Aging Well Magazine Spring 2024 by Local Umbrella Media

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Vision Vision of of Aging Aging Adventure Awaits! Fall Prevention & Yoga Do the Hustle Supporting our Veterans Mexico Si Se Puede

Spring 2024 Issue 1 Vol 2

Photo by Tyler Jordan

Serving the 50+ Community in San Diego County San Diego Oasis is an award-winning nonprofit organization that has been serving people 50+ throughout the San Diego region for the past 35 years.

Our mission is to promote successful aging through a three-fold approach: • Lifelong Learning We hold classes throughout San Diego County in 3 formats: in-person, hybrid, and online. • Healthy Living We offer sessions in fitness, dance, nutrition, life-style, and chronic disease management. • Intergenerational Programs We have hundreds of trained volunteers who dedicate their time to at-risk youth through reading tutoring, book giveaways, and mentorship programs. Ways to Participate • Become a Member (it’s free!) • Sign up for classes • Become an Elementary Student Tutor • Become a Donor • Volunteer at our La Mesa location • Volunteer at our Rancho Bernardo location • Rent space for your next party or meeting • Advertise in our catalog To learn more about these opportunities, send us an email at Info@SanDiegoOasis.org San Diego Oasis is a 501(c)3 public charity: Tax ID #30-0403895

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Navigating your future may bring uncertainity. Aging Well Partners can help discover your best path forward by empowering you with the vetted resources and trusted services that meet your specific needs. Your journey has a roadmap and we are here to help find it.

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AGING WELL MAGAZINE

anuary marks my 10th year in the senior industry. It’s a compelling field I was fortunate to stumble into. The current industry doesn’t resemble much like it did 10 years ago. It’s that fast of a growing and changing environment. For years, I envisioned a different landscape of how we could age, so it’s exciting to see that vision unfold. Ten years ago, it seemed not only predictable but inevitable how we were expected to age. From disease outcomes and management to attitudes of aging. Most aging adults today have the potential to spend half of their lives “retired.” I don’t think we will be content watching TV and watering the lawn for 20-40 years. Over the last decade, I’ve seen a desire for the aging adult to live vibrantly right up to the end. This gets said a lot, “It’s the good years you miss, not the end years.” Yes! I see this! Let’s make all the years good right to the end. I contemplated our theme of Vision of Aging for well over a month. What’s the secret? I was searching for this groundbreaking Aha moment of “yes, this is it,” and then Eureka! I realized it’s not one thing. It’s a combination of many things. First and foremost, it’s highly personal and unique to each person. No two paths are the same. Elements such as a healthy diet and exercise are crucial to starting on the right path. We are no longer teenagers who can get away with a steady pizza, sugar, and fast-food diet. Youth is not on our side, but that doesn’t mean you can’t still be vibrant and healthy. Plastered right above my three monitors in my office in bold colors on a 3x5 card reads….

“I choose to make the rest of my life, the best of my life.” —Louise Hay It’s a resounding reminder that the vision of how I age is entirely up to me and that vision requires a commitment to do what needs to be done to achieve it. It also necessitates a reevaluation regularly. Life throws us curve balls, so we must duck and swerve as required. It’s no secret we have a finite number of years on this planet, but death gives life meaning and purpose. We’re all meant to be here. My dad had an extra decade at least because he decided to redirect his health in his late 60s. My sisters and I are forever grateful for those additional years. Still, I don’t think he realized he gave us something else besides extra years with him; he gave us a crystal ball of what would happen if we didn’t change our health ways, and I am forever thankful for that. I saw what a mostly plant-based diet and daily exercise did for his health. Each moment on this earth is a gift not only to yourself but also to your loved ones. It’s our 1st anniversary, and our vision for this magazine hasn’t changed. We’ll continue to bring you essential content that is vital to live your best life and get connected with the best local resources for your aging journey. Your Vision of Aging is yours to choose and pursue. Let us know how you’re aging

well and what your Vision of Aging is for 2024. We love hearing from our readers. Here’s to you finding your own personal Vision of Aging in 2024! Age Well San Diego Jacqui Clark, CSA™ Editor Co-Founder, Aging Well Partners Jacqui Clark is a Certified Senior Advisor™ (CSA™), consultant with Living Coastal Senior Resources, and co-founder of Aging Well Partners. She is an industry-leading living-and-aging well expert, and a respected communications specialist. Jacqui@LivingCoastalSR.com

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Our Vision of Aging in this issue: Do the (Side) Hustle, No Fear: Hospice Comforts the Dying, Assisted Living in Mexico: Si Se Puede! (Yes, We Can!), How to Engage and Reskill Older Adults in New Work Opportunities, Adventure Awaits, Fall Prevention Yoga, Never Too Late to Start a Healthy Diet, Reminiscence Therapy for Memory Loss, There’s No Place Like Home (Care), Guide to Downsizing, A New Vision of Planning our Final Chapter, Supporting Our Veterans with Home Care, and More….

Brad Weber (619) 300-1732 brad@localumbrella.com

Cover photo courtesy: Tyler Jordan For print inquiries see his gallery at: www.tylerjordan.net Follow him at: instagram.com/tylerbjordan_ agingwellpartners.com | ISSUE #4

EAT WELL

It’s Never Too Late to Start a Healthy Diet

n our fast-paced world, our health often takes a backseat to the demands of daily life. We find ourselves rushing through meals, opting for convenience over nutrition, and neglecting the importance of a balanced diet. As the years pass, it’s easy to convince ourselves that it’s too late to change. However, there is always time to start a healthy diet. The Power of Choice One of our most powerful tools is the ability to make choices. No matter how many years have passed, we can always choose to prioritize our health. Adopting a healthy diet isn’t about achieving an unrealistic body image; it’s about nourishing our bodies to lead our best, healthiest, most vibrant, and fulfilling lives right up to the end of our lives. Scientific Backing: A Testament to Possibility In ancient healing practices like Ayurveda and Traditional Chinese Medicine, the emphasis is on prevention and health. In these traditions, food is medicine, and diet is a crucial health feature. Recently, Western medicine has conducted research that validates these long-held beliefs. Numerous studies have shown that changing dietary habits can significantly impact health even later in life. For instance, research published in the American Journal of Clinical Nutrition highlights that adopting a healthier diet rich in fruits, vegetables, and whole grains can lead to a lower risk of chronic diseases, such as heart disease and diabetes, regardless of age. Furthermore, a Harvard T.H. Chan School of Public Health study emphasizes that modifying dietary choices in midlife and beyond can substantially improve longevity and overall well-being. The Building Blocks of a Healthy Diet Starting a healthy diet doesn’t have to involve drastic changes overnight. It’s about making sustainable, realistic adjustments to incorporate into your lifestyle. Here are some fundamental principles to consider: 1. Prioritize Whole Foods: Whole foods, such as fruits, vegetables, whole grains, and healthy fats, form the foundation of a healthy diet. If you eat 6

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meat, avoid all red meat and choose lean proteins, including organic or raised fish, without added antibiotics and other additives. Start by avoiding all meat one day a week and then move to more meatless days. Be sure your plate is ½ vegetables, ¼ legumes, and ¼ whole grains. Avoid white foods like white bread and rice. Plant-based foods are rich in essential proteins, nutrients, vitamins, and minerals that support overall well-being. 2. Limit Processed Foods: Processed foods often contain excessive added sugars, unhealthy fats, and preservatives. Minimizing their consumption can improve energy levels and digestion and reduce the risk of chronic diseases. 3. Stay Hydrated: Water is essential for every bodily function, from digestion to temperature regulation. This is especially true as we age when everything starts drying out. Make sure to stay adequately hydrated by drinking enough water throughout the day. To calculate how much water you should drink, you calculate your weight X.05= (200 X .5=100 oz a day). Most of us need to drink more water. The best way to do this is to keep a water bottle (I use a thermos bottle) and sip warm or room-temperature water all day. You want to stop the water at least 2 hours before bed so you don’t get up all night to go to the bathroom. 4. Practice Portion Control: Being mindful of portion sizes can help prevent overeating and promote a balanced intake of nutrients. Listen to your body’s hunger and fullness cues to guide your eating habits. You should always stop eating when you are 80% full. Eat your last meal of the day at least 3 hours before you go to bed to improve your sleep. 5. Include a Variety of Foods: Eating diverse foods ensures you receive a broad spectrum of nutrients. Aim to incorporate different colors, textures, and types of foods into your meals. Embracing Change Embarking on a journey towards a healthier diet may come with its set of challenges. It’s essential to approach this process with a positive mindset and a willingness to learn. Start by setting realistic goals, such as incorporating extra vegetables into your meals or swapping sugary snacks for healthier alternatives. When you eat something you shouldn’t, forgive yourself and start fresh the next day. Remember, small, consistent changes can lead to significant long-term benefits. Seek inspiration from healthy recipes, plan meals, and experiment with new flavors and cuisines. Surround yourself with a supportive community, whether family, friends, or online groups, to stay motivated and accountable.

The Rewards of a Healthy Diet The benefits of adopting a healthy diet extend far beyond physical appearance. A balanced diet can lead to better digestion (no diarrhea or constipation), increased energy levels, improved mental clarity, enhanced mood, and a reduced risk or even improvement of chronic diseases. It can also foster a positive relationship with food, promoting empowerment and well-being. In conclusion, there is always time to start a healthy diet. The power to make positive changes lies within us, regardless of age or past habits. By embracing the principles of a balanced diet and making gradual, sustainable adjustments, you can embark on a path toward a healthier, more vibrant life. Remember, every choice is a step towards a brighter, healthier future. Books to get you motivated include: The China Study by T. Colin Cambell UltraProcessed People by Chris Van Tulleken Highly motivating documentaries available on Amazon Prime or Netflix are: Forks over Knives Game Changers

“What you are is what you have been, what you will be is what you do now.” — Buddha

Dr. Renee McLeod has been a nurse practitioner for over 45 years and an Ayurvedic practitioner for the last 15 years. She recently retired from her Integrative medical practice in Rancho Bernardo, where she focused on a holistic, patient-focused approach to health care and wellness. Her patients were taught to incorporate lifestyle changes, including better diet and nutrition, increasing physical activity, or improving sleep to prevent chronic disease and support one’s innate ability to heal. agingwellpartners.com | ISSUE #4

HEAL WELL

Fall Prevention & Yoga

hances are you know an older adult who took a nasty fall that changed their life permanently. Perhaps this person broke a hip or fractured their pelvis. Often, that person goes from living independently to moving into an assisted living community practically overnight. I have senior parents, and I encourage them to take measures to prevent a fall. This is particularly true for my 88-year-old dad, whose balance gets shakier yearly. Since he is on a blood thinner, avoiding a fall is even more critical. What are some things that he (and you) can do to help prevent falls? First, fall-proof your home (get rid of those sliding area rugs), get a vision check, and ask your doctor or pharmacist to review your medications. Second, consider yoga. As a yoga teacher for seniors, I prioritize preventing falls. This makes more sense than it may seem at first blush. How can yoga help prevent falls? • Balance work • Strength training • Proprioception (awareness of your body in space) • Ankle and hip mobility • Stress reduction Balance Work In a Yoga Class: Most yoga classes incorporate challenging

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balance postures. This often intimidates older adults who feel uncomfortable standing on one leg in the middle of a yoga room. I start all my students near a wall or with a sturdy chair nearby. Once they master various balancing challenges with support nearby, I encourage them to try to move away from the wall or chair. Pro Tip: Holding a steady gaze can help with balance. Find something in front of you that isn’t moving, and try to keep your eyes on that thing while you challenge your balance. Want to challenge yourself more? Lift your gaze towards the ceiling! Try This at Home: Try standing on one leg while brushing your teeth or washing dishes: your bathroom or kitchen counter is there if you need it. Strength Training In a Yoga Class: If you’re relatively new to yoga, shifting your body weight onto one leg (such as when you are challenging your balance) can help strengthen your core, legs, and ankles. This is a great place to start. Pro Tip: Eventually, your core, legs, and feet will no longer find your body weight challenging. When this happens, slowly add additional weight to your movements. Try incorporating a resistance band or light dumbbells. Try This at Home: Don’t have weights at home? Raid your pantry and hold a big can of pasta sauce or a couple of water

I have senior parents, and I encourage them to take measures to prevent a fall. — Jennie

bottles – just make sure what you use isn’t breakable! Proprioception - (Also called kinesthesia, is the sense of self-movement, force, and body position.) In a Yoga Class: Standing yoga poses will challenge you to focus on where your body is in space. You’ll need to pay close attention to where your arms, legs, and feet are. You can use this greater awareness when walking along a new path or finding your seat in a dark movie theater. Your body will better tune into your brain, saying, “Okay, where exactly am I putting myself?” Pro Tip: Start with your feet when observing your body in a standing yoga pose. Make sure you have a stable base of support by taking your feet as far apart as you need to. Try This at Home: An easy way to change your body’s orientation to gravity is to take the yoga pose Legs Up the Wall (coffee table or chair). Lie on your back and swing your legs up a wall, table, or chair. Look around and notice how different things look. Ankle and Hip Mobility In a Yoga Class: When taking a seated or prone yoga pose, gently turn your ankles in slow circles: the slower, the better! Moving slowly allows you to potentially influence the little nooks and crannies

often missed when moving too quickly. Pro Tip: Our hips get plenty of flexion when we walk or run. What they need is rotation! It’s easiest to rotate your hips while standing. Try This at Home: Stand on one leg (absolutely place your hand on a wall or sturdy chair; this isn’t about challenging your balance). Bend the other leg, draw your knee towards your chest, turn the leg out, and circle. Click here for a short tutorial. Stress Reduction (If you fear falling, you are more likely to fall.) In a Yoga Class: If a yoga studio offers meditation classes, go! Learning to meditate is a marvelous way to manage stress, including fears. Pro Tip: Learn a few calming breathing techniques. I have several tutorials on my YouTube channel. Try This at Home: When you wake up in the morning, sit up in bed. Place one hand near your heart and one on your abdomen. Close your eyes and take five deep breaths. If possible, allow the exhales to last longer than your inhales. I hope you will incorporate one – or all – of these suggestions into your daily life, whether you try them during a yoga class or in the comfort of your home. Together, we can minimize our risks of falling and our loved ones. *Always consult your doctor before starting a new exercise routine.

In 2017, Jennie MacGoy established her first yoga studio in Potomac Falls, Virginia, catering to seniors, those with chronic pain, and individuals aspiring to age well through yoga. In 2021, she relocated to San Diego for an improved quality of life. Jennie now specializes in teaching gentle and chair yoga to seniors in various settings, including retirement communities and nursing facilities. She also offers personalized sessions for yoga newcomers and those with diverse physical needs. Outside of yoga, Jennie enjoys beach walks, exploring coffee shops with her grown children, and spending time with her cavapoo, Penny. Connect with her at www.jenniemacgoyyoga.com. agingwellpartners.com | ISSUE #4

ADAPT WELL

A Simple Guide to Downsizing from a Family Home to a Senior Community

ou know it’s time to move, but you feel stuck, not to mention overwhelmed. How do you pack up 40 years of “stuff” and take the memories with you? Following these steps can simplify the process as you embark on a fulfilling new chapter of your life. Remember, it’s not just about letting go of possessions but about embracing a lifestyle that offers comfort, convenience, and the opportunity to create new memories in a vibrant environment. Moving to a senior community is an exciting opportunity for new experiences and connections. Embrace the change and look forward to the advantages of downsizing. Remember, you will not have to handle any maintenance issues in the future, have more time to enjoy your life, and increase your social engagement. With careful planning and the right strategies, it can be a liberating and exciting transition. Stage One: Give yourself ample time to plan and prepare for downsizing. Create a timeline that outlines essential tasks and milestones. Use a blank calendar. Determine the date you want to be done, and work backward, outlining important tasks and milestones. Play music and open the windows. Enjoy the process! Stage Two: Identify where you want to live. Evaluate your future lifestyle, care needs, and identify your desires in your new living space. Stage Three: Go through each room, closet, and garage. Inventory your belongings: furniture, paintings, lamps, small items, clothes, plants, etc. As you go through this process, ask yourself the following four questions: Do I love it? Will I use it? Do I need it? 10

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Does it evoke a positive feeling and make me smile? Categorize items into KEEP, DONATE/ SELL, and DISCARD. Suggestion: Put a sticky green dot on what you want to keep. A yellow dot on what you want to donate or sell. A red dot on what you want to discard. Stage Four: Seek assistance! Find a realtor to work with. One that has had experience working with families that have downsized and have made the same considerations that you are. They will also give you a plan of action to prepare your home and get it market-ready. Stage Five: Updating essential documents. Consult with your professionals to update your will, healthcare directives, trust documents, and any related paperwork related to your move. Stage Six: Digitize Memories. Preserving memories is important, but physical photo albums and slides can take up a significant amount of space. Consider scanning old photographs and important documents to create a digital archive. These services are readily available. Joan Chintz, DRE# 01064786, has been practicing real estate since 1991 and has a Senior’s Real Estate Specialist (SRES) certification. Excellent service, honesty, and expertise is her promise to each client. Bob Heck, DRE# 02023420, is passionate about working with transitioning seniors and their families. As a previous Director of Sales and Marketing in assisted living and memory care, Bob has guided many seniors through the transitioning process. He continues working with his wife, Joan, and supporting senior communities.

Providing extra support during power shutoffs. That’s the power to help. During peak wildfire season, we may have to shut off power in certain areas for public safety. This is called a Public Safety Power Shutoff. SDG&E partners with 2-1-1 San Diego to provide extra support to those who need it during these times. Community, health and social services — including accessible transportation — are available for those who qualify. Dial 2-1-1 (858-300-1211) for confidential assistance, 24/7. For info on SDG&E accessibility support, visit sdge.com/AFN.

TRAIN WELL

How To Engage Older Adults in Reskilling & New Work Opportunities

he world’s population is increasing at an exponential rate. It is estimated that 21% of the population will be 60+ by 2050. Longer life expectancy and healthier lifestyles will make more seniors available to remain in or re-enter the workforce. Reskilling older adults has many upsides but many barriers to overcome. An article by the World Economic Forum has outlined critical ways to engage older adult workers better. These include: • First, acknowledge that age has nothing to do with learning. Japan supports older workers to age 70 and may abolish retirement altogether. • Redefine and expand roles in health care to accommodate the demand for health services, such as increased virtual care and digital health systems. • Make it easier for older adults to return to the workplace with innovative retraining programs and help companies realize the benefit of

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One upside to using more older adult employees is to take advantage of an oversupply of potential workers.

employing older workers. • Reskilling efforts must consider older adult workers’ unique needs, preferences, and motivations and incorporate these into their hiring practices. • To minimize monotonous work, incorporate new technologies to support older workers, such as virtual training and robotics. • Ensure access to lifelong learning opportunities so older adults can easily access and participate in this training, as in internships and job-sharing practices. • Finally, educational credits toward degree programs that recognize lifelong learning should be allowed. One upside to using more older adult employees is to take advantage of an oversupply of potential workers. More importantly, this shift toward working beyond the typical retirement age brings purpose, meaning, and a feeling of productivity to the older adult.

Dr. Joe Casciani is the owner and Chief Curator for the Living to 100 Club, a source of solutions to living longer and healthier, with a special focus on mindset and attitudes about aging. He has a 40-year history as a psychologist and manager of mental health practices specializing in behavioral health services with older adults. In addition to his work as a clinical consultant, he is an engaging and inspiring speaker and helps audiences move beyond their questions and concerns about aging to create a vision of what is possible in the years ahead. He strongly believes there is value in helping people feel inspired about their future.

PLAN WELL

Medicare Set for Significant Overhaul in 2024 & 2025

n the coming year, Medicare is undergoing changes that impact beneficiaries. The Part B monthly premium will increase moderately, from $164.90 to $174.70 in 2024. Additionally, the Part A inpatient hospital deductible will increase from $1,600 to $1,632, and the Part B annual deductible will increase from $226 to $240. However, these adjustments are accompanied by modest 2% increases in copays for inpatient hospital stays and skilled nursing facilities. On the prescription drug coverage front, the Part D annual deductible will experience a slight uptick from $505 to $545 in 2024. The real boon for patients lies in changes to the prescription drug coverage, particularly in 2024, and the more substantial revisions in 2025. In 2024, the TrOOP (true out-of-pocket costs), including deductibles, copays, and discounts received in the coverage gap (aka The Donut Hole), is $8,000. Once a Medicare beneficiary reaches this threshold, they will enjoy copay-free medication for the remainder of the year, a notable improvement from previous years where a 5% coinsurance persisted. The most significant relief, however, comes in 2025 with a remarkable drop in TrOOP from $8,000 to $2,000! This transformative adjustment is poised to significantly benefit Medicare beneficiaries, alleviating financial burdens related to prescription drug costs. Your understanding of these changes is crucial to navigating and maximizing the benefits of Medicare coverage in the coming years.

Greg McMullen, a Certified Senior Advisor (CSA) since 2005, brings over 15 years of expertise in guiding seniors through the intricate landscape of Medicare health insurance options. As a licensed independent insurance broker (CA Lic#0D13621), Greg offers impartial and unbiased information to empower seniors to make informed choices aligned with their best interests. Licensed in multiple states, Greg provides virtual assistance beyond San Diego County. For more information on Medicare, please contact Greg at www.MFISPro. com (858) 922-0195 greg@ mcmullenfis.com agingwellpartners.com | ISSUE #4

LIVING WELL

Do the

Hustle!

he cost of living in San Diego and increased life expectancy is the perfect prescription for today’s retired adults to turn new and rediscovered hobbies into new careers, create purpose, and increase income streams. If you are considering your own “side hustle,” here are some factors to consider. Determine what “lights you up.” If you’ve ever experienced a “flow state” for yourself, you know there are certain activities that make time disappear. Think back to a time in your life when you loved a hobby or activity, but “life” got in the way, and you had to put it aside. The Silver Linings Transitions team finds lots of “collections”

from old hobbies, and we encourage our clients who are “rightsizing” to keep the things that “spark joy” and say goodbye to things that deplete them. After you’ve identified things you enjoy, do your market research and make sure there is a demand for the product or service you want to offer. Score San Diego pairs entrepreneurs with business mentors (many of whom are retired business professionals) and can help anyone on the entrepreneurial journey get their business started. Take classes and fill in the gaps in your service offerings. If you have yet to try San Diego Oasis or OSHER, they offer excellent opportunities for adults 50+ to take courses from experts in their field. You can also provide your own experience to these organizations. Consider soliciting the help of a grandchild or tech-savvy teen’s help to set up an online presence. You might even end up with a viral video to help you gain the attention you’ll need to catapult into the limelight. You can also find low-cost assistance by hiring a Virtual Assistant for tasks that might bog 14

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you down. Find networking opportunities and connect with groups in your community or the industry you want to enter. Don’t let your age define you. Offer your services as an apprentice or intern to gain experience and have the opportunity to pursue a career path with minimal financial investment. You can also consider freelancing on platforms like Upwork or Fiverr. This can provide you with a flexible way to monetize your expertise. Stay flexible and be open to adapting your approach based on feedback and market trends. Continuous learning and evolution are critical to long-term success. Want some ideas to get started? Consider photography, creating and selling art, performing, writing blogs and books, creating classes, workshops, tours, working with peers by teaching them a skill you’ve kept current with, consulting, nannying, hiring yourself as an “adopt a grandparent,” organizing events, organizing, answering phones, consultant in area of expertise, or working as a receptionist. The over-65 population is booming with talent, and the world still needs you. Above all else, have FUN!! As the saying goes, “Do what you love, and the money will follow.” Jami Shapiro, The author of this article, is the Founder of Silver Linings Transitions, a San Diego-based move management company specializing in seniors, organizing, and “rightsizing”’. She is a hobbyist writer and remembers writing all her friends’ articles when they had a piece due. When she retires, she plans to write a book and get her yoga certification so she can teach yoga to seniors. Find Jami at Silver Living Transitions (760) 522-1624 Info@silverliningtransitions.com

GIVE WELL

Caregiving Reimagined

any people have a fear of aging. A fear of deterioration of body and mind. A fear of loss, isolation, and loneliness. A fear of mortality. I’ll never forget the 100th birthday party of centenarian Alvin N. many years ago at the La Mesa Community Center. Failing physically and cognitively, Alvin found joy in the small everyday moments and drew us in to celebrate with him. His birthday party celebrated Alvin, his character, and his past with his family and all of us who provided care to him. It was a joy and privilege to serve Alvin and a lesson to “carpe diem” without fear of death. In charting a new trajectory for the future, redefining perceptions of aging and fostering a fresh perspective that uncovers the natural beauty in the process is critical. This idea seeks to offer compassionate care to aging adults and provide support and peace to seniors and their families. Caregivers need to be encouraged to reimagine the traditional caregiver relationship. It is not enough to care only for the physical well-being of their aging clients. A holistic approach catering to clients’ emotional and social needs is equally important to ensuring senior independence and dignity as they age. The resulting “360 View” of the aging adult/caregiver relationship enables seniors to maintain their desired lifestyle and routines. At the same time, it empowers caregivers to positively impact their client’s mental health and quality of life – now that is reimagining the Future and Vision of Aging. David Chong is CEO of Coast Care, which recently celebrated a decade of service in-home care. He’s worn many hats, including Geriatric Care Manager and RCFE administrator. Find David and his fine team at www.coastcare.org (619) 354-2544

agingwellpartners.com | ISSUE #4

CONNECT WELL

A New Vision of Our Final Chapter

or 25 years, I dedicated my life to the fast-paced world of Emergency Medicine, where I helped countless individuals escape the clutches of death. It was a fulfilling and impactful career, earning me a reputation as a compassionate and knowledgeable physician. However, in 2013, a transformative epiphany led me to a new calling that challenged my understanding of life and death. This revelation struck me during a celebration of life for a friend in La Jolla, California. As I sat on a bluff overlooking the ocean, a surge of energy coursed through me, awakening my senses. In that profound moment, I received a powerful message: “I’m here to help people die.” Given my extensive background in preventing death, this shocking directive wasn’t entirely unexpected. Years earlier, I had immersed myself briefly in hospice care while helping a friend battle melanoma. That experience lingered in my thoughts, planting seeds of a new purpose aligned with my core values: Connection, Family, Wisdom, Joy, and Freedom. This newfound path took on a profound personal dimension a short time later as I navigated the final journeys of both my parents. My Parents’ Story In the wake of my career transition, my mother’s recurrence of lung cancer unfolded in a whirlwind of doctor’s appointments and treatments that not only weren’t helpful but caused significant complications. Balancing my roles as both a doctor and son, I sometimes found myself secretly wishing she wouldn’t wake up, witnessing her daily struggles taking a toll on her and my father. Despite this, we fulfilled her wish to witness her grandson’s college graduation, albeit through a hospital bed live feed. Opting for hospice care, she died peacefully at home a short time later, surrounded by her family. This experience granted me profound insights into the anxieties families face during their loved one’s struggles. It underscored the importance of a guide—like myself—to advocate for optimal care, alleviating pain and fear. Less than a year later, my 81-year-old father’s vibrant life took a shocking and dramatic turn when he was diagnosed with stage 4 lung cancer. Despite a seven-week treatment course and an adventurous trip with his grandson, his return marked a decline, with tests revealing widespread cancer. Embracing his mantra, “It is what it is,” he chose not to pursue further treatment. Assuring him of a pain-free closure, I, as a palliative care and hospice physician, navigated my fears, dedicated to ensuring his “good” death. He died two weeks later. In the end, surrounded by family, my father’s passing exemplified a perfect death—no fuss, no pain, just love. In his final moments, he

AGING WELL MAGAZINE

became my greatest teacher, demonstrating the power and control of the human spirit. His legacy shapes my commitment to providing families with the gold standard of care as they navigate serious illness and approach life’s end. My Philosophy A serious illness doesn’t have to mean the death of the spirit. No matter what stage of an illness a person is at, it is ALWAYS possible to experience a deep sense of peace and innate wellbeing. I’ve witnessed this time after time in our patients. Death can—and should—be a beautiful transformation, but having a vision of our final chapter and planning are critically important for allowing this to unfold. My work involves fostering deep connections with patients and families going through significant health and life challenges and struggles. My team and I guide them in making decisions about their care. Hence, they enjoy the best possible quality of life – and the greatest sense of peace and well-being – while they go through the stages of serious illness, up to and including the taking of their final breath. In 2017, I joined forces with my now-wife and business partner, Elizabeth Uslander, a skilled spiritual counselor and medical social worker. Together, we embarked on a mission to revolutionize healthcare by bridging gaps to provide whole-person, traumainformed, and culturally competent care. Our goal is to honor individual and family needs and create a new paradigm—one that ensures agency and dignity for all. We emphasize the importance of end-of-life planning as a crucial aspect of aging well. Individuals can shape a fulfilling final chapter by understanding all the options, envisioning goals, clarifying intentions, and documenting wishes. Our approach extends beyond physical care, encompassing mental, emotional, and spiritual support for a holistic end-of-life experience. Though this final chapter signifies an ending, it remains an integral part of living. Everyone deserves unwavering support throughout this journey, ensuring a dignified transition on every level. In championing this cause, we aspire to redefine healthcare, making agency, dignity, and holistic care the cornerstones of a compassionate and fulfilling life until the very end. Bob Uslander, MD, and Elizabeth Uslander, MSW MTS, are the co-founders of Empowered Endings, a unique model of End-of-Life Care that fills the glaring gaps in traditional Palliative and Hospice Care and emphasizes whole person and family care, including emotional, intellectual, and spiritual health of patients and their loved ones. They are working on their forthcoming book, Permission to Choose. Find them at www.empoweredendings.com.

TINYFEST DEL MAR

MARCH 16 & 17 DEL MAR FAIRGROUNDS

TinyFest is back! 5th Annual Tiny Home show at the Del Mar Fairgrounds! TinyFest is an annual exposition that celebrates tiny living in a big way. Visitors of all ages are invited to tour the large spectrum of alternative living structures from tiny homes, buses and vans to backyard cottages, ADUs, shipping container homes and more. Experts in the tiny living movement will be giving educational presentations and attendees can shop at the Simple Living Marketplace. Live music, food and tons of inspiration are all included!

Del Mar Fairgrounds, California March 16-17, 2024 The Time Is Now! Join the Tiny Living Community and Change Your Life!

Local Umbrella Media and HealthyHOME Media are proud main stage sponsors of this event. We would love to see you there!

BUY TICKETS AT TINYFEST.EVENTS

CHOOSE WELL

Adventure Awaits

Todai-ji Temple, Kyoto

A GUIDE TO FULLFILING YOUR TRAVEL BUCKET LIST

he travel bug bit me unexpectedly in high school: I had the privilege of performing with the Long Island Youth Orchestra on two around-the-world trips. I was a teenager, and I played bassoon. Today, I’m no teenager, no longer play bassoon, and I don’t travel the way I did in high school. But that’s more than okay. My occasional later-in-life trips overseas are more satisfying, enriching, and soul-fulfilling. Every time I travel, from a one-day road trip to a weekslong overseas adventure, I feel changed for the better. Travel has the remarkable power to spark creativity, transform me into a storyteller, and enrich my life in unexpected ways. Investing in travel is an investment in myself. It’s a path to mental expansion, cultural appreciation, physical health, and a more worldly and well-rounded sense of self. And those are all essential influences in aging well. “See the world. It’s more fantastic than any dream.” – Ray Bradbury, Author.

AGING WELL MAGAZINE

If there’s a trip on your bucket list, moving it to your “to-do” list is the first step to personal satisfaction. For me, after spending so much time off the road during the pandemic, I feared my desire and energy The Design Museum, for traveling had waned. Kensington, London Fortunately, things took an upturn when a trip to Japan, postponed but paid for in 2019, was finally given the green light earlier this year. I confess I had pre-travel jitters about being so far away from older relatives who might need me, concerns about safety and security, doubts about being up for the physical demands of navigating airports, long flights, and sightseeing, and missing the creature comforts of home. Despite these worries, the trip was a huge success and renewed my confidence in traveling. It also left me eager for more.

Todai-ji Temple, Kyoto

A “living wall,” Barcelona

Marylebone Road, London

My bucket list led me to a desire to visit friends living in London. Moreover, since neither my husband nor I had ever been to Spain, we thought, If we were going to London, why not include Spain? It was a joy planning the trip, using the free service WhatsApp that let me talk with and text friends who’d been to the places we wanted to visit. Nowadays, with tools like Google Maps, Google Translate, and Google Currency Converter on our cell phones, navigating on our own has proved wholly feasible. Of course, traveling “DIY” (i.e., without a tour company) had its challenges, and maybe carrying our luggage was the toughest part. (It also convinced me to pack lighter next time.) But the rewards of tailoring our trip with the people, food, and experiences we value most were worth the effort. “Travel is the only thing you buy that makes you richer.” – Anonymous. Still, there were some lessons for me after these recent journeys. When planning a trip you’ve wanted to take, including a once-in-a-lifetime vacation, do it! And if you don’t want to do your planning (which is not the easiest of tasks), group tours can be a great option, especially for solo/single travelers. While I typically avoided group tours in my youth, I’ve found an organization well-matched to my adult travel interests. I want to understand the culture and character of a place I’ve never visited. I want information provided in a personally relevant and not superficial way, and I don’t want to feel wrung out at the end of the day. For me, my experiences touring with Overseas Adventure Travel (OAT) have been a perfect match. (And be aware that I have no affiliation with the company whatsoever.) With OAT, everything is meticulously planned for you, and I appreciate being in a small group. OAT also balances learning, recreation, and cultural immersion. Touring has many benefits, like traveling with like-minded companions, organizing details for you, securing access to behind-the-scenes experiences, and being guided by knowledgeable tour leaders. Of course, another perk is rarely needing to carry your luggage. “I haven’t been everywhere, but it’s on my list,” ― Susan Sontag, Writer and Social Critic.

Cherry blossom canopy, Kyoto

If you decide to take the plunge and travel, give yourself ample lead time to prioritize where you want to go, prepare your budget, select travel dates, and create a wish list for your journey. There are websites like AARP and Trip Advisor for trip planning advice, packing checklists, discounts, and other recommendations. Get the word out to friends for travel tips, explore options for travel insurance with medical coverage, and get an international cell phone plan for peace of mind. From my perspective, what’s most important when it comes to travel, especially when you’ve been putting it off, is to remember that NOW is the best time to do it. I encourage you to write down your bucket list now. And I wish you happy and safe travels on your adventure, whether just a one-day road trip or an 80-day around-the-world escapade!

Get Ready to Hit the Road Again o o

o o o o o o o

Prioritize your travel destinations and goals. Clear obstacles: budget, time, house-sitting needs, solo/single traveler concerns, consensus with travel companion/s, health issues. Choose the best travel timing. Determine your preferred travel mode (travel agency, tour company, independent travel). Research credit card travel rewards/travel discounts. Read travel review sites (TripAdvisor, Lonely Planet, Expedia, Airbnb, etc.). Seek advice from friends. Ask questions on your social media. Enjoy the planning process.

Jacqueline Silverman, CSA®, CAPS, is the founder of Aging Advisory Services and an Aging in Place specialist. The expertise she provides guides older adults and their families in addressing the unexpected and evolving needs that come with aging. jacqueline@agingadvisoryservices.com agingwellpartners.com | ISSUE #4

REMEMBER WELL

Reminiscence Therapy

HOW TO WALK DOWN MEMORY LANE WITH SOMEONE WITH DEMENTIA

ccasionally, we all enjoy reflecting on past experiences and remembering those moments. We hear a song that takes us back to a school dance, or the smell of homemade apple pie may transport us back to grandma’s kitchen. Visiting a childhood friend can elicit hours of stories that we may have thought were long forgotten. This is essentially Reminiscence Therapy (RT). It is beneficial for all of us, but it can be a valuable tool for someone with dementia. While someone with dementia may not remember what they did yesterday and can’t keep up with the latest news, they can tell you about where they grew up and some of their favorite things from the past. RT involves the discussion of past activities, events, and experiences. The first research on RT began when Robert Butler, in 1963, identified the process of reviewing the past and reminiscing as a normal and valuable process to making sense of the life one has lived. Reminiscence Therapy (RT)T with a structured framework is beneficial for older adults. However, trying to access memories through direct questions is not always as effective for people with dementia. Walking down memory lane can be more difficult when some roadblocks or roads have been destroyed. To help someone with dementia take a walk down memory lane, it helps first to understand what someone with dementia is experiencing and then to take a few moments to prepare to avoid roadblocks and find alternate paths to reminiscing. Dementia is a group of symptoms that includes memory loss and at least one other area of cognitive impairment, such as perception, attention, language, executive function, problem-solving, and reasoning. The severity of symptoms interferes with everyday activities and has lasted at least six months. Symptoms vary by type of dementia, but generally, people have difficulty learning new information and remembering their recent past. However, autobiographical memories of their childhood and young adult years tend to remain intact for a long time. In addition, trying to access memories directly, such as asking, “Who taught you to drive?” results in hitting a roadblock. Instead, seeing an old car or picture of one may spontaneously activate memories of learning to drive or childhood trips. The most effective form of RT for people with dementia is spontaneous reminiscing. Instead of a structured program with direct questions, presenting items from the past, such as a photo, an object, a scent, or a song, can instantly recall a memory. For someone with dementia who experiences confusion and frustration, recalling a pleasant memory, like grandma’s apple pie, can provide an opportunity to talk and share with others

AGING WELL MAGAZINE

and elicit positive feelings. Studies have shown that engaging people with dementia in Reminiscence Therapy reduces anxiety and depression and improves sleep quality, self-esteem, quality of life, and relationships with their caregivers. So, how do you do it? 1. Prepare yourself to be with the person who has dementia. Don’t think about work. Turn off your cell phone and be fully present. Think about your feelings. Are you in a good mood, or are you frustrated? Your loved one will sense and respond to your emotions. Be aware that your loved one may not remember things you want him to. That may be disappointing, but remember, he is not trying to hurt your feelings. 2. Be sure to learn the personal background of the person with dementia. What were his favorite things to do growing up? Where did he live, and what kind of work did he do? The more you know, the more you can connect. 3. Be mindful of your environment. Is your environment distracting? Is the TV on? Are there papers all over the table, or is it clear? The environment can also queue memory. 4. Are you visiting a place that is special to the person? Most activities can lead to reminiscing: baking, walking, looking at old photos, or listening to favorite music. Using a memory box filled with items from the past is also a great way to cue or trigger spontaneous memories. 5. As you engage in conversation, listen with an empathetic ear. Don’t say: “Do you remember?” Instead, say: “Tell me about this. How does this make you feel?” Share your memory or story related to the cue. Don’t rush or correct them. Instead, listen with empathy and give the person time to think and respond. Validate their thoughts, emotions, and memories. Take a walk down memory lane! Engaging in Reminiscence Therapy can bring connection and joy to you and your loved one with dementia. Mindy K. Baker, Ph.D. Director of Education Mindy K. Baker, Ph. D. is the Director of Education at the George G. Glenner Alzheimer’s Family Centers, Inc.®. Mindy has an extensive background in dementia care education and leads training classes for family caregivers and symposia for dementia care professionals. For more information on Reminiscence Therapy and/or the courses offered by the Education Department at the Glenner Centers, please call 619-543-4700 or email mbaker@glenner.org

agingwellpartners.com | ISSUE #4

ADAPT WELL

Assisted Living in Mexico Si Se Puede! (Yes, We Can!)

s costs continue to rise in San Diego and across the United States, Senior Care Consultants are increasingly pushed to seek creative options. In Fall 2018, a group of colleagues and I accepted an invitation to visit Assisted Living options in Mexico. Many in our group were apprehensive about crossing the border and considering Assisted Living outside the U.S. All 15 of us were delighted to find an affordable alternative without sacrificing care in one of the most caring and loving environments. WHY FAMILIES CONSIDER ASSISTED LIVING AND MEMORY CARE IN MEXICO: 1. Financial Considerations: The primary factor is cost— currently, about 1/3 of the cost in San Diego County. 2. Cross-Border Lifestyle: San Diegans have a history of living part-time across the border, with many owning 22

AGING WELL MAGAZINE

second homes. Many San Diegans also cross the border for reduced-cost dental and medical services and are more likely to be comfortable seeking assisted living in Mexico. 3. Cultural Embrace: The family, especially elders, are highly regarded in the Mexican culture. Mexican culture profoundly respects older adults, which resonates strongly with families contemplating such a transition. 4. Emphasis on Staff: Mexican Assisted Living emphasizes hiring and training, boasting a ratio of one caregiver to three residents. In many communities, 50% of their caregivers are nurses (RNs). There’s a strong focus on continuity of care. Employees receive incentives and bonuses as the company thrives and succeeds, creating a desirable work environment. REAL PEOPLE WHO’VE MADE THE MOVE *We’ve changed names and small details to protect privacy.

Tom Wilson was living in a beautiful residential home on the coast of San Diego with all the bells and whistles, doing quite well and paying a premium price. His Mexico decision was not due to a limited budget but because he had worked in Mexico for decades and raised his family simultaneously in Southern California and Mexico. His adult son, Ken, lived 60% of the time in Baja and felt his dad would enjoy being closer to him and a culture he had grown to love. A vet on the verge of homelessness decided to move to assisted living in Mexico. He needed a lot of care, and even with his VA Aid and Attendance benefit, he could not afford care in the United States. He got a private room in Baja at 1/3 of the cost and received all the care he needed with no concerns that he would have to move one day. It was the right decision for him in the end. Mariam was stuck in a skilled nursing facility (SNF) because she had a feeding tube. In California, that is a prohibitive condition in assisted living. Perhaps three care homes in San Diego County can secure a waiver and manage this condition effectively. Still, it always comes at a high cost, in the neighborhood of 8K-12K monthly. Mariam could not afford it and wasn’t given long to live. She did not want to live out her final months in an SNF, so she moved to Assisted Living in Mexico. Mariam moved in very thin, very sick, and not walking. Fast forward three months, Mariam no longer used a feeding tube, gained muchneeded weight, and was walking and thriving again. Her care was supervised by around-the-clock nurses and a high staffto-resident ratio that she benefited from. DID YOU KNOW? 1. Utilizing VA Aid & Attendance: VA Aid & Attendance benefits can be used to pay for care in Mexico. 2. Enhanced Care at Lower Costs in Baja: Baja offers “Half the cost for Double the Care” with a higher incidence of nurses on staff. Nurses are not mandatory in California Assisted Living, Memory Care, or Residential Care Homes. San Diego County communities that employ RNs or LVNs

typically have one nurse per 8-hour shift for up to 100 residents. A nurse on staff significantly increases costs in the U.S. assisted living and memory care communities. Prohibitive Conditions in California: · Feeding tubes · Insulin Injections (Only with a nurse on staff 24/7. Eliminates 95% of San Diego communities and dramatically increases costs.) · Tracheostomies · Stage 3 and 4 Wounds (California can manage if on hospice) *Mexico can handle the above prohibitive conditions. ** U.S. regulations vary by state for Assisted Living/Memory Care and Residential Care Homes. SOUTH OF THE BORDER TSUNAMI Mexico is witnessing its own Silver Wave, catering to the needs of an aging population. This mirrors the situation in San Diego County, recently named the most expensive U.S. city. COST CONSIDERATIONS: • The average cost of assisted living in San Diego County is $5,500-$6,500. • Memory Care is approximately $6,500. • Small care homes range from $5,500-$7,500 • The overall scale for the above is 4K-20K. • A one-time Community Fee is charged for assisted living and memory care, although about 40% of small care homes have also begun implementing a community fee. It’s usually in the range of about 1K. • The second-person fee at an Assisted Living Community is 1K-$1,800 per month. • Factors affecting costs include apartment or room type, care needs, location, and severe cognitive behaviors. So many considerations come into play regarding the cost of moving into assisted living, whether in the U.S. or Mexico. Like any sizeable annual investment, you should use a professional to help guide you. We recommend that you consult a local CSA™ Senior Care Consultant to learn about the costs and regulations in your state. Our motto at Aging Well Partners is, One Size Fits One. Jacqui Clark is a Certified Senior Advisor™ (CSA™), Senior Care Consultant with Living Coastal Senior Resources, and co-founder of Aging Well Partners. She is an industryleading living-and-aging well expert and a respected communications specialist. She has been blissfully working with aging adults for almost a decade. Jacqui@LivingCoastalSR.com. agingwellpartners.com | ISSUE #4

SUPPORT WELL

Supporting our Veterans with Home Care Options

here are more than 16 million Veterans in the United States, and half are over the age of 65 years. Many need help at home right now or will very shortly. The cost of in-home care has increased substantially over the last ten years, which adds to the tremendous challenge of finding affordable care at home for our Veterans. Luckily, the Veterans Affairs (VA) has several programs to help when care is needed. Veterans have several options to help them at home, including specific types of care services such as personal care, medical care, meal preparation, and housekeeping. The VA provides critical programs to help cover costs for home care, such as the Aid and Attendance program and the Homemaker/Home Health Aide program. Most people have heard of the Aid and Attendance program, a VA pension program veterans must qualify for. In a nutshell: This is a benefit for Veterans or Surviving Spouses who meet eligibility requirements regarding: 1. Military service 2. Net worth limitations 3.Disabilities and level of care 4. Income The Homemaker/Home Health Aide program is a medical benefit for veterans. This is not as well known. 1. This program only covers veterans with medical needs requiring additional support at home. 2. The Veteran must be registered with their local VA office and be seen by a VA doctor at least once a year. 3. Once a VA doctor sees the Veteran, the Veteran is also assigned a social worker to help navigate the VA system and available programs. 4. During their doctor visit, the Veteran or their family can request additional support at home, and the doctor and social worker will assess if they qualify for the program. During this assessment, the VA doctor determines if the Veteran does indeed qualify for additional support and how many hours they qualify for. 5. The doctor or social worker can then refer to the Homemaker/Home Health Aide program. 6. If the Veteran’s primary caregiver is living with the Veteran, then the Veteran often qualifies for their respite program. This program is an additional 30 respite days per calendar year. A respite day is six hours of care provided by an accredited VA In-Home Care company to allow the primary caregiver of the Veteran to have extra time off above and

AGING WELL MAGAZINE

beyond the hours provided for the Homemaker program. The VA does not discriminate where the Veteran lives for the Homemaker program. They can be at home, assisted living, residential, or memory care. The Homemaker hours awarded follow the Veteran wherever they call home.

A veteran could qualify for Aide and Attendance, the Homemaker program, and an additional 30 respite days. Each of these services provided by the VA can be complicated to navigate. The VA offers a community care hotline, and the County of San Diego also has a veteran support office to help guide our local veterans and their families through these services. However, it can still be challenging to qualify, so it’s highly recommended that you consult a local expert to help secure the benefits that Veterans have earned. Melanie L. Delgado is the owner of Right at Home, offering non-medical in-home care in San Diego East, Central, and South County. We support veterans through Aide and Attendance and the VA Homemaker program, and we assist lower-income individuals through contracts with PACE and support for CALAIM programs in California. Melanie is actively involved in the community, serving on the boards of East County Serving Seniors Providers (ECSSP), San Diego County Council on Aging (SDCCOA), National Placement and Referral Alliance (NPRA), and member of the South Bay Serving Seniors Providers (SBSSP). For home care or veteran support, contact us at wecare@homecare-sd.com or mdelgado@ homecare-sd.com.

EAT WELL

Now’s the Time to Embrace Healthy Eating

Making changes to your diet is an investment in your health and one that you won’t regret. Challenge yourself to make that commitment in 2024. Adding a bountiful selection of fruits and vegetables daily is a great start! Aging Well Super Antioxidant Smoothie 1 Cup Almond Milk 1 Cup Kale ½ Blueberries ½ Cup Purple Grapes ½ Cup Shredded Carrots 8-10 Almonds Add all the ingredients to a blender. Blend until smooth. Sip away and enjoy the start of a fabulous day. There are 100s of ways to create a smoothie with your favorite fruits and vegetables daily. Get creative and start blending. It’s so easy to drink fresh veggies and fruits daily.

Let Fruits and Veggies be the superstars of your diet in 2024. Antioxidants - Cherries, Strawberries, Watermelon Antioxidants & Cognitive Support - Blueberries Liver Health – Beets Fiber and Potassium – Bananas High Fiber - Raspberries Flavonoid Antioxidants – Red Apples Omega-3 Fatty Acids – Avocado Vitamin C, Flavonoids, and Fiber – Citrus Fruit Cleanse the Kidneys – Celery Kidney/Kidney Stones – Cucumbers Gastrointestinal issues – Cabbage Digestive System – Papaya Beta Carotenes, aka Vitamin A – Sweet Potatoes Cancer Fighters – Kale, Broccoli and Carrots Cholesterol - Tomatoes Vitamins A, K, and Folate – Spinach, Asparagus Phytonutrients – Garlic Bone Health - Prunes Vitamin C, A, and Fiber - Mangoes

*Always check with your healthcare professional before starting a new eating plan

agingwellpartners.com | ISSUE #4

RESOURCE GUIDE

Melina Rissone, REALTOR® (619) 865-6017 melina@melinarissone.com www.melinarissone.com As a SRES Associated Real Estate Broker with Coldwell Banker West, Melina Rissone’s mission is to support active adults and seniors with their real estate planning. She understands the emotional demands and can help minimize them. She takes the no-pressure approach to the transaction and is 100% service oriented..

Daniel Sweiger, Owner (760) 448-1021 Dan.Sweiger@brightstarcare.com www.brightstarcare.com/carlsbad A family-owned & operated company providing award-winning home care services. We help seniors and others with medical challenges remain home longer -- safely and comfortably. Our full range of services includes companion care, personal care, skilled nursing, and specialized support for those living with Alzheimer’s, dementia, and Parkinson’s.

Patti Gerke, REALTOR® (760) 525-7269 patti@pattigerke.com www.agingwellpartners.com/partners/pattigerke-realtor/ Patti Gerke is a Senior Real Estate Specialist® (SRES®) and a Certified Residential Specialist® (CRS®). Whether downsizing, distributing estate assets or moving across the country, Patti’s #1 mission is to provide each client compassionate perseverance to provide resources, expertise and guidance through the real estate planning and selling journey.

Jennie MacGoy Yoga (703) 579-0123 jennie@jenniemacgoyyoga.com www.jenniemacgoyyoga.com Specializing in providing gentle yoga and movement to people living with persistent and chronic pain, who are new to yoga, or don’t think yoga is for them. Visits to your home, park, or beach utilizing the extensive study of anatomy, strengthening, and restorative rest as it relates to yoga.

Joseph M. Casciani, PhD (858) 272-3992 jc@livingto100.club www.livingto100.club Dr. Joe Casciani is the Chief Curator for the Living to 100 Club, a source of solutions to living longer and healthier: with a special focus on mindset, outlook, and positive attitudes about aging. He offers individual coaching sessions for seniors and their families to help cope with aging.

George G. Glenner Alzheimer’s Family Center (619) 543-4704 information@glenner.org www.glenner.org The George G. Glenner Alzheimer’s Family Centers, Inc.® provide specialized day programs for seniors with Alzheimer’s and other forms of dementia. Care is available Monday through Friday with full-day and half-day rates available. Each center offers structured, therapeutic activities and socialization in a safe, secure, family-like environment.

Bob Heck & Joan Chintz, Broker Associates (310) 251-7158 Rtheck007@gmail.com www.agingwellpartners.com/partners/ chintz-team-real-estate-professionals/ Joan Chintz, Certified Probate & Trust Specialist has the experience in real estate that gives you peace of mind. Bob Heck has been a Senior Transitioning Specialist for over a decade. They understand transitioning into your next chapter in life and they’ve got you covered. Local Expertise. Global Connections.

St. Paul’s PACE (619) 677-3800 info@stpaulspace.org www.stpaulspace.org St. Paul’s Program of All-Inclusive Care for the Elderly (PACE) is a managed health care plan exclusively for seniors. As part of St. Paul’s PACE, you receive primary medical care, medication management, physical therapy, specialty services, in-home care, social work assistance, and transportation to and from the medical center.

Sean Kuhn (619) 391-8688 info@kuhnphysicaltherapy.com www.physio-on-the-go.com/ Physio on the Go is here to provide clients with a unique, highly individualized, and convenient model of care, that brings selfcare, wellness, and physical therapy directly to you—online or at home. Our mission is to empower clients to improve their health and enhance their longevity.

Bryan Devore (760) 908-3838 Bryan@DevoreRealtyGroup.com www.devorerealtygroup.com The Devore Realty Group provides three home selling options traditional home sale, renovate-to-sell, and as-is sale. Included in each home sale option are FREE downsizing services, and if you are considering a move into a senior community, we can help defer your move-in costs until after your home sells.

AGING WELL MAGAZINE

San Diego Oasis (619) 881-6262 info@sandiegooasis.org www.san-diego.oasisnet.org Oasis is a unique educational program for adults 50+ who want to continue to learn and be productive throughout life. Membership is free and open to anyone 50 or older. Join Oasis and enjoy stimulating classes and opportunities to serve your community. Julie Derry (619) 378-6895 julie@aging123.com www.aging123.com At Aging123, we specialize in educating, advocating and navigating the placement journey for aging adults and their loved ones. We’ve toured and inspected all Assisted Living and Memory Care homes and communities we refer our clients to; all you have to do is make the choice that’s right for YOU. Silver Linings Transitions (760) 522-1624 info@silverliningstransitions.com www.silverliningstransitions.com Senior Move Managers, we assist adults and their families with the emotional and logistical aspects of relocation– whether it’s to a smaller space, moving to be near family, or moving into a senior living residence. Let Silver Linings Transitions take the worry (and work!) out of the moving process. Jacqui Clark (760) 218-9866 Jacqui@LivingCoastalSR.com www.agingwellpartners.com/partners/ living-coastal-senior-resources/ Living Coastal Senior Resources have the knowledge and experience to solve the many challenges that can come with aging. We consult, advocate, and oversee the entire process of aging in place at home, managing disease, or finding the right assisted living or memory care. Age well with the right choices. Jacqueline Silverman (858) 395-7733 jacqueline@agingadvisoryservices.com www.agingadvisoryservices.com Aging Advisory Services promotes aging in place by helping older adults in the San Diego Region better understand, plan for, and manage changes associated with aging. We offer home safety assessments, referrals, and consultation services to enable people to live safely and comfortably in the residence of their choice. Nona’s Home Care (619) 788-4459 info@nonashomecare.com www.nonashomecare.com At Nona’s Home Care, our caregivers have been thoroughly trained and practiced in providing the best home care assistance while catering to the specific needs of each client. We bring the highest quality care to you, so that you may thrive in your most comfortable, and familiar environment.

Holli Bennett (619) 832-6963 holli@coastcare.org www.coastcarepartners.com We are a compassionate, non-medical home care agency servicing San Diego County. Our trained caregivers provide personalized assistance, promoting independence and enhancing quality of life empowering exceptional care and peace of mind for families. Harmony Home Medical (858) 560-8177 erica@harmonyhomemedical.com www.harmonyhomemedical.com Harmony Home Medical Supply is a medical equipment and home accessibility retailer that has been serving San Diego County for the last 15 years. They provide the products and services that can help someone live more independently and safely wherever they call home. They are truly a one-stop-shop for Aging-In-Place. Melanie L Delgado; Owner (619) 937-2330 wecare@homecare-sd.com www.homecare-sd.com Right at Home provides quality in home care services in San Diego. Our caregivers are trained, bonded and insured to provide a wide range of services and specialized support for Alzheimer’s, dementia and Parkinson’s. An authorized agency for the VA we provide exceptional care to our area veterans as well. Now Haus ADU, LLC Bill Adamas (619) 537-0066 Hello@Now-Haus.com www.NOW-HAUS.com Now Haus ADU, LLC. is a residential real estate development company specializing in ADU’s (Accessory Dwelling Unit) and Lot Splits. The new law SB9 allows innovative options for seniors to age in place and increase their retirement nest egg. We offer free property analysis and onsite consultations with homeowners looking to maximize their property’s potential. Rehburg Life Insurance Settlements Lisa Rehburg (714) 349-7981 Lrehburg@aol.com www.rehburglifesettlements.com We are life settlement brokers, helping clients sell their life insurance policies for cash. This cash can be used for anything, including saving for retirement, debt repayment, and long-term care. Our fiduciary duty is to our client to market their policy to obtain the highest amount of money that we can.

agingwellpartners.com | ISSUE #4

CARE WELL

There’s No Place Like Home (Care)

orothy was right. There’s no place like home. Of course, as we age, the declining ability to perform daily activities independently, such as dressing, bathing, and eating, makes it harder to stay home safely and comfortably. Risk factors for seniors living alone include falls and accidents, declining hygiene habits, poor nutrition, social isolation, medication errors, and inadequate physical activity. That’s where home care can help. Home care is a service that can provide individuals with medical, social, and personal care in the comfort of their own homes. This type of care is becoming increasingly popular as more people recognize its benefits. Home care services can also help individuals maintain their independence, overall health, and quality of life. By assisting with daily tasks, such as bathing, dressing, cooking, and remembering to take medications, home care services can help individuals continue to live independently in their own homes. By providing preventive care and monitoring, home care services can mitigate individuals from costly hospital stays, a goal everyone seeks. There are over 50 million unpaid family caregivers in the US, providing an estimated $470 billion of free labor. That’s a tremendous burden, and the “Silver Tsunami” will push us all to our breaking point. Experts project that by 2035, seniors will account for as much as 32% of the US population. They say at that point, adults 65+ will outnumber children under 18. Family caregivers often feel like they are the housekeeper, the repairman, the laundry person, the nurse, and the cook. Instead of feeling like chores are never-ending, a home care agency can handle those tasks so families can spend more time making memories with loved ones. Depending on how many hours or days are needed, the cost of home care can be less than that of moving into assisted living or memory care full-time care. 28

AGING WELL MAGAZINE

Home care is a broad range of personal and companion services tailored to each client’s needs. But I like to think of it as having a well-trained “personal assistant” who can help a little or a lot with whatever activities of daily living are becoming more challenging. Sometimes, we help people in unique and unpredictable ways. We once had a caregiver in San Diego who took a 90-yearold grandma to her grandson’s wedding out of town. Besides helping her get around in her wheelchair and attending to her needs, the caregiver was under strict orders from the family to water down grandma’s drinks. Grandma had such a good time that she tried to get the caregiver to stop at a liquor store on the way home so she could smuggle alcohol back into her assisted living community. We had to decline that last part politely, but you must admire Grandma’s zest for life! Sometimes, it’s the simple things that make the most significant difference. A family hired a caregiver to be a “workout buddy” for their mom, who had early-onset Alzheimer’s. She lived in a secured memory care unit, and the caregiver would take her out to the gym and ensure she got back safely. This may seem atypical; it should be the standard to help people keep doing what they love. Here’s to a new way of looking at aging. Dan Sweiger owns and is President of BrightStar Care of Carlsbad, the #1-rated home care agency in San Diego via Home Care Pulse. The award-winning in-home support services include companion care, personal care, and skilled nursing. Caregivers are trained and supported by an RN Nursing Director to provide timely advice and intervention when issues arise. Brightstar clients are 25% less likely to be hospitalized. BrightStar Carlsbad (760) 330-5081.

VISION OF AGING

Embark on a stimulating journey through this challenging word search puzzle, teeming with words that celebrate a positive vision of aging!

ANNIE’S

SUDOKU

9 6

4 2

8 7

6 3

5 3

7 2

9 8

P X Q E T H R I V I NG V A B J C A D F I B I N S P I R E D C E L E B R A T E D Z Q E N Y Q T C P MA J E S T I C N R R Z E S T E E M E D T K E D E I E M P OW E R E D I X M U S V R R N L E Q I P NMC B R I T R E J U V E N A T E DO I L A R V F I R S H J S L I L N I S A E D L L T P D T EWD G E P D R GQ E L U I I S I E V N R I E F R F C U R R S S N A T I A D A E A L T M I I E E L HG N E S C X C T I I N T DU OH T L P L C P I H V NG E E N T E O R F MO E O R E A X DO L V Q Y C QGMR U I D T C R Y E U R GH E R P I S V C E E P R E F L F E G A L E P I U D S G N L O F H R U T I N U NWP R T OWU V A I W E S C F G A E A U I L I C R S G F H E Z R E F R N F B E HMH K U E D K N F I G I R F O B O E V L D L X I S S L A U G E ONDGG I G R H E L N L K A V D I P U N MM I R E T L P K C D A O Y G M E N E D J U B I L A N T U R DDGN E N R I C H E D K I S O E Z E M P A T H E T I C N J Accomplished

Rejuvenated

Illuminated

Wise

Flourishing

Harmonious

Experienced

Spry

Emboldened

Empathetic

Celebrated

Esteemed

Sprightly

Cherished

Sparkling

Vibrant

Reﬂective

Evergreen

Fulﬁlled

Graceful

Resilient

Nurturing

Empowered

Radiant

Gracious

Enduring

Thriving

Timeless

Spirited

Thriving

Eloquent

Enriched

Grateful

Jubilant

Majestic

Inspired

Serene

Aﬃrmed agingwellpartners.com | ISSUE #4

COPE WELL

No Fear

HOSPICE COMFORTS THE FEAR OF DYING

riving down the highway last week, I noticed the traffic flow suddenly halted as the procession of automobiles became a sea of brake lights and lane mergers. An accident two miles north caused a reverse domino effect, and cars sprang into a collective pause. As I waited with other drivers, each eager to reach their destinations, I took a moment to appreciate the variety of vehicles and the kaleidoscope of colors around me. I was drawn to the assortment of car brands and vanity license plates and then to a sticker in the rear window of a pickup truck to my right. It read ‘ No Fear ‘ in bright neon green with a sinister font. Chuckling to myself, I mused, “Hard to be human without fearing something.” This made me ponder the driver’s decision to display such a sentiment publicly. What deepseated phobia had they overcome to feel the need to declare victory over it? Was it a specific fear they had conquered, or was the sticker a bold statement that there’s simply nothing to fear? With traffic completely stopped, I drifted into thought. I regularly contend with my own phobias, with spiders topping that list. Common fears among people include public speaking, heights, snakes, enclosed spaces, germs, and crowds. Psychology tells us that fear is often linked to pain or the potential loss of life. It’s a foreboding emotion but can also serve as a protective mechanism, preventing us from exposing ourselves to harm. Eliminating fear entirely would be like a child ignoring the danger of strangers. Lessening fear could foster a deeper appreciation for humanity and its potential. However, it would also diminish the emotions we feel when facing the loss of loved ones. When confronted with the prospect of death, people experience panic, trepidation, angst, and grief. In essence, people fear death, both their own and that of those close to them. In my 20 years in the hospice and palliative care industry, I’ve observed that fear is the primary emotion that hinders patients and their families from addressing the genuine feelings they experience in distressing situations. Fear triggers heightened responses such as anger and rage, a fight-or-flight reaction resulting from acute stress, and an influx of adrenaline. Fear often takes over in life-or-death situations, leading to decisions made without much rational thought. Personally, I’m conflicted when counseling patients and families. I believe recognizing mortality should be everyone’s 30

AGING WELL MAGAZINE

starting point. Globally, people are educated about the human body’s limitations and are aware of diseases and illnesses that can alter their life’s trajectory. At the very least, everyone knows they won’t live forever. So, when hospice care becomes a topic of discussion with patients, the surprise, anger, and resentment I encounter are disheartening. While I understand the tears from the emotional devastation that comes with facing the end of life, I find the denial that often overrides the decision to accept comfort care disconcerting. The Medicare hospice benefit, initiated in 1982, was designed for patients needing symptom management for seriously acute or chronic illnesses, offering an alternative to traditional curative efforts. Patients with advanced cancer, cardiac failure, respiratory disease, dementia, and other endstage conditions now had the option to receive care aligned with their wishes, focusing on symptom management through medications, medical equipment, and clinical staff visitation. In 2024, 42 years later, hospice services have expanded nationwide, available in both urban and rural settings. Patients and families often tell me, “It is a blessing to have this service at this crucial time in life. We only wish we had chosen this direction sooner.” Hundreds of patients echo this sentiment, “If only I had known…” The primary reason they didn’t know about hospice care sooner or were unprepared to accept it is fear. Physicians are typically hesitant to offer comfort care as an option, as forgoing treatment is seen as an unconventional choice. Trained to treat, doctors often fear the patient’s or their family’s reaction to stopping aggressive therapies, even when such methods may be detrimental to the patient’s overall condition. Deciding when and how to suggest comfort care is daunting for physicians. Patients with advanced, life-limiting illnesses and their doctors face the same dilemmas: When is ‘enough’ truly

enough? How can anyone be certain that nothing more can be done? What can help alleviate the fear and anxiety associated with the decision to cease treatment? Fear remains the obstacle that clouds honest conversations between physicians, seriously ill patients, and patients and their families. Yet, these difficult discussions are essential. Without exposure to avenues that promote emotional and spiritual acceptance, patients with advanced illnesses often find that the hospital becomes the place where they take their last breath – an outcome most people do not desire for themselves or their loved ones. I’ve realized that merely making the hospice benefit available is not enough. Promoting hospice services to medical professionals in chronic disease management settings is not as direct an educational endeavor as needed. At this point in healthcare, hospice professionals and physicians together must recognize the importance of addressing a dying patient’s fear of death. They must do this while simultaneously offering a pathway that replaces aggressive treatment with steadfast comfort. I was suddenly redirected back to the traffic as it began to

inch forward in unison. Passing the truck with the ‘No Fear’ sticker, I glanced at the driver, who appeared as frustrated as everyone else stuck in the gridlock. Like all of us, they were eager to return to a life of peace and comfort – a universal desire we all share. Cameron Svendsen, a seasoned Licensed Clinical Social Worker with over 25 years in the senior industry, is the Chief Strategy Officer for a leading hospice and palliative care company in Phoenix, AZ, and San Diego, CA. With 15 years dedicated to hospice and palliative care, Cameron focuses on patient advocacy and business development, contributing to innovative care strategies. A passionate advocate for seniors’ quality of life, he is also a public speaker on Advance Care Planning, Brain Health, Legacy Building, and Senior Lifestyle Adaptation. Cameron is set to launch his book, “Finally Fearless: Solving the Greatest Fears Around Death and Dying,” in 2024, addressing challenging aspects of end-of-life care in America. agingwellpartners.com | ISSUE #4

MAGAZINE www.agingwellpartners.com

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