Everbrook Senior Living was proud to host our first virtual event on May 20, 2020 featuring Pamela Atwood, MA, CDP, CLL, and the founder and owner of Atwood Dementia Group. Atwood led the group with ideas and exercises to practice at home, as many daily activities and plans have shifted during the COVID-19 pandemic. Atwood gave insight on strategies to connect with seniors in meaningful ways with items you can find in your home.

Were you unable to join us for the presentation? No worries! You can watch the following videos at your convenience to learn the tips and tricks from professionals. We'll be offering a virtual event each month. So check back soon for new and different educational webinars with top professionals in the field.

In the Month of April, the American Heart Association promotes everyone to MOVE MORE! This month we encourage everyone to participate in more physical activity. Make it your goal to move more and sit less. Staying active is one of the best ways to keep our bodies healthy, maintain our quality of life and keep our independence longer as we age. Start adding more activity into your day one step at a time. 

How long have you been sitting today? You sit while you eat your meals, drive your car, work at your desk, reading a book, watching TV, while you’re on your computer, or talking on the phone. It all adds up. People now spend a majority of their waking days sitting. The Journal of the American Medical Association published a study in 2019 that stated adults in the U.S. spent more than 6.4 hours a day sitting.

Try to reduce the amount of time you spend sitting every day to help improve your health. No matter how active you are, even if you’re getting the weekly recommended amount of exercise (150 minutes of moderate exercise), you still might be sitting too much. 

Making small changes in your daily routine will allow you to move more. Fit in 2, 5, 15, 30 minutes when possible. Be active however and wherever you can. Here are some tips to get yourself to move more throughout the day. Get up and move at least once every hour. If you’re watching TV, during the commercials take a walk down the hallway. After reading 20 pages in your book stand up, stretch and walk around. Walk while you’re talking on the phone. Park further away from the store when you go out shopping. Vacuum or dust the house. If you can’t walk or stand try seated knee lifts, arm circles, or straight leg raises. The important thing is to remember to move more, sit less.

The outbreak of COVID-19 or Coronavirus has spread fear much more virulently than the disease itself although older adults being at high risk of mortality from coronavirus certainly have much to fear. Self-isolation as a method to reduce transmission risk may not be an optimal response to the coronavirus threat for very old adults because social isolation and loneliness have been shown to be detrimental to the physical and mental well-being of seniors. Isolating seniors amid such high tension can only serve to heighten the risk to their mental and physical health. Social isolation and loneliness are prevalent among the elderly because their social networks tend to shrink in later life due to losses of friends, family or from age related functional loss. As whole communities retreat into isolation to ease concerns about acquiring coronavirus, the vulnerable elderly living in near isolation will be forced to deal with fears of dying or media reports of impending doom all alone. What an alarming development!

All gatekeepers to the elderly should increase urgency to help seniors stay connected socially during the coronavirus crisis. What seniors in later life need more than ever are peers sharing similar feelings of distress about coronavirus who can band together and help each other through this most difficult period. Gatekeepers to the elderly are reminded that social isolation and loneliness though not the same, are widely recognized among health experts as a cause of poorer health among the elderly. Social isolation is measured objectively by the number of contacts we have which can drop sharply as we age.¹ Loneliness is measured subjectively as the difference between one’s desired and achieved levels of social connectedness which can increase as we age.²

This month in Gym Talk we will be focusing on brain health. When most people think of exercise and physical activity they think of building strength, improving balance and flexibility, or going for a walk. However, exercising the mind is just as important as exercising the body. The mind needs to be challenged daily in order to keep the brain working to the best of its ability for as long as possible. 

As we age, maintaining a sharp mind is a top priority. Activities you do to improve your body also benefit your brain. Exercise can increase the blood flow and oxygen to your brain as well as help your brain grow new neuronal connections. Mentally stimulating activities for your brain are just as important. Brain games help individuals to stay focused on the task at hand, remember instructions and improve our working memory so we have the skill to remember and use relevant information while performing an activity. Try participating in arts and crafts, do word puzzles and logic games, work on a jigsaw puzzle, attempt a sudoku puzzle or trivia game to help exercise your mind. 

Try a few tasks that target memory and attention:

1. Name two objects for every letter in your first name
2. Say the months of the year in alphabetical order
3. Name six or more things you wear on your feet that start with an “S”

There are many ways to exercise the mind through brain games and activities. Try the game below for fun! Say aloud what color you see in every word, NOT the word you read as quick as possible. Go from left to right, from top to bottom.

Ready. Set. Go!

Winter has arrived so it only makes sense that this month’s gym talk is about trying to prevent the common cold and flu. The start of flu season begins when levels of the flu are high, which usually begins around October and can last until May. The flu does share symptoms with the common cold; however, the flu can take a much greater toll on the body. The influenza virus or better known as the flu can not only effect humans, but nearly every other mammal and even birds on the planet making it easy for the flu to spread around the world. There are three main types of the flu: influenza A, influenza B, and influenza C. There has been no epidemics caused by influenza C, whereas Influenza A is the most common around the world. Influenza A can infect humans and animals as well as birds, unlike Influenza B, which is only carried in humans.

Symptoms of the flu include constant cough, runny nose, fever, sore throat, chills, muscle cramps/aches, headaches, diarrhea and/or vomiting. Just because you have some of these symptoms does not mean you have the flu. The common cold has similar symptoms, but usually does not get more severe then a fever and stuffy nose and only lasts for a few days. More severe symptoms lasting longer than a couple of days indicates you should get tested by a doctor. 

Addressing Vitamin D Deficiency in Later Life?

Could sun dried mushrooms and tank-top shirts be keys to reducing vitamin D deficiencies in later life thus reducing fall risks? Well, yes and let’s discuss why. Vitamin D is often called the sunshine vitamin as it is made from cholesterol in skin and as the sun’s ultraviolet B (UVB) penetrate skin cells it causes production of vitamin D3. ¹The dilemma for seniors is that older skin cannot synthesize vitamin D as efficiently while outside activities are often greatly reduced: and, while there are few foods that actually contain vitamin D, older seniors need more vitamin D, approximately 800 IU (international units) daily, as opposed to 600 IU daily for their younger counterparts. ²(According to the Institutes of Medicine, a serum 25 (OH) D level of 25 ng/ml is adequate for most populations while deficiency is defined as less than 20 ng/ml, with insufficiency being less than 30 ng/ml. Through a process called hydroxylation, the liver and kidneys turn stored vitamin D into an active form the body uses.) 

Vitamin D Deficiency is Linked to Poorer Health 

Because older adults are vulnerable to muscle weakness and falls, maintaining sufficient levels of vitamin D is important: there is evidence that sufficient vitamin D levels can strengthen bone and muscles in older adults which leads to reductions in falls³ – the primary benefit of vitamin D is to maintain serum calcium and phosphorus levels within normal ranges to support metabolic function, neuromuscular transmission, and bone mineralization.⁴ In fact, vitamin D deficiencies are linked to a multitude of health risks. For seniors in later life, vitamin D deficiency has been linked in studies to such conditions as cognitive decline, depression, osteoporosis, diabetes, cardiovascular disease, and cancer, although there is debate about the strength of the link. ⁵Vitamin deficient older adults living in areas prone to inadequate exposure to sunlight have increased risk of experiencing cognitive decline. ⁶Vitamin D deficient older adults may experience a loss of bone density which causes fractures and falls.⁷ Vitamin D deficient older adults may experience increases of risk factors for cardiovascular disease. ⁸Vitamin D deficient older adults may experience increases of risk factors for depression and other psychiatric conditions.⁹

This month’s topic for October’s Gym Talk is breast cancer awareness. October is breast cancer awareness month and we thought we’d share some eye-opening facts on breast cancer. One in eight women in the United States will be diagnosed with breast caner in her lifetime. Breast cancer is also the most commonly diagnosed cancer in women and the second leading cause of cancer death among women. However, there has been a gradual reduction in female breast cancer incidence rates for those aged 50 and older and death rates have also been declining. There are over 3.3 million survivors in the United States Today.

The process of cell growth does not always go perfectly causing uncontrolled growth and spread of abnormal cells resulting from damage to DNA. When this occurs a buildup of cells occurs called a tumor. Both male and female are born with breast cells and yes, even a male can develop breast cancer, but it is very rare. Less than one percent of all breast cancer cases develop in men.

Fears of being placed in a nursing home preoccupy a supermajority of older adults as in surveys about their course of aging they consistently ranked memory loss, financial insecurity and losing independence as their top three concerns.¹ Yet, after age 80, the risk of being placed in a nursing home increases significantly. Seniors of advanced age experience what is termed “functional aging”, that is an inevitable, progressively declining continuum in functional ability from having a stable capacity to perform daily activities through a state of physical vulnerability (influenced by cognitive loss) in which the person is losing independence.² At advanced ages, some caregiver support becomes necessary for many, and for some, a nursing home admission. 

Although most seniors accept that the aging process accelerates physical and cognitive decline after age 80, they want to know whether they have any means to control the degree or pace of their functional losses. This article discusses the evidence-base showing that changes in lifestyle, particularly engaging in exercise targeted to improving functional fitness even in seniors who were mostly sedentary, can slow and in some cases reverse functional impairment, which in turn reduces the risk of being placed in a nursing home. In fact, there is strong evidence that long-term habitual exercise is linked to a slowing of the biological aging process, which certainly enhances independence.³: but, studies also show that even sedentary older adults who begin to exercise in later life can see significant improvements in physical and cognitive health.⁴

Functional impairment is caused by not only age, cognitive decline, multiple chronic medical conditions or following an acute medical event, but also from lifestyle choices- a sedentary lifestyle is shown to decrease functional fitness levels which in turn increases functional impairment while engaging in a physically active lifestyle appears to derive a polar opposite effect.⁵ Functional impairment reduces ability to perform activities of daily living, “ADL’s”:⁶ and, consequently, the most common reason that very old adults are placed in a nursing home is loss of ability to perform ADL’s.⁷ (Over 80% of nursing home residents need assistance with 3 or more ADL’s). Thus, when functional fitness is improved through exercise, that is, when an older adult experiences an enhanced ability to the summon strength, energy and executive function needed to carry out basic ADL’s, independence is retained for longer which reduces the risk of being placed in a nursing home.⁸

Hello! It’s National Healthy Aging Month in the month of September! What is healthy aging you ask? Healthy aging is defined as the process of developing and maintaining the functional ability that enables well-being in older age. 

As we age, a lot of things about our body change both physically and mentally. It’s very important to be open to adapt healthy habits and behaviors as we grow. Physically, getting involved in an exercise program with friends or within your community. You can use preventative services and manage your health conditions regularly by seeing your physician once/twice a year with follow-ups to make sure you’re in the best possible health. Going over medications with your MD and knowing, as well as understanding, risk factors as you age is also important. Maybe that blood pressure medication you were put on before is not needed now due to improved health! Making changes in nutrition is important as well, such as less sodium intake in the foods you eat. Make a goal to stop smoking or smoke less than you used to before. Get your balance and vision checked to prevent falls. These are all great things you can do to maintain a strong healthy body.

This month’s topic for Gym Talk is "Heat Safety Awareness".

Hot weather can be dangerous, and seniors over the age of 65 are among those most at risk for heat exhaustion. Now that the hot weather has arrived it's important to know the signs of heat exhaustion and how to stay cool.

The human body regulates temperature through sweating, until exposed to more heat than the body can handle. As you become older the ability to notice changes in your own body’s temperature decreases. Others at risk for heat illness include infants and young children, people who are ill, those with chronic health conditions or on certain medications, and people who are overweight. Health conditions can make the body less able to adapt to the heat. Also, some medicines can contribute to dehydration.

Posted in the senior resource series by Everbrook Senior Living 

VA Aid & Attendance, “A&A”, is a monthly long-term care benefit available to low-income veterans age 65 or older or disabled if younger (and/or surviving spouses as that term is further defined by VA rules) who served active duty for at least 90 days during a period of war, having been discharged other than dishonorably and who show a need for assistance or supervision with activities of daily living due to physical disability, cognitive impairment or both. Once an applicant is medically and financially qualified, he or she receives a monthly check. A&A has long been an important means to fund assisted living. The Maximum Annual Pension rate, MAPR, available to eligible veterans or spouses is*: 

2019 Basic A&A Maximum Annual Pension Rate

Veteran with no dependents: $22,577

Veteran with spouse: $26,765

Surviving Spouse: $14,529

*Dependent children are also part of the calculation but not discussed here.

Recently, the Department of Veteran’s Affairs (VA), has amended regulations governing financial eligibility for A&A, imposing for example a bright-line net-worth requirement as well as spend-down penalties for veterans who transfer assets for less than fair market value looking-back 3-years from date of application. Critics of the rule revamp warn that many needy veterans will be denied benefits and while technically accurate, the tightening of financial means testing will reduce the numbers of veterans who becomes eligible for the VA long-term care benefits but overall will help more middle-class veterans who are receiving long-term services become eligible for A&A benefits.

This month we’ll be focusing on exercise and brain health. This is a topic that usually doesn’t get a lot of attention but is very important as far as one’s mental health is concerned. When we talk about exercise were always referring to the physical part of exercise and tend to leave out the mental part, so we wanted to share some awesome news on this topic!

Let’s talk about an overview of the brain first. The brain is one of, if not the most complex, organs in our body. The human body cannot physically and mentally run without a brain. The brain produces our every thought, action, memory, feeling and experience of our lifetime. It weighs about 3 pounds containing millions of neurons (nerve cells) working hard each day so what better way to treat your brain than to exercise it with physical activity and nutrition!

Posted in the Senior Care Topics Series by Everbrook Senior Living

Seniors reading or watching the news are informed that Medicare, through its parent agency, Centers for Medicare and Medicaid, CMS, is now covering some essential non-medical services such as in-home care, transportation, and soon phone consultations with the doctor. In brief, Medicare following passage of the CHRONIC Care Act of 2017 and through reinterpretation of its own rules, has empowered only Medicare Advantage Plans, “MA”, to offer a broader array of supplemental benefits including vision/hearing screens to name a few and now non-skilled home-health to beneficiaries who demonstrate a medical need for such services. A supplemental benefit under Medicare is defined as: 

• A service or benefit not covered by traditional Medicare 
• A service or benefit that is primarily health-related, and
• A service or benefit in which the MA plan incurs a non-zero direct-medical cost.

Although seen universally as a positive step toward the continuing trend to reform coverage rules so medical providers can be paid to treat longer term chronic illness, in reality, seniors in need of home-health aides to support disabilities or who hope to talk to their doctor over the phone instead of having to travel their office will likely have to wait several years to receive those benefits in manners which make real improvements to their quality of health and life. Yet, for seniors with complex chronic illness which includes many senior living residents, MA plans appear to be the best option to get the most comprehensive coverage including essential supplemental benefits not available in traditional Medicare like in-home care or telehealth benefits, although with some uncertainties to work through. Medicare Part D amendments and other payment models being tried at CMS are not discussed here.

Nutritional fads come and go. But one fad which seems to have elevated to a gold-standard of credibility has been the so-called "Mediterranean Diet". The Mediterranean diet recommends eating lots of plant-based foods mainly fruits, vegetables, and legumes and foods infused with monounsaturated fat such as olive oil. This popular diet acquired high acclaim in the US as a nutritional best-practice in preventing heart disease after a five-year study by a group of Spanish nutrition scientists caused the New England Journal of Medicine, NEJM, to publish its conclusions suggesting that the Mediterranean diet can decrease risk of heart attack and strokes. The study concluded: prolonged exposure to the Mediterranean diet produced a substantial reduction in risk of major heart disease among high-risk people.

Recently, a statistical sleuth named John Carlisle exposed many flaws in the study namely its claim to have assigned people randomly to the study and other anomalies. Carlisle’s analysis refuted the study’s findings thus discrediting it, causing the NEJM in the summer of 2018, to retract the original publication. This turn of events has re-ignited the debate on what is optimal diet for seniors in later life and whether nutrition can have a positive impact on the health and wellness of very old adults? Ironically, much the Mediterranean diet compares agreeably to nutritional best-practice recommendations of public health organizations and other accredited bodies but without all the feigned notoriety. Yet, to deliver nutritional best-practices in later stages of life requires that special accommodation be made to address health-status changes.