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Will Exercise Help My Memory?

The study, published in the Journal of Epidemiology & Community Health, looked at data from nearly 4,500 people in the UK who had activity monitors attached to their thighs for 24 hours a day over the course of a week. Researchers analyzed how their activity levels impacted their short-term memory, problem-solving skills and ability to process things.

Prevention’s recent article entitled, “These 5 Exercises Boost Brain Health and Improve Memory, Study Finds,” reports that the study found that doing moderate and vigorous exercise and activities—even those that were done in under 10 minutes—were associated with much higher cognition scores than people who spent most of their time sitting, sleeping, or doing gentle activities.

The researchers found that people who did these workouts had better working memory (the small amount of information that can be held in your mind and used in the execution of cognitive tasks) and that the biggest effect was on executive processes, like planning and organization.

However, those who spent more time sleeping, sitting, or only moved a little instead of doing moderate to vigorous exercise had a 1% to 2% drop in cognition.

“Efforts should be made to preserve moderate and vigorous physical activity time, or reinforce it in place of other behaviors,” the researchers wrote in the conclusion.

Working out regularly can also lower your risk of cognitive decline and dementia. Exercise activates skeletal muscles that are thought to release hormones that communicate with your brain to influence the health and function of your neurons, i.e., cells that act as information messengers, Malin says.

“This could, in turn, promote growth and regeneration of brain cells that assist with memory and cognition,” he says.

The CDC recommends that most adults get at least 150 minutes a week of moderate-intensity exercise. You can walk your dog if you have one, as a study found that dog owners walk, on average, 22 minutes more every day than people who don’t own dogs.

However, the latest study suggests that more vigorous activities are best for your brain. Getting your heart rate up is key. That can include doing exercises like jogging, swimming, biking on an incline and dancing.

Reference: Prevention (Jan. 28, 2023) “These 5 Exercises Boost Brain Health and Improve Memory, Study Finds”

What Is a Letter of Instruction?

A letter of instruction can be an essential component of your estate plan. Regardless of your wealth and family situation, there is vital information you should organize and communicate to loved ones, heirs, fiduciaries and others, says Forbes’ recent article entitled, “Letter Of Instruction: Roadmap To Take This Important Estate Planning Step.”

Some people see their letter of instruction as an ethical will—a communication to their family that expresses their beliefs, wishes, wisdom and thoughts. However, a letter of instruction may serve other purposes. Therefore, you might consider drafting several letters of instruction. One might be a guide for a trusted friend to handle financial and other matters if you have an emergency. Another may be akin to an ethical will left to a child or others. A third might be to the person serving as a health care agent who will make medical decisions for you if you can’t do so.

Here are some suggested categories you might include in one or all of your letters of instruction.

ICE – In Case of Emergency. A vital purpose of a letter of instruction is to tell someone (e.g., the agent under your power of attorney for financial matters and the agent under your health proxy for medical decision-making) your wishes and critical information. For both your financial and health care ICE letters, you should list the location of the original legal documents.

ICE – In Case of Financial Emergency. For your financial ICE letter, you should indicate where key financial data is maintained and how to access it. In addition, list the bills to be paid and creditor information.

ICE – In Case of Health Care Emergency. For your health care ICE letter, you should provide key health information and indicate where health records are maintained. It is important to add the contact information for healthcare professionals and any particular health challenges. Your health insurance information should also be provided.

Key Family, Advisers, and Other People. Having a list of positions, names and contact information is helpful for everyone to see, so that they know if certain actions they might have to take may be in the purview of someone else. The listing should be by categories that make sense for you. Some of the positions/relationships you might list include the following:

  • Professional Advisers, such as an estate planning attorney, CPA, investment consultant and banker
  • Family; and
  • Trustees of trusts, the executor under your will, and powers of attorney agents

Reference: Forbes (June 18, 2023) “Letter Of Instruction: Roadmap To Take This Important Estate Planning Step”

Planning for Aging without Family Caregivers

As they age, many people have diminished capacity and cannot care for themselves. They may no longer be able to walk or drive easily and can experience difficulty with basic activities like shopping, cooking, cleaning, and arranging important doctor’s appointments. Traditionally, the adult children of the elderly have been caregivers, monitoring their parent’s health and overseeing financial decisions, reports the article “ICYMI | Getting Older Without Family” from CPA Journal. Parents without children, or those without good relationships with children, need to make alternative arrangements. An experienced estate planning attorney can help.

Living arrangements. Most people prefer to remain in their homes, in familiar surroundings. This may work if the home can be made elderly-friendly and a support system is implemented. A home alert system or automatic daily call-ins can be arranged through friends or local police departments. If remaining at home is not viable, an assisted living facility or continuing care retirement community may be the next best option if the cost can be managed.

Healthcare matters. Having a healthcare advocate is advisable for everyone. So is a Healthcare Proxy, or Healthcare Power of Attorney, which designates a person to act as the patient’s agent in making decisions. A Living Will details the kind of treatment a person does or doesn’t want if they cannot express their wishes.

Finances. As they age, people may find managing their finances too difficult. There are several options, depending on the degree of help needed. A CPA or financial advisor may be able to provide money management services. Banks may permit an account owner to add the name of another person with signatory authority—they can sign checks but are not an account owner. A representative can be named to receive Social Security funds, and they must file reports with the Social Security Administration to show how the funds have been used.

Durable Power of Attorney. This is the most critical planning tool for seniors and others. This designates an agent to act on behalf of the elderly person in financial matters. It can be created to define the scope of the agent’s authority and remains effective when the elderly person becomes incapacitated. It must be created and executed when the person has the requisite capacity.

Trusts. A trust holds legal title to an older adult’s assets, including bank accounts, brokerage accounts, or their home. The trust is managed by a trustee for the benefit of the elderly person. There are several different trusts available, depending on the situation. A Living Trust can be used while the person can still manage assets and act as their trustee, retaining the right to revoke the trust and regain title to assets. If the person becomes incapacitated, another person named the successor or co-trustee takes over, assuming the trust has not been revoked. The trustee could be a trusted professional, a relative, or a bank trust department, which may be expensive but is a good option for an aging person with significant resources but no individual to serve as the trustee.

Instead of a living trust, the elderly person may set up an Irrevocable Lifetime Trust for Medicaid and long-term care planning purposes wherein someone else is designated a trustee from the start.

Aging alone may seem like a daunting experience, but with the right planning and support network in place, it can be rewarding, enjoyable, and safe.

Reference: CPA Journal (July 2023) “ICYMI | Getting Older Without Family”

What Is Hypertensive Chronic Kidney Disease and Glomerulonephritis?

Unlike an acute kidney injury (AKI), where the loss of kidney function may be reversible, chronic kidney disease is “progressive.” That means it gets worse over time. The damage to your kidneys causes scars and is permanent. Among the diseases that can cause CKD are diabetes, hypertension, glomerulonephritis and polycystic kidney disease. This post looks at glomerulonephritis.

Very Well Health’s recent article, “Causes and Risk Factors of Chronic Kidney Disease,” explains that glomerulonephritis is a group of diseases that cause inflammation of the glomeruli and nephrons. Glomerulonephritis usually affects both kidneys and can happen alone or as part of another disease.

While it’s often hard to pinpoint what triggered the inflammatory response, the causes can be broadly broken down as follows:

  • Focal segmental glomerulosclerosis, a group of diseases that cause the selective scarring of glomeruli
  • Autoimmune disorders, which either damage the kidneys directly (IgA nephropathy or granulomatosis with polyangiitis) or trigger whole-body inflammation that indirectly damages the kidneys (such as with lupus); and
  • Inherited disorders like polycystic kidney disease, which causes the formation of cysts in the kidneys; Alport syndrome, which damages the blood vessels of the kidneys; or Goodpasture syndrome, which damages kidney membranes.

In some cases, the cause of glomerulonephritis is never found. There are also other, less common causes of CKD in adults and children. They include the following:

  • Heavy metal poisoning, including lead poisoning;
  • Hemolytic-uremic syndrome, in which ruptured red blood cells block renal filters (occurs exclusively in children);
  • Hepatitis B and hepatitis C, both of which are associated with glomerulonephritis and renal vascular inflammation;
  • Interstitial nephritis, inflammation of the kidney tubules often related to the long-term use of analgesics or antibiotics;
  • Pyelonephritis, a bacterial infection of the kidneys;
  • Prolonged urinary tract obstruction, including an enlarged prostate, kidney stones and certain cancers;
  • Recurrent kidney infections; and
  • Reflux nephropathy, the backing-up of urine into the bladder.

In addition to known causes, CKD can often be idiopathic, meaning the cause can’t be found.

Reference: Very Well Health (July 25, 2021) “Causes and Risk Factors of Chronic Kidney Disease”

How Do I Care for a Loved One with Arthritis?

Those with arthritis know how stiffness and pain can restrict the ability to move and function properly.

VeryWell Health’s recent article entitled, “Caring for Someone With Arthritis,” says there are some things that you can do (or keep in mind) when caring for someone with arthritis. These may include the following:

  • Understand their condition. Have a clear understanding of your loved one’s arthritis condition. This can help you see where they may need help. For example, suppose an individual has rheumatoid arthritis that affects their hand and upper extremity movement. In that case, they may need assistance opening bottles and jars or managing fine motor tasks, like handling medication.
  • Keep lines of communication open. Talking with your loved one about arthritis is a great way to understand how it impacts them. You should also share your feelings about caring for them with someone, since providing care and helping someone consistently may take an emotional toll on you.
  • Know when to help and when to stand back. Most people with arthritis want to remain as independent as possible. Therefore, be sure your loved one has the opportunity to be as functionally independent as possible and know that they will ask for assistance when needed.
  • Help manage medication. Sometimes managing arthritis means managing various medicines. If your parent has difficulty keeping drugs and dosages straight—or if they physically have difficulty handling medicine—be ready to assist.
  • Help with managing assistive devices. Some people with arthritis need assistive devices, like canes or walkers, to get around. Sometimes using these can be hard to use. You may help by learning how their assistive device should be used and how to operate it properly.
  • Encourage and help with exercise. Exercise has proven to be beneficial for many with arthritis. Movement helps keep joints lubricated and muscles strong, and exercise can help maintain or improve functional mobility.

Know that your family member may have times when your care and assistance are welcomed and when they want to do it alone. Stay flexible in your care and provide help when necessary and when it is welcomed.

Reference: VeryWell Health (May 29, 2022) “Caring for Someone With Arthritis”

What is a Good Exercise Routine for Seniors?

Recent studies at the Center for Exercise Medicine at the University of Alabama verified that seniors can achieve muscle growth and strength. The key is consistent effort and following a fitness scheme consisting of at least 30 minutes three times a week.

Senior Living’s article entitled, “Seventy (70) Is The New Forty (40) – Exercising Your Total Body Is Good News For Baby Boomers,” says to first consult with your doctor and make sure they give you the OK to start your fitness scheme. Then, start with the basics at a slow to moderate pace. Here’s a basic routine:

  1. Warm up. Take a short walk for about 10 minutes to get your blood flowing, and your body loosened up.
  2. Push Ups. Start with 5 to 10 pushups. If you cannot do regular push-ups, you can do these standing up, pushing off a wall. The modified pushups still work your chest muscles and triceps.
  3. Stretch Bands. Hold the bands with your hands and put your elbows next to your sides, feet shoulder width. Pull the bands across your chest. Do eight reps (repetitions) to start. When you get these bands, note that they will come in various resistance strengths. Choose a band with the least resistance, then as you increase your reps to 12, move up to the next band and start over at eight reps, building back up to 12 reps.
  4. Shoulder Exercise using Dumbbells: Dumbbells come in various sizes, starting at 2½ pounds and going up. Start with 2½- or five-pound dumbbells. Stand with your feet shoulder width, push the weights over your head and then bring them back down to the top of your shoulders. Do eight reps, and increase the weight when you build up to 12 reps.
  5. Bicep Curls using Dumb Bells. Stand erect with your feet at shoulder width. Using 10-pound dumbbells, place them in your hands, arms by your side, palms forward. Curl the weights up to the top of your shoulders, then lower them back down to your side, keeping your palms facing out to the front and your elbows tucked into your side. Start with eight reps and work up to 12.
  6. Tricep Extensions. While holding a 2½- or five-pound dumbbell in your right hand, bend forward at the waist slightly while placing your left leg out in front of your bent body, slightly bend your left leg. Rest your left forearm on your knee or upper thigh. Pull the dumbbell up along your right side waist-high, extend the right arm straight back and then bring it back to the side of your waist where you started. Reverse this position and do the same for your left tricep.
  7. Squats. For beginners, use your body weight. Stand up straight, feet shoulder width, as you squat down, push your buttock out, bending slightly forward at the waist. Don’t go past a half-squat position. Start with eight reps and work up to 12 reps.
  8. Lunges. Start with no weights. Stand up straight, extend your left foot, bend both knees simultaneously, and go down as far as possible. Don’t overextend yourself. Remember also that you need to concentrate on your balance. Return to your starting position. Do eight to 12 reps. Repeat this for your right leg. Don’t consider using weights for lunges, until you can do 25 reps per leg.

Reference: Senior Living (March 30, 2021) “Seventy (70) Is The New Forty (40) – Exercising Your Total Body Is Good News For Baby Boomers”

How is the VA Handling Aging Veterans?

The Department of Veterans Affairs and veterans organizations across the country are working to care for a new generation of older veterans who are apt to have greater expectations for longevity and independence than earlier generations, yet also may struggle with more complex medical conditions, reports Military Times’ recent article entitled, “America faces a tidal wave of aging military veterans.”

“We’re kind of compounding multiple variables, in the sense that not only are people living longer, but … many of them survived something that wasn’t survivable,” says Scotte Hartronft, the director of geriatrics and extended care at VA. “A lot of veterans have survived significant injuries over the last couple of conflicts that [they] wouldn’t have survived in previous wars.”

In California, the most populous state and home to the highest number of vets, the State Department of Veterans Affairs, known as CalVet, the state’s veterans department, is working to create a modern facility that centers the needs and dignity of older veterans. Like VA facilities across the country, people charged with caring for veterans must address the same question: How do we best care for those who have served on our behalf as they grow old?

Other states also have issues: between 2021 and 2041, the number of veterans older than 85 is expected to increase by 31%. That’s partially because the overall number of veterans nationwide is actually decreasing. Between 2000 and 2018, the number of veterans in the country declined by a third — the bulk of Americans who have served in the military served decades ago.

Vietnam and Gulf War-era veterans represent a different slice of the population than veterans who fought in World War II and Korea: the number of women veterans over 65 is expected to increase by 237% between 2021 and 2041. Racial diversity is also increasing, and the geographic distribution of veterans is shifting. As a result, veterans’ care must change. Women, for example, have a greater life expectancy than men do. Women veterans will generally need more support to continue to live independently as they age for longer — a fact compounded by the fact that women, who tend to be informal caregivers to friends and family, often have more difficulty than men finding their caregivers when needed.

In addition to higher rates of post-traumatic stress and other conditions affecting mental health, veterans are more likely to be exposed to risk factors, such as traumatic brain injuries or toxic exposure, for Alzheimer’s and other dementias. Vets also have a higher chance of being diagnosed with certain types of cancer, like lung and skin cancer. Roughly 50,000 new cancer cases among veterans are reported annually; that number is expected to rise as veterans age.

Every VA medical center will offer veteran-directed care within the next two years. This popular program provides qualified veterans with a stipend to hire local caregivers to assist them with daily living or even companionship. VA is expanding home-based primary care — which provides health care to veterans at home, many of whom are housebound — to 75 new sites and expanding its Medical Foster Care program. This lets some vets live in a private home with a caregiver rather than in a nursing home. They’re also piloting a program using predictive analytics to help determine which veterans are at the highest risk of nursing home care in the coming years to connect them with preventive services.

Reference: Military Times (June 2, 2023) “America faces a tidal wave of aging military veterans”

What’s the Best Way to Find the Right Assisted Living Facility?

News 19 Alabama’s recent article entitled “How To Choose the Right Assisted Living Facility,” provides some valuable tips for researching assisted living facilities and finding the best option for you:

Get recommendations. Ask friends, family and your doctor about assisted living facilities in the area and if they would recommend them. If someone you know lives in an assisted living facility, ask them how they like it, as their experience can provide insight into what facilities have the best reputation in your local area.

Consider your needs. Residents in assisted living facilities typically need assistance with some basic activities of daily living. This includes bathing, dressing, eating, and getting around. Some assisted living communities specialize in caring for people with specific conditions, such as Alzheimer’s. The level of care assisted living facilities offer can vary greatly, so consider how much assistance you require.

Consider the cost. Remember that Medicare doesn’t cover assisted living costs, which is why most people pay with private funds even though it’s expensive.

Consider location. A facility near friends and families is often the best choice. This lets residents receive lots of visitors. Employees will also see that the resident’s visitors scrutinize their care.

Ask questions. Before calling assisted living facilities, consider these questions:

  • How many residents live at the facility?
  • Are pets allowed?
  • What amenities are available to residents?
  • Are there personalized care plans for each resident?
  • How are additional services billed?
  • Are there doctors, nurses, pharmacists, physical therapists, housekeepers, cooks, and activity directors on staff?
  • Does the facility run background checks on staff?
  • What happens if a resident’s health deteriorates and needs additional care or a hospital stay?
  • What safety features does each residential unit feature?
  • What is the staff-to-resident ratio during the day and at night?
  • What are the meals the facility serves?
  • Are all utilities included in the overall cost of a unit?

Take note when you visit. When you tour a facility, look at the cleanliness, activities, safety features, available common areas, the friendliness of the staff and how healthy and happy the residents appear.

Compare several facilities before you decide. Don’t just choose the first facility you visit. Instead, tour several facilities and compare them.

Carefully examine contracts. Read assisted living contracts from start to finish and look for unexpected fees or deposits.  Yous should also pay attention to the rules regarding discharging or evicting a resident, late or missed payments and how the facility handles (or limits) your rights to file a lawsuit should there be an issue.

Reference: News 19 (May 14, 2023) “How To Choose the Right Assisted Living Facility”

What Should I Know About Advocating for a Loved One with Parkinson’s Disease?

Unfortunately, recent studies have shown that three out of every four hospitalized Parkinson’s Disease patients didn’t get their regular home medications on time or had doses entirely skipped.

Proper medication management is the most critical part of a successful hospitalization for someone with Parkinson’s Disease.

Antiparkinsonian medications (levodopa or amantadine, for example) must be given correctly, at the right time and in the correct dose.

If regular home medications aren’t provided in the hospital, Parkinson’s Disease patients can develop mental disturbances, increased muscle rigidity, tremors and difficulty communicating. As a caretaker, you have a vital role in helping the transition from home to the hospital run smoothly.

Next Avenue’s recent article, “How to Advocate for Your Hospitalized Loved One with Parkinson’s Disease,” has some ways you can do this.

Make sure you have an up-to-date list of medications your loved one takes. The list should include the name, dose, when it was last taken and what pharmacy is used for prescriptions. Be prepared to give this to the hospital staff when requested.

You should also list drug or food allergies, including reactions. For example, did a particular drug cause severe irritability or a rash in the past?

It is important to remain with your loved one when they arrive at the hospital until the first dose of their regular medication is administered. Note that a first dose can usually be delayed by several hours if the nurse needs to input the medication list into the chart immediately or if the hospital pharmacy is delayed in verifying the orders. However, after the first dose, future quantities will likely be on schedule.

Cooperate with nursing staff to make sure that your loved one is comfortable. Be direct, yet kind, in asking when the patient might need personal hygiene supplies, a quieter environment, or on-time medication.

As a caretaker, your education and experience regarding Parkinson’s Disease are powerful tools.

Some things might fall through the cracks in a busy hospital– and you know the patient best. So don’t be afraid to speak up and express your needs as you advocate for your loved one.

Reference: Next Avenue (December 22, 2023) “How to Advocate for Your Hospitalized Loved One with Parkinson’s Disease”

Will I Be Able to Afford Nursing Home Care?

About 60% of older adults — or 24 million households — wouldn’t have the resources to pay for in-home long-term care, despite the fact that they would prefer to “age in place,” per a National Council on Aging report.

Fox News’ recent article entitled, “Most seniors in America can’t afford nursing homes or assisted living, study finds,” says that the researchers looked at 2018 data from the Health and Retirement Study, which was a joint effort by the National Institute on Aging and the Social Security Administration that surveyed some 20,000 U.S. adults about their net wealth.

When the researchers started examining the data some years ago, they were initially surprised to see that so many older adults were at severe risk of financial insecurity, Dr. Jane Tavares, a lead researcher at the LTSS Center at UMass Boston, told Fox News Digital.

“There is a common misconception that older adults are asset-rich, but we have found in our research that this is not generally true,” she said.

Dr. Tavares also noted, “We expect that there will probably be some worsening, once we examine data for the period covering the COVID pandemic.”

The national average cost for assisted living is $4,500 per month. However, it can vary significantly depending on the location and level of care needed.

“As the population continues to age and demand for these services grows, it is likely that the cost will continue to rise,” said Dr. Steven Norris, a senior health and care expert who is also the medical director at Transitions Care in Chicago, Illinois.

The widespread shortage of qualified caretakers means facilities must pay more to secure the right people.

“For decades, there has been a lack of awareness of how expensive assisted living really is.” “Additionally, recent increases in minimum wage requirements and changes in overtime payment legislation are increasing assisted living costs,” he said.

The cost could range from $3,000 in rural areas to $7,000 to $9,000 in urban locations.

“For decades, there has been a lack of awareness of how expensive assisted living really is,” Kim told Fox News Digital.

“Some people thought health insurance would cover long-term care costs, while other people optimistically believed that they would live a healthy life forever.”

Assisted living companies had to raise prices to keep up with their costs continually. However, retirees did not see the same growth in savings or investments. Middle-aged and older adults are also now facing a very different financial landscape than the generations before them did. More than the increases in household income and assets have also been needed to keep up with rising living costs, health care and inflation. Even when older adults have assets, they are often tied up in property and need to be more readily available to help them cover costs.

The changing retirement model has also added to gaps in savings. Past generations had private, employer-sponsored pensions that provided predictable payments. Many Americans now rely on 401(K) accounts, leaving individuals responsible for saving enough money to cover their retirement years.

“With all of this combined, few older adults have any significant savings in retirement accounts — and most can’t afford long-term care insurance that would help cover the expensive costs of assisted living or nursing home care,” she explained.

“With private long-term care insurance being unaffordable for most older adults, it is key to begin considering combined public and private initiatives that can put the cost of coverage within reach and make it more appealing to consumers,” she said.

Reference: Fox News (April 26, 2023) “Most seniors in America can’t afford nursing homes or assisted living, study finds”

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