I am excited to announce Elder Rage the book, has been accepted by Audible Books for download exclusively at Amazon http://tinyurl.com/74479pq and Audible http://tinyurl.com/7seo4fm. the Author is honored it is a Book-of-the-Month Club selection receiving 50 endorsements http://www.ElderRage.com/Review.asp, 300+ Five-Star Amazon reviews, is required reading at numerous universities, and considered for a film.

‘Elder Rage’ is the authors true story of caring for her parents, written with LOL humor, to help caregivers cope with and manage their elderly loved ones medically, behaviorally, socially, legally, financially and emotionally. Includes an extensive self-help section and chapter by renowned dementia specialist, Rodman Shankle, MD. Also available in Print and Kindle/Nook eBook formats. Perhaps you know people who could be helped by it. http://www.ElderRage.com

 Omaha Business Hall of Fame

More and more patients are turning to social networks such Twitter and Facebook for health information, according to a survey by the National Research Corporation.

In the survey of nearly 23,000 people in the United States, 41% said they use social media as a source of health care information. For nearly all of them – 94% – Facebook was their site of choice, with YouTube coming in a distant second at 32%. Eighteen percent of the respondentssaid they turned to MySpace or Twitter for health information.

One in four respondents said what they learned on these sites was “very likely” or “likely” to impact their future health decisions.

The respondents who used social media were 41 years old on average. People in households earning more than $75,000 were more likely to use social media for health care purposes than households earning less.

Another survey out this week found that one in four internet users living with a chronic ailment has gone online to find others with similar health condition.

“The internet enables people to help people in a way we couldn’t help each other before,” says Susannah Fox, author of the report by the Pew Internet and American Life Project. “The internet gives people access to not only information, but also to each other.”

Many of the patients who sought out other patients online have rare diseases.

“They say no one really knows what they’re going through except someone in the same situation,” Fox says. “Those personal tips can make all the difference in the world.”

 Most of the patients in the survey also consulted with their doctors.

 “The oft-repeated fear that patients are using the internet to self-diagnose and self-medicate without reference to medical professionals does not emerge,” according to Fox.

So are you more savy , that you are turning to the internet to find answers to your health concers?

Depression is not a normal part of aging, but when older adults do have depression, it may be overlooked, according to the National Institute of Mental Health. Seniors may show different, less obvious symptoms and may be less inclined to experience or acknowledge feelings of sadness or grief. The winter months can be especially challenging because some seniors experience seasonal affective disorder (SAD), a depressive illness triggered when there is less natural sunlight.

The Geriatric Mental Health Foundation says that an elderly person who may be depressed should see a medical professional. Talk to a client’s family or doctor if you suspect a senior is depressed.

For others, keep the winter blues at bay by using these ideas to inspire ways you can cater to each client’s interests with your personal spin:  

• Eat something new – Tackle a new recipe or re-invent a traditional one. Invite family and friends once a week for dinner and take turns preparing meals. Host a potluck dinner or an evening with international cuisine.
• Exercise the mind – Try a jigsaw puzzle or solve riddles. Discuss our question of the week
• Indulge – Enjoy a healthy dessert or sip a hot drink.
• Go for a walk – Invite family members and friends for an evening stroll. During bad weather, complete laps inside a local mall or community center.

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TurkeyNoodle Soup

• 5 quarts water
• 1 cup celery, chopped
• 1/2 cup celery leaves, chopped
• 1 cup onion, chopped
• 7 chicken bouillon cubes
• 1 tablespoon salt
• 1/4 teaspoon black pepper, ground
• 1 bay leaf
• 1/2 cup fresh parsley, chopped
• 1 cup fresh peas or 1 cup frozen peas
• 1 cup carrot, sliced
• 1 cup cut green beans, fresh or frozen
• 4 cups fine egg noodles (8 Oz)
• 1/4 cup butter or 1/4 cup margarine
• 1/4 cup flour
• turkey carcass, from a 15-20 pound turkey

Directions:

In an eight quart kettle or Dutch oven place turkey bones, water — down through to and including the bay leaf.  Heat to boiling; reduce heat, cover and simmer for 1 hour.  Remove the bones to a platter and let cool.

Add the parsley through to green beans.  Heat to boiling; reduce heat and simmer for 10 minutes.  Meanwhile, scrape meat from carcass and return meat to soup pot. Add liquid if required.  Heat to boiling; add noodles and cook uncovered for 10 minutes.

Melt butter in a small frying pan; stir in flour.  Cook over low heat, stirring constantly, until the flour browns.  Stir into boiling soup.  When the soup returns to a boil; reduce heat and simmer for 5 minutes.  Serve hot.

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Holiday Card Project

Pressed Flowers/Leaves –

Pick fresh flowers or leaves from a walk. Remove any wilted petals and leaves. Try not to let flower parts overlap. Leaves should lay flat. Choose a heavy book and line the inside pages with 2 or 3 sheets of paper to protect the book. (Using paper towels might turn the whole thing to mush). Carefully lay the flowers/leaves on the paper, and cover with another 2 sheets. After closing the book I stack another couple of books on top. Or you can also place the book in your microwave and “cook” it for 30 seconds. You’ll have to repeat it a few times, checking to see if the flowers/leaves are almost dried. Then I let the book sit for at least another two weeks before opening.

Use the dried flowers and leaves to make holiday greetings for family and loved ones. Take a moment to arrange the flowers on your card, taking note of how and where you want to position them.  The pressed flowers can be mounted directly on the card itself, or you may want to adhere a background of fabric, or handmade paper to the card stock first before gluing the flowers down.  Hold the pressed flower, apply a very small amount of glue to the back of the flower, position it on the card, and gently press down.  Do the same with the stems and leaves.  Once you’ve finished adhering your pressed flowers/foliage, it’s a good idea to place the card under a heavy book for a few minutes.  The firm pressure will ensure that your pressed flowers will dry flat.

Hope you enjoy our holiday kick off of fun things to enjoy this  time of year!

Fight the flu

“A flu shot is your best protection against catching the flu,” says Randy Bergen, MD, pediatric infectious disease specialist at Kaiser Permanente. The flu virus changes often. The protection given by the flu vaccine only lasts for about a year, so you need to get a flu shot every year, preferably in the fall.

The Centers for Disease Control and Prevention recommends that children 6 months and older, and every adult, get vaccinated against the flu. Children and adults who have a chronic health condition or weakened immune system, adults 65 or older, or smokers who are between 19 and 64 should also get a pneumonia vaccine. When you come in for your flu shot, ask if you need a pneumonia vaccine.

Flu shots are safe and won’t give you the flu .

What to do if you get the flu

1.Don’t ask for antibiotics, which won’t help because the flu is caused by a virus.
2.Stay home to help avoid spreading the flu to others.
3.Wash your hands often and avoid touching your face.
4.Use home remedies or over-the-counter medications, but don’t give any cough or cold products to children 6 years old or younger.
Protect yourself and family

The flu is more serious than the common cold, so do everything you can to prevent it. A flu shot (or nasal spray) is your best defense. The vaccine is safe, won’t make you sick, and generally has few side effects.

The flu virus changes often, and the protection from the vaccine only lasts for about a year. That’s why you should get a flu shot every year, preferably in the fall.

Who should get a flu shot?
The CDC recommends everyone 6 months and older get a flu vaccination every year.

The flu shot helps prevent you from getting the flu and from spreading it to others. Even healthy people can develop serious complications or even die from the flu — so protect yourself and your loved ones by getting vaccinated.

Vaccination is especially important for:

*people 50 years and older
*children 6 months through 4 years old
*women who are or will be pregnant during flu season
*people with chronic medical conditions or weakened immune systems
*people who live in nursing homes and other long-term care centers
*health care workers
*people who live with or care for anyone at high risk for flu-related complications
*Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes.

Why kids should get a flu shot
Children can spread the flu easily to adults and other children. Getting vaccinated also helps protect infants (who cannot receive a flu shot), pregnant women, the elderly, and people with chronic conditions.

Make sure your children get all recommended vaccinations on time. Check your child’s immunization record.

Flu shots will be available beginning in early fall 2011.  They are available from your health care provider or at local CVS drug stores & local Safeway stores! Do you have a primary care physician to help you if & when you do get the flu? Dr. Thomas Yatteau is a wonderful physician here  in Sonoma County who offers Concierge medicine.

 Dont forget  or delay- Get your flu shot today!

November is National Family Caregivers Month

Every day, more than 65 million family caregivers in the United States fulfill a vital role on the care team. November is National Family Caregivers Month, a great time to honor the family caregivers who devote their lives to caring for senior loved ones.

Family caregivers need support, which is why the Home Instead Senior Care^® network launched Caring for Your Parents: Education for the Family Caregiver^SM. This family caregiver support series addresses senior resistance to care and features a variety of topics such as choosing an in-home care provider, the signs of aging, long distance caregiving and communicating with aging parents. Materials and videos are available at www.caregiverstress.com.  Tell a family Caregiver about this valuable resource.

ScienceDaily (Dec. 26, 2007) — Elderly nursing home residents receive relatively few cancer care services, including screening, surgical treatment, or hospice care, according to a study published online December 25 in the Journal of the National Cancer Institute

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Few studies have examined cancer treatment and care among elderly patients residing in nursing homes. Yet as theU.S.population ages, more people will move into nursing homes, many of whom will later be diagnosed with cancer. Cancer risk increases as people age.

Cathy Bradley, Ph.D., of theVirginiaCommonwealthUniversityMasseyCancerCenterinRichmondand colleagues assessed the cancer care received by elderly nursing home residents who were insured by Medicaid. Using data from the Michigan Tumor Registry and Medicare records, they identified 1,907 nursing home residents diagnosed with cancer. They analyzed the patient data by cancer stage at diagnosis, type of cancer, survival time, and whether the patient received surgery or hospice care, as well as other variables.

Sixty-two percent of the nursing home residents with cancer had late or unstaged disease when they were diagnosed, and almost half died within three months of diagnosis. Among patients with late stage cancer, only 28 percent received hospice care. Patients aged 71 to 75 were three times more likely to have surgery than patients aged 86 and older.

“An aging population, coupled with trends in cancer diagnosis and treatment, will shift more cancer care…to nursing homes and make investigations into the care of nursing home cancer patients particularly relevant. At present, nursing homes may be unequipped to recognize and care for their residents with cancer,” the authors write.

In an accompanying editorial, Noreen Aziz, M.D., Ph.D., and Keith Bellizzi, Ph.D., of the National Cancer Institute inBethesda,Md., describe the essential components of cancer care, which include treatment, follow-up care, and palliative care. They also discuss the importance of further studies on the cancer care needs of this unique population of elderly nursing home residents.

“Optimal palliative care will often require multidisciplinary approaches and treatment plans made in accordance with the wishes of, and in partnership with, the patient and family, with a goal of decreasing morbidity and a focus on quality of life,” the editorialists write.

The Perfect Turkey for your family Thangiving this year!

Three  Easy to follow reciepies you can create and enjoy!

Ingredients

• 1 (14 to 16 pound) frozen young turkey

For the brine:

• 1 cup kosher salt
• 1/2 cup light brown sugar
• 1 gallon vegetable stock
• 1 tablespoon black peppercorns
• 1 1/2 teaspoons allspice berries
• 1 1/2 teaspoons chopped candied ginger
• 1 gallon heavily iced water

For the aromatics:

• 1 red apple, sliced
• 1/2 onion, sliced
• 1 cinnamon stick
• 1 cup water
• 4 sprigs rosemary
• 6 leaves sage
• Canola oil

Directions

2 to 3 days before roasting:

Begin thawing the turkey in the refrigerator or in a cooler kept at 38 degrees F.

Combine the vegetable stock, salt, brown sugar, peppercorns, allspice berries, and candied ginger in a large stockpot over medium-high heat. Stir occasionally to dissolve solids and bring to a boil. Then remove the brine from the heat, cool to room temperature, and refrigerate.

Early on the day or the night before you’d like to eat:

Combine the brine, water and ice in the 5-gallon bucket. Place the thawed turkey (with innards removed) breast side down in brine. If necessary, weigh down the bird to ensure it is fully immersed, cover, and refrigerate or set in cool area for 8 to 16 hours, turning the bird once half way through brining.

Preheat the oven to 500 degrees F.

Remove the bird from brine and rinse inside and out with cold water. Discard the brine.  Place the bird on roasting rack inside a half sheet pan and pat dry with paper towels.

Combine the apple, onion, cinnamon stick, and 1 cup of water in a microwave safe dish and microwave on high for 5 minutes. Add steeped aromatics to the turkey’s cavity along with the rosemary and sage. Tuck the wings underneath the bird and coat the skin liberally with canola oil.

Roast the turkey on lowest level of the oven at 500 degrees F for 30 minutes. Insert a probe thermometer into thickest part of the breast and reduce the oven temperature to 350 degrees F. Set the thermometer alarm (if available) to 161 degrees F.

A 14 to 16 pound bird should require a total of 2 to 2 1/2 hours of roasting.

Let the turkey rest, loosely covered with foil or a large mixing bowl

for 15 minutes before carving.

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Make Ahead Mashed Potatoes

• 3 lbs potatoes (about 4 large)
• 1/2 teaspoon salt
• 2 tablespoons butter or 2 tablespoons margarine
• 2 (3 ounce) packages cream cheese, softened
• 2/3 cup sour cream
• 1/4 cup milk
• 3/4 teaspoon salt
• 1 tablespoon butter or 1 tablespoon margarine, melted
• 1/2 teaspoon paprika

Directions:

Prep Time: 15 minutes    Cook Time 1 hour

Place potatoes in a saucepan; add water to cover and 1/2 teaspoon salt.  Bring to a boil; cover, reduce heat to medium and simmer for 25 minutes or until pototoes are tender.  Drain.  Peel potatoes; place in a large mixing bowl, and mash with a potato masher.  Add 2 tablespoons butter, cream cheese, sour cream, milk and 3/4 teaspoon salt.  Mix until all ingredients are blended.  Spoon mixture into a lightly greased 12X8X2-inch baking dish.  Brush top of mixture with melted butter; sprinkle with paprika.  Bake immediately, or cover and refrigerate.  If refrigerated, let stand at room temperature for 30 minutes before baking.  Bake at 350F, uncovered for 30 minutes or until hot~

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Caramelized Butternut Squash

• 2 medium butternut squash (4 to 5 pounds total)
• 6 -8 tablespoons unsalted butter, melted and cooled
• 1/4 cup light brown sugar, packed
• 1 1/2 teaspoons kosher salt
• 1/2-1 teaspoon fresh ground black pepper

Directions:

Prep Time: 15 minutes    Cook Time: 55 minutes

Preheat the oven to 400°F.  Cut off the ends of each butternut squash and discard.  Peel the squash and cut in half lengthwise.  Using a spoon, remove the seeds.  Cut the squash into 1 1/4″ to 1 1/2″ cubes (large and uniform is best), and place them on a baking sheet.  Add the melted butter, brown sugar, salt and pepper.  With clean hands, toss all of the ingredients together and spread out in a single layer on the baking sheet.  Roast for 45 minutes to 55 minutes, until the squash is tender and the glaze begins to caramelize.  Turn the squash while roasting a few times with a spatula to be sure it browns evenly.  Serve hot.

ENJOY & Happy Thaksgiving All !~

Dementia Patients Face Burdensome

 Transitions in Last 90 Days

ScienceDaily (Sep. 28, 2011) — A new study in the Sept. 29, 2011, edition of the New England Journal of Medicine reports that nearly one in five nursing home residents with advanced dementia experiences burdensome transitions in the last 90 days of life, such as moving to a different facility in the last three days of life or repeat hospitalizations for expected complications of dementia in the last 90 days of life.

Such patterns of transitions are burdensome, particularly since the overwhelming majority of family members state the main goal of care is comfort,” said study co-author Joan Teno, professor of health policy and practice at the Warren Alpert Medical School of Brown University and a palliative care physician. “These transitions reflect the inefficiency of our health care system. Similar outcomes could be achieved by keeping these patients in the nursing home setting.”

An important reason for the prevalence of burdensome transitions might be embedded in the way Medicare pays nursing homes, said Brown health economist and lead author Pedro Gozalo. Nursing homes can earn higher payments for patients who have been transferred to a hospital for three days and they may qualify for skilled nursing services paid by Medicare rather than Medicaid upon their return. The current incentives under Medicare and Medicaid encourage nursing homes to send patients to the hospital, he said.

What makes the transitions burdensome, especially for patients with cognitive impairment, Teno said, is that they are often unnecessary, raise the risk of medical errors, and interrupt continuity of care for patients who can experience significant stress and disorientation when they are suddenly removed from familiar surroundings and people. When the patients become upset, their families experience more stress.

Because these financial incentives, market conditions, and the culture of end-of-life care vary by state, so do the rates of burdensome transitions. The authors, who also include researchers fromHarvardUniversityandDartmouthCollege, found that the overall percentage of patients experiencing at least one burdensome transition was 19 percent. State-level rates varied from 2.1 percent inAlaskato 37.5 percent inLouisiana.

“These burdensome transitions are not only bad for the patient, they also drain the federal treasury, hastening the day when the Medicare trust fund runs out of money,” said economist Jonathan Skinner from Dartmouth College, a co-author on the study.

Blacks and Hispanics were also more likely than whites to experience burdensome transitions, the authors found.

 Amiss before dying

To reach these conclusions, the team analyzed federal databases of nursing home and Medicare records accumulated between 2000 and 2007. In all, they found 474,829 patients who were older than 66, had advanced cognitive impairment, and lived in a nursing home 120 days before their death. Of these, 90,228 residents experienced at least one burdensome transition, defined as either a transfer in the last three days of life, returning to a different nursing home than the one they lived in before they went to the hospital, or multiple hospitalizations in the last 90 days of life.

Often these hospitalizations occur even though the condition prompting the hospitalization — pneumonia, urinary tract infection, or dehydration — could easily be treated in a properly equipped and staffed nursing home.

These variations were particularly wide across different geographic areas. InMcAllen,Texas, 25.8 percent of patients had multiple hospitalizations for urinary tract infections, pneumonia or dehydration, compared to only 1.1 percent of patients inGrand Junction,Colo.

The regional rate of burdensome transitions also correlates with other indicators of poor end-of-life care, Gozalo noted. Compared to patients living in the health care markets with the lowest rates of burdensome transitions, those who lived in the regions with the highest rates were three times more likely to have a feeding tube inserted, more than twice as likely to be in the intensive care unit in the last 30 days of life, and more than twice as likely to have developed an advanced pressure ulcer.

Ultimately, Teno said, all of these problems are signs of care gone awry. The best care for a patient with advanced cognitive impairment near the end of life is often to maximize comfort. The burdens of hospitalization usually outweigh the benefits.

“Our research calls for efforts to reform health care payment that create incentives to improve advance care planning and care coordination,” Gozalo said. “Current reform efforts like accountable care organizations that bundle both the hospital and post-acute care payments could begin to address some of these perverse incentives. We need financial incentives to make sure that people are getting the right care in the right place at the right time.”

In addition to Gozalo, Teno, and Skinner, other authors include Susan Mitchell of the Hebrew Senior Life Institute for Aging Research, Julie Bynum at Dartmouth Medical School, and Denise Tyler and Vincent Mor of the Brown University Program in Public Health.

The National Institute on Aging funded the research.

Burdensome transitions in the last three months of life. Nationally, about 19 percent of nursing home patients with advanced dementia experience a burdensome transition — transfer to another nursing home, unnecessary hospitalizations — in their last three months. The percentages vary widely among the states. (Credit: Brown University)

Alzheimer’s Wine Country Memory Walk 2011!.

Hey Check out our video from this years 2011 Walk to End Alzheimer’s!

Did you walk? IF so which walk did you do?