Wednesday, February 21, 2018

Healing from Grief

One of the difficult aspects of reaching our 60s, 70s and beyond is the fact that we are likely to lose more friends and family members than we did when we were younger.  Grief is something we are all going to experience.  While we cannot avoid experiencing the loss of someone we love, there are steps we can take to help us heal.

When Sheryl Sandberg, the CEO of Facebook, unexpectedly lost her husband while they were on a family vacation, she was devastated.  The couple had two young children and, difficult as it was, Sheryl knew she had to move on with her life for their sake.  It has not been easy her, and she admits that while "the fog of acute grief has lifted ... the sadness and longing for Dave remain."  While learning to heal, she wrote a book called "Option B: Facing Adversity, Building Resilience, and Finding Joy." 

AARP Magazine interviewed Sheryl Sandberg about her grief and the book she wrote in their June/July 2017 issue.  Below are a few of the recommendations she has for people who are trying to heal from grief. I highly recommend her book to anyone who is suffering from grief, regardless of their age.

Recognize the Issues Which Hamper Your Recovery

Sheryl Sandberg discusses the three P's in her book.  These are beliefs which make it harder for us to heal.  It is important to acknowledge you are feeling these emotions and recognize these feelings are temporary.

Personalization - Blaming ourselves for someone else's death.  This can cause you to develop deep feelings of guilt for things which are beyond your control.

Pervasiveness - Believing that everything in your life is bleak and refusing to recognize there is anything good or positive going on in your life.  This feeling can cause you to become more fearful and worry more than you did in the past.

Permanence - The belief you will always feel as terrible as you do now.  This can cause you to isolate yourself.

Build Your Resilience

Ms. Sandberg believes that resilience is like a muscle and you can strengthen it.  You need to believe that you will be able to develop deep, close relationships in your life once again.  Your life can have meaning and you can find joy.

While it may seem impossible at first, remind yourself that you will be able to make new friends.  Don't forget to treat yourself with compassion and patience. 

In addition to what Ms. Sandberg has said about resilience, many people have found comfort when they have turned their grief into a cause.  Whether you get involved in raising money to cure the illness which killed your loved one or, like the teenagers who have survived school shootings, turn your tragedy into the energy to fight for political change, these activities can help you recover from your grief and help you become a force for good in the world.

Journaling Can Help

Researchers have discovered that writing about your feelings, both the happy and sad, can make it much easier for you to recover from the trauma of losing someone you love.  Journaling will help you find your own voice.

Give Yourself Permission to Move on With Your Life

You will never forget the people you lost.  Their memories will always be a part of your life.  It is perfectly OK to move on, however, and let yourself experience joy, laughter and have a good time with new friends.  If the person you lost was your spouse, eventually you may want to date again.  There is nothing wrong with that.  Give yourself permission to enjoy another person and remind yourself that if you loved someone deeply before, you will be able to do it again.

At the end of the AARP interview, Sheryl Sandberg said to "acknowledge the capacity of the human spirit to persevere."

If you are experiencing grief in your life, you may also want to join a grief recovery group.  Many churches and other organizations offer them.  They are useful at helping us pull ourselves together and, eventually, move on with our lives.

If you are interested in learning more about common issues as we age, including changing family relationships, common medical issues, where to retire, financial planning, Social Security, Medicare and more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional helpful articles.

Watch for my book, Retirement Awareness: 10 Steps to a Comfortable Retirement, which will be published by Griffin Publishing in the fall of 2017.

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Wednesday, February 14, 2018

Lower Dementia Risk with Exercise

While many retired senior citizens slip into a sedentary lifestyle after retirement, they may not realize that spending too much time sitting can increase their dementia risk.  There are two main reasons for this.  First, anything which improves your cardiovascular health is also good for your brain.  Second, when your muscles become weaker, you are at a greater risk for falls, which can lead to broken bones and head injuries.  Exercise, along with other lifestyle changes, is an important part of your plan to reduce your dementia risk.

Aerobic Exercise and Dementia

It has long been known that exercise, particularly aerobic exercise, is good for your heart.  More recently, researchers have discovered that anything which improves your cardiovascular health will also improve your cognitive health.  In addition, anything which improves your cardiovascular health will also reduce your risk of having a stroke, which can cause serious brain damage.

According to a research study reported by the Mayo Clinic, people who had already been diagnosed with mild dementia or cognitive impairment improved their cognitive scores after six to twelve months of regular exercise, when they were compared to a control group of sedentary individuals with similar original scores.  This research shows you can improve your memory and cognitive function, even if you have already been diagnosed with mild memory loss, simply by consistently engaging in aerobic exercises such as brisk walking, running, dancing or swimming.

Exercise and Fall Prevention

Fall prevention is another reason why people should exercise regularly as they age.  According to the Centers for Disease Prevention, falls are the leading cause of injury and death in seniors.  Falls can lead to broken hips and other bones, which may cause you to become bedridden and potentially develop pneumonia.  Falls can also cause head injuries which could damage the brain.  Exercises which help improve your sense of balance and build strength, such as lifting weights or tai chi, will help reduce your risk of falling.

Other Exercises Which are Good for Your Brain

In a brain health class I am taking through a local college, we learned there are other types of physical exercise which can also benefit the brain and improve our balance.  Below are some of the activities which they suggest:

*  Practice different movements when you take a walk such as walking sideways, walking with your feet further apart than normal, trying to place your feet in front of each other in a straight line, walking on your toes or heels, and similar movements.  These movements help strengthen your ankles and legs while teaching your muscles how to respond to unexpected situations when you walk.

*  Practice walking and talking with someone.  Not only does this make your walks more fun, but the ability to walk smoothly while distracted by a conversation is very helpful.

*  Practice bouncing a rubber ball and tossing it to another person.  As we age, we can lose our spatial awareness.  We may find we toss a ball too hard or too softly.  Being able to throw a ball the proper distance to another person, and then being able to catch a ball tossed to us, are both important cognitive skills.  Maintaining this skill will also make us better while engaging in a variety of activities, including driving.

Reduce Stress with Yoga or Breathing Exercises

Another type of exercise which can benefit our brains are stress reducing exercises such as yoga or breathing exercises.  Learning to naturally relax and reduce our stress can make it easier for your brain to store new memories and recall old ones.

In addition to reducing stress, the practice of yoga can also improve your sense of balance, your flexibility and your strength.

As you can see, everyone should incorporate a variety of types of exercises into their weekly schedule, including aerobic exercise, lifting weights, bouncing a ball and yoga. The combination can go a long way towards improving your brain health.

If you are interested in learning more ways to reduce your dementia risk, you should check out the other articles on this blog in the Medical Concerns section and learn more about the MIND diet and other ways to improve your brain health.

If you are interested in learning more about maintaining good health as you age, retirement planning, Social Security, Medicare, where to retire and more, use the tabs or pull-down menu at the top of the page to find links to hundreds of additional helpful articles.

Watch for my book, Retirement Awareness: 10 Steps to a Comfortable Retirement, which is scheduled to be released by Griffin Publishing in 2018.

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Wednesday, February 7, 2018

Weight Watchers Freestyle for Senior Citizens

Has your doctor told you to lose weight?  If you are like many senior citizens, it may seem as if losing weight is an impossible task.  After all, if you are overweight and over the age of 50, you have probably been trying to control it for years.  In addition, you may find it more difficult than ever to get the exercise you need, especially if you have health problems. What can you try now which would be different from anything you have been trying for decades?  You may want to give the new Weight Watchers Freestyle program a close look.

Weight Watchers has repeatedly been found to be one of the most successful commercial weight loss programs.  One of the benefits is that you do not need to purchase special food or live on liquid shakes, which is the case with some other programs.  You can eat real food in reasonable, satisfying quantities.

Weight Watchers is Affordable

In some cases, your Medicare supplement or Medicare Advantage plan may cover the cost of your Weight Watchers weight loss program meetings.  They may also cover the cost of a gym membership. Call your insurance agent or provider and ask what programs they will cover for weight loss.

Another option is to sign up for Weight Watchers online and use their app on your smartphone.  There is still a fee, but it is much less than the cost of attending the meetings.  If you choose this option, you may also want to join a Weight Watchers Facebook support group.  There are several and most of them are very welcoming.  The members exchange recipes and tips for reducing the point value of their favorite meals.  They also give each other support and encouragement.

How Does Weight Watchers Freestyle Work?

The 2018 version of Weight Watchers, called Freestyle, allows members to satisfy their hunger as much as possible from a list of over 200 "free" foods.  These foods have "0" points and you do not have to keep track of them.  They include skinless chicken or turkey breast meat, eggs, fish, shellfish, unsweetened Greek yogurt, all fruits and most vegetables, with the exception of a few vegetables such as potatoes and avocados.

In addition, you have a daily allowance of approximately 23 points for women and a few more for men.   You are also allowed an extra 35 weekly points for special events and treats.  Your points can be used for food items not on the 0 point list such as red meat (roughly 1 to 1.5 points an ounce), bread (about 2 points a slice), cereal (about 6 points for 1 1/2 cups), milk and similar satisfying foods.  These points allow you to have more interesting meals.  The foods which are not on your 0 point list are the only foods you need to track when you eat them.  You can use a notebook or the smartphone app to track what you eat, and the app can also help you find the point value of thousands of homemade, prepared and restaurant foods.

The group leader at your Weight Watcher meeting or the smartphone app will tell you exactly how many points you are allowed, depending on your gender, current weight and other data.

Other Ways to Increase Your Weight Loss

In addition to following the eating program above, here are a few other tricks which may help you lose weight:

Purchase a Weight Watchers Freestyle cookbook or get their magazine, to discover more tips for healthy, low-calorie meals.

Make sure you eat at least 60 grams of protein a day, which will help satisfy your hunger and maintain steady blood sugar levels.

If you feel more motivated when you are accountable to other people, you may want to sign up for the weekly meetings rather than only use the smartphone app.  You may also want to get a weight loss buddy, so you can encourage each other to eat right and stay on the program.

Use the app to look up the point value of different foods before you go to a restaurant.  Then, you will feel confident you can enjoy a meal in your favorite restaurant without resorting to only eating salads with no dressing!  I have discovered that I can enjoy a hamburger, chicken fajitas, and many other favorite dishes whenever I go out with friends.

Get rid of fattening trigger foods in your pantry, such as chips, cookies or pastries. Replace them with a wide variety of foods from the 0 point list, such as fruit, sugar-free fruit cups, vegetables, frozen shrimp, and plain Greek yogurt.  You will also want to keep on hand a selection of low-calorie desserts, air-popped popcorn and similar treats you enjoy, so you do not feel deprived.

Get regular exercise every day.  You may feel more inspired if you wear a fitness tracker like a Fitbit Watch or a Garmin Vivofit.  Many people have discovered that fitness trackers are a good way to keep track of their improving fitness, even when the scale does not seem to be showing lower numbers.  It is another way to keep you motivated and on target.

Be sure to check with your doctor before starting any weight loss program and follow any instructions he may have regarding your food choices.  Many people with kidney disease, diabetes or other health problems will also have to incorporate specific dietary requirements into their eating plan.

If you are interested in reading more about dealing with health issues as we age, financial planning, Social Security, Medicare, where to retire and more, use the tabs or pull-down menu at the top of the page to find links to hundreds of additional helpful articles.

Watch for my book, Retirement Awareness: 10 Steps to a Comfortable Retirement, which is scheduled to be published by Griffin Publishing in 2018.

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Wednesday, January 31, 2018

What is a Nurse Practitioner?

More and more frequently, when patients visit their physician's office, they may be seen by a nurse practitioner rather than the doctor.  The reason for this change is simple:  The demand for healthcare is increasing along with the size of our population, but the supply of primary care doctors is dropping.  According to the Association of American Medical Colleges, in the next 12 years the U.S. is expected to have a shortage of approximately 43,100 primary care physicians.  Because of this situation, nurse practitioners are filling the gap.

What Tasks Can a Nurse Practitioner Perform?

When I scheduled an appointment to see the dermatologist, it was a nurse practitioner who assessed my skin and removed a tiny area for a biopsy.  Since I had never been seen by a nurse practitioner before, I was concerned she might not be as qualified as the dermatologist.   As a result, I wanted to learn more about nurse practitioners and thought my readers would also want to know what I discovered.

According to an article in the July-August, 2017 issue of the AARP Bulletin, nurse practitioners can perform many of the same tasks as doctors.  Just like the nurse practitioner (N.P.) who checked my skin, they are allowed to assess patients, diagnose illnesses, order and interpret diagnostic tests (such as x-rays or biopsies), prescribe medications and give patients instructions on their treatment.  They can also perform minor surgical procedures, such as the tissue biopsy which was performed on me.  This information was a relief to me, since these were precisely the tasks which my nurse practitioner did.

While I saw an N.P. who specialized in dermatology, 80 percent of them work in the area of primary care.  The opposite is true of physicians; only 14.5 percent of them choose a primary care residency.

What Training Does a Nurse Practitioner Receive?

My next question was how well trained my nurse practitioner was.  Was she qualified to perform these tasks?  According to the article mentioned above, a nurse practitioner must have at least a bachelor's degree in nursing, be a licensed registered nurse (R.N.), obtain national certification, and submit to peer review and clinical outcome evaluations before she can be referred to as an N.P.  Their training also stresses prevention and wellness, not just treatment. 

According to the American Association of Nurse Practitioners:

"All NPs must complete a master's or doctoral degree program, and have advanced clinical training beyond their initial professional registered nurse preparation. Didactic and clinical courses prepare nurses with specialized knowledge and clinical competency to practice in primary care, acute care and long-term health care settings."

Although they do not receive as much education and training as a physician, who must receive a four-year undergraduate degree, spend four years in medical school and then commit to another three to seven years performing a residency, nurse practitioners continue to submit to "undergo rigorous national certification, periodic peer review, clinical outcome evaluations, and adhere to a code for ethical practices. Self-directed continued learning and professional development is also essential to maintaining clinical competency." (according to the AANP website).   

Are Patients Satisfied with Care Give by Nurse Practitioners?

Despite the fact that nurse practitioners do not receive as much formal education as physicians, the patient outcomes are considered comparable.  In addition, in at least one study patients rated nurse practitioners 9.8 out of 10; doctors only scored 7.2. This indicates that patients are actually more satisfied with the treatment they received from the nurse practitioners, as compared to doctors.  In my case, I was very pleased with the attention I was given by the nurse practitioner and was satisfied that she was careful and thorough.

What Else Should You Know About Nurse Practitioners?

Nurse practitioners can practice in all 50 states.  As of early 2017, they were able to practice without the supervision of a physician in 22 states and the District of Columbia, as well as within the Veteran's Administration health system. This means they can have a private practice, without a physician on the staff.  In the other 28 states, they are restricted to only being able to practice if they collaborate with a doctor.

As of this writing, there were an estimated 222,000 nurse practitioners in the United States.  Approximately 244,000 are expected to be practicing in the U.S. by 2025.  This will go a long way towards compensating for the 43,100 doctor shortage which is anticipated by 2030.

In communities where patients receive care from a combination of N.P.s and physicians, the cost of care and the number of avoidable hospitalizations have been reduced.

If you live in a rural or under-served community where there is a shortage of doctors, you are more likely to see a nurse practitioner.  However, this is not always the case.  I live in a large, urban area and my healthcare provider, Kaiser Permanente, scheduled my dermatology appointment with an N.P. rather than an MD.

Although most people seem to be very satisfied with the service provided by a nurse practitioner, you should clarify who are seeing if you have any concerns.

This new trend could help Medicare recipients in the future in a number of ways, including making healthcare more affordable and accessible, no matter where you live in the United States.

You can learn more about nurse practitioners at the American Association of Nurse Practitioners:

If you are interested in learning more about common medical issues which affect retirees, where to retire in the U.S. and abroad, financial planning, Social Security, Medicare and more, use the tabs or pull-down menu at the top of the page to find links to hundreds of additional articles.

Watch for my book, Retirement Awareness: 10 Steps to a Comfortable Retirement, which will be published by Griffin Publishing in the fall of 2017.

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