Improving Strength and Balance Increases Your Chance of Maintaining Independence

If you have dizzy spells or find it difficult to maintain balance, you may want to investigate why. No matter your age, balance problems and dizziness can have multiple causes, and if left untreated, can lead to frightful falls.

Anyone at any age can fall, but falls for adults ages 65 and older can be more dangerous, causing fractured hips, head injuries, severe bruises and lacerations. According to the Centers for Disease Control and Prevention, each year falls affect one in three adults age 65 or older. If you are 75 or older, you are four to five times more likely to be admitted to a long-term care facility for a year or longer than those age 65 to 74 who fall.

According to Salem Hospital’s Regional Rehabilitation Center Physical Therapist Cathy  Kosboth, “As you age, changes in muscle strength, decreased joint flexibility, impaired vision, medications and changes in body shape can affect your balance.”

Fortunately, steps can be taken to help prevent falls and maintain your independence.

1. Exercise regularly to improve leg strength and flexibility. Yoga and Tai Chi are particularly good for improving balance.
2. Watch your alcohol intake. More than two drinks per day can cause unsteadiness.
3. Consult your physician about your medications. Many medications can cause dizziness or equilibrium problems. Do not go off medication(s) without first consulting with your doctor.
4. Have your vision checked every year. Wear the correct prescription.
5. Eliminate possible hazards at home that could trigger a fall. Remove clutter, be sure to have ample lighting, put non-slip strips or rubber mats in bathtubs and showers, store frequently used items in easy-to-reach locations and tack down area-rug edges.

“Often, people who fall develop a fear of falling, even if they didn’t incur a serious injury,” said Kosboth. “In addition, many people don’t tell their physician about falls. This fear can lead to less activity, affecting physical fitness and actually increasing an individual’s risk of falling.”

If you have had two or more falls in six months, or are experiencing dizziness or nausea and vomiting with movement, ask your physician for a referral to vestibular therapy.

The Salem Hospital Regional Rehabilitation Center’s certified vestibular therapists have sophisticated evaluation and treatment systems to accurately assess balance problems and provide optimal therapy. For more information, call 503-561-5986

Article Provided By: 
Salem Hospital Regional Rehabilitation Center 
503-561-5986

Are On-Line Estate Planning Forms Legal?

As an estate planning and elder law attorney, I am often asked about both the legality and wisdom of using estate planning forms purchased from an on-line service.  As to whether or not these on-line services are legal, the answer is yes.  As to the wisdom of using an on-line service for your estate planning, I often quote an old saying, that I believe that person is being “penny wise and pound foolish”. Being overly cautious with small amounts of money (the fee for creating a will or trust) can risk large amounts of money (your property and other investments).

On-line legal services are not illegal and there is a lot of good information found on the internet.  Communicating with attorneys on-line is becoming much more common.  Many law firms, ours included, provide information through their web sites and communicate with their clients via e-mail. However, on-line information gathering does not replace the need for, or the importance of, face-to-face discussion with your attorney who can ask you questions that may save you a lot of money.

Every estate planning document can have far reaching consequences and those consequences should be discussed and explained by an attorney. There are also many specific state issues that can affect an estate plan, including the definition of descendants, anti-lapse statutes, the effects of marriage or a divorce. The desire to spend as little as possible is understandable, especially in today’s economy.  But a blank form and some basic instructions cannot replace the legal skill or knowledge of a qualified attorney.

Estate planning documents should be prepared to meet the individual needs of the client and with the proper attention to the necessary legal requirements of each document. A person may spend less money today purchasing an on-line form but that person’s estate may spend a lot more money at some future date to fix the problems created by completing a form and understanding how the answers effect the entire estate.  I believe it is very important that you seek the assistance of an attorney to prepare your estate plans, to insure that your assets are protected and your wishes will be carried out as desired.

Estate planning is not the place to be going it on your own. Just as seeing a dentist to stop the pain in your tooth makes sense, seeing a qualified estate planning attorney who is familiar with the probate, trust and estate tax laws of your state to create and maintain your estate plan makes sense. Don’t be fooled by what appears to be a good deal.  Remember that other old saying, “you get what you pay for”.  It would be very disappointing to your family to find that what you had planned is not what will occur.

Article Provided by McGinty & Belcher

Dangers of Driving Tired

Driving when you are a little tired isn’t that big of a deal right? Well, actually it is. In fact, a new study shows that driving while you are tired is just as dangerous as driving drunk.¹ Many times individuals who are driving while fatigued are unaware they are tired or may be so used to driving tired that they do not know how much danger they are in. But the reduced alertness brought on by fatigue makes these drivers a danger to themselves and everyone else who is on the road.

Driving while fatigued is so dangerous, that states have actually started passing legislation to punish those who drive while fatigued. The first law of this kind was passed in 2003 and is named Maggie’s law. Maggie’s Law originated in 1997, from a traffic crash in which 20-year-old Maggie McDonald was killed when a driver crossed three lanes of traffic and hit her car head on. The driver later admitted that he had not slept in 30 hours.

As awareness grows about the dangers of driving while fatigued, it is important that we make sure that we are not letting ourselves or the ones we love drive while they are tired. This article examines one of the main causes of fatigued driving; sleep apnea.

Commercial truck drives offer many tips to help keep you awake while driving. Listening to music you do not like, chewing sun flower seeds and sitting in an uncomfortable position are all thought to help keep one alert while driving. But The Federal Motor Carrier Safety Administration (FMCSA) says that as many 28 percent of commercial driver’s license holders suffer from a common disorder called sleep apnea. While the tips listed above may marginally help someone who is sleep apnea free; most drivers will tell you that with sleep apnea, only an effective treatment can really help.

Sleep apnea is a breathing-related sleep disorder that causes brief interruptions of breathing during sleep. These pauses in breathing can last at least 10 seconds or more and can occur up to 400 times a night. Sleep apnea is a serious, potentially life-threatening condition that often goes unrecognized and undiagnosed.

Because sleep apnea affects your sleep, it also affects your daytime alertness and performance. Many people with sleep apnea report falling asleep at red lights or having to pull over and take a nap because they are literally unable to stay awake.

While many people are still unaware of sleep apnea, the disorder is very well known in industries that depend on commercial truck drives. In fact, a study conducted by the University of Pennsylvania and sponsored by the Federal Motor Carrier Safety Administration (FMCSA) found that almost one-third (28 percent) of commercial truck drivers have mild to severe sleep apnea.²   If someone with a commercial drivers license is diagnosed with sleep apnea, they are required to demonstrate that their sleep apnea is being treated before they are allowed to return to driving.

Currently sleep apnea is detected by physicians when patients complain that they are having trouble sleeping at night. But while sleep apnea testing is increasing, it is still heavily under diagnosed. In fact it is estimated that over 20 million Americans suffer from the disorder. Currently sleep apnea testing can be tested in a sleep lab or also in the patient’s home with a home sleep testing device. If left unchecked, sleep apnea can cause hypertension, heart disease, diabetes, depression, obesity along with a major loss in quality of life. Many times the symptoms of sleep apnea are very difficult to notice. If you believe that you may suffer from sleep apnea or would just like to get tested for peace of mind, please ask your physician about sleep testing.

Article Provided by:
Anne Turner BA, RRT, RPSGT, RST
A Turning Leaf Home Medical

 

Reference
1. Squatriglia, C. (2011). Driving Tired Is Like Driving Drunk
2. Pack A.I., Dinges D.F, & Maislin G. (2002). A study of prevalence of sleep apnea among commercial truck drivers (Report No. DOT-RT-02-030). Washington, DC: U.S. Department of Transportation, FMCSA.

Is it Better to Have a Will or a Revocable Living Trust?

Both wills and trusts are effective tools to manage an estate.  They perform almost the same function: specifying who gets each of your assets when you die. However, there are some essential differences between the two, and it is important to understand those differences.

What is a Will?

A will is a written document—signed and witnessed in accordance with Oregon law, that indicates how your property will be distributed at the time of your death.

When it comes to costs, wills are usually cheaper to create, but more expensive down the road when beneficiaries have to probate the estate.   Probate is a court-supervised procedure for transferring the legal title of your assets after death to your beneficiaries and is an essential difference between a will and a trust.   Property bequeathed through a will must go through probate, while trust property is not probated.

Probate proceedings are a matter of public record and the process involves:  proving to the court that your will is authentic and valid; appointing a personal representative with authority to act on behalf of the estate; identifying and appraising the property of the estate; paying debts, taxes, and legal fees ; and distributing the remaining property to the beneficiaries in accordance with the will.  This process can be difficult and is time consuming, often taking a year or more.

A will is only effective upon death, and, therefore, does not provide assistance for asset management if you become incapacitated.

What Is a Revocable Living Trust?

A Revocable Living Trust (RLT) is a written agreement between the creator of the trust, called the settlor, and a trustee who agrees to hold assets for the trust’s beneficiary(s).  Typically, one person is all three: settlor, trustee and beneficiary.   The RLT addresses three distinct phases of a settlor’s life:  First, the trust makes clear that while the settlor is alive and well, he or she will serve as trustee and manage trust assets for his or her own benefit.  Second, if the settlor becomes incapacitated to the extent that he cannot manage his finances, the trust identifies a successor trustee, and directs the successor trustee how to manage trust assets. Third, the trust directs the successor trustee how to distribute remaining trust assets after the settlor dies.   The settlor retains all rights to manage and amend or revoke the trust while he or she is alive and legally competent.

While a RLT is more expensive to create than a will, it leaves fewer burdens on a spouse, children or other heirs later.   A RLT is not only private, it allows for quicker distribution to the intended beneficiaries, with far fewer administrative costs than the more expensive, public, and time consuming probate process.

When it comes to estate planning, there are no “one size fits all” plans.   You should first meet with an attorney and identify what is important to you and your family.  Only then will you know whether a will or trust is best for you.

Article Provided by: 
Kathy Belcher, 503-371-9636
McGinty & Belcher Attorneys

Status of Healthcare, a Nurses Perspective

We have all been hearing about the healthcare reform that is needed in our country, and it has been the subject of much debate between our Democratic and Republican leaders.  It is true that healthcare costs have risen dramatically, and in its current state, our healthcare costs will bring our country to its knees if left unchanged.  I do not intend to discuss how that should be done, but rather how you the consumer, and my patient should plan for success in the unsettled times ahead.

What do we know? 

Physicians: We know that beginning with this decade, there will be a large number of physicians retiring, and according to a recent Dartmouth College study, it will result in a future physician workforce will be smaller and younger.  This shortage will create strain on  our current systems, and will require physicians to change practice models in order to keep up with the increased demands.

Nurses:  According to the American Nurses Association, there is currently a national shortage of approximately 120,000 RN’s.  This number is expected to grow to 1.5 million by the year 2015, and peak in 2020.  This will require hospitals, and medical practices to do more with less RN support.

Hospitals/Nursing Homes:  Both hospitals and nursing homes are facing significant Medicare cuts, and will need to change their operational models, and reduce expenses in order to remain viable.  One major way for these institutions to reduce costs is to shorten length of hospitalizations/admissions to the shortest possible time, while still ensuring safe care.

What does this mean to you?

Our healthcare model as we know it will need to change.  The physician to patient, and RN to patient ratio’s will worsen, and you will have less time with the professionals that can best manage your care.  Hospitals and nursing homes will, as a necessity to survive, look to minimize their costs, and will shorten your hospitalization/admission times if possible.  You will have to assume more responsibility for managing your health/recovery in the outpatient or home setting.

What can you do?

While these above mentioned scenarios are ominous, I believe if you are prepared, and educated, you can make good decisions, and help your medical providers continue to provide you with excellent care.

1.  Be prepared when you see your doctor:  Understand that their time is limited, and they can best manage your care if you have pertinent data with you at your visit.  Medication lists, blood glucose readings, weights, or blood pressure readings are some examples of things that you should have when you see your doctor.  This will help them best manage your care.
2. Know the hospitals/nursing homes in your area.  Understand that Medicare is now basing their payments to these organizations based on their quality, and knowing which facilities are best can be critical to your recovery. Some web resources: www.healthgrades.com or www.medicare.gov/nhcompare

3. Know the assisted living providers in your area.  Ask for copies of recent state surveys.  Ask about caregiver to client ratios, and nursing coverage.

Things will change whether we want them to or not.  But if you are informed, and plan by being more active in managing your care, you can be successful.   I wish you and your loved ones a happy and safe summer.

Article Provided by:
Robert Estrada, RN
Sweet Bye N Bye Inc.
Adult Foster Care Homes, and Residential Care Facilities

Medical Screening: What Test Should I Get?

Screening tests attempt to detect disease before systems begin.  Therefore, it’s important to get the right screening test as part of a good preventative care plan. Tests should have adequate sensitivity and specificity to detect disease without excessive false positive; however, there is on-going research which conditions should be screened for and which tests to use.  As a result, recommended screening tests can change with time.

The tests listed here are recommended for the general population, but your doctor may recommend other screenings based on your personal history.  For example, colorectal cancer screening is recommended for both men and women ages 50 to 75 years of age.  If you have a sufficient family history of colon cancer, your first screening may be earlier and the frequency of the test may be more often.

Keep in mind that no tests are perfect.  Screening tests can be harmful to people.  A false positive test that can show a disease when there is not one present can lead to worry, anxiety, extra testing, and high cost.  A false negative test that shows normal when there is a disease present can lead to a false since of security.  Some screening tests are invasive and carry a small inch of their own complication.

With all of the negative reasons in mind, you may be asking yourself, “why would I want to get one of these tests?”  The short answer is they are efficient at detecting disease and just may save your life.  Many diseases are much easier to treat in an early stage.  Often, detection and treatment early in the disease can also prevent other types of disease from forming.  The following are the current common preventative care screening tests recommended by the United States Preventive Services Task Force (USPSTF):

• Height and Weight
• Blood Pressure
• Alcohol and Tobacco Use
• Depression
• Diabetes ( especially if you have high blood pressure)
• Bone Mineral Density Test: In women less than 65 years old and at risk women during the age of 60 – 64 years old.
• Cholesterol Pressure: Ages less than 35 years old or less than 20 years old. Those with cardiovascular risk factors.
• Colorectal Cancer: men and women ages 50 – 75 years of age.
• Mammograms: Every 1 – 2 years for all women ages 40 years and above
• PAP Smear Test: At least every 3 to 5 years until the age 65
• Chlamydia Infection: Sexually active women less than and equal to 25 years and older
• Aortic Abdominal Aneurysm: On time for men during ages 65 – 75 who have ever smoked
• HIV Screening: A voluntary routine screening for ages 13 – 64 years of age

Regardless of which screening tests you have, be sure to communicate with your doctor, share any health concerns and be mindful of changes in your body and overall health.

Article Provided By: Matthew Degner, MD Internal medicine
Cascade Medical Clinic: 1375 N 10^th Ave., Suite B 503-769-7151
Santiam Hospital Stayton, Oregon

What Really Causes Falls in Older Adults?

It is widely believed that older adults fall because they slip or trip on something. In a study conducted by Simon Fraser University in 2012 and released in the “The Lancet”, showed that only a small proportion, about 3% of falls are caused by slipping or tripping. While forward walking, sitting down and standing quietly were activities that most commonly preceded a fall.  These functions accounted for around 41% of the falls people had while the study was being conducted.

Many companies working with seniors offer fall prevention programs, but is prevention realistic? If someone were to come up with an idea to prevent people from falling, there would be an end to the many broken hips or other injuries that hospitals all over the nation treat on a daily basis because a person has fallen. Actually, it is about helping a person to become aware of why they fall so he/she can take action to correct the activity or behavior that may cause him/her to fall.

Balance, shifting of body weight and incorrect transfer from sitting to standing or vice versa is the real cause of most falls in older adults and is a result of poor judgment or over correction of body movements while walking or transferring from one activity to another. If I had a dollar for every time I have reminded a person to walk into their walker while moving about the building I would be a very rich woman. Though many people think an older person simply can’t react quickly enough to break a fall—or may not know they’re falling until it’s too late to prevent it—researchers discovered that was not typically the case.

Lessoning the risk of falls in older adults is more about maintaining upper body strength and balance awareness. When a person chooses to move to a long term care setting, they often give up doing things for themselves and are encouraged to allow care givers to do things for them. As providers of care for older adults it is our duty to ensure that independence is maintained as long as possible and ways for residents to exercise is provided so that body strength can be maintained. Programs should also be available to explain how the body works with gravity and to provide specific exercises such as Tai Chi that improves balance. In addition classes that provide brain training to improve focus and attention are key to minimizing falls.

Cathy Parkinson CQSW
Executive Director
United Methodist Retirement Center

How Are Your Dentures?

Properly fitting dentures are essential for good health and the well being of the person who has lost their natural teeth.  Dentures are a prosthetic replacement for natural teeth that helps with your ability to eat, speak and feel good about the way you look. Your teeth play an important role in your ability to digest food. Your teeth tear, and break down your food into manageable digestible pieces for your body to gain nutrition. Without your teeth you would not be able to enjoy many wonderful foods.

A denture can help you to speak using your tongue, cheeks, and teeth to form words. It is very difficult to pronounce your words correctly without your teeth. Try saying the following: “Six sisters went to church”, and “Mississippi” notice how your upper teeth and tongue cooperate to make the “s” sound and the “ch” sounds. Now try counting from forty to forty four, notice how your upper teeth and lower lip cooperate to make the “th” and “f” sounds.

Your front teeth help support our face. Your lips are held out by your anterior teeth, your canines provide a gentle curve to your face or define the bold square look that some find attractive in men. The molars support our cheeks. Your teeth keep your chin from touching your nose.

Over time the structure of the inside of your mouth, your tissues and bone level change. It is important that you have a denture that fits well, and that doesn’t cause sore spots. It is recommended that you have a new denture made every 5-7 years. Dentures are made of materials that will wear out over time. If the teeth in your existing denture are worn, it is important to replace the denture. The new, sharper teeth will allow you to eat and digest your food more efficiently. Sometimes a simple reline can help with the changing tissue structure in your mouth. There are several reasons for the changes in your mouth. Some reasons can include medication changes, weight gain or weight loss, illness, diseases of the mouth, or accident.

Your daily activities include eating, digesting, socializing, and speaking. All of these activities involve your teeth. It is important that if you are a denture wearer, you keep your dentures fitting correctly, or replace them when necessary. Your demeanor, attitude, and the way people see you depend on a properly fitting and functioning denture.

Written by Michael D. Harris DMD and Patricia A. Moniz EFDA
Dentures to You LLC
Toll Free: (855) 389-1025
Direct: (541) 992-2588

As a Holiday Retirement resident, you’re automatically eligible to stay at other Holiday locations by reserving a guest suite. We have over 300 retirement communities across North America. So wherever you’re going, chances are, we’re there too! It’s your home away from home, and it’s absolutely free!* You’ll feel at home no matter where you are because all of our communities have live-in management teams, delicious chef-prepared meals, exciting activities and events, exercise facilities, and so many opportunities to make new friends! Even if you’re not staying overnight, you are always welcome to make arrangements to dine at any one of our communities during mealtime. As a Holiday Retirement resident, you’ll always have great food and good friends – no matter where life takes you.

As a resident in one of Holiday Retirement’s independent retirement living communities, you maintain your independence, living in your own private suite, coming and going as you please, and making the choices that are right for you. That’s the benefit of independent retirement living. While we provide the service and safety of a retirement community, you spend your time how you want: making new friends, volunteering in the community, participating in numerous enriching activities, or simply relaxing with those close to you. The choice is yours. It’s independent retirement living…for how you want to live.

Holiday Retirement offers all the comforts and amenities you expect from a retirement community, including diverse activities and events, delicious chef-prepared meals, weekly housekeeping and linen service and convenient local transportation. We take care of the basics, so you can truly enjoy your retirement. But what makes Holiday Retirement stand apart from the rest, are those extra special touches. We offer residents an innovative travel program, a pet friendly environment and peace of mind with two management teams living on site, available around the clock. This is a place to call home, yet so much more.

To view all of our locations, please visit us online: holidaytouch.com

* A fee applies to our Hawaii locations. Only our communities that have guest rooms apply.
You may stay up to 7 days in one location at a time (subject to guest room availability).

Good Nutrition: A Key to Healthy Aging

Good nutrition plays an important role in how well you age. Eating a low salt, low-fat diet with plenty of fruits, vegetables, and fiber can actually reduce your age-related risks of chronic diseases. Eating a variety of foods will help meet your nutrient needs.

Protein- a part of all living cells
Make wise protein choices- choose more low-fat quality protein sources, such as poultry, fish eggs or egg substitutes, soy, and limited amounts of nuts and low-fat meat and dairy.

Carbohydrate- body’s preferred source of energy
Choose more complex carbohydrates, such as vegetables and whole-wheat grains. Choose fewer simple carbohydrates, such as sucrose (sugar added to sweets and desserts), fructose (sugar contained in fruit), and lactose (milk sugar). Get most of your carbohydrate calories from complex carbohydrates

Fats- provides the body with energy
Select “heart healthy fats”,  such as monounsaturated fats (in olive oil, avocados, and nuts), rather than “bad’’saturated fats (beef, pork, veal, whole milk, butter, stick margarine, shortening, and cheese) and “good” polyunsaturated fats (in liquid corn oil or soybean oil). Limit the Worst- Trans fats found in vegetable shortening; some margarines (especially stick margarines); commercially prepared crackers, candies, cookies, snack foods, fried foods, baked goods, salad dressings, and other processed foods. Replace fat calories with complex carbohydrates in your diet

Water- keeps the body hydrated and must be replaced daily
Aging causes the kidneys to become less efficient. Make a conscious effort to get six to eight  8 fluid ounce glasses of water daily

Maintain a healthy body weight.
Your body’s daily calorie needs slowly decrease with age. As you age you need fewer calories per day than when you were younger. This means you need adequate protein and less fat in your diet. To help your body maintain a healthy weight, eat enough protein, less fat and increase physical activity.

As you age your bones lose mineral content more rapidly than before. This is especially true if you are a post-menopausal woman. Lower estrogen hormones increase bone loss. You need adequate daily calcium to help prevent osteoporosis. Always consult your physician or health care provider when making changes in your lifestyle, but by incorporating some healthful nutrition strategies you may find improvement in your quality of life.

Article Provided by:
Avamere
(877) 282-6373
www.avamere.com