Finding the Resolve

Dear Linda:


New Years is coming and like every year before, I’ll make some resolution. Though I always begin with good intentions, sadly I fizzle out after a week or two. Is there any hope of being successful or am I doomed to be a willpower failure?

Disgusted in Saginaw


Dear Disgusted:


The first resolution you should make is to be kinder to yourself. Changing behaviors is a difficult process often impacted by negative history. Expect a series of starts and stops in your development, and you won’t be so discouraged.

Understand that there’s a difference between resolution and willpower. Most resolutions are triggered by emotions, which are neither stable nor constant. When the emotion wanes or dies, so does the desire to persist.

Real willpower is not dependent on emotions. Training of the will requires decision, dedication and determination, and evolves into a powerful habit or ability over time. The resulting self-discipline taps an inner strength that can be exercised whenever required.

Begin by setting a reasonable and specific goal with a measurable outcome. For example, “improved health” is not detailed enough or quantifiable. Deciding to work-out 30 minutes a day four days a week is a realistic goal that will result in “improved health”. Put your goal in writing and post it on your bathroom mirror, refrigerator, dashboard, computer screen, and office wall as a reminder.

Remember you’re replacing an old habit with a new one, so practice and perseverance is crucial. Include incremental action steps. If you can’t exercise 30 minutes in one session, break it down into three-10 minute work-outs. Then double your effort the next week.

Share your goal with someone and create accountability. Though you shouldn’t make lifestyle changes for anyone but yourself, sharing your progress with a confidant can be encouraging. Find a buddy to join in. You’ll be more motivated and have more fun.

Keep a journal to track progress, recognize patterns, and release emotions constructively. Reward yourself as you reach milestones. You’ll deserve it.

Gifts for Those with Poor Vision

Dear Linda:


My Dad’s eyesight is failing. What can I get him for Christmas that will make life easier?

Holiday Helper

Dear Holiday Helper:

Begin by taking your dad to the ophthalmologist for an eye exam. Be sure his eyeglasses are the correct strength, and that any disease is properly diagnosed and managed. If he hasn’t been screened for glaucoma, request that test be done. Left untreated, glaucoma can result in blindness. The doctor can also assess whether your father is suffering with dry eye, a culprit in poor vision and more common among seniors.

Then fill his stocking with large-faced playing cards, a large-print check register and address book, low-vision puzzles, games and word searches.

Think big for under the tree: a large button telephone, a remote control and calculator, large-print books (including cook books), sheet music and calendars.

Enlarge the world for him. Magnifiers come in every size and shape. There are magnifying mirrors — hand-held and for on the wall, and magnifying watches with built-in flashlights. There are magnifiers that can be used for over television and computer screens, books and magazines, and medicine bottles.

Magnifiers can be hand-held or hands-free, lighted, page-size or as small as a credit card. Visit www.activeforever.com for a variety of products or call 800-377-8033.

If an unexpected voice won’t be disconcerting, consider the value of things that talk: clocks, watches, timers, indoor and outdoor thermometers, scales and Caller ID to name a few. Simple software converts a computer into a talking machine, and talking frames can put messages from family members’ within reach.

Buy books on tape and collections of music (including golden oldies and show tunes from old movies and Broadway). Old-time radio dramas and comedies are also entertaining. Visit www.wellhaven.com for other ideas or call 888-564-1500.

Remember time spent with your dad is more important than any gift, so consider tickets to a holiday show. Get seats close to the stage and bring binoculars.

Having Good Will

Dear Linda:


My son enlisted in the Army and is fighting in Afghanistan. I’m angry at him for putting himself in harm’s way and at those responsible for perpetuating the war. The Christmas season is upon us and I know I’m called by God to have Good Will for others but I’m struggling with that notion when there is no Peace on Earth. Is there something I can do to generate a feeling of Good Will? I don’t want to ruin the holidays.

Mary

Dear Mary:

You and your son are sacrificing so much for the benefit of other human beings—the greatest of which is freedom—to protect ours and accomplish theirs. For this, we are grateful beyond all words, as there aren’t any grand enough to thank a young man for risking his life and a mother for risking her child.

You are both making the ultimate sacrifice, and feelings about that can be ambivalent— pride, respect, terror, and anger. We’re afraid of losing forever that which is most precious.

You’re facing Christmas without your son. That would be a hardship for every mother, so don’t be too hard on yourself. Others will understand.

It’s also be a terrible struggle to reconcile the irony of wishing for Peace on Earth when we are at war, but wishing for peace doesn’t make it so. Sometimes we have to fight to protect it.

Good Will should not be based on circumstances. God asks that we have Good Will toward others even in the worst of times, and every day of the year, not just at Christmas.

Judging others keeps us from having Good Will. When we get past that and achieve real humility, we find that others, regardless of differences in race, religion, class and opinion, are the same at heart.

Developing the power of Good Will begins with a decision. Practicing the gift of Good Will purifies the spirit of the individual and brings peace to the world.

A Blessed Christmas to all.

Calling Services

Dear Linda:

My mom’s an ailing widow. Until now, I’ve been able to call everyday to make sure she’s okay, but I’m being deployed and won’t be able to for the next year. She wants to remain in her home and is well enough for that, but she needs to be checked on. The problem is that all her other relatives and friends have passed on. What can I do?

A Concerned Son

Dear Concerned Son:

Your mother must be very proud. To have a son care so much about his mother and his country speaks volumes about the job she’s done raising you.

Before you leave, be sure all her legal (i.e. Last Will and Powers of Attorney), medical (i.e. Insurance and Living Will and Directives), and financial (i.e. Trusts and Bank Accounts) documents are in order. Put all her important papers in a fireproof box. Make duplicate copies for yourself in case you need to confer about them long distance.

Develop a Care Plan to accomplish her Activities of Daily Living (like trips to doctors, pharmacy, grocery store and hairdresser), and identify any special needs she has. Then ask for help from people in the community—her neighbors, members of civic, religious and social organizations. Contact the National Eldercare Locator (800-677-1116) for help in identifying local service and aging agencies.

Her level of independence should determine the amount of support she needs. There are in-home agencies that handle housekeeping and meal preparation chores, personal care and grooming needs, and therapy and nursing requirements.

If all she needs are phone calls, there are agencies that provide only that service. No special equipment is necessary. Any touch-tone phone can receive agency calls, and you should be able to choose call times—generally made twice a day. Follow-up calls should be made if Mom doesn’t answer, and the agency will need a contact list for emergencies. Contact Call Reassurance Center at 602-265-5968 (ext. 7) for information.

Silver Sneakers

What is the SilverSneakers Fitness Program?


"SilverSneakers is a fun, energizing program that helps older adults take greater control of their health by encouraging physical activity and offering social events.

Unlock the door to greater independence and a healthier life with SilverSneakers. Health plans around the country offer our award-winning program to people who are eligible for Medicare or to group retirees. SilverSneakers provides a fitness center membership to any participating location across the country. This great benefit includes:

■access to conditioning classes, exercise equipment, pool, sauna and other available amenities

■customized SilverSneakers classes designed exclusively for older adults who want to improve their strength, flexibility, balance and endurance

■health education seminars and other events that promote the benefits of a healthy lifestyle

■a specially trained Program AdvisorSM at the fitness center to introduce you to SilverSneakers and help you get started

■member-only access to online support that can help you lose weight, quit smoking or reduce your stress

■SilverSneakers Steps for members without convenient access to a location. Please call 1-888-423-4632 (TTY: 711) to find out if your health plan offers SilverSneakers Steps.

How do I start using SilverSneakers?


SilverSneakers offers three easy ways to enroll. Simply choose one or more of the following options that best suits your lifestyle and begin enjoying your benefit today!

1. SilverSneakers at a participating location

Simply take your SilverSneakers Member ID card to a SilverSneakers participating fitness location. No SilverSneakers card? Bring your health plan ID card with you to tour the location and to see all the amenities you’ll enjoy as a SilverSneakers member. There are more than 11,000 fitness centers, gyms, YMCAs and Curves® to choose from.

Find a participating location

2. SilverSneakers Online

We make it easy for you to be part of a thriving and secure online community. At www.silversneakers.com/member we provide a comprehensive, easy-to-use wellness resource for eligible members of health plans that include SilverSneakers as part of their benefits.

Once you've signed up you will have access to all the features including:

■nutrition, fitness and health improvement plans and trackers

■health-related articles and recipes

■virtual exercise video demonstrations

■streaming video of SilverSneakers classes

■advice from experts in exercise, nutrition and life skills, and much more!

3. SilverSneakers Steps

SilverSneakers Steps is a personalized fitness program for members who don’t have convenient access to a SilverSneakers location. After registering as a Steps member on www.silversneakers.com/member you’ll receive a kit with tools to help you get fit, including resistance bands, an exercise DVD and “how-to” material. Call 1-888-423-4632 (TTY: 711) to find out if your health plan offers SilverSneakers Steps.

The sooner you start, the quicker you can take part in the fitness and the fun."

Healthways Silver Sneakers Program

Gratitude

Dear Linda:


My father was married for 52 years, had a wonderful career, and fathered well three children. Five strokes stole is ability to walk, swallow, and read—his favorite pastime. I’d like to help him stay positive, but his present condition seems to eclipse all that was good in his life. How can we refocus and find something for which to be grateful?

Sad for my Dad:


Dear Sad:

Though you can’t fully grasp the magnitude of your father’s feelings, treat him with as much empathy as possible. People are far more receptive to change when their present circumstance is understood and validated.

You father’s losses have been terrible, so expect some of the same grief stages people experience when a loved one dies—denial, anger and depression, emotions that can hinder making even the most beneficial changes. Be sure he’s had a complete examination and that appropriate medication has been prescribed.

Prevent isolation and inactivity. Discourage too much sleep, daydreaming, and watching TV. They are as much an escape as alcohol or drugs. Taking action instead is the best remedy.

Begin projects that don’t require the skills he’s lost—a new hobby, a coin or stamp collection, puzzles and crafts. Regularly attend worship services and take field trips to museum, the theater, or the library, where you can both listen to and discuss books on tape.

Set the example for gratitude for your dad. Express how much you appreciate all he’s done for you. Be very specific about how his help and guidance has impacted your life. Then ask him to share his stories—the mentors in his life, the pivotal moments, the best and most memorable times. Suggest writing them down in a gratitude journal, and read them aloud periodically. Read Simple Abundance by Sarah Ban Breathnach for inspiration.

Be sure to honor his past by writing letters of gratitude to family and friends. You will find that expressing appreciation and focusing on the blessings will impact attitude, create a sense of well-being, and produce peace of mind.

Giving Gift Cards

The holidays are approaching and it is always a dilemma to buy for those who have everything. Gift cards can be the solution.

Gift cards are simple to buy, reduce shopping time, and alleviate guess work. They allow the recipient to buy whatever they want or need in a time frame that may take advantage of after-holiday sales.

Because the stigma of cards being the lazy man's gift is gone, and they're readily available from banks, credit card companies, and a variety of retailers, they have become a popular solution. They are also a great gift for the person who may not need anything frivolous but does need the basics like groceries or gas or a splurge like a manicure or spa day.

There are drawbacks, however. They're easy to lose, can be stolen and are often allowed to expire. Fees and restrictions erode their value, and buyers aren't protected by regulations. In a letter to the Federal Trade Commission, Representative Joe Barton wrote "that consumers will be confused by the different rules that retailers have for their cards, and some have been and will be deceived about card restrictions."

To avoid difficulty, buy from a reputable merchant (avoid fraudulent cards often sold on websites). Purchase from a retailer rather than a credit card company to avoid restrictions and purchase fees that range from $2 to $10.95.

Some gift cards carry inactivity fees that reduce card value or maintenance fees (as high as a one-time assessment of $25 or $4.95 a month). Other cards expire in six months, and some merchants tack on a surcharge, which means a $25 gift card could cost you as much as $35. Be informed. Visit www.bankrate.com where all major credit card gifts cards are analyzed.

Consider a gift card from the local pharmacy, hair salon, book store or favorite restaurant. The likelihood for card use is greater.

Explain any restrictions to the recipient, and include the receipt when giving the card. It will be easier to get a replacement if the gift card is lost or stolen.

Fearing Alcoholism

Dear Linda:

I'm worried about my dad who is a 78-year-old widow. Though he's always been jovial and outgoing, lately he's cranky and totally withdrawn. The last time I visited he was shaking, covered in bruises, and unwilling to discuss why. I fear I found the answer in empty alcohol bottles in the trash.

Dear Fearing Alcoholism:

Alcoholism among seniors is considered a "hidden epidemic". The very symptoms that would suggest a problem are ignored or misdiagnosed because they are also associated with aging--dizziness and falls, incontinence and poor hygiene, confusion and impaired memory, depression and excessive napping, disinterest in food and isolation.

The typical consequences of alcohol abuse (family and financial problems, job loss and arrest) are not really a deterrent for an older person. Seniors who are retired, drive less, and live away from family and friends are able to drink alone for a long time before the problem is detected. It finally becomes obvious to the family when the aging alcoholic can no longer function independently.

The Center for Substance Abuse Treatment reported that: 15% of male alcoholics and 24% of female alcoholics began abusing between the ages of 60-69, and 14% of males and 28% of females began abusing between the ages of 70-79. Social isolation, loss and grief, housing and financial concerns, and physical and mental health problems are some of the reasons for late-life drinking.

Because of physiological changes due to aging and the pharmacological impact of mixing medications with alcohol, seniors 65 and older are even more vulnerable to the adverse effects of abuse. Their immune system is compromised and ability to resist disease greatly diminished.

Education is key before intervention can be successful. Read Aging and Addiction: Helping Older Adults Overcome Alcohol or Medication Dependence by Carol Colleran and Debra Jay (Hazelden). Visit the National Institutes of Health at www.niaaa.nih.gov. Call Focus on Recovery at 866-255-5029 for program referrals or Alcoholics Anonymous at 212-870-3400.

Confront with love, compassion and understanding. Visit a physician for proper diagnosis, and take heart. Generally, the elderly stay in recovery programs and respond well to treatment.

Parents Need to Get a Grip

I am a firm believer in raising well-disciplined children who are respectful, responsible, and motivated to excel, and those goals should be accomplished primarily by the time children begin elementary school. Though refinement of those characteristics continues until adulthood, if children are well-mannered, well-behaved and hard working at the start of school, they will experience encouragement and positive reinforcement, and their self-esteem will be nurtured based on merit.

As a result of a lot of effort on my part and a clear value system in our family, I raised two very successful children; both are college-educated and philanthropic, highly responsible with thriving careers, and well-liked and respected by others, and I didn’t have to beat them to accomplish those goals.

I am more and more distressed over what seems to be a trend in this generation. Many parents are proponents of the theory that “sparing the rod spoils the child” and wielding that rod is generally the first course of action rather than the last. My worry is that it has more to do with the parents, rather than the children, being out of control.

A horrendous example of that is the Texas woman who beat her two year old into a coma over a potty training issue and super glued her hands to the bathroom wall, and though this is obviously extreme, abuse like this has become more and more common. I recently had a repairman in my home bragging about beating his four year old with his belt. He truly believed it was the only way to make his son behave. What a terrible mistake and a particularly crazy philosophy when trying to teach a child not to hit others. Don’t these parents see the absurdity of hitting a child for hitting? Where do they think the child learned the behavior?


What is necessary for raising well-disciplined children?


Being Committed


Parents need to have a well-thought out philosophy that both agree to enforce, and they need to have a well-considered plan in place to handle situations before they present themselves. Then they need to follow through. That way they are prepared, empowered and in control of themselves.


Taking Time


Parents must devote time and energy to the JOB of parenting well. Problems are not solved with shortcuts, and hectic schedules or being tired are never good excuses for not following through. It takes time to explain to children why certain behaviors are unacceptable and why the desired behavior is required. Teaching the child to behave appropriately is the parent’s JOB. Learning to behave appropriately is a process that takes time.


Being Realistic


Parents, particularly with the first born, often have unrealistic expectations for their children. If they have set the bar too high and the child repeatedly fails, they become frustrated and ultimately lose belief in themselves. If a child is punished for something that they are not capable of doing yet, a trust is broken and a defeated child is the consequence. The parent risks killing the child’s spirit. The other consequence can be high performing children without self-confidence driving their behaviors.


Explaining Your Expectations


Explain your values in terms your child can understand. Take the time to explain the reasons behind why you are asking he/she to behave in certain ways. If your child understands the types of behavior you'd like them to avoid, they're more likely to apply that reasoning to different situations, instead of learning to stop one behavior at a time.


Assessing the Environment


If your child is acting out of sorts, be sensitive to what is going on. Have you gotten them off schedule? Is your child sick or tired or hungry? Is it a new place or situation? Are they afraid or intrigued or embarrassed? Perhaps there is good reason for a change in behavior. Make an assessment of the situation before reacting. New situations offer teaching opportunities but the parent must be patient and even forgiving if there are lapses.


Avoiding a Power Struggle


If you don’t want your child to say no to you, don’t give them the opportunity. For example, if I wanted my children to have cereal in the morning, I would say, do you want oatmeal or Wheaties. They felt empowered because they had been given a choice, but I was really in control. If I had asked instead, “Do you want cereal?” I might have gotten a no answer instead and then the battle begins.


Being predictable


It is critical that your child knows that you're going to do what you say you will. If you explain what a punishment will be, and then don't act on it, you will have less credibility the next time.


Being Consistent


It is crucial for your child to understand that if they choose a certain behavior; they will always get the same consequence. If he/she can count on the rules staying the same, they're more likely to abide by them. This also allows the child to feel as if they have control over their life.


Being Reasonable


Consequences for unacceptable behavior should be logical. For example, one time, my three year old sprinkled baby powder all over the stair case. I could have spanked her but what would that have taught. Instead, I made her clean up the mess. Because I consistently required that she clean up her messes, she made fewer and fewer of them. The punishment should always fit the crime.


Withholding rewards


Determine what your child values — it could be a toy, an activity, or even a privilege like getting to stay up. That becomes leverage when the child misbehaves. Those positive things can be withdrawn for a certain period of time. You could also introduce a negative consequence like a time-out or being sent to their room to consider what they’ve done.


Giving Positive Reinforcement


If you want your child to behave well, you have to reward those behaviors at every opportunity. Look for the moments to give praise and be effusive. Discuss the accomplishment with pride to others—Daddy or grandparents. They say it takes 20 positive comments to compensate for one criticism, and we are so quick to point out and punish the negative. Create opportunities for your child to be successful and then reward them not with things but with compliments and hugs and more of what they really want—generally your time and attention.

Dental Nightmares

I have a friend who just had the most horrible experience at the dentist. She went in to correct imperfections in her smile that had come with aging, but came out frowning instead about both the process and the outcome.

Finding the right dentist is critical for successful procedures that will impact for years the appearance and function of your mouth and teeth.

According to Dr. Susan Hollar (who is one of fewer than 250 accredited cosmetic dentists worldwide), “Most dental schools don’t teach adequate courses in cosmetic dentistry. To perform restorative and cosmetic procedures with the greatest artistic eye and highest technical skill, a dentist must study cosmetic dentistry in a post-graduate program like the American Academy of Cosmetic Dentistry (AACD) with an accreditation process similar to board certification. The dentist you select should have substantial experience in complex cases, extensive hands-on training, an expert approach to your particular case, and a gentle chair side manner to ensure comfort and easy questioning.”

Visit www.AACD.com for a list of accredited dentists in your area and for information about procedures, techniques and materials. Educate yourself about the procedures you’re considering, interview several cosmetic dentists before deciding, and tour their offices and in-house labs. You’ll be able to assess who’s given an honest evaluation of your needs and who has the highest standards for execution. You want the dentist who’s a perfectionist—the one who wants to meet your expectations for excellence but needs to exceed his/her own.

Look at before-and-after photos of the restorations you want. Beware that commercially produced photos can be acquired, so confirm who’s done the work. Ask how long the restorations last and if they’re warranted against breaking, chipping and staining.

See if the dentist uses a procedure known as the “Trial Smile”, a simulation of your new smile that adheres to your teeth. Not only do you get the look and feel of the future, but also an accurate assessment of procedural time and fees.

Great cosmetic dentistry is really an art. Take the time to do your research and find the best qualified in the field.

Surviving A Shingle Shot

Well, I finally bit the bullet yesterday and got a shingles vaccination. We have a commercial running currently that was effective in terrifying me about the extent of associated pain. It reminded me about the pain my father suffered with an outbreak both on his leg and surrounding his EYE. He described the patch on his leg as if somone had laid an iron on his skin, and the doctors were forced to call in a specialist for the eye.

I actually got my vaccination at the pharmacy. The pharmacist spent some time warning me about the possible but not probable side effects--swelling and reddness at the injection site and/or light rash reminicient of chicken pox but not nearly as severe. None of that happened, though I needed to be aware that the rash could happen during the coming two weeks, when I am also slightly contagious to the very young or old who have not been vaccinated.

The pharmacist also suggested getting my flu shot at the same time. That worried me, but she said that if I had them done at the same time, there would be no problem, but if I didn't have them done (one in each arm) together, I would have to wait 3-4 weeks before getting the flu shot. I decided to get both done, and so far so good.

Shingles is a viral response to chicken pox. Chickenpox (varicella zoster) is a common virus among children that causes mild illness and lifetime immunity. The varicella virus remains dormant in the body, however, and if the body’s immune system is weakened (by aging, stress or other infections), the virus can reactivate and cause shingles, a far more serious illness than chickenpox.

Most common in adults 65 and older, the shingles (herpes zoster) virus spreads down the nerves and causes a painful, blistering rash that patients can’t bear having touched, even by clothes. Though more common on the trunk of the body, the excruciating rash may break out on the limbs, head and in the eye (causing blindness), an emergency reason for the involvement of an ophthalmologist as well as a physician, who can treat the disease most effectively at onset. The rash pattern, blister fluid and blood samples can confirm the diagnosis. Despite the size of the rash (sometimes a small patch that seems out of proportion to the extent of the pain), the patient may feel very ill—feverish, exhausted, achy, and often depressed.

Medication can be particularly helpful within 72 hours of first symptoms. Usually within two weeks, blisters burst and crust over, sometimes leaving scars. The pain may subside as the rash recedes, but not always. Some are left with pain in that area for months and even years (called post herpetic neuralgia).

In addition to antiviral medications (which lessen disease severity and duration), steroids for inflammation, pain killers, antidepressants and anticonvulsants, topical agents may be prescribed. Shingles isn’t contagious, but the virus particles are in the blister fluid. Someone who hasn’t had chickenpox could become infected.

To learn more about shingles, contact the National Immunization Hotline at 800-232-2522 or visit www.cdc.gov. Call the National Chronic Pain Outreach Association at 540-862-9437 or visit www.chronicpain.org for information about chronic pain management.

Hospice

I have a friend who is dying. Though she was ill, no one thought the end would come so suddenly, and no one was ready in thought or emotion. She was beginning to act oddly, lose weight, sleep more, and talk less, but neither family nor friends could face the reality that the end was near until being hospitalized was necessary and the diagnosis made. She was given only a month to live.

What does one do to prepare and how does one make the end as easy as possible for the person dying? These are tough questions especially for those who are emotionally involved. The best course of action is to contact Hospice, either a service or a hospice facility. They will begin immediately to ensure that everyone's comfort is optimum.

Hospice is an excellent program that is under-utilized and often called so late in the process that many beneficial services go unused. Though the purpose of Hospice is to provide compassionate support and extraordinary care for people in the final phase of a terminal disease, the program's goal is to enhance the quality of life regardless of its duration.

Subscribing to a holistic approach, a Hospice team includes a medical director, physician, nurse, certified nurse assistants (CNAs), social worker, spiritual care coordinator, therapists and counselors. Volunteers provide companionship and emotional support to the patient and respite services for the patient's caregiver, including shopping, errands, childcare, and light meals.

Begin with discussing your loved one's condition with the doctor, who must certify to Hospice that the patient is no longer thriving or that the disease is terminal. Ask the physician to recommend the best Hospice provider or call the National Hospice Organization at 800-658-8898 or visit www.nhpco.org for valuable information and recommendations.

Once a patient has been examined, records reviewed and medications evaluated, a care plan is developed. Then Hospice will provide all necessary equipment, supplies and medicines, whether the patient is at home or in a facility, and the cost is covered by Medicare, Medicaid or private insurance. The final phase of the journey need not be feared. With help and support, the last moments in our loved one's life can be peaceful and uplifting.

Making Congress Accountable

Warren Buffett, in a recent interview with CNBC, offers one of the best quotes about the debt ceiling: "I could end the deficit in 5 minutes," he told CNBC. "You just pass a law that says that anytime there is a deficit of more than 3% of GDP, all sitting members of Congress are ineligible for re-election. The 26th amendment (granting the right to vote for 18 year-olds) took only 3 months and 8 days to be ratified!

Why? Simple! The people demanded it. That was in 1971 - before computers, e-mail, cell phones, etc. Of the 27 amendments to the Constitution, seven (7) took one (1) year or less to become the law of the land - all because of public pressure.

The public is asking for Congressional Reform Act of 2012
1. It includes No Tenure / No Pension. A Congressman/woman collects a salary while in office and receives no pay when they're out of office.
2. Congress (past, present and future) participates in Social Security. All funds in the Congressional retirement fund move to the Social Security system immediately. All future funds flow into the Social Security system, and Congress participates with the American people. It may not be used for any other purpose.
3. Congress can purchase their own retirement plan, just as all Americans do.
4. Congress will no longer vote themselves a pay raise. Congressional pay will rise by the lower of CPI or 3%.
5. Congress loses their current health care system and participates in the same health care system as the American people.
6. Congress must equally abide by all laws they impose on the American people.
7. All contracts with past and present Congressmen/women are void effective 12/1/12. The American people did not make this contract with Congressmen/women. Congress made all these contracts for themselves.
Serving in Congress is an honor, not a career. The Founding Fathers envisioned citizen legislators, so ours should serve their term(s), then go home and back to work. THIS IS HOW YOU FIX CONGRESS!

Respecting Your Elders

Just one of the interesting facts that I have learned while visiting the great state of Alaska is that the older generation is treated very differently by the various Native groups. There are some Native groups that hold their elders in very high regard. They treat them with respect, reverence even, and great care.

The younger generation is smart enough to know that their elders are a tremendous source of wisdom and experience, and that there is no point in reinventing the wheel when they already know the tried and true procedures for doing things well.

They also recognize that their elders are the keepers of the stories, the protectors of a family's history, and the bridge between the past and future, and though it may not seem important to a 30 year old to know what those stories are, that changes with maturation.

As we grow older and wiser, we begin to understand why knowing and valuing the past is critical to a family's cohesiveness and continuity in the future. Other Native groups handle the elderly differently. They consider them a "problem" to be dealt with, an obligation to be handled, someone to be facilitated.

Because the aged are less physically capable of pulling their weight and contributing to the clan, they are considered a drain on the reserves with no real value any more. They treat their elders with disdain, disrespect and ultimately exclusion.

A great book written about this ultimate death sentence is Two Old Women by Velma Wallis. The author describes how it's decided and accomplished that the women are left behind to die. What is riveting about this book is what the women do about it. There is of course an unexpected ending and an important lesson to the younger generation.

Are the Native Americans so different than the Americans in the lower 48 states? Of course not. Are you a child or grandchild that values and treats with love and respect the elders in your family or are you so focused on your own needs that you create a superficial, ultimately less reciprocal and certainly less gratifying relationship.

We are called to honor our parents. It is a Commandment. That doesn't mean to tolerate or patronize or minimize our elders. It doesn't mean to treat it as an obligation so that we don't have to bear guilt later. It is a joy to honor and care for those who have cared for you, but it takes wisdom and unselfishness to understand why.

Splendor in the Wild

I just returned from a trip to the Arctic Circle. Only 5% of all who visit Alaska take advantage of this amazing opportunity to cross the magnificent Yukon River to see the end of the world. That is a terrible shame as the Arctic tundra looks likes no where else on earth.

We left behind the beauty of the millions of black spruce trees that served as a back drop to the lemon yellow poplars and silvered birches and moved onto the skinny poles that alone could grow on the perma frost. Then we got to the Arctic tundra where no trees grew at all and the mountains were brown and lifeless. The starkness was disconcerting and dramatic.

The ferocious wind, which no foliage above ground could withstand, bit our faces and drove down our heads. It was then that I noticed the beauty below my feet. The ground cover that blanketed the floor of the tundra was striking.

The fire weed, which makes the best jelly, was cherry red. Cranberry and blueberry plants that fed the birds and squirrels painted the ground burgandy and blue, and pumpkin orange seeds dropped from a trailing vine that seemed to have no beginning or end. The expanse of color of that ground cover was so gorgeous that it looked painted. The artist's strokes were course and convoluted but made for an unforgettable masterpiece.

On the way back from the Artic, we crossed the Yukon again. Despite knowing that danger lurked around each corner in the form of bears and wolves, the compulsion to explore was so great that I had to hike down to the banks of the largest river in Northern America. It was massive, deadly cold and a watery grave for so many fisherman who had waded in, but it was beautiful and the home and food source to many native groups.

Traveling to and from the Arctic on the Haul Road was an experience I will never forget. The road, which is the only one to the Arctic, was built by the brave men and women who built the Pipeline, a true engineering miracle that required the worst kind deprivation and difficulty in living to bring us the oil still found in the depths of a state that is so rich in so many natural resources.

Reindeer and caribou and bears, oh my!

Alaska is, without a doubt, God's country. The snow covered mountains are not only massive but majestic. Snow covered and hugged by dramatic cloud formations, they glint in the sun and shine ebony in the rain.

I felt mixed about approaching anything so awesome though. The mountains offer extraordinary excitement and adventure, but one knows that danger can also lurk at every turn, mostly in the form of wolves, massive grizzly bears, and moose that will charge, particularly if they are protecting their young.

There are few roads in Alaska, so travel is a constant challenge. Transportation in town is easy enough--cars, taxis and trolleys, of course, but going from one city or town to another is a different story. The people who live here travel by small planes to the "bush" or remote areas, fly their own pontoon planes that land on any water way, or drive big trucks or heavy vans to tackle the few roads that are snow packed or ice covered. Travel here is definitely not for the faint of heart.

The other variable to dangerous driving is that the wildlife traverse the same territory, and, believe me, they have the right of way. At a couple of tons and with a jump range of eight feet, the caribou and the reindeer, can and do appear out of no where.

Also, at this time of the year and prior to going into their hibernation, bears--brown and grizzly both, can be found looking for food anywhere--in town walking down the street, in the parks where runners jog, and even in the back yard. And one does not want to come between a bear and a meal, so vigilance, care and respect for nature is mandatory.

Like most of us, I believed the wild west existed only in the history books now. Not so...Alaska is most definitely a last and wild frontier.

Alaskan Adventures

I am thrilled about traveling soon to Alaska. I begin in Anchorage, a city known for its culture and sophistication, to see the closing of the theatrical production that my friend's first book was turned into. I could not be happier for Lael Morgan's success and suggest you check out her fabulous books about the history of America's wild west including The Good Time Girls, Wanton West and Eskimo Star.

After my foray into big city life in a state known for its wild ruggedness, I will board a glass domed train to Seward to catch a ship to see the glaciers and to watch whales and bears. Then I hope to take a helicopter ride to Juneau to visit the capital of this magnificent state. With the exception of once taking a glass domed train through the gorgeous mountains in Colorado, all the rest of these adventures are entirely new to me and high up on my bucket list.

Afterwards, we are driving for seven hours through some of the most magnificent terrain our country has to offer to Fairbanks for a variety of adventures including a paddleboat ride up the river to the north country, a visit to the hotsprings that are enjoyed often during snowfalls, and a trip down Haul Road to the Arctic.

I am also looking forward to the ice museums and botanical gardens for which Fairbanks is famous. It does seem the perfect place for both. I looking forward to describing these adventures in future columns.

In deciding where to stay, we chose a Bed & Breakfast, a charming alternative to hotels or motels even in the most beautiful environments. I decided to rerun my column on B&B's below so you might also try this unique experience. I say unique because each B&B has its own style, character, type of food service and specialty offerings.

Bed & Breakfasts

Though an exotic vacation in a far-off place sounds attractive, it's not the only prescription for refreshment and rejuvenation. A change in scenery, attentive service, and someone else in the kitchen can do the trick, so consider a Bed & Breakfast in a town you've never visited.

The home styles are as varied as the locales--rustic cabins in the forest, sumptuous villas in the mountains, and charming Victorians with antique lace curtains and embroidered pillows in quaint little towns are just a few of the possibilities.

Visit www.bedandbreakfast.com (particularly on Wednesdays when it lists hot deals) for information about B&B's in your price and travel range. Then decide if you'll drive and see the country side, or fly to another part of the country or world. Be sure to include in your search any special dietary or housing needs like access for the disabled, vegetarian meals, whether or not pets are allowed, and senior discounts.

Ask the innkeeper if the room has comfortable chairs for reading, there are grab bars in the tub and shower and good lighting, particularly in the bathroom, to prevent falls in the night. If stairs are a problem, request first-floor accommodations, and see if you will have phone and email access.

Rather than choose the least expensive inn, select the least expensive room in a more expensive inn to get the most for your money. The reduced cost in the better inn is generally because it's the smallest room. Typically, however, even it has a queen-size bed and private bathroom, and you'll enjoy the same ambiance and amenities as those paying twice the price.

To further reduce the cost, travel off season (avoid holidays and school vacations) and stay mid-week. Ask for a reduction in price for staying multiple nights, and be flexible. Take advantage of last minute, get-away packages.

I Will Decide

I have a friend undergoing major surgery. He was afraid that he was not adequately prepared should he not make it or be incapabe of making his own decisions about subsequent medical care. He was right to be concerned.

If one hopes to direct the quality of last days, preparing is not only responsible but critical. According to Attorney Rick B. Weaver, elder law specialist (817-306-5962 or rweaver@shannongracey.com), “each person should consider signing three documents:


•A Directive to Physicians (giving the family directions when the person is on life support with no chance of recovery);

•A Medical Power of Attorney (appointing an agent to make medical decisions if the person is incapacitated); and

•A Do Not Resuscitate Order (done when a person is in extremely poor health and does not want to be resuscitated in a medical emergency).


The agent and back-up agent on the Medical Power of Attorney are important designations. They function like an executor on a will. If a person appoints someone as a medical agent who is not committed to carrying out the person's wishes, problems can result in the same way that an executor can fail to carry out the terms of the will.

The decision about whether or not to receive artificial feeding and hydration is becoming a larger issue each year. If a person does not want artificial feeding and hydration, this should be set forth in the Physician's Directive.

If a person does not want to be revived, it’s critical that the person sign a Do Not Resuscitate Order and keep it in close proximity. Otherwise, it’s possible that emergency medical personnel may revive the patient without knowing about the Do Not Resuscitate Order.”

Being prepared takes on new meaning when the quality of our life is at stake. You will also make it easier on family members who would be necessitated to make the life saving or altering decisions if these documents are not already in place.

Bus Stop

I am planning a trip to Alaska. I am flying there but making the arrangements using my miles was a task that took two hours and the patience of Job. It turns out those who use their American Airlines miles, even if you use what seems like a million of them, are so restricted now that I had few options for going and only a red eye coming home. You're confused about why it took so long then. So was I.

It  will be exciting when I get there, though, as I plan to take a glass dome train from Anchorage to Fairbanks and a ship to see glaciers, whales and bears on the way to Juneau. I'll let you know how those trips go.

Some of my readers who are planning vacations are reluctant flyers and concerned about the cost of train rides, so I did a bit of research on bus travel. There is a resurgence in interest in traveling by bus and that has forced the companies to redo interiors, add movie/tv monitorers and on board snacks and beverages.

I actually traveled by bus from Boston to Maine and loved every minute. The big windows allowed for great sight seeing and the seats with footstools were comfortable and even a bit luxurious. You can really recline in their seats that are bigger and more restful for long trips than you’ll find on airplanes.

You will also stop along the way for breaks, sightseeing, camaraderie and fun with your fellow passengers, and gaze out enormous windows that allow you to watch the changing countryside of our great land. So hop on a bus and see America because the routes are limitless.
Motorcoach tours are extremely popular with seniors, because bus travel is safe, comfortable, and a great way to meet new people. They offer the convenience of car travel without the drain of driving.

Custom tours can be organized from budget to deluxe itineraries and from one day to extended holiday experiences. They range from limited to all-inclusive packages (accommodations, meals, entrance/activity fees, taxes/gratuities and an on-board tour guide). Paid for in advance, the traveler doesn’t have to guess at costs along the route.

Luggage is handled for the traveler at each stop (bus to room and back to bus), and the traveler is given the agenda for the day that includes planned activities and free time to explore independently. Breakfast and dinner are generally the meals included in packages, and they can be tailored (i.e. low calorie or diabetic) for special needs. Be sure to discuss all requests when you book the tour.

To locate a dependable tour company in your area, call the National Tour Association (NTA) at 800-682-8886 or visit www.ntaonline.com to search for an NTA operator in your area. Also visit this site for a list of tour companies with their internet sites from all over the country.

Dedicated to selecting the most scenic route, the best accommodations, the finest dining, and all the must-see-sights possible, a motorcoach company makes the arrangements for a fabulous tour and resolves any concerns. The traveler just sits back and enjoys.

Adopt A Grandparent

I have been heartened recently with hearing from some amazing young people. I received the letter below and wanted to share it with you.


Dear Mrs. Altoonian:

I’m a freshman in college who was looking for a volunteer opportunity. My adviser suggested adopting-a-grandparent. I met an elderly woman with no family in my own neighborhood, and though I know I have helped my adopted grandmother, I’ve learned more from her than I can say. This special experience has turned out to be such a gift in my life, and I want others to consider doing the same.

A Grateful Teen

Dear Grateful Teen:

It’s so wonderful to hear a young person recognize the value of relationships with older people. Seniors are able to impart valuable wisdom gained from a lifetime of joy and heartache, can teach lessons learned in their work and family environments, and can share their friendship and love—capabilities that don’t diminish with age.


Harvard University research reveals that seniors who participate in social activities, spend time with friends and family, play cards and games, and exercise will live an average of 2.5 years longer than those who are more isolated. Being cared about by even one other person spares that senior from feeling alone and vulnerable.


Adopting-a-grandparent unites the generations. It offers young people an opportunity to receive precious gifts from seniors, and it offers seniors someone to visit and listen, help and serve, and love and comfort them—all critical for physical and emotional well-being.


A very successful Adopt-A-Grandparent (AAGP) program was founded by Linda Lanstraat in Atlanta, Georgia in 1978. In this organization, there are three types of volunteers who give at least two hours a week—a Friend who visits the senior at home, an On-call driver who takes seniors to functions and appointments, and an AAGP Board Member who raises awareness and funds.


Lanstraat can be contacted at linda@adoptagrandparent.org to discuss how to form a program locally and to order her newsletter. Call 404-627-4304 or visit http://www.adoptagrandparent.org.


Whether you are honoring the older generation in your family or the older generation in your life, remember them with your time, respect and love. They will be the givers in your life, the storytellers who are the lifeline to the past, and the one person you can depend on to be exceedingly joyful and grateful each time you call or visit.

Not Another Test!

Life is busy. Fitting in doctor's appointments is a hassle and keeping them is time consuming. It also can be confusing to know what wellness tests are necessary and when to have them done, but regular check-ups and preventative screenings are critical to mantaining good health. They establish baselines to which later tests are compared, and they catch problems as soon as they develop.

Additionally, it is important that we moms set a good example for our children. If they see us making our health a priority, they will be more likely to do the same.

It is also important to understand that when patients only visit physicians when they fell ill, the opportunity to prevent and sometimes even to identify diseases early is lost. When we wait until we are symptomatic, damage has already occured. If problems are caught before the onset of symptoms, there is a greater chance of resolution.

Below are the basic tests that are critical to assess wellness.

In your 20s and 30s:

• Physical Exam once a year.
• Blood Pressure Screening every other year unless abnormal; then definitely more often.
• Cholesterol Screening at age 20, particularly if patient is at increased risk for heart disease.
• Breast exam at least once every three years until age 40; then it should be annual.
• Pap test every other year from 21 to 30, then yearly.

In your 40s:

• Eye exam at least every other year. At age 45, your exam should include a glaucoma test.
• Women should have their first mammograms at age 40; then every other year unless breast cancer is in the family and then a yearly exam may be warranted.

In your 50s:

• Bone density screenings should begin at age 65. If osteoporosis or osteopenia is found, then yearly tests are warranted.
• A colonoscopy should be done at age 50. Unless results are abnormal, they can be performed there after every 10 years.

COPD

I have a friend who is struggling with COPD. He is constantly coughing now and completely exhausted. Coughing all the time zaps him physically and disrupts his sleep, so he feels like a zombie most of the time. His struggle prompted me to do some digging about this disease.


Chronic Obstructive Pulmonary Disease (COPD) refers to two lung diseases—chronic bronchitis and emphysema (often co-existing), and is the fourth leading cause of death in America. Obstructing airflow, COPD is usually caused by cigarette smoke (80-90% of COPD deaths), or inhaling chemicals, dust or pollution for a long time.

According to the National Institute of Health, “The airways branch out like an upside-down tree. At the end of each branch are small, balloon-like air sacs. Healthy airways and sacs are clear and open, elastic and springy. In COPD patients, they lose their shape and become floppy. The airway walls become thick and inflamed (swollen), and the walls between the sacs are destroyed. The airway cells produce more mucus, become clogged, and cause a continual cough.


Chronic bronchitis is the inflammation and scarring of the bronchial tube lining, and emphysema causes permanent holes in the lung tissue. Shortness of breath and coughing is the result. Symptoms can begin as early as 32-40 years of age but are often left untreated, resulting in incurable respiratory problems and even heart failure.


COPD limits physical movement, affects involvement in family and social activities, impacts the ability to do household chores and even work. Patients may eventually rely on mechanical respiratory assistance—supplemental oxygen and even ventilators.


Though there’s no cure, there is treatment. Medications don’t modify long-term decline, but can provide relief. Bronchodilator medications (inhaled as aerosol sprays or taken orally) relax and open air way passages. Oxygen therapy, antibiotics and steroids are used in acute cases, as steroids, in particular, can cause serious side effects long-term. Lung transplantation is more common now, but those with severe emphysema are at higher risk of death from the procedure.


COPD patients should be vaccinated for pneumonia and influenza. They should quit smoking, avoid pollutants, and increase exercise under a physician’s supervision. Visit www.lungusa.org.

Connecting in Modern Times

The truth is that the younger generation is on some kind of screen 24/7. Whether twittering on their phones or facebooking on the computer, they are communicating online far more often than in person, and if parents and grandparents want to stay connected and know what going on in the lives of their young loved ones, they better figure out how to follow along.


One way to keep connected, particularly for family members who are strewn around the world, is to share information through a blog.


A blog, derived from the term “Web log”, is a personal online journal. Increasingly popular since their debut in 1994, blogs can feature any subject. They not only address controversial topics including politics, religion and current events but also fluffier fare about fashion and celebrities. They function as personal diaries, too. Bloggers can change and update their sites at will, and there is not censoring.



Many free sites, like www.livejournal.com, have interactive features that allow blog readers to write comments in response to journal entries, so blogging can be a good way to keep in contact with faraway family and friends. Free blog services also keep an archive, so users can access their previous entries.



Some sites offer a “private” option that permits only certain readers to have access. However, for those who want their opinions and thoughts read by many, befriending unfamiliar bloggers increases traffic to the site and exposure to their writing. In addition to the written entries, bloggers can post images (photos and artwork) and upload links to other sites.



Though it’s estimated that only 5% of bloggers on the Web are older than 50, blogster.com reports that 22% of their users are older than 50. Blogging is not just for communicating with family and friends and the older population is using this form of social media for connecting with others who are like minded.


"When people quit working, their social group shrinks,” he said. “Blogs enable people with similar interests to develop a new social group. Blogging also aids in keeping the brain sharp."

Visit www.blogger.com for more information, and then visit www.createblog.com and blogster.com and http://www.wordpress.com/  for ideas.

Brittle Nails

There was a time when my fingernails were natuarally long and lovely. Now they’re short, peeling and brittle. I was all ready for the dermotologist to blame aging for this problem too. It seems to be the catch-all answer for many problems now that can only be managed not resolved.

Aging is just one explanation for nails that are so dried out that they chip, split or snap off. Thyroid dysfunction, malnutrician, anemea, vitamin/mineral deficiency, and diseases of the lung, kidney and liver that affect the amount of oxygen in the blood are medical reasons for first seeking a physician’s diagnosis and resolution of the problem.

Water is another culprit. When nails soak, they absorb water and expand 20-25%. When nails are dry, they contract. The more water they’re exposed to, the more they expand and contract, and that weakens them, so if you take long baths or showers, do a lot of swimming or cleaning, particularly with harsh household products, you’ll be prone to brittle nails.

Certain nail polishes, nail polish removers and nail hardeners, particularly those containing formaldehyde, can be drying. Some low grade products actually have the strength of paint strippers.

To prevent brittle nails, avoid exposure to strong detergents or wear gloves when cleaning, and use polish removers no more than once a week. Use a lactic acid moisturizer after hand washing. Keep fingernails short to avoid injury, and use emory boards to trim not metal files as they weaken the nail tip. Never bite or peel nails.

A good diet is critical for healthy nails. Foods that improve nail strength are: milk, liver, salmon, tuna, trout, shrimp and cod liver oil. Rich in biotin, cauliflower, peanuts and lentils thicken nails. B-complex vitamins and minerals including silica, iron, zinc and calcium are also beneficial.

Massage nails with castor or vegetable oil to moisturize and stimulate circulation, and give nails a break from daily use of polishes. Water-based nail products are safer and non-toxic. They hydrate the nail, allow oxygen exchange, and recondition damaged nails.

Elder Abuse

Dear Linda:


Though the nursing home in which my elderly mother resides seems nice enough, lately, I’ve been suspicious that she’s been abused. How can I tell and what do I do?




It’s difficult and painful to imagine anyone harming those who are frail, ill and totally dependent on others. The trust given by families to assisted living centers, rehabilitation facilities, and nursing homes is sacred but often broken, and don’t let the décor fool you. Some of the worst cases of fraud, neglect and abuse have occurred in the plushest surroundings.


The National Elder Abuse Study reported that over 500,000 Americans, 60 years and older, were abused in 1996. The study also revealed that only 16 percent of cases were reported and referred for help. The Senate Special Committee of Aging now estimates five million victims every year.


According to Dr. Linda Woolf of Webster University, there are six types of abuse with symptoms for each. “Neglect: malnourishment, chronic physical and psychiatric problems, dehydration, bed sores and poor hygiene. Physical Trauma: scratches, bruises, cut, burns, punctures, choke marks, restraint (rope burns, gag marks, welts), repeated and unexplained injury (sprains, fractures, detached retina, paralysis), inconsistent explanations of injuries and lag time between incident and treatment. Psychological:passivity, shame, anxiety, depression, confusion, trembling, cowering, clinging, lack of eye contact. Sexual Abuse: trauma to the genital area, venereal disease, infections, discharge, odor and any of the psychological symptoms. Financial: bank statements diverted, accounts changed from one bank to another, documents drawn up for an elder no longer competent to sign, missing property. Basic Rights: withholding mail, obstructing religious freedoms, over medicating or sedating, and preventing the elder to speak.” For more information, visit www.elderabuseprevention.com.

If you recognize symptoms, call 911 and report your suspicions immediately. Also contact Adult Protective Service (APS). The APS agency will assign a caseworker to investigate (usually within 24 hours) and intervene as necessary. Contact Eldercare Locator at 800-677-1116 for the number in your area and visit www.elderabusecenter.org for a list of hotlines—all free, anonymous and confidential.

Good Vision in a Downpour

I thought this tip from a policeman about how to achieve good vision during a heavy downpour, even at night, was too important not to pass it on.


"Most  motorists turn wipers on the HIGH or FASTEST SPEED during a heavy downpour, yet the visibility through the windshield is still bad.

In the event you face such a situation, just put on your SUNGLASSES (any model will do), and miracles! All of a sudden, your visibility will be perfectly clear, as if there is no rain.

Amazingly, you still see the drops on the windshield, but not the sheet of rain falling. You can see where the rain bounces off the road, but it works to eliminate the "blindness" from passing cars or the "kickup" if you are following a car in the rain.

Make sure you always have a pair of SUNGLASSES in your car. You are not only helping yourself to drive safely with good vision, but also might save your friend's life by giving him this idea."

Another good tip:

A 36 year old female had an accident several weeks ago. It was raining, though not excessively when her car suddenly began to hydro-plane and literally flew through the air. She was not seriously injured but very stunned at the sudden occurrence! When she explained to the highway patrolman what had happened, he told her something that every driver should know - NEVER DRIVE IN THE RAIN WITH YOUR CRUISE CONTROL ON.

She thought she was being cautious by setting the cruise control and maintaining a safe, consistent speed in the rain, but the highway patrolman told her that if the cruise control is on, your car will begin to hydro-plane when the tires lose contact with the road, and your car will accelerate to a higher rate of speed making you take off like an aeroplane.

She told the patrolman that was exactly what had occurred. The patrolman said this warning should be listed, on the driver's seat sun-visor - NEVER USETHE CRUISE CONTROL WHEN THE ROAD IS WET OR ICY , along with the airbag warning. We tell our teenagers to set the cruise control and drive a safe speed - but we don't tell them to use the cruise control only when the road is dry."

Caring Conversations

Dear Linda:
I'm 84 and just learned that I have a terminal illness. I've led a blessed life and have no fear, but feel I have loose ends, and I'm not sure how to share my final wishes with my dear family. Have you any ideas for how to begin?

Looking for Direction

Dear Looking for Direction:

You demonstrate great courage during one of the most difficult times people face. There is no doubt your thoughtfulness and consideration of others have been factors in your life well lived.

Of all the phases experienced, the end of life seems the one for which we are least prepared, yet preparation is crucial to ensuring that our wishes are respected and to determining how our final days are spent.

Time taken to prepare is the opportunity to evaluate our lives, mend fences, handle regrets and finish business. Also, making final decisions lessens the suffering in the physical, psychological and social areas for all involved.

The Center for Practical Bioethics has an excellent workbook called Caring Conversations that can be downloaded from site www.practicalbioethics.org or ordered from 800-344-3829. Using a series of questions, it guides you through the process of deciding your beliefs and preferences in the areas of spiritual/religious values, healthcare, career and work, financial matters and personal relationships.

Some examples of decisions you’re guided to make and will ultimately share with your family are: what will make you feel most comforted (living your days in a hospital or at home), treatments (pain medication but not tube feeding), duty delegation (wills and powers of attorney), and fulfilling financial obligations (prepaid funeral and trusts to pay medical bills).

Read Dying Well (Berkley Publishing Group) by Dr. Ira Byock, who suggests that dying people need to say “I forgive you. Please forgive me. I love you. Thank you and good-bye.” Perhaps the kindest and most respectful farewell is allowing the opportunity for those caring conversations.

Demonstrating Friendship

When the challenges of life happen, people often offer to help. They may bake a cake for a  funeral gathering, cook a casserol for a sick friend or donate money to a catastrophic event collection, but it is a reality that offers of help are often given out of politeness and sustained help is rarely realiazed.

I experienced the rarity after my recent surgery. I have only a son who lives locally. The rest of my family is now either deceased or living far away, and I needed help. My son, of course, was wonderful, but it was my friends who carried me through the three weeks of recovery.

They visited daily and staved off any cabin fever. They shopped and ran errands as I could not drive. They cooked and cleaned. At every turn, I experienced one blessing after another. These are friends who do not give lip service but heart service.

As we grow older, it is imperative to surround ourselves with people who are givers. How do we accomplish that? By bring a giver first. If we are generous with others, they will surely be generous with you. Now, I am not saying that you should do for others for what might come in return, because doing for others is intrinscally a good and valuable endeavor, but we should be mindful that a real support group becomes more and more critical.

I sent thank you notes to my friends who made my recovery so much easier, but words were insufficient to express how deeply I really appreciated not having to ask for help; how much I appreciated friends who anticipated needs and filled them, and how much I appreciated love expressed through action instead of words which are often offers of help without real commitment.

Such generosity was moving and monumental in my life, proof that paying it forward is rewarding on many levels. We can only exist as a member of community. They say it takes a village to raise a child. I say it takes a support group to face aging.

Putting on the Pressure

I got lots of notes of interest in my low blood pressure column, so I thought I'd better cover the other part of the spectrum--high blood pressure, particularly the issue of genetic predisposition.


While genetics is a factor associated with high blood pressure (also called hypertension), smoking, alcohol consumption (more than 3-4 ounces of 80-proof per day), caffeine (5 cups per day), obesity, oral contraceptives, a high-salt diet, and stress are major contributors to a problem that nearly one-in-three Americans have.



Referred to as the “silent killer” because there are no symptoms at disease on-set, many go for years without knowing they have hypertension. When left uncontrolled, it can lead to stroke, heart attack, and heart or kidney failure.



The best way to know if you have hypertension is have your physician get an accurate measurement of systolic pressure (as the heart beats) over diastolic pressure (as the heart relaxes between beats). Normal blood pressure (the force of blood against the artery walls) is less than 120mmHg systolic and less than 80mmHg diastolic.



Because there is no cure for hypertension, medication and life style changes are crucial for keeping blood pressure in normal range. Stop smoking (as it also leaches calcium—another contributor to hypertension), minimize caffeine, alcohol and salt consumption, and increase exercise. The American Heart Association recommends 30-60 minutes a day to reduce stress and lose weight that causes heart strain. As little as a 10-pound loss can be beneficial.



Call the American Heart Association at 800-242-8721 (http://www.americanheart.org/) to order its free packet “Understanding and Controlling High Blood Pressure” that includes “Shaking Your Salt Habit”, a guideline for healthy cooking and flavorful recipes that replace salt with other spices.



Follow the DASH (Dietary Approaches to Stop Hypertension) diet. Rich in fiber, it contains more electrolytes, potassium, calcium and magnesium than the average diet. Visit the National Heart, Lung and Blood Institute at www.nhlbi.nih.gov/health/public/heart/hbp/dash to order one free copy of the diet. Be sure to consult your physician, however, before beginning any new diet or exercise program.

How Low is too Low?

My surgery went very well. The only glitch was that I was a bit anaemic going in  and lost some blood during the process. My blood pressure, which is always  low, plumetteted to 60/40. I asked how far down it could go before we needed to worry about my being dead. They didn't answer directly, but ordered a two pint transfusion for that evening.

This was not a great process because I had to wear a blood pressure cuff all night, and they had to check oxygen hourly, so I may have gotten 15 minutes of sleep the whole night. I was not a happy camper.

The anemia was a surprise. I eat lots of lentils, dark green vegetables and fruit, but I am down to eating mostly chicken and fish---beef maybe once a month. I thought that was a good thing and though it is, it was decided that I needed to eat beef/liver once a week, and that I needed to be on an iron supplement twice a day, so hopefully this plan will do the trick.

Regarding the low blood pressure, about which, by the way I was always so proud, it can be problematic. The average is 120 for systolic pressure and 70-80 for diastolic, so an average would be 120/75. Mine has been 110/60 consistently (so really just below average), but they get excited each time.

If your blood pressure drops below 90/60, then this can be considered low blood pressure. It can be also considered low if only one of the numbers is really low, for example 120/40. There are almost as many reasons for fluctuation as there are the differences among us, but some general factors include our level of fitness, the amount of our exercise, and whether we smoke. Are some of you out there still smoking...really?

If you are a very fit person, then sometimes your blood pressure can drop below the average, and you can be absolutely fine. Low blood pressure can be caused by hormonal changes, a side effect of medicine, anaemia or a widening of the blood vessels. Hypovolemia (reduced blood volume) is the most common cause of low blood pressure which can result from a haemorrhage or blood loss, not taking in enough fluids or an excessive loss of fluids.

One  is diagnosed as having low blood pressure  if  they show other symptoms as well as a blood pressure below 90/60. Symptoms include: Chest pain, shortness of breath, irregular heartbeat, high fever, headache, stiff neck, severe upper back pain, coughing with phlegm, prolonged diarrhea or vomiting, dyspepsia (indigestion), dysuria (painful urination), foul smelling urine, seizures, loss of consciousness, fatigue, temporary blurring or loss of vision and in some cases loss of hair.

The important thing is to check your blood pressure routinely and consult with a doctor about fluctuations or associated symptoms.

Want a Joint?

Monday is the day that a surgeon will cut a six inch incision into my body, remove my knee, and replace it with a brand new joint. After a fall down some stairs, I finally smashed a knee that bone on bone. It was riddled with arthritis as a result of another surgery twenty years ago when I tore a ligament dancing, a far more happy accident than falling down the stairs and a much simpler surgery than I am facing now.

The problem is that whenever they cut into your body, scar tissue and then arthritis is also a result. Now, I am convinced I need the surgery, and friends to whom I have spoken laud the wonder of not hurting when they walk or bend, but I am worried about the physical therapy. 

My PT, whom I love, says I will hate her soon because she intends to work the new joint so hard that I will need to take vicodin to tolerate it. She says also that it could be several months of this torture, and that if I don't do all that is necessary, I face the possibility of a frozen knee, a knee that won't straighten all the way or a walk that looks more like a pirate with a peg leg. None of these prospects are attractive, obviously, but the remedy seems almost as awful.

The joint itself is a titanium prosthetic that they believe will last 15 to 30 years depending on how hard I am on it. Since I don't intend to jog or downhill ski, I believe I have a good shot at keeping it for a while, and now,  if I do need another before moving onto to heaven, they are able to go in and just replace the plastic pad and not the whole prosthetic.

An oddity of having a metal prosthetic in my body besides setting off bells and whistles at the airport is that  I will have to take antibiotics forever before any dental work including cleanings. Because the mouth is a breeding ground for bacteria, if any gets into the bloodstream, the area around the prosthetic could become horribly and dangerously infected.

Despite the difficulties associated with any surgical recovery, I am assured that I will feel like a new woman afterwards; that soon I won't even think about the knee as I go about my activities. I am focusing on that eventuality.

Make it a Happy Mother's Day

I love to run this reader letter on Mother's Day weekend. I think it speaks well about how the celebration should look. How are you honoring the woman who gave you your life then sacrificed hers to give you every opportunity?


Dear Linda:

I’m an avid reader of your special column.  I’ve been particularly interested in your Mother’s Day columns. They’ve included lovely ideas for honoring mothers. I’ve been moved to tears, because it doesn’t occur to my children, who live close, to do anything for me besides a call. Perhaps I should be content, but it’s hurtful that they never include me in their celebrations.


It isn’t as though they don’t know better. When my husband and our mothers were alive, we made Mother’s Day a special time. In the morning, I’d be awakened to breakfast in bed. The tray was decorated with flowers, gifts and cards that expressed love. My husband involved the children in the preparation of the food, and though the toast was sometimes burned and the eggs runny, nothing ever tasted better.



Afterwards, we dressed-up and visited our moms. Though they didn’t need much, we gave them something that made their growing dependence easier, and my husband never neglected to buy “each of his gorgeous gals” a corsage.



Then we all attended church. The service addressed the importance of honoring mothers—that it was small repayment for their innumerable sacrifices made constantly for the betterment of the family. We’d be filled with an urgency to express gratitude, particularly with an aging mother.



After, we’d dine out—often in the next county so we could see the spring flowers. We’d tour the town and antiqued. We’d end the day at “our favorite” ice cream shop for banana splits. We all looked forward to the day with great excitement. I don’t know how my children have forgotten, and I worry that I’m selfish to expect more.


Signed a Sad Mom

Dear Sad Mom:


I don’t think you’re being selfish to desire more. You letter speaks beautifully to the spirit of the day. Please give them this column to read and discuss.

Exercise as Medicine

Sorry about missing Saturday. This injury is throwing me for a loop. Some days the pain is worse than others and writing is hard to do when all you want to do is chug vicodin and crawl into bed. Here's the delimna though. The more we hurt, the more we want to be immobile, but it's the worse thing we can do.

When someone referred to exercise as medicine, I laughed. Now, when I was young, working-out, dancing and even running was fun to do; I didn't think twice about doing whatever I wanted with my body.

In my thirties and forties, I was chasing children 24/7. That alone can keep you nimble. Teaching in my fifties kept me moving but a bit more slowly. Now that I'm in my sixties, I think first about whether my body can do what my brain wants.

A decision not to do something now has mostly to do with whether I am physically up to the task, and I am hating it! And now that I've fallen, I feel myself thinking even more about this new phase, but here's what I'm finding out fast; the less I move, the more I hurt. And if I do the right kind of exercise in the right way, I can actually relieve pain.

The ailments that accompany aging (including high blood pressure, arthritis, rheumatism and incontinence) can impact the intensity of physical activity but are the very reasons for staying fit, limber and active.

There are several forms of exercise that can be modified in intensity. Walking, jogging and swimming are all excellent for maintaining bone, joint and muscle strength and flexibility, reducing blood pressure and stress levels, and combating pain, but I'm going to talk about yoga as a remedy.

I have tendonitis from the fall and from all the limping. In fact, even though I have to have knee replacement, I'm having more pain in my shoulder and hip. So what does the physical therapist recommend for resolution?  Long, slow stretches repeated over and over. Yoga is a form of exercise that embraces long, slow stretches and so much more.

According to the American Heart Association, heart disease is the leading cause of death for men and women in the US, causing 1.5 million heart attacks each year. Recent research has shown that yoga reduces blood pressure, lowers pulse rate, improves artery elasticity, increases the heart's stroke volume and regulates heart rhythm. Yoga benefits the heart and overall health.

Originated in India and now considered a science, yoga has been practiced for over 5,000 years. What differentiates yoga from other exercise routines is its basic principal: that there’s a direct connection between the body, mind and spirit. The theory is that good health is dependent on the positive interrelationship of these three forces, and that balance between them must be achieved.

Yoga’s unique method for maintaining this balance is to combine physical movement with proper breathing and meditation techniques. The exercises are intended to increase flexibility, improve posture and put pressure on the glandular systems to increase efficiency. Deep breathing oxygenates the blood and induces a feeling of well-being. Meditation reduces stress and heart-harmful emotions like anxiety, hostility and hopelessness. Visit www.abc-of-yoga.com for information and products.

See your physician for a thorough examination. Discuss your level of physical fitness and appropriate exercise routines, including duration and frequency. Ask whether yoga will work for your exercise of choice or as an addition to another program. Modern medicine has certainly recognized its physiological, psychological and biochemical benefits.

Dry as a Prune

Two scary things happened lately. One was that I fainted for the first time in my life. I had been sick with what I imagine was a 48 hour bug that included fever for a day and chills, and not a lot of eating or drinking, despite the warnings to drink fluids.


When I finally felt human enough to get up from bed, I promptly dropped to the floor. When I awakened, I looked up at the mountain that my bed had become, struggled to my knees, and climbed Everest to my pillows.


It was so disconcerting to my family that I was rushed to emergency care. The young doctor (She looked 12--although these days, everyone looks 12--policemen, firemen, nurses--they all look like my students) said that it could be any number of things. Her exact words were... "well, you know at your age....".  Good heavens...I was already sick. Did she really have to add insult to injury? It was annoying enough to cause a rise in my blood pressure.

After some probbing and blood work, it was determined that I was probably (the reason they call medicine a practice) dehydrated. I was admonished to go home and drink (wine sounded like a good idea, though it was not what the doctor had in mind.)


The second incident was when the blood work came back; it indicated that my kidneys were not functioning as well as they should have been. Well, it turns out that some medication that another doctor had put me on was the culprit. That determination came after many expensive tests and numerous appointments with a kidney specialist.


The medicine was causing chronic dehydration, and it was impacting my kidney function. Needless to say, I stopped the medication and became a camel. My water bottle became another appendage. 


Until I began to research what kidney disease was all about, I hadn't worried too much about dehydration, but now I know just how dangerous it can be, especially for people "our age", even dangerous enough to cause hospitalization.


Water, though not exactly the fountain of youth, is at least the “fount of life” and the most critical substance in the human body. Every organ, tissue and cell needs water to function. It transports nutrients, promotes digestion, and carries away waste. Controlling body temperature and ensuring proper blood volume, water keeps skin, mouth, nose and eyes moist.


Preventing thirst is crucial, particularly for those over 60, as it suggests that the optimum level of water in our bodies (50-75% of weight) is already compromised. Seniors are at particular risk because as aging occurs, the amount of water in the body is reduced and the ability to recognize thirst signals greatly diminished.


If enough water isn’t ingested, the body will drain the body’s organs and tissues. Symptoms are: headache, fatigue, poor circulation, muscle spasms, kidney failure, and increased body temperature and pulse rate. Weakness will escalate, and labored breathing, dizziness, and even delirium can result.


A minimum of 64 ounces per day of water, the no-calorie beverage absorbed faster than any other, is the remedy. Milk, juices, soup, and at least five servings of fruits and vegetables (high water content) are good sources for additional fluid intake.


So drink up!   Especially water...just in case you missed all those bolded words.

Help!

I fell down a stair well last week and injured my shoulder, hand and both knees to the extent that I must have surgery. It is a scary proposition--no driving for a month afterwards and as much as five months of difficult physical therapy and recovery.

Family and friends have offered their prayers and their help. It is gratifying and allieviates the fear of handling this alone, but it makes me think of those in life who must handle struggles like this without support and without resources to hire help.

Pride is also an issue. I am very independent and enjoy handling challenges myself, but this one has taught me that sometimes we are at the mercy of our situation, and the kindness of others is truly a gift that we should be gracious to accept with great gratitude.

Sometimes people don't know where to go for help especially for the aged who may have dropped out of activites, stopped going to church and are confined to their homes.

"The National Volunteer Caregiving Network (NVCN) is a membership network of local community volunteer caregiving programs, regional and state collaboratives, and individuals who support the work of volunteer caregiving. Membership is open to any organization or individual who believes they can benefit from the National Volunteer Caregiving Network.

The purpose of the National Network is to promote the sharing of knowledge, experience and ideas that can help to strengthen and support the hundreds of local volunteer caregiving programs that are currently active throughout the United States, and to foster and support the establishment of new interfaith volunteer caregiving programs in all communities that want and need the services that volunteer caregivers can provide. Local volunteer caregiving programs bring volunteers of different faiths together to care for their homebound neighbors who may be isolated and living with chronic health conditions or disabilities.

These volunteers come from churches, synagogues, and other houses of worship, as well as from the community at large, and provide many forms of non-medical assistance, such as:

•Transportation to medical and other appointments
•Help with shopping, reading or bill-paying
•Minor home repairs
•Light housekeeping or meal preparation
•Friendly visiting and telephone support
•Respite care for family caregivers

Such simple services can provide the safety net that makes it possible for those with disabling health conditions or other limitations to enjoy a better quality of life and to maintain their independence.  The Faith in Action program initiative began in 1983 with support from The Robert Wood Johnson Foundation, and today there are more than 600 local programs operating in communities across the nation. You may search by state to find a program in your area. If there is not a volunteer caregiving program in your area and you are interested in starting one, please contact the National Volunteer Caregiving Network by calling the toll-free number at 304-907-0428 or by email at info@nvcnetwork.org.

General Inquiries: Kelly, Administrative Assistant E-mail: kelly@nvcnetwork.
Executive Director, Rhonda Anderson E-mail: randerson@nvcnetwork.org 
Mail: National Volunteer Caregiving Network, 1359 National Road, Wheeling, WV 26003

“When family members and health care providers cannot fill the daily needs of a member of the community, the Faith in Action volunteer fills the gaps. Most belief systems include a mandate to help others. Faith in Action connects neighbors in need with those who want to make a difference.”

Mother's Day is coming

Dear Linda:

My mother raised two children without a husband or family support. She decided not to remarry so we wouldn't have to deal with a stepfather. When we were young, she worked from home so she wouldn't miss any of our activities, and when we went to college, she worked two jobs to pay bills. I didn't understand the extent of her selflessness until I had my own child, and now I know I can never repay her generosity, but I wanted to wish her, and every other single mother who gives so completely, a blessed Mother's Day.

Julia's Grateful Daughter


Dear Julia's Grateful Daughter:

Mothers are extraordinary creatures. They cherish their children and think of little besides their security, contentment and success, put their own desires on hold, and give all that is humanly possible. They sacrifice the bodies of their youth and a simple life of self-centered pursuits.

Regardless of the constant work, exhaustion and worry, mothers still invest every ounce of their energy and emotion into the job of raising their children. The rewards for their self-sacrifice are gray hair, guilt about not doing the job perfectly, being taken for granted, and, ultimately, an empty nest.

Ironically, if asked to do it again, most would do so in a heartbeat-their baby's goodnight kisses, toddler's small hand in theirs, and teenager's laughter and excitement at life's unfolding, all sweet compensation.

Single mothers are particularly amazing-true unsung heroes. Without showing the fear that often darkens their world, they must find the strength, endurance and courage to carry out their awesome responsibility alone and in an environment that is complicated, costly, unsupportive and even hostile.

There is help, however. Read The Single Mother's Book: A Practical Guide to Managing Your Children, Career, Home, Finances and Everything Else by Joan Anderson (Peachtree Publishers) and Going It Alone: Meeting the Challenges of Being a Single Mom by Michele Howe (Hendrickson Publishers).

Visit www.singlemothers.org, www.parenting.ivillage.com, and www.singleparents.about.com for excellent resources, information and support while accomplishing nobly the most important job of all.

Thank the Lord

It is Easter weekend, the celebration of the resurrection of Jesus Christ. It is the occasion to be thankful that Christ took on the sins of the world so that we might have a place in heaven in the presence of God.

So what's the problem? Unfortunately, it's how we've distorted the honoring of this incomparable gift. Now, I don't have a problem with also celebrating spring with bunnies and baskets and egg hunts. I loved filling my children's baskets with treats and treasures, and some of my fondest memories were my children chasing around the house searching for plastic eggs filled with chocolates, popcorn and quarters, a tradition, by the way, that they didn't want stopped well into their late teens.

But did you read the coverage of parents gone wild at several egg hunts thoughout the country? It's unbelievable---parents who encouraged their tiny children to kick, push and fight other children to grab as many eggs as possible, and if their kids weren't performing well enough, they jumped into the action themselves to grab all they could. Can you imagine adults battling children over colored eggs?

What is wrong with this generation of parents? Do they not know that their behavior says more to their children than any of their words. And what about their values--take, take, take at any cost and at anybody's expense, or their communication to their children that their security and care are really secondary to the needs and desires of their parents.

Perhaps I made a mistake in putting my children first before everything else, but I thought that was my obligation when I brought them into this difficult world. I modeled the behavior I wanted them to emulate. I instilled the values that I hoped they would act out, and I actively encouraged hard work, perseverance and responsible behavior. Then I prayed that they too would adopt those values and choose rightly when they were on their own.

Young parents must recognize that their every choice is a forever imprint on their children and the legacy they hand down from one generation to another. Jesus loved all the little children. He gathered and cherished them. Let's do the same.