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May 21, 2015
by Samantha Jeckewicz

Engaging Older Volunteers

@zx_1000@zy_500Average life expectancy has grown by 30 years in some areas of the world. All sorts of factors contribute to long lives; but more and more, we are learning that volunteering contributes to a healthy and independent lifestyle no matter what our age, but especially for older adults.

May is Older Americans Month and May 18-22 is Senior Corps Week, when the Corporation for National and Community Service promotes the value of older adult volunteering and highlights the impact that the agency’s RSVP (Retired Senior Volunteer Program), Foster Grandparent, and Senior Companion programs have on America’s communities.

With the Corporation and through our own initiatives, United Ways are connecting the skills and passion of seniors to community needs, and as a result, increasing the health and vitality of all involved. For example, with the help of senior volunteers, United Way of Bay County’s RSVP Community Garden in Michigan grows roughly 2,500 pounds of fruits and vegetables per year that are distributed by Hidden Harvest to shelters, food pantries and hunger relief organizations. Now in its 12th year, the program allows senior volunteers to grow and harvest the produce in the community garden or donate from their personal gardens.

Volunteering is also an opportunity for seniors to help their peers. In Minnesota, Greater Twin Cities United Way works with partners to train older individuals to educate their peers on the Supplemental Nutrition Assistance Program (SNAP) and provide application assistance to those who meet the guidelines. To date, senior volunteers have conducted over 1,000 screenings and helped almost 500 people complete applications, connecting a record number of seniors to the health and financial benefits of SNAP.

United Way of Central Iowa’s “older adult” volunteer effort began more than 42 years ago. Today, the 55+ Initiative is attracting even more volunteers by focusing on individuals who have already given to the United Way for a decade. A simple email sent to “loyal contributors” ages 55 and older asked for mentors for school-aged children.  In no time, 15 people responded, eager to engage more deeply in United Way’s work.

Tapping in to the wisdom, experience and enthusiasm of seniors could do a world of good for them and your community. I hope you’ll tweet #SeniorCorpsworks or #SeniorsInService to show support for older adult volunteering, and contact your local United Way to find opportunities for volunteers of all ages.


May 18, 2015
by Samantha Jeckewicz

Communication Disorders Common in Older Americans


signs-of-hearing-lossEarly Detection Key for Speech/Language, Swallowing, and Hearing Problems;

Tips for Communicating With Seniors During May Is Better Hearing & Speech Month


During May Is Better Hearing & Speech Month, Arcadia Home Care & Staffing is spotlighting the importance of early detection and treatment for communication disorders in older Americans. Roughly 40 million Americans experience these disorders. Speech/language or swallowing disorders may result from medical conditions, such as oral cancer, stroke, Parkinson’s, or traumatic brain injury. Adults may also experience voice disorders or speech/language disorders that have persisted since childhood, such as stuttering. Hearing loss is among the most common conditions affecting older Americans. In fact, according to an AARP-ASHA poll that was taken in 2011, a significant percentage of baby boomers have untreated hearing loss. Hearing and balance issues are also risk factors for falls—a serious concern for the older population—that may result in significant injury or death.

Depending on a person’s specific condition, a speech-language pathologist or audiologist can assist in potentially life-altering treatment. In the case of someone with oral cancer, for instance, a certified speech-language pathologist can deliver treatment that includes helping the person get used to the differences in the size, shape, and feel of the mouth. The speech-language pathologist will teach the person how to produce speech sounds more clearly and develop better control over weakened muscles in the throat or palate. If swallowing is an issue, treatment can vary from simple changes in food consistency to exercises for weak oral muscles to learning totally new ways to swallow. In many cases, improvement is evident within several months.

In the case of hearing loss, millions of Americans experience this in at least one ear. Hearing disorders are complex conditions with medical, psychological, physical, social, educational, and employment implications. They should be diagnosed and treated by an audiologist. Treatment options include hearing aids and other assistive technologies that meet a host of different medical needs and preferences, as well as aural/audiologic rehabilitation. Although many people may think of hearing aids as the singular answer to hearing issues, other interventions may be appropriate. This is why receiving a comprehensive evaluation by an audiologist is essential.

Many people have outdated perceptions of hearing aids (and hearing loss in general) that may lead them to delay treatment for years or forgo it altogether. Among adults ages 70 and older with hearing loss who could benefit from hearing aids, fewer than one in three (30%) have ever used them. Even fewer adults ages 20 to 69 (approximately 16%) who could benefit from wearing hearing aids have ever used them, according to the National Institute on Deafness and Other Communication Disorders. Untreated hearing loss is associated with anxiety, depression, reduced quality of life, and even earlier onset of dementia—all of which support the critical importance of early diagnosis and treatment.

Family members and friends can assist a loved one with a communication disorder in numerous ways, including providing assistance with finding a provider and accompanying him or her to appointments. There are also everyday things a family member or friend can do to help make the communication process easier for an older person who may have speaking or hearing challenges. sudden-hearing-loss

Reduce background noises that may be distracting (e.g., turn off the radio or TV, close the door, or move to a quieter place).

  • Stick to a topic. Avoid quick shifts from topic to topic.
  • Allow extra time for responding. Don’t hurry the person.
  • Be an active listener. Look for hints from eye gaze and gestures. Take a guess (e.g., “Are you talking about the TV news? Yes? Tell me more. I didn’t see it.”)

More tips for communicating better with older people are available at

For more information about communication disorders, visit


May 14, 2015
by Samantha Jeckewicz

7 Foods You Should Eat If You’re Over 50

Though you may eat the same foods you’ve always eaten since you were a kid, your nutritional needs change throughout your life.

“In youth, it’s all about growth and maintaining a body that can procreate,” says nutrition and fitness expert Dr. Pamela Peeke, author of The New York Times bestseller, The Hunger Fix. “After the age of 50, the goal is to prevent disease by maintaining an optimally healthy and active mind and body.”

Being in the best health possible means what we eat as we age matters. “As we get older, metabolism slows, and the body’s ability to break down and use its fuel sources becomes less efficient,” Peeke says.

In addition, certain vitamins become more important to help protect against diseases and health issues.

Here are the foods you should be eating to keep your body strong and mind sharp:

istock1. Fiber-rich foods, like raspberries

This, unfortunately, is something you may already know from experience: Your gastrointestinal functioning slows down as you age, and as a result, it’s important to focus on eating enough fiber to keep your system moving along.   “Fiber not only helps your gastrointestinal function run smoothly, but it also decreases gastrointestinal inflammation and cholesterol, while providing a slow release of energy-rich carbohydrates into the bloodstream,” Peeke says. “Senior women and men should aim for about 25 to 30 grams of fiber per day,” she says.   Some of the best fiber sources: raspberries, which according to The Mayo Clinic have 8 grams per cup; whole wheat pasta, 6.3 grams per cup; lentils, 15.6 grams per cup and green peas, 8.8 grams per cup.

2. Corn flakes and other B12 foods cornflakes

“As the body ages, the stomach’s acidity decreases, and as a result, it’s harder to get enough vitamin B12 in your diet,” Peeke says. Stomach acid helps release vitamin B12 from food and B12 is important because it helps maintain a healthy nervous system and key metabolic processes.   “An estimated 10 to 30 percent of adults over the age of 50 have difficulty absorbing vitamin B12 from food,” Peeke says. “People who regularly take medications that suppress stomach acid — such as antacids — may also have difficulty absorbing vitamin B12 from food.” People over 50 typically should get 2.4 micrograms of B12 every day.    Foods that come from animals, such as meat, eggs, seafood and dairy, have the highest amounts of B12, but you can also get the vitamin from B12-fortified foods such as whole-grain cereals. If you’re concerned about not getting enough B12, talk to your doctor about adding a multivitamin or B12 supplement to your diet.

cinn3. Turmeric and cinnamon

Another thing to go as we get older — taste. “Aging produces a decrease in saliva production and ability to perceive taste,” Peeke says. That means you might want to start experimenting with different spices, including turmeric.

“Turmeric has been shown to boost immune function and also decrease joint inflammation and prevent arthritis in older women,” Peeke says. Other research has shown turmeric, and its main active compound curcumin, may have a real effect on preventing Alzheimer’s and some forms of cancer.    Another spice to add into your cooking rotation: cinnamon. “Cinnamon is well-known as an anti-inflammatory and anti-microbial agent,” Peeke says.   Cinnamon also helps to maintain control of blood sugar since it slows the rate at which the stomach empties after meals, which evens out blood sugar highs and lows. “Studies also suggest a therapeutic use of cinnamon for type 2 diabetes, as it appears to improve the body’s sensitivity to insulin,” she says. “Having as little as one gram of cinnamon daily was shown to reduce blood sugar, triglycerides, LDL (bad) cholesterol and total cholesterol in people with type 2 diabetes.”

4. Water water(1)

Our sensation of taste declines as we age, so also does thirst, which means dehydration is more common.   Water is also important to optimize the body’s metabolic functions. “Women need nine cups of water, while men should drink 13 cups daily,” Peeke says. “If you’re more physically active and also live in a hotter climate, you’ll need more.”

banana5. Bananas and other potassium sources

It’s a fact that the risk of stroke and heart disease increases as we age. One way to help lower your risk: Eat foods that are excellent sources of potassium, like bananas and avocados.   A recent study of women aged 50 to 70 found that those who ate the highest amounts of potassium were least likely to experience a stroke. Potassium also can play a key role in lowering blood pressure, according to the World Health Organization.    The recommended daily amount of potassium you should be getting is 4,700 milligrams. Foods rich in potassium are potatoes, with almost 900 milligrams in one potato; bananas, 400 milligrams in one banana; avocado, over 700 milligrams per cup; and pistachios, with a whopping 1,200 milligrams per cup.

6. Calcium-rich foods greens

“Calcium is known mostly for its role in building and maintaining strong bones and teeth, but it is also required for proper functioning of the heart, muscles and nervous system,” Peeke says.    The goal is to consume 1,200 milligrams daily for men and women, but intake, Peeke continues, is an issue for men and women because of two things:

  • Consuming enough calcium can be a problem for people who are lactose intolerant, a common problem as you age.
  • Not having enough vitamin D in your body, which is necessary for you to absorb calcium (and also helps to boost immune function). “Research has shown that as you age, your access to sunlight as well as vitamin D-rich foods, topped by absorbing D less efficiently, all contribute to significantly below-normal levels of this all-important vitamin,” she says.

How to combat these two issues? “If you are lactose intolerant, eat leafy greens, such as collards, mustard, kale, and bok choy,” Peeke says. “You can also try canned salmon (with bones) and sardines, as well as tofu that has been made with a calcium compound.”   As for getting enough vitamin D, ask your doctor to test your vitamin D level. The goal is to be within 50-70 nmol/L. If your D is low, solutions include: eating D-rich foods; getting that 15 minutes in the sun every day; and taking a supplement recommended by your doctor.


broc7. Broccoli and other leafy greens

Protecting your eyes is key as time goes on, particularly since many eye problems come with aging. Lutein, related to beta carotene and vitamin A, is a valuable nutrient you need to optimize vision and prevent macular degeneration. And most people over 50 don’t get enough of it. Green leafy vegetables, along with grapes, oranges and egg yolks, are excellent sources of lutein.   


Other Eating Tips   Aside from adding the foods we mentioned to your diet, Peeke suggests these general healthy-eating guidelines:

  • Decreasing saturated fats is important to prevent cardiovascular disease, so focus on healthy fats derived from nuts, lean meats, fish, low-fat dairy, olive oil and plant-based sources like avocados.
  • Since metabolism slows with aging, it’s important to adjust how many calories you’re eating daily. Even if you’re active you need to do this. Generally, the range is 1,400-2,400 calories a day, with men having the larger number of calories.
  • Eliminate or minimize refined, processed food and drinks such as cookies, chips, candies, cakes and pastries. These processed foods contribute to increased inflammation throughout the body, which then increases the risk for cancer, diabetes and heart disease.
  • Consider supplements and a multivitamin. “Supplements in general are important to seniors, but you need to discuss what you’re taking with your doctor,” Peeke says. “In addition to the supplements, a gender- and age-specific multivitamin is important as well.”


May 12, 2015
by Samantha Jeckewicz
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Potluck Parties — What Should I Bring?

untitledEntertaining potluck-style has become more and more common, and for very good reasons. Not too many of us have the time to cook a multicourse meal, all while getting the house ready for company, setting the table, creating a bar area and so on. Sharing the work makes it much easier to entertain more frequently. And isn’t getting together with friends and family more often the point of potlucks?

Anne Byrn, well known as The Cake Mix Doctor, is also an expert on potluck parties. In What Can I Bring? Cookbook, she shares all sorts of tips on creating stress-free gatherings.

Potluck gatherings have a lot going for them, beyond just taking some of the load off the host. Folks get to show off their signature dishes, the menus tend to end up on the more interesting side and there is a built-in camaraderie to pulling together a meal as a group. Here are some of Anne’s tips for choosing the right recipe to bring to your next party.

Pick dishes that reflect the season, the time of day that the event is being held and the crowd who will be enjoying the dishes. Salads in particular are wonderfully seasonal.

Choose a dish that stands up to travel: one that won’t slip and slide in transit, that will stay hot if it is supposed to be, or cold if it is best eaten chilled. And pick a dish that is quick to assemble when you are on-site — or requires no work at all.

Select a recipe that fits the guests. Is it a group of adventurous eaters or a group who may prefer less spicy, less exotic fare? Are children included? Will there be vegetarians coming or any people with food allergies? It’s smart to ask the host about who will be attending the gathering and then select your recipe accordingly.

Make a dish look appetizing on a platter or in a bowl. Even the simplest foods — sliced tomatoes, sliced melon, sliced ham, a few good cheeses — look extraordinary on a pretty platter. How you present food is what garners those first “oohs” and “ahhs.”

Anne also provides handy lists for both the guests and the hosts, to make everything flow smoothly as the party gets under way. Here are some “What Can I Do?” points she identifies for enjoyable and seamless get-togethers.potluck-connect-westheights-org

For the guest:

  • Do select a recipe that needs no on-site assembly or that is easy to put together. Let your host know if you need to keep anything cold, or heat anything up.
  • Do ask your host to set aside counter space for food preparation. And do confine yourself to a small area of the host’s kitchen or you might be labeled a kitchen hog!
  • Do check to see how many people are coming to the party so you can make enough food to go around.
  • Do bring a serving spoon or fork or a platter, if needed.
  • Do arrive on time if you are bringing the appetizer.
  • Do see your dish through by replenishing it if needed.
  • Do offer leftovers to the host. Rinse your dish or wrap it in a plastic bag before heading home.

For the host:

  • Do plan a menu so that you have all the courses you desire — for example, appetizers, salads, main dishes and desserts.
  • Do decide how formal you want the gathering to be — china and glass or paper and plastic?
  • Do tidy up kitchen counters and free up refrigerator space for food that will come in the door. If needed, move unnecessary refrigerator items to another refrigerator or cooler.
  • Do set the serving table and decorate it, allowing space for each dish. Place a labeled index card where each dish should go.
  • Do have serving utensils ready in case your guests don’t bring their own.
  • Do preset the warming drawer or oven to keep food warm.
  • Do make the trash can accessible, along with paper towels and kitchen towels.
  • Do have the supplies on hand to wrap food to take home.


May 8, 2015
by Samantha Jeckewicz
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How to Deal With Nerve Pain If You Have Diabetes

nerve-pain-493764049-190x155If you have diabetes, you know it well: Too much sugar isn’t good for you. People whose blood sugar is too high or difficult to control are more susceptible to cardiovascular disease, kidney damage, eye problems and other complications, including nerve damage (diabetic neuropathy).

“High blood sugar is toxic to your nerves,” says Robert Bolash, MD, a specialist in Cleveland Clinic’s Department of Pain Management. “When a nerve is damaged, you may feel tingling, pins and needles, burning or sharp, stabbing pain.”

Diabetic neuropathy typically starts in your toes, feet or ankles and creeps up your body as the condition worsens, he says. However, nerve damage also can affect your hands and wrists as well as your heart, digestive system, sex organs and more.

How to avoid it

Up to 70 percent of people with diabetes have some kind of neuropathy, reports the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

“Anyone with diabetes can get nerve damage at any time,” says Dr. Bolash. “It’s most common in people whose blood sugar is poorly controlled and those who have had diabetes a long time.” According to the NIDDK, the highest rates of neuropathy are among people who have had diabetes 25 years or longer.

To avoid getting diabetic neuropathy, control your blood sugar, keeping it as close to nondiabetic levels as possible, advises Dr. Bolash.

Bad news, good news

The bad news about diabetic neuropathy is that it’s tough to reverse. It also can cause serious problems, especially in your feet. If you don’t feel blisters, sores or other foot injuries and don’t promptly care for them, you can develop raging, difficult-to-treat infections that, in severe cases, may require amputation.

The good news is that while you can’t always cure diabetic neuropathy, you often can relieve its symptoms.

“We work with endocrinology specialists to help patients control blood glucose levels. That’s critical to helping prevent or delay additional nerve damage,” says Dr. Bolash. “Then, to manage any discomfort, we explore a range of treatments.”

Find relief

Some ways to find relief include:

  • Oral medications, including prescription antidepressants and anticonvulsants, which can reduce the sensation of pain. (Over-the-counter ibuprofen is usually not effective for nerve pain.)
  • Topical medications can target pain located in a small area.
  • Nerve stimulation is an advanced treatment that can help in cases of more severe pain. The treatment can be applied to the skin or placed along the spinal cord to change unpleasant nerve pain into something more tolerable. “Stimulation doesn’t fix the damage from diabetes,” says Dr. Bolash. “It tricks the brain’s ability to sense pain.”

All patients with diabetes should discuss neuropathy with their primary care physician and be screened for diabetic complications. Physicians can diagnose neuropathy before the patient feels it, and early intervention can make a substantial difference. The sooner nerve damage is detected, the easier it can be treated.



May 4, 2015
by Samantha Jeckewicz
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6 Things No One Told Us About Being a Caregiver

It is incredible to me how one blink-of-an-eye moment can drastically impact your life.  Since our car accident two weeks ago we have found ourselves dealing daily with the aftermath.  Beyond the physical pain, there have been claims to file, insurance adjusters to talk to, paperwork to fill out, statements to make, prescriptions to fill, doctor visits to attend, and many, many conversations with our girls about what happened.  My husband has led the charge, navigating this sometimes sticky process with wisdom and kindness and compassion.  He is taking care of his girls, and we are all recovering well.

While my disability at this point is pretty minor, it has reminded me once again of just how taxing the role of caregiver can be.  A few years ago, when Trouble was just five months old, my elderly mother-in-law Marie came to live with us because she was no longer able to live on her own.  Already mired in the day-to-day chaos of caring for a colicky infant and an active toddler, we were woefully unprepared for this phenomenon called  “Sandwich Years,” a time where you have both children and parents to care for.


Hindsight is 20/20, but looking back, I truly wish we would’ve been a little more prepared for the challenges of being a full-time caregiver.  I loved my mother-in-law and desperately wanted her to be a part of my children’s life.  I wanted them to grow up knowing her and having a close relationship. I thought that the benefits of having her live with us would far outweigh any detriments.  There was so much we didn’t know, so much I wish someone with more experience could have had told us.

If I could do it again, these are the six things I most wish I would’ve known:

You will have to make hard choices

We didn’t realize, going into it, how many difficult choices would come up.  There were an endless slew of medical decisions, financial decisions, and quality of life decisions that constantly needed to be made.  Sometimes what Marie wanted to do was at odds with what everyone else wanted her to do; sometimes we were unable to sway her towards a decision we knew was best, causing frustration and resentment.  There were many times we couldn’t convince her to make a decision at all.

I truly wish we would’ve had the forethought to sit down with Marie ahead of time, before it was too late, and address some of the end-of-life issues that are so hard to talk about.  I wish we would’ve been brave enough to have that conversation.  I wish we would’ve been able to agree on a plan of action, to determine what our priorities were and to find out, from the options that were available, what she really wanted most of all.  I wish we would’ve had medical directives in place from the get-go, along with power of attorney for both financial and medical matters.  We did get them in place eventually, but not before we caused ourselves a lot of undue heartache.

Being a caregiver to an elderly parent is nothing like having another kid

Sometimes kind-hearted people, in an effort to be sympathetic, would say, “wow, caring for your mother must be like having a third child.”  We would smile and nod in agreement because, really, what else can you do when someone is trying to be nice?  But the truth was that having an an elderly adult to care for was nothing like having a toddler.  My mother-in-law had lived a whole life before I was even born.  She was set in her ways–and rightfully so.

She was extremely hard of hearing, which meant communication could be frustrating and difficult and LOUD, but she was still capable of having an adult conversation.  She had adult feelings too, which meant if we simply went about our daily routine without engaging her–because engaging her took a lot of effort and yelling that I didn’t always have the energy or patience for-she would feel neglected and ignored.  Because she didn’t hear well she was often separated by a wall of silence, even while in the same room.  This often prevented her from being a part of our normal family life and dialogue.  She required care, but a totally different type of care, managing medications, arranging doctor’s visits, trying to convince her to try a hearing aid, and helping her maneuver around the house.

Caregiving can be embarrassing and uncomfortable

There were sometimes moments in the course of the day that made us cringe, moments related to a loss of modesty and increasing difficulty with bodily functions.  We had always loved to entertain, but because we couldn’t predict how or when those embarrassing moments would happen, we stopped inviting people over.  In retrospect, perhaps we should’ve been a little more laid back, realizing that those things happen, but at the time it just felt….weird.  Having someone live in your house sometimes means seeing and hearing more than you ever wanted to.

Your relationships will be strained

Caregiving is often a thankless job, and the effects of that can cause a serious strain on all your relationships.  During that time Chuck and I were often stretched to the max, and with no one else to take it out on, we lashed out at each other.  We were more easily frustrated with our kids, and often frustrated with Marie as well.  There were times where she seemed equally sick of us, and especially of the kids.  I had hoped for a closer relationship, but I forgot that sometimes grandparents need a little space from the constant neediness of kids.  Frankly, we all needed a little space from each other sometimes, and often there was just no place to go.

Our outside relationships were strained as well.  We were frustrated and resentful of family members who had no idea what we were going through.  Most of our friends just couldn’t relate to our stage of life, and one by one they disappeared too.  Had we known better, we would’ve joined a support group of other caregivers, but I think maybe at the time we were too proud & stubborn to admit we couldn’t handle it all on our own.


A doctor’s job is to worry about prolonging life, not quality of life

That is an important distinction to remember, and one that didn’t occur to us until it was too late.  Don’t get me wrong, all the doctors who helped care for my mother-in-law were kind and compassionate, and truly concerned for her well-being.  But their first concern was always dealing with the physical concerns that would prolong her life as long as possible–managing her blood pressure and her kidneys and her diabetes.  It meant lots and lots of pills and tests and doctor’s visits, and then later, after she had a bad fall and ended up in the hospital, even more extraordinary measures to get her “well” again.

Had we the chance to do it over, I think we would’ve looked at the situation much differently.  Our primary concern would’ve been making her final years and months as enjoyable and comfortable as possible, without worrying so much about prolonging her life as long as we could.  At the very least, we would’ve realized that our job as caregivers was to advocate for quality of life, knowing that the doctors were approaching her care from a different perspective.

You will need a break

After living with us for seven months, my mother-in-law decided on her own that she would like to move to a nearby assisted living facility.  It wasn’t until someone else was sharing the responsibility for her care that we realized how much we had needed the break.  Being a full time caregiver is at times difficult and stressful, especially when you add kids and the rest of life’s demands into the mix.   Sometimes in the midst of the daily grind it is hard to see the forest through the trees, but had we known how desperately we needed to give ourselves a break, perhaps we would’ve tried a little harder to find respite care.

Looking back, I now realize we entered our caregiving situation with a blind naivety that ended up causing problems that may have been avoidable.  I am so very thankful that we managed to resolve them, and that we were able to maintain a close and loving relationship with my very dear mother-in-law to the very end.  I am also so grateful that she was once again able to enjoy spending time  with her granddaughters.  She was a wonderful woman with an amazing heart, and I still miss her a lot.

My hope is that sharing our experience–and the lessons we learned–might help those of you who are caregiving now, or will be in the future.


May 4, 2015
by Samantha Jeckewicz
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Foods That Help Keep the Pounds Off as You Age

20001A new look at what kinds of foods might help people keep their weight in check as they age found that not all calories are created equal and some foods are not as bad for the middle-aged waistline as many believe.

While men and women who ate lots of nuts, peanut butter, fish, yogurt and low-fat cheese tended to lose weight, other foods commonly seen as “unhealthy” — such as eggs, full-fat cheese and whole milk — did not seem to make a difference in weight.

On the other hand, sugary drinks and refined or starchy carbohydrates — including white bread, potatoes and white rice –  had the opposite effect.

“The idea that the human body is just a bucket for calories is too simplistic. It’s not just a matter of thinking about calories, or fat. What’s the quality of the foods we are eating? And how do we define quality?” said senior researcher Dr. Dariush Mozaffarian, of Tufts University and the Harvard School of Public Health, in Boston.

In general, the researchers reported, adults gained more weight as the “glycemic load” in their diets rose.

Glycemic load measures both the amount of carbohydrates in the diet, and the quality of those carbohydrates, said Mozaffarian.

A white-flour bagel, for instance, has a glycemic load (GL) of about 25 units, he noted; in contrast, a serving of quinoa — a whole grain — has a GL of around 13 units, and a serving of chickpeas has a GL of only 3.

In this study, every 50-unit increase in a person’s daily glycemic load — the equivalent of two bagels — was tied to an extra pound gained over four years.

What’s more, certain foods — like eggs and cheese — were connected to weight gain only if people also boosted their intake of refined or starchy carbs.

Red and processed meats, meanwhile, were also tied to weight gain. Again, though, some of the harm was reduced if a person’s glycemic load was kept in check.

So, Mozaffarian said, eating that burger with a salad, rather than fries, could be a smarter move. Better yet, he added, eat it without the bun.

The findings, reported online in the American Journal of Clinical Nutrition, are based on 24 years of diet information from nearly 121,000 U.S. health professionals. At the outset, all were healthy and normal-weight, on average.

Over time, the study found, people’s weight crept up — as it tends to with age — but the odds differed depending on the typical quality of their protein and carbs. That was the case even when the researchers accounted for other lifestyle factors, including overall calorie intake.

To Mozaffarian, that means counting calories is not enough to maintain a healthy weight in the long run.

Dietary fat was once demonized, Mozaffarian said, and that only led to people eating more refined carbs. “A lot of people still think you need to avoid fat to lose weight,” he said.

Now, Mozaffarian worries that “count calories” is the new “low fat.”

Putting calorie counts on menus, he said, could send consumers the wrong message: If that deli sandwich has a relatively low calorie count, people may assume it’s a good choice — even if it’s mainly processed meat and refined carbs.

A spokeswoman for the Academy of Nutrition and Dietetics agreed that the quality of protein, carbs and fat is vital.

“This study really brings that to light,” said Lauri Wright, an assistant professor of community and family health at the University of South Florida, in Tampa.

“But I don’t want people to think calories don’t matter,” Wright stressed.

There are also no “magic bullet” foods that will melt off the pounds, she said. Nor can people avoid weight gain, and stay healthy, simply by avoiding a few “bad” foods.

atkins_diet_1Instead, Wright advised, choose healthy carbs, including vegetables, fruits and fiber-rich grains; proteins like fish, chicken and nuts; and “good” fats such as those in vegetable oils and fatty fish.

“You could have chicken breast on whole-grain bread, plus a salad, for lunch,” she said. “For a snack, have almonds, or hummus and vegetables. Then for dinner, have salmon and vegetables.”

But, she added, “calorie balance” — including the calories burned through exercise — is still important.



May 1, 2015
by Samantha Jeckewicz
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Rheumatoid Arthritis FAQs

Q:  The term arthritis refers to stiffness in the joints. True or False?

A:  False.  The definition of arthritis is inflammation of the joints. This inflammation causes symptoms such as stiffness of the joints. It also causes pain, swelling, redness, and warmth.


Q:  Why is rheumatoid arthritis (RA) different from some other forms of arthritis?

A:   Rheumatoid arthritis (RA) differs from some other forms of arthritis because it is symmetrical, affecting both sides of the body.  Other types of arthritis may affect only one side of the body.


Q:  Rheumatoid arthritis is more severe in whom: Men or Women?

A:  Women.  Rheumatoid arthritis tends to affect three times as many women as men, and symptoms may be more severe in women as well. RA tends to affect women at earlier ages, and men seem to have more cases of remission of the disease.


Q:  Rheumatoid arthritis is most likely caused by what factor?

A:  There are thought to be several causes or risk factors associated with rheumatoid arthritis. Genetics is one component.  Hormones are believed to be another as women are diagnosed with RA more often, and it is suspected estrogen may play a role. The environment may be a factor: occupational exposure to certain dusts such as silica, wood, or asbestos can also lead to a higher risk for developing the illness, as can cigarette smoking. It is thought there may be a viral or bacterial infectious cause of RA but that is still being studied.


Q:  People with rheumatoid arthritis experience the most stiffness at night. True or False?

A:  False. People with rheumatoid arthritis tend to experience muscle and joint stiffness most in the morning or after extended periods of inactivity.


Q:  Rheumatology is the branch of medicine that involves the study of what?

A:  Rheumatology is the branch of medicine that involves the study of disorders of the joints, muscles, and bones, autoimmune diseases, and soft tissue diseases.  A rheumatologist is usually an internal medicine specialist or pediatrician, with additional specialized rheumatology training to identify and treat the more than 100 different types of arthritis in addition to other autoimmune disorders such as lupus, gout, and osteoporosis.


Q:  Surgery is the only way to treat RA. True or False?

A:  False.  Treatment for rheumatoid arthritis usually involves a combination of medication, exercise, rest, and protecting the joints. Surgery may be needed in some cases.


Q:  Rheumatoid arthritis can be cured if diagnosed and treated early. True or False?

A:  False.  Currently, there is no cure for rheumatoid arthritis. Treatment for RA that is started early on in the disease process can help minimize or slow damage to the joints and improve quality of life for patients.


Q:  The sudden appearance or worsening of RA symptoms is referred to as a what?

A:  Flare.  A flare is the sudden appearance, increase, or worsening of rheumatoid arthritis symptoms such as pain, inflammation, redness, warmth, or tenderness. Flares can last for days or weeks.


Q:  With rheumatoid arthritis, deformity of the joints is caused by chronic inflammation. True or False?

A:  True.  The chronic inflammation caused by rheumatoid arthritis can lead to debilitating loss of cartilage, bone weakness, and joint deformity in some patients. Damage to the joints is progressive and can occur over time.



April 27, 2015
by Samantha Jeckewicz
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Spring Allergy Season Could Be a Bloomin’ Nightmare

allergies-causes-and-curesIf you’ve got seasonal allergies, you probably already know that spring has finally arrived. And, some experts are predicting that this allergy season may be one of the worst in years.

After a long, cold, wet winter, trees and flowers all seem to be blooming at once, and that means a sudden, big burst of all different types of pollen at the same time.

Some experts are even predicting a “pollen vortex.”

The one bright spot? Because the pollen season started later, it’s likely to be shorter, according to Dr. Joseph Leija, an allergist with the Loyola University Health System’s Gottleib Memorial Hospital in Chicago. Leija has also been in charge of measuring the Midwest’s official pollen count for the U.S. National Allergy Bureau for the past two decades.

“The allergy season has been slow to start this year, but now we’re seeing a high pollen count from trees. They’re all pollinating together. This will be a heavy season, but since the pollination started quite late, it will be shorter,” Leija said.

Dr. Beth Corn, director of Clinical Immunology Faculty Practice Associates at Mount Sinai Hospital in New York City, said it’s difficult to quantify from year-to-year exactly how bad an allergy season might be, particularly from a patient’s perspective.

“Allergy season was bad last year, and it will be bad this year. People are very symptomatic now. But, remember, up until last week, we were still in winter coats in New York. People are noticing the stark contrast. Things have abruptly changed and people notice it,” she said.

The cities hit hardest by rough weather this winter may not see the worst of allergy season, according to the Asthma and Allergy Foundation’s Top Five Spring Allergy Capitals list. To make the allergy capitals list, a city has to have higher than average pollen counts along with higher than average medication use.

The cities given this dubious distinction for 2015 are: Jackson, Miss.; Louisville; Oklahoma City; and Memphis and Knoxville, Tenn.

But, no matter where you live or what the pollen count might be, you can take steps to ease your allergy symptoms.

The first step, said Corn, is to see an allergist and get tested so you know exactly what causes your allergy symptoms.

“It’s important to know what it is you’re treating, and when you’re seen by a specialist, they can tailor your treatment.  You’ll get the most effective cocktail of medications,” Corn said.

Both over-the-counter and prescription allergy medicines are also available. And steroid nasal sprays can help relieve allergies, while eye drops can help control eye symptoms, according to Corn.

Leija pointed out that “controlling your environment as much as possible is important. Keep your windows closed and run the air conditioner inside the house, and when you’re driving, too. If you get pollen in your hair and clothing, don’t bring it into the bedroom.”

Leija also said it’s a good idea to change clothes before you come inside, or at least not in your bedroom. And, if possible, wash pollen out of your hair before getting into bed.



April 23, 2015
by Samantha Jeckewicz
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Tips for Dealing With People Who Don’t Know They Have Dementia

Tips for Dealing With People Who Don't Know They Have Dementia

When President Woodrow Wilson had a stroke in 1919 his physical health was slightly impacted, but his mental health suffered. Film director Errol Morris, in an opinion column in the New York Times, wrote, “his close associates noticed a change in his personality. He became increasingly suspicious, even paranoid, without having the dimmest awareness of the fact that he was perhaps becoming a different person.” Edwin Weinstein, a neuropsychiatrist who reviewed Wilson’s case in the 1970s, deemed this a classic case of anosognosia – a lack of awareness that one is impaired.

A Definition of Anosognosia

It is a scary thought to consider. What if we were ill, suffering from dementia, and didn’t know it? How would our loved ones cope?

In fact, it is very difficult for caregivers and family members to make progress with a person’s illness when a loved one is showing signs of anosognosia. Yet, the condition is alarmingly common: After stroke, some studies show up to 77% of patients suffer anosognosia at least temporarily, reports one review of the literature.

It occurs frequently in those with mental illness, according to the Treatment Advocacy Center, and can also affect people who have suffered traumatic brain injury, as well as people with Alzheimer’s and other types of dementia.

What Causes Anosognosia?

Anosognosia is still difficult to define, but researchers know it results from physical, anatomical changes or damage to the part of the brain that affects perception of one’s own illness.

Studies suggest that deterioration in the frontal lobes may be involved, which “play an important role in problem-solving, planning and understanding the context and meaning of experiences and social interactions,” according to the New York Times’  New Old Age blog.

To put it another way, our right brain is wired to detect anomalies and new information and incorporate these into our sense of reality, says the neuroscientist Dr. V.S. Ramachandran, also in the New York Times. When something happens to damage that part of the brain – a stroke or dementia, for instance – then “the left brain seeks to maintain continuity of belief, using denial, rationalization, confabulation and other tricks to keep one’s mental model of the world intact.”

Anosognosia and Alzheimer’s

Anosognosia has long been recognized in individuals with strokes, brain tumors, Alzheimer’s and Huntington’s disease, says the Treatment Advocacy Center.  According to the University of Florida’s health resource AlzOnline, the prevalence of anosognosia in those with cognitive impairment or dementia can be very high.

“Some researchers have estimated that as many as 60% of people with Mild Cognitive Impairment and 81% of people with Alzheimer’s disease have some form of anosognosia.”

This is a difficult situation for caregivers, who are trying to help someone who essentially does not and cannot acknowledge they are ill. The anosognosic person with dementia may have evident problems with routine tasks, but they may insist they do not need help, or may even refuse medical evaluation or treatment – treatments which are often key to helping them realize they are impaired in the first place.

Is it Denial or Anosognosia?

To make the situation even more challenging, anosognosia may be complete or selective. They may be entirely unaware of their impairment for instance, or they may even react with anger and defensiveness if confronted about their illness. This makes it difficult to diagnose anosognosia, and tough to differentiate it from simple denial.

Here are some signs you can look for if you’re worried a loved one might have dementia with anosognosia:

  • Not keeping up with regular daily tasks or personal hygiene
  • Difficulty managing money or bills
  • Being more spontaneous or less inhibited in conversation without concern for their own behavior
  • Becoming angry when confronted with forgetfulness, lack of self-care, or poor decision making
  • Confabulation: making up answers they believe are true, though sometimes the details may be imaginary, may pertain to something that happened in the past, or even something they read or heard elsewhere

What You Can Do if a Loved One Doesn’t Know They Have Dementia

Whether your loved one is in denial of their dementia or has anosognosia, the most effective caregiver strategy is one of mitigation of the effects, rather than trying over and over to make the person understand. “Trying to make someone with this problem understand that they have changed and need to accept new limits often is an exercise in frustration,” says the New York Times. The Treatment Advocacy Center agrees: “Nobody wants to take medicine if they aren’t sick, and people with anosognosia are no exception.”

However, if not treated, a loved one could even put themselves and others in danger. AlzOnline has the following suggestions for your loved one  anosognosia:

  • Use positive approaches to communication: be gentle, encouraging and empathetic about necessary tasks
  • Provide a structured schedule of tasks, personal care and down time, and make yourself or another caregiver available to help
  • Downsize any responsibilities that are unnecessary: sometimes a home health care aide or memory care is the answer
  • Work together with the person on necessary tasks such as cleaning or money management
  • Stay calm and focused on the other person when voicing concerns: articulate your thoughts in a subtle and positive light

Lastly, try some recommended reading: I Am Not Sick. I Don’t Need Help! by psychologist Xavier Amador, a professor at Columbia University, provides practical recommendations for those who lack insight into their mental illnesses.  “It’s an excellent place for anyone in this situation to begin,” says Doris Fuller, Director of the Treatment Advocacy Center.