Brain health is a topic we get asked about a lot at Aging Wisely and some of our most popular materials include our information on Memory Loss terminology, Alzheimer’s Disease and Sundowner’s Syndrome.  Our guest blogger from SharpSeniors.com has explored the topic of brain aging and some preventative, protective steps we can take as we age to give the brain its best chance for healthy aging.  You can read more about the author in the bio at the bottom of the article as well.

The brain is a marvelous machine unlike any other on the planet. Comprised of bulb-ended nerve cells that look similar to a strand of hair with the root intact, this odd organ has the consistency of firm tofu and the look of greyish-pink spaghetti noodles. In short, it’s kind of ugly, slippery and for the vast majority of people, it’s not very appetizing to look on. Oh, but what a miracle it performs and its health is absolutely essential for the proper working of the body and that amazing cyber-like space called the mind. When the brain is affected, everything is affected, so the health, nutrition and proper function of this rather unattractive mass is highly essential.

Alzheimer’s and dementia are big news in senior health today and many fear the difficult consequences of memory loss and reduced cognitive function.  While dementia is a disease process and not an inevitable part of aging, the risk increases with age and there are some less insidious cognitive changes that do occur even in the typical aging brain.  While the research is ongoing concerning prevention and cure for these diseases, there are things a senior can do to improve the brain’s chances for health and maintain cognitive fitness.

You are What you Eat

There are some adages that ring as true today as they did when first coined, such as “You are what you eat.” Nutrition always plays a role in the health and well-being of the body especially as it ages, losing natural elasticity and cellular repair. It appears to be no different for the brain, and the right nutrients affect it as much as any place in the body, perhaps more so. The brain is responsible for releasing chemicals and impulses, information and commands to the body in which it sits housed, so it makes sense that a healthy brain is required for the direction and dispensing of such invisible functions.

Omega-3 fatty acids and fruits or vegetables high in antioxidants play a large role in brain fitness. Myriad research has led scientists to understand that diet alone can make a notable impact on brain health. Tests among rats and mice returned favorable results where a blueberry compound was introduced in animals genetically bred to exhibit Alzheimer’s symptoms.

Sugars, specifically glucose, are essential for proper brain function. Have you ever witnessed someone suffering a blood-sugar crash? In extreme cases, the simple act of peeling a banana is beyond the mind of a person whose blood sugar levels are too low. This can happen due to medication switches or diabetes-related problems, but it’s frightening to watch and can even lead to coma. This doesn’t mean that extra donut is essential for good health; it means how and what you eat are important. A study published in 2006 June issue of the American Journal of Geriatric Psychiatry showed measurable changes in the brain after just 14 days where certain eating and lifestyle changes were introduced in seniors. Part of that study included changing eating patterns to five small meals a day to reduce and prevent drops in glucose levels, the sugar energy of the brain. Low glycemic-impact carbohydrates such as those found in whole grains, which burn slower than other carbs, also helped steady the blood sugar levels.

Always with the Exercise!

Self-dispensing advice to cure almost every ailment seems to be the ubiquitous imperative to watch what you eat and keep active. It turns out to be completely true. Physical activity does not necessarily mean hours at the gym; a simple thirty-minute walk a day is sufficient for keeping the body and mind alert and healthy. It extends the lifespan and increases the quality of it. Daily walks are connected with reducing the risk of Alzheimer’s as well. Bottom line: if you can walk, do it. The benefits are too outstanding not to. Stress-reducing exercises also showed as beneficial, reducing the release of a hormone called cortisol, known for a role in impairing memory and damaging brain cells.

Working Out the Mind

Your body isn’t the only thing that needs a good ‘walking’ to stay fit; so does your mind. So how do you walk your brain? While that may sound like the opener to a great punch line, the joke’s on you if you let your brain get lazy and sit in front of the TV all day snacking on bon-bons. The easiest forms of a brain workout include crossword puzzles, word searches, scrabble, and other brain teasers. A good old-fashioned game of memory, where you match cards, or mahjong, which matches tiles, are stellar stretches. Even sudoku can help stimulate the brain’s functions. Do you like video games? Tetris still rules. For strategy games, a rousing round of chess really works the brain’s muscles. Actively practice memory recall by entering a room, picking out several objects quickly, and walking out again. Write down the objects, their placement and description in the room and check your memory. Switch environments and add variety to all activities so the brain doesn’t get too used to just a few.

If you prefer tech to standard games, that can be obliged. Simply surfing the internet has been noted to enhance brain circuitry, and playing video games, especially fast-paced ones, have been determined to assist in motor functions, eye-hand coordination and increased brain activity. Even simulation games, such as for pilots, can do wonders for the mind.

Technology to Improve Existing Conditions

In August of 2012, the results of a Harvard clinical trial were published by Medical News Todayconcerning a non-invasive technology named the NeuroAd Medical Device. It delivers a two-pronged attack to Alzheimer’s by simultaneously using electromagnetic brain stimulation in conjunction with cognitive training on a computer monitor, targeting areas ravaged by the disease. It not only prevented further degeneration but also improved existing functions. Improvement was dramatic and notable, exceeding what medications are currently capable of offering.

More and more breakthroughs are occurring every day; we seem to be on the cusp of understanding dementia and diseases like Alzheimer’s, their causes and their prevention. This is exciting, hopeful news but until they can be cured or completely prevented, taking the health of your brain in hand, so to speak, is a pro-active solution to giving your brain the best chance for good health. Engage your body and brain on a regular basis; don’t get lazy about it, and take charge of your age.

Author Bio: Sarah-Elizabeth R comes from a long line of professional writers. Her extensive experience writing for various online and in print publications has given Sarah a distinct style which showcases her writing as unique, versatile, and personal. She is currently the head writer for Sharp Seniors.com, where she writes on the important issues facing today’s aging population.   

If you want to understand more about memory loss and the terminology related to dementia, we encourage you to download our fact sheet about memory loss below, or call us with your questions or concerns.  We help families during all stages of dealing with memory loss and dementia, from ascertaining a diagnosis to preparing ahead, finding assisted care options and navigating care along the way.

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Aging Wisely is proud to say that we will be celebrating 15 years of giving professional elder care advice and help in 2013.  In 1998, Linda Chamberlain recognized that many families could benefit from expert professional advice and assistance navigating elder care. 

A couple things particularly stood out as she decided to found Aging Wisely.  First, the problems families faced were often comprehensive in nature.  As an elder law attorney, she saw this as families came in to address legal problems but often had other pressing issues to address that were not of a legal nature.  Essentially, these issues included care coordination, navigating options and various psychosocial issues.  Often, families were dealing with time-sensitive issues and feeling strained trying to navigate solutions.  Second, many community eldercare programs were either means-tested or prioritized by financial need (and many public services were “wait listed” i.e. not available immediately).  She and colleagues realized that just because a family had some financial resources this did not mean they were not in need of help.

Aging Wisely’s care managers have helped hundreds of individuals and families over the years, in a wide array of circumstances.  We have developed to meet changing needs and offer more comprehensive services.  We wanted to take a few moments to say thank you to all of the professionals and families we have been privileged to work with, as well as to share some of our reflections on elder care.

Providing elder care help over the years, we see many commonalities in the issues families face, though each situation brings its unique circumstances.  We have also seen things evolving over the years, such as:

• Elder care has become part of the family life cycle.  More than 65 million people in the U.S., or greater than 1 in 4, provide care to an aging or disabled family member.  With greater life expectancies and more chronic disease, most people will fill a caregiving role at some point and many will care for multiple family members.
• The path of elder care is more complex.  Factors that make caregiving more complex for families today may include: “sandwich” generation realities (the overlap of caring for aging parents and supporting children), long-distance caregiving/family mobility, family dynamics/makeup (divorce and remarriage, step-children, etc.).
• Options for eldercare support are more diverse than before, but also more complicated to navigate.  For example, there are 205 Assisted Living facilities doing business in Pinellas County, Florida, where Aging Wisely is based.  If you take the Tampa Bay area (Hillsborough County/Tampa, Pasco County and Pinellas County) now you have 470 Assisted Living facilities within an hour or so.
• Professional help is also more widely available and there is a more developed structure of family caregiver assistance.  Our professional association, the National Association of Professional Geriatric Care Managers, was founded in 1985 by a group of about 50 business owners who were some of the first entrepreneurs to provide such services.  Over time, the association broadened and took steps such as requiring certification for membership.  To learn more about the NAPGCM and its history, check out the Care Management Association History page.  There are constantly new resources available and many different organizations to help.  Sometimes it can be challenging to figure out who’s who and where to go for quality information, however.

What does all of this mean to families providing elder care (or even those who aren’t YET)?

1. It is essential to plan for eldercare.  Start conversations now, do some pre-planning, and don’t make assumptions.  We offer an Essential Eldercare Checklist for families, covering various stages and steps to take along the way.
2. While elder care is a very personal process, at some point your family is probably going to be best served by seeking professional help.  With all the complexities mentioned above, you can save a lot of time, money and headaches by getting good advice from someone who knows the systems and processes.
3. If your family is in disagreement or you can already foresee some complexities, be open with professionals about your concerns and ask for help in creative ways to proactively address them.
4. If you have an aging loved one who lives at a distance, begin to gather resources in their local area.  Start a process for family members to “check in” and keep an eye on how things are going.  There are some great checklists available for “elderly warning signs” such as our “Should I Be Worried?“.  Take some time to gather some phone numbers and basic information on services available where your loved one lives.
5. Understand who you are dealing with and the parameters of what you are getting.  A lot of eldercare services that seem like less expensive (or free) options are that way for a reason, or may cost you more in the long term.  Different options will work for different people, but make sure you know what you’re getting and who you are dealing with before you decide.

Familes often come together this time of year, and either spot concerns or begin to think about the immediate future for an older loved one.  Inquiries to senior care businesses tend to increase after the winter holidays and in to January and February.  If you are visiting and notice concerns, we encourage you to call and find out what type of help might be available–or even how to begin approaching the situation.  Unfortunately, health and other eldercare crises don’t take holidays, so if you are in a crisis situation we are always here to help as well.

Recognizing and Supporting Youth Caregivers

Thanks to SeniorHomes.Com for providing a guest post on this less recognized eldercare issue, youth serving as elder caregivers.

With multi-generational households on the rise, it’s not uncommon for today’s youth to find themselves in a caregiving role. Often, however, they don’t even realize it. It can start off with simple medication reminders but quickly evolve into a much more complex situation.

As the aging loved one declines, the young caregiver takes on ever-increasing responsibilities. Because it can be a gradual progression, both parties can easily fail to notice how extreme the situation has become. While other family members would take steps to ease this burden, many go months without realizing what’s happening—especially when there are many miles in between.

When is it too much?

The American Society on Aging estimates there are 1.3 to 1.4 million young adults, between the ages of 10 and 20, providing care for an aging or disabled loved one. On the surface, there’s no harm in a teenager reminding her grandmother to take her medications and helping out with simple tasks. But when the situation evolves to the point at which the teen is providing all of the elder person’s care, making doctor appointments, tending to housekeeping and even helping with activities of daily living, such as bathing and dressing, it can start to take a toll on the young person’s quality of life.

Young caregivers end up stressed, they lose sleep and are fatigued during the day, their grades may start to slip or they may drop out of school altogether. It’s been said many times that caregivers must take care of themselves first, but these kids aren’t in a position in which to do so. They need help and support from other loved ones and the community.

How to recognize a youth caregiver

It’s hard to recognize a youth caregiver. On the phone, they’ll probably act like everything is fine because they don’t realize there’s a problem. If you suspect the elder’s health is declining, ask pointed questions to uncover how much care the teen is providing on a regular basis.

It’s easier to uncover youth caregiving situations in person, so make a visit if you can. The holidays are a great time to do so as many of us travel across the miles to visit loved ones we often don’t see throughout the year. Talk to your aging loved one about their daily routine and to the teen about school, work and other activities.

Look around the home. Are there signs that the young person is handling finances, grocery shopping, cleaning and maintaining the home, preparing meals and helping with activities of daily living? How independent is your elderly loved one? Does it seem as though she’s able to meet her own needs?

What to do if you think there’s a problem

You may need to have a candid discussion with both parties. They probably don’t recognize there’s a problem, so approach the topic gently.

Evaluate your options with your family.

• Are there other family members close by who are able to help alleviate some of the burden?
• What community services are available in the local area?
• What is the financial situation like—are there any resources which could be used to hire a home care agency?

Sometimes, a little outside help is all it takes to make the situation manageable. In other cases, it might be time to consider moving your aging loved one to a senior living facility. Talking with a geriatric care manager or the local Office of Aging can help you make these difficult decisions based on the resources you have available. Reach out to organizations like the American Association for Caregiving Youth (AACY), a Florida-based nonprofit which provides resources and support to young adults serving as caregivers.

Whatever decisions you make at that time, be sure to open the lines of communication. It’s amazing what a listening ear and a shoulder to lean on can do to alleviate much of the stress these young adults face every day.

About the guest author: SeniorHomes.com is a free resource for people looking for a senior home for a loved one or themselves. We provide rich information about the options available in someone’s local market as well as great content to help them through their decisions. Check out our Florida assisted living page for an example.

If you have concerns that a young person in your family may be taking on more caregiving duties or have other eldercare concerns or needs, we’re here to help.  Call us at 727-447-5845 or click below to schedule a time to talk with our Senior Care Consultant.  Get quality eldercare advice and resources to help you make the best decisions, save time and money!

Reflections After the Second Professional Patient Advocacy Conference

Aging Wisely team members Linda Chamberlain and Shannon Martin recently had the pleasure of attending and speaking at the Second Annual Patient Advocate Conference in Orlando, Florida.  We were also pleased to be part of the first conference held last year, put on by the Professional Patient Advocate Institute, and honored to be named national award winner as a Patient Advocacy Organization.  This year the conference was even bigger and a great opportunity to share our passion for advocating, care coordination and improving patient outcomes.

The field of patient advocacy is a relatively young field, though the work of advocacy has been going on forever and many different professional roles include a duty of advocacy.  As care managers, patient advocacy services have long been a big part of what we do and are integrated in to every aspect of our process.  The conference reinforced that those of us serving as patient advocates come from different background and perspectives, but share common goals.

We thought we’d share some of the “take aways” that might be most relevant to our readers, particularly if you are a patient or family wondering if you need a patient advocate or related services.

1. A common theme was the emergence of professional patient advocacy, i.e. how this role has become more necessary as our healthcare system has evolved.  No matter your thoughts on our current healthcare system and changes coming to health care (or perhaps even what country/system you are involved in), there can be no doubt that things are more complex than ever.  Even if only by the nature of our advancing knowledge, technologies and treatments, there is more for both medical providers and patients to understand (and decide upon) than ever before.  An expert can be an invaluable partner in this process.
2. It is not just the complexity of health care that warrants the need for a professional patient advocate, but the difficulty of facing chronic health issues or serious diagnoses.  A couple speakers mentioned “world stop” moments such as getting a cancer diagnosis (or the call from a loved one about their diagnosis) and if you have had one of those, you know how the world can seem to change in a moment.
3. Coordinated care improves outcomes.  Common sense tells us this as patients and medical providers, and studies back this up with results.  It is why we find medical providers referring to Aging Wisely after they have exposure to what our care managers help them (and the client/patient) accomplish.  We talked a lot about this in our session on physician appointments, because it is many of the things that happen when the patient is outside of the doctor’s office that affect how successful any treatment plan will be.
4. Patient advocates are good researchers and resource connectors.  You don’t expect your patient advocate to know about every condition and shouldn’t necessarily be identifying the best patient advocate based on their expertise in a specific diagnosis but in how he/she can help you navigate care and identify the best experts.  This is why, as one speaker reiterated, patient advocates do not necessarily have to be nurses, though many come from that background.  Our Aging Wisely team operates very much on this premise, using a social services model to bring together resources and a coordinated systems approach.  We pull together the best experts for you–whether it means bringing in a nurse consultant, locating specialists in your diagnosis or initiating a pharmacy consult.

If you are trying to determine whether you need a patient advocate, it is likely you are facing issues which would, at a minimum, benefit from a consultation.  Some of the key points at which you should consider patient advocate services are:

• upon receiving a life-changing diagnosis (which could be an acute condition needing immediate treatment or surgery or a chronic and/or progressive condition),
• when experiencing symptoms and searching for a diagnosis or worrying that you may have been misdiagnosed,
• upon hospitalization (of self or a loved one) or transition to after-care,
• when issues arise in managing chronic conditions, coordinating care or pulling together resources to manage care.

Patient advocate services are both a service Aging Wisely offers and a part of all of the services we provide to clients.  We can be your advocate and resource coordinator, from a simple care consultation to the invaluable assessment process through ongoing care coordination and insurance/Medicare navigation.  Call us at 727-447-5845 to learn more or click below to request help.  Our Care Consultant, Sue Talbott, provides a no-obligation needs and services analysis to help you locate the most appropriate options for you and your family!

Our Aging Wisely team is looking for a responsible, dedicated On-Call Care Manager to handle our clients’ varied needs after regular business hours. Duties will include managing client emergencies (meeting clients at the emergency room, responding to calls, handling emergency room visits and other issues that arise), communicating effectively to clients’ responsible parties and regular care manager, and documenting thoroughly.

The On-Call Care Manager will cover the following hours: on-call week nights Monday-Thursday, 5 P.M. – 8:30 A.M. next day and weekends (on-call begins Friday 5 P.M. – Monday 8:30 A.M). One weekend per month will be covered by other team members so the On-Call Care Manager has one weekend free. The On-Call Care Manager will be responsible for checking phones during these hours and triaging calls, responding and following up and visiting clients when urgent needs arise. If inquiry/service calls for new clients come in during these hours, the On-Call Care Manager will also follow up to determine if urgent help is needed, or to set an appointment with Aging Wisely’s Senior Care Consultant to meet/talk with the client/family.

This position requires strong patient advocacy skills and knowledge of the healthcare system, as well as the ability to competently manage potentially high-pressure and variable situations. Important skills include: excellent communication, good documentation, triaging and identifying needs and solutions, and independent critical thinking. The On-Call Care Manager should be skilled at navigating the healthcare system and dealing with older clients and the family system. You will review notes and information left for you from the care management team for pertinent information about issues that may arise, and all of your interactions will need to be communicated and documented in our online system.

This position is salaried; salary commensurate with experience. Please fax resumes to 727-461-0001 or email to admin@agingwisely.com.

Join a great team, providing quality services making a difference to clients and families! Get steady pay for varied, flexible work and enjoy having a significant impact helping clients and the Aging Wisely team.

The 2013 Medicare costs such as copays and deductibles have recently been released.  Each year, these costs change slightly and most of them will be increasing slightly for 2013:

The standard Medicare B monthly premium will increase from $99.90 to $104.90 (higher income individuals will pay more).

The Medicare B yearly deductible will increase to $147.

The Medicare A hospital deductible (for stays up to 60 days) will be $1184 and the skilled nursing co-pay will be $148/day (for days 21-100, the first 20 days are covered at 100%).

The Medicare A premium for those who must pay a premium (individuals who do not have sufficient quarters of qualifying employment) will actually decrease slightly for 2013.

Check out Aging Wisely’s Medicare 2013 Fact Sheet for all the 2013 numbers and a Medicare analysis of the various pieces of the Medicare program.

In addition to the 2013 Medicare costs, there are continuing changes to Medicare mostly as a result of the Affordable Care Act and healthcare reform.  For example, preventative care coverage has been expanded to cover many screenings.  Medicare recipients can take advantage of the yearly wellness exam to talk with their physicians about recommended preventative care and tests.  Recipients who hit the “donut hole” in drug coverage will receive additional discounts during 2013.  This gap is being phased out altogether by 2020.

Another change that will be coming to Medicare in 2013 is a result of a class action lawsuit, Jimmo v. Sebelius.  The Department of Health and Human Services settled this lawsuit, in which claimants objected to Medicare’s skilled care requirement (for home health and inpatient skilled care) that a patient must show the potential for improvement.  The lawsuit claimed that patients who could benefit from skilled care to manage their current condition or maintain their current functioning should not be denied.

This lawsuit was settled recently and the changes will be rolling out over the next couple of months to providers and consumers.  If you have a claim you feel was improperly denied or questions about current coverage, you can review Medicare’s appeal options or contact us to find out if one of our care managers can help you through the process and with care options.

For our Florida readers (and especially those in the Clearwater/St. Pete, Pinellas County area), another recent news item has potentially big impacts to the healthcare coverage of local residents.  United Healthcare and Baycare Health Systems failed to come to an agreement in negotiations and disputes over payments.  For now, this means that the Baycare system’s hospitals, ambulatory care centers and network physicians are no longer part of United’s networks.  Some patients may use out-of-network providers, typically at a higher cost.  This affects individuals on employer-based plans as well as seniors on United’s Florida Medicare Advantage plans.

Baycare Health System’s physicians have been reaching out to patients to inform them of this situation, so if you are a patient you may have heard the news.  Other individuals who may not be under a Baycare physician’s care, but who may use hospital services, may be less aware of this dispute.  Baycare Health System hospitals include: Morton Plant Mease Hospital, Mease Dunedin and Mease Countryside, Baycare Alliant long term acute care, Morton Plant North Bay in Pasco County, St. Anthony’s and St. Joseph’s (including the Children’s, Women’s and North hospitals) and South Florida Baptist Hospital.

For United Medicare Advantage holders, you may want to consider alternative plan options during the open enrollment periods, particularly if this dispute does not get settled.  The current enrollment period runs through December 7th, and the Medicare Advantage disenrollment period runs January 1st-February 14th.  During the disenrollment period, you can only disenroll from a Medicare Advantage plan back to regular Medicare, but this may be a good option if your key providers are no longer covered under a United plan.  You would need to disenroll and choose a Part D plan for drug coverage.

For help with this issue and a complete Medicare analysis of options and costs, contact us at 727-447-5845 and request a Medicare analysis (or to ask questions about how we can help).