You Are What You Eat: Senior Nutrition

March is National Nutrition Month and an ideal opportunity for senior caregivers to make sure seniors are getting all the proper nutrition they need. It’s easier said than done. As we age, our bodies have a more difficult time absorbing key nutrients. Certain foods can lose their appeal — medications especially can affect appetite or change the way food tastes.

A nutrient-rich diet is more than essential for health maintenance, its a form of preventative medicine. A good diet can help keep common ailments such as high blood pressure, diabetes, heart problems, and high cholesterol at bay. Key nutrients are essential to keep physically and mentally fit.

Unfortunately, according to a report released by AARP, more than 10 million seniors go hungry every day, and it’s likely that “proper nutrient intake suffers when individuals are food insecure.”  What money is available for food should go to the most nutritious foods available — whole, unprocessed foods that are nutrient-dense (and generally low in calories)  are key to senior health.

You can follow the Food Pyramid for Older Adults (Tufts University) or any balanced diet in order to get the proper nutrition. I think it’s key to get your nutrients from whole foods as opposed to relying on supplements. The elderly usually already take so much medication, who wants to take more pills?

The National Institute on Aging has recommendations for eating well as you age. They suggest you plan meals and snacks to include:

  • fruits and vegetables
  • whole grains
  • dairy products, especially low-fat or fat-free
  • protein in the form of lean meats and poultry, seafood, eggs, beans, and unsalted nuts
  • limited amounts of solid fats. Keep trans fats to a minimum
  • limited amounts of cholesterol, salt (sodium), and added sugars

Don’t forget to keep hydrated with water or water-rich food such as melons, cucumbers, radishes (!), even if you don’t feel thirsty.



The NIA also suggests any seniors with high blood pressure or hypertension consider the DASH diet, which I previously wrote about here.

Caregiverlist knows senior caregivers are integral to helping the elderly to eat right and age well. You can learn basic caregiving skills by taking our 8-hour online Caregiver Certification training course provided by Caregiverlist Training University.

Short Films Highlight Ageism

Where will you be Sunday night? If you are like me and millions of viewers (43 million last year), you will be watching the 87th Academy Awards. Are you rooting for Birdman or Boyhood? Will Eddie Redmayne take Best Actor for channeling Stephen Hawking in The Theory of Everything? Who will win the Oscar for Best Actress? My money’s on Julianne Moore in Still Alice, in which she portrays a professor diagnosed with early-onset Alzheimer's.

Movies can be entertaining, informative, arresting. They have the ability to comment upon an aspect of society and, when done well, evoke great empathy.

Seniors experience ageism, discrimination, and prejudicial attitudes every day (I pity the fool who will condescends to call me “cute” when I hit 80.) Every year since 2011, the Assisted Living Federation of America (ALFA) sponsors a short film competition (under 9 minutes) about the challenges faced by older adults when they are marginalized by a society that values youth above all things.
ALFA’s goal in sponsoring this Short Films on Ageism competition is to:

  • Demonstrate the destructive forces of ageism in society and/or
  • Raise public awareness of how ageism is expressed in direct or subtle ways and/or
  • Demonstrate how individuals can change their attitudes and behavior towards older adults.

Keith Rivers, principal/creative director at Workhouse Creative! won the 2014 ALFA Short Film Competition on Ageism with his short story documentary, Salt & Pepper.



Second place winner was A Father to Dye For , directed by Lena Nozizwe and starring retired history professor, Hulme Thamsanqa Siwundhla, Ph.D.



ALFA is the largest national association dedicated to senior living communities and the seniors and families they serve. Since 1990, ALFA has championed choice, accessibility, independence, dignity, and quality of life for all seniors.

ALFA is now accepting entries for the 2015 Short Film Competition. The submission deadline is 5:00 p.m. EST on March 30, 2015.

Seniors and Online Dating

Seniors are using technology in all its aspects to improve their lives. Cell phones can also be medical alert devices. Email is a way to keep in touch with family and friends far away. Skype is the video phone promised in yesterday’s sci-fi movies.

It’s no wonder that seniors are now one of the fastest growing demographics in the online dating game. In the spirit of Valentine’s Day, US-based technology advisory company iTOK sent out a survey asking their members to discuss their online dating habits. Their findings? 1 in 5 seniors have tried online dating, with the largest group of respondents ( 36%) falling between 66 and 75 years old. And they’re not necessarily looking for lasting love, either. Seniors seeking companionship and casual relationships found their way primarily to Match.com, eHarmony, and OurTime (a dating site that caters to singles 50 and older). Fifty percent of iTOK responders were already married; 19% reported being widowed, 18% divorced, 11% single, and 2% currently dating.

Here’s their infographic:

AARP got into the game when they partnered with an online dating service and came up with HowAboutWe. As in, “How about we” take in a movie tonight? Take a baking class together? Although in my experience, most of the men seem to be under 40 years old. Not that there’s anything wrong with that. However, they are all so good looking according to their online profile photos, I have a hard time believing that a 32 year-old Javier Bardem-looking Jared would want to “hang out and hear bluegrass while drinking whiskey” with a 50-year-old woman. But perhaps I’m wrong. Certainly my Valentine’s-addled mind would love to think so.

At the risk of sounding alarmist, I might even run a background check on someone before I committed to a relationship. I know, I’m a hopeless romantic. There are a lot of scammers out there. I strongly advise to take care in all things — especially matters of the heart, where the head tends to lose.

Will Wisconsin Seniors Pay More for Drugs?

For the second time during his tenure, Wisconsin State Governor Scott Walker is proposing to cut the state’s popular SeniorCare prescription drug program by requiring Wisconsin's seniors to first enroll in the federal government’s Medicare Part D prescription coverage.

The majority of elderly in Wisconsin like the system the way it is. Some 85,000 SeniorCare members across Wisconsin pay a yearly $30 enrollment fee as well as co-pays of $5 for generic drugs and $15 for name-brand drugs, with no gaps in coverage. Medicare Part D can cost $30-$40 monthly and many plans include deductibles.

Governor Walker’s office disagrees. "In some cases, SeniorCare deductibles are higher than Medicare Part D," Laurel Patrick, a spokesperson for Gov. Walker, wrote in a statement to 27 News, Madison, WI.  "Also there is a provision under SeniorCare that requires some individuals to spend down their income, which means they need to pay for prescription drugs out-of-pocket in order to reach eligibility levels, that makes it less beneficial for many seniors."

The governor’s plan calls for seniors to first enroll in a Medicare Part D plan and SeniorCare would supplement coverage for any drugs not covered by the federal plan. His office estimates a $15 million, or 40 percent savings over the next two years in the state’s budget for the prescription drug program for low-income seniors.

Gov. Walker first proposed a similar plan in 2011. At that time, the proposal was dropped when it faced opposition from both Democrats and Republicans.

It’s interesting that when so many want less federal intervention and more statewide control, a state program with so much local support, especially when, during fall campaigns, elected lawmakers voiced their "commitment(ment) to fully fund SeniorCare."

Currently, Democrats Sen. Dave Hansen and Rep. Eric Genrich are launching a petition to drop the proposal.  They suggest the Republican governor is "putting the interests of big pharma above Wisconsin's seniors." AARP also denounces the plan, urging Wisconsin members to contact state legislators to encourage them to remove the provisions from the governor’s proposed budget.

Bracing for the Elder Boom in America

The image of a typical nursing home, right or wrong, inspires fear in the hearts of many seniors. They picture dark, dank living spaces, rife with an uncaring, or worse, malicious staff, and, perhaps most of all, they fear becoming isolated and forgotten. It’s no wonder, then, that the idea of aging in place, at home, is a popular option for elders in America. And as the baby boom gives way to the elder boom, we realize that whatever viable options are put in place for seniors today will become our aging options in the not-too-distant future.

In her book, The Age of Dignity: Preparing for the Elder Boom in a Changing America, 2014 MacArthur Fellow Ai-jen Poo discusses the need to provide an environment whereby the increasingly aging population can stay in their own homes if they choose. But finding a competent careforce will be the primary challenge. Tackling that imminent problem is Ms. Poo’s primary focus.

Living longer is a good thing, as long as there are systems in place to care for the aged. By 2035 there will be 11.5 million Americans over the age of 85, more than double today's five million. Right now, those who need long-term care, nearly 79%, live at home or in community settings, not in institutions, and 90% would prefer to age at home. Currently, the lion’s share of home care is provided free of charge by informal or family caregivers.

This dynamic is unsustainable according to demographics and to a changing society, as Ms. Poo points out in the book. Whereas the women in the family were traditionally expected to provide care for aging parents, dual-income American family households means there is no one at home full-time to absorb those duties. Households with fewer children and more elderly begins to look a little like something from Roald Dahl’s imagination.

The answer, clearly, is a vital, supported profession senior care workforce. Ms. Poo fights for the rights of domestic workers across the nation. Fair wages along with comprehensive senior care training would go a long way to help stem the high caregiver turnover rate and provide consistency for seniors, their families, and for the workers themselves. But paying for in-home care is already a challenge for most seniors and their families. Ms. Poo proposes that this nation needs to face and tackle these challenges now, so that all seniors and their families have access to the care they deserve.

Ms. Poo recently worked with the Department of Labor to include senior caregivers in federal minimum wage and overtime protections (which has since been delayed.). She is a vital part of Caring Across Generations who believe that this country has “an unprecedented opportunity to bring care back home—where we feel most safe and secure, and surrounded by love – and to create much needed jobs in the process.”

The Age of Dignity provides a positive roadmap to becoming a more caring nation while addressing our fraying safety net and the limited opportunities for women and immigrants in the workforce.

 

 

Medicare Pays Doctors for Integrated Senior Care

Eleanor is 85 years old and spends many of her days in various doctors’ offices. Her osteopath checks her progress after a recent hip replacement. Her rheumatologist helps manage her arthritis pain. She sees her cardiologist after a mild heart episode and her primary care physician treats her hypertension. No one has yet addressed her depression. With each visit, Eleanor receives prescriptions, instructions, and tests — so many that she feels overwhelmed and underinformed. 

Many seniors seeking medical care have multiple chronic conditions. In fact, it’s estimated that three in four older Americans live with MCC. That figure is only going to increase as baby boomers age. This challenges has been recognized by the U.S. Department of Health and Human Services. They are initiating federal programs to prevent and manage MCC.

As one of those programs, Medicare is now paying primary care doctors to coordinate care for their elderly patients. Typically, when seniors see so many different doctors, their care is quite fragmented. MRIs and x-rays can be duplicated (and costly) and results aren’t shared between the various specialists. Dangerous drug interactions can adversely affect patient, leading to more doctor visits and deteriorating health.

Primary care physicians are ideally situated to oversee their patients overall health. Services include non-face-to-face planning and management for patients with two or more chronic conditions. To collect the new fee, doctors would have to create a care plan for their MCC patients and spend time each month working with their various specialty physicians.

"We're hoping to spur change, getting physicians to be much more willing to spend time working on the needs of these patients without necessitating the patient to come into the office," Sean Cavanaugh, deputy administrator at the Centers for Medicare and Medicaid Services told The Associated Press.

Critics of the plan say the proposed $40 per qualified patient per month is not enough to entice doctors to take on the extra work involved. They suggest it opens the door for even more Medicare fraud. But many doctors, especially those in smaller communities, have for years coordinated care for their senior patients with no compensation. "Quite honestly, I just didn't get paid for it," said Dr. Robert Wergin, president of the American Academy of Family Physicians told the AP. Dr. Wergin spends about 2 hours a day calling on his older patients who can’t make it into his office.

Many times, caregivers also play the part of care coordinator, especially if they accompany their senior to many of their doctor visits. However, it is no doubt helpful if a professional oversees medication prescriptions, possible test duplications, and the coordination of specialists. It’s the hope of Medicare to not only increase the quality of life for patients by strengthening primary care but also, let’s face it, save money on hospital stays, emergency room visits, and post-acute care.

Do you as a caregiver coordinate any of the care for your senior? If so, how involved are you? Do doctors welcome your care coordination? Have you utilized the Caregiverlist Care Consierge to create your own Senior Care Plan?  We’d love to hear from you in the comments.

Foods that Could Lower (or Raise) Your Risk of Dementia

I’m at that age where misplaced keys or a forgotten word gives me pause. I write so much about Alzheimer’s, dementia, and other memory loss diseases, I know the havoc they wreak, not only on the patient, but on their entire family. That’s why I take a proactive approach in decreasing my odds of developing dementia or Alzheimer’s.

Keeping activeboth mentally and physicallycan go a long way in keeping those diseases at bay. Research now shows there are certain foods that can also help or hurt brain health.

The Good
AARP suggests the following foods may lower your risk of dementia. Remember, whole foods are better than supplements for nutritive value, but supplements are better than nothing, so I’ve listed the foods and their corresponding vitamins/minerals. Time to stock up your fridge and pantry with these goodies:

  • Beans and green peas (vitamin B-1 and folic acid)
  • Citrus fruits and berries (vitamin C)
  • Almonds (vitamin E)
  • Fatty cold-water fish like salmon, cod, mackerel, and herring (omega-3 oil)
  • Spinach (flavonoids, vitamins A and K, folic acid and iron)
  • Coffee and chocolate (caffeine)


The Bad
From the Alzheimer’s Association, here are some foods that contain toxins. The resulting inflammation can lead to a build-up of plaques in the brain resulting in impaired cognitive function. They should be avoided as we age.

  • Processed cheeses such as American cheese, mozzarella sticks, Cheez Whiz and spray cheese (causes protein and plaque build-up)
  • Processed meats like bacon, smoked meats, hot dogs (nitrosamines)
  • White foods like white bread, white rice, pasta, white sugar (causes insulin spikes)
  • Microwave popcorn (diacetyl)
  • Beer (nitrates)


If you are a caregiver to someone with Alzheimer’s or dementia, have you seen a change in the disease severity when you’ve altered their diet? We’d love to hear your stories in the comments section.

Also, be sure to watch the Golden Globe Awards, for which Julianne Moore is nominated as Best Actress in a Drama for her star turn in “Still Alice”, the story of a woman, a brilliant professor, wife, and mother, who is diagnosed with early-onset Alzheimer’s disease.

Go Do Good: Volunteering Senior Care

We know there is a great shortage of senior caregivers. That looming need for qualified home health aide caregivers is a topic I’ll address in depth in a New Year blogpost, but for now I’ll address some of the abundant opportunities to help the elderly within your community.

Meal Delivery
I have a friend who works with a food pantry delivering meals monthly to homebound seniors in senior housing not far from her house. This month, she included in her deliveries a small three-dollar poinsettia. She said that the gratitude for not only the meal but the extra gift was immeasurable. She also said that the deliveries would have gone much quicker and easier with more hands. If you’d like to volunteer to prepare and/or deliver a meal to a senior, the Meals on Wheels program caters (pun intended) to seniors around the country through their local communities.

Relieve Isolation and Loneliness
According to the Census Bureau (2010), in Chicago, 1 in 3 householders over 65 years of age lives alone. Little Brothers, Friends of the Elderly has made it their mission to make sure no senior lives in isolation if they don’t want to be alone. It’s a national network of non-profit volunteer-based organizations committed to relieving isolation and loneliness among the elderly. (They) offer to people of goodwill the opportunity to join the elderly in friendship and celebration of life. Contact your local chapter to investigate opportunities to visit an elder in person or by phone.

Share Your Skills
Many nursing homes and assisted living communities are always interested in hearing from potential volunteers to help with activities and programs. Usually after passing a background check, a TB test, and signing a confidentiality agreement, volunteers are welcome to help with social activities, lead arts, crafts, music, drama, and educational programs. While you won't be able to help withe Activities of Daily Living (that's reserved for trained professional caregivers,) you can share your expertise to help better lives. Technology can help bring long-distance family together, so sharing your computer knowledge can assist a senior in keeping connected. If you have video skills, help a senior center go viral! You have so much to offer share where it will be appreciated most.

As my meal-delivering friend said, “It’s amazing how much a little interaction brightens the day of the senior crowd.” Keep the great holiday feeling going all year long. Perhaps make it a New Year’s resolution to bring a little light to a senior’s life by volunteering just a little bit of your time.

And from me and Caregiverlist, Happy Holidays!

Modern Family: Rise of the Multi-Generational Household

“Grampa is coming to live with us.” “Mom, I’m moving back home.” A struggling economy and an aging society is creating a new living dynamic in American — the three- (and sometimes four-) generation home.

We know that people are living longer and, while long-distance family caregiving is still common, it is also expensive. Families may use senior home care agencies to provide professional care to assist their elderly relatives with activities of daily living. Costs can skyrocket in times of crisis when a son or daughter finds themselves scrambling to make last-minute travel plans and miss work. Senior care costs such as those for nursing homes and assisted living communities continue to increase,  and many families may find it more economical to take a parent or parents into their own home.

According to the Pew Research Center, 57 million Americans, or 18.1% of the population lived in multi-generational family households in 2012. That number has doubled since 1980. Why the uptick? Many factors come into play, but The Great Recession of 2007-2009 has had a huge effect in the change in living arrangements. Many families lost their homes in the collapse of the housing bubble, forcing them to combine households. Young adults aged 25 to 34 have become a new demographic; known as the “boomerang youth’, they find themselves returning to the family home when it’s no longer economically viable to live on their own.

I’m part of the “Sandwich Generation”. I care for my children as well as an aging parent. The time and effort (and money) I spend supporting two households could be minimized if I could just combine them. I might also be able to claim my parent as a dependent if I pay more than half of their financial support. As a dependent, my parent’s exemption will be worth $4,000 in 2015.

Multigenerational living is not a new concept by any means. In fact, prior to WWII, it was the norm. But prosperity and suburban sprawl gave way to the migration of the nuclear family. According to the Pew Research Center, in 1940, about a quarter of the population lived in a multi-generational home; by 1980, just 12% did.

The trend reversal has benefits that extend beyond the financial. If the grandparent is healthy, they can provide free childcare to the working parent(s). Many find that daily contact between grandparent and grandchild to be invaluable. And, of course, senior isolation is nonexistent. However, there are drawbacks.

The only way to make it work, according to many multi generational families who live together, is to find a space that provides separation and retrofitting existing living spaces to accommodate the elderly. This means building an addition to a current home to provide an “in-law” apartment, or adding an elevator to ease access to multiple floors.

Some builders like Lennar with their NextGen homes, are creating “homes within homes” — complete with bedroom, full bath, kitchenette, living room, laundry room and separate entrance.
Be prepared to see more of these types of living situations. It looks like I may have to give it a go in the near future. And while I’ve always dreamed of living on the Kennedy compound, I have a feeling my multigenerational family home will look a lot more like the Waltons.

WSJ: Research Debunks Myths of Aging

“I hate growing old,” says everyone, “but it’s better than the alternative.” We tend to see aging as this inevitable decline in physical and mental capability. In American society especially, we see the elderly as somehow lesser than their younger selves -- weaker, sadder, lonelier. On November 30, Anne Tergesen wrote a piece in the Wall Street Journal, backed by some solid scientific evidence, that shows that everything we believe about aging may just be wrong.

Myth #1: The Elderly Tend to be More Depressed
Are seniors more depressed? Not according to the research. Participant of a long term study conducted by research scientists at Heidelberg University, among others, older people focus on positive rather than negative emotions. “Contrary to the popular view that youth is the best time of life, the peak of emotional life may not occur until well into the seventh decade,” Prof. Laura Carstensen, director of Stanford University’s Center on Longevity says.

Myth #2: Cognitive Decline is Inescapable
With age comes wisdom. With age come experience and knowledge. Barring dementia, studies show that older people tend to see problems from multiple perspectives. Also good news? Studies have shown that older adults can improve memory by learning new skills. Old dog --meet new tricks.

Myth #3: We Become Less Productive as We Age
Fewer older workers can retire early, thanks to our economy. According to the Department of Labor, workers 55 or older make up 22% of the American labor force. That’s up from 12% in 1992. Older workers have the edge over their younger counterparts due to experience and tend to make fewer errors in their work.

Myth #4: The Aged are More Prone to Loneliness
The elderly have shown that when it comes to people they feel close to, they prefer quality over quantity. Closer ties with loved ones means that seniors value their inner circle more and shed the relationships they find problematic. Of course, loneliness is still a problem for some elderly, especially if they are isolated but, on average, research shows that older adults are less lonely than younger adults.

Myth #5: Creativity Declines With Age
This one I love: academic studies dating far back into the 19th century show that many artists are most prolific in their 40s, 50s and 60s. David Galenson, a professor at the University of Chicago, conducted research that showed artists who “rely on wisdome, which increases with age” take years to perfect their style. He cites Mark Twain, Paul Cézanne, Frank Lloyd Wright, Robert Frost and Virginia Woolf as just a few of the artists who did their best work later in life.

Myth #6: More Exercise Produces Better Results
While getting some exercise is key to healthy aging, too vigorous activity can cause “overuse injury” to the heart. Dr. James O’Keefe, professor of medicine at the University of Missouri-Kansas City recommends sticking to a “moderate cardiovascular workout of no more than 30 miles a week or 50 to 60 minutes of vigorous exercise a day, and taking at least one day off each week.”

We here at Caregiverlist are firm believers in healthy aging. With proper nutrition, exercise, and preventative measures, we know that we can enjoy life much longer than ever before. And it doesn’t hurt to follow the advice of the late Ms. Besse Cooper who made it to 116 years old. During an interview with the Guinness Book of World Records, when asked her advice on living a long, healthy life Ms. Cooper responded, “I mind my own business. And I don’t eat junk food.”

Take the time to read the full Wall St. Journal article, along with the substantiating data.

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