Increasing our awareness of stroke

May 31, 2018  
Filed under Aging Parents, Health & Wellness

By Matthew Sullivan, M.D.

 

National Stroke Awareness Month may be behind us, but work is always needed to combat one of the deadliest diseases on earth. We have all likely experienced the devastating effects of a stroke in either the life of a family member or in someone close to us. As a physician, I see the consequences of this terrible disease every day. There are many ways to work to reduce the impact of stroke in our community and as with any significant public health threat, it starts with all of us refreshing a few key pieces of knowledge.

 

Sometimes known as a cardiovascular accident (CVA), a stroke is actually a decrease in the blood flow to an area of the brain. This can happen in one of two ways—a blockage of blood flow within an artery (an ischemic stroke, the most common form) or by leakage of blood from a damaged blood vessel (a hemorrhagic stroke, less common).

 

Brain cell death due to decreased oxygen occurs within minutes and results of this can be catastrophic. In the United States, stroke is the leading cause of significant disability and is the fifth leading cause of death. It is the second leading cause of death worldwide. The numbers surrounding this disease are fairly staggering from both a personal and public health point of view, but the good news is that many strokes and their tragic outcomes can be prevented.

 

There are risk factors we cannot change, such as our age, race, gender and family history. Importantly, age is the biggest factor as chances of a stroke double in each sequential decade after age 55. Women are actually at greater stroke risk than men overall—each year, strokes kill twice as many women as breast cancer. More men have strokes prior to the age of 75 (three-quarters of all strokes happen after this age). Black and Hispanic men are also at increased risk.

 

Despite some risks that we are stuck with, there are modifiable risk factors as well. This means everyone has the ability to reduce their risk of having a stroke. Quitting smoking, eating healthier (the Mediterranean diet), increasing exercise, controlling high blood pressure, losing weight, improving your cholesterol, cutting alcohol intake, treating atrial fibrillation and controlling your blood sugars if you are a diabetic all top the list. While these things may look fairly simple, they are some of the most difficult behavior changes I talk about with my patients.

 

Change and motivation for change happen in different ways for all of us. If some of these things seem like too great a task to take on, try setting a small, achievable goal at first and slowly building from there. When in doubt about how to improve your own risk, you can (and should) talk to your primary care provider. Even a seemingly small behavior or behavior change can have a large impact. Consider that:

 

  • Smoking even one cigarette a day increases the risk of stroke by 30 percent;
  • Reducing blood pressure to healthy levels can reduce your risk by 40 percent;
  • Increased physical activity (even by walking more) can reduce risk by 25 percent.

 

Preventing a stroke is the best possible outcome. Sometimes we find ourselves in less than ideal circumstances. If a stroke does happen, the speed at which you get medical attention is key to preventing some of its worst effects. A good way to remember the signs of stroke is to “act F.A.S.T. ” This stands for:

 

  • F ace – check for drooping and asymmetry;
  • A rm – check for weakness and numbness;
  • S peech – listen for difficulty speaking;
  • T ime – call 911 and get medical help as soon as possible (time equals brain).

 

When you suspect that you or someone you love is having a stroke, don’t wait—get medical attention immediately.

 

Stroke is one of the most common and catastrophic diseases we face. I’m writing because I’ve seen how devastating the results of stroke can be, yet there are real, concrete steps we can all take to reduce that risk. By remembering to “act F.A.S.T.,” we can get timely treatment which may prevent a devastating outcome. By making a lifestyle change (or two), we can avoid a stroke entirely. Small changes can truly make a big difference.

 

Learn more at stroke.org and strokeassociation.org.

 

Editor’s note: Matthew Sullivan, M.D. , is a family medicine physician on staff at Green Mountain Family Practice in Northfield. You can reach him at 802-485-4161 or matthew.sullivan@cvmc.org

Burlington Edible History Tour 2018 Season Opens June 14

May 31, 2018  
Filed under Food, Money, News

Burlington Edible History tours, rated five stars on Trip Advisor, begin June 14 for its fourth full season.

 

Over a 1.5-mile walk, participants discover the local history and food traditions of 11 immigrant groups that built Burlington: Abenaki, African Americans, French Canadians, Germans, Greeks, Irish, Italians, Chinese, Jews, Lebanese, and Yankees.

 

Tour groups sample food at five restaurants that serve local foods. This year we are delighted to welcome two new restaurants – The Gryphon and Deli 126. They join Penny Cluse, Sugarsnap Catering at ECHO, and Monarch and the Milkweed at Maglianero.

The Gryphon is located in the first Hotel Vermont, once Burlington’s largest and most prestigious hotel, and the Deli 126 is a New York-style deli combined with a 1920s style jazz cocktail lounge.

Deli 126 Bar General Manager Emily Morton enthuses, “We are a great match with Burlington Edible History. We’re both excited to let people experience our local food and drink history. Elise and Gail discovered the existence of the Good Templars and Vermont Anti-Saloon League offices on this block and the next, two groups that pushed to prohibit the sale of liquor.”

 

Tours run Thursdays, Fridays, and Saturdays, 1:00 – 4:15pm, through October 13. Tickets must be purchased in advance through Seven Days Tickets via their website at www.sevendaystickets.com or through the Tour’s website at www.burlingtonediblehistory.com.

 

The tour donates 10% of profits to New Farms for New Americans to help new immigrants and refugees stay connected to their culinary traditions. Burlington Edible History Tour is the only Vermont destination in the tourism blog Roaming the Americas on “How to Support Immigrants and Refugees Through Travel in the United States.”

 

 

 

 

 

 

 

 

10 Tips to ACE Your Posture

May 29, 2018  
Filed under Health & Wellness, News

 

Stand Taller

Mom was right, posture is important, especially as we spend our days hunched over phones and computers.  Poor posture strains muscles and joints, and is linked to back and neck pain, as well as overall stress and even depression.  Plus slumping makes you look older.

 

HEre are 10 tips to ACE your posture  from PostureMonth.org to build new habits and retrain posture by improving your body Awareness; taking Control of how you sit, stand and move; and designing the postural Environment right for you.

 

10 Tips to ACE Your Posture

 

“A” is for AWARENESS

 

1. Take a picture:  Seeing how you really look is a great incentive to improving posture.  Check your alignment compared to a line through the middle of your head, shoulders, hips and ankles.  Any camera works for front and side pics, or use the free PostureZone app for any mobile device to visualize and track exactly how your body stacks up.

 

2. Get moving:  Take posture breaks throughout the day.  Set a reminder to get up and stretch, or try a postural exercise like the ones below.  Moving your body every 90 minutes or so will make a big difference in how you feel at the end of the day.

 

“C” is for CONTROL

 

3. Ground your feet: Lift your heels and come up on your toes, then lift your toes to come up on heels and spread toes. Roll onto the outside edge and then the inside edge of each foot.  Press down on all four corners of both feet to connect with the ground.

 

4. Center your pelvis:  Core exercise is not just for the gym.  Lengthen your spine with a gentle low back arch and tuck.  Repeat for 5 cycles to wake up and reset neglected muscles during your day.

 

5. Open your chest:  Lift your shoulders all the way up, then roll them back, and then release them down.  Repeat 5 times to open your chest and relax your spine.

 

6. Level your head:  Imagine a balloon gently lifting the top of your head toward the sky.  Keep your head level and focus on a spot directly in front of you to retrain the deep muscles that align your neck.

 

7. Take 5 Breaths: Belly breathing with your diaphragm is key to strengthening posture.  Lengthen your body and spine with 5 slow, aware breaths to let your shoulders relax and clear your mind.

 

“E” is for ENVIRONMENT

 

8. Adjust it: There’s no one single perfect posture position, and your body is designed to move.  So change it up.  Consider a desk that lets you stand up or sit down to keep moving throughout the day. Instead of an office chair, try sitting on a ball or a pelvic for a couple of hours. When taking long trips, adjust your car seat each time you stop. When texting, lift your phone up to eye-level instead of folding your head down.

 

9. Sit strong: Adjust the rear-view mirror in your car so you have to sit tall with upright posture to see. Change the angle of your computer monitor or lift it a bit higher to reduce stress on neck muscles.

 

10. Stand taller: Head up, shoulders down and pelvis engaged gives you more height and less girth.  Plus people with strong posture often feel less pain, look younger and feel more confident!

 

Recheck your posture (Tip 1) a few times a year to keep track of your improvement.  VisitPostureMonth.org for more ideas to ACE Your Posture.

 

 

Keene Medical Products Commits to Continued Partnership with Vermont Medicaid

May 29, 2018  
Filed under Aging Parents, Health & Wellness, News

The Department of Vermont Health Access (DVHA) and Keene Medical Products announced today that the medical equipment provider will remain a full member of the Vermont Medicaid provider network. Keene will continue to fulfill all categories of service to Vermonters, erasing a late April decision by the company to withdraw from the market effective June 1st.

 

Keene is an important source of medical equipment for the state’s health care providers and Medicaid members. Today’s announcement means that Vermont health care providers and members who use Keene products – including hospital beds, walkers, commodes, ostomy and enteral nutrition – can continue to count on those products and do not have to switch to a new equipment provider.

 

“On behalf of our more than 160,000 members, and especially the 4,000 that use Keene products, I thank Keene for their continued collaboration,” said DVHA Commissioner Cory Gustafson. “We are grateful that our members can focus on getting the care they need and avoid changes and disruptions.”

 

“We are committed to our Vermont customers, including those who receive coverage through Medicaid and Dr. Dynasaur,” said Keene CEO Kurt Filiault. “Our dialogue with DVHA over the last few weeks has been positive and given us confidence that our business model can continue to succeed.”

 

At issue was a recent change in Medicaid reimbursement rates made to align with changes in federal law. DVHA consulted with the Home Medical Equipment and Services Association of New England (HOMES) and its members prior to the change and has been in frequent communication with the association and its network to address implementation concerns. DVHA continues to make adjustments to ensure the new fee schedule balances the State’s commitment to its Medicaid members and Vermont taxpayers. DME companies can use the State’s Global Commitment Register (http://dvha.vermont.gov/global-commitment-to-health/global-commitment-register) to track additional changes.

 

DVHA and Keene are also collaborating on an outreach plan, notifying members by phone and mail that Keene’s services will continue, that they can disregard the company’s previous letter, and that they will not be required to switch to a different DME provider in the Vermont Medicaid network.

Today’s announcement was welcomed by Vermont’s hospitals and medical providers. “We are pleased that DVHA and Keene reached this agreement,” North Country Hospital Interim CEO Tom Frank said. “High quality rural health care relies on access to durable medical equipment, and a robust provider network is the key to providing that access. Keene is an important member of that network, so we’re relieved that this collaboration will continue.”

 

About DVHA and Keene

The Department of Vermont Health Access is Vermont’s Medicaid agency and is charged with improving the health and well-being of Vermonters by providing access to quality healthcare, cost effectively.

 

Keene Medical Products is a family-owned company with over 150 staff who focus on northern New England, providing outstanding customer service and the highest quality products at competitive prices.

 

 

 

How to Choose a Good Estate Sale Company

May 21, 2018  
Filed under Savvy Senior

Savvy Senior

Dear Savvy Senior,

Can you provide some tips on how to choose a good estate sale company who can sell all the leftover items in my mother’s house? 

Inquiring Daughter

 

Dear Inquiring,

The estate sale business has become a huge industry over the past decade. There are roughly 22,000 estate sale companies that currently operate in the U.S., up nearly 60 percent from just 10 years ago. But not all estate sale companies are alike.

 

Unlike appraisal, auction and real estate companies, estate sale operators are largely unregulated, with no licensing or standard educational requirements. That leaves the door open for inexperienced, unethical or even illegal operators. Therefore, it’s up to you to decipher a good reputable company from a bad one. Here are some tips to help you choose.

 

Make a list: Start by asking friends, your real estate agent or attorney for recommendations. You can also search online. Websites like EstateSales.net and EstateSales.org let you find estate sale companies in your area.

 

Check their reviews: After you find a few companies, check them out on the Better Business Bureau (BBB.org), Angie’s List (AngiesList.com), Yelp (Yelp.com) and other online review sites to eliminate ones with legitimately negative reviews.

 

Call some companies: Once you identify some estate sale companies, select a few to interview over the phone. Ask them how long they’ve been in business and how many estate sales they conduct each month. Also find out about their staff, the services they provide, if they are insured and bonded and if they charge a flat fee or commission. The national average commission for an estate sale is around 35 percent, but commissions vary by city and region.

 

You may also want to ask them about visiting their next sale to get a better feel for how they operate. And be sure to get a list of references of their past clients and call them.

 

Schedule appointments: Set up two or three face-to-face interviews with the companies you felt provided you with satisfactory answers during the phone interviews.

 

During their visit, show the estate liquidator through the property. Point out any items that will not be included in the sale, and if you have any items where price is a concern, discuss it with them at that time. Many estate companies will give you a quote, after a quick walk through the home.

 

You also need to ask about their pricing (how do they research prices and is every item priced), how they track what items sell for, what credit cards do they accept, and how and where will they promote and market your sale. EstateSales.net is a leading site used to advertise sales, so check advertising approaches there.

 

Additionally, ask how many days will it take them to set up for the sale, how long will the sale last, and will they take care of getting any necessary permits to have the sale.

 

You also need to find out how and when you will be paid, and what types of services they provide when the sale is over. Will they clean up the house and dispose of the unsold items, and is there’s an extra charge for that? Also, make sure you get a copy of their contract and review it carefully before you sign it.

 

For more information on choosing an estate sale company, see National Estate Sales Association online guide at NESA-USA.com, and click on “Consumer Education” then on “Find the Right Company.”

 

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

 

 

Age Well and Lindley Food Service Partner to Deliver Meals on Wheels to Northwestern Vermont

May 17, 2018  
Filed under Aging Parents, Food, News

Age Well (formerly the Champlain Valley Agency on Aging), Vermont’s largest Meals on Wheels provider, has entered into a partnership with Lindley Food Service to support the growing demand and changing environment of Meals on Wheels.  Under the current model, Age Well oversees fourteen different food vendors across Northwestern Vermont.  “With this many unique vendors, it’s difficult to provide consistent quality control and food variety for the nearly 1,500 people we serve,” stated Age Well Nutrition Director, Chris Moldovan. “Achieving the highest quality of care for aging Vermonters requires we find a way to improve our nutrition program and food production model.”

 

With 25 years of experience providing quality meals for programs throughout the northeast, Lindley has been a vendor for Age Well’s Addison County meal programs for over two decades.  This transition emerged from a three-year process that involved a consultant, focus groups, social service providers, food program coordinators, and other community members. The goals for all stakeholders in this process were the same: expand options and improve quality for home-delivered meals, ensure food safety, provide consistent training and background checks forvolunteers, and meet the dietary, religious and cultural needs of those served.

 

Lindley will begin preparing chilled meals for Age Well’s entire four county region (Addison, Chittenden, Grand Isle and Franklin County), beginning in early July. Meals will continue to be delivered by the nearly 400 dedicated volunteers who provide a meal, safety check and friendly visit to seniors who struggle with hunger and may be isolated and living alone. “Chilled meals will be prepared by Lindley and delivered in place of the old-style heated meals,” said Moldovan.  “This change will provide a number of benefits for our clients; the flexibility to reheat or freeze their meals and eat them at a time that best suits them.  Another reason for changing from heated meals to a chilled meals model was our need to enhance food safety, nutritional benefits, and level the playing field in terms of food quality” explained Moldovan.

 

Lindley will assist with menu planning, customized delivery schedules, and create special menus overseen by a Registered Dietitian.  This will enable Age Well to provide therapeutic, medically tailored and culturally appropriate meals and ensure that we are meeting the needs of those with chronic conditions and our increasingly diverse population.  With the chilled meals also comes brand new packaging, which will be clearly labelled and specifically designed to reheat easily and safely.  The use of chilled meals is now considered best practice for Meals on Wheels programs across the country.  By moving to this model and partnering with one vendor, Age Well is taking the necessary steps to ensure consistent quality of our meals, meet a broader range of nutritional needs, and continue to combat the three of the biggest threats of aging: hunger, isolation and loss of independence.

 

For more informationwww.agewellvt.org

‘Extra Help’ Program Helps Seniors With Their Medication Costs

May 14, 2018  
Filed under Savvy Senior

Savvy Senior

Dear Savvy Senior,

Are there any special Medicare programs that help seniors with their medication costs? My 74-year-old mother, who lives primarily on her Social Security, takes several high-priced drugs that sap her income even with her Medicare drug plan.  

Looking for Assistance

 

Dear Looking,

Yes, there’s a low-income subsidy program called Extra Help that can assist seniors on a tight budget with paying for their premiums, deductible and co-payments in their Medicare (Part D) prescription drug plan.

 

Currently around 10 million people are receiving this subsidy, but another two million may qualify for it and don’t even realize it. They’re missing out on hundreds, maybe thousands, of dollars in savings each year.

 

Changes in the law make it easier than ever to qualify for the Extra Help program. Even if your mom applied and didn’t qualify before, she may be eligible now. The amount of additional assistance she would receive depends on her income and assets. If she qualifies for help, she’ll pay no more than $3.35 for a generic drug and $8.35 for a brand-name drug in 2018.

 

To get the subsidy, your mom’s assets can’t be more than $14,100 (or $28,150 for married couples living together). Bank accounts, stocks and bonds count as assets, but her home, vehicle, personal belongings, life insurance and burial plots do not.

 

Also, your mom’s monthly income can’t be more than $1,538 (or $2,078 for married couples). If your mom supports a family member who lives with her, or lives in Alaska or Hawaii, her income can be higher.

 

In addition, the government won’t count any money if your mom receives help for household expenses like food, rent, mortgage payments, utilities and property taxes.

 

How To Apply

There are three ways to apply for Extra Help: online at SSA.gov/prescriptionhelp; by calling Social Security at 800-772-1213; or by visiting her local Social Security office.

 

The application form is easy to complete, but you’ll need your mom’s Social Security number and information about her bank balances, pensions and investments. Social Security will review her application and send her a letter within a few weeks letting you know whether she qualifies.

 

If your mom doesn’t qualify for Extra Help, she may still be able to get help from a state pharmacy assistance program or a patient assistance program. Visit BenefitsCheckUp.org and click on “Medications” to search for these programs.

 

Other Medicare Assistance

If your mom is eligible for Extra Help, she may also qualify for help with her other Medicare expenses through her state’s Medicare Savings Program.

 

State Medicaid programs partner with the federal government, so income and asset qualifications vary depending on where she lives. Medicare Savings Programs will pay her entire Medicare Part B premium each month. Some also pay for Part B coinsurance and copayments, depending on her income. Contact your mom’s state Medicaid office to determine if she qualifies for benefits in her state.

 

You can also get help through her State Health Insurance Assistance Program (SHIP), which provides free one-on-one Medicare counseling in person or over the phone. To locate a SHIP counselor in your area, visit ShiptaCenter.org or call the eldercare locator at 800-677-1116.

 

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

 

 

Vermont House Passes Water Funding Bill that Includes Revenue Sources 

May 7, 2018  
Filed under News

 

The Vermont House of Representatives has voted to move forward legislation (S.260) to fund clean water.  The House version of S.260 includes revenue for clean water that will go into effect as early as 2020 if alternate sources of funding are not enacted.

Read more

What You Need to Know About Reverse Mortgages

May 7, 2018  
Filed under Savvy Senior

Savvy Senior

Dear Savvy Senior,

What can you tell me about reverse mortgages for retirees? My wife and I are contemplating getting one but want to make sure we know what we’re getting into.

Running Short

 

Dear Running,

For retirees who own their home and want to stay living there, but could use some extra cash, a reverse mortgage is a viable financial tool, but there’s a lot to know and consider to be sure it’s a good option for you.

Let’s start with the basics.

 

A reverse mortgage is a unique type of loan that allows older homeowners to borrow money against the equity in their house (or condo) that doesn’t have to be repaid until the homeowner dies, sells the house or moves out for at least 12 months. At that point, you or your heirs will have to pay back the loan plus accrued interest and fees, but you will never owe more than the value of your home.

 

It’s also important to understand that with a reverse mortgage, you, not the bank, own the house, so you’re still required to pay your property taxes and homeowners insurance. Not paying them can result in foreclosure.

 

To be eligible, you must be 62 years of age or older, own your own home (or owe only a small balance) and currently be living there.

 

You will also need to undergo a financial assessment to determine whether you can afford to continue paying your property taxes and insurance. Depending on your financial situation, you may be required to put part of your loan into an escrow account to pay future bills. If the financial assessment finds that you cannot pay your insurance and taxes and have enough cash left to live on, you’ll be denied.

 

Loan Details

Around 95 percent of all reverse mortgages offered today are Home Equity Conversion Mortgages (HECM), which are FHA insured and offered through private mortgage lenders and banks. HECM’s also have home value limits that vary by county, but cannot exceed $679,650.

 

How much you can actually get through a reverse mortgage depends on your age (the older you are the more you can get), your home’s value and the prevailing interest rates. Generally, most people can borrow somewhere between 50 and 65 percent of the home’s value. To estimate how much you can borrow, use the reverse mortgage calculator at ReverseMortgage.org.

 

You also need to know that reverse mortgages have recently become more expensive with a number of fees, including: a 2 percent lender origination fee for the first $200,000 of the home’s value and 1 percent of the remaining value, with a cap of $6,000; an upfront 2 percent mortgage insurance premium (MIP) fee on the maximum loan amount, plus an annual MIP fee that’s equal to 0.5 percent of the outstanding loan balance; along with an appraisal fee, closing costs and other miscellaneous expenses. Most fees can be deducted for the loan amount to reduce your out-of-pocket cost at closing.

 

To receive your money, you can opt for a lump sum, a line of credit, regular monthly checks or a combination of these.

 

More Information

To learn more, read the National Council on Aging’s online booklet “Use Your Home to Stay at Home” at NCOA.org/home-equity. And see the National Reverse Mortgage Lenders Association self-evaluation checklist at ReverseMortgage.org/consumerguides.

 

Also note that because reverse mortgages are complex loans, all borrowers are required to get face-to-face or telephone counseling through a HUD approved independent counseling agency before taking one out. Most agencies typically charge around $125. To locate one near you, visit Go.usa.gov/v2H, or call 800-569-4287.

 

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.