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 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.