity to learn about, support, and celebrate our nation’s older citizens. I hope you will participate.

Monday, May 1, 2017

Making Well Informed Decisions

The New York State Bar Association’s Elder Law Section is sponsoring National Healthcare Decision Making Day 2017. What is National Healthcare Decision Making Day? It is a volunteer, public-service project which will involve attorneys speaking on topics relevant to older New Yorkers, their family members and caregivers. The National Healthcare Decision Making Day initiative is a collaborative effort of national, state and community organizations committed to ensuring that all adults with decision-making capacity in the United States have the information and opportunity to communicate and document their healthcare decisions. Despite recent gains in public awareness of the need for advance care planning, studies indicate that most Americans have not exercised their right to make decisions about their healthcare in the event that they cannot speak for themselves. The National Healthcare Decision Making Day will help people understand that making future decisions includes much more than deciding what care they would or would not want; it starts with expressing preferences, clarifying values, identifying care preferences and selecting an agent to express healthcare decisions if patients are unable to speak for themselves. According to a recent research study: 71% of Americans have thought about end-of-life treatment preferences, 95% have heard of a living will, but only 29% have a living will. The public is invited to attend a free session of National Healthcare Decision Making Day 2017, which is being held locally on May 9, 2017 at 10:00am, at The Dale Association, 33 Ontario Street, Lockport. A local attorney from Patricia George Law Office will be the speaker. The program will include a question and answer session, and a “legal checklist” with an overview of legal documents every New Yorker should be aware of. Topics will include: Health Care Proxies Powers of Attorney Wills DNR Organ Donations Probate What are healthcare proxies and powers of attorney? How do they differ? How can these documents help avoid problems regarding guardianship, DNR orders and organ donation requests? Why do I need a will? What insurance, pension and financial documents should I have? What must be done to complete and maintain these documents? It is important for everyone to understand the importance of having these documents in order, it doesn’t matter what your age is. When people are unprepared, it can be emotionally devastating, financially costly, and an obstacle for people to take care of everyday dealings. The program is free of charge, will last approximately one hour and the community is welcome. For more information or to register for the session, please call 433-1886. Side Bar Box: WHAT: National Healthcare Decision Making Day WHY: Volunteer, public-service project WHEN: May 9, 2017 TIME: 10:00 am WHERE: The Dale Association 33 Ontario Street, Lockport Free and open to the public Please call 433-1886 to register

Monday, March 20, 2017

Be Aware of these Scams!

Over the past several years, I have used this column numerous times as a community resource to talk about the latest scams and how to avoid becoming a victim of a scam. Scams are still out there, so I am providing some general information and ways to help you, so you don’t fall victim to scams. And, scammers are getting slicker and more daring in ways that can easily catch you off guard- making you easy prey for newer scams – one of the newer scams is threatening to withhold funds from your Social Security Benefit Payment via an authentic looking letter from US Department of the Treasury. Scam artists are sophisticated and often prey on trusting victims – their single purpose is to make money. They want anybody’s money, including your money! Included with this week’s article is a copy of a scam letter that is circulating; it is authentic looking at first glance and an example of how scammers go to great lengths to make the situation seem legitimate. This letter was personalized with name and address, which has been blacked out. Be very careful and do not give out information. And, tax time is also scam artist time. Aggressive and threatening phone calls by criminals impersonating IRS agents remain a major threat to taxpayers, also. The IRS con game peaks during filing season as people prepare their tax returns or hire someone to do so. Scammers make unsolicited calls claiming to be IRS officials. They demand that the victim pay a bogus tax bill. They con the victim into sending cash, usually through a prepaid debit card or wire transfer. They may also leave “urgent” callback requests through phone robo-calls or via phishing email. Many phone scams use threats to intimidate and bully a victim into paying. They may even threaten to arrest, deport or revoke the license of their victim if they don’t get the money. Some schemes may even say you are entitled to a huge refund. They all add up to trouble. Scammers often alter the caller ID numbers to make it look like the IRS or another agency is calling. The callers use IRS titles and fake badge numbers to appear legitimate. They may use the victim’s name, address and other personal information to make the call sound official. The IRS reminds taxpayers to guard against all sorts of con games that arise during filing season. The IRS Commissioner says, “Don’t be fooled by callers pretending to be from the IRS in an attempt to steal your money. We continue to say if you are surprised to be hearing from us, then you’re not hearing from us.” Here are five things scammers often do, but the IRS will never do: • Call to demand immediate payment, nor will the IRS call about taxes owed without first having mailed you a bill. • Demand that you pay taxes without giving you the opportunity to question or appeal the amount they say you owe. • Require you to use a specific payment method for your taxes, such as a pre-paid debit card. • Ask for credit or debit card numbers over the phone. • Threaten to bring in local police or other law-enforcement groups to have you arrested for not paying. If you get a call from someone claiming to be from the IRS and asking for money, here’s what you should do: If you do not owe taxes, or have no reason to think that you do: • Do not give out information. Hang up immediately. • Contact the Treasury Inspector General for Tax Administration (TIGTA) to report the call. Use their “IRS Impersonation Scam Reporting” web page or call 800-366-4484. • Report it to the Federal Trade Commission. Use the “FTC Complaint Assistant” on FTC.gov webpage and please add “IRS Telephone Scam” in the notes. If you know you owe, or think you may owe tax: • Call the IRS at 800-829-1040. IRS workers can help you. • Each and every taxpayer has a set of fundamental rights they should be aware of when dealing with the IRS. For more information about your Taxpayer Bill of Rights, visit IRS.gov. Identity theft is one of the fastest growing crimes in America. One out of ten adults have been victimized by identify theft. Presenting them self as a representative from IRS or US Treasury is not the only way a scammer can victimize you. Garbage pickers routinely set up phony accounts in your name. They get all the information they need from your trash. Be sure to shred or burn solicitations or pre-approved applications from credit card companies. Or, the scam begins with a phone call. NEVER give out personal information. Banks, credit card companies, mortgage companies have the information they need. They will never call to ask your social security number or other personal information. Another version of identity theft is hackers call you and say your email has been hacked. They lead you to believe they are calling from a legitimate company and are calling to help resolve your problem. Then the hackers steal your private files and identity. They often say if you send us a pre-paid Visa cash card for $500 they can completely take care of things. Another scam that has been in the news lately is an urgent call from a “grand child” who has been in an accident or some other type of trouble and need their grandparent to wire money to get them out of trouble. Beware – this type of scam has been successful and takes advantage of an escalation of emotions. This information is being provided to help stop the number of innocent people who fall victim to scammers – I hope it makes you pause and not become the next victim. Thousands of individuals already have.

Proper Lighting for Older Eyes

Lighting is a serious matter for older adults. Seniors require three times the amount of light to see as well as younger people, but are more sensitive to glare. And, people with dementia have impaired contrast perception, so they can’t see the edges of objects as well – especially if the object and background appear similar. To assist older adults maintain a safe and independent home, consider the some of the following tips: Chair seats should contrast with the floor so people can see the edge of their seat. Sink basins should contrast with the surrounding counter/vanity top. Toilets or toilet seats should contrast with both the floor and surrounding walls to make them more visible. Table settings should provide high contrast between the plates (usually white or pale color) and the table or tablecloth (dark color). Colors that are a mix of hues from the opposite side of the color wheel (red and green, or yellow and blue) will look muddy and be less attractive to older adults whose lens may be yellowed. According to a recent study, 83% of older Americans want to stay in their current homes for the rest of their lives - where they are comfortable and secure and feel independent. Safety precautions become increasingly important in order to maintain a safe environment conducive to independent living. How many of you have thought about the affect of diminished lighting?

Wednesday, March 1, 2017

Caregiving: An Attitude of Gratitude

Caring for your family member demonstrates love and commitment and can be a very rewarding personal experience. Caregiving can also be an emotional roller coaster. Family caregivers are at increased risk for excessive use of alcohol, tobacco and other drugs and for depression. You cannot stop the impact of a chronic or progressive illness or injury on someone for whom you care. But, there is a great deal that you can do to for your own well-being. Many times, attitudes and beliefs form personal barriers that stand in the way of caring for yourself. Not taking care of yourself may be a lifelong pattern, with taking care of others an easier option. However, as a family caregiver, you should ask yourself, “What good will I be to the person I care for if I become ill?” Breaking old patterns is not an easy proposition, but it can be done. The first task in removing personal barriers is to identify what is in the way. For example, Do you feel you have to prove that you are worthy of the care recipient’s affection? Do you think you are being selfish if you put your needs first? Is it frightening to think of your own needs? What is the fear about? Do you have trouble asking for what you need? Do you feel inadequate if you ask for help? Why? Sometimes caregivers have misconceptions that increase their stress and get in the way of taking good care of themselves. Here are some of the most commonly expressed: I am responsible for my parent’s or loved one’s health. If I don’t do it, no one will. If I do it right, I will get love, attention and the respect I deserve. Because we base our behavior on our beliefs and attitudes, misconceptions like those noted above can cause caregivers to continually attempt to do what cannot be done and to try to control what cannot be controlled. Once you’ve started to identify personal barriers to your self-care, you can begin moving forward one small step at a time. How we perceive and respond to an event is significant in how we adjust and cope with it. The stress you feel is not only the result of your caregiving situation, but also the result of your perception of it – whether you see the glass as half-full or half-empty. It is important to remember that you are not alone in your experiences. Your level of stress is influenced by many factors, including: Whether your caregiving is voluntary. If you feel you have no choice in taking on the responsibilities, the chances are greater that you will experience strain, distress and resentment. Your relationship with the care recipient. Sometimes people care for another with the hope of healing the relationship. If healing does not occur, you may feel regret and discouragement. Your coping abilities. How you coped with stress in the past predicts how you will cope now. Identify your current coping strengths so that you can build on them. Your caregiving situation. Some caregiving situations are more stressful than others. For example, caring for a person with dementia is often more stressful than caring for someone with a physical ailment. Whether support is available. Remember, it is not selfish to focus on your own needs when you are a caregiver – it’s an important part of the job. And, current research is finding that taking care of tired caregivers could be as important as providing care for their care-recipients. Simply listing what you, as a spousal caregiver, are grateful for can provide you with the much-needed "tender loving care" that you are providing for your spouse -- and that you are typically not receiving from any other source. So the question that I have for you is: "How is your 'attitude of gratitude'?" As we all know, we are often stressed out by the various caregiving activities we perform for our spouses. The lead professor associated with the study theorized that something as simple as writing about gratitude will help relieve that stress. Specifically, in order to show the link between gratitude and health, researchers are analyzing just how gratefulness impacts the lives of men and women who care for loved ones with Alzheimer's disease. "Caring for a person with Alzheimer's disease is a prime example of unlimited love. There is a lot of sacrifice involved, a lot of cost, and no reward" the lead researcher said. While her research is focused on Alzheimer's caregivers, the results of that research can be extrapolated to all caregivers - especially spousal caregivers. In order to better understand how to help caregivers, half of the research group fill out "gratitude journals" in which the participants listed what they were grateful for each day. The other half of the research group filled out "hardship journals" in which the participants listed the hardships incurred each day. Both groups wrote in their journals for two weeks. Researchers theorize that those who completed the gratitude journals will have increases in their respective psychological well-being, general health, and life satisfaction. Previous research with college students found that gratitude had improved their physical and cognitive health. Since caregivers are dealing with much more serious issues, an emphasis on gratitude could conceivably help them cope with their daily problems more effectively. I have a GREAT "attitude of gratitude" -- how about you? It really does help get through challenging days as a caregiver.

Adversity and Well Being

A recent study lends a fresh perspective to the famous quote, “That which does not kill us, makes us stronger.” The authors of this study examined the relationship between cumulative lifetime adversity and human resilience. By analyzing a nationally representative sample of the population, the authors found that individuals who experienced a moderate amount of adversity during their lifetimes had higher levels of mental health and wellbeing than (a) people with an extensive history of adversity and (b) people without any history of adversity. Taken at face value, these results seem to contradict prior research which has consistently found the experience of adversity to be positively correlated with poor mental and physical health. That said, the authors of the current article emphasize that this is the first study to examine cumulative life adversity—compared to prior research which has historically analyzed individual events or singular categories of events. In other words, in the past, researchers have either studied the occurrence of a single event in a person’s life (e.g., asking a person to describe one adverse event that occurred during their lifetime), or a single category of adverse events that can be experienced by many people. This study took a novel approach by to the topic of adversity by combining both of these methodological techniques to assess the cumulative effects of multiple events affecting the same individual across multiple categories of adverse events that tend to affect different individuals. If both the prior findings and the current study are valid, this would suggest that the experience of adversity, can produce both a debilitating effect in the immediate time-frame in which the event occurs, and a toughening (i.e., overall strengthening) affect over one’s entire life time. Consequently, this accrual of lifetime toughness would continue to bring new perspective to one’s future appraisals by placing them in a position of greater wisdom via the confidence stemming from the knowledge that they have successfully dealt with past experiences of adversity. In short, if aging is defined by the wisdom and strength that comes from it, then what doesn’t kill us may actually make us stronger—in moderation.

Signs Your Parents Need Help at Home

By Marlo Sollitto Knowing when to begin discussions about needed assistance with aging parents is not always as simple as one might think. Maybe you've noticed that dad's unopened mail is piling up. Or mom, once meticulous about her appearance, is wearing wrinkled clothes and not doing her hair. Perhaps there are bruises on your loved one's arms. When you bring up these observations, their instant response is, "Everything is fine, there's no need to worry." Admitting they need help would mean they can no longer take care of themselves, and no one wants to lose their independence. "Denial is the unrealistic hope that a problem is not really happening and will go away by itself. Admitting they need help and accepting assistance is not easy for people as they age. It represents a loss of independence. Denial plays a major role and signs get ignored," says Paul Hogan, Founder and Chairman of Home Instead Senior Care. The burden often falls on the family to recognize the signs that an aging parent might need help with daily living tasks. This doesn't necessarily mean that your loved one has to move to assisted living or a nursing home, but they may need some extra help in their home. If they're not willing to admit it, how do you know if your elderly parent needs home care? Look for the red flags listed below. Signs Your Parent Needs Help at Home • Spoiled food that doesn't get thrown away • Missing important appointments • Unexplained bruising • Difficulty getting up from a seated position • Difficulty with walking, balance and mobility • Uncertainty and confusion when performing once-familiar tasks • Forgetfulness • Unpleasant body odor • Infrequent showering or bathing • A strong smell of urine in the house • Noticeable decline in grooming habits and personal care • Dirty house, extreme clutter and dirty laundry piling up • Stacks of unopened mail or an overflowing mailbox • Late payment notices, bounced checks and calls from bill collectors • Poor diet or weight loss • Loss of interest in hobbies and activities • Changes in mood or extreme mood swings • Forgetting to take medications, or taking incorrect dosages • Unexplained dents and scratches on a car Once the problem is realized, the family must decide if home health care is the best option. It is generally defined as non-medical support services delivered at the home of the senior. "The aim of this kind of care is to allow seniors to remain at home longer rather than moving to an assisted living community, nursing home or other type of senior care facility. It may be appropriate if a senior prefers to stay at home but needs minor assistance with activities of daily living," says Sam Almengor, National Accounts Director for Senior Helpers, a national company that provides professional in-home assistance services. "One of the most frightening prospects for seniors is leaving home," Hogan says.