Reminiscing- Is it Helpful? A Look at Brain Fitness and Overall Wellness

Could remembering that story about riding bikes with your best friend actually be good for your health?

Could memories of your neighborhood and favorite games and toys assist in your overall well being?

Could coming to terms with difficult remembrances help you move on and live life to the fullest?

Indeed, it appears to be so. Over 100 studies over the last 10 years have found that reminiscing lowers depression, alleviates physical symptoms (arthritis, asthma), and stimulates the hippocampus where memories are stored in the brain.

In fact, Dr. Gene Cohen, a noted authority on creativity and aging, says autobiography is like chocolate for the brain--especially in older adults. So one very affordable and easy way to work that brain is to think back and consider the details in your memories and experiences.

Here are 4 fun ideas to test your memory:

• Can you actually remember a conversation that happened 20 years ago? Who was it with? What was it about? Did anything happen as a result of it?
• Remember a picnic from the past (maybe at a family reunion). Can you recall what you heard, smelled, tasted, touched, or saw at that event? Try to write it down.
• Walk yourself down the street of your neighborhood when you were a kid—even take out a piece of paper and jot down boxes for each neighbors house. Who lived in the houses? Who were your favorite and least favorite neighbors? What were some of the funny things that happened on your street?
• Try to describe one of your grandparents or parents to a friend. Can you recall their mannerisms, their appearance, and what they liked to do with their time? Think about what life lessons you learned from them.

In addition to the creative benefits of remembering, Dr. Andrew Weil, author of Healthy Aging, recommends that everyone compose an ethical will (this is simply a heartfelt letter to your loved ones). This type of letter of love can help people say what matters most to their family and friends. Just write it from your heart and tell them how you really feel.

Life review has also been found to touch all seven dimensions of wellness--especially helping people socially, emotionally, and intellectually. People at ALL stages of life can benefit from a look back at the past. That’s because, when we look to the past, it can help us come to terms with things, learn from our mistakes, see the joy in our lives, and discover what’s next.

Beth Sanders is the founder of LifeBio.com and author of the Memory Journal. In 1993, she interviewed her own grandmother and realized that she never knew her as well as she could or should until that day. Her passion for family history and stories has helped thousands to preserve relationships and create a lasting legacy. Life Bio has appeared in the Wall Street Journal, Associated Press stories, the Chicago Tribune, and she has appeared on numerous radio programs including Satellite Sisters, Life Online with Bob Parsons, and Coping with Caregiving. For more information visit www.lifebio.com.

Funding Cuts for Seniors- Could the Timing be any Worse?

As more residents are forced to pay for their own way in long term care, the timing for Medicare and Medicaid cuts could not be worse.

66% of residents in an assisted living facility in 2009 reported being the primary source of payment for the costs of housing and care. The impact of the economic recession has hit seniors and their families hard with an almost 60% drop in the number of families able to contribute to a loved ones care. The trend of more seniors being solely responsible for the costs of housing and care will only be made worse as the combination of a slow economic recovery and additional cuts to programs such as Medicare and Medicaid are being contemplated as part of President Obama’s health reform plans.

Over the coming years these economic and political realities will be exacerbated by the baby boomers reaching retirement age and then their “senior living” years (shifting to use of home healthcare, assisted living and skilled nursing home care). Cuts to programs such as Medicare and Medicaid may be shortsighted. During a recent interview with healthcare policy expert Gail Wilensky on PBS’ News Hour (Aug. 10), her insight into the impact of these cuts was very specific:

GAIL WILENSKY: The notion that you can cut $500 billion to $600 billion dollars out of the Medicare and Medicaid program and think that you don't risk affecting access for groups of seniors is simply incorrect. That is a whole different story. What most of the ways to get money quickly, which is what you want if you want to use that money to expand insurance coverage for people don't have it, are sure ways that Congress will score as being a real saving, and that means whacking reimbursement. They're going to lower reimbursements for a nursing home. They're going to lower reimbursements...

JUDY WOODRUFF: For nursing homes?

GAIL WILENSKY: ... for nursing homes, for home care. They're going to reduce the amount hospitals who have high re-admissions for certain illnesses have. Now, do you want to go after some of these in reforming the delivery system? You do in careful and slow ways, but just whacking reimbursement, which is the only way to get quick savings upfront, is a whole different matter.

There is no doubt that our nation’s healthcare system needs reform, but before cutting real dollars to provide care to our nation’s most vulnerable population, areas to concentrate on first are administrative waste, unnecessary medical testing, frivolous law suits, and excessive drug and medical equipment costs. Regardless of the outcome of this latest attempt to reform healthcare, seniors and their families must prepare themselves to shoulder more and more of the burden of the costs for senior housing and care. Private funding sources are going to continue to become the rule and not the exception as time moves along.

If you want to add your voice to the healthcare reform debate, click here (http://www.ahcancal.org/advocacy/Pages/SaveOurSeniors.aspx) to learn how on the American Health Care Association (AHCA) website.

Chris Orestis
Lifecare Funding Group

Is 87 Too Old To Travel?

Alice, a seasoned traveler who is now a widow and has mobility issues, wasn’t sure. She loved to go on cruises, which she had been doing for some 50 years. However, she had always gone with her husband, who was also an adventurer. Without him, she felt so lost. She had the money. She had the desire. Could she do it physically? Knee problems and leg pain were getting her down. She could no longer walk or stand for long periods. She had serious doubts. (read more).

When a family member suggested getting a wheelchair for the trip, Alice balked. She could stand, exercise, walk, drive her car, live independently and take care of herself for the most part. A wheelchair?? Isn’t that for OLD people?

She booked the trip, invited to treat her adult children to the cruise, and then nearly canceled. She’d been to Europe before. The hills, the walking, the stamina needed just might be beyond her capabilities. But, when her family talked her into getting the wheelchair, ordered it for her, and it arrived, she changed her mind. This might be ok.

Twelve days in beautiful ports with the excitement, the services of a cruise ship, and her familiarity with this kind of travel was enough to entice her to go ahead. One of her kids accompanied her on the flight to the port of departure. That helped. So did the wheelchair escort in the airports. She learned that wheelchair customers go to the front of the line. The other kids met her at the rendezvous point, and it all worked out well.

The lightweight, portable wheelchair was a godsend. (Cost: $150.00). It weighed just under 15 pounds and collapsed easily. It had to be pushed by one of her kids, but that was fine. She used it often during the exploration of the ports of call, always accompanied by a family member. She could sit in the shade and wait awhile if they wanted to go ahead for a bit and see something in a place that was too steep for her.

With the use of a well engineered assistive device and some help from her family, Alice was able to enjoy the trip from start to finish. She walked freely around the ship without the chair, only taking it to go ashore. This is a success story for an 87 year old who had never traveled without her husband, and was brave enough to take the risks and adapt to her limited mobility. Last we heard, Alice is planning the next cruise, looking ahead to savoring life as much as possible.

By Carolyn L. Rosenblatt, R.N., B.S.N., Attorney

AgingParents.com

When Driving a Car is a Perilous Proposition for Your Parents: The Signs to Look for and What You Should Do

I floored the gas pedal. My head whiplashed. How fast the car was going I'm uncertain, but it must have been at least 50 MPH in less than 10 seconds. It required a bit of effort, but I took my foot off the gas, momentarily coasted, then jammed on the brake pedal as hard as I could and swerved hard to the right attempting to avoid an oncoming car. A pretty harrowing experience!

Impaired vision, diminished flexibility and reduced reaction time—a deadly recipe for many Elderly Drivers.

If only my reaction time had been a split-second quicker. And, if only my neck, legs and arms had the range of motion they once had when I was younger. Not to mention my eyesight. I couldn't see the traffic signal very well.

Fortunately, I was driving on a closed-course track at Rentschler Field in East Hartford CT and, at all times, was in the comforting presence of a professional defensive driver from Liberty Mutual and was following his instructions.

But the scenario I just described is not unlike what many elderly drivers may experience when they are operating a motor vehicle. Impaired vision, diminished flexibility and reduced reaction time is a deadly recipe for any driver no matter what age he or she may be.

My ordeal that day at the closed-course track opened my eyes, literally, to the perils of driving that many seniors may experience. I was a fitted with a specially-designed "senior simulator" suit and special vision-impairing glasses to help simulate the effects of aging on my driving ability.

At 61, I am in reasonably good health. My range of motion is average for my age. My reaction time, although slowed from what it used to be when I was 28 years old, remains good. And my eyesight is 20-20 with glasses. The notion that someday I might have to surrender permanently the driver seat for the passenger seat is not on my radar screen.

The issue of when a person should stop driving can be filled with emotion and, if not handled properly, can lead to a dispute among family members that can unravel a relationship to its very core.

My father-in-law was in his late seventies when it became abundantly evident that driving a car would not only place him in peril, but other nearby drivers and pedestrians. We think he sensed it himself that the days of tooling around town were nearing an end. It was only after my wife and her brother sat down and talked with him that he agreed to give up the car keys. Interestingly, though, he refused to give up the car. For two years the car remained in the garage before it was finally sold.

My uncle was 83 at the time when he was not longer able to safely drive a car. Despite pleadings from his adult children, he strongly resisted turning over the keys. Finally, he relented, but only when his wife refused to be a passenger anymore if he was behind the wheel. Tough lady, my aunt. Good for her.

Friends in Michigan are, right now, dealing with the same issue with their 80-year-old father. I know the man. He's a terrific guy, although more stubborn than a mule when it comes to heeding the warning signs about driving. Here's a guy who routinely falls, had a hip replacement, and has the range of motion of a stale pretzel.

These three examples can be repeated unfortunately thousands of times across the nation.

For example, I received this email from Marie (last name omitted for privacy), who faced a very similar, yet familiar, situation. Marie writes:

"Yes this can be a very difficult step to take with your elderly parents. I am one of five children; our mother turned 79 in January of 09. About 5 years ago she was diagnosed with "pre-Alzheimer's." She was having mishaps with driving just prior to this time, knocking off the side mirrors, running into things taking a corner into a driveway to sharp, etc.

So she fought long and hard to keep the freedom to drive, especially since she was mostly self sufficient and lived alone. Other family drama and circumstances occurred to create the need to finally take the keys for good. Then, we worked in coordination as a family, with her primary care doctor, and, at that time, part-time care givers, to encourage her to not drive. We only allowed her to drive with one of us in the car. This was oftentimes a nerve racking experience. Then, unbeknownst to her, because we notified the Dept. of Motor Vehicles, in our state, and sent a letter from her doctor which stated she should no longer drive, they revoked her license, but it stated she could get it back upon passing a driving test. Well, that was over 6 months ago and she no longer talks about re-taking her test, much less studying for it.

My suggestion is that the family members, as well as close friends, must work together and continue to communicate to the person the safety of the situation, AND work out other options, public transportation, care givers, friends to take them to church, etc. It is a tough thing to take away this "right," but I feel that the responsibility lies with those closest to the elderly driver, (even if this means close friends), as in our experience, the elderly person themselves is usually NOT willing to stop driving. You have to be willing to create a bad effect on them in order to save their life and the lives of others on the road."

The Warning Signs
If you have noticed any of these warning signs in your parents driving, perhaps it's time to start the conversation with them about driving safety:

> Running red lights or stop signs
> Performing jerky stops or starts
> Problems seeing road signs or traffic signals
> Hitting curbs
> Straying into other lanes
> Reacting slowly Riding the brake
> Easily distracted while driving

The purpose of the event I attended in CT was for the introduction of the Driver Seat Game by Liberty Mutual.

The Driver Seat Game is a comprehensive program to provide families with resources that address the emotionally charged issue of determining when it’s time for elder parents to transition from driver’s seat to passenger seat.

The web-based game is an innovative digital approach to tackling the highly sensitive subject of senior driving. A series of mini-games actively portray the challenges many senior drivers face by dramatizing visual decline, reduced mobility and poor reaction time in three impairment stages that act as the game's difficulty settings. Players must navigate different driving scenarios: busy traffic, going to the grocery store, finding parking in crowded lots, and even evading wildlife on winding country roads. Additionally, trivia challenges throughout the game educate the player and reinforce the underlying campaign goals of awareness and empathy in the active game experience. The Driver Seat Game will empower adult children to work with their parents to find a transportation solution that makes sense for their family.


I played the game and really think it is the best way for Baby Boomers – and, frankly, people from all age groups – to understand the problems faced by older drivers.

While presented as an online game, it is compellingly realistic for the aging population and addresses some very serious issues. Most importantly, it sensitizes adult children to the very emotional changing needs of their parents.

A what a Conversation Starter!
The Driver Seat Game is a great conversation starter, too. Most families are simply not addressing the very important issue of senior mobility, perhaps because they feel ill-equipped on how to approach it.

According to a recent national survey of Baby Boomers and senior drivers by Liberty Mutual, the vast majority (75 percent) of adult children say neither they nor anyone to their knowledge has ever spoken to their parents about driving safety issues. An even greater percentage of seniors (88 percent) say no one has had these conversations with them.

The survey sheds light on a possible reason why Boomers and their aging parents don’t discuss driving safety. More than half of Boomers (58 percent) think their parents would find a conversation about changing their driving habits “uncomfortable,” and more than one in three (38 percent) believe their parents would “be angered” by such a discussion.

Encouragingly, revealed the Liberty Mutual report, this isn’t the case. Only one-quarter (24 percent) say they would find the conversation “uncomfortable,” and 9 percent say they would “be angered.” Further, 92 percent of seniors say their adult children “have a right” to raise this issue with them.

The Driver Seat Game and other comprehensive online resources can be found HERE at the Liberty Mutual senior driving resource center.

Note:
If you would like to share a story about how you handled this issue with your parents, join the dialogue. Email me at MartinDiano@Gmail.com.

by Martin Diano—Publisher, BB[KC]

About Martin Diano
Martin is publisher of the Baby Boomer [Knowledge Center]™ and Founder of Boomer Authority™. You can follow him on Twitter @MartinDiano, friend him on Facebook, and connect with him on LinkedIn.

Will My Loved One Need An Income Cap Trust to Get Medicaid Benefits?

Applying for Medicaid assistance to help pay for the cost of long-term nursing home care has always been a confusing process. It is pretty rare for a person to be able to apply for Medicaid and be eligible right away. There is almost always some advance planning required. For many Medicaid applicants, that planning includes the creation of something called an Income Cap Trust.

Many states, including Oregon, have something called an “Income Cap.” The Income Cap rule states that if your monthly income is over a certain amount (currently $2,022 per month), you do not qualify for Medicaid long-term care assistance. This is true even if you have care costs that far exceed your income. For example, if your monthly Social Security and pension income is $2,200 per month, and your care costs are $6,000 per month, you do not qualify for Medicaid since your income is higher than the Income Cap.

This used to be a real problem for people, and many years ago, the only answer was to move to another state that did not have an Income Cap rule. Fortunately, the laws have changed, and a person whose income is over the Income Cap can now become qualified for Medicaid assistance by setting up a special type of trust known as an Income Cap Trust.

An Income Cap Trust is designed to hold the Medicaid applicant’s pension and Social Security income. A bank account is set up in the name of the Income Cap Trust. Each month, all of the ill person’s income is deposited into the Income Cap Trust account. So long as the trustee of the Income Cap Trust (usually a spouse, partner or adult child) agrees to spend the income in a manner approved by Medicaid, the ill person will not be disqualified from receiving Medicaid assistance, even though his or her income is over the Income Cap.

An experienced elder law attorney can be of tremendous help in this process. Most importantly, the elder law attorney prepares a plan for the spending of the ill person’s monthly income in accordance with the Medicaid rules, and submits the plan to Medicaid for approval. There are ways to design the “spending plan” in a way that provides the maximum benefit to the ill person and a healthy spouse. An experienced elder law attorney can make sure you don’t miss out on these opportunities. Remember that an Income Cap Trust takes some time to set up. You don’t want to get all of the way through a Medicaid application and be told “your application would be approved, but where is your Income Cap Trust?” Having your Income Cap Trust established at the right time can prevent long delays in Medicaid eligibility. At an average nursing home cost of $6,500 per month, a delay in your Medicaid application can prove very costly.

Do you know someone with a loved one who is in long-term care, or may need it in the future? Please pass this article along to them, so they will know about the need to plan in advance. You may save them from a stumble upon the Elder Care Path.

Geoff Bernhardt is an elder law attorney in Portland, Oregon. For more information on
his firm and on Medicaid issues, please visit his website at www.elderlawpdx.com.

Is Dad Okay?

Depression is the most common of mental conditions which can be treated, but among the elderly, it is one of the most overlooked. Sometimes, it’s because physicians don’t recognize the signs and symptoms. Sometimes it’s because of an overall attitude of society that perhaps feeling low is just part of getting old. The danger in overlooking depression is twofold. First, quality of life that could be improved isn’t, and unnecessary suffering goes on. Second, the alarming fact of elder suicide looms. Depression is both an emotional occurrence and a physical event. The physical component is triggered by brain chemistry, and can be helped.

Feeling low doesn’t have to be a permanent part of getting older. There are many elders who are able to take aging in stride, and accept the many limitations that accompany getting along in years. Aging is frequently marked by losses. Loss of spouses, siblings and friends, as well as losses of physical strength and abilities can lead to sadness. The sadness associated with loss can often be lessened with time. But what if Dad, who lost his wife last year, just doesn’t seem to care about anything anymore? If more than a year has passed since loss of a spouse, and an aging parent still seems unable to move forward, it may to be time to see the doctor for a checkup.

If you are able to accompany Dad to the doctor, mention the problem specifically. Loss of enjoyment of things one normally likes is one of the symptoms of depression. Other symptoms include feeling sad for extended periods, loss of appetite, sleeping too much or not enough, eating too much, difficulty making decisions, steady weight loss, or unusual weight gain, irritability, outbursts of temper which are not normal, and withdrawal from friends and family.

Depression is one of the most treatable of all mental health problems. Many excellent medications can make a great difference in one’s mood and ability to participate in life. Counseling or talk therapy can also be a great help in managing feelings of loss and grief and in helping an aging parent to get through the grieving process.

If Dad is just not getting back to the way he was, and has an alarmingly long, ongoing period of sad mood and other symptoms, encourage him to see his doctor. Plan to go with him to be sure he doesn’t gloss over the problem. Many elders are unaccustomed to talking about their feelings. They may lack the basic vocabulary to describe them. The adult child can offer gentle assistance with this difficult area. If unchecked, depression can become a downward spiral with no end. It can become worse and more miserable for the depressed person as time passes.

Addressing depression in an aging parent can lead to relief, and improved quality of life. It is a loving act to suggest that the problem can be improved. It may take the initiative of a son or daughter to get help for Dad, but the effect of help if well worth your effort.

By Carolyn L. Rosenblatt, R. N., Attorney at Law and Dr. Mikol S. Davis, Psychologist, AgingParents.com
Carolyn L. Rosenblatt, R. N., Attorney
Dr. Mikol S. Davis, Ed.D., Psychologist

Ms. Rosenblatt is a registered nurse, who practiced nursing for 10 years, working mostly with elders, before becoming a lawyer. She has practiced law for 30 years, as an advocate for individual rights. In 2006, she and her psychologist husband, Dr. Mikol Davis, founded AgingParents.com, a consulting and mediation service for families with aging loved ones in San Rafael, CA. Dr. Davis’s practice of 35 years has focused on anxiety and depression. Together, they form a team to assist with legal, health care and mental health aspects of aging. Ms. Rosenblatt is the author of The Boomer’s Guide to Aging Parents, available at AgingParents.com.


© 2009, Carolyn L. Rosenblatt, R. N., Attorney at Law and Dr. Mikol S. Davis, Psychologist

Sitters Make Hospital Stays Safer and Less Lonely

You would think hospitals, where you are surrounded by nurses, doctors and medical staff, are one of the safest places to be. However this is sadly not the case. With one or two busy nurses working 12-hour shifts and handling many patients with critical needs, it can be a long wait before anyone comes to check on you. Plus, it only takes an instant for a dangerous fall to occur. 10% of fatal falls for older adults occur in hospitals. Dementia, disorientation and medication are the leading factors that contribute to falls in hospitals.

The best safety precaution is a specialized caregiver known as a “hospital sitter.” Hospital sitters provide round-the-clock companionship and make observations of any health problems. Sitters can monitor and keep patients company, converse and read or even run necessary errands. However, sitters cannot aid or participate in any patient care or physical contact and must stay out of the way of hospital staff.

Sitters are under the direction of the hospital’s registered nurses. In the event of an urgent need, fall or medical emergency, the sitter will be there to immediately summon the nurse in charge. One of the most helpful tasks that sitters can do is to keep a journal. Sitters can record every doctor visit/outcome that occurs during their shift and describe any procedures done and the expected and actual outcomes. Sitters can also maintain emergency contact information for the patient’s family, as well as essential legal documents—including a copy of the patient’s Advanced Directives, in case a relative is unable to be contacted for a critical decision.

Hospital sitters provide peace of mind for the patient’s family. They supply vigilance that ensures safety and companionship and reduce a patient’s boredom and depression. They also enable the patient’s family to go home and rest, knowing their loved one will never be alone.

Dr. Kathy Johnson, PhD, CMC
Home Care Assistance, Inc.
www.homecareassistance.com
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Kathy N. Johnson, PhD, CMC is a Certified Care Manager and the Co-Founder of Home Care Assistance, Inc. She holds a Doctorate in Psychology from the Illinois Institute of Technology. Kathy is committed to serving the needs of seniors nationwide.