After one year of operation, two new Jewish Family Services programs are helping dozens of Kansas City seniors maintain their independence.

JET Express, which provides door-to-door transportation, and Help@Home, which provides home-repair and other services, allow seniors to avoid having to move out of their private homes and into assisted-living type facillities. Both are available to anyone in the metro area who meets certain criteria.

JET Express (JET is an acronym for Jewish Elder Transit) has provided more than 1,000 rides since September 2008, and the demand is increasing. For a flat fee of $2.50 each way, people 65 and older who have no other means of transportation and who are not wheelchair bound can call and get rides around town — to doctors appointments,  hairdressers, shopping, volunteer commitments, lunch with friends, cultural activities. “Any activity that keeps older adults active and independent (is eligible),” said Dawn Herbet, director of Older Adult Initiatives.

JET Express riders must call five working days ahead of the time they need a ride. The hours of operation are 8 a.m. to 9 p.m. Sunday through Thursday and 8 a.m. to 10 p.m. Friday and Saturday. Trips are limited to 30 miles round trip beginning at the driver’s home, unless it’s for medical purposes, in which case the 30-mile limit is waived.

“We can only give one ride a week at this time, until we get a larger cadre of volunteers,” Herbet said. “We’re hoping to go to two rides soon.”
Ruth Forman and her mother, Phyllis Forman, use JET Express on Friday nights to attend Congregation Beth Torah’s Shabbat service.

read on

By Meredith Moss, Staff Writer

KETTERING —The idea is to deliver a “holiday in a box.”

“Hanukkah is the festival of light, and we’re trying to bring light into our seniors’ homes,” says Deva Zwelling, assistant executive vice president of the Jewish Federation of Greater Dayton. “The older people get, the harder it may be for them to get out to our communal activities. We want to keep them connected, so we bring the holiday to them.”

The festive eight-day holiday, which begins tonight, Dec. 11, at sundown with the lighting of the menorah, celebrates religious freedom. An additional candle is lit each night until all eight are burning.

Read on

By Bob Moos

Seniors battered by the tough economy are selling their life insurance policies to replenish their retirement nest eggs.
Unlike younger investors, older adults may not have the time to wait for the market to recover all of their losses, so they’re turning to this previously overlooked asset to see whether they should sell it and use the money to pay medical bills or other expenses.
Seniors sold life insurance policies with a face value of $11.8 billion last year, almost double the value of policies sold just two years earlier, according to the U.S. Senate’s special committee on aging, which recently held a hearing on such transactions.
A "life settlement," as a sale is called, may be an attractive option for seniors who determine they no longer need their life insurance policy, said Doug Head, executive director of the Life Insurance Settlement Association, an industry group.
Policyholders typically sell their insurance through life settlement brokers to investment companies for lump sums that are usually several times greater than they would receive if they surrendered the policies to the insurance companies, he said.
The new owners pay the remaining premiums on the policies and become the beneficiaries when the original policyholders die.
But a life settlement doesn’t always make sense, insurance experts caution, and seniors considering such a sale should consult with an independent financial adviser to figure out whether it’s the best move for their particular circumstances.
"If you’re thinking about selling your life insurance mostly because you’re strapped for cash, there may be other ways to tap the value of your policy without losing your coverage," said Houston lawyer and insurance expert David McDowell.
"You may be able to take out a loan against your policy or receive a partial payout through an accelerated death benefit," he said. "It’s worth visiting with your life insurance agent and exploring the options before sacrificing your coverage."
Life settlements are also ripe for questionable business practices, so prospective sellers need to work with licensed brokers screened or monitored by state regulators, said Susan Voss of the National Association of Insurance Commissioners.
STARTED IN AIDS CRISIS
The life settlement business grew out of the AIDS crisis of the 1980s. In what were called viatical settlements, people living with AIDS sold their unwanted life insurance policies for cash they often used to cover medications or treatments.
As medical breakthroughs extended the lives of many people with AIDS, the industry shifted its focus from the terminally ill and toward seniors in their mid-60s or older, said Scott Gibson of Lewis and Ellis, an actuarial consulting firm in Richardson.
"The best candidates for a life settlement are now people in their 70s or older who have a life insurance policy valued at $500,000 or more that they no longer need, perhaps because their spouses have passed away," Gibson said.
The industry hit a bump earlier this year as capital dried up. But now that investors are returning to the market, buyers’ offers for policies have improved, said Russel Dorsett, co-managing director of the Select Life Settlement Corp. in Houston.
Though the amount that seniors receive for their life insurance will vary depending on their age, gender and overall state of health, the average payout today is slightly less than 20 percent of the policy’s death benefit, he said.
"That’s still three or four times more than they’d get if they simply surrendered their policies to the insurer," Dorsett said.
Bill Clark, managing director of the Clark Financial Group in Frisco, said he sees a number of circumstances in which older policyholders may want to consider a life settlement as part of their retirement and estate planning.
"A policy may not be needed anymore," he said. "The beneficiaries may have become financially independent and aren’t counting on the policy’s proceeds, or the policyholder determines the estate no longer needs life insurance to pay death taxes."
COMPLEX TRANSACTION
As more people become aware of life settlements through financial planners, Clark said, more policyholders will at least check out the price they could get for an asset they once regarded as virtually untouchable until death.
Still, selling a life insurance policy is often a complex transaction involving time and paperwork, so consumers should turn to financial advisers who know the risks, said Ana Smith-Daley, a deputy insurance commissioner for Texas.
"An independent adviser can help you decide whether selling your policy is in your best interest," she said. "If it is, the adviser will probably call on a broker to shop around your policy to determine what kind of price it will fetch."
Seniors also need to understand that their medical records will be examined as part of the sales and that the buyers of their policies will occasionally check on them to determine when to collect the death benefits, she said.
"In this buyers’ market, investors are looking for the individuals most likely to die," said Stephan Leimberg, editor of Tools and Techniques of Life Settlement Planning. "They want you old and ripe. That way, they’ll pay the fewest premiums and get the best return on their investment."
Smith-Daley said sellers may also pay taxes on the proceeds from a life settlement and lose their eligibility for Medicaid or other government benefits, so anyone contemplating a sale should consult a tax adviser or lawyer.
But even with those considerations, industry officials expect life settlements to exceed $100 billion over the next couple of decades as boomers convert unwanted or unneeded life insurance to cash to bolster their lagging savings.
"Under the right circumstances, it’s a viable and valuable option that will only become more popular," Gibson said.

BEFORE YOU SELL

What to consider before selling your life insurance:
PROS:
- You have no other assets and need the money.
- Your beneficiaries don’t need the death benefit.
- You can’t afford your premiums anymore.
- Your payout will be higher than your policy’s cash surrender value.
CONS:
- You may be unable to buy life insurance again.
- Your beneficiaries won’t receive the death benefit.
- You won’t get a fair price for your policy.
- Your payout may be less than 20 percent of the death benefit.
SOURCE: Dallas Morning News research

"We need to protect Medicare," Republican National Committee Chairman Michael Steele exhorted last week, "and not cut it in the name of ‘health-insurance reform.’ " It was a rousing defense of government-run health care from the . . . conservative chairman of the GOP. But incoherence doesn’t necessarily make for bad politics. In this case, Steele was aiming his message directly at America’s seniors. Lucky for him, they share his incoherence in full.

In late July, President Obama recounted a letter from a woman who told him, "I don’t want government-run health care, I don’t want socialized medicine, and don’t touch my Medicare." The president chuckled. "That’s what Medicare is," he protested at an AARP town hall. "A government-run health-care plan that people are very happy with."

Jokes aside, the White House is struggling to attract seniors to health-care reform. No age group is as solidly opposed to the project as the over-65 set. But that’s the same set that relies on government-run health care and loves it.

That’s not how it’s supposed to work; successful government programs are supposed to create constituencies for their expansion. But the happy experience of Medicare has made seniors less, not more, open to a generous welfare state. It hasn’t created advocates for more single-payer health care; it has created advocates just for Medicare. And they fear that health-care reform will endanger Medicare.

Resolving this tension could decide the future of Obama’s make-or-break domestic policy push. The opposition of seniors matters. Older people vote in bigger numbers than younger people do; they’re more likely to call their representatives or attend a town hall meeting. Most important, says Robert Blendon, a Harvard scholar who studies public opinion on health care, "they make off-year elections. The secret about Congress and health policy is that in 2010, there will be a lot more seniors at the polls than there were in 2008."

Just ask Bill Clinton. In September 1993, the strongest supporters of his plan to reform the health-care system were seniors. A solid 62 percent approved of his efforts. By April 1994, the president had lost 25 points among seniors, and they were his weakest backers. "In the Clinton plan, it didn’t come out till later that the financing came substantially from Medicare," Blendon says. But once it did, seniors revolted. In that fall’s midterm elections, Democrats lost more than 50 seats in the House. Seniors were a big part of the reason — giving Republicans 51 percent of their votes.

Seniors are moving in a similar direction this year. A Washington Post-ABC News poll this month found that only 35 percent of people 65 and older approved of Obama’s handling of health care. Compare that with 44 percent of respondents between the ages of 30 and 64, and 57 percent of 18- to 29-year-olds. More telling, only 8 percent of seniors thought reform would improve their health care, while 42 percent thought their care would get worse. All this despite the fact that a staggering 94 percent of seniors are satisfied with the quality of care they receive, and Medicare polls much better than the private health insurance market.

What are seniors so afraid of?

From the beginning, Medicare has been named as one of the potential sources of savings that would fund subsidies for the uninsured. That sounds like service cuts, even if the specific changes don’t involve anything of the kind (most of the savings would come from reducing overpayments to the private insurers that participate in the Medicare Advantage program).

So the fear is not of a welfare state but of changes in their welfare state. The result is that the coalition against reform is an odd union between people opposing government-run health care and people defending government-run health care. It’s a potent combination.

Seniors are also the most conservative segment of the population and are getting more so. They constitute not only the sole age group that Obama lost in last year’s election, but also the sole age group in which his results were worse than those of John Kerry in 2004. And both Obama and Kerry underperformed Al Gore’s 2000 results.

"The Roosevelt seniors are being replaced by the Reagan seniors," says Paul Begala, who helped run Clinton’s 1992 campaign. A May poll by the Pew Research Center found that for the first time in 20 years, the GOP is now an older party than the Democrats.

The June Post-ABC poll asked whether respondents would prefer a smaller government with fewer services or a larger government with more services. Seventy percent of seniors — the segment of the population with government-run health care and a government pension, also known as Social Security — preferred a smaller government, compared with 37 percent of people 18 to 29. Seniors are the age group most solidly opposed to the public option. In fact, in the August Post-ABC poll, they were the only age group in which a majority opposed it. "Seniors are like the American West," says Julian Zelizer, a Princeton historian. "They depend on government and then say they hate it."

But taken as a whole, the attitudes seniors express on health care are arguably the greatest vote of confidence anyone has offered reform. Seniors live in America’s version of Canada. They have single-payer health care. And they love it. They love it so much that they’ve got the chairman of the RNC swearing to protect it.

By Paula Span

My friend Diane Fener, an attorney in Virginia Beach, Va., maintains a busy schedule when she travels to New England to see her parents.

“I make the circuit,” she said. She visits her mother, who for two years has lived in the dementia unit of an assisted living facility in Rhode Island. She visits her father in his apartment about a half-hour away in Massachusetts. And his second wife, Ms. Fener’s stepmother, in a nearby nursing home; she, too, has dementia. And the man who was her mother’s second husband for nearly 20 years.

“Four stops,” Ms. Fener said. “I don’t get as much time with each of them as I’d like.”

This is the aftermath of a spike in the divorce rate that struck in the 1970s. States liberalized their divorce laws, working women became less inclined to remain in unsatisfying marriages, the cultural stigma of divorce faded — and 30 years later, the grown children of these broken marriages are dealing with the unanticipated consequences.

“It adds another layer of complexity to an already complex and emotional situation,” said Suzanne Mintz, president of the National Family Caregivers Association.

U.S. Census Bureau data shows how much more common this scenario has become than in decades past. In 1960, about 4 percent of people over 60 were currently divorced or separated; by 2000, the proportion had climbed to more than 9 percent of men and 10 percent of women.

A higher proportion of the 60-plus population is currently married now, in part because lengthening lifespans mean that fewer become widowed (PDF). But many of those are second or third marriages, according to census data: among men over 50 who’d ever been divorced, almost 56 percent were married in 2004, as were 40 percent of ever-divorced women.

Which can create some thorny situations.

Years after parents split, their children may wind up helping to sustain two households instead of one, and those households can be across town or across the country. Further, unmarried women (whether single, widowed or divorced) face significantly higher poverty rates in middle and old age, according to a study by the Institute for Women’s Policy Research (PDF) that AARP published last year.

Diane Fener and her sister and brothers each contribute money to support their mother and father. “I don’t resent any of it,” she said, “but if they hadn’t gotten divorced, their budgets wouldn’t be as strained.” Neither would their offspring’s.

With remarriages, moreover, the cast of characters increases. Children may find themselves caring for three or four older people instead of one or two, dealing with several sets of doctors, social workers, accountants and attorneys. And with stepsiblings, sometimes a squadron of them.

“There are more people to share some of the burden, but also more people to negotiate with,” said Xenia Montenegro, author of an AARP report on midlife divorce (PDF). “You may have more sources of support, or more sources of conflict.”

Consider my friend Linda Engelhardt, a New Jersey photo stylist, who has spent much of the past year coping with four elderly people, aged 80 to 89, all with serious health problems. As the child geographically closest to both her father, who died in March, and stepmother in Westchester County, N.Y., and to her mother and stepfather in New Jersey, she’s often the caregiver on the scene. But nine other children — her own three siblings, her stepmother’s three kids and her stepfather’s three — voice opinions, ask favors, get involved in decisions.

Sometimes it all works reasonably well. When Ms. Englehardt’s mother and stepfather were both hospitalized, she was in frequent touch with a stepsister in Connecticut. But now, after a subsequent dispute, they haven’t spoken in six months. “I was there for her when her dad was in need, but when I needed help for my mother, she wouldn’t get involved,” Ms. Englehardt said. “It’s a strange situation.”

Here’s another: Diane Fener’s divorced parents, both 88, for years were so at odds that they couldn’t be seated together at their grandchildren’s birthday parties. Recently, though, they’ve become close again. He visits her regularly; she recognizes and trusts him. After years of Alzheimer’s disease, Ms. Fener said, “She was gradually forgetting more and more. And somewhere in there, she forgot she was sore at him.”

As these people grow older, many will choose to continue living on their own or may decide to move in with family.

However, some will prefer to reside with people closer to their own age or will, by necessity, need to live in a facility that can cater to their changing medical needs.

What should you keep in mind if you must choose an eldercare facility for yourself or a loved one?

The Minnesota Society of CPAS (MNCPA) offers some tips.

Know your options

There are several types of facilities available.

Independent living options are generally intended for healthy people who want to live among other seniors in a community designed for them.

Assisted-living arrangements are meant for those who are relatively healthy but who may need help with meal preparation, personal care or other needs. At the other end of the scale are nursing homes, which generally have 24-hour medical care available and are intended for those with more serious health problems and will require regular care and attention.

What’s best for your loved one?

Your choice, of course, will depend on the current state of your older relative’s health and what changes you might expect in their situation in the near future.

In other words, there’s no need to pay more for a facility that offers round-the-clock nursing care if it’s not necessary now, but that may be a worthwhile expense if the senior has health problems.

Check the quality

Many people find eldercare facilities based on recommendations from others with family members in those facilities.

While this is a great starting point, the only way to make a final decision is to visit the facility yourself and draw your own conclusions.

Immediately on arrival, you will be able to judge whether the buildings and grounds are tidy and well maintained and seem cheerful and inviting.

Ask whether a registered dietician or nutritionist plans meals and tour the kitchen to see if it is clean and orderly.

Spend some time at the facility to see if the staff seems consistently friendly and caring to residents.

Consider location

Some seniors are reluctant to change residences, while others consider a move to be a welcome relief after years of maintaining a home.

In either case, most seniors usually favor a facility that is near to their family and friends.

To find a facility in your desired location, go to www.eldercare.gov.

Check resources

More information on choosing an eldercare facility can be found on the Web site of the U.S. Administration on Aging at www.aoa.gov and on the Medicare site under “Compare Nursing Homes in Your Area” (go to www.medicare.gov).

Medicare’s “Guide to Choosing a Nursing Home” also contains useful advice on how to pay for one of these facilities.

Know your options

Keep in mind that moving into a facility may not be necessary.

Many communities offer services for the elderly, home health care aides or adult day care centers.

A medical professional or a hospital social worker or discharge official can provide some advice on alternative choices.

Information and resources are available at www.mncpa.org/information and at MyTaxTime.com, which includes tax and financial planning information for individuals and small businesses.

A free CPA referral service is also available on the Web site or by calling 1-800-331-4288.

By Naomi Creason, Sentinel Reporter

Adult children find difficulties in making meals for senior parents, especially those with medical and nutritional needs.

It will be 2011 when the first wave of baby boomers hit 65.

The number of people 65 and older has leveled off since 1990, but in a June study, Pew Research Center said that age group will start rising again when the first of 76 million baby boomers become senior citizens.

The research center projects that by 2050, 1 in 5 Americans will be over the age of 65 and about 5 percent will be older than 85 – up from 2 percent now.

The increase in those numbers means an increase in the number of adult children who are taking care of both their kids and their parents, according to Pew Research. Though the number of aging parents receiving financial aid from their adult children is fairly low – 14 percent compared to the 51 percent who still give money to their children – the help that these parents seem to seek from their kids revolves around household chores and errands.

Kurt Kay found that one of the tasks families need the most help with is preparing meals.

“For our caregivers, a lot of (the work) is cooking meals for them,” Kay said of his business, Home Instead Senior Care, which focuses on care-giving services for seniors who try to live independently at homes or in residential facilities in Cumberland and Perry counties.

“Family members are very concerned about the food their seniors eat,” Kay said.

Home Instead, located at 5002 Lenker St., Mechanicsburg, estimates that 83 percent of its caregivers help with groceries or other errands and 65 percent assist with meal preparation.

But according to directors from area senior residential facilities, cooking for a parent does not have to be an unrewarding job. The key is to keep things interesting.

Know their tastes

Jeremy Fry has worked in the senior care industry for six years. Now the director of dining services at The Woods at Cedar Run in Lower Allen Township, Fry believes that to get a good handle on how to prepare meals is to get a good handle on who you’re cooking for.

“I think the best thing you could do is get to know what the resident likes to eat,” Fry said. “It’s not just about what they’re allergic to, but it’s also about what they just don’t like to eat.”

It’s a simple but important question to ask for Fry, who serves

about 135 residents more than 10,000 meals a month. Personal taste, however, isn’t always cut and dried.

“It’s hard cooking for someone who remembers what his or her mom’s cooking used to taste like,” Fry said. “Especially with them aging, their taste buds disappearing and the medications that make food taste differently, the food won’t always taste the same way, and everyone is always very critical about food.”

Much as his residents want the same food from their childhoods, they also keep the same eating habits they had as a child.

That’s one of the reasons why John Bowen, director of social services at Bethany Village, is intent on keeping portion sizes healthy.

“One thing the residents hate is wasting food,” he said. “A lot of them grew up in the Great Depression, so they want to clear their plates. Plus they’re paying for the food, too. So we control portion size. We do ask them when they get here if they prefer small, medium or large portions.”

Portion sizes may be a bit of a change to what seniors are used to, according to Fry, who took note of what portion sizes are like now at a lot of restaurants.

“I think the biggest challenge for them is the portion size,” Fry said. “You go to a restaurant and order a New York strip and you get 12 ounces of beef, but we have guidelines for our portions. Our beef and chicken is 3 to 4 ounces – that’s the biggest size for them.

“At first they think it’s too small, but eating it, they realize it’s the size they can eat. We don’t want to waste anything, and they don’t want to waste anything – it’s their money that we’re spending.”

Take control

That kind of control over food intake is important for both the directors and individual adult children trying to take care of their loved ones. Portion size is just one area that can lead to healthier diets.

Fry found that controlling the ingredients in the food can also help seniors eat healthier.

“I think when you make it yourself, you know what you’re putting into it,” he said. “We don’t add any salt here, unless we’re baking and the recipe calls for it. We use a low sodium base. Salt isn’t supposed to be the flavoring.

“If I’m making a cream of broccoli soup,” he said, “I want the first thing they taste to be broccoli, not salt. If you buy raw items and make it yourself, you can control what goes into it.

“There’s an old saying to shop around the outer edge of the grocery store, because that’s where the produce, meats and dairy products are,” he added. “Get the vegetables and fruits that are in season – they’re usually better and cheaper than frozen vegetables.

“If you get a whole chicken, you can make two or three meals at home from that. You can eat some of the chicken and then use the legs for another meal. It’s cheaper to buy the whole chicken than to buy the sliced portions at the grocery store.”

Creativity is also a crucial component in keeping loved ones interested in what they’re eating.

“We try to show our creative side,” Fry said. “When you have a captive audience like this, you don’t want to keep doing the same thing over and over. But they do want consistency.”

Warning signs of poor eating

So how do you know if someone isn’t eating right? These 10 warning signs are red flags that may signal a potential problem in senior citizens:

1. Loss of appetite.

If the person has always been a hearty eater but no longer eats as he or she used to, it’s time to find out why. Underlying illness could be the root cause.

2. Little to no interest in eating out.

If your loved one has always loved eating out at a favorite restaurant but no longer shows interest, lack of nutrition may be the problem.

3. Depression.

Change in appetite is a classic sign of depression. Be sure to follow up with a physician if you suspect depression may be a problem.

4. Sudden weight fluctuation.

A weight change — losing or gaining 10 pounds in six months — is another sign that something could be amiss.

5. Expired or spoiled food.

Check the refrigerator for expired or spoiled food. Older people could be saving food until it’s no longer safe. Make sure that all food is labeled with the date, in large letters and numbers.

6. Skin tone.

Observe the person’s skin tone. If they are eating properly, the skin should look healthy and well-hydrated.

7. Lethargy.

If your loved one has regularly been active and enjoyed taking walks but suddenly becomes lethargic, encourage him or her to see a doctor. Poor nutrition could be to blame.

8. Cognitive problems.

Seniors who live alone might forget to eat. Dementia and cognitive problems can lead to nutritional deficiencies. Quick intervention is vital.

9. More than three medications.

Medication can influence both appetite and weight. Check with the person’s doctor to find out if the medications could be the culprit.

10. A recent illness.

Illness or a hospital stay could make a senior stop eating. Keep tabs on your loved one’s recovery, making sure he or she has reliable help at home.

Senior shopping list

They may seem like common staples for any healthy diet, but the following 12 foods hold special nutritional value for senior citizens.

These items were developed by Home Instead Senior Care in cooperation with nutrition experts at Duke University Medical Center and the University of Maryland.

Seniors are asked to consult a doctor before beginning any diet or nutrition program.

1. Oatmeal

A great source of soluble fiber, oatmeal has been shown to help lower blood cholesterol and may reduce the risk of heart disease and stroke.

2. Eggs

With only 75 calories per serving, eggs contain 13 essential vitamins and minerals, including vitamin D, which is important in absorbing calcium needed for bone strength. Lutein and zeaxanthin found in egg yolks may reduce the risk of cataracts and help prevent macular degeneration.

3. Yogurt

Rich in calcium, yogurt can contribute to the calcium requirement needed to prevent osteoporosis. Good bacteria is added to some yogurt, which may help people with digestive problems that often accompany aging. Mixing yogurt with fortified cereal provides added vitamins, including vitamin B12, which many seniors have difficulty absorbing from foods that naturally contain that vitamin.

4. Blueberries

These blue beauties are among the top fruits and vegetables for antioxidants. Research on aging and Alzheimer’s disease reveals that blueberries may also improve memory and coordination.

5. Apples

The benefits of apples are too numerous to name. The pectin in apples supplies galacturonic acid to the body, which lowers the body’s need for insulin and may help in the management of diabetes.

6. Fish

Bluefish, mackerel, salmon, sardines, trout and tuna (bluefin and albacore) are a low-fat, high-protein source of nutrients. The American Heart Association recommends fatty fish twice a week to improve heart health.

7. Chicken

Poultry is an excellent source of protein that contains less fat than most meats. Chicken, especially breast meat, contains half the fat of a steak. Chicken also has niacin and selenium, which possess cancer-fighting properties.

8. Broccoli

A good source of multiple nutrients including vitamins K, C, E, B, and calcium and iron, broccoli has been found to protect against cancer, heart disease, stroke and macular degeneration.

9. Soy (edamame)

Nutritionists recommend consuming up to one serving a day of soy as a replacement for foods high in saturated fats. Some studies have shown that soy improves bone health. Be sure to consult your doctor before adding soy to a senior’s diet.

10. Sweet potatoes and squash

Sweet potatoes provide beta carotene and vitamins C and E, all of which promote healthy skin, hair and eyesight. Squash is a good source of beta carotene and vitamin C.

11. Rice

As a complex carbohydrate, rice digests slowly, allowing the body to utilize the energy released over a longer period, which is nutritionally efficient. Rice has low sodium content and contains useful quantities of potassium, the B vitamins, thiamin and niacin. Rice contains only a trace of fat, no cholesterol and is gluten free, so it’s suitable for people with celiac disease.

12. Dark chocolate

Consumed in moderation, this high-calorie, high-fat food has been found to boost HDL cholesterol (known as good cholesterol) and lower blood pressure.

As a result of the study showing the stress on family caregivers to provide and cook food for their loved ones, Home Instead Senior Care has developed a “Cooking Under Pressure” handbook, promoting healthy, stress-free grocery shopping and meal preparation tips and recipes.

Some of the tips include creating a shopping list so seniors regularly have healthy ingredients, collecting interesting recipes and making sure seniors have the companionship they need to make mealtimes and shopping enjoyable.

The handbooks are free through the Mechanicsburg Home Instead office by calling 582-2734, and are also available on the Web site www.foodsforseniors.com.

Over the years, while responding to medical emergencies, I’ve encountered many people who are caregivers. That is to say they are in charge of caring for another individual, mostly family members, spouse, siblings, elderly, parent, or child, who are mentally or physically unable to care for themselves. This situation is more prevalent in today’s society due to the aging population of baby boomers. In fact, the national family care givers association estimates more than 50 million care givers in this country.

It is a stressful job to care for people who are afflicted with any number of chronic ailments or illnesses such as Alzheimer’s.

Caregivers’ burnout is a state of physical, emotional, mental, and financial exhaustion that may be accompanied by a change in attitude- from positive and caring to negative and unconcerned.

Burnout can occur when caregivers don’t get the help they need, or if they try to do more than they are able either physically or financially. Caregivers who are "burned out" may experience fatigue, stress, anxiety, and depression. Many caregivers also feel guilty if they spend time on themselves rather than on their ill or elderly loved ones.

The symptoms of caregiver burnout are similar to the symptoms of stress and depression. They include:

• Withdrawal from friends, family and other loved ones.
• Loss of interest in activities previously enjoyed.
• Feeling blue, irritable, hopeless and helpless.
• Changes in appetite, weight, or both.
• Changes in sleep patterns.
• Getting sick more often.
• Feelings of wanting to hurt yourself or the person for whom you are caring.
• Emotional and physical exhaustion.
• Irritability.

Caregivers often are so busy caring for others that they tend to neglect their own emotional, physical and spiritual health. The demands on a caregiver’s body, mind and emotions can easily seem overwhelming, leading to fatigue and hopelessness — and, ultimately, burnout. Other factors that can lead to caregiver burnout include:

• Role confusion. It can be difficult for a person to separate the role as caregiver from the role as spouse, lover, child or friend.
• Unrealistic expectations. Many caregivers expect their involvement to have a positive effect on the health and happiness of the patient. This may be unrealistic for patients suffering from a progressive disease, such as Parkinson’s or Alzheimer’s.
• Lack of control. Many caregivers become frustrated by a lack of money, resources, and skills to effectively plan, manage, and organize their loved one’s care.
• Unreasonable demands. Some caregivers place unreasonable burdens upon themselves, in part because they see providing care as their exclusive responsibility.

Here are some steps you can take to help prevent caregiver burnout:

• Find someone you trust, such as a friend, co-worker, or neighbor, to talk to about your feeling and frustrations.
• Set realistic goals, accept that you may need help with care giving, and turn to others for help with some tasks.
• Be realistic about your loved one’s disease, especially if it is a progressive disease such as Parkinson’s or Alzheimer’s.
• Don’t forget about yourself because you’re too busy caring for someone else. Set aside time for yourself, even if it’s just an hour or two. Remember, taking care of yourself is not a luxury. It is an absolute necessity for caregivers.
• Talk to a professional. Most therapists, social workers, and clergy members are trained to counsel individuals dealing with a wide range of physical and emotional issues.
• Take advantage of respite care services. Respite care provides break for caregivers. This can range from a few house of in-home care to a short stay in a nursing home or assisted-living facility.
• Know your limits and do a reality check of your personal situation. Recognize and accept your potential for caregivers burnout.
• Educate yourself. The more you know about the illness, the more effective you will be in caring for the person with the illness.
• Develop new tools for coping. Remember to lighten up and accentuate the positive. Use humor to help deal with everyday stresses.
• Stay healthy by eating right and getting plenty of exercise and sleep.
• Accept your feelings. Having negative feelings, such as frustration or anger, about your responsibilities or the person for whom you are caring is normal.
• Join a caregiver support group. Sharing your feelings and experiences with others in the save situation can you help you manage stress, locate helpful resources, and reduce feelings of frustration and isolation. The internet is a great tool for finding such support groups.

Tribune Staff Writer

Patient and caregiver describe how they cope.
SOUTH BEND — Phil Reinoehl recalls how Alzheimer’s disease drifted into his life.
After a normal day at work a year and a half ago, he says, he returned to his South Bend home and fell asleep. When he awoke, he couldn’t remember how to turn on his computer, pay bills or tell the difference between his microwave oven and a cupboard.
The years had taught him that "avoiding things doesn’t help." So he went to a psychiatrist, who told him he may have had a vitamin B deficiency and gave him a shot of B. Doctors then ran tests on him, including an MRI brain scan, and found that he likely had Alzheimer’s. All he understood of the disease was that "you can’t do anything, and then you die."
Reinoehl shared his tale in front of a few dozen people who Memorial Hospital gathered Tuesday for a "community plunge" to learn about the disease and dementia. They were from businesses, health care and education, along with family caregivers.
After his diagnosis, Reinoehl fell into a deep depression for the next few months.
"I was 58 at the time," he says. "All I wanted to do was live and die. It really was a very empty feeling."
Then he hit a turning point and decided to be proactive.
Reinoehl says he sets a daily routine because he has trouble remembering what he’ll be doing the next day.
"I don’t know completely what I did yesterday," he says. "I know I was baby-sitting my grandkids, but the details I couldn’t tell you completely."
Still, he professes: "I’m very hopeful about the future. … It’s a heck of a lot easier to live with this than to live against it."
Reinoehl’s talkative personality shines through, plus a sense of humor. But he’s felt at times as though, in groups, people avoid talking with him.
"I think I need to be challenged and to challenge myself to take care of myself," he says, feeling that he’d go downhill quickly if other people took care of everything for him.
Caregiver’s challenge
In another family, Janice Owens looks at that care from a different perspective. She’s the caregiver for two men in much more advanced stages of Alzheimer’s: her husband and her father. She’s grateful for the care her dad Raymond receives at Madison Center’s Providence House and that her husband Robert gets at Ironwood Hills Assisted Living.
It’s important, she says, to be sure the caregiver doesn’t become too isolated. She quit her job to care for both men, such an absorbing task that she soon lost contact with her friends.
"Even a trip to the store becomes very, very difficult," she says.
As Owens put it, they are "the two most important men in my life." She has legal guardianship of her dad, who is 89, and power of attorney for her husband, who is 79.
The reality that both have the disease has shaken her up even more, she says, than Sept. 11, 2001, when she was just a block away from an airplane’s crash into the Pentagon.
"I heard, saw and smelled carnage," she recalls of that terrorist act.
She says she wouldn’t have been able to talk to the "community plunge" group four months ago. She’d just moved her husband into Ironwood Hills. It was the right thing to do, but she was grieving the loss. After 37 years of marriage, Robert was out of their home.
"It was official," she recalls. "I had to find a new way to make the relationship work."
Robert was diagnosed in 2006. She’d been noticing the signs of it.
Her father Raymond had mental lapses that her mother had covered up. But, as her dad drove her mom and aunt to a family gathering in 2006, he became confused and stopped the car over a railroad tracks. A train was speeding toward them. Her mom and aunt screamed, and he came to his senses in time to drive on.
The stress of that event caused her mom to have a heart attack the next day. A month later, her mom was lying on the floor. Her dad lay at her side "to be with her." He didn’t think of calling 911, or that it was even necessary, Owens says. By the time he called a relative the next day, she’d died.
This was a man, Owens says, who’d served as radio operator in the Army, had an IQ of 130 and could read Morse code at one time.
After a lot of talking with family members, she had him tested a year ago, confirming that it was Alzheimer’s.
Her advice: Don’t give in to denial about the disease.
Then reach out for help.
"I’ve come in contact with a multitude of people in the community who’ve lent a hand to me," she says. "You don’t need to sit at home and suffer with it alone. … There is so much in this community. You can always put your hand out, and there will always be a hand to reach back to me and pull me up."

By Brittany Pieper

LUBBOCK, TX (KCBD) – If you’re retired, health care costs keep increasing and now the amount you take home from Social Security is about to decrease. It’s a reality many senior citizens face today. Last week the government announced seniors will not see a cost of living adjustment in their Social Security checks for the next two years. This is because cost of living is actually down due to lower gas and energy prices, but many seniors say their costs are actually still going up.

"It worries a lot of people," said Robert Rouse who is a retired Texas Tech economics and finance professor. Thanks to his career, his financial future is stable, but he says many of his peers do not have that same comfort.

A large number of senior citizens who depend on Social Security will have to tighten their budgets soon. For the first time in years they will not see a cost of living increase in their Social Security checks. That coupled with rising Medicare drug premiums means many will actually get a smaller take-home check. "If their incomes don’t go up, the fact that medical payments have increased is going to actually reduce their standard of living," said Rouse.

Darleen West receives Social Security and said, "I’m disappointed of course. I think everybody is who is on Medicare, and we’re all very concerned about the increased cost of medical care, very much so." West says seniors cut some of those medical expenses by doing their homework. "Check with your doctor about pharmaceuticals that can be generic," she said.

Rouse says another solution is downsizing to decrease your cost of living.

He hopes the government will be able to control the problem of rising costs as they work to reform healthcare. "Contact your congressman and say we need to have an additional amount as far as this is concerned," said Rouse.

Texas Tech Finance Professor, Scott Hein, says the best way to deal with a smaller check may just be basic budgeting, "Be price conscious, and look for those deals that you can really help yourself out by buying things that are more reasonable. Substitute the cheaper stuff for the more expensive stuff."

While many seniors are concerned about the state of Social Security, Hein says it’s younger people who should really worry. He thinks post Baby Boomer generations should start saving now because you may not be able to count on Social Security the way seniors do today.