Jewett Promoted to Rehabilitation Director

March 31, 2014  
Filed under News

Burlington Health and Rehabilitation Center recently announced that Katie Jewett has been promoted to Rehabilitation Director.

Jewett is a graduate of the Master’s Physical Therapy program at Quinnipiac University. She joined the Burlington Health and Rehabilitation Center team in August of 2008.

“On behalf of Burlington Health and Rehabilitation Center, we are thrilled to have such strength in our therapy team and to announce Katie’s new position as Rehab Director,” said Meagan Buckley, Executive Director. “We pride ourselves on our ability to be able to promote from within, and Katie’s promotion is a testament to her strong rehab skills, positive patient outcomes and exceptional customer service. We look forward to her taken our rehab program to the next level.”

Getting Enough Vitamin D Could Save Your Life

March 31, 2014  
Filed under Health & Wellness

By William F. Supple, Jr., Ph. D.

Our ancestors evolved under the rays of the equatorial sun. Skin produces Vitamin D (VitD) when exposed to specific frequencies of ultraviolet light. Our bodies advantageously incorporated this readily available, natural resource into many aspects of growth, development and function. As man migrated away from the sun, skin mutated thereby reducing melanin content in an attempt to maximize essential VitD production. Over the past half-century, effective technologies to eliminate all cutaneously-generated VitD synthesis have been developed as part of a systematic vilification of the sun in regard to its contribution to general health. Consequently, the incidence of the diseases that plague the developed world (cancers, cardiovascular diseases, autoimmune diseases) are at the highest levels ever, with no ceiling in sight.

Presently, the Institute of Medicine recommends 600 IU of Vitamin D3 daily for most adults. This amount of VitD is enough to keep bones from crumbling and the development of rickets, a bone-deforming disease, but not much else. Consider this: when young 20-year-old skin is exposed to full spectrum sunlight, the equivalent of 25,000 IU VitD is made in 15 minutes. A healthy adult will use approximately 3,500 IU of VitD per day. In the absence of UVB light, the recommended 600 IU per day quickly leads to VitD starvation. Consequently, most people are VitD deficient, some severely so.

It is estimated that 75 percent of the population of the United States has blood levels of VitD below 20 ng/ml; indicative of a state of VitD starvation. Since most foods provide insignificant amounts of VitD, the state of chronic starvation is compounded by sunscreen use, air pollution, skin color, indoor lifestyle, obesity, age and living at a northern (greater) latitude. For example, due to the angle of the sun in the northern hemisphere during October to May, the VitD-generating UVB rays deflect off the atmosphere, resulting in no cutaneous generation of VitD. So even though the sun may feel nice on the face in the winter, it’s not generating any VitD.

Vitamin D is really not a vitamin at all, but is one of the most potent hormones in the body. The VitD made by the skin or taken by mouth circulates in the blood and is converted to the active hormonal form by the kidney or at the target tissue receptor. Just about every cell in the body has a receptor for VitD — again suggesting how critical VitD is in cellular function. The active form of VitD, 1,25(OH)D3, is the interesting substance involved in the beneficial health effects of VitD. 1,25(OH)D3 attaches to its receptors throughout the body and affects the transcription of genes. The expression of information in genes is basically the recipe of life; how new tissue should be synthesized or made, and how systems and organs should function. Common sense suggests that removing an essential biological substance like 1,25(OH)D3 will result in adverse consequences.

In the United States, many disorders have distinct North-South gradients, with the incidence of various autoimmune diseases (multiple sclerosis, psoriasis, arthritis, Crohn’s Disease, ulcerative colitis), certain cancers (breast, prostate, colon, lung) and some cardiovascular diseases more prevalent at greater latitudes. In the Southern hemisphere, the gradient is reversed South-North, yet remains consistent with regard to latitude. Greater latitudes result in less sunlight exposure, consequently less VitD production and generally lower measured serum VitD levels in people living in higher latitudes. A recent study involving thousands of subjects summed up the risk of not getting enough VitD succinctly in its title: Strong associations between 25-hydroxyvitamin D concentrations with all-cause, cardiovascular, cancer and respiratory disease mortality (Schottker, et. al, 2013).

Take-home message: the lower the level of VitD, the greater the chance of death.

Vitamin D, Inflammation and Disease

Chronic inflammation kills…it’s just a matter of how and when.

Vitamin D is necessary for the proper function of the immune system. Without adequate Vitamin D, the immune system disrupts healthy tissue function by mistakenly attacking it, causing inflammation – generally referred to as autoimmune disease. Autoimmune disease affects widely different systems in the body, but shares a common feature: immune system dysfunction producing chronic inflammation. Atheriosclerosis, psoriasis, arthritis, multiple sclerosis, cancers of epithelial origin (colon, breast, prostate, lung), Crohn’s disease and ulcerative colitis are examples of autoimmune diseases affecting disparate tissue types from blood vessels to skin to brain cells. However, these conditions all share a common cause: inflammation resulting, in many instances, from vitamin D deficiency. Correct the vitamin D deficiency and remove the inflammation that may be at the root of the autoimmune disease.

Not surprisingly, many of the side-effect ridden prescription drugs that offer temporary help with some of these conditions affect the immune system in much the same manner as does VitD. As an example, by modulating the function of tumor necrosis factor, Infliximab (trade name Remicade) reduces inflammation but not without great cost. Without adequate VitD, the immune system does not function properly. The immune system ‘misreads’ signals and attacks healthy tissue causing inflammation. Inflammation causes the symptoms of autoimmune disease. Chronic inflammation is often a precursor to the development of a variety of serious conditions mentioned above. Correct the VitD deficiency to normalize immune system function, and, hopefully, avoid serious problems.

What to do

If most of this information is new to you, you’re not alone. Many will appreciate that there must be consequences of removing an essential biological substance like VitD. Those consequences are expressed as the rampant growth of autoimmune diseases and cancer.

Start getting some sensible sun exposure during the summer months. Sunburns are associated with elevated risk of melanoma, sensible sun exposure is not.

Most must supplement in the winter months to avoid VitD starvation. Take vitamin D3; this is the type of vitamin D that our bodies incorporate best. Vitamin D2, which is an expensive prescription form of VitD, is of questionable value as studies have shown it to be 87 percent less bioactive than a comparable dose of D3. Furthermore, buy VitD3 in small quantities, a month’s supply at most, as VitD potency rapidly degrades when exposed to air. Buying the garbage can size at Costco is pointless since the expiration countdown starts once the can is opened.

How much Vitamin D do you need?

Conventional thinking among various VitD scientists and physicians is that between 2,000 and 5,000 IU per day is appropriate for most healthy adults. While these amounts may seem like a lot, keep in mind that the body can produce 10,000 to 25,000 IUs of vitamin D after 10-15 minutes of full body summer sun exposure. Vitamin D toxicity is very rare. It can happen to those who take 40,000 IU a day for a couple of months or longer. And in such isolated instances, the treatment is to simply stop taking the additional VitD until blood levels drop. It is impossible to ‘overdose’ from sun-generated VitD as there are checks and balances in place to prevent overproduction. Have you ever seen an unhealthy looking lifeguard?

Get your VitD level tested. A simple blood test can tell you what you need to know. Depending on the extent of the deficiency, the amount of VitD and the time necessary to get into a specific range will vary. The following table is a rough guideline for assessing VitD status:

Vitamin D Status Serum Level
Deficient 0 – 30 ng/ml
Insufficient 31 – 39 ng/ml
Sufficient 40 – 60 ng/ml
Ideal 61 – 90 ng/ml

As a very general rule of thumb, all other things being equal, a tablet containing 5,000 IU of VitD3 will get serum levels around 50 ng/ml after one to two months of daily use.

In some diseases, researchers have studied the benefits of high doses of vitamin D. If you have a disease for which research has shown there may be a benefit in taking larger amounts of vitamin D, and if you would like to consider taking more than 10,000 IU/day, work with your doctor.

Test your vitamin D [25(OH)D] levels every 3 months and make sure that your blood levels are within a safe and healthy range.

If you have an inflammation-based condition that you think might benefit from VitD, do some research—maybe there is a VitD connection. Be an advocate for your own well-being and those around you. Involve your healthcare provider.

If you are in good health with no known inflammation-based disorders, keep it that way. As the saying goes, an ounce of prevention is worth a pound of cure. The common sense of VitD coupled with the growing body of peer-reviewed, scientifically-valid studies examining the role of VitD in general health is compelling. Inflammation, muscle strength and growth, and the genetic basis of aging itself are all intimately related to VitD. The amazing story that is VitD is just beginning to be told, make sure you’re around to benefit from it.

QUIZ: Are you smarter than a lizard? Cold-blooded animals sun themselves to get warm right? Wrong. Lizards injected with VitD prior to being placed in the sun don’t sun themselves as long as lizards injected with a placebo. Furthermore, the effect is dose-dependent; the more VitD that’s injected into the lizard, the less time it spends in the sun. The lizard is measuring blood levels of VitD and regulating its sun exposure based on that measure. The lizard is ‘smart’ enough to go into the sun to get its VitD. Do you go in the sun?

On a personal note, I was plagued by plaque psoriasis for 20 years. I eradicated it with a combination of vitamin D3 and folic acid seven years ago. My serum levels are between 80-110 ng/ml. My wife suffered from ulcerative colitis which was eliminated as well once we realized the inflammation-based link between both disparate conditions. Both diseases did not respond to traditional treatments, yet were wiped out by simple vitamin D. Absolutely amazing!

William F. Supple, Jr., Ph. D. received his doctorate in Neuroscience from Dartmouth. He is one of the founders of StarPower LifeSciences, a not-for-profit educational foundation whose mission is to spread enlightenment regarding the power of Vitamin D in health, disease and longevity. More information about the foundation, its mission and Vitamin D can be found at StarPowerLifeSciences.org.


Massage and Reiki: Relax, De-stress, Be Happy

March 31, 2014  
Filed under Health & Wellness

By Clara Rose Thornton

In the contemporary, abstract world of online socialization, financial distresses, and time lost to gadgetry and the work life, we should avoid relegating the body — which the mind occasionally shouts too loud to hear — to the realm of neglect. The human mental state can be a rodeo, and if left unchecked, the body might begin to behave as if it’s simply hanging on for dear life. The disjunction of body and mind reaps vastly negative consequences, yet is easier to eliminate than some might think, believes long-time massage therapist Laurajean Stewart of Barnet.

“When our body perceives something as a challenge to our well-being, a cascade of automatic nervous system responses takes place. In today’s society, there are many stressful events, even those we don’t consciously recognize, thus our bodies are being forced into ‘deer-in-the-headlights’ mode, constantly,” Stewart said.

“We forget that stress is not only in our heads. If there’s a dip in the roof of your house, you might not know about it, but every time it rains or snows, the water collects there until one day you have a leak. Stress is accumulative. And for every emotional or psychological response to an event, there is a physiological component, too,” she said.

Stewart acts as co-vice-president of the Vermont Chapter of the American Massage Therapy Association (AMTA), is founder of Barnet’s Thousands Hands Massage Therapy, and has been practicing seven massage disciplines for 35 years. She’s seen the recent rise in popularity of “recreational” massage, that is, treatments for relaxation and stress reduction, in tandem with therapeutic massage – the ancient Eastern traditions used in the United States since the mid-19th century to address muscular pathologies and athletic strain.

“Massage” is an umbrella term, encompassing approximately 50 treatments within various disciplines. Proven are the biological benefits of these healing treatments that manipulate muscle and connective tissue, and well-documented are their mental, spiritual, and energetic benefits, earning them rightful recognition in America’s complementary and alternative healthcare sector. Yet when massage arts are mentioned, laypeople commonly think of the classic, simplified idea of a Swedish massage, regularly downplayed in pop culture as being as accessible and tepidly effective as giving a loved one a shoulder rub.

Treatment from trained therapists such as Stewart have serious immediate and cumulative effects, many of which speak to problems tending to plague advanced years including:

increased range of motion in muscles and joints

release of endorphins that help to break the pain/spasm cycle

warming of muscle tissue to decrease stiffness within the body

promotion of nutrition and tone of tendons, muscles, and ligaments

increased circulation to promote faster healing

stress and tension reduction

Co-Vice-President of the AMTA-Vermont Chapter Jennifer Smith Findley of Lake Elmore, who specializes in geriatric massage, hot stone therapy, and lymphatic drainage among other techniques, agreed. “Massage is tailored specifically to the needs and goals of the individual person, and those needs change over time. There are so many ways massage can help a person reach and maintain his or her goals, whether it be range of motion, flexibility, balance, or even circulation. As therapists, we understand what can happen to bodies as they age, such as the reduction of muscle mass.”

Stewart was optimistic when I asked what she felt about the effects of massage’s ubiquitous commercial presence today, whether she felt it dilutes the level of seriousness or purity of the tradition in the eyes of pop culture, similar to complaints about the Westernizing and bastardization of yoga (pet yoga spas, expensive yoga clothing, etc.).

She replied, “In my opinion, anything done consciously, with presence of mind, knowledge, and respect doesn’t do injustice to ancient ways. If no one brought these and other time-honored traditions into the present, the old ways would die out, unknown.”

Another technique experiencing a rise in popularity, with documented benefit, although struggling to find acceptance in the healthcare community, is Reiki. The Japanese word “Reiki,” itself derived from a Chinese term, is most commonly interpreted in English to mean “universal energy.” Reiki is an energy-shifting modality developed by Mikao Usui on Mount Kurama in Japan in 1922, within and using the structures and principles of Buddhism. The treatment involves a trained Reiki practitioner using palms, placed on or above the client, to open energy channels and serve as a conduit between the client and universal energy streams, called “ki” in Japanese, or the more commonly recognized Chinese “qi.” Reiki is sometimes called palm-healing.

Williston’s Sandy Jefferis, co-president of the Vermont Reiki Association, stressed that, “Reiki is perfectly whole by itself. It is not part of a religion, and does not require any other discipline to be useful.”

“(During a Reiki session) people can notice a variety of sensations. Almost everyone experiences a deep feeling of relaxation. Reiki reduces stress, promotes wellness, brings perspective and wisdom to life’s challenges, complements medical therapies and generally promotes balance and wellbeing,” she said.

Reiki can be useful for clients for whom touch is just not possible.

Findley incorporates Reiki into her practice, and echoed both Stewart and Jefferis when she mentioned a sense of accord as a wellness gauge. “Worthwhile massage therapists and Reiki practitioners speak about connections, whether they be physical or spiritual, the connections between systems inside our bodies, and the connections we have with each other and the world. The more in touch we are with our bodies, the more we get to know them, the better off we are.”

If you are considering massage therapy, www.amta-vermont.org offers a comprehensive roster of therapists in the state, overviews of the treatments they offer, and education on which treatments might benefit you most. For those interested in Reiki, www.vermontreikiassociation.org provides detailed resources for choosing the right practitioner.

Curious-minded individuals who’d like to give alternative medicines and wellness therapies a trial before committing to a private practitioner might look into Essex Resort and Spa, ten minutes from the Burlington airport, which offers a broad range of treatments from Reiki, reflexology, and hot stone therapy to deep tissue and sports massage. Find info at www. essexresortspa.com.

Choosing the Best Fish for the Planet and Your Health

March 31, 2014  
Filed under Food

By Stephanie Choate

Vermont is stuffed with local, organic, humane food. From condiments to meat to vegetables of all shades and shapes, it’s not hard to find food you can feel good about eating. But one thing that stumps many locals is selecting seafood that’s healthy and caught without overly harming the environment and ecosystems.

Overfishing is in the news a lot, and for good reason. Many of the ocean’s fish populations are being fished to extinction, or have been nearly decimated already.

“Nearly 85 percent of the world’s fisheries are fished to capacity, or overfished,” according to the Monterey Bay Aquarium’s Seafood Watch website, www.seafoodwatch.org, one of the most respected programs to help consumers and businesses make choices for healthy oceans. “Our seafood choices have the power to make this situation worse, or improve it.”

It’s a lot to process, but there are tools to help consumers get started.

FINDING SUSTAINABLE SEAFOOD

“A lot of seafood is not managed in a way that’s going to provide for the future,” said Victoria Galitzine of FishWise, a nonprofit that works to promote the health and recovery of the ocean by guiding consumers and retailers to sustainable purchasing decisions.

Galitzine said there are lots of tools out there specifically created for consumers who want to find sustainable seafood.

“There are a lot of sustainable options out there, there really are,” Galitzine said. “The U.S. is doing particularly well. Fishery management in the U.S. tends to be pretty rigorous, compared to other countries. There are good options available, you just to ask the right questions and find the right people and use the tools available.”

One of the “very best,” Galitzine said, is Seafood Watch, which uses a stoplight color-coded method to organize seafood into three categories—best choices (green), good alternatives (yellow) and avoid (red).

Seafood Watch produces a region-specific printable pocket guide that you can stash in your wallet and pull out at the grocery store fish counter, as well as a sushi guide. It also has free mobile app, so you can have detailed species guides on your smartphone at the fish counter, helping you select the most eco-friendly choice from a sometimes-bewildering array of options.

The guides, updated every six months, rates fisheries based on whether the stocks are healthy and abundant, don’t threaten populations, minimize bycatch (unintended species caught in nets or on lines, some of which are endangered) and avoid impacting marine habitats and ecosystems.

Two of the most important things to look out for, Galitzine said, are where fish are caught and how they are caught.

“Just asking questions is good to show businesses that consumers care about these issues,” she said. “You may not get an answer, but often asking the question sends the message to retailers that people care.”

You don’t have to be in it alone, though. Many stores or restaurants are educating their workers or waiters about smart fish choices, and they can help you make a decision.

Eric LaVigne, co-owner of Vermont Meat & Seafood in Williston, said he does his best to make sure everything sold in his store comes from sustainable sources. He knows what he is selling and where it came from—something he said is important to his customers.

“We try to do our research before bringing anything into the store,” he said. “There’s a limited amount of fish in the sea. We want to make sure future generations get to enjoy the same seafood we get to enjoy.”

“Pretty much any fish you can get, there’s good sources and there’s terrible sources,” he said. He uses Seafood Watch and works with his vendors, Earth and Sea in Manchester and Black River Produce in Springfield, to source sustainable wild-caught fish or fish from well-managed farms.

“Our vendors have the same values as us,” he said.

Burlington’s City Market partnered with FishWise last winter to put Best Choice labels on the seafood that meets FishWise’s standards—the same ones used by Seafood Watch—so consumers can immediately identify the sustainable options.

“We wanted an opportunity to be able to source more sustainable seafood and share educational information with our customers,” said Allison Weinhagen of City Market. “When customers are ready to make a decision that’s right for them and their family, we’re all about giving them the information to do that.”

Weinhagen said approximately one third of the seafood in City Market is labeled as a best choice. The end goal is to be transparent, Weinhagen said.

“We’re here to meet the needs of our members, and to meet their needs, they need to know what they’re buying,” she said.

WATCHING MERCURY LEVELS

Like many foods, seafood can come with risks of contaminants, including pesticides, chemicals and metals, such as mercury.

Mercury, at high levels, may damage the brain, kidneys and developing fetuses, according to the Agency for Toxic Substances and Disease Registry.

Methylmercury builds up in the tissues of fish, so, in general, the higher the fish is on the food chain—or the larger and older the fish—the higher the mercury level. Large, predatory fish—sharks, swordfish, bigeye and Ahi tuna, marlin—end up with the highest levels of mercury and other toxins.

The National Resources Defense Council produces a downloadable pocket guide, ranking common fish from the lowest to highest levels of mercury, at www.nrdc.org/mercury.

THE GOOD, THE BAD AND THE UGLY

There are countless fishing or farming locations and methods. Here is a breakdown of a few:

Salmon: Some salmon tops sustainable seafood lists, while others come with serious health and eco-system concerns.

Seafood Watch recommends that consumers look for wild-caught salmon from Alaska, Washington and Oregon, which have healthy, well-managed stocks.

In general, farmed salmon is best avoided, with some exceptions.

“Salmon farming is associated with numerous environmental concerns, including water pollution, chemical use, parasites and disease,” according to the Environmental Defense Fund’s website.

The organization issued a health advisory for farmed salmon, due to high levels of PCBs—persistent chemicals that may cause cancer.

Seafood Watch recommends that consumers avoid all farmed Atlantic salmon. It takes a massive amount of food to raise salmon—three pounds of wild-caught fish to produce one pound of farmed salmon. In addition, salmon farmed in open pens release waste and pollution directly into the ocean, infecting healthy wild fish with parasites and disease.

However, some farmers are turning to closed systems, which keep the water and fish contained on the farm. Since U.S.-farmed Coho salmon require less food, Seafood Watch listed it as a “best choice.”

Shrimp: The large majority of shrimp sold in the U.S. comes from Asian or South American markets, where regulation is minimal, according to the Environmental Defense Fund.

Seafood Watch lists several shrimp sources among its “best choices:” U.S.-farmed freshwater prawns or shrimp farmed in fully recirculating systems or inland ponds; wild-caught Canadian Pacific spot prawns; wild-caught Oregon pink shrimp; and black tiger shrimp from Southeast Asian Selva Shrimp Verified Farms.

However, Seafood Watch recommends that consumers avoid most important farmed shrimp, which typically damages habitats and runs the risk of pollution and the introduction of non-native species.

Consumers should also avoid shrimp caught by skimmer trawl, which can harm sea turtles. All states except Louisiana enforce strict federal regulations to protect sea turtles, so while Seafood Watch ranks shrimp caught in most states by otter-trawl in the Gulf of Mexico as a “good alternative,” it recommends that consumers avoid shrimp caught in Louisiana or Mexico.

Tuna:Tuna is one of our most beloved fish, but its also one of the most threatened by severe overfishing. As a large fish high on the food chain, it also carries a risk of high mercury content.

Look for tuna labeled troll- or pole-caught. Long-line or purse seines can ensnare large amounts of unintended species, including endangered species.

Seafood Watch identifies the best tuna choices as:

Yellowfin caught on a troll- or pole-line in the U.S.

Albacore caught in the U.S. or Canadian Pacific on a troll- or pole-line.

Bigeye caught in the U.S. or Atlantic on a troll- or pole-line.

Skipjack caught on a troll- or pole-line or purse-seine that is FAD-free, or without the use of a fish-aggregating device.

Avoid all Bluefin tuna, which is being fished faster than it can reproduce.

Kid- and budget-friendly canned tuna doesn’t have to be written off either. Canned tuna labeled “white” is always albacore. “Light” may be bigeye, yellowfin, skipjack or tongol tuna.

Seafood Watch recommends selecting albacore tuna from the U.S. or British Columbia labeled troll- or pole-caught or light tuna labeled as skipjack—other species are less healthy. White albacore tuna from other sources is labeled as a “good alternative,” thought not a top choice.

Light tuna is also lighter in mercury content. The National Resource Defense Council has a chart with recommendations for canned tuna consumption based on weight. A 30-pound child should not eat more than one can of light tuna every two weeks or white albacore every six-weeks. An adult weighing 150 pounds or more can eat a can of light tuna every three days and white albacore every nine days.

Aside from being environmentally destructive, long-line caught tuna catches larger fish with higher mercury levels, while troll and pole lines catch smaller fish with lower mercury levels.

BEST BETS

With scores of information—some conflicting—it can be difficult to definitively pick the best fish. But Seafood Watch has put together power list it calls “The Super Green List,” identifying the fish that are currently the best for your health—lowest in mercury and high in Omega-3s—and responsibly farmed or caught.

The elite list

Atlantic Mackerel (purse seine from Canada and the U.S.)

Freshwater Coho Salmon (farmed in tank systems, from the U.S.)

Pacific Sardines (wild-caught)

Salmon (wild-caught, from Alaska)

Salmon, Canned (wild-caught, from Alaska)

Best Choices

The Environmental Defense Fund has also selected its best choices for fish that are eco-friendly and healthy:

U.S. and Canadian Albacore tuna

Canadian Atlantic mackerel

U.S. and Canadian Pacific sardines

Alaskan and Canadian sablefish/black cod

Canned salmon

Wild Alaskan salmon

Other top picks

Other seafood that appear on both Seafood Watch’s list of the most sustainable fish and the NRDC’s list of low-mercury fish include:

U.S. catfish

Clams

Snow, Kona, Dungeness and blue crab

U.S. farmed crayfish

Atlantic croaker, especially non-trawl

North Atlantic mackerel, wild-caught or purse seine

Striped mullet

Oysters

Perch, especially from Lake Erie or farmed in tank systems

Atlantic Pollock, especially from Norway

Salmon from Alaska, reefnet-caught salmon from Fraser River or Washington. Avoid farmed Atlantic salmon.

Pacific sardines from U.S. and Canada. U.S., Canadian or Ecuadorian tilapia

Farmed Rainbow Trout

Whitefish, trap-net or wild-caught

‘Home Safety is Bone Safety’

March 31, 2014  
Filed under Health & Wellness

Making small changes around the house can help decrease the number of falls that occur. Falls in the home are the leading cause of injuries to Americans age 65 and older. (Courtesy photo)

New public service campaign aims to help decrease falls at home

Falls within the home are the most prevalent cause of both fatal and nonfatal injuries among Americans age 65 and older, leading to more than 2.3 million emergency room visits and 21,000 deaths in 2010. The American Academy of Orthopaedic Surgeons (AAOS), in partnership with the Orthopaedic Trauma Association (OTA), recently launched a new public service campaign, “Home Safety is Bone Safety,” to help decrease falls at home and help seniors maintain active and independent lifestyles free of injury and pain.

Designed for seniors and their caregivers, the campaign features a Falls Awareness and Prevention Guide that provides tips to fall-proof areas of the home. The guide also addresses:

Lifestyle choices, such as eating healthy and staying physically active, that encourage maintaining strong bones and reduce the risk of a fall-related injury;

Medical factors such as osteoporosis, arthritis and vision or hearing loss that increase the risk of a fall-related injury;

Risk factors such as inadequate footwear and excessive alcohol consumption that increase the likelihood of a fall;

How to contact a friend, relative or emergency service in the unfortunate event of a fall;

How to get up from a fall safely without causing further injury.

“The new falls prevention campaign highlights the importance of a proactive approach to addressing risk factors and fall-proofing the home,” said Hassan Mir, MD, orthopaedic surgeon and assistant professor of orthopaedics and rehabilitation at Vanderbilt University Medical Center.

According to the Centers for Disease Control and Prevention (CDC), one out of every three adults age 65 and older will suffer from a fall each year. Of the more than 2.3 million fall-related injuries treated in 2010, approximately 662,000 of those patients required hospitalization.

Even if someone does not suffer a severe injury, that person is still more likely to develop a fear of falling. This fear might cause someone to reduce their level of physical activity, which has the long-term effect of decreasing bone density and only increases his risk of a fall over time.

To determine your risk factors and review tips, find the Home Safety is Bone Safety guide at http://orthoinfo.aaos.org/falls/.

Some Very Good Reasons to Memorize Poetry

March 31, 2014  
Filed under Arts & Entertainment

By Ginger Lambert

Every day we hear in the media that exercise is good for improving our mood, keeping our cholesterol in check and lowering our blood pressure. What about exercising our brains? I believe that with as little as five minutes a day, it is possible to reverse cognitive decline. Some memory loss is normal, but through conscious mental activity, we can maintain the integrity of our brain. Learning a poem, at any age, keeps our minds active and stimulated, and improves memory.

There are benefits to learning a poem by heart. As we age it is important to change up our routines and challenge ourselves every day. According to The Scaffolding Theory of Cognitive Aging (STAC), developed in 2009, the brain responds to aging in different ways. Though there is a natural degradation in cognition, these processes can be reversed in response to stimulating activities and learning.

You might be saying at this point, “But why should I attempt to learn a poem when I can Google it?”

When one goes deep into the poem, spending days or weeks with it, the nuances that might slip past when merely reading the poem become more obvious. The more time we spend with a poem, the more it becomes a friend. Practicing different intonations for a phrase can uncover a new twist on the poem’s meaning, while also stimulating new brain activity.

A social benefit of learning a poem by heart includes a sense of poise that develops when one recites from memory. Public speaking becomes less daunting when one can effortlessly recall “Ode to a Nightingale.” The energy it takes to learn a poem can help to develop focus and improve self-confidence.

Exploring the imagery of a poem can inspire imagination and enhance creativity. Spending time with a poem can encourage greater understanding and empathy. Poems written centuries ago give us a glimpse into other times and cultures.

If improving vocabulary if your aim or developing an understanding of English syntax, learn a Keats or Shakespeare sonnet. If you want to impress your friends, learn a longer poem like “The Love Song of J. Alfred Prufrock” by T. S. Eliot. Waiting for an appointment, you will have a pleasant distraction when you can recall a poem you have memorized. Waiting in line at the grocery store or stuck in a traffic jam become more tolerable when you actively engage your brain by recalling a poem you have learned.

In a society that is moving so fast, slowing down to memorize a poem can be a calming activity. If you really want to do something that is pure self-enrichment, learn a poem. All of these benefits will complement a strengthened memory.

Ginger Lambert is receiving a BS in Exercise Science in May of 2014. She writes a blog on matters related to fitness and brain health. She is working on memorizing her 21st poem and teaches a workshop on memorizing poems by heart.


Hiring a Home Healthcare Worker? Follow These Important Tips

March 31, 2014  
Filed under Business

By Kurt Kazanowski

Whether it’s to help the elderly with daily needs like bathing and toileting, or perhaps a patient with a debilitating condition such as ALS, home healthcare workers play an important role in the lives of many.

In recent times, however, a few bad apples have brought about a bad name for the industry.  In a recent case in Detroit, a home healthcare worker was hired to care for an 80-year-old woman with dementia. Not only was the patient neglected, the worker allegedly stole more than $1.5 million from the family that hired her.

This horrifying story demonstrates how vulnerable the elderly can be and how naive some families are when hiring a caregiver or home care agency. The time to address this problem is now because the need for in-home care will continue to grow as the aging of America crests in 2030.

Despite these unfortunate incidents, home healthcare workers play a vital role for many people who otherwise would be forced out of their homes and into a long term care facility. The industry is filled with plenty of hardworking, honest and caring professionals. As a consumer, you want to ensure the best care for a loved one, and you can by doing your due diligence. 

Shop around

Chances are you wouldn’t buy the first car you test drive or settle for the first pair of jeans you spot hanging in the store, so why would you settle on the first home healthcare company you find or meet with? Start by reviewing the company’s website. Check the reviews from other families who have used this company.  Visit www.caring.com for reviews and feedback about in-home care companies. 

Background checks must be ongoing 

Find out if the home care agency completes a national criminal background check, as well as conducts a motor vehicle background review every six months. One background check upon hiring is not enough. Screening must be an ongoing process. Never hire a company that doesn’t take this simple step to ensure the safety of its patients.

Regular quality assurance checks

Find out if the home care company does regular quality assurance checks. A quality assurance check is a regular spot check on the caregiver to make sure all is well in the home and that the care plan is being followed. It ensures that your loved one is properly cared for, bathed frequently, takes medication as prescribed and is living in a clean and healthy environment.

Status reports

Find out if the home care agency you hire meets with you or speaks to you on a regular basis to update you on the care being delivered to your loved one, and answers any questions you have.  A reputable company will do this on an ongoing basis or as frequently as you request.

Meet with the healthcare worker ahead of time

When you meet with a homecare company, often times you meet with an administrator or someone whose job it is to sell you on the company. Request to personally meet the healthcare worker who will be providing care for your loved one in advance of him or her showing up to your home. Any reputable home healthcare agency would be willing to arrange that. Also, make sure and speak to the families of other patients your home healthcare worker cared for and ask for their honest feedback. 

Family members must remain active in the process

Also remember that family members play an important role in looking after a loved one: keeping an eye on credit card statements, checking and saving account balances and other important financial documents; having important mail forwarded; making unannounced visits to the parent’s home; getting and reviewing receipts from home care workers for any shopping or payments made on behalf of your loved one.    

Many people believe they can hire a private caregiver through the Internet for less money than hiring a personal care company.  And while this may be true, be sure you understand the potential downside before you make that decision. 

If the caregiver is injured on the job, you are responsible for damages. Caregivers working as independent contractors are typically not bonded and insured, and any loss you experience through theft most likely won’t be recovered. Who is going to pay the mandated taxes and withholding? Finally, you truly don’t know who you are letting into your home as a background check won’t be completed, unless you want to shell out the money and do these on your own twice a year.  

The world’s population will always be aging and the need for in-home care will always be a top priority for a lot of families. With some good due diligence, you will find a personal care home health company that will provide both excellent care and give you peace of mind.

Kurt A. Kazanowski, MS, RN, CHE is a health care executive with more than three decades of experience.  He owns Homewatch CareGivers.  For more information, visit www.thehomecareexpert.com.

Tips for Regaining Flexibility

March 31, 2014  
Filed under Savvy Senior

savy-srBy Jim Miller

Dear Savvy Senior,

Can you offer some good stretching tips and resources for seniors? I’ve gotten so inflexible in recent years I can hardly bend over to tie my shoes anymore.

—Stiff Senior

Dear Stiff,

Of all possible exercises, stretching tends to be the most overlooked and neglected among seniors, yet nothing is more vital to keeping an aging body limber and injury-free. Here’s what you should know along with some tip and resources to help you regain some flexibility.

As we age, our muscles naturally lose their elasticity if you’re not active, which can make common day-to-day activities like reaching down to tie your shoes, or looking over your shoulder to back your car out of the driveway difficult.

But the good news is, by incorporating some simple stretching exercises into your routine (at least three times a week) you can greatly improve your flexibility, as well as enhance your balance, posture and circulation, relieve pain and stress, and prevent injuries. Stretching is also important as a warm-up and cool-down for more vigorous activities, and leg stretching is an excellent way to prevent nighttime leg cramps, too.

Stretching Basics

Stretching exercises should focus on the muscles in your calves, front and back thighs, hips, lower and upper back, chest, shoulders and neck. If you’ve had hip or back surgery, you should talk to your doctor before doing lower-back flexibility exercises.

If you don’t have any experience with stretching, there are books like “Stretching for Dummies” and “Stretching for 50+” that you can purchase at your local bookstore or amazon.com that provide instructions and illustrations of proper techniques.

There are also a number of DVDs and videos you can buy to guide you through a series of stretching exercises you can do at home. Collage Video (collagevideo.com, 800-819-7111) sells several at prices ranging between $10 and $20, as does iefit.com and amazon.com.

Also see go4life.nia.nih.gov, a resource created by the National Institutes on Aging, that offers a free exercise DVD and booklet that provides illustrated examples of stretching exercises. You can order your free copies online or by calling 800-222-2225.

While stretching, it’s very important to listen to your body. You want to stretch each muscle group to the point where the muscle feels tight. If it hurts, you’ve gone too far. Back off to the point where you don’t feel any pain, then hold the stretch for 10 to 20 seconds. Relax, then repeat it three to five times, trying to stretch a little farther, but don’t bounce. Bouncing greatly increases your chance of injury.

It’s also a good idea to warm up a little before you start stretching by walking in place and pumping your arms. And remember to breathe when you stretch. Keep in mind that muscles that have not been stretched in a while take time to regain their flexibility. So be patient and go slowly.

Eastern Options

Another popular way to improve your flexibility is through gentle yoga or chair yoga. In chair yoga, you replace the yoga mat with a chair where most poses can be duplicated. This is much easier on tight, inflexible muscles.

To get started, there are DVDs and videos that offer yoga instructions and routines for seniors that you can do at home. Some good resources for finding them are peggycappy.net and yogaheart.com, or check with your local public library.

Tai chi is another good exercise option for improving flexibility and balance. To learn it, it’s best to work with an instructor who can teach you the correct movements and breathing techniques. To locate a class in your area, call your local senior center, health club or wellness center or check your yellow pages. If nothing’s available, tai chi DVDs for seniors (see amazon.com, collagevideo.com and iefit.com) are a good alternative.

Shingles Vaccine: Electronic Medical Records and Pharmacist Intervention Improve Care

March 31, 2014  
Filed under Health & Wellness

While people over the age of 60 account for more than half of all shingles cases, less than 15 percent get the vaccination that helps prevent the blistering skin rash, which can cause lingering nerve pain.

“I awoke with such pain in my head and neck area I thought someone must have taken a lead pipe to me during the night,” recalls Rose Hallarn, who was 57 at the time. “After watching what I went through, my husband made a point of getting vaccinated – both because of what he had seen me go through and also on advice of his physician – but it wasn’t something that was necessarily top of mind for him before that.”

Now, a new study from researchers at The Ohio State University is reporting that older patients who receive written information on shingles were almost three times more likely to get vaccinated than those that didn’t receive a similar communication. The study is also one of the first to show that using a patient’s electronic medical record (EMR) coupled with pharmacist intervention markedly improves preventative care of shingles over the current standard.

The research team, led by Stuart Beatty, a pharmacist with Ohio State’s College of Pharmacy, says that the low vaccination rate is due to a combination of factors including lack of awareness, cost, access to clinics able to store the fragile vaccine and the fact that face-to-face appointments don’t offer enough time to discuss shingles, also known as herpes zoster.

“With older patients, there are usually more pressing health issues to discuss during routine appointments, so herpes zoster falls off the list,” said Beatty. “Plus, as a live vaccine, it’s not appropriate for people with certain illnesses. There usually isn’t time to figure all that out in a regular office visit.”

For the six-month study, which was supported by the Ohio State Center for Clinical and Translational Science (CCTS), Beatty and his team used electronic medical record (EMR) data to identify more than 2,500 patients over the age of 60 without a documented herpes zoster vaccination. Some were randomized to receive information about shingles via a secure email linked to their online personal health record (PHR) or a mailed postcard, while others received no information outside what they may have gotten in a routine doctor visit.

Pharmacists reviewed the EMRs of patients who had received emails or mailed information to identify eligible vaccine candidates, and then sent them a vaccination prescription via standard mail, along with a list of local pharmacies that offered the vaccine. Vaccine fulfillment was tracked by reports submitted to the team by local pharmacists.

Patients with an active PHR that received email information on shingles had the highest vaccination rate of 13.2 percent, compared to a rate of 5 percent for patients with an active PHR that did not receive the email information. For patients that did not have an active PHR but did receive mailed information, the vaccination rate was 5.2 percent compared to a rate of 1.8 percent for patients without an active PHR and received no information.

Neeraj Tayal, MD, an Ohio State Wexner Medical Center general internist on the research team, noted that while the numbers of patients vaccinated may seem small, the study was conducted in 2010-2011, a time when the national vaccination average was actually 6 percent, far lower than today’s average of 15 percent. Tayal also suggests that despite the overall low vaccination rate, the results challenge the notion that there are too many logistical barriers to this type of effort.

“It took pharmacists a matter of minutes to review the chart and mail out a prescription. This saved the physician time, the patient time and improved the overall health of our patients,” said Tayal, who is also an expert on how EMR and PHR can improve clinical practice. “By utilizing pharmacists as members of a care team, many perceived logistical barriers were managed and overcome.”

Hallarn, who did not participate in the study, recovered fully from her bout with shingles, and got vaccinated to help prevent a recurrence. An active user of her online health record, Hallarn says she requested a prescription for the shingles vaccine online through her chart, but then had to manually update her file to reflect that she had gotten the vaccine, something that study authors acknowledge is an ongoing issue.

“We found a few patients that said they had already been vaccinated, but there was no record of it in their EMR, which isn’t surprising given that the current information exchange between a physician’s office and a community pharmacy is extremely limited,” said Beatty. “As EMR use and a team approach to patient care increases, this health information exchange will be critical for success.”

An example that authors point to in the study was that during the EMR review, pharmacists were able to identify a few patients who shouldn’t get the vaccine. These patients had their chart updated so the contraindication will appear for any provider trying to order the vaccine in the future. According to Tayal, this offers a peek at the potential of EMRs.

“Between 40 and 60 percent of office-based providers and hospitals in the U.S. have adopted an EMR system. While it’s too early to tell whether EMRs will save money, our intervention model shows there are opportunities to manage chronic and preventable illnesses, prevent medication interactions, and integrate team-based care in ways that would result in better care and cost savings,” said Tayal.

Winter and spring are the most common times of the year for shingles outbreaks. According to Tayal, shingles generally causes a blistering rash on the face, chest, belly or legs, and is accompanied by intense pain lasting between 2-4 weeks. Some patients are stricken with a prolonged pain syndrome called “post herpetic neuralgia” that can last months, or in rare cases, years. The rash can lead to complications ranging from blindness to urinary problems. The pain often develops before a rash is noticed so patients often seek medical attention for pain that is misdiagnosed until the rash develops. The vaccine can reduce the chances of catching shingles by 51 percent or reduce the severity of an outbreak.

The study was published in The American Journal of Medicine.

Ready, Get Set, Sale!

March 31, 2014  
Filed under Fashion

Check out new spring collections when shopping the sales. Designer Peter Pilotto’s collection for Target is a winner in bright colors, like this purple floral dress for $69.99. (Target and Net-A-Porter.com)

By Sharon Mosley

Chances are you’re not yet quite ready to shop for spring clothes. You’re probably still snuggled up in your heavy sweaters and sweatpants, slugging through cold rain and blowing snowstorms. But, hey, it is sale time and worth browsing for some great deals, right? And if you’re really serious about scoring some fashion bargains, you’ll head out to your favorite store even if there’s a blizzard.

Here are some ideas to keep you on budget:

Shop in your own closet. I know you’ve got cabin fever and you want to hit the streets, but it really pays to assess what you already have at home. Many of us have a strange way of buying the same thing over and over and over. How many pairs of black leggings do you have?

Make a list of what you really need. Sounds simple, doesn’t it? But how many times have you wished you had a blouse to go with that long emerald green skirt you bought last year just because it was the Color of the Year? You may even want to take that skirt with you to find its perfect mate.

Replace the basics. No, it’s not as fun as finding that furry faux coat at 75 percent off, but if your old trustworthy trench is getting a little rugged around the edges, this is the perfect time of year to consider replacing it with a newer model. You know classics will always be good investments, especially if you can find them on sale.

Be prepared. Wear comfortable clothes and shoes when you go shopping. Make sure you wear clothes that you can easily slip on and off. Leave the tight boots at home and wear flats. Suit up like a shopping warrior who means business, but wants to have some fun, too.

Check online. There may be plenty of good deals out there, and some are online. You can often get extra discounts just by perusing the websites of the stores you intend to visit. When you get coupons in the mail, stick them in your purse immediately, so you will have them with you when you go shopping.

Don’t get overwhelmed. If the racks are brimming with a tangled mess of clothes, just take your time. Get into the spirit of skimming the hangers for those hidden treasures. I often do this by color. I know I don’t need another black pair of pants, so I just skip over to the next aisle.

Try the merchandise on for size. This is a step that many of us just want to skip when we are in sale mode with a hundred other shoppers. But it can pay off. How many times have I just “known” without a doubt in my mind that that sweater would definitely fit me, and then get it home and it swallowed me up? Remember, sizes can vary from label to label drastically. So unless you know that you “always” wear a size 8 in a particular designer jean, err on the safe side and try everything you buy on, no matter how good a deal it seems.

Get out of your style rut. Sale time is a great time to reevaluate your own wardrobe. If you’ve been stuck in a rut, take advantage of buying something a little “outrageous” when it’s marked down. Try something that may not really be “you.” You never know how good it may make you feel … especially when you got it half price.

Explore the new season. You may have promised you would only shop the sales, but once you’re in the stores, look around. Check out the new spring merchandise that’s bound to be lurking just inside the entrance door. You never know what kind of deal you’ll find … before it goes on sale!

— CNS

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