BY NEDA McGUIRE
FOR THE FREE LANCE-STAR
As we grow older, whether we are religious, spiritual or agnostic, our view of the world changes.
The small issues that used to stress us aren’t as important anymore. We begin to see that the world is very much interconnected, and there is something greater than just ourselves.
With the sunset of our lives closer in older age, most find a shift in attitude with deeper appreciation for nonmaterial things in life.
One person I recently interviewed, Nancy Jaquay, told me she realizes that there is someone else in control, and that we are here to learn lessons and help each other through this life.
“If we give of ourselves, we will receive fourfold,” she said.
Although our bodies and minds may be changing as we age, the perspective of “one-ness” and giving back allow people with this outlook to be happier and more content.
Another thing that’s common with older adults is a love of telling stories and reminiscing. If you have ever wondered why this is, it is because growing older compels us to do a life review. It helps us to come to terms with issues that may not have been completed and find peace.
Other stories may be told as a method of imparting wisdom to the younger generations. These stories help our older adults make sense of their lives.
One of my projects for my gerontology master’s-degree program was to interview an older adult and to do a life review with her. I chose one of my precious clients, Mrs. T., who was 98 years old.
She lived on her own and had a very sharp mind combined with great wit. She was still taking time to go to the ElderStudy program at the University of Mary Washington.
The process we undertook and the results of her life review is an experience I cherish and will never forget. I could see her trying to come to peace with unfinished business from some of the more difficult periods of her life. There were other stories where she took time to educate me, and she yearned to pass on her wisdom.
During this holiday season, as your family comes together, I hope you can take time to slow down and ask some questions of the older adults in your family. Make it an intergenerational game and you will see your loved one come to life! You can begin the conversation with questions such as:
What stories do you want to be passed on through our family?
What is your favorite song, and what memories does the song invoke?
What values or biggest lessons have you learned that you want your grandchildren to know?
Such dialogues and storytelling can help change our views on older adults. They help our younger generations see older adults in a different light, and the storytellers can be valued and assured that they still have much to give back to their families.
In this season of Thanksgiving, I am thankful for all the older adults who have blessed me with their insights and love.
Neda McGuire is a local gerontologist and owner of Comfort Keepers, a home-care organization in Fredericksburg. She can be reached at fredericksburg@comfortkeepers .com or 540/370-0008.
BY ELIZABETH McMASTER
FOR THE FREE LANCE-STAR
I have decided to defer the topic of asset protection and preservation until December’s column.
I want to focus in November (the month of giving thanks and being thankful), on legally preparing for life’s curveballs, which can come at any time.
Recently, my family lost a member to cancer. The time period from diagnosis to death was not long and caught many of us by surprise. At his funeral, the priest asked us this: Do we have our spiritual baggage packed and ready to move into heaven?
This made me think of another question: Who among us has our legal affairs in order so that our families do not have the extra burden of visiting lawyers or courts when they should be focusing on the family in a time of crisis? Unfortunately, too often I see people during such a time of crisis, as do others in my area of practice.
I do not know why people do not prepare for their possible incapacity and their inevitable death, but I can venture a few guesses.
Perhaps it’s just not a fun thing to think about or it’s perceived as being too expensive, and some feel that it won’t be their problem since they will be gone—or at least not lucid (I have actually heard this one on several occasions).
I can also tell you that as some people get older and start having symptoms of dementia, they can become paranoid and therefore no longer trust their loved ones to assist them with decision-making, so this becomes a problem as well.
Another issue is that some people do not have loved ones to assist them so they do not know where to turn.
For these individuals, professionals such as myself and my colleagues can step into the roles of fiduciaries and administrators for estates, as we do when family members do not trust one another in these capacities.
I encourage my clients who do see me for estate planning to go over their estate plans with their family members who may have roles in the execution of the estate or may be named as agents on
a durable general power of attorney or advance medical directive during any type of incapacity.
Some choose to put together a formal book or binder that may include all legal documents, insurance policies, banking and investment information, retirement plan information and funeral plans.
Another important thing to have ready is passwords. We live in a digital age, and many of us do our banking and bill paying on the computer. If someone needs to step in to pay your bills, it is much easier if they have your passwords. Of course, this should be someone you trust with your finances, and usually it is the person or persons you have named in your POA.
There is a misconception that funeral arrangements are part of your estate plan, but usually by the time the will or trust is read or found, the funeral has already occurred.
I advise my clients to prepay and preplan their funerals. Not only do you make life easier on your family, you can lock in at today’s prices. Prepaid arrangements can be for cremation or burial, including a funeral or scattering of ashes if cremation is chosen. Your wishes will be known, and there will be no second-guessing on the part of your family members.
Again, this is not a fun topic to discuss with your loved ones; I understand that. However, planning can make their lives much easier, so that they can focus on you in your time of need.
Be thankful this Thanksgiving for those you love, and tell them you love them, because we never know what the next day may bring.
Elizabeth McMaster is an elder-law attorney in Fredericksburg. Email her at firstname.lastname@example.org.
BY JENNIFER MOTL
Save money by adding the curry spice turmeric to your medicine cabinet. From arthritis aches and pains to upset stomach, turmeric has been shown to decrease inflammation in clinical studies.
There’s also preliminary evidence it may help prevent heart attacks, reduce blood sugar, and reduce the risk of a variety of cancers. It’s also being used in mouthwash.
Turmeric, which gives its golden color to curry powder and mustard, has been used in Indian cooking and traditional medicine for about 4,000 years.
Today, some folks take supplements of curcumin, a potent antioxidant found in turmeric. However, turmeric also contains more than 100 other natural compounds not found in supplements. So consider adding more turmeric to your food.
Of course it’s important, especially if you’re ill, to keep seeing your doctor and taking your regular medication. But spicing up your foods with turmeric may also help you along.
Turmeric is rated “generally recognized as safe” by the U.S. Food and Drug Administration, and it’s unlikely to cause side effects in the amounts normally used in food.
Some of the strongest evidence for turmeric involves its effects on joint and stomach pain. For knee pain, turmeric worked about as well as ibuprofen, according to the National Institutes of Health. You can read their full report on turmeric online at nlm.nih.gov/medlineplus/druginfo/natural/662.html.
For arthritis, it may be helpful to take curcumin, 500 milligrams two to four times a day, according to the National Institutes of Health.
Turmeric also has been shown to kill viruses and a variety of germs, including H. pylori, the bacteria that causes painful stomach ulcers.
I’d still recommend that anyone who has H. pylori take the antibiotics that a doctor prescribes. After the antiobiotics are done, however, I would recommend spicing foods with turmeric in hopes of preventing a relapse. And of course continue to follow up with the physician.
Some studies show that taking turmeric before meals can help reduce indigestion as well as bloating, gas and irritable bowel syndrome.
For upset stomach, you can take 500 milligrams of turmeric up to four times daily, according to the National Institutes of Health. That translates to about 1/4 teaspoon of turmeric four times daily.
Turmeric might be useful for more serious digestive problems such as ulcerative colitis. One study showed that turmeric supplements helped people with ulcerative colitis stay in remission longer.
One digestive issue you might want to avoid turmeric for is gallbladder issues, according to the National Institutes of Health.
MANAGING BLOOD SUGAR
Turmeric has been used in Indian medicine to help lower blood sugar for people with diabetes. New research shows that curcumin, a turmeric extract, may help prevent diabetes, too.
A study by American and Thai scientists found that when volunteers with pre-diabetes received curcumin capsules for nine months, none developed diabetes. That compares to a 16 percent diabetes rate in volunteers who received a placebo, or blank pill, according to the journal Diabetes Care. A separate study suggested the spice may affect blood sugar by inhibiting pancreatic enzymes.
Diabetes is a serious illness, and turmeric is not a substitute for medicines and healthy eating. More research is needed before we know exactly how much turmeric can be useful for diabetes. It’s certainly fine to use the spice in food, however.
PROTECT THE HEART
One study of curcumin extracts found that the supplements lowered triglyceride levels in healthy middle-aged adults. Some studies suggest it may help prevent dangerous blood clots.
Taking curcumin after heart surgery, or coronary artery bypass grafting, reduced the risk of heart attacks by 35 percent in a small Thai study.
However, the National Institutes of Health recommends stopping turmeric supplements two weeks before any surgery because of potential for bleeding.
RESEARCH FOR CANCER
Studies too numerous to mention are looking at the possibility that turmeric may help prevent or reduce the spread of cancer. Some suggest that curcumin may make cancer cells more vulnerable to chemotherapy and radiation therapy.
And combining turmeric with ginger, another spice often found in curry powder, may make it even more effective. That’s according to research on prostate cancer cells.
As always, if you are being treated for cancer, talk with your physician before taking any supplements. It’s safe to use usual amounts of spices on foods.
Taking black pepper with turmeric makes it easier for the body to use turmeric, according to a Slovenian study.
Curcumin, one of the most powerful chemicals in turmeric, is hard for the body to absorb unless it’s consumed with fat. Heating turmeric may also make it slightly easier to absorb.
People in India and Pakistan liberally season foods with turmeric and curry powder, and it is still used medicinally in those countries. Often, it’s combined with other spices in warm milk. That makes sense, because the spices and the fat in the milk would make the turmeric easier to absorb.
Try this recipe for Turmeric Milk adapted from HimalaynInstitute.org. In a saucepan, simmer 2 cups low-fat milk, ½ teaspoon turmeric and a dash each of ginger, cinnamon and black pepper. Serve warm.
If you prefer a sweeter beverage, try combining the turmeric milk with a banana in the blender for a smoothie.
Jennifer Motl is a registered dietitian. Formerly of Fredericksburg, she now lives in Wisconsin. She welcomes reader questions via her website, brighteating.com, or by email at healthyliving@freelancestar .com.
BY STEVE WATKINS
You don’t go to sleep in a mud house and wake up in a palace.
It’s an old yoga saying that I repeat all the time to folks new and old who join me when I teach my yoga classes. I’ll be the first to admit it can come off sounding like an insult—“So you’re comparing us to mud houses?” someone once retorted—but the idea is an important one.
You might want to get into shape, or into better shape, but just wanting it isn’t going to make that happen. And striving in foolish ways to achieve your goal can even be counterproductive. Forget the palace—the last thing you want is that mud house crashing down on top of you.
If you force yourself to bend or fold or stretch further than your body is ready to handle, you’ll injure yourself, plain and simple. I’ve done it more than once. And the older I get, the longer those injuries take to heal. And the longer they take to heal, the longer I have to lay off exercising. And the longer I lay off exercise, the harder it is to get going again.
When it comes to physical activity, especially as you pass 50, abide by the Hippocratic Oath: First do no harm. And even then, expect a few bumps in the road. Because even with the best of intentions, and the wisest of plans, stuff happens.
Many years ago I came up with a genius routine to jumpstart my running, which has waxed and waned over the years. I decided to set aside half an hour every day for a month. On Day One I would run for one minute and walk for 29. Day Two: run for two minutes, walk for 28. Day Three: well, you get the picture. By Day 30 I would be running for the full half hour.
I invited my older daughter to join me, and for most of the first two weeks, the plan worked to perfection. We were halfway there: 15 minutes running, 15 walking. We weren’t in the palace yet, but that mud house was getting smaller and smaller in our rearview mirror.
And then, on Day 16, my daughter wore street shoes. She’d left her sneakers at a friend’s house but figured she could tough it out. She should have taken another day off. Instead, she got nasty blisters on each foot, and that was the end of that. She had to bail while her feet healed up, and then she got busy with other things. I finished the month successfully, but the experiment fizzled after that.
I learned something, though—or relearned something: The best definition of success isn’t just reaching a goal, or crossing a finish line first, though there’s no denying the pleasure in that.
True success, though, be it a 30-minute run-walk or an hour’s yoga, is being able to keep going the next day and the day after that and the day after that.
As I get older, I care less and less about how far or how fast. The best mantra, when we’re smart enough to listen, is “Perseverance and patience.”
‘PALACE ENOUGH FOR ME’
Years ago, after a bad accident, multiple surgeries, and months in the hospital, I was faced with the task of putting my broken body back into working order. I’d lost a third of my body weight. My muscles were atrophied. My self-confidence was shot.
Someone suggested tai chi as a gentle activity for beginning my rehabilitation. Tai chi has been described as “moving meditation,” and it was certainly that for me. After a month of regular practice, it gave me back enough strength, and range of motion, that I decided I was ready to try running.
I found a pair of old tennis shoes and headed to the track, making sure to pick a time of day when no one else was there to see how badly I was sure to struggle. And sure enough, I didn’t even make it halfway around once before I collapsed, hurting and gasping. I eventually got up and hobbled the rest of that one lap and called it a day.
The next day I went back. Did some tai chi under a shade tree, and then hit the track again. Another half lap. More gasping and hurting. More walking. One and done.
I kept it up, though. One look in the mirror at the wreck of my body was enough motivation for that. So every day, except for the ones when I was too tired to get out of bed, I did my tai chi and shuffled through my laps.
After three months, with time off for shin splints, I was ready for my first 5K. There were a lot of rabbits on the starting line, and boy did they ever take off. I have no idea who finished first. Those guys were long gone by the time I finished.
But as far as I was concerned, slow and steady had won the race.
I got up the next day and went for another run. Just a couple more of those slow, steady miles, out and back from home.
The place I lived at the time, you might say it was no longer a mud house. And it was palace enough for me.
Steve Watkins is a yoga teacher and award-winning author. His website is stevewatkinsbooks.com.
BY DELISE DICKARD
Recently my former boss retired from his position at Harvard University as a lecturer in psychology. I think he was almost 80 years old.
I worked for him for about five years and probably wouldn’t be writing this column if it weren’t for him. He saw through my improper Louisiana grammar—despite my bachelor’s and master’s degrees—to my creativity as a person and writer.
The favorite part of my job—as assistant director of the master’s program in Harvard’s continuing education division—was the career counseling I was privileged to provide.
I delivered this counseling as best I could to many older folks with minds as eager as a child’s to unearth and follow their passions. It was beautiful to watch a 60-year-old former engineer finally studying literature, or a 50-something housewife finally getting to study history.
What these wonderful folks did with their graduate degrees, once achieved, was not as important as the glow on their faces when they found and pursued their passion—after spending most of their lives doing what they had to do just to get by.
Sometimes late in life, people may feel a sense of crisis, wondering: Am I doing what I wanted to do with my life? Erik and Joan Erikson, who developed the eight (later nine) stages of psychosocial development, deemed the pertinent question for the age group: “Did I make my life count?”
My grandfather worked his entire career as a projectionist in a movie theatre, working into the night running the movie projectors and troubleshooting problems that might arise. He did this so that those in the theater below could escape into whatever fantasy Hollywood had concocted for them.
After he retired, he piddled around with gardening and his passion for planting fruit trees. But nearing 70, he turned his full focus to becoming a painter and worked tirelessly, delighting friends and family alike with his artwork.
My experience in counseling those pursuing continuing education later in life, and the lessons from my grandfather, remind me that it is never too late to pursue your passion. Here are some thoughts for your journey.
Think outside the box. When I ask people to consider their own passion, sometimes they haven’t discovered it yet. I typically ask them to fill out a lined legal size paper with each line naming some potential passion. I encourage them to consider large dreams (like visiting Paris) and smaller ones (like growing orchids). If you try this, think about sports, nature, arts, music and more. Fill out each and every line so you can get beyond the things you say when you introduce yourself—and consider things haven’t thought about in years.
Let your intuition, not your judgment, guide you. The judging mind is the one that wants to make sure the passion is practical. This mindset has its purpose, and you can use it when it comes down to making a plan to pursue a passion. But during the exploration phase of this process, this judging mind needs to take a nap. Write out what makes you giggle, what thrills you, and the unimaginable.
Be open to all possibilities. Try not to focus on what won’t work, but the way in which you, with this one lifetime of opportunity, might make anything work. Think, “I can do it and will do it.” At the end of day, you might decide the price is too great. That’s OK. Maybe the trip to Paris would mean selling your car, and you’d rather keep your car. Staying open leaves you in the driver’s seat, without an overactive critical mind making all the decisions.
The time to believe in yourself is now! I remember my mother saying (around 40) that she felt too old to do this or that—and now she’s over 70 and in great health. I always said to her “The time is now; you’ll never be any younger!”
Years ago, I took a class called “the Nature of Drama” at Harvard. There was a lovely older woman there, and I never would have guessed she was about 90 years old. Nor would I have guessed—if someone hadn’t told me—that it was Joan Erikson. She and husband Erik were doing something far from their expert field of psychology: They were writing a play. I never saw the play, but the idea that someone so famous in psychology circles could still find a new adventure was impressive.
The Eriksons’ stages of psychosocial development included eight stages through which a healthily developing human passes from infancy to late adulthood. Later, after Erik’s death, Joan admitted that they got the eighth stage a bit wrong because, when they were writing about the stages, they had not yet reached this very old age.
She took the initiative, just before she died, to add the ninth stage. The ninth stage deals more with the loss of functionality and independence. Still, she impressed me as a woman who retained her independence well into her 90s, and never stopped exploring new opportunities.
With her good sense of humor, she said the final stage is preoccupied with “what body part is going to work today?” Still, she became for me, an older-age role model.
Dr. Delise Dickard is a life coach, psychotherapist and director of Riverside Counseling. She welcomes reader feedback. For contact information, visit riversidecounseling.org.
BY JENNIFER MOTL
Heartburn affects almost half of Americans, especially folks over 45, and there are some gentle diet changes that can help alleviate it.
Healing heartburn goes beyond knowing what to avoid. It’s also about knowing which foods are most soothing—such as yogurt and, surprisingly, certain spices and herbs.
Heartburn is often caused by GERD, or gastroesophageal reflux disease. That means stomach acid is backing up into the throat, which can cause a burning sensation in the chest. The pain can be so bad that it wakes people up at night and distracts them from their work during the day.
About 30 percent of Americans have GERD, according to Mary Washington Hospital’s Heartburn Treatment Center. GERD can worsen chronic coughing and asthma, according to the National Institutes of Health, and may lead to throat cancer over many years.
But about 10 percent of the time, the heartburn is due not to reflux but to an infection of Helicobacter pylori. This bacterium can cause pain, ulcers, anemia, B-vitamin deficiencies and even stomach cancer if not treated with antibiotics. About half the world’s population has H. pylori, though not everyone gets symptoms from it. There can be other causes of chest and stomach pain, too, so if you have heartburn frequently, please see your health care provider.
If you do a mild case of GERD, diet and lifestyle changes may solve the problem. There are medications that can help, too. However, food is not enough to cure an H. pylori infection. Antibiotics are a must. Certain foods can amplify the antibiotics’ power, but they do not replace the antibiotics.
To help contend with heartburn, you’ll want to eat more of certain foods while avoiding some other foods. Yogurt, cranberry juice, olive oil, broccoli sprouts and several spices all have been shown to reduce H. pylori infections.
I recommend eating yogurt daily. Folks who took their antibiotics with probiotics (the friendly bacteria found in yogurt) were 10 percent more likely to be cured of H. pylori and had 66 percent fewer side effects, such as diarrhea, according to research done in China and Michigan.
Antibiotics taken with cranberry juice kill 10 to 20 percent more H. pylori, according to Asian studies. Drinking an ounce of virgin olive oil every day for two weeks killed H. pylori in 10 percent of Spanish volunteers. Broccoli sprouts also can kill H. pylori, according to New Zealand researchers. You can buy broccoli sprouts at health-food stores.
Despite frequent advice to avoid spicy foods, research shows some spices aid healing. Studies have showed that turmeric (a yellow spice found in bottled mustard and in curry powder) is especially potent against H. pylori. Other spices such as cumin, ginger, cayenne or chili pepper, oregano, nutmeg, cloves, parsley and lemongrass also kill some of the bacteria.
While spices are not as effective as antibiotics, it may be helpful to spice up your food while you take your antibiotics and afterward, to reduce relapses.
STEER CLEAR OF SOME THINGS
If you’re a heartburn sufferer, avoid coffee, both regular and decaffeinated, because both have been shown to irritate the stomach. Try decaf tea if you crave a hot drink.
Also avoid carbonated beverages such as sodas and energy drinks. The fizzy bubbles put pressure on a muscle—called a sphincter—that separates the stomach from the throat, worsening reflux.
Avoid alcohol and peppermint, both of which relax the sphincter. And avoid fried, greasy or fatty foods, which can trigger the stomach to make more acid.
Contrary to popular belief, you don’t necessarily need to avoid tomatoes, oranges, vinegar, chocolate, onions or spicy foods, unless you are personally sensitive to them. Try eliminating these foods and slowly adding them back; then watch to see if you have a reaction.
If you have H. pylori, eating less salt can help keep your infection from returning, according to some studies. Scientists aren’t clear on how strict you need to be, but I recommend reading food labels and limiting sodium to 2,000 milligrams daily, the amount that keeps your heart healthy.
Besides tweaking your eating habits, you can adjust your lifestyle to reduce reflux. Try some of these ideas from the National Institutes of Health and the American Gastroenterological Association.
- Wear loose-fitting pants or belts to reduce pressure on the stomach.
- Do not lie down within three hours of eating.
- If you are bothered by pain at night, consider placing bricks or books under the head of your bed to create a slight incline. This helps gravity keep the acid in your stomach, where it belongs.
- Quit smoking—for unknown reasons, tobacco irritates the stomach.
- Ask your pharmacist if you are taking any medications that irritate the stomach. Aspirin and ibuprofen are common culprits.
- If you feel more pain on stressful days, consider therapy. Or try do-it-yourself options such as yoga or meditation.
- Exercise is doubly helpful—not only does it relax you, it also can help you lose any unwanted pounds. Statistically, overweight folks are more likely to have GERD, so exercise can help.
Between tweaking your lifestyle, adding soothing foods and checking in with your physician, you’ll likely be feeling better soon.
Jennifer Motl is a registered dietitian. Formerly of Fredericksburg, she now lives in Wisconsin. She welcomes reader questions via her website, brighteating.com, or by email at healthyliving@freelancestar .com.
BY STEVE WATKINS
One Saturday earlier this month, I sat in a cottage out in deep woods in Caroline County—windows open, eyes closed, listening to the glorious sound of the wind in the trees.
I heard birds singing, a couple of dogs barking. Felt a warm ray of sun on my shoulders. I was supposed to be meditating, focusing on my highest chakra, and I suppose I was, though in an idle sort of way.
I’d have probably reached nirvana, too, if it hadn’t been for the other sounds that came wafting through the windows. Actually, “crashing through” might be more accurate.
It was stuff getting blown up on the firing range over at Fort A.P. Hill, a couple of miles north. Kind of a distraction from finding that elusive higher consciousness.
Still, just sitting there doing nothing—even with the occasional explosion—gave me a nice long break from just about everything. I came away from the experience feeling considerably calmer and more invigorated than I’d been when I started out. Those feelings lasted for much of the rest of the day.
Lord knows we all need a break now and then, and even though this column is called “Fit After Fifty,” I’m not just talking about taking a break from exercise. If you’re like me, even if you do let yourself have a mini-vacation from working out, or from work, there are still too many things occupying your brain.
Many of them, increasingly, are of the electronic variety: TV, movies, iPod, email, Internet, Facebook, video games, cellphone and myriad apps, “Angry Birds.” I’m sure I’m leaving a few out.
How often do we truly give ourselves a break from all that busy-ness, all that noise? Researchers have determined that constantly checking email makes us anxious. I’m guessing the same thing goes for Facebook.
Earlier this year, University of California–Irvine researchers reported that, in a study, checking email kept people in a “high-alert” mode, while separating people from email for five days lowered stress in measurable ways.
Younger people claim to be able to handle all this multi-tasking without too much trouble, though I have my doubts. What I don’t doubt is that those of us who grew up in a quieter era have a deep, immediate need for some good old-fashioned peace and quiet, whether we know it or not.
There’s a reason that savasana, the corpse pose, which comes at the end of a yoga practice and is basically just lying down on your back with your eyes closed for five or 10 minutes, is most people’s favorite.
Perhaps not surprisingly, scientists have found that meditation—sitting comfortably with no distractions, focusing your thoughts on something calming (as opposed to just letting your thoughts drift)—appears to reduce anxiety and stress.
In a recent study, people who meditated for 30 minutes a day over an eight-week period developed more gray matter in the area of the brain associated with learning and memory.
And the meditators showed a reduction in gray matter in the part of the brain associated with anxiety and stress.
There’s more good news about meditation, as other studies have indicated that it may help lower blood pressure and lead to longer attention spans.
I’m as driven as anybody when it comes to working out and trying to stay fit, especially as I get older. But I also feel an increasing need to take breaks now and then—from everything—as an essential part of being healthy. Maybe through meditation, maybe by sitting quietly on the couch petting the dog. Or maybe just by turning off all the electronics and listening to the wind in the trees.
Henry David Thoreau, who knew a thing or two about the benefits of getting away from all the noises and distractions of life, put it this way in a letter to a friend:
“I have an immense appetite for solitude, like an infant for sleep, and if I don’t get enough for this year, I shall cry all the next.”
Steve Watkins, professor emeritus of English at the University of Mary Washington, is a yoga teacher and award-winning author. You can reach him through his website, stevewatkins books.com.
BY DONYA CURRIE
One of the biggest questions looming in Lydia O’Neil’s mind as she neared 65 was whether she could afford to retire.
“I didn’t know what Medicare would cover and what my co-pay would be,” said O’Neil, 68, of Fredericksburg.
Many people have those same questions as they approach their 65th birthday, and with good reason. Medicare, the government health program for the elderly and disabled, has complex rules and a myriad of options. Penalties ensue if a person does not enroll when eligible. And there are different enrollment periods for medical and drug coverage.
“It is confusing, and you don’t want to do anything wrong,” said Karl Karch, 66, of Fredericksburg, who found himself navigating an online Medicare “maze” in the months before he turned 65.
“If you don’t dot the i’s and cross the t’s, you’re fearful you could do something to jeopardize your benefits for the rest of your life,” Karch said. “There’s that added stress that goes with it.”
“People start to get information right around the time they turn 65, but sometimes they get confusing information from their employers,” said Fred Riccardi, director of programs and outreach for the Medicare Rights Center, which runs a national help line to assist in sifting through enrollment and coverage questions. “There’s just some misinformation out there. Also, one thing I’ve realized, too, is some people aren’t aware of the costs associated with health insurance in general. Not only do you have to pay your Part B premium, you also have to think about your drug coverage and your co-insurance.”
Medicare Part B covers medical care such as doctor visits, and carries a premium of about $100 a month for most people. Part A covers hospitalization and carries no premium because it’s paid for out of the yearly taxes deducted from a person’s paycheck throughout his or her working life.
Part D is prescription drug coverage, an option that can be especially confusing because it is administered through private health insurance plans, which can vary widely in what they cover. Monthly Part D premiums range from about $15 to nearly $120.
A person’s 65th birthday also brings the need for decisions about Medigap insurance, also known as co-insurance or Medicare supplemental insurance, which picks up the tab for services not covered by Medicare such as deductibles and co-pays.
And yet another question is whether to opt for a Medicare Advantage plan; those are provided by private insurance companies and cover both prescription drugs and medical care. As with other private insurance, a plan can change from year to year.
Add in a difficult economy that’s forcing some people to work well after age 65 and some to delay receiving retirement benefits, and you have the potential for mass confusion, said Terri Lewis, regional communications director for the Social Security Administration. What she wants to make clear is there is no one-size-fits-all when it comes to enrolling in Medicare.
“Every situation is so individual,” Lewis said. “We just want to be sure that people don’t forget that Medicare eligibility begins at 65.”
Both Lewis and Riccardi said people should begin the enrollment process, whether they opt for only Part A or all parts of Medicare, three months before their 65th birthday.
SOURCES OF CONFUSION
One source of confusion: The full Social Security retirement age is 66, but people can choose to begin receiving benefits as early as age 62 or as late as age 70. The Medicare eligibility age remains at 65.
Enrollment in Parts A and B is automatic for those already receiving Social Security benefits. Everyone who wants Medicare prescription drug coverage must actively enroll (unless they qualify for both Medicare and Medicaid).
People can enroll online, via phone or by visiting the local Social Security Administration office, which for the Fredericksburg area is on Southpoint Parkway in Spotsylvania County.
“Another thing that might be important for people to understand is [if] you do enroll for Medicare with Social Security, when it comes to questions about their coverage, that’s where we have to defer to their health care provider,” Lewis said.
In other words, call 800/MED-ICARE or visit medicare.gov, which are both run by the Centers for Medicare & Medicaid Services.
For recent retirees, Medicare enrollment can be especially confusing, Riccardi said. Many questions come in to the help line from people who have neglected to enroll in Part B because they had employee or retiree insurance coverage or COBRA, which allows a former employee to continue coverage for a set time period. Not enrolling at the right time can mean penalties tacked on to Medicare premium payments, and also a dangerous gap in coverage.
“We see that all the time; people don’t take Part B because they have retiree coverage or COBRA,” Riccardi said. “That’s a major pitfall, and it’s pretty heartbreaking depending on the story that you get.”
O’Neil, who retired from the Central Rappahannock Regional Library three years ago, sought help from local elder-care advocate Valerie Hopson–Bell in choosing her Medicare coverage. She has Parts A and B as well as a supplemental policy through Anthem, the same company that provided her health insurance while she was working. She has changed Part D plans each year to find the one that best fits her needs.
“I think that maybe some people don’t completely understand that every year you have to shop a new Medicare D plan,” O’Neil said. “They change drastically from year to year, and what was good for you in 2011 might not be good at all in 2012, and you really need to research these plans and what they’re offering each year and determine which one’s the best for you.”
Karch chose Medicare Parts A and B, a low-cost Part D prescription drug plan and supplemental insurance through the insurance company he had previously used for his overall health coverage.
“So far, I’ve had the need to use Medicare, and once you’re enrolled and you’re paying your premium, things are pretty good if you have a provider who’s still going to accept Medicare,” Karch said. “I’ve had some needs where I didn’t even have a co-pay. It’s an excellent insurance once you figure out how to enroll properly.”
WHAT YOU NEED TO KNOW
How can you enroll?
- Visit socialsecurity.gov.
- Call 800/772-1213.
- Go to the local Social Security Administration office, 4954 Southpoint Parkway, Fredericksburg, Va. 22407. The hours are Monday–Friday, 9 a.m.–3:30 p.m.
Why should you enroll? A person who does not enroll in Medicare when first eligible faces financial penalties for life. Those penalties vary, but for Part B, for example, under current premium rates, waiting a year tacks on 10 percent, or about $10 a month, to the cost of the premium.
When should you enroll? Be prepared to enroll three months prior to your 65th birthday. If you do not enroll at age 65, you can file online during the general enrollment period, Jan. 1–March 31, but coverage usually won’t begin until July 1. You could qualify for a special enrollment period if you are currently covered by an employer or union health plan through your or your spouse’s job.
How can you get help enrolling?
- Free individual insurance counseling is available through the Virginia Insurance Counseling and Assistance Program. In the Fredericksburg area, VICAP is based at the Rappahannock Area Agency on Aging, 540/371-3375.
- Medicare Rights Center national help line: 800/333-4114 (Monday through Friday, 9 a.m.–5 p.m.)
- AARP Medicare Starter Kit: aarp.org/health/medicare-insurance/ info-04-2011/medicare-starter-guide.html
- ElderCare Connections of Fredericksburg: 540/419-4387 or eldercareconnections.net
SIDEBAR: DREADED DOUGHNUT HOLE TO DISAPPEAR
The federal health care reform law brought some good news for people on Medicare.
Preventive services such as a yearly wellness visit, mammogram, bone mass measurement, and cholesterol and diabetes screening are now fully covered without a Part B deductible or co-payment. The same goes for yearly flu and pneumonia shots and immunization against hepatitis B.
Because nothing associated with Medicare is simple, there are exceptions. For some preventive services, the actual services are free but a person might have a co-payment for the office visit. Also, those enrolled in Medicare Advantage plans might be responsible for a co-payment for preventive services.
The law also seeks to eliminate, over time, the dreaded prescription drug coverage “doughnut hole.” The gap in coverage for people with Medicare Part D has meant that once someone’s plan has paid a certain amount for prescriptions, that person then has to pay all drug costs up to a certain limit each calendar year. For some, that has meant hundreds or even thousands of dollars in drug bills.
Under the Affordable Care Act, the hole closes gradually between now and the year 2020. This year those in the doughnut hole get a 50 percent discount on covered brand-name prescriptions and a 14 percent discount for generic drugs. The discounts rise to 55 percent for brand-name drugs and 35 percent for generics by 2015, and 25 percent for both in 2020.
The change is good news to Lydia O’Neil, 68, of Fredericksburg, who struggled to make ends meet in 2011 because of so many prescription drug charges while she was in the doughnut hole.
“I was just robbing Peter to pay Paul to pay for my prescriptions,” O’Neil said.
Learn more about the Medicare-related changes in the health reform law at www.healthcare.gov/news/factsheets/2011/08/seniors.html.
Donya Currie is a freelance writer in Stafford County who regularly contributes to Healthy Living and other health-related publications, including the AARP Bulletin. You can write to her at email@example.com.
BY VALERIE HOPSON-BELL
THE FREE LANCE-STAR
Consider these three scenarios:
Neighbors are helping neighbors on a regular basis by doing grocery shopping and running errands.
Church members are assisting a homebound member by balancing his checkbook and helping write checks for monthly bills.
A friend is bringing meals over three days a week and tidying up the living area for an ailing friend.
What do these situations have in common? All involve people who are serving as unofficial caregivers.
Caregivers can be family members, friends, neighbors, church members and others who do the work out of love and moral obligation. A caregiver can also be someone you hire for pay. Both help you manage your activities of daily living.
Being in this field of work, I have learned that seniors do not want to burden their family members, especially their adult children. Unfortunately—or in some cases, fortunately—it falls to those who are physically closest to those in need to pick up the slack.
Many times, adult children are the last to know that their parents can no longer take care of their activities
of daily living. Usually when the neighbor or church member becomes overwhelmed with helping the senior, calls are made to agencies within the community to find assistance. This step usually starts the discussion of getting the family involved.
In the adult children’s defense, I know that when people with dementia talk with their children they attempt to hide their inadequacies by keeping the conversations very general and by telling their loved ones they are fine.
Usually spouses protect each other in the same manner, and it isn’t until one of the spouses is removed from the situation that the family picks up on just how fragile the situation is.
If the person in need is alone, sometimes family members will not know until they go for a visit. Once the situation becomes clear, then someone steps in to provide care.
Dementia is a good example. Once a condition—dementia is a good example—has been diagnosed, the caregiver learns what the loved one needs help with.
I have a friend who said it best: “People know who they are caring for, but they don’t know what they are caring for.”
Be open to learning techniques for dealing with your loved one in a proactive manner. See out support groups that help you know you are not alone in your situation.
TAKE CARE OF YOURSELF
I believe one of the most important pieces of the caregiving puzzle is to learn how to take care of yourself while providing daily care to your loved one. If you don’t take care of yourself, then you will not have any energy to fully care for someone else.
Oftentimes caregivers will not maintain doctor visits for themselves; they forget to exercise and to eat nutritiously. They allow themselves to become drained, and it soon leads to caregiver burnout.
Look for ways to reduce stress, such as getting a massage, maintaining your hobbies and using talk therapy or counseling to help you release anger and, in some cases, guilt.
Tips for successful caregiving:
1. Respect your loved one’s dignity.
2. Give your loved one some control.
3. Carve out some “me” time.
4. Establish a routine for yourself and your loved one.
5. Focus on your loved one, not on the disease.
6. Don’t be afraid or ashamed to ask for help when needed.
7. Make a conscious effort to remember the good times.
8. Preserve your friendships.
When there are multiple caregivers, it’s very important to determine one another’s strengths.
One person might be more organized and more adept at maintaining records. Another may be more skilled at communicating with family members and doctors.
One person might be more nurturing and should be the “hands-on” caregiver. Another might be better equipped to help maintain the house and lawn.
Everyone is not cut out to do everything in providing care to others. Do not judge. Accept what others have to offer and celebrate your partnership in caring for a loved one.
Caregiving is a hard job. You will get frustrated, but try to remember why you’re doing it in the first place. Diseases often change people, so remember the core of your loved one prior to the disease.
After it’s all said and done, know that you’ve done your best.
Partners in Aging Inc., a local nonprofit group, is hosting its first Caregiver Appreciation Luncheon on Sept. 13.
The group is accepting nominations for Caregiver of the Year. If you know someone deserving of a nomination, visit partners inaging.org or call Teresa Bowers at 540/371-2704.
Valerie Hopson–Bell is a geriatric care adviser at ElderCare Connections LLC. She can be reached at 540/419-4387 or firstname.lastname@example.org.
BY CATHY DYSON
THE FREE LANCE-STAR
Carol Whitenack is a grandmother of five and a soft-spoken nurse who takes care of premature babies—until it’s time to show off her chiseled body onstage.
Then the tall, lean Spotsylvania County woman slips into a sequined bikini and 4-inch acrylic heels. She puts on makeup (which she never wears otherwise), flashy jewelry, and paint and oil to make her toned body look tanned.
The 55-year-old participates in figure competitions, a less masculine version of bodybuilding. She’s judged on muscle tone, symmetry and how feminine she looks while flexing every muscle in her body.
Her 5-foot-7-inch frame is rated against those of women less than half her age, and she comes out pretty well, if she says so herself.
At the 2012 Arnold Classic in Ohio five months ago, Whitenack placed ninth in her class among women from around the world, many in their 20s and 30s.
“There she was, the oldest one from all the countries represented,” said Medina Roberts, her trainer at Sport & Health Club in Fredericksburg. “I was so proud of her.”
Whitenack, who has worked out at the gym for 20 years and always has eaten a healthy diet, was pretty proud, too, that she had the courage to bare it all.
Backstage at the event, she was with younger women who ate Gummi Bears and drank alcohol—to get needed carbohydrates—and pranced around naked.
Whitenack did not join them.
“I’ve had four kids,” she said, adding that no matter how much weight she lifts or how many squats she does, “things still kind of fly south a little bit.”
‘YOU HAVE THE BODY’
Whitenack, who turns 56 in October, had been taking classes at Sport & Health with Roberts. She admired how well Roberts did in figure competitions, and asked a lot of questions about it.
In May, Roberts placed in the top five in the International Federation of Physique Athletes’ Super Bowl in Richmond.
Roberts, who’s 43, encouraged Whitenack to try it.
“You have the genetics, you have the body, you can do it, too,” she told her.
Last year, Whitenack committed to investing the time and effort needed to compete. It wasn’t easy, given her schedule.
She works three 12-hour shifts a week in the neonatal intensive care unit at Mary Washington Hospital.
“When I’m not at work, I’m here,” Whitenack said about the gym.
Roberts devised an exercise plan to build up areas that needed strengthening and to whittle away at the few fat pockets on Whitenack’s trim body.
Whitenack has great legs, Roberts said, and she focused on tightening them. She gave Whitenack barbells to lift and do lunges with on the gym floor to build her shoulder muscles, so her thin waist would appear even smaller.
Whitenack did whatever was asked of her, cheerfully, even as Roberts loomed over her and asked her to yank on the cable machine or lift her back up in a bridge position one more time.
“One more, give me one more, baby,” said Roberts, who’s from Bosnia and lived in Germany. “You got it, come on, one more. Nice.”
SHE’S THE ‘FOOD NAZI’
Whitenack was always conscious of her weight and has been reading food labels since she was a child. When she was at the University of Maryland, she persuaded the cook to make healthier options for her, such as buckwheat pancakes instead of those made with white flour.
She got a degree in dietetics and worked briefly as a nutritionist. But she had little sympathy for people who said they wanted to lose weight but weren’t willing to change their lifestyles.
She got aggravated when they told her they ate a whole cake over the weekend.
So she worked in a nursing home, hoping to entice those around her into healthy diets. As she watched nurses work, she decided that’s what she wanted to do.
She went back to school and got her nursing degree. She has been tending to sick babies for 30 years.
Whitenack hasn’t changed her strong opinions about food and exercise. She put a pool in her backyard and made her kids swim regularly and eat three square meals and a healthy snack before bedtime.
She’s so careful about what she eats that her co-workers call her the “food nazi.”
She has even helped train her trainer, Roberts, on achieving a better diet.
‘YOU’RE A STAR HERE’
Whitenack raves about the courage Roberts has given her, grateful that she has helped her strut her stuff among younger competitors. Roberts also does all of Whitenack’s makeup and body painting.
“I’m more excited when she is onstage than when I am,” Roberts said.
Whitenack has quite the cheering section at Sport & Health. Roberts said people were talking about her showing in the Arnold Classic for months.
“Let’s be honest, you’re a star here,” Roberts said.
Whitenack doesn’t know about all that, but she is gratified by the response she’s gotten.
When she’s at a competition and the announcer calls her name—and tells her age—audience members and judges alike stand up and applaud.
“That’s when I win,” Whitenack said. “That’s my trophy right there.”
Cathy Dyson: 540/374-5425