The signs of being a hoarder aren’t always as obvious as the pictures above. Older loved ones often accumulate many belongings over a lifetime. What makes someone a hoarder: when does the normal accumulation of belongings cross into potentially detrimental hoarding behavior? How can you identify if your parent is a hoarder or if you’re being overly concerned?

What Distinguishes a Hoarder

Hoarding is the persistent difficulty discarding or parting with possessions, regardless of their actual value (Anxiety and Depression Association of America).

Someone who hoards shows the following symptoms, which help to distinguish a hoarder from someone who simply has too many belongings:

• Inability to throw away items
• Severe anxiety about discarding items or shown when attempting to discard them
• Great difficulty organizing items
• Indecision (about what to keep or where to put possessions–may say things like, “I’m trying to decide which room would be best for these papers” when the papers have been in the hallway for many years)
• Distress (the possessions are often not a pleasure for the person but cause embarrassment or anxiety)
• Protectiveness of the items: suspicion of other people touching them
• Obsessive thoughts and actions: irrational fears of running out of/needing items, checking obsessively on the items whereabouts or counting
• Functional impairments: problems experienced due to the hoarding behavior such as compromised living space and home safety, health hazards, financial and relationship problems and isolation

As you can see, there are some key differences between a hoarder and a collector (or someone whose possessions have accumulated due to physical, financial, or other barriers to getting rid of them). A collector will take pride in items and often display them in an organized fashion.

Though a collector may spend a great deal of time collecting and finding information about what he/she collects, this behavior doesn’t cause functional life problems. The behavior of a collector tends to cause pleasure, where for a hoarder the possessions cause distress and anxiety. Despite this, the hoarder most often doesn’t see the behavior as a problem.

Research about Hoarding

Hoarding was first defined as a mental disorder in the 5th edition of the DSM (Diagnostic and Statistical Manual of Mental Disorders) in 2013. It has been associated with Obessive Compulsive Disorder, though its features are a bit distinctive (such as the lack of awareness/acknowledging the problem, whereas OCD patients typically identify a problem but cannot stop the behavior). Hoarding doesn’t seem to stem from the same neurological mechanisms as OCD or respond to the same medications. Research professionals believe there may be a few different types of disorders at play in hoarders (some combined with OCD or as a part of OCD behavior, while “pure hoarding” is an independent disorder). Hoarding is more common in people with other issues such as depression, anxiety and ADHD. A hoarder has often experienced a major life stressor, such as death of a loved one or divorce, and difficulty coping.

Signs of hoarding behavior may show up in childhood, but its symptoms are usually worst in later life as the hoarder has had time to accumulate possessions. Many times we see cases where the hoarding was somewhat hidden (or known only to close family, who had little success dealing with it) until the person becomes ill, experiences falls/gets hurt or needs eldercare services to come into the home.

Help for the Hoarder

Dealing with a hoarder can be very frustrating and overwhelming. We will share more in our next post about resources and how our team has helped hoarders and their families. In the meantime, don’t hesitate to contact us online or by phone (727-447-5845) to find out more about help for the hoarder.

Over the last few weeks the image of my Dad on a ventilator has kept me awake at night. I’m still feeling very frustrated his Living Will was not available to prevent the insertion of a ventilator tube.

The Vial of Life program I discussed in my last blog post seems outdated when you think of all of the technological advances we have available. Many states have bracelets available you can wear to signify your desire of Do Not Resuscitate (DNR) and/or Comfort Measures Only (CMO). Some states allow for state registration of your completed DNR and CMO forms with electronic access made available to health care providers.

Fitbit, can you help?  Storing your known allergies, diagnosis, current meds, and treatment desires (i.e. DNR, CMO) on a secured site with access available through your Fitbit would solve a multitude of issues. Fitbits are widely accepted and worn by all ages. You can purchase fashionable Fitbits as well as very plain Fitbits. Your Fitbit can be a bracelet or it can attach to a piece of your clothing. I imagine a necklace could easily be developed.

Lives could be saved by immediate access to known allergies or diseases. What many people do not realize is that the Electronic Medical Record (EMR) System used by their physician’s office, their specialist physician’s office, their dentist, and their local hospital do not work together, therefore each location has their own set of medical records. If you have been to the doctor or have had a hospitalization you quickly see how many times you need to share the same information. Not only is it irritating to have to repeat when you are not feeling well there is lots of opportunity for error.

We may be years from nationwide legal health care directives but having a method of universal access to your healthcare information would save many lives. From bee stings to diabetes emergency treatment access to medical information could save lives.

The use of a Fitbit as universal access to self-established legal documents and health care records could save lives as well as help individual’s ensure their end of life wishes are going to be followed.  Plus all the current enjoyment of tracking your steps and staying healthy. Fitbit, can you help?

Update: I wrote to Fitbit Support and they expressed appreciation for my suggestion about Fitbit storing information such as known allergies, diseases and treatments. Stay tuned! I’ll let you know if anything develops from this as well as other possible technology solutions. Hopefully our experiences can help companies develop better solutions! 

As we lead up to Older Americans month with the theme of “Blaze a Trail”, we’re here to share additional resources and tips around the Older American Month tips sheets. Today’s topic, “wellness”, is one near and dear to us, and we have loads of great information for you!

Wellness Inspiration and Getting Started

First, for some inspiration, check out these amazingly fit older adults and learn how some of the myths you believe about aging and wellness are probably not true! Wellness is definitely possible in your later years, and it’s never too late to get started. It is even possible to challenge yourself with workouts like Crossfit. Weight lifting and building core strength can greatly improve quality of life and functionality for older adults.

But, as the OAM tip sheet recommends, pace yourself and check with your doctor about news fitness routines. Don’t think of wellness as chore, but think about things you might enjoy adding to your life. Did you love to go dancing when you were younger? Do you enjoy the outdoors? Would it be fun to socialize with a group and meet new friends through exercise class or a walking group?

Check out our local fitness ideas, including lots of fun groups/classes and free ways to stay fit. Joining up with a partner or buddies can help keep you on track, with the added bonus of socialization for mental and intellectual wellness.

Nutrition for Wellness

Staying active is important, but so is healthy eating. Check out our great resources on healthy eating and longevity and commit to making one small change today! Consider trying “meatless Monday” (or one day/week or meal each day with no meat), adding one additional serving of vegetables to your daily diet or cutting back on sugary drinks. Here are some great resources for eating wellness:

Healthy Food for a Long, Healthy Life, including the world’s 100 healthiest foods and easy ways to incorporate more vegetables and fruits into your diet

EasyLiving’s Aging and Nutrition, including tips for healthy eating on a budget

Engage for Wellness

Staying engaged (socially and intellectually) is important for brain health and overall well-being. Consider volunteering or try learning something new.

Here’s the Older Americans Month Tip Sheet on Civic Engagement for some ideas. Our team loves helping clients continue all the activities they enjoy (or trying new ones!). Contact us for a wellness assessment and recommendations or for help with senior transportation, meal preparation, senior concierge services and more.

Don’t forget to “like us” on Facebook…we’ll be highlighting amazing seniors blazing trails in all walks of life along with wellness tips and inspiration all month and beyond!

Join us to learn more about filing a Florida Medicaid application for long term care benefits! Our expert, long-time elder law attorney and advocate, Linda Chamberlain, has filed thousands of Florida Medicaid applications for clients and she’s here to take some of the mystery out of this process for you! Make plans to join us on Tuesday, May 10, 2016 from 1:00-2:30. RSVP to reserve your seat, as they’re limited to the 1st 20 attendees.

What will you learn in the Florida Medicaid application workshop?

• What long term care services does Florida Medicaid cover? What are the programs and options for care?
• Who qualifies for long term care assistance under Florida Medicaid?
• How to file a Florida Medicaid application for long term care services
• What documents are required when filing a Florida Medicaid application?

This workshop specifically covers long term care services under Florida Medicaid, not other types of Medicaid programs. Please contact us if you need resources about other Medicaid programs or are not sure about what types of services or programs you might need. Our seasoned elder and disability advocacy team can help you find all the right resources!

*Informational materials are not intended, and should not be taken, as legal advice on any particular set of facts or circumstances. You should contact an attorney for advice on specific legal problems.

Click below for the event flier with all the details:

Filing a Florida Medicaid Application workshop flier

RSVP for the Florida Medicaid application workshop by calling 727-447-5845 or emailing lashford(at)agingwisely.com.

Blazing a Trail to Older Americans Month

Our Aging Wisely team has been privileged to work with many amazing older adults. We see all the value of their history and wisdom, as well as the varied ways they contribute to society today. Older adults have long made great contributions to society with important roles in politics, the arts, business, science and more. This year’s theme, “Blaze a Trail,” emphasizes the ways older adults are reinventing themselves through new work and passions, engaging their communities, and positively impacting lives of people of all ages.

While we celebrate and support older adults year-round, we will use the time leading up to Older Americans Month to focus on some special older adults blazing trails in our community and world. We will also highlight the importance of advocacy and planning for aging issues and share specific tips and resources on the various “Blazing a Trail” topics highlighted in the OAM tips sheets (reinvention, securing your finances, wellness, civic engagement).

History of Older Americans Month

A meeting in April 1963 between President John F. Kennedy and members of the National Council of Senior Citizens led to designating May as “Senior Citizens Month,” which later became “Older Americans Month”.

The annual observance, spearheaded by the U.S. Department of Health and Human Services’ Administration for Community Living, offers the opportunity to learn about, support, and celebrate our nation’s older citizens. Every President since Kennedy has issued a proclamation asking that the entire nation pay tribute to older persons in their communities.

Older Americans Blazing a Trail

We’ll be sharing more stories of older adults who play a big part in society today and don’t let age keep them from pursuing excellence. We welcome your suggestions/comments! Here’s some inspiration to kick us off:

Check out a few of our favorite ultra-fit seniors, 97 year-old-yoga instructor Tao Porchon-Lynch, marathoner Harriette Thompson, and bodybuilder Ernestine Shepard.

Just a few famous examples of older adults’ contributions to society:

Laura Ingalls Wilder published her 1st book at age 64 and completed the series at age 76.

Benjamin Franklin signed the Declaration of Independence when he was 70.

“Grandma” Moses inspired many with her paintings, after picking up the paintbrush for the first time at age 76.

Ruth Bader Ginsberg, 83-year old Supreme Court Justice, took her seat at age 60 as the 2nd woman Justice.

Join us on Facebook to share your inspiring stories during Older Americans Month and to get our latest updates.

This picture of my 91 year old Dad and his grandson was taken a little over a week ago.  We had just enjoyed a great brunch and visit.  The next day he went to the Hard Rock casino for some fun and enjoyed a delicious dinner.  By Wednesday AM he was experiencing shortness of breath and spitting up blood.  His wife called 911 and he was placed on a ventilator upon arriving at the Emergency Room.

The emergency room did reach out to his wife for consent, however she didn’t understand what type of tube they were talking about and just said “yes, do what needs to be done”.

The last few days have been like riding a roller coaster of emotions.  I’m sharing this story to help others avoid this situation.  I have felt great sadness these last few days and believe my Dad has experienced suffering.  My Dad passed away on Sunday afternoon.

After my Dad was placed on the ventilator in the Emergency Room he was moved to the Intensive Care Unit.  There is nothing that quite prepares you for seeing someone you love on a ventilator.  A million thoughts go through your mind and you can’t help but think about how uncomfortable it must be and that you never want to be in this situation.  Imagining any of the sensations of what a tube down your throat may feel like immediately brings gagging and nausea to my mind.

I do not feel comfortable sharing a picture of him lying in the Intensive Care Unit, with a ventilator next to him, several tubes down his throat and many IV’s connected to him along with a port in his chest to receive medications.  I choose to remember how relaxed and happy he was on Sunday and hope you can capture those feelings with this image of him.

While the health care providers provided constant reassurance my Dad was not feeling a thing and had no pain it did not make me feel any better about the situation.  The sadness of losing your Dad is painful and it is even a greater sadness to see the tube inside his mouth and down his throat, forcing him to breath.  It looked like it enlarged his neck, and the position of his neck and head looked awkward, unnatural and uncomfortable.

My Dad remained fairly stable the rest of Wednesday and Thursday.  On Thursday he had a few seconds of his eyes opening from time to time and we would try to reassure him about what was happening.  It was impossible to tell if he could hear us or understood what we were saying.  He was receiving a continuous drip of Propofol, a sedation medication.  If you have ever had a colonoscopy, you more than likely were given Propofol.  It did bring me some relief to have that comparison as I have had a colonoscopy and do not remember anything of the procedure.  However, I also do not remember if anyone was speaking to me and if they were, what they may have been saying.

Thursday the health care providers collected more information regarding my Dad’s medical history, medications, etc.… and continued to run a variety of tests.  One of the problems we struggled with was gathering his medical information.  Shortly after he got remarried he changed all of his physicians to the nearby Veterans Hospital.  My Dad nor his wife maintained his medical records and the hospital reported they have found it near impossible to access or obtain medical records from the VA Hospital.  We often remind our clients it is their responsibility to maintain their health care records and encourage them to maintain all of their records.  Please take this suggestion and get your medical records organized today.

On Friday my Dad had a bronchoscopy and the physician reported they would attempt to start weaning him off of the ventilator to see if he could return to breathing on his own.  The doctor took a few minutes to explain to us that if they were unable to wean my Dad from the ventilator the next step would be to remove the tubes in his mouth and to do a tracheotomy.  Tracheostomy (tray-key-OS-tuh-me) is a surgically created hole through the front of your neck and into your windpipe (trachea) allowing for the long-term use of a ventilator to help you breathe. The term for the surgical procedure to create this opening is tracheotomy.

Please know, there is a good chance that my Dad could have avoided all of this if his wife would have presented his Living Will to the ambulance as well as if she would have refused the ventilator.

We are fortunate in our area to have our Emergency Medical Services (EMS) recognize the “Vial of Life.”  You can alert EMS to find your health care documents, Designation of Health Care Surrogate, Living Will, Do Not Resuscitate form,  list of medications, emergency contacts, etc.… by placing an “orange colored sticker” on your front door or on your refrigerator/freezer in your home.  This sticker informs them to look in your refrigerator/freezer for your documents.  I typically recommend keeping them in a Ziploc style bag so they can easily be sighted.

When I ask the health care provider what would have prevented them from placing my Dad on a ventilator the provision of the Living Will was the first thing they mentioned along with alerting EMS with the “Vial of Life” sticker.  Please take the time right now and check if your EMS recognizes the “Vial of Life” and collect your medical information and execute a Health Care Surrogate Designation as well a Living Will with your wishes.

On Friday afternoon as our family and my father’s wife gathered around him we were able to review what a Do Not Resuscitate Form involved.  His wife was shocked to hear from the Doctor that the compressions are done with such force that ribs are typically broken and that there would be a significant amount of damage to my Dad’s body due to his advanced age and health status from CPR.  While it was difficult for her she agreed to sign the Do Not Resuscitate form.

On Saturday morning they tried to reduce the amount of his oxygen and the ventilator support, unfortunately it was a short lived experience because his oxygen levels dropped too low and they immediately had to return him to the full strength of the ventilator.  When the Doctor arrived to review his status he informed us that the maximum number of days safely on the ventilator was 10 days and if he was still alive he would have to have the tracheostomy.  Once he would have that procedure and was stabilized he would need to relocate to a nursing home that was medically able to manage tracheostomy patients.  The Doctor reported there was one nursing home in our geographical area that could provide the support needed.  He said he doubted my Dad would tolerate the procedure well due to his breathing issues and congestive heart failure.

With a little prodding the Doctor then addressed Comfort Measures Only, defined as: “Comfort Measures Only refers to medical treatment of a dying person where the natural dying process is permitted to occur while assuring maximum comfort. It includes attention to the psychological and spiritual needs of the patient and support for both the dying patient and the patient’s family.”

If his wife was willing to have the ventilator (life-support) removed my Dad would receive comfort measures only.  The Doctor predicted my Dad would not breathe well on his own and stated they would administer Morphine and Ativan to make him as comfortable as possible.  This was a difficult decision for my Dad’s wife to make, however she ultimately decided it was the right thing to do.

On Sunday morning we gathered at the hospital, around my Dad’s bed, and we each had our final moments with him and then the ventilator was removed.  I wasn’t sure what to expect, however thought he would only survive a short period of time.  After an hour or so of watching him struggling to breathe and listening to the gurgling of his lungs filling up with fluid you start to panic inside.  More medications were administered and after another hour or so he passed away.

A few years ago our 15 year old Labrador “Margo” had a medical emergency.  As a family we took her to the Veterinarian, he said there was nothing he could do to help her survive.  We all had the opportunity to hold her, and sit with her while the doctor injected medication and with two or three minutes she peacefully died.

I wish it would have been as easy with my Dad as it was with Margo.  I understand these are not everyone’s wishes, but I believe it is important for everyone to understand their decisions and the “rest of the story.”  Often when we are provided information regarding decisions to make we are only provided partial information or information someone thinks we can handle.  It is up to us to ask enough questions to make sure we understand our decisions.  There is also new vocabulary to learn, “vent,” “DNR”, “Living Will,” “CMO,” and many more.

While my Dad’s goal was live to 102 years old, the same age his mother passed away – I have no doubt he never knowingly would have wanted to have his last five days as we just experienced.

When an elderly loved one needs help at home, there are several options for Florida home health. Medicare covers intermittent, skilled care at home but most seniors (and others facing disability or chronic illness) will need some additional home care support at some point. It can be difficult to wade through the Florida home health options, so our experts are here to help!

What are my options for Florida home health care?

Privately Hiring an Individual Caregiver

We generally don’t recommend this option for several reasons. Read “The Unasked Questions When Hiring a Home Caregiver” for more detail. One of our favorite celebs, Betty White, is being sued by her caregiver, a cautionary tale about the problems that can arise when you are acting as the employer. Taxes are another important issue, as the state of Florida notes: “If you employ an independent health care professional, you should ask them who will be responsible to pay household employment taxes, income withholding taxes, and unemployment taxes. If he or she does not pay these taxes, you may be required to pay them.”

Additionally, we’ve talked to a number of families over the years who had a caregiver get injured on the job. Without worker’s compensation insurance, this can be a costly problem. Other concerns include caregiver oversight and management, handling backup care, what happens in disaster situations (e.g. Florida hurricanes) and when additional care is needed.

Agencies Regulated by Florida (see this chart for a side-by-side comparison):

• Home Health Agency (HHA): Florida home health agencies, both Medicare-certified and non-medical, are regulated by strict guidelines by the state. Agencies must take steps such as developing care plans, documenting client’s advance directives, providing detailed disaster plans approved by the state, quality assurance and handling the normal duties of an employer (taxes, managing hours worked and insurance). Staff is required to have training in Alzheimer’s/dementia and agencies must carry liability and malpractice insurance.
• Nursing Registry (NR): A registry matches health care professionals like home health aides, CNAs and nurses with clients. The healthcare professionals are independent contractors, not employees of the registry. If you choose to use a nurse registry, make sure to ask about/consider insurance coverage, backup care and supervision. Different agencies may offer more extensive services than others, or you may need to create a plan for handling these issues.
• Homemaker/Companion (HCS): This is another type of agency for Florida home health services, which is only permitted to provide non “hands on” care such as errands, transportation, and household help. These services are also often provided by the 1st two types of agencies.

How can we decide which Florida home health choice is best for us?

• Think about the client’s current and future needs. For example, a homemaker/companion agency might seem fine for now, but almost all clients needing these services require some hands-on assistance at some point (even if temporarily after a hospitalization of when ill). Do you want to have to go through the hiring process over again or bring in two agencies to get the job done?
• Do family members live locally? What kind of help can they (or others) offer? If family members live nearby and can assist with oversight and employment, some of the less formal options may be feasible. If all family members are long-distance or no one has the time to handle all the tasks involved (or fly down at a moment’s notice), you would benefit from a home health agency with great HR management or hiring a care manager to manage the situation. Don’t underestimate what is involved in managing eldercare needs.
• Assess true costs. Is saving money on the per hour cost going to save money overall? Consider employment taxes, insurance needs, and opportunity costs (i.e. if a family member will handle oversight and employer duties, what time, and therefore opportunities–including quality time with your loved one, does this cost?).
• Weigh risks in light of the client’s situation.  It is important that all parties understand the potential risks to a client’s assets (for example, if facing a lawsuit like Betty White, or costs from an on-the-job injury or fraud/theft with little recourse) and how different scenarios may play out.
• Work out a budget and assessment of options. Our care managers can provide a personalized assessment, advising of pitfalls you might not have considered. You may decide to run some risks or deal with an occasional problem for a significant cost savings, or the care manager may be able to help you save in other ways or tap into benefits programs. There are often unique ways to set up a plan to better meet your loved one’s needs while not compromising quality.
• Consider all available resources. We’ve had clients in the past who owned a company or made other arrangements to manage employees. There may also be family members who are willing to take on certain roles. You may have professional advisers or a care manager who can assist with specific needs. Tap into programs or resources to stretch your budget or reduce the level of care needed.
• Beyond just which type of Florida home health provider you choose, it is important to research and feel comfortable with who you’re hiring. Ask for references and/or QA survey results, find out more about their process and policies, understand fees in detail, and make sure you are comfortable with the management and direct care providers.

Want the best experts to guide you in this process? Contact our team today (727-447-5845) to find out how we can help make your eldercare journey easier.

You might also be interested in “Concerns about Hired Caregivers“. If you run into trouble with a caregiver, this guide will help you know your options and where to turn for help.

Recently we received a call from a very anxious out-of-town daughter looking for help to find an assisted living facility for her 78-year old Mom.   After several emergency room visits the doctor let Mom know it was unsafe for her to live alone and highly recommended she move to an assisted living facility.  Daughter reported Mom’s income is $900.00/month and she has one bank account with $12,000.  Mom’s home has a small mortgage and her equity is approximately $30,000.

Helping the daughter calculate how much Mom can spend each month is difficult to calculate since there is no way of knowing how long Mom may need the assisted living care.  It’s even harder to find a facility in the Pinellas County area that charges less than $2,500 per month that you or I would want to live in.  Unfortunately there is no quick fix for this predicament.

Nursing home care is a Medicaid entitlement program in the state of Florida.  What does that mean?  If a physician certifies you need the level of care a nursing home provides and your income and assets fall within the program limits, Medicaid must pay the nursing home after you have paid them your income each month.  The average monthly cost of nursing home care according the State of Florida is $8,346.  This is a safety net if you need nursing home care.

If the physician certifies you need assisted living level of care or home care and your income and assets fall within the Medicaid program limits, you must call the Aging and Disability Resource Center (ADRC) and get placed on a waiting list for financial assistance.  The waiting list is long, there are over 50,000 Floridians on this list.  How much financial help will they get when their slot comes up to number 1?  Medicaid will pay $1,100 per month towards their care costs (not room and board costs).

Our client has the predicament of being extremely careful with funds while hoping they eventually get a slot from the waiting list.  If she runs out of money prior to getting a slot on the waiting list she will need to relocate to a facility that only charges $900 per month or hope she meets the level of care for a nursing home.  What type of choice is that for our elder?

Please join us Tuesday, April 5, 2016 1pm – 2:30pm for a workshop:  How to Pay for Long Term Care.  We look forward to seeing you then.

LTC, or long-term care, is something more and more people understand they need to plan for in their retirement, insurance, and health planning. However, very few really understand what LTC is or how to approach planning for it. We’ll share some key LTC facts and Florida LTC costs and let you know about a great workshop coming up where you can learn from one of our area’s foremost LTC experts.

What is LTC?

Long term care is the type of care many people need for some period of time as they age. It is not acute medical care (i.e. surgery and immediate after-care or treatment for an injury or illness) but the type of “custodial care” that includes help with getting around, safety support and assistance with ADLs and iADLs.

Long term care isn’t a place (i.e. a nursing home) but can be provided at home, in day time settings (adult day care/programs), at an Assisted Living Facility (ALF), nursing home and sometimes in other settings. It can be provided by family members, and families do provide millions of dollars worth of unpaid care each year. However, many people will also need paid assistance at some point and the costs (as you can see below) can be quite staggering if you have to pay “out of pocket” (from your income and savings).

What does LTC in Florida cost?

Here is some general data from Genworth’s 2015 survey of long term care costs. Join Linda Chamberlain for our upcoming LTC workshop to learn more specifics about budgets, options and resources to pay for LTC.

Home health aide costs for Florida LTC (in-home care)

Florida ALF costs

Nursing home costs in Florida for LTC

To understand more about the various options for long-term care and the true costs involved, we encourage you to attend our upcoming LTC workshop. Linda Chamberlain, Aging Wisely founder and Board Certified Elder Law Attorney, has worked in LTC and Medicaid planning for 25 years. She will share valuable information and planning tips, as well as answering your questions.

Want to understand what Medicare covers? Confused about Medicaid v. Medicare? Considering buying LTC insurance or worried about how you’ll cover costs from your retirement savings? Want to understand why planning is worthwhile and how you can maximize your choice as you age? This workshop is for you!

How to Pay for Long Term Care

Tuesday, April 5, 2016

1:00-2:30 PM

1180 Ponce de Leon Blvd., Suite 700, Clearwater, FL 33756

Click here for the LTC workshop flier and RSVP to hold your seat today (space is limited!). You can call us at 727-447-5845 for reservations or questions.

You want to know the secrets to a long, healthy life? They aren’t as mysterious as some marketers would have you believe. There is no magic pill or drastic diet or exercise program that guarantees a long life. Researchers have studied “blue zones” where people are known to live long, active lives and have found the commonalities among these people. Healthy food is one of the biggest components of their longevity. This month, we are focusing on healthy food made simple: tasty recipes, resources for quick but healthy food, and ideas to add variety to your diet while including more healthy food.

Baby Boomers have the longest life expectancy of any generation thus far, yet higher levels of hypertension, diabetes and high cholesterol, obesity and disability than the generation that came before them. Healthy food can reduce the health risks associated with these issues, for a long and HEALTHY life.

Healthy Food=Sexy Diet

Variety is actually one of the keys to getting healthy food in your diet. Anything can be okay in moderation…the key is to have varied, healthy food as the bulk of your “fuel”. Healthy food doesn’t need to be boring and tasteless. It can be varied and delicious, and will definitely give you added energy and vitality. Enjoy your food, try new things and feel better…simple recipe for longevity, but not always so easy to implement (which is why we’re here with help).

Plant-based foods should make up the bulk of your diet, according to the best health and medical researchers. At a Johns Hopkins’ women’s conference last year, several physicians reiterated a plant-based diet as the key to healthy aging.

How can you add more variety while enjoying your meals?

• Add veggies into your meal and slightly decrease the size of animal protein, or go vegetarian one or two days/week. Taste a variety of veggies and try different preparation methods.
• Add veggies to foods you already like and experiment with styles of food you like (Indian vegetarian curry, veggie sushi, spicy Mexican dishes with healthy beans, comfort foods revised with added vegetables or lower calorie/fat options).
• Try something new. Pick a new recipe, grab a new fruit or veggie at the store; check out this A-Z of veggies.
• Cook extra, so you have less work and more healthy choices on hand.
• Check out these easy tips for sneaking more fruits and vegetables into your diet, including prep ahead Meatless Mondy recipes, seasonal guides and on-the-go options.

As We Get Older We Need More “Bang Per Bite”

Nutrition needs increase as we get older, while caloric needs decrease. Therefore, we need nutrient-dense foods (to get the most “bang per bite) to fuel our bodies for energy and wellness. Healthy food isn’t just about keeping weight down; healthy food keeps us well and helps us recover. Medications can affect nutrition: statins increase the need for Coenzyme Q10 and acid-blocking meds reduce absorption of B12 (lack of which is associated with dementia risk).

The tips above are great for getting more nutrient dense foods. Temptation is all around us today, but so are options. Even the gas station or convenience store has healthy options (hidden among many very unhealthy ones) so you can grab something pretty healthy on-the-go. On a recent trip, I picked up the following snack at Walgreens: a “protein pack” (nuts, cheese and lean turkey) and a banana. At the airport, I was able to grab a pack containing two types of sliced apple and a small thing of cheese and crackers. They also had delicious yogurt, Kind bars and several types of salads. The truth: I felt better and I’d rather eat a nice meal or get myself a treat I’ll enjoy, rather than something unhealthy but pretty tasteless from a convenience store or airport.

• Eat lean foods with high levels of nutrients. Here’s a great list of “the world’s 100 healthiest foods“. This is great because not only are they healthy, but readily available and pretty affordable.
• Consume more fiber. You will feel fuller and fiber can help with weight control and of course, digestion.
• Cut sodium. Herbs can be used to flavor foods and reduce the need for salt. Processed foods are the worst culprit, though, so having convenient fresh foods available is your best weapon.

Here are some additional tips from EasyLiving about eating a varied diet and doing it on a budget.

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What the Tuck?

Is tucking part of your workout?  Can you stand straight, push your navel into your back and tighten your abdominal muscles – if the answer is yes – you know how to tuck!  I recently had the opportunity to attend a Clearwater Pure Barre class, and wow!!  (Thank you to my daughter-in-law Lauren, owner of the Pure Barre studio).  It was a workout as well as an education.  I loved it!

I have to admit, I was a little nervous walking in to the class as it appeared most of the other participants were under 40 (I haven’t seen the 40’s for years :-).  And while it took me a few minutes to catch on I very quickly joined in and started making some moves that were new to my body!  I couldn’t complete every exercise, the instructor said give it time and I will eventually be able to make it the entire hour.  I enjoy the challenge and for now will make this a part of my weekly exercise, at least 3 times per week.  It is one hour that flies by!

Working out has never been fun for me – I have to make myself do it.  I’ve tried everything and the only exercise I come close to loving is snow-skiing – and of course I live in Florida.  I do know from all that I read and from the many clients I have met that moving is vital to healthy aging.  I want to be healthy, it’s just sometimes I don’t use my discipline to stay focused.

Two times per week I meet with an incredible personal trainer who has taught me the proper way to stretch and strength train.  Sometimes the goals are simple, balance on one leg, jump rope without missing.  Often we focus on real life skills, for example the ability to get up off the floor safely while lifting my grandchild’s weight.  She also works each week on my posture – what a challenge that has been.  Between a curvature of my spine (Kyphosis – inherited from my father’s side of the family) and my many years of sitting in front of a computer my body has been trained NOT to stand straight.  The daily stretching of the tissue is helping enormously as well as the strengthening of the weakened muscles. I had no idea how many different ways there are to stretch.  I can’t imagine life without a foam roller.

I was shocked initially to see how poor my balance actually was.  Not that I am falling or losing my balance, but how I was unable to bend over on one leg and pick something up?  What year did I stop being able to do that?  I’m not really certain how I quit moving certain directions but since my children have left home I have often let work get in the way and become my grand excuse not to exercise.  Clients and their problems often gain my full attention in the goal of providing great service and solutions (can you hear my justification for not exercising).  While clients are important, many of them have stressed to me how important it has been to them to concentrate on their health and staying fit.  Their reward is less pain and maintaining independence – I want both of those!

Along with getting my Exit Strategy organized this year I am making my health a priority.  Come back and check out Linda’s Journal as I work through my exercise, eating habits, and medical screenings.  I’m happy to share my tips and struggles – I would love to hear all about yours.  Please email me at Linda(at)agingwisely.com.

Can Seniors Crossfit?

A common misconception is that certain types of exercise are appropriate only for certain age groups and that when we get older, it’s time to take it easy. Well, older adults today are breaking the mold and doing amazing things with fitness over 50 (and 60, 70, 80!). Obviously, at any age if you have medical conditions, you need to check with your doctor before starting a fitness routine. But, there is no fitness routine that should be inaccessible to any age group. Just check out these inspirational older adults who are proving you can gain ultimate fitness over 50 and beyond: “Fit at 102”, Video: Seniors Using the Crossfit Method, and Crossfit Grandma’s Video Diary After Losing 79 Lbs.

What is Crossfit?

Crossfit™ is a strength and conditioning program which is designed for overall fitness (versus a specialized program). CrossFit is focused on “constantly varied, high-intensity, functional movement” and brings in various types of exercise. There are many Crossfit gyms across the country and there are also competitions held for Crossfit athletes.

Fitness Over 50: Research

“Exercise is almost always good for people of any age,” says Chhanda Dutta, PhD, chief of the Clinical Gerontology Branch at the National Institute on Aging, stated on WebMD. Some older people will worry that they might fall/hurt themselves if they exercise when in fact exercise has been shown to prevent falls: it can prevent bone loss, make you you stronger, improve balance, boost your memory and mood, and ease symptoms of many chronic conditions associated with aging.

Unfortunately, according to the National Institute on Aging, just over half of adults 65+ are inactive and only 11% of people 85 and over engage in any regular exercise. Evidence shows that most could work out safely, especially if shown how.

Maria Fiatarone Singh, who’s been studying strength exercise in older adults at the University of Sydney for many years concludes, “If I had to do only one thing for the frail older person, it would clearly be weightlifting exercises.” She has done studies with frail elderly in nursing homes and post-hip fracture patients showing the benefits of relatively intense strength training. Even if Crossfit isn’t for you, the concept of incorporating strength training and a well-rounded fitness routine should be part of most older adults’ lifestyles.

Benefits of Crossfit for Older Adults (Even if you don’t Crossfit!)

Here’s a great post from one older adult who saw many benefits of Crossfit in her daily life. She noticed obvious improvement in balance and strength: being able to regain balance if she trips over something, climbing stairs and opening jars with ease. Little things that can become harder with age (and lack of fitness) like getting up and down from chairs and the toilet or in and out of the car suddenly became easy. Her endurance for all kinds of activities improved. We often accept the aches, pains and limitations of an aging body as part of getting older but her story shows how some challenging exercise can really turn that around. The strength training benefits of Crossfit style workouts can be perfect for reversing muscle mass and strength.

Crossfit and other exercises that challenge the body can also give you a new sense of confidence. The group nature of Crossfit can make it more fun and inspiring.

Another one of the benefits of Crossfit for older adults is the increase in core strength. This helps you maintain balance and more easily handle a stumble or trip.

The benefits of Crossfit for fitness over 50 can apply to other types of routines. The important point is to build strength and endurance, especially to make up for the muscle loss that comes with aging, and to enhance balance. Fitness classes or working out with a personal trainer can motivate you and ensure you benefit and stay safe. We have a whole host of fitness ideas for you!

What’s your fitness over 50 secret? Have you experienced the benefits of Crossfit or started a new routine later in life and found success? Come over to our Facebook page to share more!

Could the key to a long life be in these little devices?

Knowledge is power, but action is necessary to put that knowledge to use. We know the keys to a long life from research on the world’s longest-living populations. Meanwhile, modern life is pulling us further away from these healthy habits. Fortunately, a modern solution may also help us truly take action towards living a long life.

Wearables are seen by many as a great possibility for building healthy habits into our daily lives. A wearable device incorporates technology into something you wear such as clothing or an accessory (think Apple Watch, Fitbit or Google glass). They always make me think of James Bond!

A PWC study found that consumers see great potential with widespread use of wearable health technologies for long life and better health:

• 56% believe life expectancy will grow by 10 years because of wearables
• 46% believe they will decrease obesity

And, the potential for these devices being integrated into a healthy, long life is amazing! Cisco estimates the number of wearable devices in use will jump to almost 177 million by 2018.

The advantage of wearable health technologies is the ability to get real-time data that we can use to change behaviors and prevent disease (before we see symptoms, when reversing damage becomes much more difficult). Seventy-one percent of Americans claim that wearable technologies have improved their overall health. By bringing the data right into our daily lives (it can’t get much more convenient than wearing it), people tend to be more accountable for their personal health and fitness, all of which can lead to a long life and less illness. There are devices that remind you to take medicines or keep up with healthy habits (fitness especially), help track nutrition, monitor/correct posture and more.

Wearable technology has the potential for a big impact on healthcare. Right now, a doctor’s interaction with patients is mostly limited to the office visit which gives the doctor a very small window into the daily life of the patient. Wearable technology can monitor key vital signs and send measurements of important data to the patient, caregivers and medical providers. Wearables also have enormous potential for research purposes.

The Best Fitness Wearables for a Healthy, Long Life

The Jawbone is a reasonably priced option that covers the basic measurements and features you’d want in a fitness tracker. Simply slip it on your wrist and track: activity (steps, calories burned and bursts of activity), sleep mode (tracks sleep time and quality and offers a smart alarm to wake you more easily during the best part of your sleep cycle) and a stopwatch you can set for timing exercise.

The Misfit Flash is a great option for first-timers and the budget-conscious, coming in at about $25-30. This wearable offers all the typical tracking you’d expect (sleep, steps/activity) but also does well timing various types of activity such as swimming and even sports. The Xiaomi Mi Band has gained incredible popularity in China, and is now available outside of China, as an ultra-affordable option. Get it on Amazon for as little as $18-27.

For those who want to monitor their heart rate, the Fitbit Charge HR is a great option. While covering the usual activity tracking, this one also does a great job as a heart rate monitor/tracker (and has a nice app with the ability to set challenges for yourself). You can also log food with a bar code scanner, food database and calorie counter.

Garmin also has a range of sophisticated options.

Stay tuned for more about all kinds of unique wearable health technologies and ways tech is changing healthcare, caregiving and our access to a healthy, long life. Sign up for our newsletter so you never miss out!

Sure, we all know it’s important to exercise. It’s one of the keys to living a long life but also one of the best ways to maintain an active, healthy lifestyle and feel great. Some of us have our exercise routines pretty well locked in, but might lose motivation or get bored at times. For others, it’s always been hard to commit to exercising on a regular basis. So, today we bring you FUN fitness ideas: unique programs (and help for specific “problem areas”), cool ways to take advantage of the outdoors, and free ways to work out and find fitness partners.

FREE Fun Fitness Resources

• Find exercise buddies with Meetup.com. Checking our local Meetup groups for fitness activities we quickly found a walking challenge group in Brandon, “Happy Healthy Living in St. Pete” which has had meditation meetups, sunrise runs, and co-working days for a holistic approach, paddleboarding groups, kayakers, and any number of running groups, bootcamps and more. Joining Meetup is free and it’s a great way to find exercise buddies, try different types of exercise, and meet people with similar interests.
• Check out the many Pinellas County community fitness centers and “free fitness zones”–outdoor areas with special fitness equipment (free/no membership required). Fees are involved for some of the community fitness centers but they tend to be quite affordable and may offer senior discounts.
• Find videos online to workout at home. Youtube has an endless selection of exercise videos, as well as experts demonstrating techniques.

Unique Fun Fitness Ideas

Try a completely new form of fitness (some specially targeted at concerns you might have):

• The Feldenkrais method (which is taught at Largo’s community center) “uses gentle movement and directed attention to improve movement and enhance human functioning” to help break rigidities. It has been shown to improve back and neck pain, balance and functional mobility.
• Yoga or pilates can be very beneficial to creating strength and flexibility. There are so many types and options. Suncoast YMCA offers yoga classes for the beginner, yogalates, Hatha yoga, chair and senior yoga free for members. Hot yoga can bring a new challenge (but, like all other forms of exercise, check with your doctor first) if you’re ready to heat things up a bit! And, for us lucky residents of Tampa Bay…take advantage of the beautiful environment with beach yoga (check out Meetup for more beach yoga and exercise groups). You can find Pilates classes at various fitness centers and specialized studios for reformer Pilates. There is quite a bit of research on the positive effects of Pilates on postural alignment, body composition, back pain, and balance.
• Dance: Pure Barre is an increasingly popular program that uses the ballet barre to perform small isometric movements set to fun music. It is considered a total body workout and people tend to see great results…plus it’s fun and different (and can bring you back to your ballet days!). For those who love to dance, you might also want to try Zumba (there’s also aqua Zumba and a more low-key version called Zumba Gold) or many other dance-cardio classes. An evening out ballroom or line dancing is great for you too!
• Tai chi and qi gong are great for body and mind. The Taoist Tai Chi society offers classes at the Dunedin Hale Center and several locations throughout Pinellas County (and the U.S.). Tai chi’s benefits for balance and reducing the likelihood of falls as you get older are well-documented. It is also a great stress reducer. Qi Gong an “ancient Chinese health care system that integrates physical postures, breathing techniques and focused intention.” It heals body and mind, due to its focused attention on breathing and movement. Both of these are offered at a number of community centers in Pinellas County.

Fun Fitness in the Great Outdoors

Getting outside and exercising in the fresh air is one of the best things you can do! If you live in Tampa Bay, there’s nothing better than a walk on the beach; walking, running or biking on the Pinellas Trail (and others); joining a friend for a stroll across a bridge for a sunset view; or hiking around one of our many parks. What about trying paddleboarding or kayaking? Bring a friend or your EasyLiving companion, join a meetup or just get out and enjoy some quite time by yourself.

• Make a goal to do one active outdoor activity/week, especially checking out new areas (there’s probably places you haven’t explored within 5 minutes of home).
• Add simple outdoor activities to your regular routine: do some gardening, take a quick stroll after dinner, attend festivals where you spend time walking around, park further away when shopping, or walk for your local errands.

Ok, you’ve got no excuse now! There’s something for everyone (and every budget) on this list so get out there and get active. Join us on our Facebook page for ongoing fun fitness tips and to share your success stories.

The surprising story of Japan’s Nagano Prefecture, once plagued by high blood pressure and strokes, now known for longevity among both women and men

The Japan Times recently published an article on “How Japan’s saltiest residents came to live the longest“, an interesting twist for those who credit Japan’s longevity to a diet filled with fish. Nagano Prefecture is a land-locked area, once known for digesting high levels of salt (used to preserve foods during long winters). Some of its most famous foods are preserved and pickled foods and a salty miso. So, how did this region go from being plagued by high blood pressure and strokes as recently as the 1960s to the highest levels of longevity in the world?

The solutions might surprise you! This story proves that people can make small changes that can make a dramatic difference in longevity (and quality of life). The area began tackling the issue by first focusing on the high salt diet, encouraging residents to make realistic changes. For example, instead of eating the salty miso soup with each meal, residents could cut back to once/day.

By adding more fresh vegetables (which refrigeration had made possible), people could still eat favorite foods but reduce the salt in their overall diets. The average Nagano resident consumes more vegetables each day than other Japanese people. This advice was echoed many times over at a recent Johns Hopkins women’s conference I attended, with a constant refrain from gerontologists, aging specialists and other researchers that a plant-based, nutrient-dense diet is essential to health and longevity.

The life expectancy for Nagano residents (from a 2013 study) is 80.88 years for men and 87.18 years for women. Japan’s national averages (2013) are 79.59 and 86.35, and the U.S. stands at about 76 and 81.

More than just living a long time, this area originated the concept (and slogan) of being “spry and energetic” in life and dying “a quick and painless death”. This concept of healthy life expectancy is increasingly popular, as most people worry that with longevity can come decreased quality of life. The question really becomes how can we not only live longer, but live better (i.e. aging wisely!). To read more about some of the ways Japan is tackling this question check out EasyLiving’s recent article on “Rethinking Aging: Lessons from Japan“.

So, what can you learn from Nagano’s residents to increase healthy longevity and age wisely? The surprising news is how easy it can be to make small changes (residents weren’t told to turn to the latest diet trend or completely eliminate anything).

• Consider implementing one small change in diet (e.g. eating meat-free one or two days/week, reducing sugary drinks to once/day, adding one serving of vegetables to each meal, using more herbs and less salt) immediately. Try the great recipe in the Japan Times article and use online resources for new ways to make veggies delicious. See how you feel and determine ways you can make additional small changes this year.
• For healthy, happy aging make small changes in lifestyle, one geared toward physical activity (parking further away to add more steps, taking a short walk each morning, trying a stretching or balance exercise video for a few minutes each day) and one geared to social/intellectual stimulation (taking a course or joining a new activity, setting time aside for lunch with a friend once/week or to Skype with family members). Think back to a hobby or interest you once enjoyed that perhaps you have given up, and find new ways to bring it back into your life!

For more longevity secrets, aging wisely advice, health research and more: