So, we know we can’t be friends with everyone. Sometimes it’s hard just to be kind to some acquaintances. Then again, it’s possible to love people that you don’t really like.

Around the holidays, it seems that all those things are exaggerated. Whether it’s work, church, home or extended family, we are bombarded with amplified social obligations. So, when we’re struggling in any relationship those issues can become larger than life.

Family caregivers are among America’s unsung heroes.

Today, an estimated 65.7 million Americans, or nearly 30 percent of the general population, provide unpaid care to an older adult or a younger person living with illness or disability. These family caregivers devote enormous time, energy and resources to ensure their loved one can remain living with dignity in familiar surroundings.

Research shows that nearly 90 percent of people age 65 and older want to stay in their homes and communities for as long as possible. Many older adults rely on family or friend caregivers for the support to make that possible. Those family caregivers are the foundation of long-term care nationwide.

Questions and Answers about Long Term Care

  1. What are some good resources to learn about the skilled nursing facilities in the area?  It seems as though you can get great care in some places and not in other places. 

 

  1. One of the best places you can find information about nursing homes is on Medicare’s website.  There you can compare reports on nursing homes within a zip code range, or look for information by name of facility.  Included in the report is information on how nursing homes have performed on health and fire safety inspections, how the nursing home is staffed with nurses and other healthcare providers, and how well the nursing home cares for their residents.  This information comes, primarily, from the Centers for Medicare and Medicaid Services’ (CMS) health inspection database, a national database of resident clinical data known as the Minimum Data Set (MDS), and Medicare claims’ data.

Another great resource for information about nursing homes, and long term care options in general, is the Michigan Long-Term Care Ombudsman Program.  This program is authorized in the Older Americans Act and the Older Michiganians Act and works to address the quality of care and quality of life for residents who live in licensed long term care facilities.  If you have questions about long term care options in general, or concerns about a specific facility, the local Long Term Care Ombudsman is a great resource and an advocate for nursing facility residents. Learn more about the program at  www.MLTCOP.org or by calling 866-485-9393.

My father was an aeronautical visionary. In WWII, when a small plane was needed to fly supplies into and wounded persons out of remote areas with hardly any landing space, a design competition was held. When engineering teams presented their creations to see which could land and take off in the shortest strip of runway, my father’s team landed the runway crossways. His Stinson L5, “the Flying Jeep”, hangs in the Smithsonian today. I didn’t inherit that gene.

Dereck Thompson, a writer for The Atlantic, recently wrote of interviews conducted within Google’s “Moonshot Industry”. This portion of the company is devoted to what they call radical creativity, exploring breakthrough technology to address huge societal problems.

A good friend of ours who lost her husband a few years ago told us, “Death itself is hard enough. But it’s the process of dying that is so difficult.”

She had had to assist him in most of the activities of daily living for years, including the negotiation of procedures through the medical community.

Another friend of ours suffered from a fast-spreading cancer. She had endured more than one extensive procedures, including radical surgery. But up until a few days before she died, a doctor told her family that just one more procedure would have her up and functioning normally.

My husband has decided we should go camping. We camped for many years when our kids were young, and have great memories of those times. We camped in tents, on the hard ground, and as the years went on we were able to borrow Grandpa’s trailer. Caught in a moment of sweet nostalgia, I thought it sounded fun, so I said, “yes!”

Now, I’m thinking it through. We’re renting a camper, so that’s on the pro side of the list. It has a bathroom in it, so I think that’s on the pro side as well. I don’t know how it works though, so it may end up on the other list. We used to just walk over to the campground bathroom with our flip-flops on. But now bathroom trips occur more often than they used to, and I feel a little different about using bathrooms in the woods where critters may surprise me.

Supposedly we can park the trailer at the campground, and in “five easy minutes” have it all set up. I wonder if that time frame is for 30-year-olds, or if it applies to 60-somethings? While we’re fairly fit, we have had a few new parts installed – three hips, a couple knee surgeries…you know, the usual. And so what if it takes us a half hour. That’s part of the adventure, right?

I expect we’ll take walks around the park. We did a lot of that in those early camping days. We may not go quite as far, but that’s okay. We’re also taking our dog with us, and she won’t let us just sit around. That’s a good thing.

And now I’m thinking about the dog. She’ll probably hear the move of every raccoon, squirrel and cricket, and will be forced to protect us with her ferocious bark. And I suppose there will be children around the grounds to annoy her as well. Do campers still play loud music at night? I do not want to be one of those grumpy seniors who complains about such things. Maybe we’ll go out and dance to their music until they retreat.

Jeff describes feeling like he walked into the doctor’s office one person and walked out someone entirely different. He says he went in a 56-year-old self-employed businessman, husband and father and he came out an Alzheimer’s patient.

“We sat in the car for almost an hour. We cried some, but mostly we just sat,” Jeff’s wife Cindy says. “It was like all our plans, our life, came to a crashing halt with that one word. Alzheimer’s.”

When Jeff first started exhibiting signs of memory impairment, Cindy says they shrugged it off to stress and an unwelcome but natural part of getting older.

While memory can change as you grow older, Alzheimer’s disease and other forms of dementia are not a part of normal aging. Dementia is caused by a number of diseases that affect the brain. The most common is Alzheimer's, but diseases also include vascular dementia, dementia with Lewy bodies and Pick's disease and more.

Alzheimer's slowly destroys an individual's memory, judgment, cognition, learning, and eventually ability to function. Prevalence of the disease is on the rise. An estimated 5.5 million Americans have Alzheimer's disease according to a 2017 Alzheimer’s Association report.

Alzheimer’s disease is the second most feared diagnosis among adults age 55 and older, second only to cancer, according to a MetLife Foundation study. In a similar study conducted by the Alzheimer’s Society, almost two-thirds (62%) of people surveyed felt a diagnosis of Alzheimer’s disease or another form of dementia would mean their life was over.

Dementia Friends is a global initiative working to change people’s perceptions of dementia.

Developed by the Alzheimer’s Society in the United Kingdom, Dementia Friends was launched to tackle the stigma and lack of understanding that often results in people with the condition experiencing unnecessary levels of loneliness and social exclusion. It’s an effort spreading around the world.

Dementia Friends America, co-chaired by the National Association of Area Agencies on Aging, was launched in early 2017 and is being spearheaded in Michigan through Region 8 Area Agency on Aging in Grand Rapids.

Dementia Friends America works to raise awareness about the disease and help people understand how they can take small steps to support people living with dementia.  The effort aims to reduce fear and avoidance, and ensure people living with dementia are included and supported. The program accomplishes this via an online training that involves watching a series of short videos and committing to take action.

The videos are short vignettes illustrating how you can be supportive of people with dementia you encounter throughout the community. Some examples include the grocery store, bank, restaurants, the library and pharmacy. There’s also information for first responders and other professionals. The videos provide quick takeaways that are easy to put into practice in your everyday life.

You can help people in our community who are living with dementia and their families by becoming a Dementia Friend. Visit dementiafriendsusa.org/become-friend to learn simple actions you can take to make your community one where people living with dementia are valued and supported in helpful ways. After watching at least three of the videos and committing to take action, you’ll receive a certificate indicating your commitment to being a “Dementia Friend”.

Jeff describes feeling like he walked into the doctor’s office one person and walked out someone entirely different. He says he went in a 56-year-old self-employed businessman, husband and father and he came out an Alzheimer’s patient.

“We sat in the car for almost an hour. We cried some, but mostly we just sat,” Jeff’s wife Cindy says. “It was like all our plans, our life, came to a crashing halt with that one word. Alzheimer’s.”

When Jeff first started exhibiting signs of memory impairment, Cindy says they shrugged it off to stress and an unwelcome but natural part of getting older.

While memory can change as you grow older, Alzheimer’s disease and other forms of dementia are not a part of normal aging. Dementia is caused by a number of diseases that affect the brain. The most common is Alzheimer's, but diseases also include vascular dementia, dementia with Lewy bodies and Pick's disease and more.

Alzheimer's slowly destroys an individual's memory, judgment, cognition, learning, and eventually ability to function. Prevalence of the disease is on the rise. An estimated 5.5 million Americans have Alzheimer's disease according to a 2017 Alzheimer’s Association report.

Alzheimer’s disease is the second most feared diagnosis among adults age 55 and older, second only to cancer, according to a MetLife Foundation study. In a similar study conducted by the Alzheimer’s Society, almost two-thirds (62%) of people surveyed felt a diagnosis of Alzheimer’s disease or another form of dementia would mean their life was over.

Dementia Friends is a global initiative working to change people’s perceptions of dementia.

Developed by the Alzheimer’s Society in the United Kingdom, Dementia Friends was launched to tackle the stigma and lack of understanding that often results in people with the condition experiencing unnecessary levels of loneliness and social exclusion. It’s an effort spreading around the world.

Dementia Friends America, co-chaired by the National Association of Area Agencies on Aging, was launched in early 2017 and is being spearheaded in Michigan through Region 8 Area Agency on Aging in Grand Rapids.

Dementia Friends America works to raise awareness about the disease and help people understand how they can take small steps to support people living with dementia.  The effort aims to reduce fear and avoidance, and ensure people living with dementia are included and supported. The program accomplishes this via an online training that involves watching a series of short videos and committing to take action.

The videos are short vignettes illustrating how you can be supportive of people with dementia you encounter throughout the community. Some examples include the grocery store, bank, restaurants, the library and pharmacy. There’s also information for first responders and other professionals. The videos provide quick takeaways that are easy to put into practice in your everyday life.

You can help people in our community who are living with dementia and their families by becoming a Dementia Friend. Visit dementiafriendsusa.org/become-friend to learn simple actions you can take to make your community one where people living with dementia are valued and supported in helpful ways. After watching at least three of the videos and committing to take action, you’ll receive a certificate indicating your commitment to being a “Dementia Friend”.

Questions and Answers

  1. Is Medicare giving everyone a new random number or just the people turning 65 after this year? 

 

  1. Yes, everyone who currently has Medicare will be getting a new number and card.  This is being done to remove people’s Social Security numbers from the cards to better protect against identity theft.  The randomly assigned numbers will be a combination of numerals and upper case letters.  The new cards will begin rolling out in April 2018 through April 2019.  It will take a while for so many cards to be distributed nationwide, so don’t be worried if your friend or relative gets their card before you do.  Your current Medicare card will remain your active card until your new one arrives. 

Every house seems to have its “swirl” zone. That place where leaves, seed pods, or snow swirls against something and heaps into a mound. The swirl zone at our house inconveniently forms on the steps to our front porch and the garage door. While away for a couple days, our neighbor decided to blow our leaves; very thoughtful of her.

Inter-connectedness of people is important. With the passing of a brother-in-law recently, people at his memorial frequently remarked how much they’d liked stopping for a chat as he enjoyed an afternoon sitting on his front porch. Acquaintances and friendships grew.

It was opening day for the Detroit Tigers. I had decided to take my bike to school since I could get home faster than I could by taking the city bus. I wanted to absorb as much of announcer Harry Heilman’s play-by-play as I could.

But about half way home, it started to snow. In about fifteen minutes, I was soaking wet and very cold. The game had been called, now a minor consideration.

Age or disability combined with low-income status is not an arbitrary predictor of an individual’s ability to make decisions about their health insurance.

But that was the perspective given by one former health insurance executive at a national conference in Chicago last week.

Speaking about people who are dually eligible for both Medicare and Medicaid – people often referred to as ‘duals’ -- a former CEO of a major U.S. health plan stated, “All duals should be mandatorily enrolled [in managed care] almost for their own protection.”

Today is National Grandparents Day!

Many people assume that Grandparents Day resulted from lobbying by florists, greeting card companies and similar businesses. This could not be farther from the truth. Grandparents Day is a day for celebrating the connections between the generations, and its origin was decidedly noncommercial. The holiday has remained fairly true to its roots. Susan Adcox, writer for “The Spruce” tells us that the roots of Grandparents Day go back to 1956 and a West Virginia mother named Marian McQuade.

While helping to organize a community celebration for those over 80, Mrs. McQuade became aware of the many nursing home residents who were forgotten by their families. She wanted a holiday to bring attention to these forgotten individuals and to honor all grandparents. In 1973 West Virginia became the first state to have such a day.

  1. My father seemed incoherent the other day and I discovered he had taken Vicodin given to him by a neighbor.  I am shocked he did something so foolish!  He refuses to talk to his doctor and now I wonder if he’s got a drug problem ---what can I do?

 

  1. Unfortunately, drug abuse and misuse is on the rise in persons over age 55.  Opioid addiction and related hospitalizations and deaths have increased dramatically in the last ten years for this demographic.  Part of this lies in physicians prescribing too many pills, such as a 30-day supply when a 5-day supply is sufficient, and not paying enough attention to patient’s history, such as other doctors prescribing for the patient, and potential drug interactions.  Another dynamic is the increased marketing of prescription drugs and people’s willingness to take drugs to address even minor issues.  Finally, some studies indicate that, since the 1960’s drug culture, more people are open to using drugs, and sharing drugs, as well.

It is, therefore, more common than one would think that a neighbor or family member might say, “Your knee is hurting?  Here, don’t spend money on a doctor visit, I have this drug leftover from my dental procedure…”  You are correct that this is a foolish practice for both parties.  It most certainly is an illegal action on the part of the friend, no matter how well-intended, and it is dangerous for your father as he might not be taking an appropriate dosage or might have an allergic reaction or drug interaction.

A cousin called from the Seattle, WA area wondering if I knew anything about services available in southern Florida. Her dad, my uncle and a widower of several years living alone, was recovering from a hip replacement and needed support.

About the same time, a friend from the Detroit area called about help for her father living in southern Ohio. Her father’s macular degeneration had progressed into serious disability and her mother had just passed, leaving her dad without his well-sighted partner. 

Both women have busy jobs and are long distance caregivers. They can visit, but not live by their respective fathers. Both fathers wanted to stay where they were if possible. Tough situations; surprisingly common.

What is a caregiver?  Sometimes called an informal caregiver, this could be any unpaid individual (for example, a spouse, partner, family member, friend, or neighbor) involved in assisting others with routine activities of daily living and/or medical tasks.

National statistics from the Family Caregiver Alliance out of San Francisco in 2015 showed that 43.5 million persons provided regular, unpaid care to someone needing ongoing help. Of these, 5-7 million were long distance caregivers. The number of long distance caregivers is projected to double by 2020.

While most caregivers, about sixty-six percent, live within ten miles of the person they’re caring for, nationally, long distance caregivers live an average of 450 miles from their care recipients; or approximately seven hours travel time. Their anxiety tends to be higher; they worry a lot.

What to do? There’s no one answer, every situation is different. But there is an invaluable resource available when trying to figure out what help might be available in another part of the country. The Eldercare Locator is a phone call, or online “click”, away.

Launched in 1991, the Locator is funded by the U.S. Administration on Aging, part of the Administration for Community Living, and administered by the National Association of Area Agencies on Aging. 

Here’s how it works. By calling 1-800-677-1116, you’ll be connected to a professional trained in eldercare and well-versed in common issues and needed services. The Locator receives about 300,000 requests for assistance annually on a wide range of topics including transportation, housing, benefits eligibility and home and community-based services. 

Want to know about specific local services in a given community? Just give the person taking your call the city or zip code where the person you want to help lives, and they’ll be able to connect you directly with a local expert virtually anywhere. Locally, at Area Agency on Aging, we serve as the local expert and routinely get calls patched through from the Locator from distant friends or family wanting to help someone here in southwest Michigan.

Call times are handy. Locator phone lines are manned Monday-Friday from 9:00 a.m. to 8:00 p.m. Eastern Time.  

A second option is to access the Locator online. You can go to www.eldercare.gov and punch in the city or zip code you’re interested in. Local contact information will pop up. You can narrow your search by choosing certain topics to research. Information and brochures on high-profile topics are also available.

Want to know more about how the Locator works? Check out the publication at www.n4a.org/files/EldercareLocatorDataReport.pdf

Figuring out a plan long distance isn’t easy, but these tools can help a lot. Good luck.

 

“…work is an important part of what gives our lives meaning and direction.” – Michael R. Bloomberg, financier, philanthropist, former mayor of New York City 

Recently, columnists have been expressing concern about not just jobs, but the role that working itself plays a role in our lives. Automation, particularly computers and robots, have been replacing human workers in manufacturing and retailing. Professional observers have concluded that as many as 42% of jobs will be replaced by machines by 2050.

And it’s not just the loss of income that concerns many observers. It’s the idea that that work gives our life meaning, and the sense of purpose in our lives. And simply not working will diminish us as human beings.

Well, where better to see how not working affects our well-being than at a place where nonworkers gather – the local downtown restaurant around breakfast time.

Last week a friend and I made our regular weekly breakfast outing at the restaurant and watched clusters of nonworking retirees coping with their unemployment. They seemed to be confronting their lack of employment with commendable courage, laughing, telling stories of earlier days, regaling one another with family tales, commenting on current events, extolling the potential of their favorite teams, smiling a whole bunch. In short, they seemed to be happy to have the opportunity to get together.

In the past few years, I’ve asked many nonworking retirees if they miss work. Overwhelmingly they say no, but they tend to miss the people with whom they worked and the familiar structure of time and place.

I’ve learned too that what observers ignore is that some jobs are simply not satisfying. One of my first jobs in high school was setting bowling pins manually. It was difficult, dangerous, and sometimes painful, with pins flying around from lane to lane. I never found any redeeming value in the actual labor. Only the paycheck.

When I was in junior college, I worked second shift as a trucker in a large company building engines. I watched co-workers on the assembly line doing mind-numbing, repetitive tasks for hours at a time. Adam Smith, the father of capitalism, warned how minute, repeated operations can be spirit-crushing. Not much meaning or sense of purpose there.

And even if a sense of purpose could be salvaged by a productive, satisfying job?  What is so magic about a 40-hour week? Couldn’t people find a sense of purpose in 20 hours a week, through a job-sharing system? Couldn’t we actually use that automation to reduce the burdens of production, to give us more time to do things we choose to pursue on our own? More likely the problem is not in work, it’s in income.

That old saying, “Idle hands are the devil’s playground,” which extolls the seeming virtues of toil, ignores the opportunities of freedom. And retirees can be instructive here. Some renew ties to family, develop new social networks, pursue passions, like golf, arts and crafts, develop new areas of personal endeavor.

Or if the personal interest hobbies still lack meaning, compassion can be your guide. My friend Charles is a member of the St. Joseph/ Bennon Harbor Rotary Club. He became aware of the problems of toxic water in the Dominican Republic. So with his fellow Rotarian Terry, from the Lakeshore club, he set out to mitigate the problem. So for the past several years, they have organized volunteers, set up  schedules, made trips to the Dominican Republic, raised money, and installed water filters. They didn’t get a nickel for their work, but they have been internationally recognized.

Fortunately, they had the time and the freedom from work to develop a new sense of purpose. 

Intergenerational relationships are the exception rather than the rule.  These relationships seem natural and normal to me, so I was surprised to find out that is not the case.  For the most part, age segregation prevails.

According to Generations United (a national coalition whose mission is to improve the lives of children, youth and older people through intergenerational collaboration, public policies, and programs for the enduring benefit of all), “kids spend their days at school, mostly among peers born the same year they were. Young and middle-aged adults cluster at work. And elders gather for clubs, classes, and meals that often expressly bar the young. Millions of college students and elders live in age-restricted housing, and most American neighborhoods skew young or old.” 

If you think you’re too old to start your own business, think again. About 26 percent of all recent startups were formed by people between the ages of 55 and 65, That’s up from 15 percent in 1996.  

Risk-taking Millennials are often thought to be the leading generation in terms of having an entrepreneurial mindset, but it’s Baby Boomers who may have the greater passion for launching a new business.  

Britt Hysen, editor-in-chief of Millennial magazine claims that “60 percent of Millennials consider themselves entrepreneurs” but Federal Reserve Data shows the share of people under 30 who own a business is now at a quarter century low.   

Questions and Answers

  1. A recent severe storm blew down trees and cut power for several hours and made me think of my grandmother and what she would do if that happened in her area.  We all live at least an hour’s drive from her.  What can I do to make sure she will be ok until we can get to her?

 

  1. Thinking about possible emergency situations and devising a plan of action is the first, best step toward ensuring your own safety as well as those you love.  For all kinds of emergencies, from natural disasters such as storms, fires and floods, to accidents such as chemical spills or terrorist attacks, preparation is key.  The message from agencies such as the Federal Emergency Management Agency (FEMA) and American Red Cross is “Get Ready Now!”  From the website www.ready.gov, there are three steps for emergency preparedness:  1) Get a Kit; 2) Make a Plan; and 3) Stay Informed. 

On a trip to the canyonlands of Utah last April, my husband and I followed a piece of local advice and decided to drive up a less traveled dead end road to a high reservoir. The increasing elevation drove back spring; no leaves on trees, patches of snow, the few houses we passed still closed tight from winter.

                We pulled up to a small, gravel clearing at the end of a long lake with a single dock jutting out twenty feet or so.  A big sky and unobstructed view went for miles to distant canyon walls.  Stepping out of the car, it hit me with force – silence! No breeze, eerily still and completely silent, yet we were in wide open country.

Wow. I hadn’t realized how long it had been since I’d experienced silence outdoors. Years, maybe decades, maybe hardly ever. I stood on the dock and listened, nothing came. Eventually I heard birds, perhaps geese, splashing in a takeoff or landing. Where were they?? At the far end of the lake I could see them, tiny dots moving. Sound had carried with remarkable clarity over an amazing distance. 

I lingered in awe. Those twenty minutes or so standing in natural silence turned out to be one of the highlights of the trip. It was a different peek at wilderness; the contrast with my usual daily life startling. I’d always worked to find time for connection with the natural world – but maybe not enough.

Hmm---- maybe that’s food for thought for an eventual retirement plan.

                Area Agency on Aging (AAA) is in process of creating an expanded campus designed to focus on continual personal reinvention and growth. C. S. Lewis once said, “You’re never too old to set another goal or dream a new dream.”  We hope to add momentum to the fire behind that statement.

                A colleague of mine recently retired. She commented, “That line, that I’m not retired, I’m refired, describes what I hope for in this next stage of my life.”  She’ll do well, but it does take planning.

                A writer for Psychology Today, Melissa Kirk outlines a multi-step process for reinvention. She points out that reinvention is usually prompted by major change: leaving a job or relationship, moving, loss of a loved one or health, and so on. While people think about their future in retirement, they sometimes wait for it to find them, instead of pro-actively planning. Planning is not all about money.

                Kirk supports creating a vision for your future, writing down the desired results of the vision, seeing oneself in that role.  She advocates giving oneself regular reminders of the vision; pictures, articles, opportunities to experiment being important. Then, taking time to think through steps to move forward, writing them down into workable tasks and taking time to mull over options.

                We plan for education, for work, for family. We tend to plan comparatively little for retirement, though many hope to spend decades in this phase of life.

                A number of my friends don’t even like the word retirement. They think it sounds like they’re not doing anything. Not true. Most are repurposing themselves and enjoying the journey. It a time of rich reinvention, maximum wisdom and creativity.

                For those of you who have toyed with the idea of pursuing a business of your own, the timing is perfect for you. Cornerstone Alliance, through a grant from AARP and in partnership with AAA, is sponsoring a half day “Work For Yourself 50+” workshop. Four sessions are planned with the first coming up August 29th at 2900 Lakeview in St. Joseph. Call Stacey Stephens at (269) 925-0147 to learn more.

There was a small typo in the copy just sent --- please use this one instead --- thank you!!!

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