Planning for the Last Chapter of your Life

It’s one thing to plan for your retirement; it’s another to plan for the last years of your life.

Dr. Lee Ann Lindquist, chief of geriatrics at Northwestern University’s Feinberg School of Medicine, wondered if people could become better prepared for such emergencies, and so she designed a research project to find out and so with the help of Patient Centered Outcomes Research Institute, she started a web tool that helps, as she says, “plan for the period before the end, when health problems become more common.”

Click here for this great assessment tool for individuals, family members and caregivers.

Plan Your Lifespan

Looking for help planning or assessing your current lifestyle and health needs? Broad Street can help. We provide Personal Assistants who can help manage overall healthcare and awareness. Through our Professional Network we can help you find the right resources and doctors to help answer questions or identify areas of concern. We provide home care in Wilmette, the North Shore area of Chicago. For more information, please call 847.728.0134.

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Looking out for Vitamin B12 Deficiency

It was once said that a person with normal eating patterns, living in the developed world, shouldn’t be concerned about vitamin deficiency. In our modern world however, it’s not always that simple. One’s age, their prescription medications and their lifestyle can all challenge one’s level of vitamin intake. According to Patrick J. Skerrett writing for Harvard Medical School’s Health Publication, Vitamin B12 Deficiency can be sneaky and harmful.

What harm can having too little of a vitamin do? Consider this: Over the course of two months, a 62-year-old man developed numbness and a “pins and needles” sensation in his hands, had trouble walking, experienced severe joint pain, began turning yellow, and became progressively short of breath. The cause was lack of vitamin B12 in his bloodstream, according to a case report from Harvard-affiliated Massachusetts General Hospital published in The New England Journal of Medicine. It could have been worse—a severe vitamin B12 deficiency can lead to deep depression, paranoia and delusions, memory loss, incontinence, loss of taste and smell, and more.

What does vitamin B12 do?

The human body needs vitamin B12 to make red blood cells, nerves, DNA, and carry out other functions. The average adult should get 2.4 micrograms a day. Like most vitamins, B12 can’t be made by the body. Instead, it must be gotten from food or supplements.

And therein lies the problem: Some people don’t consume enough vitamin B12 to meet their needs, while others can’t absorb enough, no matter how much they take in. As a result, vitamin B12 deficiency is relatively common, especially among older people. The National Health and Nutrition Examination Survey estimated that 3.2% of adults over age 50 have a seriously low B12 level, and up to 20% may have a borderline deficiency.

Are you at risk?

There are many causes for vitamin B12 deficiency. Surprisingly, two of them are practices often undertaken to improve health: a vegetarian diet and weight-loss surgery.

Plants don’t make vitamin B12. The only foods that deliver it are meat, eggs, poultry, dairy products, and other foods from animals. Strict vegetarians and vegans are at high risk for developing a B12 deficiency if they don’t eat grains that have been fortified with the vitamin or take a vitamin supplement. People who have stomach stapling or other form of weight-loss surgery are also more likely to be low in vitamin B12 because the operation interferes with the body’s ability to extract vitamin B12 from food.

Conditions that interfere with food absorption, such celiac or Crohn’s disease, can cause B12 trouble. So can the use of commonly prescribed heartburn drugs, which reduce acid production in the stomach (acid is needed to absorb vitamin B12). The condition is more likely to occur in older people due to the cutback in stomach acid production that often occurs with aging.

Recognizing a B12 deficiency

Vitamin B12 deficiency can be slow to develop, causing symptoms to appear gradually and intensify over time. It can also come on relatively quickly. Given the array of symptoms it can cause, the condition can be overlooked or confused with something else. Symptoms may include:

  • strange sensations, numbness, or tingling in the hands, legs, or feet
  • difficulty walking (staggering, balance problems)
  • anemia
  • a swollen, inflamed tongue
  • yellowed skin (jaundice)
  • difficulty thinking and reasoning (cognitive difficulties), or memory loss
  • paranoia or hallucinations
  • weakness
  • fatigue


While an experienced physician may be able to detect a vitamin B12 deficiency with a good interview and physical exam, a blood test is needed to confirm the condition.

Early detection and treatment is important. “If left untreated, the deficiency can cause severe neurologic problems and blood diseases,” says Dr. Bruce Bistrian, chief of clinical nutrition at Harvard-affiliated Beth Israel Deaconess Medical Center.

B proactive

It’s a good idea to ask your doctor about having your B12 level checked if you:

  • are over 50 years old
  • take a proton-pump inhibitor (such as Nexium or Prevacid) or H2 blocker (such as Pepcid or Zantac)
  • take metformin (a diabetes drug)
  • are a strict vegetarian
  • have had weight-loss surgery or have a condition that interferes with the absorption of food


A serious vitamin B12 deficiency can be corrected two ways: weekly shots of vitamin B12 or daily high-dose B12 pills. A mild B12 deficiency can be corrected with a standard multivitamin.

In many people, a vitamin B12 deficiency can be prevented. If you are a strict vegetarian or vegan, it’s important to eat breads, cereals, or other grains that have been fortified with vitamin B12, or take a daily supplement. A standard multivitamin delivers 6 micrograms, more than enough to cover the average body’s daily need.

If you are over age 50, the Institute of Medicine recommends that you get extra B12 from a supplement, since you may not be able to absorb enough of the vitamin through foods. A standard multivitamin should do the trick.

Broad Street can help. We provide Personal Assistants who can help manage overall healthcare and awareness. Through our Professional Network we can help you find the right resources and doctors to help answer questions or identify areas of concern. We provide home care in Wilmette, the North Shore area of Chicago. For more information, please call 847.728.0134.

 

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Royal Health

Queen Elizabeth II is 90 years old and recently celebrated her Sapphire Jubilee, marking 65 years of reign.

According to The Telegraphwhen she thanked the nation for its kind messages after overtaking Queen Victoria to become the longest-reigning monarch in British history, she admitted the royal record was “not one to which I have ever aspired”. She added: “Inevitably, a long life can pass by many milestones. My own is no exception.”

Though it cannot be denied that she lives a safe and sheltered life, her habits have also contributed greatly to her healthy age.

As to her health habits to keep her vigor, according to the BBC, “She rides once or twice a week when she’s at Windsor and walks during the day. If she doesn’t have time to walk the dogs in the morning she will walk them in the afternoon,” Dickie Arbiter (her former press secretary) says.

“Unlike many modern workers she doesn’t sit at a desk all day. During an investiture she is standing for up to 90 minutes.”

The idea being that the best exercise is constant activity, rather than spending half an hour doing the same thing like running on a treadmill.

After a long day the Queen is careful to get a good night’s rest. “She sleeps around seven hours a night and is woken around 7.30am in the morning,” Arbiter says.

Strong relationships, often a sign of healthy living are in her court as well. She has a very strong marriage to Philip her husband of 69 years.

Darren McGrady, who was the Queen’s personal chef, told People magazine last year that she keeps a close eye on her figure. He said when she isn’t entertaining she sticks to simple meals like grilled chicken with salad.

“She’s very disciplined. No starch is the rule. No potatoes, rice or pasta for dinner,” he said.

“During the war they lived on rations liked everyone else. Her Majesty still prefers to eat simple food afterwards, like meat with veg, not processed foods.”

If she has a drink she will only have one. She doesn’t smoke.

Cheers to Elizabeth and her 65 years of reign!

Broad Street can help. We provide Personal Assistants who can help manage overall healthcare and awareness. Through our Professional Network we can help you find the right resources and doctors to help answer questions or identify areas of concern. We provide home care in Wilmette, the North Shore area of Chicago. For more information, please call 847.728.0134.

 

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Staying Active in the Winter

The deepest part of winter is upon us; the months of January and February. There are no holidays to distract us and keeping up appearances despite the frigid temperatures can be tough, particularly if you are sensitive to less light (gray days). It can be difficult enough to want to get out from under the warm blanket in the morning, much less consider exercise. However, being active in the winter is a great way to “get through it”.

If you’re used to a nice daily walk in the warmer months, it can be disheartening to look out upon icy sidewalks or snow drifts. Consider mall walking as an alternative. Many large malls are open before the stores and can accommodate as many laps as you can for no cost. Locally, Northbrook Court Mall (in Northbrook at Lake Cook, just west of the Edens Expressway) is a great place to walk. You’ll be in great company as many have known this secret for years. Just north by a few miles is Vernon Hills and the Hawthorn Mall off of Milwaukee Ave. and Route 60.

Looking to swim? If you don’t feel like investing in a full health club membership, you can pay a day rate and have access to a pool when you want it. Try a YMCA too, like McGaw YMCA, in Evanston or the North Suburban YMCA in Northbrook.

The internet is now the greatest library in the world. There’s no shortage of free exercise video instruction on YouTube. Yoga, stretching…you name it, there’s an instructional video for it. Buy a few small 1-5 pound weights at your local Target and you’re gym-ready in your own living room.

If you do go outside make sure you layer well and have very smart footwear. Always avoid icy areas and take the long road around snow drifts. Exercise in any format will help you keep a happy demeanor on the grayest of days. Next thing you know it will be March and April and we’ll be back in business for better weather.

Broad Street can help. We provide Personal Assistants who can help manage overall healthcare and awareness. Through our Professional Network we can help you find the right resources and doctors to help answer questions or identify areas of concern. We provide home care in Wilmette, the North Shore area of Chicago. For more information, please call 847.728.0134.

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Holiday Well-Being

The holidays, as a time to come together, are a time when you may see family you haven’t seen in a while. This is a great opportunity to look for signs of well-being (or not) in your elders. Behavioral changes and shifts in level of vitality can be helpful “first clues” to the progression of age-related challenges.

According to Agingcare.com, look for subtle changes in your loved ones’ emotional well-being. You can’t always gauge someone’s spirits over the telephone, even if you speak daily. Take note for signs of depression, including withdrawal from activities with others, sleep patterns, lost of interest in hobbies, lack of basic home maintenance or personal hygiene. The latter can be an indicator not only of depression, but also of dementia or other physical ailments including dehydration, a serious condition sometimes overlooked in elders in the winter months. If you notice sudden odd behavior with your loved one, be sure to seek medical attention as it could be a urinary tract infection which is prevalent in elders and easily resolved with antibiotics.

The home environment is a great place to focus your attention too. For instance, your parent may have always been a stickler for neatness or for paying bills promptly. If you discover excess or unsafe clutter and mail that has piled up, a problem may exist. Also, keep an eye out for less obvious indications for concern. Scorched cookware, for example, could be a sign that your parent forgets if the stove is on. An overflowing hamper could mean he or she doesn’t have the strength and/or desire to do laundry. And by all means, check prescriptions and medication bottles for expiration dates; and make note of all prescriptions your family member takes and place that information in your personal files as well as the elder’s wallet in case of an emergency.

Communicating your concerns with your elders may take a sleight of hand on the part of diplomacy. Always address concerns by respecting the elder and their right to independence. Seeking the advice of professionals can be helpful too if you are unsure about your perceptions. Delivered with love and respect, care and concern for the elder is a great gift for the season.

Broad Street can help. We provide Personal Assistants who can help manage overall healthcare and awareness. Through our Professional Network we can help you find the right resources and doctors to help answer questions or identify areas of concern. We provide home care in Wilmette, the North Shore area of Chicago. For more information, please call 847.728.0134.

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Relaxation Techniques to Help Navigate the Political Transition

The current U.S. change in Administration, via the President-elect, seems particularly up for grabs. As if the election itself wasn’t a storm of contention, we are still feeling the impact of multiple opposing sides of ideology.

How can we, as the witnessing American public, follow these changes with grace and not let them stress us out? Like a storm on a body of water, there will be waves and a lot of churning. The mud at the bottom will make things murky, but in the end, the storm will end and the water will clear.

Person relaxation techniques will help you navigate the next year until things settle down.

According to the Mayo Clinic, practicing relaxation techniques can reduce stress symptoms by:

  • Slowing your heart rate
  • Lowering blood pressure
  • Slowing your breathing rate
  • Reducing activity of stress hormones
  • Increasing blood flow to major muscles
  • Reducing muscle tension and chronic pain
  • Improving concentration and mood
  • Lowering fatigue
  • Reducing anger and frustration
  • Boosting confidence to handle problems

To get the most benefit, use relaxation techniques along with other positive coping methods, such as thinking positively, finding humor, problem-solving, managing time, exercising, getting enough sleep, and reaching out to supportive family and friends.

Easy relaxation techniques include;

  • Deep breathing
  • Hypnosis
  • Massage
  • Meditation
  • Tai chi
  • Yoga
  • Biofeedback
  • Music and art therapy

As you learn relaxation techniques, you’ll become more aware of muscle tension and other physical sensations of stress. Once you know what the stress response feels like, you can make a conscious effort to practice a relaxation technique the moment you start to feel stress symptoms. This can prevent stress from spiraling out of control.

Remember that relaxation techniques are skills. As with any skill, your ability to relax improves with practice. Be patient with yourself. Don’t let your effort to practice relaxation techniques become yet another stressor.

If one relaxation technique doesn’t work for you, try another. If none of your efforts at stress reduction seems to work, talk to your doctor about other options.

Broad Street can help. We provide Personal Assistants who can help manage overall healthcare and awareness. Through our Professional Network we can help you find the right resources and doctors to help answer questions or identify areas of concern. We provide home care in Wilmette, the North Shore area of Chicago. For more information, please call 847.728.0134.

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What is the PSA Test for Prostate Cancer?

Ben Stiller has recently brought awareness to the topic of prostate cancer based on his own admission of dealing with the disease. According to Live Science, the actor, who is now 50, said doctors detected the cancer because Stiller had undergone a prostate-specific antigen test, or PSA test, which looks for levels of the protein PSA in the blood. Abnormally high levels of PSA in the blood can mean that a man has prostate cancer, but not always. In Stiller’s case, a follow-up MRI and biopsy showed he had prostate cancer.

“This thing saved my life,” Stiller said of the PSA test.

But the test is controversial because of false positives – being told you have cancer when you actually don’t.

According to The National Cancer Institute, prostate-specific antigen, or PSA, is a protein produced by cells of the prostate gland. The PSA test measures the level of PSA in a man’s blood. For this test, a blood sample is sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter (ng/mL) of blood.

The blood level of PSA is often elevated in men with prostate cancer, and the PSA test was originally approved by the FDA in 1986 to monitor the progression of prostate cancer in men who had already been diagnosed with the disease. In 1994, the FDA approved the use of the PSA test in conjunction with a digital rectal exam (DRE) to test asymptomatic men for prostate cancer. Men who report prostate symptoms often undergo PSA testing (along with a DRE) to help doctors determine the nature of the problem.

In addition to prostate cancer, a number of benign (not cancerous) conditions can cause a man’s PSA level to rise. The most frequent benign prostate conditions that cause an elevation in PSA level are prostatitis (inflammation of the prostate) and benign prostatic hyperplasia (BPH) (enlargement of the prostate). There is no evidence that prostatitis or BPH leads to prostate cancer, but it is possible for a man to have one or both of these conditions and to develop prostate cancer as well.

Until recently, many doctors and professional organizations encouraged yearly PSA screening for men beginning at age 50. Some organizations recommended that men who are at higher risk of prostate cancer, including African American men and men whose father or brother had prostate cancer, begin screening at age 40 or 45. However, as more has been learned about both the benefits and harms of prostate cancer screening, a number of organizations have begun to caution against routine population screening. Although some organizations continue to recommend PSA screening, there is widespread agreement that any man who is considering getting tested should first be informed in detail about the potential harms and benefits.

Currently, Medicare provides coverage for an annual PSA test for all Medicare-eligible men age 50 and older. Many private insurers cover PSA screening as well.

Testing can be helpful as a way to avoid disease as we age. Consider your options and do your research.

Broad Street can help. We provide Personal Assistants who can help manage overall healthcare and awareness. Through our Professional Network we can help you find the right resources and doctors to help answer questions or identify areas of concern. We provide home care in Wilmette, the North Shore area of Chicago. For more information, please call 847.728.0134.

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What is Kratom and Why are People Talking About It?

Due to the highly problematic use of opioids of late, talk of alternative pain relief is hitting the news. Kratom, a substance new to the United States used as an alternative for pain, will soon be banned by the DEA and some users are not happy about it.

WebMD reports; Kratom is a tropical tree in Southeast Asia. Its leaves have been used for hundreds of years to relieve pain. They can be eaten raw, but more often they’re crushed and brewed as tea or turned into capsules, tablets, and liquids.

In low doses, kratom acts as a stimulant. In large amounts, it acts as a sedative, and the DEA says it can lead to psychotic symptoms and psychological addiction. According to the CDC, about 42% of cases of kratom use reported between 2010 and 2015 involved non-life-threatening symptoms that required some treatment. About 7% of exposures were classified as major and life-threatening. The DEA says it knows of 15 kratom-related deaths between 2014 and 2016.

Kratom has been on the DEA’s list of drugs and chemicals of concern for several years. But the DEA notes that its use appears to be going up. Law enforcement agencies across the country seized more kratom in the first half of 2016 than ever before. U.S. poison control centers received 263 calls about kratom in 2015, a tenfold increase from 2010, the CDC says.

LiveScience reports; Some people have reported experiencing withdrawal when they have stopped using kratom as well as developing a tolerance to the drug, according to the study. “Withdrawal symptoms and developing tolerance to the substance were generally, though not uniformly, reported to be mild relative to opiates,” the researchers wrote.

About one in 10 people in the study reported withdrawal symptoms after a period of heavy use followed by at least one day without using the drug, the study found. The findings highlight the importance of educating people about the potential risks of kratom use, the researchers wrote.

People who have had substance use problems in the past “should carefully weight the potential pros and cons” of kratom use, namely that while it may be a less harmful substitute for other drugs, it may also be difficult to stop using the drug, the researchers wrote.

According to Narconon.org, kratom is included in a newly-defined class of drug called New Psychoactive Substances, so-named by the United Nations Office on Drugs and Crime.

Undesirable effects of kratom include;

  • Edginess, nervousness
  • Vomiting (can be severe and prolonged)
  • Nausea (can be severe and prolonged)
  • Sweating
  • Itching
  • Constipation
  • Delusions
  • Lethargy
  • Respiratory depression
  • Tremors
  • Aggressive or combative behavior
  • Psychotic episodes
  • Hallucinations
  • Paranoia
  • Addiction effects may include:
  • Loss of sexual desire
  • Loss of weight
  • Darkening of skin on face
  • Constant cravings that drive one to use more of the drug

Withdrawal effects of kratom are very similar to those of opiates like heroin or prescription painkillers and include;

  • Diarrhea
  • Muscle pain
  • Muscle tremors and jerking
  • Restlessness and sleeplessness
  • Severe depression
  • Crying
  • Episodes of panic
  • Sudden swings of mood
  • Irritability

For the latest information on kratom use, see Kaiser Health News.

As with any substance, do your research before embarking on any remedy and consult with a doctor before self-medicating. Just because something is unregulated and comes in the form of tea or another seemingly easy application, doesn’t mean it’s harmless.

Broad Street can help. Our Personal Assistants and Professional Network can help you manage your condition, pain and medications. Call us at 847.728.0134 for more information.

 

 

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Pneumonia and Older Adults

Hillary Clinton and her present bout of pneumonia is bringing a lot of awareness to the topic of health and older adults. According to a recent article on ABC News, for U.S. seniors, hospitalization for pneumonia has a greater risk of death compared to any of the other top 10 reasons for hospitalization, according to the American Thoracic Society, a physician’s organization that advocates for improving care for lung diseases.

Pneumonia is usually caused by infection with viruses or bacteria. Risk factors include other lung diseases such as cystic fibrosis, COPD, and asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke, or a weak immune system. Diagnosis is often based on the symptoms and physical examination. Chest X-ray, blood tests, and culture of the sputum may help confirm the diagnosis. The disease may be classified by where it was acquired with community, hospital, or health care associated pneumonia.

The overall death rate for pneumonia in the United States is 16.9 per 100,000 population, but that rate rises dramatically with age, to 27.9 for people from the ages of 65 to 74, 98.6 for people aged 75 to 84 and 414.7 for people 85 and over.

According to the Centers for Disease Control, more than 53,000 people in the U.S. died from pneumonia in 2013, the most recent year for which statistics are available. People over the age of 65 accounted for more than 45,000 of those deaths.

Each year, hospitals in the U.S. admit more than 1.1 million people for pneumonia, making it one of the top causes of hospital stays nationwide. More people were admitted to hospitals for pneumonia in 2010 than for bone fractures, according to the CDC.

Pneumonia is an inflammatory condition of the lung affecting primarily the microscopic air sacs known as alveoli. Typical signs and symptoms include a varying severity and combination of productive or dry cough, malaise or feeling weak, green or yellow sputum, pain in the chest, confusion, fever, chills, shortness of breath and trouble breathing, depending on the underlying cause.  It is widely believed that the signs of pneumonia in the elderly can differ from the general population. In this way, A Place for Mom warns, a person may think she is simply suffering from the cold or flu. An older patient might not have a fever but rather be more lethargic, lose their appetite or suffer from dizziness or a fall.

For seniors, the best defense is to get a vaccine, available from your doctor.

Broad Street can help. We provide Personal Assistants for companionship, caregiving and help managing conditions. Through our Professional Network we can also provide support services like Geriatric Case Managers and Nurse Advocacy to help you maintain a lifestyle and awareness of overall wellness. Call us at 847-728-0134.

 

 

 

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How to Find the Right Home Care

The days of yore when everyone lived together in a large multi-generational home and looked out for each other no longer exist. For elders living alone who need help at home, you need to hire a companion or caregiver. How do you find the best agency?

The following questions will help you find the services that best fit your needs;

  • Are you licensed?
  • Are your caregivers trained or certified?
  • Do you have nurse supervision or oversight for your non-medical caregivers?
  • How do you determine how to match the caregiver with the client?
  • Are your caregivers trained in specific conditions such as Dementia or Diabetes?
  • Do you provide or help provide any other services such as delivered meals or clutter organization?
  • How do you provide communication with family members and doctors?
  • How do you formulate a plan of care?
  • Do your caregivers accommodate special dietary restrictions for the client such as Kosher or Gluten Free?
  • Do you provide an assistive technology or family portal to access client information digitally?
  • What are your emergency procedures?
  • What is your service disruption plan if the caregiver falls through?
  • Do you offer short-term respite care?
  • Do you provide live-in caregivers?

Home care services and agencies can vary in both quality and breadth of services provided. Don’t wait until the last minute to find service for a family member needing help after discharge from a hospital procedure or rehabilitation. Do your research and ask the right questions early in the process. This will help you find the caregivers and support that best fit your needs.

Looking for home care in Wilmette, Illinois? Broad Street can help. We provide Personal Assistants for companionship and caregiving. Through our Professional Network we can also provide support services like Geriatric Case Managers and Nurse Advocacy. Call us at 847-728-0134.

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