Broad Street in Make It Better Magazine: Assisted Living or Home Care?

Assisted Living or Home Care? How to Help an Elderly Loved One Make the Right Choice
by Susan Pasternak – Make It Better Magazine, July 11, 2017

For Jeff Pryor, keeping his 93-year-old mother, Adele Pryor, in her own home after his father passed was a priority.

“It’s a very personal decision,” Pryor says. “My example was my father, who took care of my mother for 20 years after she had a stroke. I’ve tried to live up to that example and we have an opportunity to do that with care in her home.”

As baby boomers age and require more help with daily life, many will face the choice between staying in their homes with some sort of support, or moving to an assisted living facility. Making that decision is deeply personal, and should take into account personality, location of family, and finances.

When the last of the baby boomers reaches age 65 in 2029, that generation will represent more than 20 percent of the total U.S. population. Add to that the fact that 70 percent of Americans require some kind of long-term care after they turn 65 and this country will see a huge spike in demand for senior living facilities and services in the coming decades, according to a Genworth Financial study.

While there’s a range of living and support situations for aging seniors, many people initially consider the benefits and challenges of in-home assistance versus moving to an independent or assisted living facility, depending on how much care is needed. The benefits of staying in one’s own home are obvious; a move can cause emotional upheaval for those used to a lifetime of independence and the comforts of home. And experts point out that even in an assisted living facility, residents might end up requiring one-on-one care.

“We have plenty of clients who live in assisted living facilities,” says Sam Cross, administrator at Broad Street Home Care, which leverages its on-staff nurses and professional network to bring high-quality care to seniors. Broad Street nurses and other support staff members work with Pryor and his family to provide the best caregivers for his aging mother. “Really the two elements to consider are: where do you want to live and what services do you need?”

The goal of assisted living is to maximize independence for residents, while offering on-demand assistance with tasks such as meal preparation, housecleaning and laundry, the dispensing of medications, and bathing and dressing, if needed. Assisted living residences are ideal for people who are finding it a challenge to live independently, but do not require more intensive care found in a higher-level nursing facility. However, situations often arise that require higher level medical care, which is when the resident would likely need to hire supplemental help, or move to the assisted living facility’s skilled nursing section.

Assisted living facilities also offer social and emotional support, an intangible benefit for seniors who don’t want to feel isolated. These facilities often offer organized activities and outings. Meal times offer opportunities to engage with other residents, as do enrichment programs that are often scheduled throughout the week.

“Just being around people is important,” says Nancy Siegel, a care manager at Senior Living Experts, which offers personalized service to evaluate care needs, budget and geographical preference.

Ideally, a move to assisted living is initiated proactively, and not as a reaction to a change in health or the passing of a spouse, and started in good health, when the senior can make thoughtful and informed decisions.

“We urge people not to wait until there’s a crisis to start thinking about this,” says Maribeth Bersani, chief operating officer at Argentum, an advocacy organization representing for-profit senior living facilities. “Take tours and meet the residents. Go to an open house if there’s a new community opening up. There is some of that gut instinct involved. It’s a little bit like love: you’ll know it when you see it.”

An important factor to consider is price. In-home aid typically costs between $20 and $27 per hour, experts say. The cost for assisted living varies depending on many factors such as quality of the residence, the staff to resident ratio, types of meal plans, and other factors, with the national median falling around $3,000 per month, according to various studies. In a growing number of states, some assisted-living services are covered under Medicaid, but most people pay out-of-pocket or through a long-term-care insurance policy.

Whether looking for an in-home aide or an assisted living facility, experts caution to ask the right questions and to understand that higher prices do often translate to higher quality and more services. Seniors weighing the financial implications of either hiring in-home might consider hiring an aide for just a few hours a day to help with meal preparation and light housekeeping. However, quality caregivers looking for full-time work will then look elsewhere, or try to piece together multiple jobs, which isn’t ideal for what can be physically and emotionally tiring work.

“If consistency in a caregiver is important, you have to be prepared to meet a certain threshold of hours,” Cross says.

In addition to assisted living and in-home care, proactive seniors are also exploring another option: CRCCs, or Continuing Care Retirement Communities, which provide independent living options for on-the-go seniors but also offer services providing a greater level of assistance if the need arises. For example, should a spouse fall ill or become memory-impaired, they are able to move to an assisted living or nursing care building, while the partner is able to live independently, all on the same campus.

-Susan Pasternak



Summer Travel Tips

Travelling this Summer? Here are a few tips to consider before heading to the airport:

  • The Transportation Security Administration offers a handy checklist that offers up tips based on what is and is not allowed through security.
  • If you have special needs, the TSA offers support for security check-in via TSA Cares. The helpline provides travelers with disabilities, medical conditions and other special circumstances additional assistance during the security screening process. Call ( (855) 787-2227) 72 hours prior to traveling with questions about screening policies, procedures and what to expect at the security checkpoint.
  • Research the weather a few days before you leave so that you can pack accordingly.
  • Visit your doctor before you leave to make sure you’re on top of all vaccinations, medication refills and treatment instructions (take a copy with you written out by your doctor) in case you need to visit a medical provider at your destination.
  • If you’re changing time zones, medication schedules, along with changes in eating schedule may need to be considered. In addition, jet lag can be a real trial when you aren’t used to the disruption. Make sure you plan your activities with enough of a time buffer before your flight and after reaching your destination so that you don’t wear yourself out.
  • Make sure you have enough medications for the duration of the trip.
  • Long air travel can make one prone to Deep Vein Thrombosis. Drink plenty of water and take an aspirin (if it’s safe for you to do so) before your flight. Make sure you get up from your seat at regular intervals to walk a bit. If you are concerned, speak with your doctor before flying.
  • Pack spare items like prescription glasses or other necessary items, in carry-on bags and packed bags, that may end up getting lost or delayed during travel.
  • Go to the website of your destination airport to get familiar with the layout or to find out about any special announcements (construction or repairs) that are currently highlighted. In general the internet can be a great resource for specific travel information, delays and local announcements.

Travel has become more complex. If you haven’t gone on trip in a while you’ll be surprised at how the landscape has changed. Additionally, the summer months have increased traffic at the airports. You’ll feel more relaxed if you begin your trip prepared and supported.

Need extra help? Broad Street provides Travel Companions; Personal Assistants who help plan itineraries, support departure and return travel and provide active companionship during the trip for a more enjoyable and engaging experience.

We also provide Personal Assistants who can help manage overall health care and awareness in the home. 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, Illinois, the North Shore area of Chicago.

For more information, please call 847.728.0134.



Questions to ask before you fill that prescription for an Opioid

Opioid use is currently a huge topic in America.  An estimated 2.1 million people in the United States suffer from substance use disorders related to prescription opioid pain relievers and the amount of deaths related to opioid use account for half a million since 2000.

One of the main reasons for the problem stems from the unfortunate fact that doctors didn’t think there was a risk of addiction associated with opioids used for acute conditions. So prescriptions were handed out liberally for folks with legitimate pain. Research has now shown that the risk of addiction is high even with short term use. The medical community is wiser but it’s still important as a patient to understand the risk.

Harvard Health provides a great list of questions to ask your health provider before accepting pain meds:

Is this medication an opioid?

Drug names are difficult to remember and easily confused, so you’ll want to determine whether a painkiller is an opioid.

Is this safe to take with my other medications?

Opioids aren’t advisable if you’re taking a benzodiazepine — a class of drug used to treat anxiety, depression, and insomnia.

Are there any non-opioid pain relievers I could take instead?

Some nonsteroidal anti-inflammatory drugs (NSAIDs) like celecoxib (Celebrex) and diclofenac (Voltaren), which are more potent than nonprescription NSAIDs, are available by prescription. Although these medications may have more troublesome side effects than over-the-counter NSAIDs, they won’t lead to dependence or addiction.

Is this the lowest dose possible?

You don’t want to take a higher dose than you need for pain relief. It’s better to start with a small dose and ask your doctor to increase it if necessary.

May I have fewer pills?

Take the lowest dose possible for the briefest time possible. If you still have unmanageable pain once you’ve finished your prescription, you can discuss further options, including continued opioid use, with your doctor.

How should I taper off the medication?

You may need to gradually reduce the amount you take to avoid withdrawal symptoms like muscle pain and nausea.

Should I have some naloxone (Narcan) on hand?

This drug, which rapidly reverses the effects of an opioid overdose, is available by prescription as a nasal spray.

Managing pain doesn’t need to have the additional concern of prescription risk attached to it. The CDC now recommends three days of use of opioids for most conditions of pain. Like many drugs of this nature the effectiveness wanes after too much use. Sticking to a short term regimen makes sense. Alternative therapies, like physical therapy, are also widely used to help relieve pain. Consider all of your options before you accept a prescription automatically.

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




Fall Prevention

1 in 3 Americans aged 65+ fall every year. Falls are the leading cause of fatal and non-fatal injuries for older Americans. However, falling is not an inevitable part of aging. Through practical lifestyle and environmental adjustments the number of falls among seniors can be reduced substantially.

Why is Falling so Dangerous?

Older adults don’t heal as quickly and efficiently as younger people. So any injury for an elder is going to be more serious than it would be for a younger adult or youth. Falls can lead to broken bones, damaged nerve-endings, concussions, dislocations and musculature problems. The most prevalent fall-related injuries among older adults are fractures of the hip; spine; upper arm; forearm; and bones of the pelvis, hand, and ankle.  A minor injury can lead to bed rest and recovery time that further weakens the individual. A major injury can lead to surgery which includes extended bed rest and risk of infection and other complications associated with surgery. That’s assuming you notice you have an injury at all. Many individuals who fall don’t notice immediate injury and fail to identify brain trauma.  Bleeding in or around the brain, swelling, and blood clots can disrupt the oxygen supply to the brain and cause wider damage later on.

With a fall, age-related challenges together with the added problem of injury and weakness during recovery time can become the starting point to longer term pain, disability, loss of independence and premature death. It’s not surprising then that many falls lead to a decline in overall health and well-being and even shortened life span.

Risk Factors

The circumstances surrounding fall risk are based on a host of factors that may work in conjunction, increasing the risk. According to the Journal of Physiotherapy, “There are a range of body structures and functions involved in maintaining the body in an upright position. To avoid falling, a sighted ambulant person needs adequate: vision to observe environmental challenges like uneven or slippery surfaces; awareness of where body parts are in space; reaction time; and muscle strength to extend the legs against gravity.”

Additionally, acute medical problems such as infection, chronic conditions such as diabetes, and progressive conditions such as Parkinson’s disease can also impact a person’s posture. Medication, specifically dose, interactions and metabolism can also add to the mix. Psychoactive medications have been particularly associated with falls.

Accounting for the physical risk factors can only take you so far; “A person’s behavior is also crucial in the consideration of risk for falling. People can choose which tasks they undertake and how they undertake them. Behavior is likely to be influenced by cognitive impairment, insight and level of support available. Some individuals with a high physiological risk of falling may be able to avoid falling by increased awareness and use of assistance when required. Individual variations in attitudes and behavior probably explain the differences between measured fall risk and actual falls experienced.”

What’s the Solution?

Fall prevention strategies are now a major component of most senior lifestyle programs. The idea is to improve the overall quality of the elder’s lifestyle, strength and health so that if a fall happens, it’s not a game changer.

Fall prevention strategies fall under 4 categories;

  • Improving the environment (home and surroundings) around the elder including;
    • Good lighting
    • Clutter removal
    • Easy access to avoid reaches
  • Exercises to help strengthen legs and balance in general
  • Medication management
  • Safety-related skills and behaviors (occupational therapy)

The strongest single predictor of future falls is a history of previous falls. An individual’s reason for falling the first time is likely to recur if measures aren’t taken to prevent falling. There are assessment tests that can be given by doctors and occupational therapists. Renovations to the home to improve safety can be tax deductible. If you think there is fall risk in your future or the future of a loved one, it’s a good idea to plan ahead, assess risk and take measures. Fall prevention, like diet and exercise, ensures longevity and is worth the effort.

Broad Street can help. We provide Personal Assistants who can help manage overall health care 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, Illinois, the North Shore area of Chicago. For more information, please call 847.728.0134.


Better Brain Activity Through Un-Focused Time

Think a stronger brain means hours of Sudoku or brain training? Nope. There’s a part of your brain, referred to as the Default Mode Network, that while at rest helps you retrieve memories, link to better creative thinking and can help you feel more connected. The good news is that the best way to tap into this part of your brain is to rest, relax and effectively “do nothing”.

According to Harvard Health here are some great ways in which to activate the “unfocus” network of your brain;

Napping: If, for example, you are dog tired in the mid-afternoon, and just need your mind to be clear, a 10-minute nap might be all you need for sharper thinking. But if you have a major creative project ahead of you, whether it is an innovative idea at work, or redecorating your house, you will need at least 90-minutes of napping time. This gives your brain enough time to shuttle around ideas to make the associations that it needs to make.

Positive constructive daydreaming (PCD): It’s hard to imagine daydreaming as a type of training, but it is. It has to be the right type of daydreaming. According to Jerome Singer, who has studied this for decades, slipping into a daydream is not of much use; neither is guiltily rehashing everything that makes you feel bad — like the expense you incurred when you bought the shoes you liked, or the one-too-many drinks that you had at a party. But there is a type of daydreaming that will make you more creative and likely re-energize your brain. Called positive constructive daydreaming (PCD), it is best done while you are engaged in a low-key activity, not when you are fading. And as opposed to slipping into a daydream, which is more like falling off a cliff, you must parachute into the recesses of your mind with a playful and wishful image — perhaps one of you lying on a yacht or floating on your back in a pool on vacation. Then comes the swivel of attention — from looking outside, to wandering inside. With this move, you engage your unfocus brain and all the riches that it can bring.

Physical exercise and free-walking: In the brain, thinking supports movement, and movement supports thinking. In fact, exercise improves your DMN function. It normalizes it in obese people (who have too much of it) and increases connectivity in young healthy people. Even a single session can make a difference. Aerobic exercise can help prevent atrophy of key regions within the DMN, and also help the connectivity between different regions too. Walking does boost creative thinking, but how you walk matters. One year of walking boosts the connections between the different parts of the DMN too. In 2012, psychology professor Angela K. Leung and her colleagues tested three groups of people. One group walked around in rectangles while completing a mental test; one group walked around freely; and the last group sat down while taking the test. The free-walking group outperformed the other two groups. Other studies have shown that free-walking results in improvements in fluency, flexibility, and originality of thinking. So if you want to boost your creativity, go on a meandering hike on a safe path less traveled. Furthermore, walking outdoors may be even more beneficial than puttering around the house (unless you’re using PCD, of course!)

So go ahead, skip all the cognitive high-jinx and take a walk, a cat nap or a day dreaming excursion. Your brain (and stress levels) will thank you.

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.


Legal and Financial Planning for Alzheimer’s Disease

Alzheimer’s Disease is a condition you want to get in front of as soon as you can. Aside from the necessary therapies to help alleviate the condition, the long term landscape for individuals and their families is a serious consideration when it comes to legal and financial concerns.

Advice from the National Institute on Aging suggests early-stage planning to match early-stage diagnosis;

“When possible, advance planning should take place soon after a diagnosis of early-stage Alzheimer’s disease while the person can participate in discussions. People with early-stage disease are often capable of understanding many aspects and consequences of legal decision making. However, legal and medical experts say that many forms of planning can help the person and his or her family even if the person is diagnosed with later-stage Alzheimer’s.”

The National Institute on Aging offers an excellent planning guide, excerpted below, with full document available here.

Legal, Financial, and Health Care Planning Documents

When families begin the legal planning process, there are a number of strategies and legal documents they need to discuss. Depending on the family situation and the applicable State laws, some or all of the following terms and documents may be introduced by the lawyer hired to assist in this process. Broadly speaking, these documents can be divided into two groups:

  • documents that communicate the health care wishes of someone who may no longer be able to make health care decisions
  • documents that communicate the financial management and estate plan wishes of someone who may no longer be able to make financial decisions

Advance Directives for Health Care

Advance directives for health care are documents that communicate the health care wishes of a person with Alzheimer’s disease. These decisions are then carried out after the person no longer can make decisions. In most cases, these documents must be prepared while the person is legally able to execute them.

A Living Will records a person’s wishes for medical treatment near the end of life. It may do the following:

  • specify the extent of life-sustaining treatment and major health care the person wants
  • help a terminal patient die with dignity
  • protect the physician or hospital from liability for carrying out the patient’s instructions
  • specify how much discretion the person gives to his or her proxy (discussed below) about end-of-life decisions

A Durable Power of Attorney for Health Care designates a person, sometimes called an agent or proxy, to make health care decisions when the person with Alzheimer’s disease no longer can do so. Depending on State laws and the person’s preferences, the proxy might be authorized to:

  • refuse or agree to treatments
  • change health care providers
  • remove the person from an institution
  • decide about making organ donations
  • decide about starting or continuing life support (if not specified in a living will)
  • decide whether the person with Alzheimer’s will end life at home or in a facility
  • have access to medical records

A Do Not Resuscitate (DNR) Order instructs health care professionals not to perform cardiopulmonary resuscitation if a person’s heart stops or if he or she stops breathing. A DNR order is signed by a doctor and put in a person’s medical chart.

Advance Directives for Financial and Estate Management

Advance directives for financial and estate management must be created while the person with Alzheimer’s still can make these decisions (sometimes referred to as “having legal capacity” to make decisions). These directives may include some or all of the following:

A Will indicates how a person’s assets and estate will be distributed upon death. It also can specify:

  • arrangements for care of minors
  • gifts
  • trusts to manage the estate
  • funeral and/or burial arrangements

Medical and legal experts say that the newly diagnosed person with Alzheimer’s and his or her family should move quickly to make or update a will and secure the estate.

A Durable Power of Attorney for Finances names someone to make financial decisions when the person with Alzheimer’s disease no longer can. It can help people with the disease and their families avoid court actions that may take away control of financial affairs.

A Living Trust provides instructions about the person’s estate and appoints someone, called the trustee, to hold title to property and funds for the beneficiaries. The trustee follows these instructions after the person no longer can manage his or her affairs.

The person with Alzheimer’s disease also can name the trustee as the health care proxy through the durable power of attorney for health care.

A living trust can:

  • include a wide range of property
  • provide a detailed plan for property disposition
  • avoid the expense and delay of probate (in which the courts establish the validity of a will)
  • state how property should be distributed when the last beneficiary dies and whether the trust should continue to benefit others

Who Can Help?

Health Care Providers—Health care providers cannot act as legal or financial advisors, but they can encourage planning discussions between patients and their families. Qualified clinicians can also guide patients, families, the care team, attorneys, and judges regarding the patient’s ability to make decisions.

Elder Law Attorneys (ELAs)—An ELA helps older people and families:

  • interpret State laws
  • plan how their wishes will be carried out
  • understand their financial options
  • learn how to preserve financial assets while caring for a loved one

The National Academy of Elder Law Attorneys and the American Bar Association can help families find qualified ELAs. See the list of resources at the end of this fact sheet for more information.

Geriatric Care Managers—Geriatric care managers (GCMs) are trained social workers or nurses who can help people with Alzheimer’s disease and their families:

  • discuss difficult topics and complex issues
  • address emotional concerns
  • make short- and long-term plans
  • evaluate in-home care needs
  • select care personnel
  • coordinate medical services
  • evaluate other living arrangements
  • provide caregiver stress relief

Broad Street can help. We provide Personal Assistants who can help manage overall health care and awareness. Through our Professional Network we can help you find the right resources like Estate Planners  and Wealth Managers as well as Elder Attorneys. We provide home care in Wilmette, the North Shore area of Chicago. For more information, please call 847.728.0134.


Patient Safety

Patient safety or as it’s otherwise termed, “preventable harm” in health care is a public health crisis and is growing as a leading cause of death in the United States.

According to Stat News, “the Centers for Disease Control and Prevention estimate that nearly three-quarters of a million Americans develop health care-associated infections each year, 75,000 of whom die during that hospitalization. Additionally, other patients get the wrong medications, endure mistakes in surgery, experience falls in the hospital, receive treatments meant for someone else, develop pressure ulcers, and more. More than 12 million patients each year experience a diagnostic error in outpatient care, half of which could cause harm. One-third of Medicare beneficiaries in skilled nursing facilities experience adverse events.”

Entities such as The National Patient Safety Foundation, who recently published A Call to Action, are increasingly calling on health care leaders and policymakers to initiate a coordinated public health responses to improve patient safety to ensure that patients and those who care for them are free from preventable harm.

As an individual there are a few things you can do to minimize your own risk in the healthcare arena;

  • Wash your hands to prevent infection and don’t be shy about reminding others, especially the medical staff, to do the same thing.
  • Ask questions about the risks and benefits of any treatment or procedure.
  • Don’t go alone – bring a trusted ally with you whenever possible.
  • Know your medications and why you’re taking them.
  • Repeat back to your clinicians what you think they’ve told you.
  • And understand your care plan by asking the NPSF Ask Me 3 questions: What is my main problem? What do I need to do? Why is it important for me to do this?

Broad Street can help. We provide Personal Assistants who can help manage overall health care and awareness. Through our Professional Network we can help you find the right resources like Nurse Advocates to help navigate your experience, needs, 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.


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.


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.



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!

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