Health Care Planning Starts at Home

Before you
put it off again, ask yourself: Would you rather have a say in the most
important decisions of your life, or leave them to chance?
Every adult
can write a health care advanced directive, such as a living will or health
care power of attorney, to make his or her health care preferences clear and
legally binding, but only about one-third of adults have actually done so.
The most
common misperception about advance care planning is that it requires completing
a complex legal document. In reality, planning can start at home through a
thoughtful conversation with loved ones.
You should
focus on two questions:
can best serve as your health care agent or proxy to make decisions for you if
you become incapable, even temporarily, of speaking for yourself?
guidance can you give your proxy and others involved with your care about how
you would want decisions made?
It might be
most helpful to start by answering questions such as: what would matter to me
the most at the end of life? Is the quality of life or the length of life more
important to me?

Document your decisions
Once you have
your answers, make sure you document your decisions. The only legal document
you need is one that appoints a health care proxy.
The actions
you take and decisions you make will likely be influenced by your stage of life
and health experiences.
For example,
a healthy 20 year old typically won’t have much to say about their end-of-life wishes,
but they should still appoint a health care proxy in case something was to
happen. Adults nearing retirement age may have more-formed opinions because of
experiences with their own and others serious illnesses. And a 90 year old with
an advanced, progressive condition may have very specific preferences for his
or her last days.

Talk to your doctor
Once you and
family members have discussed your health care wishes, it is important to
discuss them with your physician and get your advance directive into your
primary health record.
treatment may involve multiple health care settings and multiple health care
professionals, you or your health care agent may need to repeat this process
many times.

advance care planning is a continuing conversation, not a one-time chat.

3 Eye Diseases of the Aging

1. Cataracts
normally passes through the eye’s clear lens to the retina, the light-sensitive
area at the back of the eye. Sometime after age 40, small clumps of protein can
form in the lens and cause it to become cloudy and the loss of vision cannot be
corrected with glasses or contact lenses. This clouding is called a cataract.

Treatment: There is no cure for cataracts. Surgery
is the only effective treatment.

Looking ahead: A new procedure called laser-assisted
cataract surgery uses a computer-guided laser to deliver pulses of energy to
perform some of the steps that are now carried out with handheld instruments.
Studies are now underway to evaluate the safety and advantages of this new

2. Macular Degeneration
The macula, a
tiny area near the center of the light-sensitive retina, helps produce sharp
close-up vision enabling you to read fine print, recognize faces, and sew on a
button. Progressive damage to the macula knocks out central vision, although
side vision remains clear. After the age 50, the condition is called
age-related macular degeneration (AMD).
A combination
of factors including, family history, smoking, and sunlight, play a role in its
AMD has two
forms: dry and wet. The dry form generally progresses slowly over a period of
years. About 10% of dry AMD cases progress to wet, which happens when new blood
vessels under the macula leak blood and fluid. Wet AMD is more aggressive and
can cause severe vision loss in a matter of weeks or months.

Treatment: The standard of care for wet AMD uses
antibodies to help prevent the growth of leaky blood vessels in the eye. The
therapy can actually improve vision, the only method to do so. There is no
cure, but for someone with moderate or severe AMD, either wet or dry, supplements
of high levels of antioxidant vitamins and minerals could slow its progression.
The supplements do not benefit people with early AMD.

Looking ahead: A small clinical trial tested the
safety, but not the efficacy of transplanted human embryonic stem cells to
treat people with problems affecting the macula. Four months after the
procedure, the researchers found no safety concerns, no signs of rejection, and
no abnormal cell growth. Larger trials are in the offing for this
groundbreaking development.

3. Glaucoma
Your risk for
glaucoma goes up if you are over 45, have a family history if glaucoma, are
nearsighted or farsighted, are African American or Hispanic, have diabetes,
migraines, or low blood pressure.
researchers no longer think of glaucoma solely as an eye disease, but rather a
neurological disorder associated with nerve cells in the brain the degenerate
and die, similar to what happens in Parkinson’s and Alzheimer’s diseases. For many
years, doctors believed that increased pressure within the eye brought about
glaucoma’s damage, so the only goal was to lower pressure with surgery and
untreated, glaucoma can cause blindness. Only about half the people who have
the disease are aware of it. There are usually no early symptoms because
glaucoma progresses slowly and affects peripheral vision first.

Treatment: Eye drops to lower pressure are the
most common early treatment. Surgery may be recommended to improve the flow of
fluid out to the eye and control pressure.

Looking ahead: Research focuses on damage to retinal cells
that connect the eyes to the brain, Medications that slow down the death of
these cells and protect healthy cells are in the clinical trials. Some are
injected into the eye, some are slow-release implants surgically placed in the
eye and some are eye drops.
If you have any
eye concerns talk to your doctor.

Lower Your Risk of Dementia by Eating these 6 Foods – Plus a dose of sunshine

1.    Beans
offer incredible benefits for the brain. Beans and green peas provide a rich
dietary source of B-complex vitamins, plus they provide plenty of protein and
fiber. Vitamin B-1 (thiamine) is important for a healthy nervous system and is often
found in enriched grain products and cereals.
2010 University of Oxford study found that people diagnosed with mild cognitive
impairment who took a supplement containing folic acid and vitamins B-6 and
B-12 for two years lowered their levels of homocysteine, an amino acid that has
been linked to Alzheimer’s disease, and showed less brain shrinkage than those
receiving dummy pills.
2.    Citrus
and orange juice are a convenient and inexpensive source of ascorbic acid
(vitamin C), as are tangerines, limes, lemons, and other citrus fruits. Sweet
peppers, strawberries, cantaloupes, tomatoes, broccoli, leafy greens, lettuce,
and cabbage can also raise your Vitamin C level.
scientists have found that Vitamin C actually dissolves toxic plaques of the
kind that accumulate in the brains of Alzheimer’s patients.
C is an antioxidant, which is essential for healthy skin and blood vessel
3.    Almonds
E is an antioxidant that works on a molecular level to promote healthy blood
vessels. Vitamin E occurs naturally in almonds, other nuts, and avocados, but
the most common sources are healthy vegetables oils, like olive oil, canola oil,
and sunflower oil. Some green vegetables, like spinach, broccoli, and collards
also provide this nutrient.
have shown that people with the highest blood levels of Vitamin E have a
reduced risk of developing Alzheimer’s.
4.    Fish
fats, also known as “healthy fats,” found in fish reduce inflammation in the
body and help heart function.
best dietary sources are oily cold-water fish, such as salmon, herring and
mackerel, eaten once or twice a week. Those who do not eat fish can consult
their doctor about whether to take fish-oil supplements.
5.    Spinach
is rich in Vitamins A and K, folic acid, and iron. It is also packed with at
least 15 different antioxidant compounds known as flavonoids which have been
shown to inhibit the formation of the beta-amyloid plaque that build up in
those with Alzheimer’s disease.
researchers reported in 2005 that people who ate eight servings of green, leafy
vegetables a week along with five servings of cruciferous vegetables, such as
cabbage, broccoli, or kale, showed less cognitive impairment than those who ate
6.    Coffee
2009 University of Florida study showed that caffeinated coffee decreased blood
vessel levels of a plaque-forming protein and even reduced Alzheimer’s-like
cognitive impairment. Decaf did not have the same benefits. The study also
showed that beta-amyloid protein levels dropped in elderly people without
dementia after they were given caffeine.
7.    Get
some sun
vitamin D plays a vital role in regulating out immune system and how our cells
use calcium, so it is effects are felt throughout the body including the brain.  Salmon, sardines, eggs, and fortified foods
like milk and soy products are good dietary sources for this important
bodies make vitamin D naturally whenever our skin is exposed to sunlight, but
this ability declines as we age, so many older people are vitamin D-deficient.
Just 15 minutes of bathing sunscreen-free arms and legs in the sun a few times
a week generates plenty of vitamin D. If you can’t spend time in the sun you
can take a vitamin D supplement, but make sure to consult your physician first.

Is Stress Making you Forgetful?

Here are 5 easy strategies that will calm you down and
maybe even make you less forgetful.
to know your stress response.
Before you can tame tension, you need to
understand what triggers it. But getting at that is not always as simple as it
sounds. Due to a mix of genetics, hormones, and cultural factors, stress
affects everyone differently. Gender also makes a difference: A man’s blood
pressure spikes more sharply under stress than a woman’s, though she may feel
jolts of stress more often, and about more things.
a personal body scan. Does your heart race? Do you struggle with a pain in your
gut that antacids can’t get rid of? Do you often forget or misplace things, or
find yourself barking at people for no good reason? All of these may be signs
of stress. Try to home in on what might be triggering it: a call from a sick
parent? Another spat with your spouse? Keeping a daily log can help you spot
patterns, and be sure to consult your physician to rule out serious health
 Move it!
Exercise short-circuits the stress
response by triggering the release of BDNF (brain-derived neuropathic factor),
which nourishes cell growth, as well as endorphins (serotonin, dopamine, and
norepinephrine), brain chemicals that boost feelings of well-being, ease muscle
tension and improve sleep.
procrastinate. Carve out 150 minutes a week of moderate aerobic exercise. Couch
potatoes should start slowly- 10to 15 minutes every other day, working up to 30
to 45 minutes, five days a week. Just walking, jogging, swimming, or biking can
get your heart pumping a bit faster and makes you break a sweat.
on it
Sleep loss means mind loss. When you
sleep poorly, your mood, memory, creativity, and problem-solving capabilities
all suffer.
much is long enough? The National Sleep Foundation suggests adults aim for
seven to nine hours of sleep each night.
Over the years, researchers have linked
different forms of meditation to cardiovascular health, pain relief, a healthy
immune system, and stress reduction. Now they are discovering it also changes
the very structure of the brain and may help preserve cognitive function.
are many types of meditation. Mindfulness focuses attention on the present,
helping you observe problems without reacting emotionally to them;
transcendental meditation uses a mantra as a focal point to quiet the mind; in
guided imagery or visualization, you are led by a teacher(in class or tape) to
tap all your senses and imagine a calm, relaxed state. Tai chi and yoga
incorporate deep breathing and meditation into various poses.
Ideally, set aside at least 15 to 20
minutes twice daily to meditate. Even a 5 minute break to sit quietly,
breathing slowly and deeply from your abdomen, can break the gridlock of
The worst stress is triggered by
situations that leave you feeling powerless. Just fretting itself can decrease
physical and psychological well-being.
Dwelling on upsetting events increases
levels of inflammation throughout the body, leaving you more susceptible to
age-related diseases, including dementia, and making you more vulnerable to
future stressful events small and large.
worriers have a perpetual ticker tape on anxiety running through their minds.
If you are one of them, schedule a worry break: Set aside 15 minutes a day to
actively dwell on problems and concerns. When that time is up, thought, tell
yourself to STOP. You can also try keeping a “worries” journal for one week.
You may be surprised by how many of the things you lost sleep over never


Top Ten Facts about Diabetes

Diabetes is a silent epidemic affecting 246
million people in the world. This is almost 6% of the world’s adult population.
Diabetes in Asians is five times the rate of the
white population.
India is the diabetes capital of the world. It
is estimated that currently there are 40 million people with diabetes in India
and by 2025 this number will increase to 70 million.
Central obesity or apple shape of the body and
insulin resistance is the main reason for diabetes increase in Indians.
Diabetes causes 6 deaths every minute and 1 in
20 deaths in the world is due to the condition. Every year it is estimated that
3.2 million people in the world die due to diabetes or its related issues.
Diabetes is an important “silent killer disease:
as there is usually no early symptom of the disease.
Almost 90 to 95% of diabetes is type 2 or maturity
onset type; that affects people in their misled age. Type 1 or juvenile diabetes
affects 70,000 children under the age of 15 years old every year.
The major cause of increase in the incidence of
diabetes is a sedentary lifestyle. Exercise and diet can either reduce or delay
the incidence of diabetes by over 50%.
Diabetes is the number one cause of kidney
failure in the world. Every year it is responsible for 5% of blindness in
adults and one million limb amputations.
The current cost of treating diabetes and its
complications in the world is an estimated $215-375 billion.


Common Skin Problems among the Elderly

Skin problems are common among the elderly.  Some skin conditions are considered a normal
part of aging, while others may indicate an underlying health problem. 
Here are
the most common skin conditions that affect elderly people, and how to treat

Dry Skin
Dry, flaking skin is by far the most common skin problem
among the elderly, affecting 75% of people over the age of 65. The loss of oil
glands is the main cause of dry skin. Dry skin gets itchy, which results in
lots of scratching or picking at the skin. Dry skin can also become cracked and
in severe cases, can bleed or become infected.
Treating dry skin:
  •          Use a cleansing soap that has moisturizer or is
    formulated for dry skin.
  •          Use body lotion like Eucerin.
  •          If you are applying the appropriate moisture and
    not noticing an improvement try gently exfoliating to slough off old skin
    cells, Bathe your loved one every other day, rather than every day.
  •          Check water temperature. Water that is too hot
    can dry out the skin.
  •          Choose cotton clothing, rather than polyester or
    other synthetic fabrics and avoid tight clothing.
  •          Use a soft washcloth for bathing and showering.
  •          Increase water consumption to keep skin
  •          Avoid caffeine, which can cause itching.
  •          Use humidifiers and vaporizers to get more
    moisture in the air.

While it may take quite a bit of force to cause a bruise in
a young child, even minor bumps and scrapes may cause extensive bruising in an
elderly person. Blood vessels become more fragile as we age, and bruising may
even occur without prior injury.
Treating bruises:
  •          Apply a cold compress to the bruise. This
    reduces the blood flow to the area, reduces the size of the bruise and decreases
  •          Avoid medications that cause bleeding, such as
    non-steroidal anti-inflammatories (Ibuprofen, Advil, Naproxen).
  •          People who take medicines that reduce clotting
    (blood thinners) or have abnormalities should seek the advice of a physician or
    other health care professional.
  •          If the bruise takes up a large area of the leg
    or foot, the leg should be kept elevated as much as possible.
  •          Be on the look-out for other signs of elder

Pressure Sores and
Bed Sores
A pressure sore, or bed sore, is an open wound on the skin
that occurs as a results of the person lying in the same position for extended
periods of time.
Treating pressure sores:
  •          Avoid long periods of time being in the same
  •          Make sure the mattress isn’t too hard. Gel
    mattresses or alternating air pressure mattresses can help alleviate pressure
  •          Massage the body occasionally to increase
  •          Brush liquid band-aid over the wound to help
    heal it.
  •          Call the doctor when you notice severe redness
    developing. This is an indicator that sores are about to surface.

Shingles is a disease that affects nerves and causes pain and
blisters. It is caused by the same virus that causes chickenpox. The first sign
of shingles is often extreme sensitivity or pain on one side of the body.
Symptoms include burning, tingling, pain, numbness, and fluid-filled blisters.
If you suspect your loved one has shingles, call his/her doctor for treatment.

Skin Cancer
Skin cancer begins in the cells that make up the outer layer
of the skin. It often develops on skin exposed to the sun, but skin cancer
cells can also occur on areas of the skin not ordinarily exposed to sunlight. 
There are 3 types of skin cancer that typically impact older people:
  •          Melanoma
  •          Basal cell skin cancer
  •          Squamous cell skin cancer

To be on the lookout for skin cancer, check moles twice a
year. Here are some warning signs to look for:
  •          Changes in the appearance, including the size, shape,
    and color of a mole.
  •          Moles with irregular edges or borders.
  •          More than one color in a mole.
  •          An asymmetrical mole.
  •          Moles that itch, ooze, or bleed.
  •          Ulcerations

If you think you have a changing mole or new skin growth see
a dermatologist for evaluation.

Fingernails: 5 Signs That Point to Bigger Health Problems

Changes in fingernails can indicate everything from heart
disease to thyroid problems and malnutrition. Here are some nail conditions
that might require medical attention:

Nail Separates from
Nail Bed

What it looks like: Fingernails become loose and can
separate from the nail bed.
Possible causes:
  •          Injury or infection
  •          Thyroid disease
  •          Drug reactions
  •          Psoriasis
  •          Reactions to nail hardeners

Yellow Nails
What it looks like: Yellow discoloration in the fingernails.
Nails thicken and new growth slows. Nails may lack a cuticle and may detach
from the nail bed.
Possible causes:
  •          Respiratory conditions, such as chronic
  •          Swelling of the hands (lymphedema)

Spoon Nails
What it looks like: Soft nails that look scooped out. In
spoon nails (koilonychias), the depression in the nail usually is large enough
to hold a drop of liquid.

Possible causes:

  •  Iron deficiency
  • Anemia

Nail Clubbing
What it looks like: The tips of the fingers become enlarged
and nails curve around the fingertips.
Possible causes:
  •          Low oxygen levels in the blood, which could
    point to heart disease.
  •          Inflammatory bowel disease
  •          Cardiovascular disease
  •          Liver disease

Opaque Nails
What it looks like: Nails look mostly opaque, but have a
dark band at the tips (a condition known as Terry’s nails).
Possible causes:
  •          Malnutrition
  •          Congestive heart failure
  •          Diabetes
  •          Liver disease

If your senior parent/loved one has one of these nail
problems, and it does not go away, make an appointment with their doctor to get
it diagnosed.


Brain Facts: Did You Know?

The human brain has about 100 billion neurons.
From the age of 35 years about 7,000 neurons are lost daily.
During early pregnancy the neurons in the fetus
can multiply at a rate of 250,000 neurons per minute.
The brain is composed of 75 to 80% water.
Dehydration can affect proper functioning of the brain.
The brain consists of 60% white matter and 40%
grey matter. White matter is the supporting matter and Grey is the thinking
matter of the brain.
An adult brain weighs about 3 pounds. This is
about 2% of a person’s body weight if they weigh 150 pounds.
Our brains consume 20% of the oxygen that we breathe
and roughly 20% of our daily calories.
15-20% of all blood pumped out of the heart goes
directly to the brain.
All the thinking in the brain is about
electricity and chemicals. The brain is more active and thinks more at night
than during the day.
The brain itself is incapable of feeling pain.

You can’t feel your own tickle. The brain is
smart enough to neutralize the sensation. The cerebellum sends a signal to the
rest of the brain of your intentions and as a result the sensation is ignored.

Long-Term Care: Paying for Long-Term Care

Long-term care involves a variety of services provided at
home, in the community, and in facilities. These services include:
  •          Home-based care such as home health aides.
  •          Community-based care such as adult day care.
  •          Facility-based care such as assisted living and
    nursing homes.

Costs Can Be High
Long-term care can be expensive. Americans spend billions of
dollars a year on various services. Hoe people pay for long-term care depends
on their financial situation and the kinds of services they use. Often, they
rely on a variety of payment sources, including:
  •          Personal funds
  •          Government health insurance programs, such as
    Medicare and Medicaid.
  •          Private financing options, such as long-term
    care insurance.

Personal Funds
At first, many people pay for long-term care services with
their own money. They may use personal savings, a pension or other retirement
fund, income from stocks and bonds, or proceeds from the sale of a home.
Much home-based care is paid for using personal funds (“out
of pocket”), Initially, family and friends often provide personal care and
other services, such as transportation, for free. But as a person’s needs
increase, paid services may be needed.
Many older adults also pay out-of-pocket to participate in
adult day service programs, meals, and other community-based services provided
by local governments and nonprofit groups, which help them remain in their
Professional care given in assisted living facilities and
continuing care retirement communities is almost always paid for out of pocket,
though in some states Medicaid may pay some costs for people who meet financial
and health requirements.

Medicare and Medicaid
Another source of funds for long-term care is government insurance
programs like Medicare and Medicaid. Medicare is Federal health insurance for
people age 65 and older, younger people with certain disabilities, and all
people with late-stage kidney failure. Medicaid is a Federal and State health
insurance program for people with limited income and resources. These programs
have rules limiting who is eligible and what services are covered.

To read the complete article go to:

Long-Term Care: Planning for Long-Term Care

Start Early
You can never know for sure if you will need long-term care.
You may never need it, but an unexpected accident, illness, or injury can
change your needs, sometimes suddenly. The best time to think about long-term
care is before you need it.
Planning for the possibility of long-term care gives you
time to learn about services in your community and what they cost. It also
allows you to make important decisions while you are still able. You will need
to make:
  •          Health decisions
  •          Legal decisions
  •          Financial decisions

Decisions about Your
Begin by thinking about what would happen if you became seriously
ill or disabled. Talk with your family and friends about who should provide
care if you needed help for a long time.
You might delay or prevent the need for long-term care by
staying healthy and independent. Talk to your doctor about your medical and
family history and lifestyle. He or she may suggest actions you can take to
improve your health.
Healthy, eating, regular physical activity, not smoking, and
limited drinking of alcohol can help you stay healthy.  So can an active social life, a safe home,
and regular health care.

Legal Decisions
Planning for long-term care includes legal planning. That means
creating official documents, often called “advanced directives,” that state
your wishes for medical care in an emergency and the end of life. You can also
decide who will make health care decisions for you if you cannot make them
It is important to consider what you want before you need
long-term care. Discuss the options with family members, a lawyer, and others.
These discussions can be hard, but telling others your wishes ahead of time answers
questions they might have later and takes the burden off of family.
Experts recommend creating three types of legal documents,
or advanced directives. There are:
  •          A health care power of attorney
  •          A living will
  •          A do-not-resuscitate order, if desired

Getting Expert Advice
Lawyers and other professional can help you create legal
documents to ensure that your health care wishes are expressed. These experts
understand state laws and how changes, such as a divorce, move from y our home,
or death in the family, affect the way documents are prepared and maintained.
Be sure to discuss your preferences and give copies of your
legal documents to family members, your health care proxy, and your doctor. It
is very important to review documents regularly and update them as needed.

Financial Decisions
Financial planning is another important part of long-term
care planning. Government health insurance programs, including Medicare and Medicaid,
pay for some long-term care services, but not others. Most people do not have
enough money to pay for all of their long-term care needs, especially if those
needs are extensive or last a long time.

Reviewing Your
Think about your financial resources and how you feel about
using them to pay for long-term care. These resources may include:
  •          Social Security
  •          A pension or other retirement fund
  •          Personal savings
  •          Income from stocks and bonds

It is a good idea to review your health insurance coverage.
Many health insurance plans provide little, if any, coverage for long-term
care. Learn what exactly is covered and what is not.
To find out what long-term care services are in your community,
contact your Eldercare Locator at 800-677-1116 or visit
See the final part to this article, part 5, on Wednesday,