Caregivers Guide To Auto Insurance

If you’re helping out a relative or friend who can’t drive, your to-do list probably looks endless. But here’s one more thing you might not have thought to include: Ask about car insurance coverage.

Auto insurance is fairly straightforward in ordinary situations. A standard policy generally covers the car owner, drivers in the household who are listed on the policy and anyone else the owner lets use the car occasionally.

But it gets a little blurry outside the standard lines. Here are four scenarios and how car insurance would come into play:

1. Your great aunt gives up her license, but maintains a car for you to drive her to appointments.

Usually the person insuring a car is a licensed driver.

“But there are some companies out there that will allow you to exclude yourself and name someone else as the primary driver on the policy,” says Penny Gusner, consumer analyst for CarInsurance.com. (See: “When is it time to take the car keys?“)

In this case, your aunt would ask her insurer to exclude her and name you as the primary driver. The auto insurance company would use information about you, such as your age, gender and driving record, to help determine the premium for the policy. (See: “Learn how car insurance rates work.”)

Have your aunt call the car insurance company or agent she used before giving up her license. An insurer is more likely to accommodate special circumstances for a customer with a good track record with the company. Your aunt should also review liability limits to make sure they’re adequate, Gusner says. As a senior on a fixed income, who probably didn’t drive much even when she had a license, she may have lowered the limits to save money on car insurance.

2. Your sister is laid up for six months with a broken leg, so you move in and use her car to help out.

If you visit for a couple of weeks, then your sister’s policy probably would extend coverage to you as a “permissive driver” — someone she lets borrow her car occasionally.

“But if it’s for 30 days or more, then you probably will need to be listed on the policy,” Gusner says.

Insurance companies want information on all the licensed drivers who live in the household and have regular access to the car. Neglecting to tell the company about a driver who shares the household could create a sticky situation if that driver crashed the car.

Your sister should let her car insurance agent or company know that you’re living with her. Once she’s up and around again and you move out, she can remove you from the policy.

3. You make extra cash chauffeuring elderly neighbors to the store.

Call your car insurance company if you’re using your own car. Check whether your errand-running counts as business use of the vehicle. Some policies exclude coverage for certain types of business use.

Ask your neighbors to check their own policies if you’re using their cars.

4. Your grandmother asks you to drive her to a monthly bridge game.

In most cases your grandmother’s policy would cover you as an occasional “permissive driver.” Still it’s a good idea to double-check coverage with the car insurance company.

“Some policies are more stringent than others about what ‘occasional’ drivers are,” Gusner says.

And some include tricky exclusions. Cheap car insurance policies, for instance, sometimes exclude everyone but the named drivers, or they exclude permissive drivers under the age of 25. In some states, insurers are allowed to include “step-down provisions” in their policies, which reduce the policy’s liability limits to the state-minimum requirements when permissive drivers are using the car. These types of limitations are more common with nonstandard, inexpensive policies.

“Your best bet is definitely to call and clarify coverage with your insurance company,” Gusner says.

The original article can be found at Insurance.com:
Caregiver’s guide to car insurance

At Home Instead Senior Care, we have highly trained CAREGivers that would be happy to assist in your daily non-medical needs.  We can drive you to appointments, shopping or running errands.  Give us a call at 360-782-4663 and we’d be happy to answer any questions.

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Vitamin D Prevents Fractures

A new analysis of nearly a dozen studies testing vitamin D in older individuals has concluded that it takes a daily dose of at least 800 international units (IU) to consistently prevent broken bones.

A dose that high was found to reduce the risk of hip fracture by 30 percent and other breaks by 14 percent. Lower doses didn’t have any effect.

The report, published in the New England Journal of Medicine, also suggests that too much calcium — perhaps more than 1,000 milligrams (mg) per day — can weaken the benefit.

“These hip fractures cost a lot and are a really serious event. They are usually the end of independent life for a senior person; 50 percent do not regain their mobility. Reducing the risk by 30 percent with just a vitamin supplement would be an enormous public health opportunity,” study researcher Dr. Heike Bischoff-Ferrari of University Hospital Zurich in Switzerland told Reuters Health.

The Institute of Medicine recommends that most adults get 1,000 to 1,200 mg of calcium per day and 600 to 800 IU of vitamin D. It sets a recommended upper limit at 2,000 mg of calcium and 4,000 IU of vitamin D.

Bischoff-Ferrari said the lack of benefit seen in other studies “may be explained by adherence to treatment and vitamin D supplements taken outside the study medication.”

Dr. Richard Bockman, a hormone expert at the Hospital for Special Surgery in New York, said the findings are an important counterbalance to last month’s widely-reported recommendation by the U.S. Preventive Services Task Force.

The government-backed task force advised against taking doses of less than 400 IU of vitamin D with 1,000 mg of calcium and concluded the evidence was unclear for higher doses. It also said the supplements carry a risk of side effects such as kidney stones.

Bockman said the best trial is a 2003 study, known as the Trivedi trial, in which volunteers received an average of 800 IU per day as a single 100,000 IU dose every four months.

“It clearly showed a reduction in fracture risk in people who were getting vitamin D,” he said.

In an editorial, Dr. Robert Heaney of Creighton University Medical Center in Omaha, Nebraska, said the problem with the conflicting studies may be that most have failed to consider each person’s vitamin D levels to start with.

Giving it to people who already have enough, or not giving enough to people with very low levels, may show no benefit, he said.

“In this regard, as in several other respects, nutrients are unlike drugs. Once an adequate concentration has been achieved, additional intake has no effect,” said Heaney.

Bischoff-Ferrari said the new results came without directly including the Trivedi results. “The authors lost the data sets to a computer accident,” she said.

The new analysis is based on 11 trials that tested various regimens of oral vitamin D in people age 65 and older, mostly women, against an inactive placebo. Some of the trials also included calcium.

Overall, there were 4,881 hip and other fractures (not including breaks of the spine) among more than 31,000 people.

Vitamin D did not cut the rate of hip fracture significantly, and the drop in other fractures was small. When the researchers looked at people getting the highest doses of the vitamin, typically 800 IU daily, the benefits were clearer, with a 30-percent drop in hip fractures and 14-percent decline in other broken bones.

“Notably, there was no reduction in the risk of hip fracture at any actual intake level lower than 792 IU per day,” the researchers said.

The benefits at the higher dose were seen regardless of age, additional calcium intake, whether the patients lived at home or in an institution, and baseline levels vitamin D.

Just as important is the discovery that too much calcium – more than 1,000 mg per day – may dilute vitamin D’s benefits to bones, she said. Because many supplements contain 1,000 mg, the calcium people get in their diets may send people over the limit.

“This is a very, very important public health message,” Bischoff-Ferrari said. “There are still doctors around who are giving calcium without vitamin to hip fracture patients. Imagine giving a calcium supplement and increasing the fracture risk.”

In an earlier study, she added, fewer than 10 percent of the people coming into the hospital for a hip fracture had been taking the vitamin. And 60 percent of them had suffered another fracture in the prior decade, yet “the red flag is not coming up.”

“In the medical world, vitamin D seems like a very low priority. It may be the lack of lobbying for it, the fact that it costs almost nothing” and some people think it’s too good to be true, she said. “But the data are impressive.”

Home Instead Senior Care has highly trained CAREGivers that can help with your daily non-medical needs. Please call our office at 360-782-4663.

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Better Than Take Out

 The purpose of this article is to help busy people find quick and easy ways to put satisfying, tasty meals and snacks on the table without spending a lot of time in the kitchen.  Therefore, it makes sense to think of as many ways as possible to cut down on time spent in the kitchen.  The following  provides information on  general tips for decreasing time spent on food preparation.

Timesavers

·          Except in the case of cheeses that don’t come pre-shredded or grated such as Gruyère and Gorgonzola, buy shredded cheese in bags. 

·          When shredded cabbage is called for, use a bag of coleslaw.

·          Consider quick alternatives to chopping and mincing onion and garlic.  For onion, use a bag of fresh chopped onion available in the produce section of the market or frozen chopped onion available in the frozen foods section.  A jar of crushed garlic is a very handy alternative to fresh garlic.  For a quick way to peel and mince fresh garlic, cut off the ends of the clove, smash it with the side of a knife or cleaver to break the skin, peel the skin off and mince it by making checkerboard cuts into the clove through which you slice sideways.  If this

·          When doing a vegetable sauté,  never cut  vegetables first on a cutting board and then put them into the pan.  Put the oil on and chop the onion right into the pan.  (The same goes for garlic, although this is not a method for children to use.)  Add softer vegetables when the onions are translucent by chopping these directly into the pan as well.  If you are not comfortable with this, your cooking time may be a few minutes longer than that indicated, but it shouldn’t vary by much.Rice

Obviously, one of the fastest ways to get something that passes for rice on the table is to use a minute-style rice, but for those who prefer the taste and texture of less refined types of rice, there are some other methods to try.  First, you might consider investing in an electric rice cooker.  Rice cooks quickly with no attention required and it keeps warm until you are ready to serve it.  For help cooking specific kinds of rice, consider the following:

Basmati Rice:  This is an excellent rice, but can be a long and tricky job when cooking it stove-top.  Instead, do it in the microwave.  While you are fixing your ten-minute meal stove-top, your basmati is cooking in the same time on the other side of the Atlantic in the microwave.  For 1 cup basmati, add 2 cups water.  Put it in a microwave safe bowl and cover.  Usually just lay a plate on top of the plastic mixing bowl.  Heat it on high for about 9 minutes.  Depending upon the size and material of your container, it should be more or less done at this point.  If it needs a little more time, continue cooking for a minute or two. 

Wild Rice:  Whether in the microwave or stove-top, it seems to take an awful long time.  You can use 3 cups water to 1 cup wild rice and cook it using the same method as described for basmati rice above except that the cooking time is between 20 and 25 minutes.  Once you have invested this much time in the cooking, maximize the effort by freezing the results in 1/2 to 1 cup increments in freezer bags.  Then you can use wild rice whenever you want by defrosting it in the microwave.  Add 1/2 to 1 cup wild rice to 2 or 3 cups cooked white rice for a tasty, nutritious side dish.  Seasoned with garlic powder, green onions, and a bit of butter, it’s a winner.

Pasta

Pasta preparation time depends upon the type of pasta you choose to use.  Here are some timesaver ideas for pasta.

Capellini, Angel Hair and Fideos:  If you want to prepare a quick pasta for a main dish or a side dish, one of these thin string pastas is a great choice.  They cook up in about three minutes, once the water is boiling.  These are not good pastas for freezing and reusing later.

Fusilli, Corkscrew, Elbow, Bow Tie, Penne:  These pastas take longer to cook-between 7 and 10 minutes, depending upon the one you choose.  They are, however, sometimes the best choice for the dish you want to make.  If you plan to use them for your quick pasta dish, make sure you start the water as soon you begin preparing the other ingredients.  Then, the pasta will be ready about the same time you have finished with chopping and cooking the vegetables or making your sauce-about 15 minutes, max. 

Another way to make these pastas user-friendly is to cook them ahead of time and freeze them in gallon size plastic bags for reheating later.  To do this, drain the pasta well and rinse with cold water so that it is room temperature.  Freeze it in a plastic pouch-about 2 cups to a pouch. To heat for use, put the bag in the microwave cracked open for air to escape and heat on high for 2 1/2 minutes.  Move it around a bit and heat on high again for 2 1/2 minutes.  It should be ready to serve.  Rinse with hot water and use in your dish.  This method allows you to have thick pasta ready to use in five minutes.  Some cooks may like this method.  Others will prefer cooking pasta fresh when they plan to serve it.

Potatoes

If you want to make potatoes for potato salad or other chopped potato dishes, do not boil the whole potato and then rinse, cool and chop.  This method is very time consuming.  To be as efficient as possible, chop your potatoes (with the skin on-it never hurt anyone) and drop them into the boiling water already at the size you plan to use.  When they are done, rinse them in cold water.  They both cook and cool more quickly this way.  Be careful not to cook to mush unless you want to use them to make mashed potatoes, in which case you may want to peel them first.

Other Useful Tips

As you look through the recipes, you may have some questions about lowfat or other healthy substitutes you can use for listed ingredients.  Consider these ideas:

Feel free to use lowfat sour cream and imitation mayonnaise when sour cream and mayonnaise are called for in a recipe.

When milk is an ingredient, you can use nonfat milk unless otherwise noted.

While a recipe may call for a tablespoon of oil in the pan when browning onions and the like,  dispense with the oil when you cook at home.  Pput the vegetables in a hot pan and keep them moving until they are done.  Then  add the remaining ingredients.  You can use this dry pan method if you like or use a little oil or butter in the pan when you brown vegetables.  Also,  never add any oil to the pan when you brown meat of any kind.  If the pan is too dry, you can add a bit of water to keep it from scorching.

At Home Instead Senior Care, we can send a CAREGiver to your home to help prepare meals and other non-medical needs. Call our office at 360-782-4663 and we’d be happy to answer your questions.

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Ways Seniors Can Save Money

Saving money is not only necessary, it’s almost patriotic. Here are 20 ways you can do your bit for the savings cause. They work for me. I hope they work for you. Check off the ones that apply to you and then take action.

1. Shop for new Medicare coverage. It is a mistake to assume that last year’s Medicare coverage is still the best deal for you. Health reform has accelerated changes that were already affecting Medicare policies and prices. Open enrollment for 2013 plans runs until December 7.

2. Try one shopping trip a week. This will limit impulse purchases, force you to do better meal planning, and also cut down on car expenses.

3. Bargain for lower interest rates. Why should everyone benefit from lower rates but you? If you have any debt outstanding, now is the time to seek a better deal.

4. Refinance your mortgage. With home loan rates at 50-year lows, take a careful look at refinancing. How much will it cost you? Divide this by the number of years you expect to stay in your home. Then look at how much your monthly payments would decline with a lower mortgage rate. How many years will it take you to come out ahead? If it’s only a few years, get yourself into a bank or other mortgage lender now.

5. Pay annually if you can. Insurance and other annual services will let you pay the bill in smaller monthly installment payments. But while these monthly payments are not considered a loan, that is exactly what they are. You wind up paying the equivalent of interest in the form of higher payments.

6. Buddy up on groceries. Build a shopping list for that weekly supermarket trip with a neighbor or other friend. You’ll get some good social time and save money by buying larger sizes and splitting them.

7. Buddy up on travel, too. Every time you find yourself going on an errand by yourself, ask if there might have been a friend you could have taken along. And for vacations, it’s often possible to lower the per-person costs if you travel with friends.

8. Brew it yourself. OK. Every list needs something you can ignore. Go get that venti latte!

9. Don’t buy movies and books. The library remains a great way to save a buck on books and movies. If you’re comfortable with eBooks and streaming videos, check to see if your library has started offering digital lending. Many have.

10. Never pay a late fee. Make a list of when all your payments are due. If you use online bill payments and are not worried about overdrafts on your bank account, set your recurring bills for automatic payment and save time along with those late fees.

11. Unplug unused devices. I tried this and the results showed up right away in the next month’s power bill. Most electronic devices use a bit of power even when you’re not using them. Make it a habit to only plug things in when you’re using them. Maybe your family room won’t be lit up like Bourbon Street anymore with all those little lights.

12. Turn off heat to unused rooms. This is a no-brainer, but it’s surprising how many obvious things we don’t do. If you use hot-water radiators, make sure you bleed off any air pockets that have built up in them since last winter.

13. Use programmable thermostats. Why heat up (or cool down) your home when no one is there? It’s one thing to turn down thermostats during the winter, but it’s even better to program your home’s temperatures to turn off the heat (without risking pipe damage) when you’re not there or at night when you’re sleeping.

14. Merge your home phone and cellular services. As the number of cell phones continues to soar past the total for landlines, the question of whether you really need both is getting louder.

15. Generic is good. Look for generic store brands and give them a try. And when it comes to prescriptions, there is even less reason to stick with branded drugs if identical generic versions are available.

16. Flaunt your age for discounts. If there is one virtue of old age that is worth exploiting, it is senior discounts. Look for them. Use them.

17. Make your own birthday and other event cards. The mark-up on greetings cards must be enough to make the folks at Exxon jealous. By crafting your own messages, you will save money. Even more, that personal touch will probably make a very favorable impact on the recipient.

18. Drink water, not soda. And I don’t mean bottled water. Changing this single habit will help your wallet gain weight while the rest of you slims down.

19. No partial loads. Do not waste energy, water, and detergent by doing partial loads of dishes or laundry.

20. Barter. I truly believe the Internet created to let us swap stuff. So, before you go out and buy a new appliance or hardware tool, see if you can find someone online willing to trade it for something you have. If you’re not in a rush, go to Craigslist and set up automated email alerts for the items you’re seeking. For more information, go to Money Saving Tips

We here at Home Instead Senior Care, hope you enjoy these tips.  If you or a loved one needs non-medical care, please call us at 360-782-4663. We’d love to answer any questions or send you information on our services.

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Travel Tips For Seniors

The retirement years can be an exciting time to see the world, and travel is easier and safer than ever before for senior citizens. With a little planning and some caution, seniors can safely visit almost any destination. But the Centers for Disease Control and Prevention urge older travelers to follow the simple tips below to ensure safe travel.

All travelers, including senior citizens, should see a doctor for a pre-travel visit, ideally 4–6 weeks before they travel, although even a last-minute visit can be helpful.

The doctor should be told about illnesses the traveler has and medicines he or she is taking, since this will influence medical decisions. In addition to providing vaccines, medicine, and advice for keeping healthy, a doctor can conduct a physical exam to assess a senior’s fitness for travel.

Seniors should consider their physical limitations when planning a trip. Seniors with heart disease, for example, might choose an itinerary that does not involve strenuous activities. Seniors may also have a hard time recovering from jet lag and motion sickness, so they should take these factors into account when planning a trip.

Before travel, seniors should have information about their destination that could affect their health, such as the altitude and climate. They should be aware of whether the destination is prone to natural disasters, such as earthquakes and hurricanes, since seniors may have more problems in those extreme situations.

Vaccines

Before travel, seniors should be up-to-date on routine vaccines, such as measles/mumps/rubella and seasonal flu. Some of these may be considered “childhood” vaccines, but their protective effect decreases over time, and the diseases they protect against are often more common in other countries than in the United States. More than half of tetanus cases are in people over 65, so seniors should consider getting a tetanus booster before they travel.

Seniors should also receive other vaccines recommended for the countries they are visiting. These may include vaccines for hepatitis, typhoid, polio, or yellow fever.

Use of some vaccines may be restricted on the basis of age or chronic illnesses. Yellow fever vaccine, for example, should be given cautiously to people older than 60 years, and it should not be given at all to people with certain immune-suppressing conditions. Seniors should discuss their detailed travel plans with their doctors and, if necessary, alternatives to vaccination.

Injury Prevention

Although exotic infections make the headlines, injury is the most common cause of preventable death among travelers. Seniors can minimize their risk of serious injury by following these guidelines:

  • Always wear a seatbelt.
  • Don’t ride in cars after dark in developing countries.
  • Avoid small, local planes.
  • Don’t travel at night in questionable areas.

In addition, seniors should consider purchasing supplemental travel health insurance in case of injury or illness overseas. Many health plans, including Medicare, will not pay for services received outside the United States. Seniors who are planning travel to remote areas should consider purchasing evacuation insurance, which will pay for emergency transportation to a qualified hospital.

For more information on healthy travel, visit www.cdc.gov/travel.

If you need help preparing for a trip, our CAREGIvers can come to your home to help you get ready or even be a travel companion.  Call Home Instead Senior Care at 360-782-4663.

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Coping With Aphasia

Aphasia is a condition that usually results from stroke or other brain injury. It damages parts of the brain involved with communication. People with aphasia have trouble expressing themselves and/or understanding what others are saying to them. Many people with aphasia also have trouble with reading and writing. But, their thought process is the same as it was before. It is as if there is a short circuit in the brain between the ability to think and the ability to use language; people with aphasia are literally trapped inside their own heads. Because they have a hard time making their needs known, they can become frustrated, isolated and depressed. Aphasia affects about 25-40% of stroke survivors, or more than 1 million Americans.

It cannot be cured, and there is no pill yet to make it better. Working with a speech-language pathologist is often effective, but insurance and Medicare coverage for speech therapy is becoming increasingly limited. To make matters worse, even though aphasia is relatively common, many people with aphasia are discharged from the hospital with little information about how to live with it. (One study found that a significant percentage of spouses of people with aphasia lacked a basic understanding of the condition.)

Yet there are simple steps that spouses, caregivers, friends and relatives can take to further communication and make the condition less devastating:

  • Many people with aphasia say their aphasia gets worse when they are in a stressful or pressured situation. Give the person with aphasia time to finish his/her sentences. Even if you think you know what they are going to say, wait until you get a clear signal that your suggestion would be welcome.
  • Be sensitive to background noise and turn off radios, TVs, appliances. Keep your voice at a normal level as shouting will not help. Group conversations and family dinners can be difficult for people with aphasia.
  • Try using pictures, gestures, writing, and facial expressions. The important thing is to get the point across, not that one’s speech be perfect.
  • Use yes/no questions to check that the person with aphasia has understood you. (But make sure they are using “yes” and “no” appropriately; some people with aphasia will say “no” when they mean “yes,” especially right after their stroke).

    At Home Instead Senior Care, we can help you or your loved ones with your non-medical needs.  Our CAREGivers are highly trained to help with your daily needs.  Please call our office at 360-782-4663.

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Retirement Nest Egg

Financial retirement was very different for our parents. They worked for the same company for most of their careers. When they retired, they started receiving monthly checks from their company pensions. Nowadays, financing retirement is much more complicated. But it doesn’t have to be. Read on to find out how.

There are two issues that must be dealt with so you can have the freedom in retirement to focus on living instead of constantly worrying about your investments. The first issue is how much money you can receive on a monthly basis. The second issue is how long you will live.

These issues are inter-related. Very few people have an endless supply of money. Most have a nest egg that they’ve accumulated over time. The nest egg includes money from a 401(k), the lump-sum from the company pension and other monies that have been set aside.

Wouldn’t it be nice to know that you will receive a paycheck each month in your retirement and that the amount of your pay can increase each year? Better yet, what if that could be done in such a way that your nest egg continues to grow in value?

I believe that we need to re-think the way we invest during retirement. Let.s face it: the size of a retiree’s nest egg isn’t what it needs to be if you can only get paid 4%. I regularly talk to retirees that need to withdraw 6-7% a year. Traditionally, doing that would result in depleting the nest egg by age 80-85 or sooner. That won’t cut it.

Life expectancy continues to increase so you need to be able to depend on your money lasting far beyond age 85. If you retire at age 60, it’s becoming much more likely that you will live 30 or even 50 years. That’s places a lot of pressure on your nest egg!

According to the Urban Futures Institute, the big killers of the pre-World War II years all had disappeared from the leading causes of death by the 1980′;s.The main causes of death nowadays are cancers and cardiovascular disease. There are billions of dollars being invested in research each year trying to find ways to prevent or cure both.

Researchers are finding that current death rates for those over age 95 are far less than what had been predicted. Previously, it was anticipated that the death rate would continue to climb as one got older. What’s taking place, though, is that the death rate for those who live to age 95 actually drops off.

It’s not uncommon to see people live to be 100 or 105 or 110. Keep in mind that those age 100 lived most of their lives before many of the major medical advances occurred. In general, people retiring today are in much better health than their parents were at age 60.

It’s vital that your nest egg last longer than you do. The only way for that to occur is if the nest egg continues to grow over time. If you continue to take out more than you earn you are guaranteed to run out of money at some point. In that situation it’s a race between your money and your life span. If your nest egg continues to grow, though, it will always last longer than you. For more information check out:Senior Journal

If you or a loved one needs help with non-medical needs, please give us a call at 360-782-4663.  We’d be happy to help assist you anyway we can.

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SPEAK UP

Palliative care is still not a well-known or understood service, although it has proven to help many patients and the families of patients living with a serious illness or health problem in dealing with emotional, physical and spiritual concerns. A new educational campaign has been launched by The Joint Commission that may heighten awareness of this special health care.

The Joint Commission’s new educational campaign, “Speak Up: What you need to know about your serious illness and palliative care,” covers topics such as how and when to get palliative care, questions that palliative care providers may ask you, questions to ask them, where to find information, and more. The campaign brochure provides helpful tips and encourages people to take action to improve their health.

Palliative care is special health care designed to improve the quality of life of patients and their families by relieving the pain, symptoms and stress of a serious or debilitating illness. Designed to help patients feel better, palliative care can help to relieve symptoms such as loss of appetite, pain, nausea and sleeplessness, as well as provide help with health care decision making, managing health care and supporting family members.

“Seriously ill patients have special physical, emotional and spiritual needs,” says Ronald M. Wyatt, M.D., M.H.H., medical director, Division of Healthcare Improvement, The Joint Commission. “By considering the option of palliative care, these patients and their families may find that palliative is a way to prevent or relieve suffering.”

The Joint Commission’s new palliative care education campaign is part of the award-winning Speak Up program. Speak Up brochures are available in English and Spanish at www.jointcommission.org. The Speak Up program urges people to take an active role in their own health care.

The basic framework of the Speak Up campaign urges patients to:

Speak up if you have questions or concerns, and if you don’t understand, ask again. It’s your body and you have a right to know.

Pay attention to the care you are receiving. Make sure you’re getting the right treatments and medications by the right health care professionals. Don’t assume anything.

Educate yourself about your diagnosis, the medical tests you are undergoing, and your treatment plan.

Ask a trusted family member or friend to be your advocate.

Know what medications you take and why you take them. Medication errors are the most common health care errors.

Use a hospital, clinic, surgery center, or other type of health care organization that has undergone a rigorous on-site evaluation against established state-of-the-art quality and safety standards, such as that provided by The Joint Commission.

Participate in all decisions about your treatment. You are the center of the health care team.

At Home Instead Senior Care, we can take care of your daily, non-medical needs.  Please call our office fore more information or to answer your questions, 360-782-4663.

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Elderly Men And Vitamins

In a randomized trial that included nearly 15,000 male physicians, long-term daily multivitamin use resulted in a modest but statistically significant reduction in cancer after more than a decade of treatment and follow-up, according to a study appearing in JAMA. The study is being published early online to coincide with its presentation at the Annual American Association for Cancer Research Frontiers in Cancer Prevention Research meeting.

“Multivitamins are the most common dietary supplement, regularly taken by at least one-third of U.S. adults. The traditional role of a daily multivitamin is to prevent nutritional deficiency. The combination of essential vitamins and minerals contained in multivitamins may mirror healthier dietary patterns such as fruit and vegetable intake, which have been modestly and inversely associated with cancer risk in some, but not all, epidemiologic studies,” according to background information in the article..

“Observational studies of long-term multivitamin use and cancer end points have been inconsistent. To date, large-scale randomized trials testing single or small numbers of higher-dose individual vitamins and minerals for cancer have generally found a lack of effect.”

“Despite the lack of definitive trial data regarding the benefits of multivitamins in the prevention of chronic disease, including cancer, many men and women take them for precisely this reason.”

J. Michael Gaziano, M.D., M.P.H., of Brigham and Women’s Hospital and Harvard Medical School, Boston, (and also Contributing Editor, JAMA), and colleagues analyzed data from the Physicians’ Health Study (PHS) II, the only large-scale, randomized, double-blind, placebo-controlled trial testing the long-term effects of a common multivitamin in the prevention of chronic disease.

The trial includes 14,641 male U.S. physicians, initially age 50 years or older, including 1,312 men with a history of cancer at randomization, who were enrolled in a multivitamin study that began in 1997 with treatment and follow-up through June 1, 2011. Participants received a daily multivitamin or equivalent placebo.

The primary measured outcome for the study was total cancer (excluding nonmelanoma skin cancer), with prostate, colorectal, and other site-specific cancers among the secondary end points.

PHS II participants were followed for an average of 11.2 years. During multivitamin treatment, there were 2,669 confirmed cases of cancer, including 1,373 cases of prostate cancer and 210 cases of colorectal cancer, with some men experiencing multiple events.

A total of 2,757 (18.8 percent) men died during follow-up, including 859 (5.9 percent) due to cancer.

Analysis of the data indicated that men taking a multivitamin had a modest 8 percent reduction in total cancer incidence. Men taking a multivitamin had a similar reduction in total epithelial cell cancer.

Approximately half of all incident cancers were prostate cancer, many of which were early stage. The researchers found no effect of a multivitamin on prostate cancer, whereas a multivitamin significantly reduced the risk of total cancer excluding prostate cancer. There were no statistically significant reductions in individual site-specific cancers, including colorectal, lung, and bladder cancer, or in cancer mortality.

Daily multivitamin use was also associated with was a reduction in total cancer among the 1,312 men with a baseline history of cancer, but this result did not significantly differ from that observed among 13,329 men initially without cancer.

The researchers note that total cancer rates in their trial were likely influenced by the increased surveillance for prostate-specific antigen (PSA) and subsequent diagnoses of prostate cancer during PHS II follow-up starting in the late 1990s.

“Approximately half of all confirmed cancers in PHS II were prostate cancer, of which the vast majority were earlier stage, lower grade prostate cancer with high survival rates. The significant reduction in total cancer minus prostate cancer suggests that daily multivitamin use may have a greater benefit on more clinically relevant cancer diagnoses.”

The authors add that although numerous individual vitamins and minerals contained in the PHS II multivitamin study have postulated chemopreventive roles, it is difficult to definitively identify any single mechanism of effect through which individual or multiple components of their tested multivitamin may have reduced cancer risk.

“The reduction in total cancer risk in PHS II argues that the broader combination of low-dose vitamins and minerals contained in the PHS II multivitamin, rather than an emphasis on previously tested high-dose vitamins and mineral trials, may be paramount for cancer prevention. … The role of a food-focused cancer prevention strategy such as targeted fruit and vegetable intake remains promising but unproven given the inconsistent epidemiologic evidence and lack of definitive trial data.”

“Although the main reason to take multivitamins is to prevent nutritional deficiency, these data provide support for the potential use of multivitamin supplements in the prevention of cancer in middle-aged and older men,” the researchers conclude.

This work was supported by grants from the National Institutes of Health and an investigator-initiated grant from BASF Corporation. Study agents and packaging were provided by BASF Corporation and Pfizer (formerly Wyeth, American Home Products, and Lederle), and study packaging was provided by DSM Nutritional Products, Inc. (formerly Roche Vitamins).

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Chewing May Affect Dementia

People who maintain their chewing ability are probably less likely to develop dementia, compared to those who cannot chew well any more, researchers from the Department of Odontology and the Aging Research Center at the Karolinska Institutet and from Karlstad University found.

The authors reported their findings in the October issue of the Journal of the American Geriatrics Society.

We all live in aging communities. The older we get, the greater are our chances of losing cognitive functions, such as the ability to solve problems, make decisions and remember things.

According to previous studies, several factors can contribute to our risk of dementia. Some studies have pointed to a link between having no teeth and losing cognitive function more rapidly, and being more likely to develop dementia.

Some studies have suggested that the more we chew at any age, the smarter we become. Researchers from Bayor College of Medicine found that university students who regularly chewed gum had better standardized math scores than their counterparts who did not.

Why  loss of teeth may raise dementia risk?

The action of chewing makes more blood flow to the brain. People with few or no teeth will chew less; resulting is less blood flow to the brain. The hypothesis is that if there is less blood flow to the brain, the risk of eventually having dementia rises.

So far, nobody has carried out a study which specifically focuses on the significance of chewing ability on a national scale in elderly people.

A team of Swedish researchers have done just this. They set out to determine whether tooth loss and chewing ability might impact on cognitive function. They gathered and examined data on a nationally representative sample of 557 elderly people (aged 77 years or more).

They discovered that people who had a problem with chewing hard food, such as apples, had a considerably higher risk of developing dementia. The association between chewing ability and developing cognitive impairments remained even after they took into account possible confounding factors, such as education, mental health, sex and age.

The researchers concluded:

“Whether elderly persons chew with natural teeth or prostheses may not contribute significantly to cognitive impairment as long as they have no chewing difficulty.

The results add to the evidence of the association between chewing ability and cognitive impairment in elderly persons.”

What is dementia?

Dementia is the deterioration in one’s ability to process thought (cognitive function, intelligence). The signs and symptoms of dementia get worse over time. The deterioration in cognitive function in a person with dementia is more than might be expected from normal aging.

Dementia is caused by damage, as may occur after a stroke, or disease, such as Alzheimer’s.

Dementia is a non-specific syndrome in which certain areas of brain function may be affected, such as attention, problem solving, language, or memory. Dementia is not a disease while Alzheimer’s is.

During the initial stages of dementia, the higher mental functions are affected. During the later stages more basic details become harder to recall, such as which day of the week it is, how to get to the shops and back, or identifying who people are.

Dementia is much more common among seniors, but can affect adults of any age.

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