Unnecessary trouble

Unnecessary trouble

How do you care for someone who refuses to let you help them?

My mother refuses to have outside help. It needs to be me, her daughter, who helps her. But she really wants a servant.

She raised me to be a woman who’s practical. Who thinks about what people might need and gets it for them. Who does what needs to be done. You’d think that would make me a good caregiver. I want to make things as easy as possible for her.

That’s not what she wants.

She’s been having trouble getting around on her own, even in the house. The doctor suggested we minimize her fall risk. I reorganized the ground floor of the house according to the instructions in the pamphlet he gave us. Rolled up the throw rugs, moved furniture over so nothing was blocking the doorways, anchored the bookcases into the wall in case she grabbed onto them. She was livid. She insisted everything be moved back, safety be damned.

And she keeps falling. She tripped on the rug. At first I thought she didn’t call for help so I wouldn’t know she fell. Perhaps she hoped she’d be able to get herself up and I’d never know, never be able to tell her I told her so. Which I wouldn’t say, but we both are thinking it.

But she can’t get herself up when she falls. She’ll try, though. She will sit there for hours, refusing help, straining and failing to hoist herself up. She won’t use a walker. She won’t make the house safer. Instead, she falls and lays there until she soils herself.

That’s usually when she’ll give up and let me help her to her feet. She’ll wait until she needs to use the toilet urgently before she agrees to let me help her up. And then with the strain of getting up, even with me lifting her, she’ll have an accident on both of us.

I thought she’d learn that lesson the first time and not repeat it. I was wrong. The third time I tried to, delicately, suggest she should let me help her up sooner because of what had happened the last two times. That did not go over well. Apparently it’s disrespectful for me to try to prevent her from having an accident — both the falling and the soiling both of us — but it’s not disrespectful for her to choose to harm herself.

Who has to clean up after this? I do. Who has to take hours from my day to deal with this every time? I do. Hours when I should be doing other things to care for her. I am willing to care for her, but she insists on making this job much more difficult than it needs to be.


Reduce Your Out-of-Pocket Healthcare Costs

Reduce Your Out-of-Pocket Healthcare Costs

Patients are shelling out a larger amount of their income to healthcare providers now more than ever. In fact, according to Forbes, patient payments account for over one-third (35%) of revenue for providers.

This makes it the third highest revenue stream, with Medicare and Medicaid taking top spots. Even when patients have company-provided healthcare coverage, most still have to fork over payment for deductibles, copayments, premiums, and other out-of-pocket expenses.

With the trend in healthcare on the incline, it is safe to say that costs aren’t coming down anytime soon. Patients though can still take healthcare into their own hands and lower out-of-pocket healthcare costs by using these two tips. Read on to find out what they are!

1. Choose Generic Over Brand Prescriptions

Companies of brand prescriptions and over-the-counter medications would like you to believe that their products are the best in the healthcare industry.

And, with the number of advertisements pushing brand name medicine to consumers on a daily basis, it can seem like those companies are right.

However, the frequency of those advertisements is the only main distinction between brand and generic medicine.


According to the Food and Drug Administration (FDA), general medications are just as effective as name brand medicines in terms of safety, quality, strength, how they are administered, dosage, strength, and their performance characteristics.

The FDA also has its Generic Drugs Program perform rigorous reviews on generic medications to ensure they comply with all necessary requirements.

On top of this, the FDA inspects approximately 3,500 drug manufacturing plants per year to make sure they meet the FDA’s standards.

So, the next time you are at your local grocery store shopping for cough medicine, choose the generic brand over a name brand; it will help with your cough and your wallet.

2. When Not an Emergency, Go to Urgent Care

Both the emergency room and urgent care are places to go to when you need your illness or injury treated at that moment, however, there are clear distinctions between the two. Knowing them could save you a trip to the emergency room, which can cost as much as 40% more than your monthly rent.

Emergency Rooms

Emergency rooms are for emergencies. They are facilities equipped with the latest machinery and staffed to handle the direst, most life-threatening situations, including severed limbs, heart attacks, facial wounds, and other critical injuries and illnesses.

Urgent Care Clinics

Urgent care clinics, while sounding similar to emergency rooms, aren’t intended for emergencies.

They are facilities for those who need to visit their primary care provider but can’t get in because it’s after normal business hours or appointments are booked up for the day or week.

According to Scripps, individuals can go to urgent care facilities if:

  •      their symptoms happen gradually and/or they already know what their diagnosis is
  •      fever minus a rash
  •      it’s painful to urinate
  •      ear pain
  •      persistent diarrhea
  •      throwing up
  •      sore throat
  •      Sprain or shallow cut (minor trauma)

Again, if it’s an emergency, go to the emergency room. Knowing the difference between the emergency room and urgent care could save you thousands of dollars, with you (or a loved one) going to urgent care for that sore throat instead of taking a costly trip to the ER—even when you work for a company that provides healthcare for employees.  

Final Thoughts

With healthcare insurance on the up and up, it’s important to know how you can cut healthcare costs, even when you have company-provided healthcare insurance.  

No matter what healthcare reduction tips you use, one of the best prevention tips is eating a balanced diet and exercising at least 150 minutes per week.

In doing so, you will save you that trip to your doctor’s office in the future. What other healthcare saving tips do you recommend? Leave a comment!

Wendy Dessler is a super-connector with Outreachmama who helps businesses find their audience online through outreach, partnerships, and networking. She frequently writes about the latest advancements in digital marketing and focuses her efforts on developing customized blogger outreach plans depending on the industry and competition.


8 Tips for Gentle Decision-Making for Your Aging Elders’ Care

8 Tips for Gentle Decision-Making for Your Aging Elders’ Care

Caregiving is a relentlessly shifting landscape, predictable only in its unpredictability. Each change requires new research and new decisions. Caregiving is rife with decisions, and at times, some might have the potential for sadness or disagreements.

You may be in a position of being required to make decisions for your loved ones, but the smoothest path may be to help your elders make their own choices. They are vulnerable, losing their sense of being in control of their lives, facing an uncertain future; at our best we, as caregivers, can try to guide and respect their choices.

Your parents or loved ones may not see the future as you do. Most of them did not grow up in a world with self-determined choices. Their lives were scripted: they served in the military, got jobs, married, and had kids. They do not function in a future of possibilities, of “what ifs.” When they start to fail they may only have desperate thoughts of nursing homes reeking of urine and disinfectants.

In my book, While They’re Still Here, I discuss my personal experiences with caring for my aging parents. Becoming their fulltime caregiver was not easy, and there were some bumps along the way, but I was able to find my way and help my parents in a way that worked successfully for all of us. Here are some tips for gentle decision-making when you know the house is on fire and your parents say they don’t mind a little smoke.

Decision making based on the teachings of our childhoods:

1. Respect your elders. Keep your mouth shut and your ears open. When decisions must be made, first listen. Then listen some more. Chat. That’s what you’ll miss the most “later.” Act as an advocate not as the decision-maker. Be as respectful as you would be of your best friend’s parent. I couldn’t begin to fix my parents’ problems until they could explain them, and they couldn’t explain them until they felt their opinions and ideas would be valued by me. Maybe I knew I was actually nodding in disbelief, but at least they felt heard and thought I was agreeing. I hoped by the next day I could come up with a reasonable, logical proposal rather than the blunt retorts running through my brain right then.

2. Patience is a virtue. Haste makes waste. Proceed as slowly as circumstances allow. Present an idea and let it soak. I often reminded myself that it took my parents eighty years to create their problems, and I wasn’t going to solve them overnight. If you’ve walked a lifetime on a rocky road together, maybe all you can do today is help take some gravel out of their shoes. But it will matter tomorrow when their feet aren’t so sore.

3. Because I said so. Time has changed their memories. Let them tell their stories the way they want to be remembered. Let them be the people they wish they’d been. Find the pearl in the bad memory. If in the worst year of your life, the only highlight was Uncle Henry’s goat eating all the laundry off the line, laugh it up. Uncle Henry bought you all new clothes; then your dad got the goat to eat the threadbare old couch . . .Let go of the past and start decision making from where they are now.

4. It’s about time you grow up. Be the grown up, even if you have to leave the room and scream in a pillow. Your roles have reversed. Be the parent everyone wished they’d had. Maybe yours weren’t the best parents way back when, but be your best now. Let time heal.

5. If you don’t have something nice to say, don’t say anything at all. Avoid potential regret. Frame every thought with as much kindness as you can muster. You can’t ever take back harsh words. If you are always doing the best you can, then later you can trust that you did the best you could. This promotes sound sleep “later.”(Do not expect to sleep well while caregiving.)

6. Hold your horses. Approach decisions as if no decision is imminent. Try not to give opinions. “Do you think you’ll still want to stay here someday when you don’t want to drive anymore?” Put it in the future, empower with “don’t want to drive,” not “can’t drive.” Try to be vague. While you’ve been up all night on your computer trying to find solutions, they’ve only been frozen in fear. You could continue the conversation with, “I kinda think I’d want to be somewhere that they had transportation, like where Aunt Hilda lives.” Then make a sandwich or open the mail; just be normal. Let your elder start to think about it. In an hour or a day or a week, they may say, “Can I afford to live somewhere else?” Be their helper, not their overseer. Just casually respond, “I’m not sure. But we can check it out just so you’ll know if it’s an option.” Your adrenaline may be shooting through you while your brain makes a to-do list, but act as if it’s a dinner choice. Italian or Thai? Anything else will build pressure.

7. We’ll cross that bridge when we come to it .Try to understand the priorities from your loved one’s frame of reference. What can they no longer do right now—Pay bills? Grocery shop? Clean the house? Get to the doctor? What are they grieving right now? Stand in your parent’s shoes and guide decisions from their perspective. There is no way to plan for the unknown anyhow, so you may as well just deal with what is in front of you.

8. Let nature take its course. You can’t stop this train called aging or prevent it from derailing no matter how hard you try. But with compassion and kindness as your engineer, you may be able to enjoy the scenery as you take this last ride with your elder. Just remember, they’ll be deciding the route, not you.

Aging and elder care can be intimidating for elders and caregivers alike. However, it can be peaceful if you keep in mind your elder’s fears, concerns and needs, and help them take as active a role as they are capable of taking in their care. By following the tips above, you can help ease your elders’ worries, foster positive conversations on their needs and care, and reduce some of your own stress and tension as their caregiver.

Patricia WilliamsPatricia Williams grew up in Elyria, Ohio surrounded by relatives and friends, then spent a few unforgettable years in Cumberland, Maryland. She is now retired from a long and satisfying career as a dental hygienist and lives in Olympia, Washington, where she has enjoyed gardening, crafting, tracing genealogy, reading, caring for pets, and entertaining visitors on the same parcel of paradise since 1977. She lives with her spouse, Katy Murray. Her new memoir, While They’re Still Here, releases in November 2017. Learn more about Williams at www.patriciawilliamsbook.com.

How Social Interaction Plays a Principal Role in Dementia

How Social Interaction Plays a Principal Role in Dementia

Dementia is an umbrella term for a progressive age-related disorder which is primarily seen in senior patients. It is associated with deterioration of the patients’ memory, cognition, behavior and a decline in their ability to perform activities of daily living. Alzheimer’s disease is the most common type of dementia that makes up nearly 70 percent of the cases.

One in ten Americans aged 65 years and older suffers from dementia. 2017 statistics reveal that an estimated 5.3 million senior Americans are living with dementia related to Alzheimer’s disease.

According to the U.S. Census Bureau, nearly 28 percent of seniors aged 65 years and older are living alone. Seniors with dementia are at a higher risk of social isolation, leading to serious consequences for the patient.

If you have a senior loved one who is suffering from dementia, it is crucial that you engage him/her in suitable social activities to make him/her feel loved and cared for.

Here are five ways in which social interaction can affect your senior’s health positively and boost his/her longevity and mental wellbeing.

1. Social Interaction Preserves Cognitive Function

Research has found a strong connection between loneliness and impaired cognitive function. Patients with dementia are often pessimistic about their future and tend to feel lonely owing to social isolation. This happens mainly due to retirement, the death of a spouse and/or close friends, and the lack of mobility.

Numerous studies confirm that seniors with dementia who have a strong social network experience delayed cognitive impairment. Larger social circles have a protective influence on the comprehension and reasoning ability of seniors battling dementia. Seniors who have a considerable amount of support from their families are at a lower risk of developing memory-loss symptoms.

When seniors interact with other family members, relatives, and friends, they have to think of ways to converse and respond. Scientists believe that this basic exchange is a form of exercise that stimulates the brain cells and the formation of brain synapses, thus fueling the creation of new nerve cells.

Encourage and help your senior to build a social network by participating in voluntary and social service activities and cognitive rehabilitation programs. These activities can be a valuable source of social connection for your elder, making him/her feel valued.

2. Meeting People Comes with Psychological Benefits

Dementia is often associated with psychological conditions such as stress, depression, anxiety, and mood disorders. Researchers estimate that nearly 95 percent of seniors living with dementia suffer from behavioral and psychological symptoms such as agitation, aggression, depression, delusions, hallucinations, and sleep disturbances. These symptoms are commonly referred to as the neuropsychiatric symptoms of dementia.

Seniors with strong family and social bonds tend to have a positive outlook as they have someone reliable to talk to. Remaining socially active can significantly reduce the risk of psychological disorders and improve sleep quality.

Getting quality sleep is crucial for dementia patients to calm their psychosomatic symptoms of depression and anxiety. The National Sleep Foundation states that undisturbed sleep relaxes the brain and helps it focus and retain information better.

Plan meaningful activities for your senior, keeping in mind his/her physical abilities, leisure interests, past work life, and social preferences. Take your senior for a movie or a play, invite family and friends for a game of cards, or go through a photo album and talk about old times. These activities will improve your senior’s mood and reduce challenging behaviors.

3. Get-Together Offer Physical Health Benefits

Engaging in social interaction offers numerous physical benefits to patients with dementia. Participating in group physical activities improves the patients’ ability to perform activities of daily living and reduces the risk of falls.

Group activities like exercising, walking, and playing games offer social interaction opportunities and can be adapted to suit a wide range of physical limitations of seniors.

Take your senior for regular walks in the park. Encourage him/her to join yoga, meditation or exercise class. Engaging in group exercises builds a strong social circle, improves mood, boosts physical strength, and reduces the risk of age-related ailments.

4. Socializing Improves the Overall Quality of Life

Dementia can significantly impact your senior’s quality of life, causing him/her to feel isolated, agitated, frustrated, depressed, and embarrassed. Your senior’s inability to perform daily tasks and remember simple things can affect his/her emotional wellbeing as well.

Patients with dementia often land up in hospitals mainly due to fractures, urinary tract or chest infections, or strokes. These patients have twice as many hospital stays every year compared to other seniors, contributing to a total annual healthcare cost of $259 billion.

According to a research paper presented at the Annual Alzheimer’s Association International Conference, social interaction can significantly improve the quality of life of patients with dementia, ease their agitation, and reduce overall healthcare costs. Support from family, friends, and relatives can go a long way in building the confidence of elderly patients.

5. Social Stimulation Promotes Independence

Seniors with dementia need assistance with personal and domestic tasks. Moreover, they often feel frustrated about and guilty of not being able to help with household activities. This increased dependence on others and feeling of being incapacitated often makes them irritable and damages their confidence levels.

Having compassionate loved ones who celebrate happy times with them and listen to their frustrations and offer solutions can be extremely comforting for seniors with dementia. This social stimulation fosters their independence as they feel connected and secure about their support system that assists them when required.

Involving your loved one in simple domestic activities like sorting out the post, organizing the laundry, arranging fresh flowers, and laying the table for a meal can make him/her feel involved and boost his/her confidence.

Seeing a loved one live with dementia can be painful. Fortunately, personal relationships and social environment can play a principal role in improving the patient’s cognitive skills and overall quality of life. Caregivers, family members, and friends can help their ailing loved one feel more valued by being around him/her during this tough period.


There is mounting evidence highlighting the role social interaction plays in improving the lives of seniors with dementia. The above points will help you encourage your senior to engage in activities that will build and strengthen his/her social circle, enabling him/her to live a fulfilling life.


Evan Thompson, CEO and founder of Senior.One has a long standing interest in finding solutions for seniors. He helps connect senior citizens and their family members with elder care service providers and find the resources they need in one place. He offers information on nursing homes, hospice, financial planning, adult care, lifestyle and assisted living facilities in Albuquerque. He provides information on housing, medical professionals, financial planning services, and lifestyle options.

Why thank you can’t wait

Why thank you can’t wait

Our son, Ben, is responsible for bringing the most remarkable people into our family’s life. They’ve come in the form of teachers, therapists, bus drivers and service providers – all caregivers who have shared their life with ours. I’ve learned that there’s no good reason to wait to say thank you.

Ben was born with severe cognitive, physical and speech development issues that require 24-hour care. If not for his caregivers, I don’t think Ben or our family would be in the good place that we are today.

The relationships we’ve developed with Ben’s caregivers have helped us establish a strong network of support. We are grateful for them and their willingness to care and love him as much as we do.

They’re caregiving has extended further than their job duties. When I’ve needed advice about how to approach a situation or vented about bureaucratic issues that prevented Ben from receiving services, they’ve provided insight or a listening ear to help get me through the tough times.

They hear the words, “thank you,” from me on a regular basis, but I also attempt to do something special for them as well.

Here are 5 ways to say thank you throughout the year:

Create a care package

Put special items in a box or reusable bag to show your appreciation for their work. Bus drivers and bus monitors are often underappreciated for what they do. A care package with a box of tissues, baby wipes, paper towels and glass cleaner will make them feel appreciated and help them be prepared for eventual situations. It also saves them having to buy these items with personal funds.

Consider making a “survive the first week” box for a teacher. Send in a tote bag with lip balm, mints, aspirin, a chocolate bar and other personal items that the teacher can have at their disposal during that hectic first weeks of school.

Give a gift for the road

Therapists often drive throughout the day traveling to different schools and homes to work with clients. Purchase a small lunch bag and fill it with a drink, snack and a magazine for a treat in between clients.

Many caregivers would appreciate a gift card to a local coffee shop or cafe so they can have a moment alone.

Volunteer your time

In some cases, giving a bit of your time can help ease the pressure off a caregiver or give them the opportunity to attend a special event.

I’m active with a leadership team at my son’s school because his teacher asked me to a be a part of the group. His teacher represents the interests of the special education program, and I can show my support of her and advocate about issues that affect her class.

Make or bake something

My favorite gift is a handmade bookmark that has the poem, “You’ll never know” printed on it. Add a bookmark to a book by a caregiver’s favorite author, a paperback for the beach or a volume of inspirational poems.

Not crafty and don’t have the time to bake? Pick-up store-bought muffins or cookies. It shows someone that you care about them.

Write a note

Most of us worry about stumbling over the right words to say how we feel about someone. In fact, that apprehension sometimes prevents us from ever writing the note. But words can mean so much to the receiver. Say thank you, pick one thing you are grateful for and sign it with your name. That’s it.

At the end of each year, I write the bus driver and monitor a note telling them how much it’s meant for me to know that Ben was in safe and capable hands while on the bus.


Are you waiting to say thank you to someone special in your life? Try one of the ideas above or use one as an inspiration to develop your own unique thank you.

Doing this already? Tell us who you show appreciation to. How do you say thank you? Add your ideas in the comment section.

vanessaVanessa Infanzon is mom to three beautiful boys. Her oldest son, Ben, is a smart, funny and determined 14-year-old. He doesn’t let anything stop him from doing what he loves – swimming, being outdoors and eating out. Vanessa is also a contributing writer for Ross Feller Casey.


Advocating for a family member in the hospital

Advocating for a family member in the hospital

It’s incredibly stressful to have someone you love in the hospital. Not only are you worried about their health, it almost seems like hospitals were designed to be as stressful as possible! Constant interruptions, florescent lights, beeping and blinking machinery, and incredible levels of crowding guarantee we’re all on edge.

Sometimes, especially with teams of medical staff coming and going at random, I wonder if my son is getting the best care. Are these staff members familiar with his medical history? Do they have all the information they need? Are they ordering tests he doesn’t need and skipping over ones that might be more appropriate? Medical staff are rushed and exhausted…and only human.

After more than a decade of being in-and-out of hospitals with my son, I feel confident in my ability to advocate for him to get the best care possible.

I always keep a notebook with me. I take notes when I’m talking to the doctors, including their names and titles, so I can keep track of things. I ask questions of the doctors at the time, but I also have the details I’ll need to look things up on my own later and ask follow-up questions.

I ask staff members if it’s okay to contact them with questions and how they prefer to be contacted. If someone is okay with me emailing them questions I make sure not to abuse the privilege and be respectful of their time.

I stay calm. Yes, it’s an emergency for me and my son is my top priority. But I recognize that’s true of just about everyone in the hospital. Hospital staff need to balance the needs of all of their patients, so I’m firm in asking for the care he needs, but also remember that things can’t always happen on the timeline I’d like.

I’m persistent. It’s tough to find the right balance of making sure things aren’t forgotten without becoming that mom.

I’m open to suggestions. My son and I know his health best, but we’re in the hospital for a reason — these people are experts, too. It can be difficult, but I try to make sure we’re working with his medical team and not just trying to convince them to take the course of treatment we think is best.

I appreciate the staff. Hospital staff are people. They have good days and bad days, too. I try to remember this, thank them for their help, and cut them slack when they drop the ball. Treat others like you’d like to be treated.

Susie Miller

Family Caregiver Alliance launches an online service for family caregivers of adults with serious health conditions

Family Caregiver Alliance launches an online service for family caregivers of adults with serious health conditions

For the first time, family caregivers can get support and information tailored for their situation–free, secure, and accessible 24/7 SAN FRANCISCO, Sept. 12, 2017 /PRNewswire-USNewswire/ — Family Caregiver Alliance (FCA) announces the launch of FCA CareJourney™, a dynamic online service, mobile-ready that delivers specialized information directly to family caregivers. Based on FCA’s 40 years of service… (more…)

Older cancer patients rate own physical abilities as better than their caregivers do

Older cancer patients rate own physical abilities as better than their caregivers do

Older cancer patients and their caregivers often differ in their assessment of the patient’s physical abilities, with caregivers generally rating the patient’s physical function as poorer, according to a new study published in The Oncologist. The study also found that differences in assessment of physical abilities between patients and caregivers were associated with greater caregiver burden.

For as long as possible, older cancer patients are generally cared for in their own homes by family or friends, with spouses being the most common caregivers. This care can include everything from ensuring patients take their medication to transporting them to hospital appointments to bathing and dressing them, and can impose emotional, financial and physical burdens on caregivers.

“Caregivers are such an important part of our healthcare system, particularly for older adults with cancer,” says corresponding author Arti Hurria at City of Hope National Medical Center, CA. “We wanted to further understand the factors that are associated with caregiver burden.”

Based on their experiences treating older cancer patients, one factor Hurria and her colleagues at City of Hope thought might be important is differences in assessments of patient health and physical abilities between patients and their caregivers. “In daily practice we sometimes see a disconnect between what the patient perceives their general health and abilities to be in comparison to what the caregiver thinks. We wanted to see whether this disconnect impacted caregiver burden.”

To do this, Hurria and her colleagues questioned 100 older cancer patients being treated at City of Hope, together with their caregivers, about the patient’s general health and physical function, meaning their ability to perform everyday activities. They then compared the answers given by the patients and their respective caregivers. They also assessed the level of caregiver burden experienced by the caregivers, defined as a subjective feeling of stress caused by being overwhelmed by the demands of caring, by conducting a standard questionnaire on topics such as sleep disturbance, physical effort and patient behavior.

The 100 cancer patients, aged from 65 to 91, were suffering from a variety of different types of cancer, with the most common being lymphoma, breast cancer and gastrointestinal cancers. The ages of the caregivers ranged from 28 to 85 and the majority were female (73%), mainly either the spouse of the patient (68%) or an adult child (18%).

Hurria and her colleagues found that caregivers consistently rated patients as having poorer physical function and mental health and requiring more social support than the patients themselves did. However, only the disparity in the assessment of physical function was associated with greater caregiver burden. What is still unclear is the cause of this disparity.

“I think there are two possible explanations,” says first author Tina Hsu. “One is that older adults with cancer either don’t appreciate how much help they require or, more likely, they are able preserve their sense of independence and dignity through a perception that they feel they can do more than they really can. Alternatively, it is possible that caregivers who are more stressed out perceive their loved one to require more help than they actually do need. Most likely, the truth of how much help the patient actually needs lies somewhere between what patients and caregivers report.”

Based on their findings, Hsu, Hurria and their colleagues advise that clinicians should consider assessing caregiver burden in those caregivers who report the patient as being more dependent than the patient does themselves.

“Caregivers play an essential role in supporting older adults with cancer,” says Hsu. “We plan to further explore factors associated with caregiver burden in this population, particularly in those who are frailer and thus require even more hands-on support. We also hope to explore what resources caregivers of older adults with cancer feel they need to better help them with their role.”

Bruce A. Chabner, MD, Editor-in-Chief of The Oncologist, commented, “This report emphasizes the importance of direct communication between the health care team and the patient.  Among older patients, the reports of local caregivers may not accurately reflect the patient’s sense of well-being and symptoms.  The message is:  talk to the patient first!”

Article citation: “Are Disagreements in Caregiver and Patient Assessment of Patient Health Associated with Increased Caregiver Burden in Caregivers of Older Adults with Cancer?” Tina Hsu, Matthew Loscalzo, Rupal Ramani, Stephen Forman, Leslie Popplewell, Karen Clark, Vani Katheria, Rex Strowbridge, Redmond Rinehart, Dan Smith, Keith Matthews, Jeff Dillehunt, Tao Feng, David Smith, Canlan Sun, Arti Hurria. The Oncologist. Published Online: August 14, 2017; DOI: 10.1634/theoncologist.2017-0085. http://dx.doi.org/10.1634/theoncologist.2017-0085

About The Oncologist
Now celebrating its 22nd edition, this internationally peer-reviewed journal focuses on clear and concise interpretation addressing the multimodality diagnosis, treatment and quality of life of the cancer patient. Each issue is meant to impact the practice of oncology and to facilitate significant communication in the introduction of new medical treatments and technologies. The Oncologist is the official journal of the Society for Translational Oncology (STO).

About AlphaMed Press
Established in 1983, AlphaMed Press, which has offices in Durham, NC, San Francisco, CA, and Belfast, Northern Ireland, is the publisher of three internationally renowned peer-reviewed journals. The Oncologist® (www.TheOncologist.com), which is entering its 20th year, is devoted to community and hospital-based oncologists and physicians entrusted with cancer patient care. STEM CELLS® (www.StemCells.com), celebrating its 35th year, is the world’s first journal devoted to this fast paced field of research. STEM CELLS Translational Medicine® (www.StemCellsTM.com), currently in its sixth year, is dedicated to significantly advancing the clinical utilization of stem cell molecular and cellular biology.

About Wiley
Wiley, a global company, helps people and organizations develop the skills and knowledge they need to succeed. Our online scientific, technical, medical and scholarly journals, combined with our digital learning, assessment and certification solutions, help universities, learned societies, businesses, governments and individuals increase the academic and professional impact of their work. For more than 200 years, we have delivered consistent performance to our stakeholders. The company’s website can be accessed at www.wiley.com.

A new age of care

A new age of care

Before there were nursing homes and social security legislation, the elderly lived in almshouses which also housed insane, homeless and inebriated people. Living conditions in these facilities were horrendous and dangerous. Thankfully, after some legislation passed nursing home numbers began to rise and gave seniors a better environment to live. Although there are still problems that occur, nursing homes are adopting new innovations and technologies to increase the quality of care for the elderly population.

The number of people older than 60 is set to hit one billion by the end of the decade, according to the United Nations Population Fund and HelpAge International. These increasing numbers show us the importance of the future of nursing home. With new advances, nursing homes are working towards a more active, social and healthy lifestyle that seniors can enjoy as they age.

For seniors that don’t require nurse care full time, independent living is becoming a popular choice. This allows the elderly to live in a senior facility and still have the ability to make independent choices on mobility, activities and food preparation. The elderly are also starting to co-house with one another allowing them to share the responsibilities and bills. With user-friendly technology such as alarm sensors that detect floods, carbon dioxide leaks and if someone falls makes these options viable for seniors who are still active.

Senior can be lonely and miss their family while living in nursing homes but video technology is helping them to connect. Services such as Skype or Facetime allows seniors to see and talk to their families, friends and even doctors. Technology advancements in wearables and mobile health are also helping seniors. Wearables can help healthcare providers to monitor heartbeat, hydration and physical activity. Mobile health can help remind seniors about medical appointments, insurance, records and taking medication.

Technology will continue to impact the way the elderly population are cared for. Caregivers need to stay updated with all the options in order to choose the best for their family members.

Nursing Home Healthcare

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5 ways to honor yourself and your loved one after loss

5 ways to honor yourself and your loved one after loss

Grief is often a foreign feeling for most until they are faced with it head on. When you lose a loved one, it can be hard to do much of anything, but life must go on. From the heirloom furniture passed through generations to old love notes, choices are thrust into your lap whether you are ready or not. Decisions are immense or can be something as simple as what to do about the food in your loved one’s cabinets.

For some, settling an estate and sorting through the items left behind brings closure.  For others, it can make a difficult time even worse. Here are five tips to honor your loved one and yourself during this difficult time:

 Take a moment.

After the initial loss, grief is forefront to other emotions and life feels chaotic. Advice comes from every direction whether you ask for it or not. Many will tell you to hurry through the sorting and delegating of items. Personally, I advise clients to take a moment, and a deep breath before you make hasty decisions. This will prevent future family arguments and possible regrets.

If finances and circumstances allow, give yourself a good 30 days before jumping into any major decision-making in the dissolution of your loved one’s legacy. Also, you need to use this time to move through your grief and find healing. If you push it away or ignore it, grief will manifest in disruptive and painful ways. This is your time to process it in its freshest state.

Don’t do it alone.

If your family works well together, use this time to revisit old memories. Choose what physical talismans of those memories you wish to hold onto.

If you find yourself explaining and justifying your choices to your friends or family, they are not the right ones to assist you during this time. Look for someone who is empathetic. Try to involve individuals around you that allow you to make choices without judgment.

Ideal supporters at this time are organized and show up with an open and clear mind.

Honor their memory.

Of the items you will keep or distribute to friends and family, there is likely to be a surplus of belongings that can be useful to someone not in the immediate family. Not every member of the family even wants to take your loved one’s items. But who should get these items?

Focus on local organizations. Small non-profits and thrift organizations can thrive from your donations. Make choices that feel good and honor the wishes of your loved one. Think about organizations that were important to them, and their beliefs. If they did not have a connection with any organization, what charities are important to you? Through selecting organizations that resonate with you or your loved one, the entire process can be a healing one that benefits many.

Keep track of your decisions.

Six months to a year after you dissolve your loved one’s material legacy, when the dust clears from the darkness, different individuals might inquire about particular objects. How about dad’s golf clubs? Mom’s crystal glasses?  The family photos?

This is where your helpful, empathetic friend comes into play again. Have them help you keep track of your decisions. You are then able to look back and know what decisions you made. Knowing what went where will be incredibly efficient in the long run.  List each item and assign it a number,  then add the location the item came from and who/where the item is going. This offers peace of mind, and prevents future arguments.

Take care of yourself.

This process is difficult, but you need to prioritize your needs, too. Your basic needs such as hydration, nutrition, and rest are essential during this period. You might not feel like doing much of anything, but covering the basics will preserve your future well-being and health. It is easy to be distracted by the emotions and the intimidating amount of work that lies ahead.

Sickness is common in this period, as your body responds to the grief and stress. Don’t neglect your health, job, friends, other family members and the need to grieve. Taking care of yourself not only honors you, but your loved one as well.

Laura Olivares is founder of Nothing Forgotten, Inc., which guides and manages all aspects of the downsizing or dissolution of a loved one’s material legacy.  It is the first and only after-death service that repurposes, recycles and resells up to 95% of the personal belongings back into the community.  www.nothingforgotteninc.com

Caregiver’s Lament: Rescue Me

Caregiver’s Lament: Rescue Me

Rescue me, for an afternoon
or an hour, or a few minutes.
I no longer want someone
to come into my life
and take over all my problems
and become my hero
and the owner of my life.
I don’t want that.
I just need someone
to rescue me for a few minutes
so that I remember that it’s possible
for somebody besides me
to do some of the things I do.
So that I don’t feel
totally indispensable
to the life of someone else.
And if you would rescue me
for five minutes
and someone else would rescue me
for five minutes
then, if enough people rescued me,
I would have the strength
to rescue myself the rest of the time.
And I could be
my own hero.
 by Cynthia Rush
7 Techniques For Keeping Your ‘Thought Life’ Healthy And Your Stress Level Low

7 Techniques For Keeping Your ‘Thought Life’ Healthy And Your Stress Level Low

Life gives people plenty of reasons to be stressed.

Relationship problems, child-rearing issues, job woes and a lack of money are just some of life’s complications that can weigh people down – and cause health problems.

“It’s difficult to stay healthy and energized when stress is a daily reality,” says Dr. Greg Wells, author of The Ripple Effect: Eat, Sleep, Move and Think Better.

“Chronic stress can damage your body, threaten your mental health, put a strain on relationships, and take the joy out of life.”

But there’s no reason to surrender to stress, Wells says. He suggests seven techniques that can help you have a healthier “thought life” and recover from chronic stress:

• Move your body. Rhythmic, repeated motion is particularly soothing to the mind and body. A long walk, cycling, swimming, or running will all work, but any kind of movement relieves tension, improves circulation, and clears your mind.
• Get into nature. Head to the garden, the park, or the woods to lower your blood pressure, strengthen your immune system, reduce tension and depression, and boost your mood. “It’s stunning how good it is for your health to be in nature,” Wells says. “And I recommend you leave the cell phone and earbuds at home.”
• Practice yoga or Tai Chi. Therapy, yoga and Tai Chi are good ways to decrease stress and anxiety, increase energy, and boost the immune system. They also give you more stamina—needed in stressful times—and improve the quality of your sleep.
• Have perspective. Don’t be so quick to conclude that you “can’t handle” a stressful situation. “This is truly a mind-over-matter opportunity,” Wells says. “Believing that you are strong and resourceful actually makes you stronger and more resourceful.” Don’t give in to negative self-talk about not having what it takes to manage life, he says.
• Change the nature of your response. Research indicates that taking an active, problem-solving approach to life’s challenges relieves stress and can transform it into something positive. If you withdraw, deny the problem, or spend all your time venting, you’ll feel helpless. Instead, Well says, be determined to make a change, put effort into it, and plan for better results.
• Practice slow, deep breathing. Start applying the power of deep breathing each day. It will make a huge difference. Wells recommends you start small by taking three deep breaths each time you sit down at your desk—in the morning, after breaks, after lunch, and so on. It will help you become more patient, calm, and relaxed.
• Block time for single-tasking. Each day, schedule time in your calendar for focusing exclusively on one task. This task should be something that is important to you. “People love to talk about multi-tasking, but while doing several things at once might make it seem as if you are working hard, it’s an illusion,” Wells says. Your body and mind are not designed to work that way and it causes extra stress.

“Ultimately, it’s important to remember that your thoughts have a strong influence over stress levels,” Wells says. “What you choose to think about, or not think about, dictates how your body and mind react to everyday life.”

Dr. Greg Wells is an authority on high performance and human physiology. Wells’ latest book, The Ripple Effect: Eat, Sleep, Move and Think Better, hit shelves earlier this year. Dr. Wells is an Assistant Professor of Kinesiology at the University of Toronto where he studies elite sport performance. He also serves as an Associate Scientist of Translational Medicine at The Hospital for Sick Children, where he leads the Exercise Medicine Research Program.

Tai Chi May Help Prevent Falls in Older and At-Risk Adults

Tai Chi May Help Prevent Falls in Older and At-Risk Adults

An analysis of published studies indicates that tai chi may help reduce the number of falls in both the older adult population and at-risk adults. The findings, which are published in the Journal of the American Geriatrics Society, offer a simple and holistic way to prevent injuries.

Tai chi is an ancient Chinese practice focused on flexibility and whole body coordination that promotes harmonized motion in space. Previous research has shown that tai chi is an effective exercise to improve balance control and flexibility in older individuals. This suggests that the practice might help protect against falls, which are a primary cause of traumatic death for older adults.

To investigate, Rafael Lomas-Vega, PhD of the University of Jaén in Spain and his colleagues searched the medical literature for relevant studies. The team identified 10 randomized controlled trials analysing the effect of tai chi versus other treatments (such as physical therapy and low intensity exercise) on risk of falls in at-risk and older adults.

There was high-quality evidence that tai chi significantly reduced the rate of falls by 43% compared with other interventions at short-term follow-up (less than 12 months) and by 13% at long-term follow-up (more than 12 months). Regarding injurious falls, there was some evidence that tai chi reduced risk by 50% over the short term and by 28% over the long term. Tai chi did not seem to influence when an older or at-risk adult was likely to experience their first injurious fall.

“Tai chi practice may be recommended to prevent falls in at-risk adults and older adults. The length of the interventions ranged from 12 to 26 weeks. The frequency of the 1-hour sessions ranged from one to three times per week,” said Dr. Lomas-Vega. “Due to the small number of published studies, further research is needed to investigate the effect of tai chi on injurious falls and time to first fall.”

Full Citation: “Tai chi for risk of falls. A meta-analysis.” Rafael Lomas-Vega, Esteban Obrero-Gaitán, Francisco Javier Molina-Ortega, and Rafael del-Pino-Casado. Journal of the American Geriatrics Society; Published Online: July 24, 2017 (DOI: 10.1111/jgs.15008): http://doi.wiley.com/10.1111/jgs.15008

The Journal of the American Geriatrics Society is a comprehensive and reliable source of monthly research and information about common diseases and disorders of older adults. For more information, please visit http://wileyonlinelibrary.com/journal/jgs.

About Wiley
Wiley, a global company, helps people and organizations develop the skills and knowledge they need to succeed. Our online scientific, technical, medical, and scholarly journals, combined with our digital learning, assessment and certification solutions help universities, learned societies, businesses, governments and individuals increase the academic and professional impact of their work. For more than 200 years, we have delivered consistent performance to our stakeholders. The company’s website can be accessed at www.wiley.com.

Featured image: cowardlion / Shutterstock.com

8 Things Senior Citizens in Assisted Living Don’t Want to Hear

8 Things Senior Citizens in Assisted Living Don’t Want to Hear

Dealing with elder adults and senior citizens can be incredibly difficult. All of us, at some point, have experienced their seemingly strange behavior, the incessant talk about things that seem irrelevant to us, not taking the prescribed medications, and the frequent emotional outbursts. These small problems, however, can turn into a major issue for those in regular contact with senior citizens, particularly the caregivers working in an assisted living facility.

The first step towards resolving this dilemma is to improve your communication. Whenever you are interacting with senior citizens, you must choose your words carefully. If you don’t approach your conversations with utmost care, you will get worst reactions irrespective of your good intentions.

Better communication with seniors begins with understanding how much damage your words can cause to the seniors who already feel alone and neglected. If you care about the residents in your assisted living facility, you should avoid saying the following eight things when speaking to them.

1. “Sweetie” Or “Honey”

Infantilizing elder adults under your care is downright patronizing. Most adults don’t like to be called “honey,” “dear,” or “sweetie,” or any other pet name at all. Do not call them anything that you would also call a person under age ten, including “dear,” “sweetie,” “honey,” or worst of all, “young lady” or “young man.” You can call them “Sir” or “Ma’am,” which is a general title of respect applicable to all adult men and women. However, calling them by their names is the best way to open a conversation.

2. What’s It Like to Be Your Age?

Senior citizens are not different; they are merely their own category. However, asking them, “What is it like to be your age?” implies you are treating them as different people. Plus, old age brings plenty of health issues that most senior citizens don’t want to discuss with anyone. So, never open a dialogue with this question.

If you want to strike a personal conversation, try a more subtle approach such as “Tell me, Frank, how has the “culture of senior high” changed since you graduated?” Besides, if a senior resident wants to share something with you, they are more likely to do it on their own.

3. How Can You Forget That?

Short-term memory loss is a common complaint among older adults. In fact, they often lose short-term memory before long-term. As a result, they tend to forget all kinds of small things such as where they put their glasses or cane. Such memory lapses can be frustrating. However, this doesn’t mean you should be snapping and asking, “How can you forget that?” repeatedly.

You can try placing a few Post-it notes on the desk, fridge and the bathroom mirror as reminders. Remind them in a gentle tone. Saying something such as, “You are likely to trip and fall if you forget to keep your glasses handy, resulting in a serious injury.” can keep the tone light. Most, importantly, don’t lose your patience as impatience is what triggers the hurtful demeanor of conversation.

4. You Could Do That If You Really Tried

As a caregiver, you must have heard that you must encourage senior residents to participate in different activities and routine tasks to avoid loneliness. However, there is a thin line between encouragement and compulsion. The remark, “You could do that if you actually tried” implies compulsion, not encouragement.

Just because a senior citizen is in a physically fit condition, doesn’t mean he/she should go out there and play football. They need start with manageable activities such as a stroll in the garden. Plus, you need to stop when the senior citizen says so. Forcing them into doing things they don’t like isn’t going to help anyone including you and your colleagues.

5. I Just Showed You How to Do That Yesterday

Whether it is handling the new TV remote or making a video call with their children, learning new technology can be a challenge for most elder adults. However, with patience, you can teach them to use the latest gadgets. Most cable operators and even cell phone operators provide senior-friendly gadgets that make the learning process a lot easier.

Alternatively, you can print the step-by-step instructions in a large font and leave them near the TV remote. You can also contact volunteers from the nearest senior citizen center, high school, community center or college to teach basic internet and computer skills to the senior residents at your assisted living.

6. You Already Told Me That

We all have the tendency to repeat ourselves at some point. However, we often get upset with senior citizens as they repeat themselves too often. You must have heard those Vietnam War stories from a war veteran so often, you could repeat them word-to-word, in your sleep. But, as a responsible caregiver, it is your job to listen to these repetitions with patience over and over again.

7. Why Is Your Room or Bed So Messy?

Keeping the room and bed tidy becomes increasingly difficult in old age, particularly if you are suffering from ailments such as arthritis. Aging also brings a variety of hygiene and cleanliness issues to the forefront. As a caregiver, you have to deal with these issues regularly. So, instead of being harsh, help them with the housework.

8. Let Me Give You a Hand

Though the senior residents in your community will need help with some housework, don’t go overboard with helping, particularly if they can get around on their own. Promoting their independence not only promotes their sense of achievement, but also gives them assurance that they can control certain aspects of their lives. So, let them be as self-sufficient as possible. For example, if they can take a stroll or use a computer on their own, let them do it.


Though dealing with senior citizens can be difficult at times, as a caregiver, it is your responsibility to allow them to live as respectable individuals. You will have to connect and reconnect with them to build a better relationship. None of this sounds easy, but avoiding the above eight comments when speaking to elder adults can help resolve this dilemma.

What have you done to improve your relationship with the senior citizens in your assisted living facility? Let us know in the comments section below.

Featured image: Maxpixel

Evan Thompson, CEO and founder of Senior.One has a long standing interest in finding solutions for seniors. He helps connect senior citizens and their family members with elder care service providers and find the resources they need in one place. He offers information on nursing homes, hospice, financial planning, adult care, lifestyle and assisted living facilities in Albuquerque. He provides information on housing, medical professionals, financial planning services, and lifestyle options.

Caregivers – Playing a Crucial Role, Yet Held in Low Esteem

Caregivers – Playing a Crucial Role, Yet Held in Low Esteem

Though it has many settings, and spans many decades, my new novel, Women Within, takes place primarily in a retirement home. The three main characters in the book, a ninety-four-year-old woman who slips back and forth through the years of her life, and her two aides, drive the plot.

I wanted to write a novel about the female experience. That meant addressing a lot of challenging issues like sexual assault; a woman’s status compared to a man’s (always lower); being an unwed mother; the impossible standards of the ideal female body that no one can really meet. These themes are woven throughout the book, along with another that at first I didn’t specifically identify.

In Women Within, this particular subtext is caregiving. The old lady awash in the past is Constance Maynard, a retired professor of history. Eunice Fitch, a fifty-something recluse with a big heart, has been taking care of people since she was a teenager. Her need to coddle, cosset, and even pamper is great on the job, but when it comes to relations with men, it’s a disaster. She enables brutes and swindlers without even realizing it. That’s her personal subtext—the downside of being too willing to soothe.

Eunice’s partner on her daily rounds is Sam (formerly Samantha) Clark whose big hands and strong muscles make her an ideal worker. Though only in her twenties, Sam, too, has done her share of caregiving, primarily to her damaged mother, protecting her in what she will soon learn has always been a vicious lie, a concoction about how Sam came into the world.

These women are poorly paid, almost as invisible as their charges. Maybe it’s because their work requires no special training, just a certain nuanced sensitivity about what people need, which can’t really be taught. Maybe it’s because they don’t generate income or profits for their employers. A retirement home makes its money from its residents, and while they state a commitment to a certain level of quality care, presumably ensured by people like Eunice and Sam, that standard is often goes unmet.

I speak from personal experience. My father spent his final years in a retirement community that was touted as having exquisite amenities. He wasn’t mistreated, but nor was he nurtured. He was sustained. As his interest in life declined, as he disconnected from people, the interest shown him also seemed to wane. Human psychology no doubt suggests that one is likely to be more engaged with someone who shows a reciprocal interest. That said, would not that engagement be encouraged with a bigger paycheck?

Caring for young children requires a great deal of engagement, too, which I suspect most people bring to that job, but those folks earn pretty little. Again, the problem seems to be the idea of generating income. Teaching a child the alphabet, or the basics of proper behavior and courtesy towards others is essential, but doesn’t generate income the way writing a computer code might, or selling a house in a hot market. This is short-sighted. Many studies show that children who get good quality care when young go on to be good wage earners and successful citizens. It’s a long-term commitment where kids are concerned, yet the people who nurture them outside of the home aren’t valued very much.

I’m sure much of this has to do with the fact that by and large caregivers are women. I suspect that the low status jobs that men land in, like unskilled physical labor, pay more. I could make this a point of research, of course. I could dust off my Economics degree, and polish up my MBA, and make a good, thorough study, but then where would my fictional characters be? Waiting for me to fill them in and round them out.

And that returns me to my three retirement home ladies. Before Constance goes downhill once and for all, she decides to turn her former home into a community center to help disadvantaged women. After her death, Eunice launches a home care business of her own, putting to good use everything she’s learned in over thirty years at Lindell. And Sam – well, Sam’s an interesting case. The retirement home seems to be just a step along a widening path. She comes into a little money, and decides to go back to school to study poetry. Her favorite author is Sylvia Plath, whose suicide reinforces for Sam that unhappy marriages are perilous things, even as she finds herself falling in love, and preparing to take on yet another caregiving role.

I close with a plea for caregivers everywhere. Give them their due. See their value, not just in a private setting, but in our larger society. Consider where we would all be without them. Understand that not everything is purely tangible. Consider the intangible, the behind-the-scenes efforts that build character and promote empathy. Imagine what the world would be like, with more people garnering well-deserved respect for the service they perform every day for another human being.

Anne Leigh Parrish

Are Seniors Really At The Most Risk For Scams?

Are Seniors Really At The Most Risk For Scams?

You may have heard from a friend or family member that seniors are the at the biggest risk for scams. It’s a commonly touted idea that because seniors have more economic freedom than other classes of society, because they worked more years on average, that scammers target them assuming they have lots of money to spare.

As it turns out, this isn’t just an urban myth. The hyperlinked article shows the results of research conducted by the North American Securities Administrators Association (NASAA). The results show clearly that seniors are the most targeted population group per capita. “It is imperative that we detect and prevent senior financial fraud before criminals who prey on our most vulnerable citizens steal from and devastate them,” said NASAA President and Minnesota Commissioner of Commerce Mike Rothman.

The good news is that are steps that seniors and their caregivers can take to seriously reduce their risk. The first step is free. Check out the infographic in this post and teach the senior to identify the most popular type of scams. By identifying and understanding how they work, the senior will be able to be more alert to the risk when a scammer contacts them. There are also identity theft protection services that can help provide aid to seniors after-the-fact. If their online security was breached, services like LifeLock will stop the damage and restore the senior’s credit.

If the senior uses a landline it is a good idea to look into some form of Caller ID. This might seem unnecessary to those who grew up using cell phones, but many seniors still don’t know who’s calling until they pick up the phone. This places them at increased risk to pick up for a scammer. If the phone screen/attachment read “Unknown Number” rather than the actual digits of the caller, they would be on high-alert and more likely to pick up a scam.

The combination of software protection like the caller ID and identity theft services, along with the manual identification of risk factors with the senior, should substantially reduce their risk of being scammed. There’s no need to frighten them with heavy statistics about their scam risk — the best approach is always to frame the problem in a positive light, by showing them how much they stand to gain by making sure they’re well-protected. This approach will increase the chances they’re receptive to understanding the risk factors.

identifying scams targeting the elderly

Brent Scott

Community Manager, LifeLock (a Symantec company)

4 Tips For Overcoming Life’s  Most Traumatic Experiences

4 Tips For Overcoming Life’s Most Traumatic Experiences

Wouldn’t it be great if our most difficult days came with Hollywood-happy endings?

In the movies, when faced with the worst possible situations, our heroes rise to the occasion and find strength they never knew they had. But those who experience real-life traumas are just as likely to end up questioning their faith in God, their family and themselves.

The scars, both physical and emotional, may never completely heal. And it can take years to find “meaning” from it all.

Even those who seem equipped to handle the worst – because of their religious beliefs or strong family and community connections – can find themselves questioning everything.

“There certainly are difficult lessons to learn when your life is suddenly turned upside down,” says Susan Mattern, author of “Out of the Lion’s Den: A Little Girl’s Mountain Lion Attack, A Mother’s Search for Answers.”

In 1986, while Mattern, her husband and their two children were hiking in Casper’s Wilderness Park in Orange County, California, a mountain lion grabbed her 5-year-old daughter, Laura, and disappeared. By the time she was found and rescued, Laura had been severely mauled. She survived, but lost the use of her right hand and the vision in one eye. She had severe brain injuries, and her life hung in the balance for weeks.

Mattern, a former nun, struggled with guilt, anger, stress and frustration as she fought to help her daughter recover – and to hold the county accountable when she learned the staff knew there were mountain lions in the park but hadn’t warned visitors.

In the decade after the attack, she lost her religious faith, but came out of the experience with a new kind of happiness and fulfillment.

Mattern has these tips for those battling to come back after a life-changing trauma:

  • Have faith in yourself. If you don’t believe in a higher power, or if you lose your religious faith, you can find your own meaning in life. “It was very difficult to give up my beliefs,” she says. “But instead of a vast emptiness where God used to be, there is caring, love and friendship.”

  • Have more than one focus. Mattern’s primary goal was helping her daughter get well, but the family also spent years battling Orange County in court. “The trial took up so much of our life, and that was a good thing in many ways,” she says. “It gave us another purpose.”

  • If you can’t find courage within yourself, look to those you love. Decades after her daughter’s attack, Mattern still is in awe of her friends; her husband, Don; and her daughter’s rescuers, doctors and legal team. But she draws the most strength from Laura, who isn’t bitter and lives an independent and fulfilling life.
  • Don’t expect to draw lessons from the experience right away. You may need to wait for the lessons to become apparent. It will take time and painful reflection, but it’s worth it, Mattern says. “It would be so depressing to go through all of this, only to learn nothing and have done nothing.” She realized, after years of searching, that the meaning of life was right in front of her – in her family, and the love she shared with family and friends.

Mattern says that after Laura grew into a young woman they were looking at a book that posed the question: If you could change one day in your life, which day would it be?

Mattern thought the choice was obvious. Laura disagreed.

“That day changed all of us, I know,” she told her mother. “But I wouldn’t have become the person I am today, and we wouldn’t have cared for each other as much as we do, or have such a wonderful family. No, I would leave that day just like it was.”

Susan Mattern, author of “Out of the Lion’s Den” (www.outofthelionsden.net), grew up in St. Louis, Missouri, and was a nun for six years before moving to California, where she met and married her husband, Don. They have two children, David and Laura. In 1986, Laura was attacked by a mountain lion in an Orange County park, and the family spent years helping her recover and fighting the county in court.

Work Better Together with 8 Useful Tips

Work Better Together with 8 Useful Tips

For every 100 million Americans who live with chronic pain, there are that many caretakers. The National Alliance for Caregiving and AARP conducted a national survey looking at family caregiving in the United States. The average caregiver renders 21 hours a week of unpaid care, has been caregiving for about 5-1/2 years, and can expect to maintain that level of care for an additional 5 years.

There are burdens for the caretaker just as there are life changes for the pain patient. Coming together is the beginning. Keeping together is progress. And working together is success.

Ulf Jakobsson, professor of the Center for Primary Health Care Research at Lund University in Lund, Sweden, explained, “Beyond the pain, there may be adverse effects on daily activities and quality of life for patients and their families. Some of these effects may include disruption of an individual’s ability to concentrate, be productive, socialize, or sleep, and may lead to feelings of isolation, depression, and anxiety.”

For the Pain Patient

It’s really easy to get lost in your pain. Yes, it can be all consuming but do not let that stop you from living. There are actions you can take every day to help you find your new normal. Start here.

Move. Try simple exercises or yoga. Movement helps loosen your muscles which can decrease your pain while allowing you to feel productive. Instead of taking the elevator, take the stairs. Every little bit helps. Depending on your pain levels, you can work with a physical therapist to avoid further injuring yourself. The main goal of physical therapy is to educate patients on the mathematics of stretching and strengthening, which in turn, aids in managing your chronic back pain — eventually accelerating your tissue healing — leading to recovery.

Invite. Ask your caretaker to attend a doctor’s appointment with you. Ironically, sometimes, if a caretaker doesn’t hear the information directly from a medical professional, they may not fully grasp the depths of your pain. Yes, they observe you on a daily basis, but it’s different. They may only see that you need guidance and may not understand why. Bringing them along to your appointment will allow them to hear straight from the horse’s mouth. It may even help them to appreciate how you feel on a daily basis when you ask for help.

Join a Support Group. Even if your caretaker apprehends your chronic back pain a little more, they may never completely relate to what you are going through. That’s why finding a local or virtual support group where people with your condition gather can be helpful to speak with like minded people who feel your pain, every day.

For the Caregiver

Guadalupe Palos, a licensed clinical social worker, registered nurse, and clinical research manager at MD Anderson Cancer Center in Houston, Texas , shared, “Caregivers of people in pain face a unique danger — it’s very easy to make the pain experience the center of the entire family’s world.

“For example, the atmosphere in a home often may be linked to whether the person in pain has a good or bad day. If it is a bad day, the caregiver’s reactions may range from being overly protective to silent anger. Whatever the reaction, it may affect other family members and even the person experiencing the pain. If the caregiver uses empathy and maintains a sense of calm, the family world is safe. But if the reaction is negative, it contributes to the chaos of the pain experience.”

Stay Calm and Be Supportive. Palos says to encourage the patient to become a self-advocate for their pain management. If they are included in their care, it may distract them from concentrating on their pain.

Communication is Key. Speaking, watching and listening are three crucial ingredients necessary to care effectively. Palos also explains that direct verbal communication between the patient and caregiver offers a better evaluation for greater pain management.

Take Time for Yourself. This is not being selfish. This is a way to keep your sanity. You are just as important as the patient you care for and you can’t properly care for another if you neglect to care for yourself.

“There are some simple things, including (a) doing something for yourself every day, such as meditating, taking a walk, or talking to a close friend; (b) not isolating yourself because of your caregiver role: (c) accepting the help that people offer; (d) bringing humor into your life; and (e) finding your spiritual self,” Palos concluded.

All for One and One for All

When you’re a full-time caretaker, it’s easy to think that your job is to sit stationary in the house with the patient watching television or waiting on them. Get creative. Find ways to get outside the house and do things that meets each of your internal needs and breaks up the in-house routine.

Get Busy, Together. Engage in normal activities that the pain patient and caregiver alike can do unitedly. Think outside of the box. Consider seeing a movie together,  allowing the caretaker to choose what you see. Or try a mediation session where you both can get your zen on while bonding in a unique fashion. Regular meditation can work to lower the body’s level of pain as well as improve sleep.

Get Active, Together. Start small. Instead of driving to that appointment or errand, try walking there together. It doesn’t have to be a sprint, just whatever your bodies can handle. If walking to an appointment will not work due to your location or the patient’s pain levels, go for that leisurely walk around your neighborhood with one another. The vitamin D and wind on your faces should improve your mood and allow you to take that break from the household monotony.

Lifestyle Coach and Certified Personal Trainer Simone Krame says, “Fitness is not always running the marathon or pushing ourselves to the extreme until we puke. It’s about moving in a way that feels good. It’s about getting that energy flowing and the endorphins moving – doing something that helps us. Our bodies are the physical homes for our spiritual selves, and we must take care of them in order to live a healthy lifestyle.”

So whether you’re the caretaker or the patient, instead of working against each other, work with one another. For the one in 10 Americans who live with chronic pain and their associated caretakers, this one’s for you. After all, we cannot accomplish all that we need to do without working together.

Macey Bernstein is a content specialist with a passion for crafting useful and actionable content that improves the lives of her audience. She is a dedicated reporter with a nose for news, a love for community, and a reputation for impeccable ethics. From writing press releases and legal briefs to event planning and execution she displays exceptional skill in journalism and creative direction. Macey is a graduate of the West Virginia University School of Journalism with a bachelor’s degree in journalism and public relations. For more information visit her Website.

Travel with Seniors: A Little Planning Delivers a Lot of Fun

Travel with Seniors: A Little Planning Delivers a Lot of Fun

The busy summer vacation travel season is well underway, as families and friends gather for special occasions, trips of a lifetime, and everything in between. Whatever means of transportation is required, traveling with an older parent or loved one can add layers of complexity to a journey – not to mention assistive equipment such as walkers and wheelchairs – but sometimes a necessarily leisurely pace can allow everybody involved to relax and truly enjoy themselves, no matter what time of year you and your elderly companion hit the road. 

Flying With a Senior Companion

Unpredictable delays notwithstanding, flying usually gets you to a destination faster, but it requires more organization and patience than other modes of transportation. Even though TSA regulations in the United States seem to be a moving target, concessions have been made to seniors (75-plus) and their companions that expedite getting through security checkpoints. Here are a few additional tips to ensure safe and healthy travel with seniors:

  • First, confirm with your loved one’s physician that he or she is cleared to fly, and has had current flu and pneumonia vaccines. Request a doctor’s note explaining any surgical implants or paraphernalia, such as needles. If applicable, a TSA disability notification card can make it more expedient to get through security.
  • At the time of booking, request any desired assistance (wheelchair, electric cart, pre-boarding privileges), and reconfirm a day or two before departure.
  • Select seats in advance, when allowed. An aisle seat toward the front of the plane offers easier boarding and deplaning, but being near the toilets may be desirable for long-haul flights. Compression socks are recommended on flights longer than a few hours, even for travelers without risk of deep vein thrombosis (DVT).
  • Check in for the flight online 24 hours in advance, or call customer service for help choosing an optimal seat.
  • Pack light, but plan to check bags if an aircraft change is part of the itinerary.
  • Get to the airport a full hour earlier than suggested for your departure time.
  • Keep your older traveler’s prescription medications separate from other belongings for easy screening. On-board baggage limits don’t apply to medical supplies, equipment, mobility aids and assistive devices. Liquids exceeding 3.4 oz/100 ml are permitted. (Visit www.tsa.gov for further details regarding U.S. departures.)
  •  If your travel companion has dietary restrictions, order a special meal in advance, when offered, or bring his or her food on board.
  • Apply hand sanitizer liberally, and use antibacterial wipes to disinfect hard surfaces around his or her seat.


Tips for Traveling Abroad with Seniors

International travel with a senior may seem especially daunting, but once you dive into the planning process you may find the prospect isn’t as scary as you think. Many nations show great respect to older people, and as world populations age, it has become easier than ever for seniors to travel the globe.

Expert Valerie Grubb, author of Planes, Canes, and Automobiles: Connecting With Your Aging Parents Through Travel and the popular blog Travel With Aging Parents, has traveled extensively with her own mother. “Narrow sidewalks and ancient tourist sites can make some destinations in Europe tricky when vacationing with a parent in a wheelchair,” says Grubb, “so I strongly suggest doing a little research on accessibility before just showing up. That said, Mom and I particularly enjoy Paris and London, and have found local businesses and people to be incredibly helpful as we navigate around the city.”

Here are a few more tips to keep in mind:

  • Several weeks in advance, make sure any vaccines recommended for the destination are up to date.
  •  Ensure passports are valid for at least six months after the return date and request any necessary visa(s) well ahead of time.
  • Have a doctor provide a list of generic names for prescription drugs, as overseas pharmacists or physicians may not recognize all pharmaceutical brand names.
  • Travel insurance for seniors is costly, but it can be a lifesaver. Not only can a senior who takes ill be reimbursed for all or part of a trip, but a policy including evacuation insurance can help get him or her to appropriate medical care in case of an emergency.
  • Consider upgrading your cellular service to a roaming plan that provides full use of your phone for the duration of the trip, so you’ll be able to search the internet freely and call a hospital or ambulance immediately should the need arise. (In the European Union, call “112” for a police, fire or medical emergency.)


Traveling With Older People – The Basics

Destination, type of travel, and health and mobility are all mitigating factors that come into play when planning a trip, but a list of tips for traveling with seniors is a great place to start:

  • Do plenty of advance research and don’t hesitate to inquire about senior discounts – for travel, hotels, food, entertainment – both domestically and internationally.
  •  If he or she wears prescription glasses, bring a backup pair, as well as sunglasses for bright days. (Fitover and clip-on styles are great options.)
  • Hearing aids? Don’t forget spare batteries.
  • Use a smartphone to photograph all identification, medical cards and prescription bottles in case of loss or theft.
  • Keep meds in original packaging, and bring a week’s additional supply.
  • Pack a tote with favorite healthy snacks and beverages, and items such as playing cards, a book, travel pillow, and sweater or blanket.
  • Even for seniors who don’t have cognitive impairment, a wearable GPS device or ID bracelet bearing your name and contact phone number can bring peace of mind.
  • A ground-floor hotel room or one near an elevator may be best for seniors with mobility issues. Confirm that rooms identified as “ADA compliant” include grab bars and space for wheelchair maneuverability, as needed.
  • Don’t overschedule, and remain flexible to allow for naps or restroom stops. Whether due to medications, a specific condition, or simply age, older travelers are more likely to tire earlier. Symptoms of Sundowners Syndrome may be more pronounced when seniors with dementia are away from familiar surroundings.
  • To take some of the pressure off you and your family, consider hiring a professional caregiver to accompany you on your travels.


Overland Adventures

If time isn’t an issue, a road trip is the easiest and most straightforward way to travel with seniors. Although protracted hours on the asphalt can be exhausting, driving provides the option to stop anywhere and for as long as desired: unplanned detours to must-see sights (Wall Drug or World’s Largest Ball of Twine, anyone?) require little more than a flexible schedule.

While bus and train journeys offer less spontaneity and little or no privacy, they eliminate driving responsibilities, often provide Wi-Fi connectivity, and a restroom is always nearby.

Bon Voyage!

North American cruises are a popular vacation option for seniors because they take a lot of the preparation and trepidation out of travel: most ships and destinations are well equipped to cater to the social, medical, and mobility needs of older passengers. For people who live near one of the nearly 30 U.S. and Canada departure ports, embarking on a cruise is only slightly more onerous than navigating Costco on a Saturday afternoon.

While getting to overseas points of origination requires more time and effort, international cruises can offer senior travelers and their companions exotic experiences that don’t skimp on safety, comfort, or the convenience of English-speaking staff. 

One More Tour, With Honor

Seniors who served in the U.S. military may be eligible for an all-expenses-paid trip to Washington, D.C., to visit the National World War II Memorial and other sites that pay homage to their sacrifice during wartime. Honor Flights are made possible by generous donations from corporations, individuals, volunteers and airlines – including Southwest, the organization’s official carrier.

Since 2005, the non-profit Honor Flight Network (consisting of two groups that joined efforts in 2007) has flown tens of thousands of veterans to one of the three D.C.-metro airports, where arrivals are greeted by representatives from Heroes’ Welcome, an Honor Flight sub-group. A friend, family member or volunteer guardian typically accompanies vets.

As of May 2017, there are 131 hubs in 45 states, making it easier than ever for a veteran to get to an Honor Flight departure point. The program is primarily available to World War II and terminally ill veterans, but is also increasingly open to veterans of the Korean and Vietnam wars. To donate, apply or learn about self-funded tour participation, visit honorflight.org.

For more information

Traveling with an Elderly Parent

Caregiver Tips for Traveling with the Elderly

4 Ways to Soothe Sundowner’s Symptoms

Caregivers Traveling with Families

7 Tips for Safe and Healthy Travel with Seniors

Honor Flights Offer Veterans One More Tour with Honor


Medication management for seniors

Medication management for seniors

If you help care for an aging loved one, or are advancing in age yourself, you are probably aware of the importance of medication management. As people age, they can develop multiple chronic conditions, which may require several long term prescriptions. In fact, nearly 40 percent of elderly adults living in their own homes are prescribed more than five medications. In turn, follows an increased risk of drug interactions, side effects, and accidental missing or doubling of doses. Medication management is a set of practices to prevent these events from happening. Polypharmacy, the term used to describe the usage of five or more drugs at once, can pose potential dangers for aging loved ones. Adverse drug events, or ADEs, due to negative effects of polypharmacy are to blame for 700,000 emergency room visits and 120,000 annually, resulting in $3.5 billion in medical costs across the country. Comprehensive medication management is no small task, and here are a few tips to get you started.

Courtesy of BrightStar Care

Tips to Deal with a Controlling Aging Loved One

Tips to Deal with a Controlling Aging Loved One

As people age, it’s not uncommon for their personalities to change and for them to become more controlling.  It’s usually the result of medication, pain, the frustrations of having difficulty doing things that were once easy and changing family dynamics.  While it can be frustrating and even unpleasant at times to deal with, there are things you can do to make the situation better and more bearable.

Kurt Kazanowski MS, RN, CHE, has more than 30 years working with seniors, first as a nurse, and now in hospice and homecare. 

His advice for dealing with a controlling aging loved one:  

1. They want to control something. 

Everyone wants to feel they can control their own lives, but there comes a point when we all lose grip of it. Our independence slips away, and we need help for the simplest things. That can be a defeating concept. It is a challenging reality with which to come to terms. Be sensitive to this in your aging loved one. Being surrounded by support and understanding only makes it easier.

2. Medications can change personalities.

Keep in mind when your loved one began their medications. Take note of any personality changes within two weeks, one month and a few months span. If you notice the personality changes coincide with the new medication and not another variable, speak with their health care provider about options.

Medications manipulate the chemical balances in our brains, and when that occurs, our moods and behaviors can shift. Offer the idea of starting one medication at a time to see how your senior changes in accordance to the new meds. This way, it is easier to pinpoint which medication causes which side effects.

3. Pain can make people act out.

When you are not feeling well and your body is in pain, it can cause you to lash out at those around you. If your senior parent is doing this, offer to find them relief in the form of therapy or medication. Occupational therapy can be a great tool to overcome painful patterns of movement and seek some relief.

4. Consider family dynamics.

Was your aging loved one always in charge of the family? Did they always dictate how things were going to be done? They might still be trying to exude this power over the other family members. If you are a child and the primary caregiver, your parent might still be trying to act out these old dynamics.

Controlling behaviors are considered abuse. Try to talk with your parent about how their actions make you feel. It is not too late to do this, and as your dynamic changes to caregiver, it can be a good time for healing past wounds. 

5. Use positive reinforcement patterns.

Reward the positive behaviors of your loved one. Do not reward, or punish, the negative behaviors. Using reinforcement patterns is one method to motivate your controlling loved one to better actions. If they are becoming upset or angry, offer them kindness and suggest to discuss it. If they don’t respond respectfully, leave and tell them you will come back when it is a better time. It may sound harsh, but it is better than scolding them or getting upset yourself.

6. Talk, if they are willing. 

Sometimes your controlling parent or loved one lashes out to get attention, like small children. They want someone to give them some more attention and care. Ask them how you can help. Genuinely speak to them. Most importantly, listen to what they are saying. They may just want to vent their frustrations to someone that cares. We can all understand that.

7. Grant them the little victories.

For them to feel they still have control, let them make decisions when possible. If you are going out to eat as a family, let them select the restaurant. Ask their opinion about important life matters to include them in situations. Help them find a creative outlet so they can focus their controlling energy into projects. Knitting, painting or sewing are some good options that require creative choices for them to control themselves.

8. Bring in the backups.

If nothing else works, you do have other opportunities. Don’t fret. You need to set your boundaries with your loved one, and if they do not respect that after a point, you can seek other help for them. There are assisted living and nursing home options. That way, there is a professional caregiver that will deal with the daily tasks for them. You can then take the personal family member role and see them whenever you see fit.

Kurt Kazanowski is an author, speaker, coach and consultant in the areas of aging, hospice and home care. He is a native of Detroit, Michigan, and has over three decades of experience in the field of healthcare. He received his bachelor’s degree in nursing from Mercy College of Detroit and practiced as a public health nurse for many years. Today, Kurt is the owner of two successful personal care home health companies – Homewatch CareGivers in Michigan where he lives and First Home Care in Moscow, Russia.

Kurt is also the author of A Son’s Journey.

Vets bill to keep veterans choice program afloat is signed

Vets bill to keep veterans choice program afloat is signed

Donald Trump signs vets bill to keep veterans choice program afloat

President Trump on Saturday signed a bill that will pump funds into the Veterans choice program to keep it up and running, while Washington continues to fight over how best to give veterans the care they earned – but which the government has sometimes failed to deliver. Approved in the wake of the wait-list scandal that… (more…)

Cancer survivors are more likely to use opioids

Cancer survivors are more likely to use opioids

A new study found that opioid prescription use is more common in cancer survivors than in individuals without a history of cancer. This was true even among survivors who were ten or more years past their cancer diagnosis. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings come at a time of rising rates of opioid overdose and addiction that experts have categorized as an epidemic.

Little is known about prescribing opioids to relieve pain in individuals who have survived cancer. To investigate, Rinku Sutradhar, PhD, a senior scientist at the Institute for Clinical Evaluative Sciences in Toronto and an associate professor with the University of Toronto in Canada, and her colleagues analyzed information dating back to 2010 on 8601 adults at least five years past a cancer diagnosis who were matched with 8601 individuals without a prior cancer diagnosis based on sex and calendar year of birth. Follow-up was stopped at any indication of cancer recurrence, second malignancy, or new cancer diagnosis. The researchers looked for opioid prescriptions filled at a pharmacy during the observation period for each individual.

The rate of opioid prescribing was 1.22 times higher among survivors than corresponding matched controls. Over a 36-month period, the average number of opioid prescriptions filled by survivors was 7.7, compared with 6.3 for controls. This increased rate of opioid prescribing was also seen among survivors who were 10 or more years past their cancer diagnosis. Individuals with lower income, and those who were younger, from rural neighborhoods, and with more comorbidities had significantly higher prescribing rates. Sex was not associated with prescribing rates.

“Our research findings raise concerns about the diagnosis and management of chronic pain problems among survivors stemming from their cancer diagnosis or treatment,” said Dr. Sutradhar. “Physicians providing primary care to cancer survivors should consider close examination of reasons for continued opioid use to differentiate chronic pain from dependency.”

Full Citation: “Cancer survivorship and opioid prescribing rates: a population-based matched cohort study among individuals with and without a prior history of cancer.” Rinku Sutradhar, Armend Lokku, and Lisa Barbera. CANCER; Published Online: August 7, 2017 (DOI: 10.1002/cncr.30839).


URL Upon Publicationhttp://doi.wiley.com/10.1002/cncr.30839

About the Journal
CANCER is a peer-reviewed publication of the American Cancer Society integrating scientific information from worldwide sources for all oncologic specialties. The objective of CANCER is to provide an interdisciplinary forum for the exchange of information among oncologic disciplines concerned with the etiology, course, and treatment of human cancer. CANCER is published on behalf of the American Cancer Society by Wiley and can be accessed online at http://wileyonlinelibrary.com/journal/cancer.

Follow us on Twitter @JournalCancer and Facebook https://www.facebook.com/ACSJournals

About Wiley
Wiley, a global company, helps people and organizations develop the skills and knowledge they need to succeed. Our online scientific, technical, medical, and scholarly journals, combined with our digital learning, assessment and certification solutions help universities, learned societies, businesses, governments and individuals increase the academic and professional impact of their work. For more than 200 years, we have delivered consistent performance to our stakeholders. The company’s website can be accessed at www.wiley.com.

Is it Alzheimer’s or another dementia form? Why doctors need to distinguish

Is it Alzheimer’s or another dementia form? Why doctors need to distinguish

Alzheimer’s disease now affects an estimated 5.5 million Americans, and after decades of feverish work, researchers have so far failed to find a treatment that halts or reverses the inexorable loss of memory, function and thinking ability that characterize this feared illness. But researchers have been quite successful at devising ways to diagnose Alzheimer’s earlier and… (more…)

Advice for older adults on staying safe in hot weather

Advice for older adults on staying safe in hot weather

Risk of heat-related health problems increases with age

With summer here and the temperatures rising, it is important to understand the health risks that excessive heat can bring and know the signs of heat-related illnesses. Older adults and people with chronic medical conditions are particularly susceptible to hyperthermia and other heat-related illnesses. The National Institute on Aging (NIA), part of the National Institutes of Health, offers advice to help combat the dangers of hot weather.

Heat stress, heat fatigue, heat syncope (sudden dizziness after exercising in the heat), heat cramps and heat exhaustion are all forms of hyperthermia. Hyperthermia is caused by a failure of the body’s heat-regulating mechanisms. The risk of hyperthermia can increase with the combination of higher temperatures, underlying general health, and individual lifestyle.

Lifestyle factors that can increase risk include not drinking enough fluids, living in housing without air conditioning, lack of mobility and access to transportation, overdressing, visiting overcrowded places and not understanding how to respond to hot weather conditions.

On hot and humid days, especially when an air pollution alert is in effect, older adults, particularly those with chronic medical conditions, should stay indoors in cooler places. If possible, people without air conditioners or fans should go to places that do have air conditioning, such as senior centers, shopping malls, movie theaters and libraries. Cooling centers, which may be set up by local public health agencies, religious groups and social service organizations in many communities, are another option.

There are many factors that can increase risk for hyperthermia, including:

  • Dehydration
  • Alcohol use
  • Reduced sweating caused by medications such as diuretics, sedatives, tranquilizers and certain heart and blood pressure drugs
  • High blood pressure or other health conditions that require changes in diet. People on salt-restricted diets may be at increased risk; however, salt pills should not be used without first consulting a doctor.
  • Use of multiple medications. It is important, however, to continue to take prescribed medication and discuss possible problems with a physician.
  • Age-related changes to the skin such as poor blood circulation and inefficient sweat production
  • Heart, lung and kidney diseases, as well as any illness that causes general weakness or fever
  • Being substantially overweight or underweight

Heat stroke is a life-threatening form of hyperthermia. It occurs when the body is overwhelmed by heat and unable to control its temperature. Signs and symptoms of heat stroke include a significant increase in body temperature (generally above 104 degrees Fahrenheit), changes in mental status (like confusion or combativeness), strong rapid pulse, lack of sweating, dry flushed skin, feeling faint, staggering or coma. Emergency medical attention is critical for a person with heat stroke symptoms, especially an older adult.

If you suspect that someone is suffering from a heat-related illness:

  • Call 911 if you suspect heat stroke.
  • Get the person out of the heat and into a shady, air-conditioned or other cool place. Urge them to lie down.
  • If the person can swallow safely, offer fluids such as water, fruit and vegetable juices, but not alcohol or caffeine.
  • Apply a cold, wet cloth to the wrists, neck, armpits, and groin. These are places where blood passes close to the surface of the skin, and the cold cloths can help cool the blood.
  • Encourage the individual to shower, bathe or sponge off with cool water if it is safe to do so.

States, territories, tribes, and tribal organization may be able to help eligible households pay for home cooling and heating costs. People interested in applying for assistance should contact their local or state social services agency.

The NIA’s AgePage on hyperthermia in English or in Spanish contains additional information and resources. It can be viewed online athttps://www.nia.nih.gov/health/publication/agepages. Free print copies of the AgePage are available through online ordering or by calling1-800-222-2225.

About the National Institute on Aging: The NIA leads the federal effort supporting and conducting research on aging and the medical, social, and behavioral issues of older people. The Institute’s broad scientific program seeks to understand the nature of aging and to extend the healthy, active years of life. For more information on research, health and aging, go to https://www.nia.nih.gov/.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments and cures for both common and rare diseases. For more information about NIH and its programs, visit https://www.nih.gov/.

When betrayal is freedom

When betrayal is freedom

For fifteen years I cared for him.

His accident was days after our engagement. My mother pulled me aside and said I could still walk away if I wanted. I knew it would be a hard road of nursing him back to health. No one knew if he’d recover or what recovery would mean. It meant putting my career on hold. Putting my family second. Putting my fiancee first in all things.

And I did. I stayed with him. For weeks in the hospital. For months of being home bound as he regained his strength.

I married a man who was still, we hoped, getting better. He has gotten stronger. Or perhaps simply better at adapting to his circumstances.

For fifteen years we lived like this. With me bearing the burden of responsibility for both of us in so many ways. With me still letting him be the man of the house. With me always putting my husband first.

I finally decided I couldn’t live like this anymore. With my identity all wrapped around his. Subsumed by his.

My nephews are in that phase where they’re obsessed with favorites. What’s my favorite food? Color? Hobby? Animal? I realized I didn’t know any of the answers for myself any more. But I knew them all for my husband.

I didn’t do anything dramatic. I decided to join the local gym and take a class once a week with some other ladies from church. To make sure we attended church together every week. To take a little time each week doing something for me, even if something else feels more important. That’s three or four hours a week for myself, after fifteen years of ignoring myself in favor of someone else.

He didn’t like it. He met someone new at church. I should have known something was wrong when he stopped trying to make excuses to not go. I was so excited when he stopped protesting, when he started getting ready on his own. I was thrilled to see people every week, feel connected to something. He felt connected to something else.

The thing is, part of me is thrilled. To be free, finally.

Sometimes the bitterness wells up in my throat. I gave so much to him and it was never enough. Does he even realize what I did for him? But I know it doesn’t matter. I know what I did. I know how much of myself I’m willing to give. And I know he would never do that for me.

It’s as if a weight has been lifted off of me. It has been, really. The weight of a man who I’ve supported all of these years.

Moving forward, I can finally support myself.