OutreachNC August 2020 by OutreachNC

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Feature Intro: Seeking Support - Building Social Networks for Optimal Health

It is the summer of 2020 and the world faces lockdowns, shutdowns, stay-at-home orders, closures and more. We are in a global pandemic. We are distanced and separated from loved ones, jobs and community events that otherwise sustained and bolstered us. Travel has become challenging or, for some, impossible. As we all stick together through these difficult times, the importance of community, connection and support is highlighted. Who will help us when we are sick? Who will call, send a letter or check in? Who will text us a joke, offer a Bible verse or deliver a meal when we can’t get out or haven’t had a good laugh in a few days? The benefits of social support are well documented. According to the Centers for Disease Control and Prevention (CDC) and the National Association for Chronic Disease Directors (NACDD), “Adequate social and emotional support is associated with reduced risk of mental illness, physical illness, and mortality.” Social support includes emotional support, informational support, instrumental support and appraisal/esteem support. Each form of support plays an important role in contributing to the strength of our overall support system, much like the legs of a stool. Without one leg, the others struggle to maintain balance, and things (life) can get wonky and unstable. But how do we find support before we need it? How do we continue to foster community in times of isolation, whether those times include a pandemic or other circumstance? How strong are our social support networks, and how do we strengthen them, connect to them and rebuild them if life circumstances have changed and left us with gaps we need to fill?

CONTENTS

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ASK THE EXPERT: WHAT IS HIPAA? FEATURE: SEEKING SUPPORT FAITH: HOSPITALITY OF HEART RECIPE: MASTER TRAIL MIX VETERANS CORNER: WORKING POSTRETIREMENT

LETTER FROM THE EDITOR

Amy Phariss, Editor-in-Chief, OutreachNC | editor@outreachnc.com

AUGUST 2020 - 2 We’re in the home stretch of what has felt like a long summer. Then again, is it already August? Will the weather be turning again in a month or two? It’s hard to imagine. Time has felt, for these last months, as if it has simultaneously flown by and stood still. I, like so many others, was certain life would be ‘back to normal’ by now. I’m beginning to understand that adjusting to a new normal might just be my next big challenge. As I consider this, I am soothed by the idea that what is good is still good: friendships, kindness, faith, community and most fiction written before 1950. And I am reminded, too, that with change comes opportunity. We have all had time to think. We have all had time to slow down, to look hard and to, as Anne Sexton wrote, put our ears down close to our souls and listen hard. It’s stunning what we hear when we do this, and though a pandemic is nothing short of a pandemic, it has at least afforded us a new perspective, which always promotes growth. Colette Bachand writes this month about hospitality and how it is manifest in uncertain times. As I read her piece, I was comforted by the reminder to be hospitable to everyone, including myself. The Moore County Veterans Service Office takes a close look at vetern employment post-retirement, including tips for entering the civilian workforce and resource for making the adjustment. Our recipe this month is a master trail mix recipe, completely customizable for your tastes and dietary needs. On a recent hike in Western North Carolina, mid-way to the top of the peak, I was reminded of just how handy a snack of trail mix can be, especially when it’s homemade and devoid of chemicals. I’m happy to report I made it to the top of the trail and appreciated every almond and pumpkin seed along the way. We hope everyone is staying healthy, both mentally and physically, as we keep our masks on, our hands washed and a six-foot distance from those around us. We’re in it together, as always. Stay strong,

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ASK THE EXPERT: WHAT IS HIPAA?

What is the different between HIPPA and HIPAA? I actually love this question. If you are on social media, you have probably noticed a lot of people throwing around privacy terminology, including HIPPA and HIPAA, also referred to as Hipaa. The correct acronym is HIPAA. It stands for the Health Insurance Portability and Accountability Act. It is commonly misspelled as HIPPA. I always remember it by telling myself it is not a hippo. So, what is HIPAA anyway? HIPAA was signed into law in 1996 to provide security and data privacy for patient’s medical information. It typically applies to healthcare providers and organizations who transmit health data electronically. If you are a HIPAA covered entity, there are 5 main rules that compliance focuses on: 1. Privacy – the protection of medical records. This is why when you go see your doctor, you are given a notice of privacy

AUGUST 2020 - 3 practices and asked who they may share health care information with. Under this section, the individual also has the right to inspect or obtain copies of their records and request corrections. 2. Security – the standards, methods and procedures related to how your information will be stored, accessed and transmitted. This is why information is often encrypted, password protected and stored in secure software portals. 3. Transaction – this area deals with codes that must be used correctly related to medical diagnosis and accuracy of medical records. 4. Identifiers – National health plan identifiers are used to identify health plans and payers (such as Medicare and Medicaid). These identify the employer in HIPAA transactions. 5. Enforcement – this area outlines the penalties for any violations. These were increased in 2015. These measures were intended to reduce healthcare fraud and abuse, enhance standards for health information, increase portability of medical information and protect the security and privacy of such information. HIPAA protects an individual’s privacy by prohibiting certain uses and disclosures of a person’s health information, including medical records. HIPAA does not necessarily apply to every person and every entity; the term is often used in a much wider sense than intended. It only applies to covered entities and their business associates. This typically includes hospitals, doctors, clinics, psychologists, dentists, chiropractors, nursing homes, pharmacies and other healthcare providers, insurance companies and related entities.

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Seeking Support: Building Social Networks for Optimal Health & Wellness

By: Amy Phariss

continued from page 1 This month ONC examines the four areas of social support and how we can build and strengthen these networks for healthier, happier lives.

Emotional Support Emotional support is often offered by friends, loved ones, clergy, counselors and family. These are the people we turn to for comfort, to share stories with and with whom we can share our problems. As we age and grow through many life transitions, our relationships shift and change. We may lose some friendships due to physical distance, emotional growth or life circumstances. Family members may grow apart, move out or even die. It’s easy to get caught up in the details of change (the financial obligations, the unpacking of boxes, the necessary medical decisions) so that one day we look up and realize we’re tapped out emotionally; our buckets are empty, and we don’t know where to turn for a refill. Though it may seem counter-intuitive, stopping to assess how many relationships we have that give us energy and help keep us emotionally healthy is an

important task. Do we have someone to call when we feel sad or blue? Is there someone we can be honest with, even if that honesty isn’t very ‘pretty?’ The number of close relationships will vary for each person, but knowing there are people we can count on, trust, laugh with and lean on is important in feeling loved, nurtured, cared for and safe. Investing in these relationships is as important as finding them, which means reaching out as often as we hope others will reach in.

If circumstances have changed and social circles have dwindled, it may be time to start exploring new ways to meet friends or connect with others. New hobbies, interests or skills are great starting points. If you’ve recently picked up running, for example, join a running club. Though you may love nothing more than reading a novel alone in your favorite chair, joining a book club will allow you to meet others who share your passion for literature. We often lean toward the same patterns and habits we’ve had most of our lives, but as situations change and life deals us a new hand, we need to open ourselves to new adventures and the relationships that come along as a part of these journeys. The key to emotional support is finding a balance. Too much support can feel overwhelming. Maintaining too many connections can be burdensome and actually detract from the depth many seek in interpersonal relationships. However, as we age and circumstances change, too few close relationships and emotional supports mean we feel isolated, lonely and fearful in our ability to meet life’s inevitable challenges.

Informational Support Informational support can be a powerful tool as we face life transitions and meet life’s day-to-day demands. Advice, suggestions and information are all examples of informational support. Whether we are dealing with financial issues related to retirement, job loss, or funding a grandchild’s education, seeking

AUGUST 2020 - 5 informational support from a financial professional is a wonderful way to clarify goals and understand proper next steps. Informational support takes the guess work out of the problems we face.

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When armed with information, we feel less anxiety and more control about not only our challenges but our futures.

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Informational support does not need to come only from professionals, however. A family member who recently went through a divorce might offer his or | her experience as an example of what to expect with custody arrangements or pension disbursement. While this won’t serve as legal advice, it is still informative and helpful as a means of informational support.

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Often referred to as ‘tangible support,’ instrumental support includes the practical, hands-on help people | give us. This is signing up for a meal train when a neighbor’s wife is ill or when we cut the lawn of a church member who must travel to see his family. This is delivering groceries, driving a friend to a chemotherapy treatment, or delivering a bottle of wine after the grandkids have left for the summer. Instrumental support is….instrumental.

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Instrumental Support

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The key to informational support is to find trusted, reliable sources for information and avoid feeling overwhelmed by too much. We have all felt inundated with advice, some of it well-intended but not necessarily accurate or timely. Decide what information you are seeking, which sources are the best for your particular circumstances and who you might trust to either offer advice or pass along the name of a trusted advisor.

o W E Do T

AOS & Friends Care was incorporated and approved by the IRS as a 501(c)(3) tax exempt nonprofit in 2015. Our Mission is to raise awareness and provide direct care and community support to older adults, with a focus on those with dementia.

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AUGUST 2020 - 6 AOS Care Management’s Jennifer Tyner is an Aging Life Care Manager with over 20 years of experience helping older adults age well. Tyner offers her advice on creating and sustaining an active, healthy and varied social life at any age.

4 TIPS FOR BOOSTING SOCIAL SUPPORT AND OVERALL WELLBEING 1. Get Outside. Tyner stresses the importance of getting outside, especially while socializing. She says, “Outdoor book clubs have become the new thing! Everyone brings their own book and maybe even a picnic style meal (or just wine!). Create a neighborhood scavenger hunt. Join an outdoor exercise class.” 2. Give Back. Social support is as much give as it is take. Tyner notes that giving back in our communities and social networks is often a very social act. Says Tyner, “So many people are in need right now, so those that feel isolated may benefit from volunteering – give blood, set up a local mutual aid network, become pen pals with a local nursing home resident, volunteer at the food bank, etc.” Giving back is a way of engaging, connecting and supporting those in our own circles and beyond. 3. Eat together. Make mealtimes social. Tyner suggests even using FaceTime during meals, allowing families and friends to still sit down to a meal together even if distance prevents them from physically sitting at the same table. Tyner says, “It’s proven that seniors eat more when they have company. Schedule times to eat and chat with friends.” 4. Play with a Pet. Not all friends stand on two feet. Animals have been proven to have therapeutic qualities, which we wrote about back in our June, 2020 newsletter. Pets or even the pets of friends or neighbors can be incredibly soothing and social, providing comfort, motivation for exercise and joy for their human friends. Tyner says, “It might be the perfect time to rescue a fureverfriend.”

We help others, and they in turn help us. We cannot offer support without also needing it and vice versa. Instrumental support can also be found through professionals. Car services, grocery delivery, and aid/ companion services are all examples of instrumental support. As noted above, finding quality, caring professionals means instrumental support can also serve as emotional support, strengthening our network even further. Researchers from the International Journal of Qualitative Health and Wellbeing (2012) found older patients reported higher levels of subjective life satisfaction when they received emotional support from professionals (Pejner, Zeigert & Kihlgren). Seniors also found it easier to adapt to health issues and other adjustments as part of the aging process with emotional support from professionals. When we find a pet sitter who asks about our mother’s health, that provides noninstrumental support. A hairdresser who listens to the grandkids’ latest updates provides emotional support while engaging in instrumental support. Instrumental support can be professional without being simply transactional. Investing in finding instrumental care that meets other needs is well worth the time and energy it takes to find a great fit.

Appraisal/Esteem Support This form of support is different from comfort or emotional support in that it helps remind us of our inherent strengths, skills and practical resources. Examples of esteem support include a friend reminding us how resilient we have been throughout our lives and how many battles we’ve faced and endured, so that we might find the strength again to continue fighting a new challenge. We might be reminded of how we endured divorce, depression, addiction or the loss of a loved one earlier in life, so the latest diagnosis or loss is endurable as well. Counselors, clergy, friends, family and professionals all provide appraisal support, and allowing for a biggerpicture perspective is often the difference between sinking into a deeper depression or the ability to step back, assess the problem and find a solution or, at least,

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a way forward. Esteem support isn’t only valuable in times of trouble, either. As we age, we inevitably face new situations and circumstances. A friend might remind us of our management skills as head of the PTO when our kids were younger as we struggle to apply for a new job. A counselor might remind us that we’ve never stopped learning (on the job, with our kids, as we’ve moved around the country) when we might be afraid to go back to school for fear of being ‘too old.’ Our lives are full of moments of doubt.

Appraisal and esteem support help us go beyond moments of doubt, remember our inner strengths and call upon our own resources. Overlap between the four areas of social support is a key ingredient in building our networks and making the most of what we have to offer others as well as what we can receive ourselves. Support groups are a wonderful example of social support that offer comfort (emotional), advice (informative) and resilience (esteem). Comparing the experience of participants before and after attending support groups, researchers in the United Kingdom found, “…prior to joining their groups many participants felt isolated, lacked hope and were at risk of mental ill-health” (Worrall et al, 2018). Support groups enhanced certain protective mental health factors including enhancing control felt by participants, increasing resilience and community assets, and promoting inclusion. Support groups may offer information regarding a certain medical condition, comfort and hope during a stressful life event (the death of a spouse, for example) or even highlight the skills and resources we already possess to grow our wealth, health or professional development. In words often attributed to Abraham Lincoln, “And in the end, it’s not the years in your life that count; it’s the life in your years.” Social support networks help give those years life, adding dimension in the form of comfort, advice, encouragement and an occasional delivery of much-needed baked goods. Quality of life isn’t a solo job. We need each other, and when we take the time to build our social networks, to invest in the relationships around us and to strengthen the community of spirit that celebrates our humanity, we all thrive.

Mia Lorenz is an experienced attorney whose 25-year record of service in the law demonstrates her commitment to her clients and community. She is passionate about assisting clients in their quest to maintain control and dignity as they age and/or experience illness, as well as plan to preserve assets while maintaining care. Active in the community as legal advisor to NAMI Moore County, AOS & Friends Care, Inc. and Linden Lodge.

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Interview a Veteran!

ASSIGNMENT

Sept. 1, 2020 DEADLINE! SECOND ANNUAL INTERVIEW A VETERAN CONTEST Open to all students between the ages of 12 and 18. Interview a Veteran about the lessons learned during his/her military service.

• submit in interview format including the questions posed and the answers given • include a brief description of how the interviewer knows the Veteran • provide a brief background of the Veteran’s service • maximum of 1000 words in length

The winning interview will be published in the November ONC issue and will receive a $100 gift card.

Interviews should be emailed to: Amy Phariss, Editor in Chief - OutreachNC editor@outreachnc.com

Walter’s wife called and said this: “ Walter, don’t forget your swimsuit – water’s just fine! ”

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Catch every word with a CapTel phone, and you’ll never be caught with your pants down. A free service provided by CapTel NC is the solution for people with a hearing loss. A CapTel allows them to hear and read everything the person on the other line says to them! For more information about the service or to get a CapTel phone, contact Kim Calabretta, CapTel NC Manager:

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Walter, who has hearing loss, heard this:

“ Just forget your swimsuit... won’t have mine! ”

n (844) 519 4806 (new phone number) n captelnc.com FEDERAL LAW PROHIBITS ANYONE BUT REGISTERED USERS WITH HEARING LOSS FROM USING INTERNET PROTOCOL (IP) CAPTIONED TELEPHONES WITH THE CAPTIONS TURNED ON. IP Captioned Telephone Service may use a live operator. The operator generates captions of what the other party to the call says. These captions are then sent to your phone. There is a cost for each minute of captions generated, paid from a federally administered fund. No cost is passed on to the CapTel user for using the service. CapTel is a registered trademark of Ultratec, Inc. NC Department of Health and Human Services • Division of Services for the Deaf and Hard of Hearing ncdhhs.gov/divisions/dsdhh • NCDHHS is an equal opportunity employer and provider. • 06/2020

GRAY MATTER GAMES

ACROSS

1. Takes off 6. Gillette product 11. Hug 13. Styled with Brylcreem 15. Pigeons’ housing 16. Animal fat 17. Barely get, with “out” 18. More disgusting (slang) 20. ___ v. Wade 21. Actress Sorvino 23. Safari sight 24. Oil source 25. Cavern, in poetry 27. ___ and outs 28. Feasts 29. Thong 31. Carbon residue (pl.) 32. Mass of developing tadpoles 34. Sing like Bing

36. Malady 39. Bake, as eggs 40. Action film staple 41. Pound sounds 43. High school dance 44. Jalopy 46. Anger, with “up” 47. “Baloney!” 48. Summertime (2 wd) 50. ___-Atlantic 51. Picture 53. Hawser 55. Child’s movable walking assist (pl.) 56. Internet seller 57. Eye sores 58. Doesn’t ignore

DOWN

1. Tobacco use 2. Turns to show other side 3. “___ we having fun yet?”

4. R-rated, maybe 5. Use elbow grease on 6. Isuzu model 7. Gulf V.I.P. 8. Blast 9. Fragrant 10. What a cobbler does 11. Swelling 12. Print using metal plate and acid 13. Nuisances 14. Considers 19. Extra large 22. Painting, for one (2 wd) 24. Panasonic rival

26. Overthrow, e.g. 28. Soft 30. Carbonium, e.g. 31. “Do the Right Thing” pizzeria owner 33. Folded like a fan 34. Colored lithographs 35. Mob disbursement law (2 wd) 37. Vilely 38. Slats 39. Bit of parsley 40. Impulses 42. Exodus commemoration 44. Habits

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45. Former capital of Japan 48. Acute 49. Q-Tip 52. Chipper 54. Deception

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FAITH: HOSPITALITY OF HEART

In a favorite bookstore in Paris, there is a sign over a doorway whose message has touched me since I read it decades ago. Presumably penned by the store owner, it reads:

AUGUST 2020 - 11 Since COVID-19 crept into our lives, if we are honest, rather than being open, it’s been easier to close down. Rather than opening our hearts, it’s been easier to shut them off and crawl inside.

“Be not inhospitable to strangers, lest they be angels in disguise.”

Which is why, in this season of physical distancing, I’ve turned to a hospitality of spirit.

I was reminded of that bookstore recently when preparing a Bible study on friendship. It seems the writer of Hebrews had the same idea long before the bookstore owner.

While I might not be offering physical space, I am offering hospitality of heart, open to the possibility of angels in my midst. I’m hospitable to new ideas, new ways, new people, new thinking. Even hospitable to myself, knowing I am doing my very best.

“Do not neglect to show hospitality to strangers, for thereby some have entertained angels unaware,” echoes Hebrews 13: 1- 2. The idea of hospitality is odd to think about in these days of social distancing. Our souls long for the opportunity to be hospitable, open our guest rooms to visitors, call the neighbors over for wine, prepare a meal for favorite friends. Or not. Pandemic realities give hospitality a real challenge.

Sometimes, as Hebrews suggests, we have entertained angels without knowing, and I am sure we are doing just that during this pandemic. Angels, we often forget, can even be difficult times from which we learn and grow. Practicing hospitality of heart, at a time the world around us is practicing anger and division, has never been more important. After all, only hospitable hearts can heal the world.

I guess that is one of gifts of believing in the companionship of a Loving Creator, the promise that The idea of being hospitable requires an we are not alone and, especially in the messiness, Love opening – an opening of heart, an opening of sends angels. If our hearts can remain hospitable in this spirit, an opening of eyes and ears. Hospitality season, God will find ways to comfort and strengthen requires vulnerability (what if I burn the us. If our hearts can remain open, I have no doubt we roast?) Hospitality requires letting go of things we can’t control (If my guest doesn’t like lavender will look back and see the angels who carried us, and, I think too, we will find that something new has been soap will they be insulted?). growing in the fertile place of an hospitable soul.

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Pet Friendly

August 31 is National Trail Mix Day!

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I know. We are excited to be hearing about this, too. As we lean toward the end of summer and pack up for our final vacations (such as they are given the ‘circumstances’), many of us will be spending a few more weeks outdoors, hiking in the mountains or taking one last trip to the beach, our towels strategically placed 6-feet from our nearest neighbor, our toes dipped in the luke-warm water of the Atlantic ocean once again before fall rolls back around. As we plan our trips, days, car rides and hikes, what to eat tops our list of to-dos, and this month’s Trail Mix Master Recipe gives you just enough structure to get you started but all the freedom in the world to make this recipe your own, just like the vacation, car ride or afternoon at the beach. However you choose to make it, enjoy a handful between vistas or instead of a fast-food pitstop, giving your body a healthier, cheaper and far more satisfying option instead.

ONC’S TRAIL MIX MASTER RECIPE

This recipe is a base recipe, which means it’s a suggestion. Play with it. Adapt it to your diets, your needs and especially your taste buds. Just go light on the goodies and heavy on the healthy stuff, and you’ll reap the rewards of what trail mix was intended to be: a healthy, substantial snack to keep you trucking along through Mother Nature’s wildest destinations. Even if you’re not hiking the Appalachian Trail, a snack-sized bag of this mix is great while watching an evening movie, as a snack for a visiting grandchild hangry in the early evening or as a pre-workout snack before pumping iron. See. So versatile.

INGREDIENTS: • 4 cups nut mixture (dry, roasted almonds, shelled pistachios, roasted peanuts, cashews – the key here is to include a variety of nuts and keep them low-salt and roasted rather than, say, honeyroasted) • 1 cup dried fruit/berries (blueberries, chopped apricot, tart cherries, cranberries, etc. – again, you can mix & match) • 1 cup semi-sweet or bittersweet chocolate chips • 1 cup unsweetened coconut flakes (not the shredded, sweetened flakes used for baking) • 1 cup seeds (pumpkin, sunflower or a mixture of the two) Combine all ingredients and store in an airtight container. We like to use a glass jar with an airtight lid and a wide mouth for optimal scooping. For trips, divvy the mixture up into snack-sized containers or bags for portable snacking options. Hit the road knowing the combination of healthy fats and that little hit of sugar will keep you going for hours without spiking your blood sugar and leaving you hugging a tree and crying for a candy bar.

AUGUST 2020 - 14

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A PART OF THE LIBERTY FAMILY OF SERVICES

Jim Pedersen, VSO & Director of Moore County Veterans Service Office | 910-947-3257

VETERANS CORNER: Working Post-Retirement

Veterans re-enter the workforce for a variety of reasons. They may miss working, need a little extra income to boost their retirement pay, or lose a job a few years shy of retirement. Over the last few months, COVID-19 has left many veterans unexpectedly unemployed. The Bureau of Labor Statistics listed the veteran unemployment rate at 3.5% in March. In April, that number jumped to 11.8% and was at 8.8% at the end of June. Our office works closely with the NC Works office in Aberdeen to link veterans, especially older veterans, with employment and training resources. Sam Levinson, Disabled Veteran Outreach Program Specialist and Local Veteran Employment Representative at NC Works Career Center in Aberdeen, helps veterans in Moore, Montgomery, Richmond and Scotland counties locate gainful jobs.

He said older, retired and disabled veterans bring traits like confidence, reliability, duty and discipline to the workplace. Employers recognize their value and welcome them to apply by including words like “seasoned applicants encouraged to apply” in job advertisements. Despite the many attributes they bring to the workplace, older veterans may face barriers to finding gainful jobs. At the top of this list is technology. Many retirees need to upgrade their computer knowledge before they are ready to seek work in a market that relies on technology over face-to-face and paper applications. He suggests veterans brush up their computer skills through a computer literacy class at their local community college. Levinson laid out a guideline for older and retired veterans who wish to re-enter the workforce.

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AUGUST 2020 - 15 • Apply for unemployment if needed. • Set up an email and create a resume. Levinson and other veteran’s representatives can help with resume preparation. • Visit the local NC Works office for job-seeking assistance. Each office has a veteran’s representative who can help the veteran assess their skill sets and proficiency with computers and other technology, refer to other services, introduce potential employers and help with interview skills through mock interviews and other resources. • Be prepared to do some of the work. This includes searching online resources for available jobs, applying online and attending job fairs and other employersponsored activities. Finally, Levinson encourages any older person who wishes to re-enter the job force to decide exactly what they are looking for. He stresses the importance of being specific in deciding the type of job they are seeking and expectations about work hours, pay, proximity to their home, etc. Veterans who want to find employment may reach Sam Levinson at 919-805-6542. During pandemic closures, the Moore County Veterans Service Office has been operating via telephone, email and mail to serve veterans and their families. Veterans can leave records and other paperwork in the secure drop box in front of the office at 707 Pinehurst Ave., Carthage. Veterans and their families who have questions about VA benefits, disability and other veteran services may call the Moore County Veterans Service Office at 910-947-3257 for assistance or to schedule a phone appointment.

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