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A special Senior Living Guide published by The Daily Nonpareil Also online at www.NonpareilHealth.com

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Miller Orthopedic treats conditions or injuries relating to bones, joints, ligaments and muscles. Our goal is to get you back to optimum health as quickly and safely as possible. We will recommend a treatment program that fits your individual needs. Our services range from in office conservative care and diagnostic tests to inpatient and outpatient surgical procedures.

Dr. Daniel Larose

Dr. Roy Abraham

Sports Medicine Specialist

Dr. C. Kent Boese

Dr. Huy Trinh

Dr. Thomas Atteberry

Spine Specialist

Sports Medicine Specialist

Dr. Inderjit Panesar

IT’S QUALITY OF LIFE.

Dr. Bradley Copple

Total Joint Specialist

Dr. Caliste Hsu

Hand & Microvascular Surgeon

Podiatric Surgeon

Total Joint & Sports Medicine Specialist

Theresa Gallo PA-C

Podiatric Surgeon

One Edmundson Place • Suite 500 • Council Bluffs, IA 51503 Omaha Clinic • 16221 Evans Plaza (South of 162nd & Maple) 712.323.5333 • www.millerortho.com 14188 Senior Living & Care Guide Cover.indd 2

10/11/2013 12:36:22 PM


Someday is not the time to plan your funeral or memorial service.

Call to start Pre-Planning

Today!

1221 N. 16th Street Council Bluffs, IA

712-256-9988 Mike Hoy

Funeral Director

Bud Kilnoski

www.HoyFuneral.com


4 Senior Living & Care Guide 2013

Table

Contents

Senior Living & Care Guide

of

Table of Contents

Improving heart health need not be difficult.............................................5 Advice for aging athletes..........................................................................6 Feature Page IWCC offers Continuing courses for ..... seniors. Southwest 8Education is all about seniors 5 ...........................8 Aging notMobilis always provides the culpritspecialty behind cataracts........................................11 products ..... 7 Financial pointers for What older,isunmarried couples.....................................12 assisted living? ..... 9 Is assisted livinghelps right local for you? ..... 11and women........14 County Veterans Affairs office servicemen Making the decision to leave home ......................................16 12 A checklist for choosing an assisted living facility. Supporting your loved ones ..... 13 Treat sleeplessness with vitamins and supplements..............................19 A checklist for choosing an assisted living facility ..... 14 Glossary of Glossary senior housing terms. ..........................................................20 of senior housing terms ..... 19 Preparing for hospice care. . ....................................................................24 Living at home: Tips for a safer environment ..... 25 RetirementOvercoming information emotional for medicare beneficiaries.................................25 roadblocks ..... 26 to start receivingstill retirement benefits ..... 28 AreWhen expired medications safe?.........................................................28 Long-term explained ..... 30 .........................29 Physical therapy a vital part of care treatment and recovery. Veteran benefits available for seniors ..... 30 What is Parkinson’s disease?���������������������������������������������������������������� 30 Assisted living financial worksheet ..... 33 The basics of atrial fibrillation.................................................................31 Paying for assisted living and other types of care ..... 34 When is the right time to leave home?...................................................32 Assisted living financial worksheet.........................................................33 Shedding pounds after 50......................................................................34

Advertiser Directory Advertisers (Alphabetical)

Business Page

American Travel Center ..... 9 Miller Orthopedic Specialists....................................................................2 Bellewood Courts ..... 9 Hoy-Kilnoski Funeral Home......................................................................3 Bethany Heights .....14 Angels Home Health.................................................................................5 Caretech, Inc. .....14 The Center................................................................................................7 Council Bluffs Foot & Ankle Care ..... 5 Daily Nonpareil .....8,10 Boys Town................................................................................................8 Dickinson Investment Advisors ..... 5 Immanuel Pathways. ...............................................................................10 Dr. Farid Sadr .....22 Bluffs Acres............................................................................................11 Glen Haven Home ..... 6 Bethany Heights......................................................................................12 Home Instead .....29 Hospice with Heart..................................................................................13 Hoy-Kilnoski Funeral Home ..... 3 Audiological Services, Inc.......................................................................14 Hy-Vee Drugstore .....31 Dr. Farid Sadr.........................................................................................15 Iowa Heart Center .....Inside back cover Caretech, Inc...........................................................................................16 Jennie Edmundson Hospital ..... 7 Kanesville Heights .....12 Dickinson & Clark, CPA..........................................................................18 Midlands Living Center .....32 Mobilis, Inc.............................................................................................20 Miller Orthopaedic Affiliates, P.C. .....Inside front cover Super Saver............................................................................................21 Mobilis, Inc. ..... 6 CVS Pharmacy........................................................................................23 Monarch Villa .....13 Ridge Family Practice.............................................................................25 Primrose Retirement Community ..... 8 Real Estate Equities/Village Risen SonCooperative.................................................26 Christian Village .....Back cover Glen Haven Home...................................................................................27 Southwest 8 Senior Services .....11 Southwest 8 Senior Services..................................................................28 Struyk Turf .....16 The CB Center .....18 Primrose.................................................................................................29 The Rose of Council Bluffs .....27 Iowa Hospice by Harden Healthcare.......................................................32 Touching Hearts at Home .....14 West Broadway Clinic.............................................................................35 West Broadway Clinic .....21 Risen Son...............................................................................................36


Improving heart health need not be difficult Metro Creative Connection Heart disease is one of the leading causes of death across the globe. According to the World Health Organization, ischaemic heart disease, in which blood supply to the heart is reduced, is the leading cause of death in middle- and highincome countries and the fourth-leading cause of death in low-income countries. Perhaps the most troubling fact about the prevalence of heart disease is that it can be largely preventable. The American Heart Association notes that there are several ways to easily improve heart health and avoid becoming one of the millions of people to succumb to heart disease. • Embrace aerobic exercise. Aerobic exercise is essential to cardiovascular health. Daily aerobic exercise, which can be as simple as walking around the neighborhood, can help men and women lower their blood pressure, maintain a healthy weight and lower their bad cholesterol, which can circulate in the blood and cause blockages that can lead to heart attack. • Adopt a low-sodium diet that’s also low in cholesterol. Diet can be a friend or foe with regards to heart disease. A heart-friendly diet that’s low in sodium and cholesterol can help you maintain healthy cholesterol levels as well as a healthy blood pressure. • Monitor your blood pressure. A blood pressure reading is a staple of many doctor visits, but men and women should monitor their blood pressure even when they aren’t visiting their physicians. High blood pressure does not always produce symptoms, but that doesn’t mean it isn’t potentially deadly. High blood pressure is the leading cause of stroke and can contribute to heart and kidney disease. So be sure to monitor your blood pressure and discuss with your physician ways to lower high blood pressure.

ANGELS CARE HOME HEALTH

WHAT WE DO

Here is what h t we can do d ffor you! t4LJMMFE/VSTJOH t'BMMT1SFWFOUJPO t8PVOE$BSF t#MPPE(MVDPTF.POJUPSJOH t%JTFBTFNBOBHFNFOUBOEFEVDBUJPO t.FEJDBUJPONBOBHFNFOUBOEFEVDBUJPO t"OPEZOFÂŽ5IFSBQZGPSOFVSPQBUIZ  BOEXPVOET t$PNNVOJDBUJPOCFUXFFOZPVBOE ZPVSEPDUPS t#MPPEESBXTJOUIFIPNFGPSBOZMBCT ZPVNBZOFFE t1IZTJDBM5IFSBQZ 0DDVQBUJPOBM5IFSBQZ  BOE4QFFDI5IFSBQZ t)PTQJUBM5SBOTJUJPOBM$BSF1SPHSBNT  $)' )FBSU"UUBDL 1OFVNPOJB

4FSWJOH

$PVODJM#MVGGT and surrounding areas 712-352-3640 www.angelscarehealth.com


6 Senior Living & Care Guide 2013

Advice for aging athletes Metro Creative Connection Retired professional athletes often speak about the difficult moment when they knew it was time to retire from professional competition. The transition can be easy for some but far more difficult for others. But aging amateur athletes know you need not be a professional to realize there comes a time when your body is telling you it’s time to ease up. Athletes are used to pushing themselves and stretching their limits, but some limits are best not pushed. Such is the case with the limits posed by aging. While athletes don’t have to completely fold up shop and hang up their cleats, tennis shoes or other athletic equipment as they approach senior citizen status, there are steps aging athletes can take to ensure they aren’t pushing their bodies too far as they grow older. • Recognize your new recovery time. Veteran athletes tend to have a sixth sense about their bodies, knowing how long they need to recover from common ailments like ankle sprains, knee pain, back pain and shin splints. Despite the body’s remarkable ability for recovery, it’s not immune to aging, and that recovery time will increase as the body ages. Whereas a sprained ankle might once have been as good as new after a few days or rest, aging athletes must recognize that the same ankle sprain now might require more recovery time. Returning too quickly from an injury can only make things worse for aging athletes, so don’t push yourself. • Take more time to warm up. As the body ages, its response time to exercise increases. This means the body needs more time to prepare itself

for cardiovascular and strength training exercises. Increase your warmup time as you age, gradually increasing the intensity of your warmup exercises until your body feels ready for more strenuous exercise. • Focus on flexibility. The more flexible you are, the more capable the body is of absorbing shock, including the shock that results from repetitive activities. But as the body ages, it becomes less flexible, which makes it less capable of successfully handling the repetitive movements common to exercise. Aging athletes should focus on their flexibility, stretching their muscles before and after a workout. In addition, activities such as yoga can work wonders on improving flexibility for young and aging athletes alike. • Don’t stop strength training. Some aging athletes mistakenly feel they should stop strength training as they get older. No longer concerned about building muscle, aging athletes might feel as if they have nothing to gain by lifting weights and continuing to perform other muscle strengthening exercises. But the body gradually loses muscle mass as it ages, and that loss puts the joints under greater stress when aging athletes perform other exercises. That stress can put people at greater risk for arthritis, tendinitis and ligament sprains. While you no longer need to max out on the bench press or challenge yourself on the biceps curl, it is important to continue to make strength training a part of your fitness regimen as you age. Aging athletes need not associate aging with ceasing their athletic pursuits. But recognizing your limitations and the changes your body is going through is an important element of staying healthy as your approach older adulthood.


Thank you, Council Bluffs, for voting

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Guest must be 50 years of age or older and complete a guest registration card. Signed Waiver and Release of Liability required for guest to participate. All Center policies, guidelines and procedures apply to all using facility. One coupon per person. Expires 11-30-2013

Make new friends, learn new skills, get healthy, feel better, have fun!

714 S. Main Street • Council Bluffs, IA 51503 712-323-5995 www.thecbcenter.org


8 Senior Living & Care Guide 2013

IWCC offers Continuing Education courses for seniors Ashlee Coffey acoffey@nonpareilonline.com

L

earning doesn’t stop after formal education ends. It continues on for every age, including senior citizens. For the life-long learners out there, Iowa Western Community College offers courses geared towards every age through its Continuing Education Program. Located in the Looft Hall Conference Center on the Council Bluffs campus and at locations in Atlantic, Clarinda, Harlan and Shenandoah, the program is for “anyone who is a lifetime learner,” said Marcia Antworth, Business and Technology coordinator in the Continuind Education program. “We have a variety of classes designed for people

in their 20s and 30s, all the way up to people in their 80s and 90s,” Antworth said. “We’ve done some youth programming in the summer, also.” Antworth noted that the program is “huge.” “We had 466,807 contact hours and 37,916 enrollments in Continuing Education for July 1, 2012 through June 30, 2013,” she said. According to Denise Norman, Continuing Education coordinator, all of the general interest classes are geared towards any adult age group, including senior citizens. “We offer a lot of arts and crafts classes, painting classes and iPad basics classes that seniors might enjoy,” Norman said. “Also, the cooking classes are popular with all ages, too.” Other popular classes among seniors include photography, home and garden, music lessons,

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yoga and other dancing classes, and floral design, where students learn how to put together bouquets. “We just have a wide variety of classes,” Norman said. “We try to offer what’s trending – pretty much what the community’s needs are. We try to keep up with all of that.” Norman said “there are quite a few seniors” participating in general interest classes – though she couldn’t give exact numbers for sure. “Most are taking classes just for fun because they’re interested in life-long learning,” she said. “I think of one woman who is retired from Iowa Western and she takes as many classes as she can. She has time to take them since she is retired.” While the college doesn’t offer a senior discount towards classes, Norman said they try to keep the cost low so “anyone can afford to

Senior Living & Care Guide 2013 9

Classes generally range from $19 to a couple hun-

dred dollars depending on the course, according to college officials. Financial assistance is available to

those interested or in need. For students in need of financial assistance for a noncredit course, there are several options available based on eligibility.

For seniors interested in continuing their passion for learning, Norman said to just contact the

Continuing Education department at (712) 3253255 or email ce@iwcc.edu. People can also visit

the website – www.iwcc.edu/continuing_education – or stop by the office for more information. The

Continuing Education program is located in the

Looft Hall Conference Center on campus, 2700 College Rd. “We also send out a catalogue twice a year – in

January and August. It has all the classes listed

but we’re always adding classes,” Norman said. “They can call any time and we can sure send them the information. We all enjoy talking about the classes we have to offer.”


Your home.Your care.Your pace.

Our program provides a comprehensive system of health care. The model of service is PACE: Program of All-inclusive Care for the Elderly. Our program includes primary, acute and long-term health care as well as therapeutic and recreational center services and transportation. Services are provided in the home, in the community and at our PACE Center. For complete program details and beneďŹ ts, please call 712-256-PATH (7284).

1702 N. 16th Street Council Bluffs, IA 51501 www.immanuelpathways.org

PACE participants may be fully and personally liable for the costs of unauthorized or out-of-PACE program services. Emergency services are covered. Participants may disenroll at any time.


Senior Living & Care Guide 2013 11

Aging not always the culprit behind cataracts Metro Creative Connection Many men and women develop cataracts as they approach their golden years. While aging is the single biggest risk factor for cataracts, there are other factors that can contribute to cataracts, which can afflict people of all ages. According to the American Optometric Association, the following factors can contribute to the development of cataracts. • Alcohol consumption: Studies have shown that higher alcohol consumption can increase a person’s risk of developing cataracts. • Diabetes mellitus: Persons with diabetes are at a higher risk of developing cataracts than those who do not have diabetes. • Medications: Certain medications have been associated with the development of cataracts. Corticosteroids and chlorpromazine and other phenothiazine related medications have been linked to cataracts in the past. • Nutrition: Men and women who do not eat a nutritious diet may be increasing their risk of developing cataracts.

LOW TAXES

The AOA admits studies examining a potential link between nutrient deficiency and cataracts are inconclusive, but studies have suggested there is such a link between the formation of cataracts and low levels of antioxidants like vitamins C and E. • Smoking: Smoking can increase a person’s risk for a host of ailments, including cataracts. • Ultraviolet radiation exposure: Persons who aren’t adequately protected when exposed to ultraviolet, or UV, radiation have a greater risk of developing cataracts. Some people may be born with cataracts or develop them during childhood. Such cataracts are known as congenital cataracts and may be the result of the mother having contracted an infection while pregnant. Kids born with cataracts may also have inherited them. For example, cataracts may be a side effect of Alport syndrome, a genetic condition characterized by kidney disease, hearing loss and abnormalities in the eye. Cataracts are often mistakenly considered a byproduct of aging. But not every aging man or woman will develop cataracts, and not all cataracts are a byproduct of aging. Learn more at aoa.org.

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12 Senior Living & Care Guide 2013

Financial pointers for older, unmarried couples Metro Creative Connection Moving in together is something typically associated with young couples, but more and more unmarried men and women over the age of 50 are choosing to cohabitate. According to an analysis of 2012 U.S. Census data conducted by the Performance Reference Bureau, roughly 10 percent of the 15.3 million opposite-sex unmarried cohabiting partners in the United States are between the ages of 55 and 64, while 15 percent are between the ages of 45 and 54. Such figures indicate that living together as an unmarried couple is no longer exclusive to younger couples. The incentives for older, unmarried couples to cohabitate are similar to those for younger ones, but older couples should heed a few financial pointers before deciding to move in together. • Iron out the financial details ahead of time. Young couples who move in together often do so as a precursor to getting married. Such couples do not typically have much in the way of financial assets and, as a result, do not need to come to any formal agreement regarding their finances. Older couples, however, might be bringing a more substantial financial portfolio into the relationship, and these finances can complicate matters. Before moving in together, older couples should document their finances and how household expenses, including a mortgage if one exists, will be paid. Decisions regarding who will receive the tax breaks you might be eligible for when paying a mortgage should also be considered. Documenting your financial situation can protect your assets should you break up. If these arrangements are not documented, unmarried couples who break up could find themselves in a contentious financial battle not unlike couples going through a divorce. • Maintain some financial independence. Older, unmarried men and women who choose to cohabitate with their partners should still maintain some financial independence after moving in together. A joint checking or savings account might work down the road, but initially keep these accounts separate to avoid any disputes. Keep paying your own bills, including car payments

and credit cards, at the onset as well. • Update certain documents and policies. Upon your death, a partner with whom you cohabitate does not have the same legal rights of inheritance as would a spouse. As a result, it’s important for unmarried individuals who cohabitate with their partners to update their wills, especially if they have been cohabitating for an extended period of time and want their partner to be taken care of in case of their death. In addition to updating information regarding beneficiaries, older men and women might want to update certain information regarding their health, like who should take legal responsibility for medical decisions should one partner become incapacitated. In addition to updating your will, update any existing life insurance policies and retirement benefits to include your partner if you so desire. • Discuss any changes with your family, especially any children. When you make changes to your will, those changes will affect your beneficiaries. Upon making these changes, discuss them with your existing beneficiaries so your partner does not have to deal with relatives whose feelings might be hurt upon your death. This might not be an easy discussion, but you will want your partner to have your family as a support system upon your death. Older, unmarried couples are choosing to cohabitate more. While there are incentives to doing so, there are some precautionary measures couples should take before moving in together.

Proud to be part of this community BETHANY HEIGHTS 11 Elliott St. 712-328-8228 Alzheimer’s Support Group Meetings offered at 6:30 pm the last Tuesday of each month at Bethany Lutheran Home. Open to public. Call 712-328-9500 for details.

BETHANY LUTHERAN HOME 7 Elliott St. 712-328-9500


November is National Hospice and Palliative Care Month. Our staff provides the following hospice and palliative care services:

•Hospice House •Medications and treatments related to patient’s terminal diagnosis •Durable Medical Equipment (i.e. hospital bed, walker, oxygen, etc.) •Nursing services •Nurse on call 24 hrs a day for emergencies •Social work services •Chaplain services •Hospice aide services •Volunteers •In-patient respite care at an approved facility for up to 5 days •Acute continuous care •Dietician services •Physical, occupational and speech therapies •Continuous care in a patient’s home in an acute crisis •Short stay in-patient care at an approved facility to treat out-of-control symptoms which are unable to be managed at home •Bereavement services for up to 13 months following the death of a loved one •Pet Therapy •Pet Pet of Mind Program •Music Therapy

300 W. Broadway, Suite 114 Council Bluffs, IA 51503

(712) 325-6802

Glenwood Hospice House 357 Indian Hills Drive, Glenwood, IA 51534

(712) 527-4660

www.hospicewithheart.org Proud MeMber of the CounCil bluffs ChaMber of CoMMerCe


14 Senior Living & Care Guide 2013

County Veterans Affairs office helps local servicemen and women TIM ROHWER timothy.rohwer@nonpareilonline.com

O

ne might say Darlene McMartin, director of the Pottawattamie County Department of Veterans Affairs, wears many hats because she and her staff provide many services to county veterans and their families. To be a good communicator is one of those duties. “Interviewing skills are important to find out what needs they have. Every veteran has a different need.” McMartin regularly speaks at veterans organizations and civic clubs about the services her department provides, she added. “We do a lot of outreach programs, speak-

ing engagements. I spoke at the Vietnam Vets Southwest Iowa Last Person Club. They meet once a year to honor those who passed on.” She and her staff also travel to county nursing homes and assisted living facilities, as well as visits to the home to keep veterans aware of benefits available. “Our primary purpose is to file for benefits to veterans, whether it’s county, state or federal benefits” McMartin said. “We try to get them enrolled.” Veterans are also referred to other agencies for more specific needs. For example, many are told to seek help from the West Central Community Action Agency for home heating assistance, she said. The local men’s shelter, overseen by Pastor

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Senior Living & Care Guide 2013 15

Harry Wallar, is contacted for housing homeless veterans, she said. “The number of homeless is increasing.” Her office helps veterans contact organizers on Honor Flights to see memorials in Washington. “I went on an Honor Flight and we assisted them there,” McMartin said. On an monthly basis, her office will receive 600 calls dealing with all sorts of issues, she said. About half of those callers will come into the office for more direct contact, with the rest having their concerns handled over the phone, she said. To help needy veterans, her office houses a small food pantry and clothing area. “The county doesn’t have money to put into that or it’s very minimal,” McMartin said. “We have wonderful organizations that contribute to our pantry. It’s not geared toward large families. We have just a little area with some shelves, and it’s for a short term situation.” Warm clothing, especially coats, are donated by

Dr. Sadr

Internal Medicine

712-308-1563 www.sadrmd.com 801 Harmony St, Suite 202 Council Bluffs, IA 51503

the public to help veterans, she added. And, any veteran can come in and take one. “It’s not an eligibility-based program.”

Staff photo/Kyle Bruggeman

Director of Veterans Affairs for Pottawattamie County Darlene McMartin poses for a portrait inside her office on May 30, 2013.

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Farid Sadr, M.D.

Wyatt Schmidt, Samantha PA-C Senanayaka, PA-C

3502 Metro Drive, Suite 200 • Council Bluffs, IA 51501 at Metro Crossing No

712-256-7172

appointment necessary

Hours: Monday - Friday: 8am-8pm; Saturday: 8:30am-3pm www.convenientcarecouncilbluffs.com


16 Senior Living & Care Guide 2013

A checklist for choosing an assisted living facility

When you are looking for an assisted living or residential care setting, please consider the following checklist to help you make the best choice to meet your individual needs. Licensure • Does the home have a current state license? If the answer is “no,” do not use the home. Certification and quality Review • Does the home have a formal quality assurance program? • Does the facility belong to a state care association? • Does the staff regularly attend educational programs to maintain or enhance there skills? Moving in • What does the moving in process entail? What are the paperwork requirements and the timeframes involved? • How is the initial personal needs assessment managed? Who completes the assessment? • Is the residence affiliated with a hospital or nursing home should acute or long-term care be needed? If so, is there a priority admission process? • If you need hospital or nursing home care, is your room held? What are the associated fees? Is there a discount for unused services (e.g. meals)? • Does the residence subscribe to a set of resident rights and responsibilities? Is a printed copy available? Service planning • Are the family and the resident involved in the service planning process? How often are resident’s needs assessed? Who completes the assessment? • Are there special programs for memory impaired residents and residents suffering with dementia? Are there accommodations for memory-impaired residents to be outside and exercise? • Are there special programs for residents with disabilities? • How are emergency situations managed? What is the

protocol for such events? Is a physician available in an emergency? • Will the facility assist in arranging for other medical services? • Will the resident’s personal physician be notified in an emergency? • Does the home have a transfer arrangement with a nearby hospital? Is emergency transportation readily available? • What happens if the health care needs of a resident change? Under what conditions are residents asked to move if there is a change in health status?

Services and activities • Does staff assist residents in administration of medication? If so, what kind of staff? • Must the resident use the residence’s pharmacy? Does the pharmacy provide a yearly review and consultation services? • Are there professional nursing services on site? If not, does the staff assist residents and families in making arrangements through a home health agency? • Are the services of a physical, occupational or speech therapist available or arranged? • Does the residence provide bed linens and towels? • Does the residence provide laundry service? • Are there beauty and barber shop services available on site? • Is assistance in bathing and personal grooming available? • What recreational and spiritual activities are available? Request or review a copy of the activities calendar. • Are arrangements made for residents to worship as they please? • Are activities planned around each resident’s individual preferences and life pattern? • Are group and individual activities available? • Are residents encouraged to participate?

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• Are outside trips planned? • Do volunteers work with residents? • Are the activity supplies available for resident use outside of scheduled programs? • Is transportation provided for medical appointments and recreational purposes? • Is there a resident council? How often does it meet? • What are the suggestion, complaint, or grievance procedures? • Are social services available to assist residents and families? Staff • Inquire about the residence’s staffing patterns and philosophy. • What training and qualifications are required for staff? Are there on-going training programs provided for staff? • Observe staff and resident interactions. Are they positive? Courteous? • Does staff show interest in and respect for individual residents? Do they know residents by name? • Is staff trained to protect resident dignity and privacy? • Does staff handle resident requests in a timely way? • Does the residence have a volunteer program? If yes, what types of activities do the volunteers perform? • Does the administrator/ director practice an “open door” policy to answer questions, hear complaints, or discuss problems?

Senior Living & Care Guide 2013 17

Costs and fees • What is included in the basic daily/monthly cost? Ask for a printed copy. • Does the residence have a written schedule of fees for extra services? If so, request a copy. • Under what circumstances might the fees change? How much notice is given if there is a fee increase? • Is there a security deposit? What is the refund policy? Are advanced payments returned if the resident leaves the home? • Can service agreements and/or contracts be amended or modified?

Location • Is the facility and environment pleasing to the resident? • Is the facility convenient for frequent visits of family and friends? • Is the location of the residence convenient to shopping, medical services, and entertainment areas? • Is the facility convenient for the resident’s personal physician? • Is the facility near a hospital where the resident’s personal physician practices? Cleanliness • Is the facility as clean as you set your personal standards? Lobby • Is the atmosphere welcoming? • Is the furniture attractive and comfortable? Are certificates and licenses on display? • Hallways • Are halls large enough for two-way traffic to pass easily? • Are halls well lighted?

Living space and accommodations • Are there adequate community areas for resident use? Is equipment (such as hobby supplies, easels, yarn, etc.) available? Are residents using equipment? • Are the resident rooms furnished or unfurnished? What is the policy about personal belongings? • What is the policy for overnight guests? Are there guestrooms available? What are the guest fees? Is outdoor furniture available for residents and visitors? • Is additional storage space available? Is there an extra fee? • Does the residence meet the rules for people with disabilities? • Can residents have automobiles? Is there assigned parking? Is there an extra fee? • Are there patios and courtyards available for resident use? Is there an area for resident gardening? • Is exercise equipment available? • Does the residence provide security? • Are pets allowed to reside in the residence? If so, are there additional fees and or deposits? If not, are pets allowed to visit?


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Senior Living & Care Guide 2013 19

Toilet facilities • Are toilets convenient to bedrooms? • Are they easy to use for a resident with physical challenges? • Is there a sink conveniently available to each bathroom or bedroom? • Do bathtubs and showers have non-slip surfaces and handgrips? Dining room and meals • Is the dining area attractive and inviting? • Are tables convenient for those with physical challenges? • Are personal food likes and dislikes taken into consideration? • Are special diets accommodated? • Does a dietician or nutritionist review the menus? Request or review copies of the menus • Is food tasty and attractively served? Ask to try a meal. • How often do the menus rotate? Are residents and families involved in the menu planning? • Are residents allowed to have guests for meals? Is there a separate guest dining room? • Are there reasonable choices of dining times? • Is there plenty of time allowed for each meal? • Are snacks available? • Is food delivered to residents unable or unwilling to eat in the dining room? • Are those needing help receiving it? Kitchen • Is the food preparation area separate from the dishwashing and garbage areas? • Is food needing refrigeration not standing on counters? • Does kitchen help observe sanitation rules? Your part • If you are selecting a facility for someone else, are you: • Involving this person in the choice? • Prepared to ease the resident’s transition to the home by being with them on admission day and staying a few hours to get them settled? • Ready to visit the resident frequently and to make sure those friends make similar visits? • Willing to provide the resident with the same amount of love in the facility that you would if they were at home? Waiting for placement • After you have identified an appropriate facility, you may find there is no vacancy. Put your name on the waiting list. In the meantime, check alternatives such as day care, night care, home health agencies and other community resources that

Treat sleeplessness with vitamins and supplements Metro Creative Connection Millions of people around the world battle insomnia. Sleeplessness may be a byproduct of different conditions, and treatment may depend on the underlying cause of the insomnia. Many people find using all-natural supplement therapy is enough to ward off sleeplessness. Insomnia is more prevalent among elderly individuals and women. Those who are looking for more natural approaches can use the following vitamins and minerals in conjunction with good sleep hygiene: • Calcium and magnesium combination: Calcium and magnesium have been shown to relax the central nervous system, helping the body drift into sleep. It is important to note that a balanced ratio of calcium to magnesium helps calcium work properly. It is recommended to take 500 mg of calcium and 250 mg of magnesium once per day, later in the evening. This can be done after dinner or a few hours before going to bed for best results. • Vitamin B6: Vitamin B6, also known as pyridoxine, is a water-soluble vitamin required for the synthesis of the neurotransmitters serotonin and norepinephrine. It also helps with myelin formation. Taking 50 mg of vitamin B6 daily can help in the production of serotonin and promote sleep. It is believed to work well for people who struggle to stay asleep through the night. • Vitamin B12 and vitamin B5 combination: Taking 25 milligrams of B12, especially when supplemented with vitamin B5 (pantothenic acid), can be a successful sleeplessness remedy. Vitamin B12 deficiency is quite common and is a factor for many patients who suffer from insomnia, especially seniors. Vitamin B5 may also relieve stress. • 5-HTP: Serotonin is a key neurotransmitter involved in sleep and mood, and 5-HTP, or 5-hydroxytroptophan, is a precursor to serotonin. It is recommended to take 100 to 300 mg, around 45 minutes before retiring for bed. Sleeplessness is something that can cause anything from mere annoyance to a long-term health problem.


20 Senior Living & Care Guide 2013

Glossary of senior housing terms This list can help you navigate commonly used terms and the different senior housing and care choices available. Accreditation: A seal of approval given by an autonomous governing body to a community or service provider. To become accredited, the community or provider must meet specific requirements set by the accreditation entity and is then generally required to undergo a thorough review process by a team of evaluators to ensure certain standards of quality. The accrediting organizations are independent, not government agencies or regulatory bodies. Some examples of accreditation bodies for the senior housing and care industry include CARF (Commission on Accreditation of Rehabilitation Facilities), CCAC (Continuing Care Accreditation Commission) and JCAHO (Joint Commission on Accreditation of Healthcare Organizations). Activities of Daily Living (ADLs): Bathing, eating, grooming, dressing, toileting and other day-to-day activities. ADA (Americans with Disabilities Act): Passed by Congress in 1980, this law establishes a clear and comprehensive prohibition of discrimination on the basis of disability. Administrator: In most cases, a licensed professional who undertakes the duty of managing the day-to-day operations of a care facility such as a nursing home or assisted living facility.

Making Life Accessible

Adult Day Care: Structured programs with stimulating social activities and health-related and rehabilitation services for the elderly who are physically or emotionally disabled and need a protective environment. The participant is usually brought to the care facility in the morning and leaves in the evening. Advantage list: List of health service providers that agree to give particular insurance company policyholders a preset discount. Aging in place: A concept that advocates allowing a resident to choose to remain in his/her living environment regardless of the physical and or mental decline that may occur with the aging process of aging. There is a wide range of home care services that can help you maintain your independence within the comfort of your own home. Alzheimer’s care center: A treatment center that specializes in providing care for those with Alzheimer’s disease with more of the care geared towards supervision of the patient in a safe and controlled environment. Alzheimer’s: A progressive, neurodegenerative disease characterized by loss of function and death of nerve cells in several areas of the brain, leading to loss of mental functions such as memory and learning. Alzheimer’s disease is the most common cause of dementia.

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Senior Living & Care Guide 2013 21

Ambulatory: The ability to walk freely and independently, not bedridden or hospitalized. Assessment: An evaluation, usually performed by a physician, of a person’s mental, emotional and social capabilities. Assisted living: It is a special combination of housing, personalized supportive services and health care designed to meet the needs – both scheduled and unscheduled – of those who need help with activities of daily living. Services provided in assisted living residences usually include: • Three meals a day served in a common dining area • Housekeeping services • Transportation • Assistance with eating, bathing, dressing, toileting and walking • Access to health and medical services • 24-hour security and staff availability • Emergency call systems for each resident’s unit • Health promotion and exercise programs • Medication management • Personal laundry services • Social and recreational activities Caregiver: The primary person in charge of caring for an individual with Alzheimer’s disease, usually a family member or a designated health care professional. Case management: A term used to describe formal ser-

vices planned by care professionals.

Charge Nurse: An RN or LPN who is responsible for the supervision of a unit within a nursing facility. The charge nurse schedules and supervises the nursing staff and provides care to facility residents.

Congregate Housing: Is similar to independent living except that it usually provides convenience or supportive services like meals, housekeeping, and transportation in addition to rental housing. (from ALFA)

Continuing Care Retirement Community (CCRC): Is a community that offers several levels of assistance, including independent living, assisted living and nursing home care. It is different from other housing and care facilities for seniors because it usually provides a written agreement or long-term contract between the resident (frequently lasting the term of the resident’s lifetime) and the community which offers a continuum of housing, services and health care system, commonly all on one campus or site. (from ALFA)

Continuum of Care: Care services available to assist individuals throughout the course of a disease. This may include Independent Living, Assisted Living, Nursing Care, Home Health, Home Care, and Home and Community Based Services. Convalescent Home: See Nursing Home.

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22 Senior Living & Care Guide 2013

Dementia: The loss of intellectual functions (such as thinking, remembering, and reasoning) of sufficient severity to interfere with a person’s daily functioning. Dementia is not a disease itself but rather a group of symptoms that may accompany certain diseases or conditions. Symptoms may also include changes in personality, mood, and behavior. Dementia is irreversible when caused by disease or injury but may be reversible when caused by drugs, alcohol, hormone or vitamin imbalances, or depression. Developmental Disability (DD): Affliction characterized by chronic physical and mental disabilities, which may include: cerebral palsy, retardation, thyroid problems, seizures, and quadriplegia. Director of Nursing (DON): A DON oversees all nursing staff in a nursing home, and is responsible for formulating nursing policies and monitoring the quality of care delivered, as well as the facility’s compliance with federal and state regulations pertaining to nursing care. Financial Counseling Programs: Help seniors with managing their finances, bills, and completing Medicaid, Medicare or insurance forms. HIPAA (The Health Insurance Portability and Accountability Act of 1996): This act became a law on January 1, 1997. The act states the requirements that a long term care policy must follow in order that the premiums paid may be deducted as medical expenses and benefits not paid be considered as taxable income. HMO: A Health Maintenance Organization (HMO) is an organized system for providing comprehensive health care in a specific geographic area to a voluntarily enrolled group of members. Home Health Care: Provision of medical and nursing services in the individual’s home by a licensed provider. Hospice Care: Philosophy and approach to providing comfort and care at life’s end rather than heroic lifesaving measures, it can include medical, counseling, and social services. Most hospice care is furnished in-home, while specialized hospices or hospitals also provide this service. Independent Living: Is a residential living setting for elderly or senior adults that may or may not provide hospitality or supportive services. Under this living arrangement, the senior adult leads an independent lifestyle that requires minimal or no extra assistance. Generally referred to as elderly housing in the government-subsidized environment, independent living also includes rental assisted or market rate apartments or cottages where residents usually have complete choice in whether to participate in a facility’s services or programs. (from ALFA) See Senior Apartments. Instrumental Activities of Daily Living (IADLs): Secondary level of activities (different from ADLs, such as eating, dressing, and bathing) important to daily living, such as cooking, writing, and driving.

Kitchenette: Each facility may have its own definition of a kitchenette, but generally one includes a sink, cabinet space, and a mini-refrigerator, maybe a microwave. In contrast, a full kitchen would usually have a burner unit, sink, cabinets, fullsize refrigerator, and possibly a microwave or stove.

Licensed Practical Nurse (LPN): LPNs are trained to administer technical nursing procedures as well as provide a range of health care services, such as administration of medication and changing of dressings. One year of post high school education and passage of a state-licensing exam is required.

Life Care Community: A Continuing Care Retirement Community (CCRC) that offers an insurance type contract and provides all levels of care. It often includes payment for acute care and physician’s visits. Little or no change is made in the monthly fee, regardless of the level of medical care required by the resident, except for cost of living increases.

Living Will: A written document, which states the wishes of an individual in advance concerning the use of life saving devices and procedures in the event that the person is terminally ill or has suffered an injury and is no longer competent.

Long-Term Care: Care given in the form of medical and support services to persons who have lost some or all of their capacity to function due to an illness or disability.

Long-term Care Insurance: The insurance which pays for a succession of care giving services for the elderly or chronically ill. This care may be provided in a facility (nursing home, mental hospital, etc.) or in the individual’s home with a nurse or aide.

Managed Care: Can best be described as the partnership of insurance and a health care delivery system. The basic goal of managed care is to coordinate all health care services received to maximize benefits and minimize costs. Managed care plans use their own network of health care providers and a system of prior approval from a primary care doctor in order to achieve this goal. Providers include: specialists, hospitals, skilled nursing facilities, therapists, and home health care agencies.

Medicaid: Public assistance funded through the state to individuals unable to pay for health care. Medicaid can be accessed only when all prior assets and funds are depleted. There are income eligibility criteria that must be met to qualify for Medicaid. Medicaid accounts for about 52 percent of the nation’s care costs, and is the source of payment for almost 70 percent of residents in nursing homes. Medicaid can reimburse Nursing Facilities for the long-term care of qualifying seniors, and in some states, Medicaid pays for Assisted Living care through Medicaid waivers.

Medicare: A federal health insurance program for people age 65 and older and for individuals with disabilities. (from AA) The Social Security Administration regardless of income administers Medicare. It also provides for hospital and nursing facility care (Part A) and physician services, therapies, and home health care


Senior Living & Care Guide 2013 23

(Part B). Medical Director: The medical director coordinates with an individual’s personal physician to ensure that the facility delivers the care that is prescribed. In some instances, the medical director may be a resident’s primary physician. A staff medical director assumes overall responsibility for the formulation and implementation of all policies related to medical care. Medications Management / Medication Administration: Formalized procedure with a written set of rules for the management of self-administered medicine, as in an assisted living setting. A program may include management of the timing and dosage for residents, and could include coordination with a resident’s personal physician. The resident must take the medication him or herself. For instance, the facility can remind the resident that she needs to give herself the medicine injection, but the facility cannot perform the actual injection itself. Medigap Insurance: Private health insurance that is used to pay costs not covered by Medicare, such as deductibles and co-insurance. National Association of Insurance Commissioners (NAIC): A national organization made up of state officials who are in charge of regulating insurance. They have considerable influence and strive to promote national uniformity in insurance regulations.

Non-Ambulatory: Inability to walk independently, usually bedridden or hospitalized.

Not-for-Profit: Status of ownership and/or operation characterized by government by community-based boards of trustees who are all volunteers. Board members donate their time and talents to ensure that a not-for-profit organization’s approach to caring for older people responds to local needs. Not-for-profit homes and services turn any surplus income back into improving or expanding services for their clients or residents. Many not-for-profit organizations are often associated with religious denominations and fraternal groups. Not-for-profits may also interact with Congress and federal agencies to further causes that serve the elderly.

Nurse Assistant: Nurse assistants work under the supervision of a Registered Nurse or Licensed Practical Nurse. A Nurse Assistant provides the most personal care to residents, including bathing, dressing, and toileting. Must be trained, tested, and certified to provide care in nursing facilities that participate in the Medicare and Medicaid programs.

Nursing Home: Provides 24-hour skilled care for the more acute patients. Patients generally rely on assistance for most or all daily living activities (such as bathing, dressing and toileting). (from ALFA) One step below hospital acute care. Regular medical supervision and rehabilitation therapy are mandated to be available, and nursing homes are eligible to participate in

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24 Senior Living & Care Guide 2013

the Medicaid program. These facilities are State Licensed. Also referred to as Nursing Facility or Convalescent Home. See also Skilled Nursing Facility. Occupational Therapy: A creative activity prescribed for its effect in promoting recovery or rehabilitation. This is done to help individuals relearn activities of daily living and is generally administered by a licensed therapist. Physical Therapy: The treatment of disease or injury, by physical and mechanical means (as massage, regulated exercise, water, light, heat, and electricity.) Physical therapists plan and administer prescribed physical therapy treatment programs for residents to help restore their function and strength. Quality care: Term used to describe care and services that allow recipients to attain and maintain their highest level of mental, physical, and psychological function, in a dignified and caring way. Real Estate: These housing options offer home ownership opportunities for adults 55 years of age and older, or sometimes 62 years and older. Some communities offer rental programs and rent-to-own options. The types of residences you may find are: Single Family Homes, Cottages and Patio Homes, Condos and Townhouses, Manufactured Homes, Gold Communities and Gated Communities. Registered Nurse (RN): Graduate trained nurse who has both passed a state board examination and is licensed by a state agency to practice nursing. A minimum of two years of college is

required in addition to passage of the state exams. The RN plans for resident care by assessing resident needs, developing and monitoring care plans in conjunction with physicians, as well as executing highly technical, skilled nursing treatments.

Rehabilitation: Therapeutic care for persons requiring intensive physical, occupational, or speech therapy in order to restore to the patient to a former capacity. Residential Care: See Assisted Living.

Respite Care: Services that provide people with temporary relief from tasks associated with care giving (e.g., in-home assistance, short nursing home stays, adult day care).

Senior Apartment: Age-restricted multiunit housing for older adults who are able to care for themselves. Usually no additional services such as meals or transportation are provided. Similar to Independent Living.

Senior Citizen Policies: Insurance policies for those over the age of 65. In many cases these policies are in combination with coverage provided by the government under the Medicare Program.

Support group: Facilitated gathering of caregivers, family, friends, or others affected by a disease or condition for the purpose of discussing issues related to the disease.

Preparing for hospice care Metro Creative Connection Hospice care is usually the last step when all other options have been exhausted. Making the decision to move a loved one to hospice care can be an emotionally wrenching time. • Visit various medical care centers to see if away-from-home options provide the care and environment you desire. If Be sure to establish what type of hospice care you prefer. This may include care within a nursing home or hospital, or in the comfort of your own home. • Sign a medical durable power of attorney. This signed document gives authority to an adult age 18 or older, who then has the right to make necessary medical and healthcare decisions for you in the event you become incapacitated. • Clearly indicate your wishes regarding resuscitation. A signed document may alert emergency healthcare personnel or others of your wishes not to

be resuscitated. This document must be signed by you and a doctor and witnessed by others. • Decide on the duration of care. Hospice care generally lasts six months. This enables a long stretch of palliative care. Should you live beyond the time period, hospice care can continue. Studies have shown that patients who receive hospice care for at least 30 to 60 days gain greater benefit than those who are placed in hospice only in their final days. • Investigate financial options for hospice. Medicare and Medicaid provide hospice coverage in 44 states. Many private insurance plans have a hospice benefit as well. Understand how payment is made to figure out if private funding will be necessary. Not all hospice programs are the same. Certain core models of care are followed by many hospice facilities, but options vary. Hospice can provide comfort in a person’s final days and help sufferers better enjoy life and time spent with loved ones in these last days.


Senior Living & Care Guide 2013 25

Retirement Information For Medicare Beneficiaries When to start receiving retirement benefits You already are receiving your Medicare benefits. At some point you will need to decide when to start receiving your Social Security retirement benefits. If you were born during the years 1943-1954, your full retirement age is 66. If you choose to delay receiving your retirement benefit beyond full retirement age, your benefit will be increased by as much as 8 percent for each year up to age 70. Your benefits will no longer increase if you delay beyond age 70. You can use Social Security’s online Retirement Estimator at ssa.gov to see a personalized estimate of your retirement benefit, as well as the effects of different retirement options. Retirement may be longer than you think The age you start receiving benefits can make a big difference in your monthly benefit amount. You may need your monthly income to be sufficient for a long time, because more people are living longer than ever before. For example: • The typical 65-year-old today will live to age 83; • One in four 65-year-olds will live to age 90; and • One in 10 65-year-olds will live to age 95. For more information on life expectancy, go online to socialsecurity.gov/planners/lifeexpectancy. htm. Rules that may affect your survivor If you are married and die before your spouse, he or she may be eligible for a benefit based on your work record. If you wait until after your full retirement age to begin receiving benefits, the surviving spouse benefits based on your record will be higher. What about receiving benefits while you work? When you reach your full retirement age, you can work and earn as much as you want and still receive your full Social Security benefit payment. Also, additional work may increase your benefits. Each year we review the records for all Social Security recipients who work. If your latest year of

earnings turns out to be one of your highest years, we refigure your benefit and pay you any increase due. Use the online Retirement Estimator to find the best option for you Everyone’s situation is different. Social Security has an online calculator that can provide immediate and accurate retirement benefit estimates to help you plan for your retirement. The online Retirement Estimator is a convenient, secure and quick financial planning tool. It uses your own earnings record information, thereby eliminating any need to manually key in years of earnings information. The Estimator also will let you create “what if” scenarios. You can, for example, change your expected future earningsto create and compare different retirement options. To use the Retirement Estimator, go online to socialsecurity.gov/estimator.

CONTINUED PAGE 27 Quality, Affordable Healthcare

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Senior Living & Care Guide 2013 27

Retirement Information For Medicare Beneficiaries (cont.) CONTINUED FROM PAGE 25 It’s so easy to apply online for benefits The easiest way to apply for Social Security retirement benefits is to go online at socialsecurity. gov and select “Apply Online for Retirement Benefits.” Remember to complete your application three months before the month in which you want retirement benefits to begin. If you do not have access to the Internet, you can call 1-800-772-1213 (TTY number, 1-800-325-0778) between 7 a.m. and 7 p.m., Monday through Friday, to apply by phone. You also can apply at any Social Security office. To avoid having to wait, call first to make an appointment. Interested in other useful information? You can visit these Social Security webpages: • socialsecurity.gov/retire This planner provides detailed information about Social Security retirement benefits under current law and points out things you may want to consider as you prepare for the future. You can even download a copy of Social Security’s Online Retirement Planning CD. • www.socialsecurity.gov/mystatement On this webpage you can create a personal account and check your earnings record on your Social Security Statement. The Statement is available online to workers age 18 and older. You also can print a copy of your Social Security Statement. If your Statement does not include all of your earnings, let your employer and Social Security office know about any incorrect information. • www.socialsecurity.gov/faqs This webpage has answers to some of the most frequently asked questions about Social Security. You also can visit these other government websites: • www.mymoney.gov This site contains information on retirement planning, responding to life events and other important money-related issues. It also con-

tains calculators for all of your financial planning needs. • www.sec.gov/investor/seniors.shtml Are you looking for information about the investment options available to you as you enter retirement? The Securities and Exchange Commission has a wealth of information on different investment products and topics available. Contacting Social Security For more information and to find copies of SSA publications, go online to socialsecurity.gov or call toll-free, 1-800-772-1213 (for the deaf or hard of hearing, call our TTY number, 1-800-325-0778). The SSA can answer specific questions from 7 a.m. to 7 p.m., Monday through Friday. Generally, you’ll have a shorter wait time if you call during the week after Tuesday. We can provide information by automated phone service 24 hours a day. – Information provided by The Social Security Administration at ssa.gov.

Where Your Family Comes First Where Your Family Comes First � 24 Hour Skilled Nursing Care � Physical, Occupational & Speech Therapy in house For Admissions please contact Director Nursing, Jennifer ForofAdmissions please Nichols, contact BSN, at 712-527-3101 Director of Nursing, Jennifer Nichols, BSN, at 712-527-3101 302 6th Street, Glenwood, IA 51534

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28 Senior Living & Care Guide 2013

Are expired medications still safe? Metro Creative Connections It is 2 a.m. and that cough and stuffy nose you have been battling is still keeping you up. You reach for the nighttime cold relief medicine only to find it expired a few months ago. If you take a dose to ease your symptoms, will you be putting yourself at risk? This situation is a relatively common occurrence. Many medicine cabinets are stocked with over-the-counter drugs as well as prescription medications that may be past their expiration dates. It is a good idea to routinely discard expired medicines, but if you happen to take a drug that has passed its expiration date, you will most likely suffer no ill effects. According to the Harvard Medical School Family Health Guide, the expiration date on a medicine is not the dates when a drug becomes hazardous. Rather, it marks the period of time after which a drug company can no longer guarantee the efficacy of the medication. Since 1979, drug manufacturers selling medications in the United States have been required by the Food and Drug Administration to stamp an expiration date on their products. This is the date until which the manufacturer can still guarantee full potency of the drug. Expiration dates also may be a marketing ploy. Francis Flaherty, a retired FDA pharmacist, has said drug manufacturers put expiration dates on products for marketing purposes rather than scientific reasons. It doesn’t make financial sense to a company to have products on the shelves for years. Therefore, most drug manufacturers will not do long-term testing on products to confirm if they will be effective 10 to 15 years after manufacture. The U.S. military has conducted their own studies with the help of the FDA. FDA researchers tested more than 100 over-the-counter and prescription drugs. Around 90 percent were proven to still be effective long past the expiration date – some for more than 10 years. Drugs that are stored in cool, dark places have a better chance of lasting because the fillers used in the product will not separate or start to break down as they might in a warm,

humid environment. Storing medicines in the refrigerator can prolong their shelf life. Though a pharmacist cannot legally advise consumers to use medication past an expiration date, most over-the-counter pain relievers and drugs in pill form should still be fine. Certain liquid antibiotics and drugs made up of organic materials can expire faster than others. For those who still want to err on the safe side, routinely clean out medications from cabinets once they expire. However, if an expired medication is taken by mistake, there’s little need to worry about potentially adverse effects.

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Senior Living & Care Guide 2013 29

Physical therapy a vital part of treatment and recovery Metro Creative Connection Illnesses of the musculoskeletal system can result in temporary loss of mobility. But physical therapy can help to prevent those temporary problems from becoming permanent. The American Physical Therapy Association says physical therapists diagnose and treat individuals of all ages who have conditions that limit their abilities to perform functional activities. Limitations in mobility may result from injury or illness or be present at birth. Many physical therapists develop a plan to reduce pain and restore function through various treatment techniques with the ultimate goal of restoring a patient’s functional independence. Physical therapists are licensed healthcare professionals who must receive a degree from an accredited physical therapist program before taking national licensure exams that enable them to open a practice or work in a facility. The Bureau of Labor Statistics predicts a 30 percent growth in physical therapy careers through 2018, which is a rate better than all other occupations. Unemployment rates for physical therapists are very low, and they are in high demand. Physical therapists employ various physical modalities to help with certain conditions. For example, a patient may be asked to perform various range-of-motion exercises to restore function to an injured part of the body. Physical therapists also may use heat, cold and electrical impulses to reduce pain and stimulate muscle function. Physical therapy sessions frequently include some form of massage as well. While athletes frequently rely on physical therapy as they recover from injuries, others can benefit from physical therapy as well. For example, physical therapy may work in conjunction with other treatments for cardiopulmonary disease. The cardiopulmonary system delivers oxygen to active tissues, which plays an important part in movement. When the cardiopulmonary system is compromised, muscles and other tissues may not function as they should, and certain exercises and mobility therapies may be needed. Physical therapists also aid in improving physical ailments related to neurological diseases, such as cerebral palsy, multiple sclerosis, spinal cord injuries,

Parkinson’s disease, and Alzheimer’s disease. Physical therapists may also help treat poor vision, poor balance and paralysis. Children who have learning disabilities related to a neurological or physical condition may benefit from certain forms of physical therapy. For example, vision problems can compromise academic performance, so physical therapy that aims to enhance visual tracking skills and strengthen the eyes in conjunction with corrective lenses may help youngsters, or even adult students, perform better in the classroom. Very often physical therapy will be recommended by a general doctor or an orthopedic surgeon as part of recovery from a surgery or a condition. The therapist may work in conjunction with another doctor to provide a program that helps foster a faster and safe recovery. Physical therapy tends to begin gradually and resistance is slowly built up as the body strengthens. The length of physical therapy will depend on the condition and the recommendation of the therapist and doctors overseeing the treatments.

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30 Senior Living & Care Guide 2013

What is Parkinson’s disease? Metro Creative Connection

Though millions of people across the globe are living with Parkinson’s disease, many people have limited knowledge of this disorder. The extent of many people’s experience with or knowledge of Parkinson’s disease begins and ends with Muhammad Ali and Michael J. Fox, two high-profile personalities who have publicly acknowledged their fight against this potentially debilitating disorder. As much as Ali and Fox have done to bring awareness to Parkinson’s disease, the disorder largely remains a mystery, even to those medical researchers who have devoted their lives to finding both a cause and a cure for Parkinson’s. But there are some things the medical community does know about Parkinson’s, and a greater understanding of this disease might help find a cause once and for all. What is Parkinson’s disease? Parkinson’s is a chronic and progressive movement disorder, which means the symptoms will continue and worsen over time. Parkinson’s involves the malfunction and death of nerve cells in the brain known as neurons. Some of these neurons are responsible for producing dopamine, a chemical that sends messages to the part of the brain that controls movement and coordination. As Parkinson’s progresses, less dopamine is produced, making it more difficult for a person with Parkinson’s to control his or her body’s movements. What are some symptoms of Parkinson’s? Symptoms of Parkinson’s disease vary from individual to individual, but the Parkinson’s Disease Foundation notes that the primary motor signs of Parkinson’s include: • tremor of the hands, arms, legs, jaw, and face • bradykinesia, or slowness of movement • rigidity or stiffness of the limbs and trunk • postural instability or impaired balance and

coordination Parkinson’s progresses slowly, and a person might begin to feel somewhat weak and notice slight tremors. These tremors gradually progress to additional symptoms. For example, a person might notice their voluntary movements, such as walking or even rolling over in bed, have become slower. Other symptoms can include difficulty rising from a sitting position or, in the later stages, difficulty swallowing. Are there any known causes of Parkinson’s disease? There is no known cause for Parkinson’s disease, but scientists are exploring a potential relationship between the loss of cells in other areas of the brain and body and Parkinson’s disease. According to the PDF, scientists have discovered that signs of Parkinson’s disease have been found not only in the mid-brain but also in the brain stem and the olfactory bulb. Concerned men and women who have or have had a family member with Parkinson’s disease often want to know if there is a genetic link. Evidence to a possible genetic link remains highly controversial and inconclusive, so any potential genetic implications regarding Parkinson’s disease remain unclear. Some evidence has suggested that toxins in the environment may cause Parkinson’s disease. These toxins, which include manganese, carbon monoxide and carbon disulfide, may selectively destroy the neurons that produce dopamine, potentially causing Parkinson’s as a result. Certain medications and street drugs have also been known to produce symptoms similar to those associated with Parkinson’s. Antipsychotics used to treat severe paranoia and schizophrenia as well as MPTP, a synthetic heroin contaminant, can cause Parkinson’s-like symptoms. More information about Parkinson’s disease is available at pdf.org.


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The basics of atrial fibrillation Metro Creative Connection When working properly, the human heart is a wonder. The heart’s two upper chambers work in conjunction with the two lower chambers to deliver blood and oxygen to every area of the body. Sometimes the heart may beat irregularly and rapidly, in which a person is experiencing atrial fibrillation, or AF or “afib.” When a person is healthy, the atria (upper chambers) of his or her heart contract, followed by the ventricles (lower chambers) in a normal sinus rhythm. When timed perfectly, this beating enables the efficient flow of blood throughout the body. Normally, the heart beats at a rate of 60 to 100 times per minute at rest. When atrial fibrillation occurs, the electrical rhythm of the heart is not orderly and many different impulses fire rapidly at once, causing a chaotic rhythm in the atria, which can no longer effectively contract blood into the ventricles. The result is an irregular, fast heartbeat that may range in 300 to 600 beats per minute at rest. There is no one cause of AF, which has been linked to a number of different heart conditions. These include, but are not limited to, hypertension, coronary artery disease, heart valve disease, cardiomyopathy, congenital heart disease, and pulmonary embolism. Hyperthyroidism and excessive alcohol consumption as well as pneumonia and certain lung conditions also may contribute to AF. The Mayo Clinic says the older a person is, the greater his or her risk for atrial fibrillation. Around 8 percent of the United States population over the age of 80 has AF. In many cases, AF exhibits no symptoms and a person may not realize that the heart is beating erratically. Fainting, chest pain, lightheadedness, confusion, and shortness of breath may be symptoms of AF. Others with AF have reported palpitations, which are the sen-

sation of a racing heartbeat that almost seems like the heart is flopping in the chest. Very often people spend several years with AF without knowing it. A doctor will diagnose AF through a variety of different tests. An electrocardiogram, or ECG, graphs an image of the electrical impulses traveling through the heart. This is one of the more common ways to diagnose AF. A monitor may be worn for a few days to continuously record the heart rhythm. Oftentimes a person can live with AF without any problems. However, there are some dangers in letting AF go untreated. Because the heart is beating irregularly, blood flow can be compromised and not pump efficiently. This can make the heart weaken and lead to heart failure. When the atria are not beating correctly, blood will not flow through them as quickly. This may cause blood to pool in the upper chambers and contribute to clot formation. If a clot dislodges and gets pumped into the brain, it can cause a stroke. Treating AF may require a series of medications to prevent clots and reset the rhythm of the heart. Resetting the rhythm is known as cardioversion, which can be done with medication or through a brief electrical shock under sedation. Blood-thinning medications, such as Warfarin, may be prescribed. Such medications help the blood stay thin and prevent clotting. Routine checkups may be needed while taking a blood-thinner because small cuts can result in significant blood loss. Drugs used to keep the heart rate normal and prevent episodes of AF include sotalol, dronedarone, dofetilide, and amiodarone.. It may take some time to get the right balance of treatment to prevent future bouts of AF, but there is no guarantee it won’t come back. Working with a doctor can make the process go more smoothly, and treatment with medication may need to continue throughout a person’s life.


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When is the right time to leave home? Metro Creative Connection Few people like to admit their age is affecting them. However, as we age, certain abilities become compromised, and it may no longer be practical for aging men and women to remain in their homes, or at least live there alone. Comfortable living alone may be a signal to an older adult that he or she still has independence. Taking away a license or suggesting a move may cause feelings of animosity. But at some point in time, friends or family members of an aging man or woman might need to broach the topic of moving to an assisted living facility. Such a discussion can be difficult, but having some evidence that a change is necessary may make the news easier to process. Sometimes the older adult may have already made the decision that a move is necessary, which will make the process even easier. Here are some steps to keep in mind: • Make sure to develop a strong relationship with your loved one. This relationship should be consistent and keep you in frequent contact so you can best assess his or her liv-

ing situation. • Talk things over with other siblings or relatives to see if others feel the same way you do. Perhaps they have a different point of view. • If there are problems at home, make your case by pointing them out. Show the elder adult how day-to-day life has grown more difficult and how certain burdens may be lifted by changing living situations. • Indicate that access to health care and a safe environment are some of the key benefits of moving to a senior community. Point out other benefits, such as companionship with similarly aged people, activities, transportation, and the presence of a maintenance staff to ensure nothing falls into disrepair. • Do your research and have the names and amenities of different residences available to discuss. Request brochures from senior communities and offer to make trips to view the homes together with your senior relative. • If the idea of a “home” is not what your loved one has in mind, discuss the options of moving in with a relative and if this would be a more comfortable situation.

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Assisted living financial worksheet

Use this itemized worksheet in estimating the monthly cost of needed services. Not all items may be applicable to your specific situation. $_____ Entrance and/or Initial Assessment Fee $_____ Selected Unit and Basic Service Package $_____ Cost for Meals $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____

Cost for Housekeeping Cost for Personal Laundry Service Cost for Linen Service Cost for Medication Management or Assistance Cost for Personal Care Assistance (bathing, dressing, eating, etc.) Cost for Recreational Field Trips Cost for Transportation Cost for Telephone Service Cost for Cable Television Beauty Shop Charges Other Charges Other Charges Other Charges Total Estimated Monthly Charges

Make sure you are aware of the following: ____ Know what the basic service package includes ____ Know all costs associated with your service package ____ Know about additional services and their associated fees (e.g., medication management) ____ Know the circumstances why fees might change and how much notice is given to families and residents ____ Understand the services planning process ____ Understand the service contract ____ Know about the criteria and policies associated with discharge ____ Understand resident rights and responsibilities ____ Know the residence’s grievance policy and procedure ____ Understand how many staff are available and their qualifications ____ Have the name and telephone number of the staff contact person


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Shedding pounds after 50 Metro Creative Connection Losing some weight is a goal for many people regardless of age. While youngsters and young adults might be able to get away with a few extra pounds without suffering any significant consequences, older adults carrying some extra weight might be putting their overall health at considerable risk. Shedding weight after the age of 50 is not always easy. As a person ages, muscle mass tends to dwindle while body fat has a tendency to increase. Since fat burns fewer calories than muscle, weight gain as a person ages is bound to happen. But that doesn’t mean such weight gain is inevitable. In fact, men and women willing to make certain changes with regard to diet and exercise can shed pounds after 50 while preventing future weight gain. Diet Men and women need fewer calories as they age. For example, men and women in their 40s may need as many as 200 calories more per day than they will when they reach their 50s. Counting calories might seem difficult, so men and women in their 50s and older who don’t think they can count calories can try to eat more low-calorie foods like fruits, vegetables and whole grains. Consuming fewer calories often requires changing dietary habits, not only with regard to what you’re eating but also how you’re eating and even how you shop for food. Men and women used to dining out for lunch every day can start bringing their own lunches so they can gain greater control of their daily caloric intake. For those who find they’re frequently too exhausted to cook each night, they can prepare meals in advance to have healthy, homemade meals waiting instead of always ordering takeout or delivery. When shopping for food, people should avoid doing so on an empty stomach so they’re less inclined to buy un-

healthy snacks. Exercise Exercise is another essential component to shedding pounds after 50, though men and women over 50 should always consult a physician before they begin a new exercise regimen. The Centers for Disease Control and Prevention points out that regular exercise can help older men and women prevent the onset of a host of ailments, including heart disease and diabetes. In addition, the CDC notes that regular physical activity as one ages helps muscles grow stronger, which increases the chances that an individual will be able to perform necessary daily activities without the assistance of others. Maintaining that independence into older adulthood is a goal for many men and women, and it’s a goal that’s far more realistic for men and women who exercise than it is for those who don’t. When coupled with a healthy, low-calorie diet, routine exercise can help men and women over 50 shed extra weight and keep the weight off once it’s gone. According to the CDC, older adults need at least 2 hours and 30 minutes of moderate-intensity aerobic activity, such as brisk walking, every week and muscle-strengthening activities on 2 more days a week. These muscle-strengthening activities should work all the major muscle groups, including the legs, hips, back, abdomen, chest, shoulders, and arms. Muscle-strengthening activities include lifting weights, working out with resistance bands, exercise such as push-ups and sit-ups that use body weight for resistance, and yoga. Even gardening that involves digging and shoveling can be considered a muscle-strengthening activity. Weight gain is often an expected side effect of aging. But men and women don’t have to gain weight as they get older.


New Patients Welcome!

Isam Marar, MD

Diana Rabadi- Marar, MD

Theresa Oltman, ARNP

John Urbanski, FNP/BC

Scheduled Appointments:

Our Health Care Services:

Monday-Friday 8:00 a.m.-4:00 p.m. Same day appointments available

• Family Medicine from Newborns to Elderly • Internal Medicine • Endocrinology • Diabetes • Women’s Health Care • On Site X-Ray & Dexa Scan

Paige Trausch, PA-C

Walk-In Clinic: Monday-Thursday 5:00 p.m.-7:00 p.m. Saturday 9:00 a.m.-1:00 p.m.

PLEASE CALL 712-256-5600

TO SCHEDULE AN APPOINTMENT 1701 W. Broadway • Council Bluffs, IA 51501 www.westbroadwayclinic.com

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Senior Living & Care Guide 2011

Home, Sweet Home!

At Risen Son Christian Village we go to great lengths to make you feel at home. We exist to honor God by providing excellent care for you. And we take that very seriously. We work hard to bring every advantage to our residents. So, if you’re looking for a place to call home, please give us a call. We’d love to show you around!

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Senior Living & Care Guide 2013