Aging at
Altitude
Through the Generations Local Guide to Healthy Aging, Smart Planning & Active Living
SPRING 2021 VIRTUAL EXPO AND WEBINAR SERIES VIRTUAL EXPO: APRIL 7-MAY 31 | LUNCHTIME CONVERSATIONS: APRIL 12-30
BILL ALLEN
Senior Real Estate Specialist® Making real estate transactions less stressful & more successful! Buyers and sellers ages 60+ have unique real estate needs, whether its downsizing from the family home or moving into a new community. “I will have lasting gratitude for Bill Allen’s incredible work selling our mother’s Boulder home in the difficult time following her passing. I don’t know how we would have made it through without him. Not only did he explore all options regarding selling the house (or even not selling it) & get us a great price when it sold, but he pointed us toward helpful resources to assist us in getting the house ready to be sold from another state. This was above and beyond his role in selling the house and it was helpful beyond measure. Bill has lived in Boulder for many decades and he has a great knowledge base and understanding of the real estate market and it’s ebbs and flows. I think he also has a natural ability to understand the particular concerns and needs of his clientele. If you haven’t met Bill, you should know that something about him just has a calming effect. This is a definite plus as the time in which one buys or sells real estate is usually stressful. I would recommend him to anyone trying to choose a realtor because he is intelligent, sincere, trustworthy, informed, patient, a great communicator, and very dedicated to his clients’ needs. He is clear in explaining things and you don’t ever feel that he is rushing anything about the process unnecessarily. I highly recommend Bill Allen for any real estate need.” ~Brigid Hoffman
Let my 30+ years of real estate experience work for you!
Bill Allen, REALTOR , SRES ®
303-441-5690 • 303-570-9814 ballen@boulderco.com www.boulderbillallen.com
®
2425 Canyon #110 | 1320 Pearl BoulderCO.com | 303.449.7000
Features SMART PLANNING
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14 16 18 20 21 22 23 24
A Snapshot of Senior Living Senior Care: Find the Best Fit for Flourishing Buying and Selling a Home as a Senior Estate Planning Elder Law Attorneys: A Primer An Eco-Friendly End of Life Reverse Mortgages Seeing to Senior Health Needs Annuities for Seniors Hospice & Palliative Care
HEALTHY AGING
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28 30 31 32 36
Aging 101: Taking Care of Yourself Get Your Spring Back Sun Safety Tips for Seniors 5 Ways to Help Prevent the Spread of Illness Eyes, Ears and Age Two Roads Converge for Help when Vision is Impaired
38 40 41 42
Getting Rest, for the Rest of Your Life Supplements Supporting Healthy Aging Getting Back in the Saddle Dementia, Alzheimer’s and Neuroplasticity
ACTIVE LIVING 46 48 49
Movement and Fall Prevention In-Home Services for Aging Staying Active for Your Health
Aging Altitude at
VIRTUAL EXPO APRIL 7 – MAY 31
The virtual expo will showcase local experts and resources with helpful information, photos, videos and a contact form for more information.
WEBINAR SERIES APRIL 12 – APRIL 30
The moderated webinar series will broadcast live and will feature Q&A sessions. Sessions will also be available for on-demand viewing.
For More Information, Visit DailyCamera.com/Aging
Aging Altitude at
CONTRIBUTING WRITERS Brittany Anas, Jessica Benes, Barbra Cohn, Linda Thorsen Bond, Emma Castleberry, Kathleen Duff, Adam Goldstein, Sarah Huber, Julie Kailus, Emily Kemme, John Lehndorff, Wendy McMillan, Pam Moore, Elise Oberliesen, John Teehan, Darren Thornberry, Shelley Widhalm CREATIVE DIRECTOR Greg Stone MARKETING CONSULTANTS Julie Casper, Pete Christiansen, Jeanine Fritz, Ruth Garfield, Thais Hafer, Rich Hopkins, Jim Koppel, Keith Kratochvil, Abbie Lance, Dale Sekuler RETAIL ADVERTISING MANAGERS Jill Stravolemos, Christine Labozan Aging at Altitude is an advertising feature of the Boulder Daily Camera, Broomfield Enterprise, Colorado Hometown Weekly and Longmont Times Call. ©2021 Prairie Mountain Media.
A WELCOMING SPACE TO CALL YOUR OWN
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APRIL 2021
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LUNCHTIME CONVERSATIONS WEBINAR SERIES 12 NOON TO 1 P.M. // MONDAY THROUGH FRIDAY // APRIL 12–30, 2021 MONDAY, APRIL 12 // HEARING HEALTH // Timing is Everything: How Hearing Keeps You in the Moment Presented by Family Hearing, Chelsea Walters, BS BC-HIS, Board Certified Hearing Instrument Specialist, Owner TUESDAY, APRIL 13 // FUNERALS & WHAT YOU NEED TO KNOW // The Importance of Pre-Planning Presented by Crist Mortuary Kevin Wood, General Manager Holistic Funerals / “Green” Burial Presented by The Natural Funeral Karen van Vuuren, Co-Founder and Managing Partner
WEDNESDAY, APRIL 14 // SENIOR LAW // Trusts: Probate and asset protection for you and your beneficiaries Presented by Braverman Law Group Diedre Wachbrit Braverman, Esq. Critical Legal Documents: How to plan for incapacity or poor health. How best to enable adult children or trusted friends to act on your behalf. Presented by The Germany Law Susie Germany, Owner and Lead Attorney
THURSDAY, APRIL 15 // DEPRESSION, DEMENTIA, DELIRIUM // The Three Ds: The difference of each and how to treat. Presented by AltaVita Senior Residences Haleh Nekoorad-Long, M.D., Board Certified Geriatric Psychiatrist FRIDAY, APRIL 16 // AGING AND YOUR EYES // Age-Related Macular Degeneration Presented by Eye Care Center of Northern Colorado, Matthew Manry, M.D.
Blurry Vision: Common causes in the aging population Presented by Eye Care Center of Northern Colorado, Melissa Burton, O.D.
MONDAY, APRIL 19 // DENTAL HEALTH // Getting Rest, for the Rest of Your Life: How your dental health tells a story about your sleep Presented by Dental Horizons, Dr. Andrew Kelson TUESDAY, APRIL 20 // SPINE, MUSCLE & JOINT CARE // Spine, Muscle and Joint Care Presented by Spine West Physiatry and Sports Physicians, Cliff Gronseth, M.D. WEDNESDAY, APRIL 21 // FINANCIAL HEALTH // Understanding Annuities Presented by Financially Intact Ron Vejrostek, Tax and Financial Consultant THURSDAY, APRIL 22 // CANNABIS AND CBD // The Health Effects of Cannabis and CBD Presented by Terrapin Care Station FRIDAY, APRIL 23 // MOVEMENT & FALL PREVENTION // Exercises for Your Body, Brain and Mind Presented by The Feldenkrais Store Al Wadleigh, Guild Certified Feldenkrais Practitioner Beyond Balance: How Open Communication Can Reduce Fall Risk Presented by Kind Rehabilitation Scott Salus OTR, LSVT
MONDAY, APRIL 26 // NEUROPLASTICITY & BRAIN HEALTH // Neuroplasticity: How to Reduce Stress and Improve Brain Health Presented by The Brain & Behavior Clinic Dr. Ilene Naomi Rusk and Dr. Pat Henry
TUESDAY, APRIL 27 // HEARING HEALTH // Hearing Health Tech: Not Your Grandma’s Hearing Aids Presented by Boulder Valley Hearing Samantha Warren, AuD, CCC-A, Clinical Director of Audiology WEDNESDAY, APRIL 28 // MEN’S HEALTH // Men’s Health: Non-surgical treatments for erectile dysfunction Presented by Superior Medical Solutions Kolleen Hulyk, Managing Partner
THURSDAY, APRIL 29
REVERSE MORTGAGES Utilize Your Equity Strategically to Live a More Fruitful Life During Your Golden Years Presented by Fairway Independent Mortgage Corporation, Gabe Bodner, Branch Manager
The Truth about Reverse Mortgages
Presented by Approval Reverse Mortgage Jackie Hahn, Approval Reverse Mortgage
FRIDAY, APRIL 30 Healthy Aging through Exercise, Nutrition & Wellness Visits
Presented by Mary Hansen, Licensed Advisor/ Medicare Solutions; Todd Wisser, M.D. , Senior Medical Director, Medicare Advantage Growth & Retention, Evergreen Internal & Family Medicine PRESENTED BY:
For more information call 303.473.1400 or your marketing consultant.
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AGING AT ALTITUDE
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AGING AT ALTITUDE
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SMART PLANNING
A Snapshot of Senior Living in Boulder County By Brittany Anas for Aging at Altitude
O
ver the past year, the COVID-19 pandemic has ushered in a great deal of uncertainty. The real estate market has been among one of the wildest of the wild cards. Mortgage rates hit historic lows, home prices overheated, and housing inventory was squeezed even tighter, especially in Boulder 6
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County. For the county’s senior population, the pandemic plus the unprecedented real estate market, poses unique challenges. Even though it’s a seller’s market, for instance, some seniors and their families are uncomfortable with open homes amid COVID-19, explains Diane Stow, a broker associate with RE/MAX Alliance in Longmont. Meanwhile, the isolation over the past year
may have others thinking more seriously about moving into a senior living community, she explains. Here, in Boulder County, leaders and real estate agents are paying special attention to the changing demographics and shifting needs of the senior population. They’re preparing for the wave of retirees (locally, seniors are the fastest-growing demographic) and have some
early predictions of how COVID-19 will affect the more imminent needs of seniors. As vaccines roll out, here’s a snapshot of senior living in Boulder County, and the unique needs of this population.
A shortage of inventory
No doubt, the aging population will put pressure on several sectors of Boulder’s economy, from healthcare systems to labor DAILY CAMERA, TIMES CALL
shortages as Baby Boomers retire. Housing, and a lack of inventory for those who want to downsize, is a county-wide challenge. On the surface, seniors who are looking to sell their homes may appear to be in a solid place. The average home sale in Boulder County has increased nearly 21 percent from $753,069 to $909,663 and county-wide homes are selling for 2.6 percent over asking, according to statistics from the Colorado Association of Realtors. Seniors who are interested in moving into assisted living or independent living communities aren’t necessarily challenged with a lack of inventory, explains Stow. However, in a fast-moving market, some are having a difficult time coordinating their moves if there’s a waitlist in the communities they’re planning to move into, she explains. Many senior buyers are positioned to be all-cash buyers (a
major advantage in this market). But, there’s still an extreme shortage of inventory, which can make it a high-pressure market many are uncomfortable with, she says. When she’s working with seniors who are looking to downsize, she asks them: “What’s your ‘no tears’ price.” That way, they can put in a strong bid and not feel like they’re missing out if they lose out because it sells for more.
An aging population in Boulder County
Boulder County is aging. As seniors live longer and healthier lives, the demographics in the county are changing, with 26 percent of the population projected to be 60 and older by 2035, which is up from 19 percent in 2015, according to the Boulder County Area Agency on Aging’s most recent annual report. This increase is projected to be sustained through at least 2050.
Boulder County is unique in that its most dramatic increases in population will occur in the community’s 80 and older population. Those who are 80 and up are projected to increase by 244 percent by 2050. With an unprecedented demographic shift, senior living communities are at the ready. Communities throughout Boulder are expanding, remodeling and implementing new programs to keep seniors socially distanced during the COVID-19 era. As an example, Balfour Senior Living expanded to Longmont in fall 2020, offering a continuum of independent living, assisted living and Alzheimer’s and memory care accommodations. To stay engaged with the community amid COVID-19, the Balfour Blanketeers have been knitting and donating hundreds of blankets for Project Linus. And, for fun, Balfour in
Longmont held a sociallydistanced “Margaritas and Music” event recently. At Golden West Senior Living, common area spaces and resident apartments are going through renovations. Amid COVID-19, the Board of Directors has also agreed to not increase rent for residents in 2021. Health and safety have also been a priority as vaccinations roll out. By mid-March, and after three clinics, more than 90 percent of Golden West residents received their vaccination. Balfour Senior Living residents and employees are exceeding national averages for COVID-19 vaccinations in senior living communities.
Looking forward: Postpandemic senior housing
One trend to keep a watch on is if the distribution of the COVID vaccine will result in more seniors listing their homes for sale this
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SMART PLANNING
summer, says Realtor Dale Pearson of RE/MAX of Boulder. “Boulder County’s active listings on the market are currently at historic lows and the pandemic has made many seniors cautious to venture out over the last year,” says Pearson, who holds a National Association Realtors designation as a SRES (Seniors Real Estate Specialist). “Many have not seen their adult children or grandchildren in a year. This may lead to a trend of seniors selling their existing homes this summer and moving closer to their out of state adult children now that vaccinations are available to the senior residents of Boulder County.” Simultaneously, seniors may also be ready to travel again and there could be an emerging trend in which retirees begin buying the second home or vacation home that they’ve
dreamed of, he says. “That may lead to seniors selling their existing Boulder County homes and taking their equity to purchase homes in more affordable areas of the country with milder climates or communities that are closer to their adult children,” he says. On the flip side, Boulder County happens to be an attractive area for young families to live, with a good job market and an active outdoor lifestyle, so we may see more grandparents and seniors moving to the area to be closer to their adult children who live and work here. In general, though, Boulder County Baby Boomers tend to be healthier, have a slow retirement rate and an attachment to the area, he says.
Balfour Senior Living 1331 Hecla Drive, Louisville, 844.354.8877, balfourcare.com
Golden West 1055 Adams Circle, Boulder 303.444.3967, gwboulder.org
Boulder County Area Agency on Aging 3482 Broadway, Boulder 303.441.3570 bouldercounty.org/ departments/communityservices/area-agency-aging
Dale Pearson RE/MAX of Boulder 2425 Canyon Blvd., #110 Boulder, 303.818.5640, mainlevelliving.net
Diane Stow RE/MAX Alliance, 512 4th Ave., #101, Longmont, 303.775.3338, dianestow.com
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SMART PLANNING
Senior Care:
Find the Best Fit for Flourishing By Sarah Huber for Aging at Altitude
T
he best senior care is where you or your loved one will flourish, explained Shirley Berg, executive director of Academy University Hill in Boulder. And the key to flourishing in the senior years, time and again, is a joyful, welcoming living arrangement that supports seniors physically, mentally and emotionally. Senior care options include independent living, assisted living, memory care, a skilled-nursing facility and for short-term needs, respite care.
INDEPENDENT LIVING Independent living offers support and community for 10
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those around 55 and older. At Brookdale Meridian Boulder, for instance, independent living is “for older adults who can still live independently but without the responsibilities of day-today chores like maintenance, cooking meals and cleaning,” said Marcia Klassen, executive director at Brookdale Meridian. She continued, “With perks like housekeeping and laundry and a first-class dining team, all residents have to worry about is what activities they want to do to fill their day.” Likewise, at Academy University Hill, a monthly fee covers some meals, weekly housekeeping and maintenance of the residence, in addition to wellness programs, community
activities and access to the fitness room and pool. Academy independent living residents often venture to nearby Chautauqua Park, and many care for pets in their apartment or bungalow. Independent living communities boast a built-in peer group alongside a slew of amenities, from tennis courts and golf courses to gyms, beauty salons, lecture series, libraries, movie theaters and an array of clubs. Transportation to restaurants, shopping and medical appointments is sometimes included. Recognizing that seniors may be sticking to a fixed budget, John McCarthy, CEO and president of Golden West Senior Living, noted that Golden West has “long provided an estimated 40 percent of the affordable living apartments for seniors in central Boulder.” Studio and one-bedroom apartments feature a full kitchen, and rent and utilities are lumped into a set monthly bill.
ASSISTED LIVING
Assisted living is a long-term solution for those desiring more physical support than an independent environment can offer. Care staff may assist residents with daily living activities, and trained medical practitioners are available around the clock. Assisted living residents at Academy University Hills receive “one-on-one caregiving assistance daily that includes nurse oversight, medication management and administration, personal grooming and all meals,” Berg said. Similarly, Golden West’s assisted living “service package includes nurse-monitored medication programs, assistance with showers and laundry, wellness checks, three nutritious meals a day” and scheduled events, McCarthy said. Social connections and
physical movement and support are imperative to assisted living. “We take the health and wellness of our residents very seriously and involve a personal trainer, community life director and nurses to regularly interface with the residents with expertise and engagement,” Berg said. “We also have been intentional about creating a culture that welcomes resident and family participation in its community life.”
MEMORY CARE
Memory care is designed for those with Alzheimer’s Disease or another form of dementia. Staff are trained to meet the distinctive needs of individuals with memory loss and provide frequent cognitive and physical stimulation. Specially designed apartments ensure a safe and secure environment, and everything from music to meals are purposefully selected to nurture a comfortable, healthy atmosphere. AltaVita Senior Living has grown from one specialized Memory Care Centre, to encompass three residences with three levels of care including Independent Living, Assisted Living and Memory Care. They specialize in Memory Care with Dr. Haleh Nekoorad-Long as the Medical Director at the Memory Care Center. As a geriatric psychiatrist, she works with aging adults and issues including dementia, depressions and bipolar disorder. At the Meadows Assisted Living at Frasier in Boulder, memory care residents value familiar routines and meaningful interactions, including pet and art therapies, that offer opportunities for reminiscence. Julie Soltis, director of communications at Frasier, said, “With 19 custom apartments each for community, the Meadows is known for its attentive care and close-knit family atmosphere. Frasier’s DAILY CAMERA, TIMES CALL
No matter your unique needs, I can help find a plan that works for you! Plans may include: • Medicare Advantage Plans • Medicare Supplement Insurance Plans • Prescription Drug Plans Make an informed decision and possibly save hundreds or even thousands of dollars each year! Call today to set up a no obligation consultation. Phone & in-person appointments available.
Mary Hansen
Licensed Insurance Advisor
303-548-2841
missmary.hansen@gmail.com AgingAtAltitude.com
Medicare plans as unique as you are!
Join us at any of our Upcoming Virtual Medicare 101 Events APRIL 16 AT 2:00 PM APRIL 29 AT 11:00 AM
MAY 3 AT 6:00 PM MAY 12 AT 1:00 PM
Call or Go Online to Register.
This event is for Educational purposes only. No plan or benefit information will be shared. For accommodations of persons with special needs, please call 303-548-2841 (TTY 711)
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SMART PLANNING
caring staff works with residents and their families to create a care plan tailored to each resident.”
SKILLED-NURSING CARE
Skilled-nursing care is the highest level of care for seniors outside a hospital and is the best choice for intensive medical or therapy care. A licensed physician oversees each patient’s care, and a variety of medical professionals, including therapists and nurses, are constantly available. At the Katherine & Charles Hover Green Houses at Hover Senior Community in Longmont, all therapy services are offered on-site, in addition to full clinical support. Meals, laundry and housekeeping and transportation services, as well as palliative and hospice care, may also be offered by skilled-nursing facilities.
RESPITE CARE
For those needing short-term care, respite care offers assistance for a specified period of time. This is ideal for those healing from surgery or requiring intensive physical therapy or an option for seniors when their
Featured Senior Living Communities AltaVita Senior Residences (Independent, Assisted, Memory Care), 1001 AltaVita Ct., Longmont, 720.745.8250; 1002 AltaVita Ct. Longmont,303.834.8800, altavitaliving.com Balfour Senior Living (Independent, Assisted Living, Memory Care, Skilled Nursing, Respite Care), 1331 Hecla Drive, Louisville, 844.354.8877, balfourcare.com 12
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usual caregiver is unavailable. Respite care varies by the needs of the resident, from assisted living with medication management to those requiring skilled-nursing care. At Cinnamon Park Assisted Living in Longmont, respite care residents may choose from private or companion rooms and participate in a regular lineup of community activities, said Trini Lopez, Cinnamon Park administrator. Respite care residents receive medical care in conjunction with personal care, housekeeping and meal services. Regardless of the final decision, families should recognize that “moves are indeed stressful for elders,” Berg said. “Families should consider how a community approaches levels of care that a resident may need or come to need.” Some communities, such as Academy University Hill, offer multiple care options within apartments, allowing residents to layer assistance services even as they remain in their residence. Berg urged families to “add care when it’s needed, determining with Golden West Senior Living (Independent, Assisted) 1055 Adams Circle, Boulder 303.444.3967, gwboulder.org Brookdale Senior Living (Independent) 3350 30th St., Boulder, 303.444.0200; 3375 34th St., Boulder, 303.473.0333; 801 Gillaspie Drive, Boulder, 303.494.3900; 2240 Pratt St., Longmont, 303.682.1066, brookdale.com Cinnamon Park Assisted Living (Assisted Living) 1335 Cinnamon St., Longmont, 303.772.2882, seniorhousingoptions.org/ properties/cinnamon-park
family just the right support so that a resident can remain as independent as possible as well as a vital member of the whole community.” Soltis agreed: “Life Plan communities,” or communities that offer several levels of care, “allow seniors to live independently while still providing the social, medical and emotional support services Flatiron Terrace Senior Living (Independent, Assisted and Memory Care), 930 28th St., Boulder, 303.939.0830 Frasier (Independent, Assisted Living, Memory Care, Skilled Nursing, Respite Care), 350 Ponca Place, Boulder, 303.499.4888, frasiermeadows.com Hover Community (Independent, Assisted Living, Memory Care, Skilled Nursing) 1380 Charles Drive, Longmont, 303.772.9292, hovercommunity.org The Academy Boulder (Independent Living, Assisted Living, Memory Care,
they need,” she said. “A Life Plan community fosters lasting relationships, building a community of friends, which helps increase life expectancy.” Finally, Soltis mentioned, families thinking ahead might appreciate that “residents may be able to deduct the portion of the entrance fee and monthly fees each year attributable to prepaid health care.” Skilled Nursing, Respite Care), Multiple locations, 970 Aurora Ave., Boulder, theacademyboulder.com The Avenues Crofton Park (Independent/Boutique Living) 12431 King St., Broomfield, 720.730.9957, livetheavenues.com The Carillon at Boulder Creek (Independent, Assisted, Memory Care), 2525 Taft Drive, Boulder, 720.565.6844, leisurecare.com/ourcommunities/carillonboulder-creek Juniper Village (Independent, Assisted Living, Memory Care, Skilled Nursing, Respite Care), 1078 S. 88th St., Louisville, 303.665.3722, junipercommunities.com DAILY CAMERA, TIMES CALL
Finding the
right place
We are here to assist your family through each step in the search for senior living. Whether you’rre beginning your search or just have questions, we’re ready to share our knowledge and experience to help you make a thoughtful, well-informed decision. We’re ready to listen, understand and partner to find the right options for you or your loved one. Brookdale Boulder Creek
Brookdale Longmont
Brookdale Meridian Boulder
Independent Living 801 Gillaspie Drive Boulder, Colorado 80305
Independent Living 3350 30th Street Boulder, Colorado 80301
(303) 214-2899
(303) 214-9010
(303) 214-9415
(303) 214-9429
Assisted Living 3375 34th Street Boulder, Colorado 80301
Assisted Living 2240 Pratt Street Longmont, Colorado 80501
431426 BP
Brookdale North Boulder
©2021 Brookdale Senior Living Inc. All rights reserved. BROOKDALE SENIOR LIVING is a registered trademark of Brookdale Senior Living Inc.
#1 in Customer Satisfaction with Assisted Living/Memory Care Communities Tied in 2020. For J.D. Power 2020 award information, visit jdpower.com/awards
brookdale.com
SMART PLANNING
Buying and Selling a Home as a Senior
By Emma Castleberry for Aging at Altitude
W
hen it comes to real estate, seniors present a unique market. Whether you are buying a new home or selling your existing one, it’s important to find an expert who can help you through the process and provide specific advice. “Seniors typically need more time to plan, and more time to plan makes transitions more comfortable whether buying or selling or both,” says Bill Allen, a Senior Real Estate Specialist (SRES) who has been serving Boulder for 30 years. Seniors face a number of distinct challenges, including latelife planning, accessibility needs, and, often, a larger accumulation of household items like furniture 14
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and keepsakes. When selling a home, it’s important to consider tax implications and plan for the large-scale downsizing and moving process. When shopping for a new home, seniors need to consider location and accessibility. They also need make sure they are fully informed before taking the significant step of buying a new place. No matter what, the pros recommend having a strong support network of family and friends to help you with the transition.
SELLING A HOME AS A SENIOR
If you are sifting through decades of material belongings to downsize to a smaller place, you don’t want to have to worry too much about whether you’re getting the best price for your home. Realtor Alana Childre
remembers this process quite well from when she helped her 99-year-old grandmother move out of her home and into assisted living. “The change of that was emotional for her and the family, but I was with her every step,” says Childre. “A home full of 45 years of memories, personal belongings, and home maintenance issues had to be delicately handled in order to get top dollar for her home. I have helped numerous clients do the same.” As life happens, we tend to accumulate more stuff, so the help of professionals in organizing your belongings can be useful. There are also plenty of local groups that help organize and distribute possessions to storage and charitable services. When you start the process of
preparing your home for sale, it will be important to have at least a basic idea of your next move, whether that’s independent or assisted living, or a new singlefamily home or condo. “Make a decision on what your needs and wants are in a new home, so you can then decide what you want to keep and what you need to get rid of,” says Wendy Conder of Windemere Realty. “Set a goal of when you want to move and what needs to be done prior to that.” As with any large project, breaking the process down into small, manageable chunks is the best way to tackle selling your home! When selling a home, Childre recommends that seniors do their research and ask pointed questions about the tax implications. She also adds that a professional stager can be helpful in making the selling process more seamless, especially if your home has older, wellloved furniture. “It’s important to include family members,” she adds. Your support network can provide invaluable aid once you’ve decided to go through with selling your home.
BUYING A HOME AS A SENIOR
“Buying a new home is challenging,” says Allen. “Senior buyers need the benefit of good people who have your best outcomes at heart. Buying and selling in this market is a challenge and selling your house won’t be as hard as finding a new home. We need to strategize.” Allen’s top tip for home buying strategy? “Find a broker who cares about you and who DAILY CAMERA, TIMES CALL
SMART PLANNING
Bill Allen, RE/MAX of Boulder 2425 Canyon Blvd. #110, Boulder, 303.441.5690, billallenboulder.com
Bill Allen
Alana Childre
can relate to what you’re going through,” he says. Conder says, above all, seniors should take their time when purchasing a new home. “Don’t let anyone make you feel pressured,” she says. She also recommends making location a priority. Is the house you’re looking at close to your doctor’s office? What are the transportation options besides driving? You should also considered accessibility. Will the home need to be modified as aging occurs? How extensive will those modifications need to be?
APRIL 2021
Wendy Conder
Dale Pearson
Don’t hesitate to get the information you need to make an educated decision. Ask questions if you don’t understand a part of the home buying process, and keep open lines of communication with your realtor. If you need advice about resources like trash removal or a handyman, just ask!
ENLIST SUPPORT TO MAKE THE PROCESS EASIER
“Seniors are making life changing decisions and in many cases, it is the last home or move they will
Diane Stow
make,” says Conder. “They have unique needs and challenges and they need someone they trust to help them make tough decisions easier.” Regardless of what the next chapter of your life holds, the sale or purchase of a new home is an exciting prospect. Even if you’ve bought or sold a home before, the market is ever-changing and there will likely be a learning curve. Surround yourself with people you trust to help you navigate this complex experience and ensure you end up in a home space that makes you happy!
Alana Childre RE/MAX of Boulder 2425 Canyon Blvd., #110 Boulder, 720.560.9690, alanachildre.com Wendy Conder, Windemere Realty 600 5th Ave., Ste. D, Longmont, 303.775.0108 facebook.com/WindemereRealty Dale Pearson RE/MAX of Boulder 2425 Canyon Blvd., #110 Boulder, 303.818.5640, mainlevelliving.net Diane Stow RE/MAX Alliance 512 4th Ave., #101, Longmont, 303.775.3338 dianestow.com
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Estate Planning: The Differences Between Wills & Trusts By Darren Thornberry for Aging at Altitude
W
hy would you need a trust, not a will? Should you have them both? What happens if you die and you don’t have either one in place? These are common questions that many people have. In this Q&A with a local expert, we hope to bring some clarity to the issue of wills vs. trusts. Braverman Law Group: “Some people make the mistake of thinking that if they set up a will, their affairs will be in order. But this is just not the case. The best approach is to create a
comprehensive strategy so that all of your plans are completed and you don’t have to worry about if things are taken care of.” Deirdre Wachbrit Braverman, Esq., was kind enough to take our questions on this topic. We hope you find this information very helpful!
What’s the primary difference between a will and a trust and who typically would need one versus the other? A will goes through a process called probate when you die. Probate is a court-supervised process meant to transfer assets
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from someone who has died to the people they intend to leave them to. A trust is an entity that owns your assets so that when you die, they do not need to go through probate. They’re not owned in your name so there’s nothing for the court to transfer.
What are a couple of the differences of wills and trusts?
The trust offers more privacy because it is not filed with the court in public records. Your name, your beneficiaries’ names and addresses, and what they’re inheriting is kept completely private. The trust is also less burdensome to administer for
the person you’ve given that job to. There are no court filings or hearings for them to worry about. Because the trust avoids probate, the assets get to your beneficiaries much more quickly. In a simple estate, the beneficiaries may see their inheritance in weeks rather than months or years. Finally, because it avoids probate, it’s less expensive to administer. There are two downsides to the revocable living trust. One is that you have to transfer all of your assets into it while you are living. That’s a bit of a hassle. And it’s more expensive to set up because it’s a more comprehensive and sophisticated document.
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If you own your own home or any other real estate, a trust is for you. If all of your assets are in accounts, you may be able to rely on a will and still avoid probate. If you have less than $70,000, probate is not required.
Perhaps this seems obvious, but why is estate planning, whether using wills, trusts, or both, so important?
If you don’t do either, you are leaving a mess for your survivors. You’re making fighting more likely. You’re leaving a big burden of paperwork and phone calls for someone. If you have more than
$70k, you’re forcing your next of kin to go through probate in order to receive their inheritance. And your assets may not go where you want them to. When we meet with clients, we often find that beneficiary designations, taken as a whole, don’t reflect their wishes. They’re often out of date. Estate planning is the process of preparing all of your assets to go to your loved one in the least burdensome way. It’s a gift they’ll appreciate after you’re gone. Braverman Law Group 1823 Folsom St., #101, Boulder, 303.800.1588, braverman-law.com
GLOSSARY OF HELPFUL TERMS Courtesy of Braverman-law.com. We encourage readers to visit this website for more information!
LIVING WILL — You can express your wishes about lifesaving measures and life support methods at end of life now before it’s too late. REVOCABLE TRUST — Sometimes called a living trust. This is a trust that you can change while you are still living. This document accounts for how you want your property to be distributed upon your death. WILL — Your will ensures that your final wishes are documented legally and in writing. It is also where you designate who the executor will be. A will accounts for what will happen to your belongings, including assets and any property to be disbursed. You can also designate who will become the guardian for your children if something happens to you. HEALTHCARE POWER OF ATTORNEY — No one will argue that it’s difficult to think of getting older and needing someone else to make health decisions for them, but the worst thing to do would be to wait until you can’t make those decisions for yourself. By planning for this eventuality now, you can have a say in what will happen to you and choose who makes your medical decisions. FINANCIAL POWER OF ATTORNEY (POA) — This important designation should never be overlooked. The person assigned to be your power of attorney can assist you with handling your financial decisions such as paying bills when you are no longer able. Choosing someone who is trustworthy and makes sound decisions is critical.
APRIL 2021
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Elder Law Attorneys: A Primer By Darren Thornberry for Aging at Altitude
E
lder law attorneys are advocates for the elderly and their loved ones who handle a wide range of legal matters affecting an older or disabled person. We interviewed a local elder law attorney, Susie Germany (coelderlaw.com), to better understand the scope of what they offer.
What does an elder law attorney do?
An elder law attorney focuses on long-term legal planning considering three major factors:
what a person’s care plan or health situation is, their financial picture and assets, and what legal documents or strategies will work best to help protect and provide them with the most effective legal planning to meet their circumstances. These legal documents may be medical durable powers of attorney, financial durable powers of attorney (POA), wills or various types of trust planning. Elder law encompasses estate planning and requires knowledge of various public benefits programs such as Social Security, Medicaid and Medicare in addition to tax planning, all of which have
Do the people you trust have the authority to make decisions for you if you can’t make them for yourself? Have you left a mess for your family to clean up after you’re gone? Has it been more than five years since your estate plan was updated?
J Join Us on Wednesday, April 14 at Noon on the Virtual Aging at a Altitude Conference to Learn How to Protect Yourself!
(303) 800-1588 • frontdesk@braverman-law.com • https://www.braverman-law.com/ 18
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SMART PLANNING
complex rules and regulations. Our clients range from families of younger folks who have sustained a sudden traumatic brain or spinal cord injury to families planning for their family members who suffer from some form of dementia. We also work with everyday people just wanting to get their affairs in order.
Are there certain issues that it’s crucial you have an elder law attorney to handle?
It is crucial for folks to consult an elder law attorney when considering any gifting strategies or adding people onto the title of their home or bank accounts or transferring those assets to their family members or friends, as this can have important tax consequences and defeat or impact Medicaid eligibility. Due to COVID-19, we are also strongly encouraging folks to review their advanced directives (living wills) and medical durable powers of attorney with an elder law attorney to make sure their current end-of-life wishes are accurately reflected in their legal planning documents.
Are there common misconceptions about elder law?
The most common misperception about elder law is that it only applies to older people. Elder law attorneys also work with younger folks and their families who may be receiving or seeking eligibility for various public benefits programs like Medicaid due to disability. It is also a common misperception that elder law is a boring area of law and all we deal with is “old people problems.” Nothing could be farther from the truth. We jokingly call this area of law in our office “Days of Our Lives, the Senior Version.” We see everything from elder
JUNE 2021 2020 APRIL
abuse, elder exploitation both by strangers and family members, dating site scams, to hotly contested guardianship and conservatorship cases and will and trust litigation cases that go on for years. We often are navigating family disputes and our cases involve criminal law, bankruptcy or civil litigation. These cases are all about people, their wishes and their relationships with their families and their assets. Nothing about that is boring. Sometimes it is tragic or frustrating, but no two cases are ever exactly alike. As an attorney, I like the challenge of constantly learning something new.
What’s a misstep or pitfall that an elder law attorney helps an older adult to avoid?
A common misstep an elder law attorney helps an older adult avoid is adding a child to the title of the senior’s home or bank accounts or transferring everything they own into that child’s name to do “Medicaid planning.” The other pitfall elder law attorneys often help an older adult avoid is naming the wrong person, such as a child who may be financially irresponsible, as the senior’s financial agent under a power of attorney. People often name their adult kids in these roles just because they are the children, but they do not consider if the child is really qualified. Often older adults are not aware of how dangerous naming the wrong person can be. This has been instrumental in the surge of elder fraud and exploitation cases we see.
Are there a few crucial legal documents that parents of adult children should have in place? And would these be different than what an aging adult generally would need?
children, like college students, a medical durable POA and a financial durable POA are important to have in the event of emergency as kids are emancipated at age 18. As parents of children who have special needs are well aware, every child is different and has different abilities, strengths and challenges that may evolve over time. Some adult children may have the ability to sign and understand POAs; others may not and adult guardianship or conservatorship may be needed. For future financial planning for children with special needs, parents may want to consider funding a special needs trust for that child either during that parent’s lifetime or at their death both for financial management or for public benefits eligibility or consider an ABLE (achieving
a better life enrichment) 529a savings account. Both have very specialized rules. Supported decision-making may also come into play where a supportive group of folks involved with an adult with disabilities may be an alternative to formal court-supervised roles like guardianship. Planning for folks with disabilities Is very individualized, as we are all different, and not one size fits all. Germany Law 77 Erie Village Square Suite 100, Erie, 303.454.3711, coelderlaw.com Kottke & Brantz 2975 Valmont Road, #240, Boulder, 303.449.6161, kbcolorado.com
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AGING AT AT ALTITUDE ALTITUDE AGING
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Going Green
Local alternatives now available for an eco-friendly end of life By John Lehndorf for Aging at Altitude
O
ne-size-fits-all doesn’t suit most of us during our lives as individuals. The same is true when we are making end of life decisions. Mortuaries in Boulder and Longmont now offer a surprisingly wide range of burial and funeral options from the alternative to the traditional. For instance, if you have lived your life respecting nature, eating organically and supporting a sustainable lifestyle, can your end-of-life arrangements reflect your values? The Natural Funeral which opened in Lafayette in 2019 as an independent, natural, holistic funeral home. “We pride ourselves on being local and sustainable. All of our caskets are crafted locally using Colorado beetle kill wood and artisans make our urns,” says Karen Van Vuuren, co-owner of The Natural Funeral. Among the services the facility offers is a “green” burial which doesn’t involve embalming and a service called Reverent Body Care. “We care for the deceased using all-natural products and no chemicals,” she says. The staff prepared the deceased with a gentle preparation ceremony involving washing, anointing and blessing. The Natural Funeral is also a pioneer in the eco-friendly water cremation process. “It’s a choice that will become more popular because it’s less polluting. It doesn’t require the high heat and fossil fuels that traditional cremation requires,” Van Vuuren 20
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says. In the past, extremely difficult year, families were not able to be present at funerals and burials. “As the pandemic restrictions have been gradually eased, we are able to have more on-site gatherings. It’s so important to get that human-to-human contact back,” she says. In Boulder, Crist Mortuary & Cremation is like an old reliable friend who is always there to help, especially during life’s most challenging times. The full-service funeral home can provide chapel spaces, cemetery
spaces, custom headstones and markers, and services including flowers, catering, audio and video production and music. The facility includes the appropriately named Mountain View Memorial Park in North Boulder which includes a cremation cemetery and niche options. Pre-planning allows you to create a unique celebration of life. Open since 1968, Crist Mortuary’s veteran funeral planning advisors record your wishes in detail and can add information about family history and the estate. A site for the
gathering can be chosen in advance. These preparations lighten the emotional and financial load on grieving family members. The Natural Funeral 102 W. Chester St., Lafayette, 720.515.2344, thenaturalfuneral.com Crist Mortuary 3395 Penrose Place, Boulder, 303.442.4411, dignitymemorial.com/ funeral-homes/boulder-co/ crist-mortuary/2558 DAILY CAMERA, TIMES CALL
Reverse Mortgages
Specialists say reverse mortgages help seniors move forward and age in-home “Everything else goes up in retirement – all of your costs – but not your income. A reverse mortgage allows you to access f you watch much network a portion of the equity in your television you know you home without having to repay are certain to see tons of those funds,” Hahn says prescription ads including In addition, staying in your litanies of scary side effects home can saves money. “It is far and advertisements for reverse cheaper to stay living at home and mortgages that really don’t get care than to move to a long explain much. care facility. A reverse mortgage “A reverse mortgage is a also frees up funds that can be payment-optional financing tool used for in-home for homeowners 62 and up who You can’t be care,” she says. Jackie Hahn have a significant forced from your says that she amount of home gets equity,” says home. The loan mainly to say “Yes!” Gabe Bodner, a reverse mortgage doesn’t come due to most folks who apply for a specialist at until your 150th reverse mortgage. Fairway Mortgage However, she birthday. in Boulder. recommends not One critical waiting years and – Jackie Hahn goal of reverse applying as a last mortgages is to resort when some homeowners preserve assets for the long run. “It reduces the risk of running out may not qualify financially. “A reverse mortgage really of money before you die. That’s a should be discussed as part of primary concern of many reverse everyone’s financial planning for mortgage clients,” Bodner says. retirement. It’s not a question There is an abundance of of how valuable your home is. I misunderstandings about reverse talk to clients who have multimortgages. “First, you can stay million-dollar homes and those at home as long as your health with $300,000 homes, ” she says. allows for the rest of your life. If By John Lehndorf for Aging at Altitude
I
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you live to be 110 then you are at home and never have to make a mortgage payment,” Bodner says. The only requirements are that the homeowner maintain the property and pay the taxes and insurance. There are many other advantages to homeowners from the program, according to Jackie Hahn, reverse mortgage specialist at Approval Reverse Mortgage in Longmont.
APRIL 2021
Gabe Bodner, Fairway Independent Mortgage Corporation 777 29th St., #102 Boulder, 720.600.4870, reversemortgagesco.com Jackie Hahn, Approval Reverse Mortgage 357 Main St., Longmont, 303.651.6007, approvalreverse.com
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centers, clinics, and medical offices all follow rigorous safety and cleaning protocols. Health care facilities have been modified for greater social distancing and, following CDC guidelines, evaluate and treat COVID-19 patients separately. Health care providers are doing everything they can to make sure your visit is both safe and effective.
TELEHEALTH OPTIONS
Seeing To Senior Health Needs During COVID-19 By John Teehan for Aging at Altitude
T
here is no question COVID-19 has disrupted many things in life. The pandemic has complicated work and family life and how many people – especially seniors – have been managing their health. With all the restrictions put in place at many health centers and a flood of ever-changing information, it’s easy to see how it can become overwhelming. These complications have made it challenging for some to access proper health care when needed. Seniors, especially, have been hit hard by the recent complications associated with seeking proper health care. We reached out to Mary Hansen, a Bridlewood Medicare Agent, for her thoughts and advice on seniors’ health care needs during the COVID-19 pandemic.
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She notes that during this time, it’s essential to look after yourself by getting the timesensitive medical care needed to stay healthy. Recurring health conditions, sudden symptoms, and the need for preventive care should still be treated with a sense of priority – COVID-19 notwithstanding.
STAYING ON TOP OF HEALTH CARE NEEDS
Chronic conditions, such as heart disease or diabetes, need regular checkups, lab visits, and imaging. Your physicians will want to monitor your progress and make sure treatment is working. If you’ve been working with your doctor on ways to handle pain management associated with migraines, fibromyalgia, nerve pain, or arthritis, you’ll want to continue that care, so daily living is more manageable. Your physician may wish to conduct cancer screenings to
address possible early detection and treatment. Some of these screenings are time-sensitive and should not be put off. Most critically, COVID-19 concerns should not get in the way of emergency treatment for symptoms associated with heart attacks, strokes, or intense stomach or abdominal pain. In a medical emergency, every minute matters. Getting care quickly can make a big difference in your treatment and help you have an easier recovery. If you or a family member are experiencing these or other emergency symptoms, call 911 or visit your nearest hospital’s emergency room. Emergency rooms are following strict safety measures to keep you safe from COVID-19.
KEEPING IN-PERSON VISITS SAFE
Your health and safety are a top priority. Hospitals, health
A telehealth appointment via phone or videoconferencing software may seem like it’s not a “real” medical visit at times. That said, they can be essential to helping you maintain your health. Suppose you don’t feel confident or safe with an in-person visit. In that case, a telehealth session can allow you to discuss symptoms, progress, prescriptions, or other issues with your physician. If there are serious concerns, you can talk about how to address them best.
LOOKING AHEAD
The COVID-19 pandemic won’t last forever. It’s good to know that health care professionals such as those at Aging At Altitude take your safety and security seriously. And that they’re doing their part to keep COVID-19 from spreading. Your team will always guide you to the best care option for your needs, whether that’s a video visit or an in-person visit. There is no reason for seniors to put off crucial health care needs. Mary Hansen, Bridlewood Insurance Medicare Solutions 303.548.2841 agingataltitude.com New West Physicians, Part of Optum 303.763.4900 nwphysicians.com DAILY CAMERA, TIMES CALL
SMART PLANNING
ANNUITIES FOR SENIORS:
Are They a Safe Investment Strategy? By Shelley Widhalm for Aging at Altitude
I
nvestors have three safe places to invest their money, bank products, U.S. Treasury notes and bonds, and three of the four types of annuities. “This is why I love annuities: they earn a reasonable amount of interest over their term, and they are terribly flexible to make them work however your financial plan needs them to work,” said Ron Vejrostek, owner of Vejrostek Tax and Financial in Longmont. Annuities are a type of savings account issued by an insurance company rather than a bank and are a way to provide a lifelong income, as described by Vejrostek at his website, ronsoffice.biz. Though not FDIC insured, they are backed by insurance
companies, which typically guarantee the principle and a minimum amount of interest, usually 1 to 3%, Vejrostek said on his website. Ron Vejrostek Annuities grow tax deferred and do not carry early withdrawal charges, he said. The first type of annuity is an immediate annuity, which serves as the basis of most financial plans, Vejrostek said. Immediate annuities guarantee a monthly payment based on the age of the investor and the interest rate at the time they are issued, he said. They can be purchased with funds from a 401K, IRA or other retirement account, a brokerage
account or another form of asset and typically are used during retirement years. “People are more familiar with them than they think are, because (some) older people have pensions, where pensions are built on immediate annuities,” Vejrostek said. Two other types of annuities are the fixed annuity and the fixed indexed annuity, which generate a greater rate of return than the immediate annuity. The fixed annuity provides a fixed interest rate for the entire length of the annuity contract, while fixed indexed annuities allow investors to participate in stock market gains but not in the losses. During market gains, investors receive a portion of the interest, but when the market goes down, the annuity holds its last locked-
in value. “It’s tied to the performance of the market but is not invested in the market, so you can’t lose money,” Vejrostek said. “You’ll never get rich with a fixed interest annuity, but you’ll never go broke because you can’t lose money.” The final type of annuity is the variable annuity with full investment in the market and that carries a heavy set of fees. Investors can gain or lose money with this type of annuity, unlike the other three that offer more of a guarantee.
Vejrostek Tax and Financial 421 21st Ave., #213 Longmont, 303.776.0867, ronsoffice.biz
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Hospice & Palliative Care What’s the difference and should I add it to my support team? By Pam Moore for Aging at Altitude
C
ompassion is the cornerstone of TRU Community Care’s mission. The non-profit, Colorado-licensed, Medicare and Medicaid-certified healthcare organization has been serving Boulder, Broomfield, Adams, Jefferson, and Weld Counties since 1976. Today, they proudly provide care for community members coping with advanced illness and loss, with hospice and palliative care among their many offerings. According to Jen Thomas,
Director of Development and Communications, hospice and palliative were designed for people with serious illness. She says both services offer “a collaborative, interdisciplinary approach to managing physical, emotional, and spiritual needs.” With a focus on quality of life, both “can be provided wherever the patient calls home.” But while hospice is a form of palliative care, the converse is not true. Though both palliative and hospice care focus on comfort, the former is administered concurrently with curative treatment; the latter does not. According to Thomas, “Palliative
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care can begin at any time at the discretion of the physician and patient.” She says the average patient receives palliative care for at least one to two years. Hospice care, meanwhile, begins “when a patient is certified to have less than six months to live.” Whether and at what point you should add palliative or hospice care to your support team depends on your unique situation. Palliative care may be indicated when your goal is to remain as comfortable as possible while also receiving medical treatment to manage your illness and prolong your life. The TRU Palliative Care team can help your primary physician manage your symptoms, help you and your family determine your care goals, coordinate home services, and help you plan your advance directives. Thomas explains that palliative care patients’ interdisciplinary care team may be comprised of physicians, nurse practitioners, nurses, social workers, chaplains, and volunteers. When your doctor deems your illness to be terminal and you are approaching the end of your life, it may be time to consider hospice care. At this point, while you can no longer control your health status, the TRU Community Care team will work with you to create a care plan that focuses on making the most out
of the time you have, making sure each aspect of your care is aligned with your values to the fullest extent possible. According to Thomas, hospice interdisciplinary care teams may include professionals such as nurses, physicians, nurse practitioners, social workers, home health aides (CNA’s), spiritual counselors (also known as chaplains), volunteers, grief counselors, and medical directors. No matter what type of care you receive, all TRU Community Care patients receive a team approach to their care from day one. According to Thomas, “a patient care consultant and/or an intake/admissions coordinator works with the patient, family, and/or existing care team to establish care with TRU.” Once a patient enters the system, “any member of the patient’s care team can and will be in touch with the patient and family,” she says. There’s a reason they’ve been providing end-of-life care for over four decades. As Thomas explains, “TRU Community Care clients appreciate first and foremost the compassionate care they receive.” TRU Community Care/ TRU Hospice Care Center 1950 Mountain View Ave., Longmont, 303.604.5272, trucare.org
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Hearing is often thought of two dimensionally, in terms of pitch and volume. But not to be underestimated is the space in which those factors reside — time. Join Chelsea Walters, B.S., BC-HIS, of Family Hearing to discover time’s role within sound itself, its influence on the quality of your hearing, and how it’s shaped by hearing technology today. The moments that matter most are fleeting. Learn how hearing well keeps you present in the moments that matter to you.
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HEALTHY AGING
AGING 101:
Taking Care of Yourself By Jessica Benes for Aging at Altitude
I
t has to be your occupation as an aging adult. You have to be more conscientious about your physical, mental, dietary, doctoring health than you ever were as a younger person. “Use it or lose it,” says Dr. David Remmert, doctor of psychology and manager of older adult programs at Mental Health Partners. Remmert said it’s necessary to make it a habit to track your whole body wellbeing as a person gets older, to maintain excellent self care. He had a lot of advice on self care tips as a person ages. 26
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As a young person, sometimes you eat right when you can, you exercise when you can, but you really have to pay attention in a different way as an older adult, he said.
MENTAL HEALTH
Remmert noted that older adults don’t have any more mental health issues than younger counterparts. Those reasons for mental health struggles might be different but the percentage isn’t higher. “However, it’s a well known effect that older adults don’t get recognized for their mental health issues as often as young adults,” he said. There’s a bit of mentality in the healthcare
industry that of course you’re depressed, you’re old, you’re weak, he said. Mental health challenges in older adults shouldn’t be overlooked or discounted. As adults get older, many struggles come to light that weren’t fathomed earlier on. Older adults might struggle with a loss of independence or autonomy due to having to move into a nursing home or assisted living facility. This might cause depression or anxiety. There is also sometimes a crippling sense of irrelevance, loss of purpose or meaning in life after retirement or children moving away. They will also struggle with grief or depression (which are two
different things) after a partner dies. They might also struggle with a confusion over technology or the quickly changing times. Remmert suggested several self-care tips to alleviate some of these issues. Many of Mental Health Partners’ vibrant older adults are avid volunteers. They went from being doctors, stockbrokers or lawyers to building homes and helping in their community. Older adults might also consider joining clubs at local senior centers or finding other social mediums. They should also ask for help, talk to someone like the advocates at Mental Health Partners, or otherwise find support and not suffer alone. DAILY CAMERA, TIMES CALL
PHYSICAL HEALTH
The type of exercise older adults take part in will differ depending on their physical and other limitations, but it is necessary to get some kind of daily exercise. Remmert suggested getting that resting heart rate up to get the heart beating and blood flowing. “Watch that diet in a way that’s heart healthy and nutritious. Stay away from the traps we get away with in our younger years; fast food, greasy food, hamburgers,” he said. The number of doctors an older adult might see will often increase and can get confusing, but it’s important that those doctors are in coordination with each other to help you track your doctoring care, Remmert said.
SOCIAL HEALTH
Again, older adults should get involved, join a club. Many senior centers even have groups that get together and do puzzles, knit and socialize. If they are isolated, older adults should sign up for Meals on Wheels programs in their community to deliver meals to the homes. “We need to make sure they (older adults) feel honored and relevant, it can be a humbling experience to transition to older adulthood. We need to respect that they have contributed their lives to our culture and they deserve something in return,” Remmert said. “We don’t always do a great job of recognizing the contribution they have made over the course of their lives. They’re not a drain on society, they have paid their dues.”
SPIRITUAL HEALTH
Remmert loves it when older adults have a church, a synagogue, a mosque, or another place of worship to go to. “When they have some spiritual involvement with formal organized religion, it can go a long way,” he said. The social APRIL 2021
aspect of these places of worship is important as well as feeding that side of them that has spiritual beliefs and living those beliefs. “I’m always encouraged by older adults going to church regardless of if I agree with them religiously or politically, I’m thrilled that they’re thinking, involved, feeling relevant and vibrant,” he said. “It really is having a passion for something. Nurturing that passionate side of yourself that has beliefs in faith is an important aspect of older adulthood.”
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EMOTIONAL HEALTH
There is a stigmatization around the issues of aging and getting older,” Remmert said. “Older adults come from a generation that you pull yourself up by your bootstraps. Again he said that people struggling with depression, sense of isolation or anything else should reach out to someone, like the advocates at Mental Health Partners. The organization has a Senior Reach program for anyone who is 60 and over where therapists provide treatment free of charge to older adults in their homes. Whatever insurance does not cover is covered by a grant. He also said that medication can help with depression and anxiety. Yes, there are some contra-indicated medications out there that cause cognitive confusion, but there are plenty that work on mental health conditions in a competent way that can change the game for older adults. “Ask for help, reach out for help,” he said. Mental Health Partners Locations in Boulder, Broomfield, Lafayette and Longmont, 303.443.8500 mhpcolorado.org. 24/7 Crisis Line: 1.844.493.8255.
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HEALTHY AGING
Get Your Spring Back Reduce Pain and Restore Mobility
By Julie Kailus for Aging at Altitude
W
ith spring right around the corner, happily vaccinated seniors may be drawn outside for warm, sunny days. But year pent up in a pandemic could make spring activities a little more challenging. Whether you or a loved one is struggling with atrophied muscles, a nuisance injury that hasn’t been checked at a doctor’s office, or natural signs of aging that have become more pronounced, the good news good news is medical and therapeutic facilities are opening back up. There’s no better time to find a professional who can help 28
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with pain and mobility, not to mention putting that spring back in every step. We caught up with a few local experts to learn about modalities that can help the aging population move through physical limitations this season.
PHYSICAL THERAPY: BASELINE REHABILITATION
Physical therapy is one effective, hands-on rehab approach that can help with strength, endurance, stability, and flexibility. The skilled nursing facility at the Life Care Center of Longmont, for example, sees patients who have pain due to bone fractures, joint replacements, cardiac surgery, neurological pain issues related to strokes, general arthritis,
Parkinson’s disease, among other conditions. “It’s never easy to convince someone who is having pain to start to move to help with decreasing pain. That’s what makes a physical therapy special,” says Claire Townsend, MSPT, Director of Rehabilitation at the Life Care Center. “We have a great knack for convincing people to move despite their pain and helping them get back on their feet.” Physical therapy can help manage the physical side of inflammation, stiffness, and soreness through exercise, manipulation, and massage. It also helps the body heal itself by encouraging the production of natural pain-relieving chemicals.
“We all know, the less you move, the more pain you experience,” Townsend says. “The more safe, therapeutic activity and exercise you get while working with a physical therapist, the less pain you’ll feel and the more you’ll be able to function on a daily basis.”
TAPING & DRY NEEDLING
Knee pain is one common condition among aging adults. Chuck Philipp, owner and CEO of Alpine Physical Therapy and Alpine PT Home Care, starts patients with ice and rest to reduce swelling. If the pain doesn’t subside then it’s on to a doctor or physical therapist for additional assistance. DAILY CAMERA, TIMES CALL
HEALTHY AGING
“A doctor can determine whether there is any structural damage. If your doctor does not feel that you need surgery, he or she will often recommend physical therapy,” Philipp says. “A PT can work on improving your mobility through stretching, ice, heat, electric stimulation, dry needling and taping.” Knee, elbow, and shoulder pain all typically respond to kinesiology therapeutic taping. “A skilled therapist or aide can apply tape in a way that will improve mobility, reduce swelling, and reduce pain during movement of joints and ligaments,” he said. “When applied properly, tape can last for at least a week and be very effective.” Dry needling is another trend in manual therapy that’s used in home healthcare and clinics to treat chronic pain and restriction of motion. It’s used to treat trigger points in muscles with the use of small hypodermic, sterile needles.
A practitioner inserts a solid filaform or hollow-core needle into contracted muscles in effort to improve circulation, increase venous and lymphatic drainage, and stimulate the stretch reflex of muscles and overlying fascia. “Dry needling aims to reduce reflexive muscle tension by targeting the contracted muscle areas,” he says. “It’s highly effective, especially when other treatments are not achieving desired results.”
PHYSICAL MEDICINE: A HOLISTIC APPROACH
A slightly different approach is physiatry or physical medicine. Dr. Cliff Gronseth, a wellknown physiatrist, or physician who specializes in maximizing function, performance, and quality of life, says his trusted team at Spine West follows these basic tenets when initiating any functional improvement plan in the senior population:
Everyone is unique. A onesize-fits-all model usually does not work and may be harmful at times. Hearts, bones, and muscles have different tolerances. Even elite, well-honed athletes can hurt themselves with changes in training routine. If you are unsure what’s best for you, get evaluated before starting a new activity program. Make a plan. To paraphrase Yogi Berra: If you don’t know where you’re going, you may not get there. Like diets, many wellintentioned exercise programs fail without goals. Proper movement, nutrition, and mental attitude are all part of a good rehabilitation plan. And goals may change as milestones are reached. Keep it positive: A restoration program is a marathon, not a sprint. Research has shown that it may take three to four days of rehab to recover from one day of sedentary activity, so be patient. Activities that give you positive
feedback have the best chance of sustainability. A “wellness buddy” may help you achieve your goals, as well as some pain management techniques. Not matter what approach you choose for healing pain, Boulder County is full of experts who can help you put a pleasant spring in your step — just in time for a season full of possibilities. Alpine Physical Therapy 1310 Baker St., Longmont, 303.772.2255; 1566 Vista View Drive, Longmont, 720.266.7100, alpinephysicaltherapylongmont.com Life Care Center 2451 Pratt St., Longmont, 303.776.5000, lcca.com/locations/co Spine West 5387 Manhattan Circle, Boulder, 303.494.7773, spinewest.com
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HEALTHY AGING
Sun Safety Tips for Seniors Tips For Spotting And Preventing Skin Cancer
By Linda Thorsen Bond for Aging at Altitude
M
ore people are diagnosed with skin cancer in the U.S. than all other cancers combined. One in five of Americans will develop skin cancer by age 70. In Colorado, our active lifestyles provide even more risk. We sat down with Dr. Sarah Bair and her team at Crossroads Dermatology in Longmont to get their tips for early skin cancer detection and prevention. The owner of Crossroads Dermatology did her residency in Florida but sees more skin cancer in Colorado then she did there. “People here have such an active lifestyle, they’re so outdoorsy, and we have higher exposure at this altitude,” she said. When asked if she thinks people should just stay inside, she laughed. “Going outside is important for your health,” she said. “I wouldn’t tell people to say inside, but I would recommend that they protect themselves while outdoors. I recommend wearing a wide-brimmed hat and sunscreen of SPF 30 or higher anytime you’re outside in the sun. Be sure to reapply it every two hours as long as you are outside. You should also do a monthly check of your skin. Anything that is changing or looks new or that looks different from your other spots is important to have checked.” She recommends having a baseline skin exam with a dermatologist. “That can give you an idea of what to look for, and you’ll get recommendations that are specific to you,” Dr. Bair 30
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said. “People say. ‘I did all my skin damage when I was younger.’ But you continue to damage your skin even later in life. It’s the accumulated DNA damage that increases with age that can lead to skin cancer.” Although melanoma is the most dangerous skin cancer, squamous cell cancer is more common. Dr. Bair said squamous lesions are pink or flesh colored, possibly hard or crusty and often tender, sensitive or growing. She said, “There is a pre-squamous cancer called an actinic keratosis that we can easily treat with liquid nitrogen or chemo therapeutic cream. By destroying these pre-cancers, we prevent them from developing into a squamous cell skin cancer. Often those treatments expose other
spots that are precancerous and highlight how much sun damage people really have.” Dr. Bair also commonly sees patients with basal cell skin cancer, the most common cancer worldwide. It often appears as a pink, pearly or scaly spot that sometimes itches or bleeds. “Luckily, basal cell skin cancer is usually easily treated,” said Dr. Bair. “People are living active, outdoorsy lives here when they’re 70, 80, and 90 years old. Anyone can get skin cancer – men, women, fair-skinned people and dark-skinned people, any ethnicity. We all need to protect ourselves from burning. There are so many people living here whose skin wasn’t designed for the Colorado sun. We all need
sunscreen, hats and shadeseeking behavior to protect against cancer, wrinkles and brown spots.” Dr. Bair doesn’t just concentrate on skin care professionally, she takes it personally. “I had a basal skin cancer, and it made me personally very aware of the dangers. In addition to my daily sunscreen, I wear UV-protective shirts and hats to help protect my skin. There are many ways to protect your skin and they all can make a difference.” Crossroads Dermatology Dr. Sarah Bair, 2350 17th Ave, Ste. 100, Longmont, 303.848.8334 crossroadsdermatology.com DAILY CAMERA, TIMES CALL
HEALTHY AGING
5 Ways to Help Prevent the Spread of Illness (Family Features)
T
his year, as cold and flu season converges with the COVID-19 pandemic, it’s important to take precautions to help prevent the spread of illness and infection both in and out of the home. The similarities between cold, flu and COVID-19 symptoms can be confusing, and a spike in the seasonal flu could place additional strain on already tight health care resources. To help ease confusion and provide guidance, Dr. Darria Long-Gillespie, ER physician and Clorox spokesperson, outlined these best practices that can help keep you and your family healthy. Develop a Household Plan: Make sure everyone in your household and immediate family is on the same page about how to best prevent the spread of illness within your home. Consider an informal “household contract,” where each
member will alert the household if he or she comes in contact with an infected person or starts showing symptoms. This is important to help protect everyone in the house as well as visitors to your home, particularly those who are at-risk (such as older relatives) and can allow you time to prepare should any family member need to selfquarantine. Don’t Skip the Flu Shot: Your first line of protection against illness is a flu shot, which not only reduces your risk of getting the flu, but also helps protect your community and conserve health care resources. This is especially important this year, since some of the symptoms of COVID-19 and the flu overlap and can be difficult to tell apart. Because accessing the flu vaccine may be more challenging this year for many Americans due to the pandemic, Clorox has donated $1 million to Direct Relief, Visiting Nurses Association of America
and Families Fighting Flu to help provide access to, and spread awareness of, the importance of flu vaccinations. Maintain Regular Healthy Habits: One of the best defenses is a good offense, and the same is true when preparing for cold and flu season. Aiming for a well-balanced diet full of non-processed foods, staying hydrated, exercising and keeping a regular sleep schedule are all keys to keeping illness at bay. Disinfecting high-touch surfaces with a disinfectant that’s approved by the Environmental Protection Agency to kill SARS-CoV-2, the virus that causes COVID-19, can also help support prevention, especially if you have members of the household leaving frequently for work or school. Attend Necessary Medical Appointments: It’s important for you and your family to attend annual physical exams and other necessary medical appointments
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– whether it’s virtually or while following appropriate safety precautions in person. These checkups are crucial for keeping up to date on your prescriptions and general well-being, identifying any potential medical issues and monitoring recurring issues. Contact your doctor’s office to see if it is open for in-person or telehealth appointments in order to make the best decision for receiving care for you and your family. Create Prevention Packs: Keep illness prevention items, such as face masks, hand sanitizer, disposable gloves and disinfecting wipes, in one centralized spot at home. Also keep additional kits in easy-to-reach areas like the center console of your vehicle or inside your purse or backpack for when you’re on the go. Find more tips for fighting illness this cold and flu season at Clorox.com.
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Eyes, Ears and Age How age can impact hearing and vision
By Wendy McMillan for Aging at Altitude
C
hanges may seem slight at first. Some days you may simply find it harder to adjust for glare, or find yourself frequently asking others to repeat themselves. When you notice signs of sensory decline, rest assured, you’re in good company. We can all appreciate change is a normal part of aging. That said, while we can’t prevent all agerelated changes, simple measures can protect our vision and hearing to dramatically reduce risk for serious disease. What’s more, treatment options abound
What Do the Experts Say? Hearing and vision loss prevention tips
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“Staying active, eating a nutrient-rich diet, annual visits to the doctor, reducing noise, and safe habits in noisy conditions are factors within our control when it comes to preserving [hearing] abilities and functionality.”
“Good UV-protection sunglasses and a well-balanced diet go a long way in supporting macular health and limiting sun damage. Also key is not smoking. For avoiding Age-related Macular Degeneration, that is the biggest risk factor we can take charge of.”
“It’s important to have an audiology screening by midlife if not sooner. Same idea with hearing health – if you’re over 50 years old and haven’t had a hearing test since grade school it’s time to establish a baseline.
CHELSEA WALTERS Board-Certified Hearing Instrument Specialist at Family Hearing
MELISSA BURTON Optometrist at Eye Care Center of Northern Colorado
SAMANTHA WARREN Audiologist at Boulder Valley Hearing Associates
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for vision and hearing loss that go beyond stemming the impact, and keep life flourishing. When hearing and vision are strained, insecurities may cause us to retreat. Such tendencies lead to social isolation, which in turn cause loneliness, depression, and further health complications. Fortunately, preventative care goes a long way in lessening the impact of aging. Moreover, today we have a growing host of treatments available, including cutting-edge advances that keep us connected and thriving. We talked with local experts for insights on time’s toll on our eyes and ears, and steps we can take to wholly embrace our sensory world at any age.
Ear and eye health
Many factors shape the ways in which we age, least being genetics. While we can’t change our inherited makeup, lifestyle choices offer the opportunity to support and optimize health. “Hearing loss coexists with health conditions like diabetes and heart disease because the inner ear relies on good circulation,” says Chelsea Walters, Board-Certified Hearing Instrument Specialist and Co-owner of Family Hearing in Broomfield, Boulder, and Lafayette. “Staying active, eating a nutrient-rich diet, annual visits to the doctor, reducing noise, and safe habits in noisy conditions are factors within our control when it comes to preserving abilities and functionality.” Eye health is similarly responsive to healthy lifestyle choices, says Dr. Melissa Burton, an optometrist at Eye Care Center of Northern Colorado. “Good UV-protection sunglasses and a well-balanced diet go a long way in supporting macular health and limiting sun damage,” she says. “Also key is not smoking. For avoiding AMD (Age-related Macular Degeneration), that is the biggest risk factor we can take APRIL 2021
charge of.” Another simple measure to protect our vision is keeping the eyes properly lubricated, Burton says, particularly in Colorado’s dry climate. Staying hydrated, employing humidifiers, and keeping car vents from blowing into our faces all help protect our eyes. “So often I see patients who are convinced that they have a serious condition, when the solution they are looking for can be as simple as using artificial tears,” Burton says, adding that offering patient education is one of the most rewarding aspects of her practice. “We are taught to brush our teeth every night, but we’re rarely informed about the importance of eye hydration. If untreated, dryness can lead to severe complications, and in some parts of the world, even blindness.” Beyond the basics, how can we protect our vision and hearing? The answer may seem too obvious, but can’t be underscored: take advantage of care through regular check-ins with your providers. For eye health, annual appointments at every age can make all the difference, Burton says, adding that patients don’t always realize that medicallycertified practices often accept medical as well as vision-specific insurance. It’s important to have an audiology screening by mid-life if not sooner, says Dr. Samantha Warren, an audiologist at Boulder Valley Hearing Associates. “With dental health we know the best approach is to have cleanings done regularly and not wait until there’s pain,” she says. “Same idea with hearing health--if you’re over 50 years old and haven’t had a hearing test since grade school it’s time to establish a baseline. After that tests should be done every 3 to 5 years--more often if recommended based on other medical conditions.” Of course, by the time we
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HEALTHY AGING
notice age-related changes, we may be past the point of prevention. “For most seniors, whatever the cause, sensory loss is making an impact on quality of life,” says Walters. “So now, the question at hand is, ‘what do I do about it’?” Good news, today’s choices are better than ever.
Why is my vision blurred?
Many changes to the eye occur naturally with age, including reduction in tear gland production, changes to the lens, and biochemical factors that are unavoidable. However, it’s important not to grow complacent, says Burton. “Don’t assume that because you’re 85, you can’t enjoy 20/20 vision,” she says. Through an annual, comprehensive eye examination, your provider can diagnose issues before they become more
problematic, offering the best solutions. Often vision loss is related to multiple conditions, Burton says, and attempts should not be made to self-diagnose. Glaucoma, for instance, usually related to increased pressure in the eye, can lead to permanent vision loss yet may not necessarily exhibit early symptoms. Cataracts – a clouding of the natural lens that is truly inevitable with age – typically form slowly without pain. Cataract surgery, which restores eyesight by removing the clouded lens, is one of the most common, safest and most patientfriendly surgical procedures worldwide. “Technology is always advancing,” Burton says, explaining that today’s equipment, tests, and advances in research allow for determining a wealth of personalized information now, with so much
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more available that can be done. “Make the most of your resources,” she says. “Let us help you.”
Age-related hearing loss
“Hearing loss if most often the result a decline in the sensory organs in the inner ear,” says Warren. “The “piano keyboard” of sounds you start with--the cilia in the cochlea--stops transmitting all of the pitches to the brain. People often believe hearing loss will be an all-or-none loss, when in reality you typically lose the treble or high-frequency pitches first.” This type of loss leads to “situational difficulty” at first, Warren explains. Depending on the person talking and the environment, problems may span from zero to multitudinous, resulting in doubt or denial regarding whether or not there is a hearing issue. Dismissing hearing issues as simply normal aging can quickly complicate overall health. When hearing loss accumulates gradually, those affected may not realize how much they are missing or how hard they are working to understand speech. “The brain is the true organ that listens and when the ears aren’t providing the information it needs, it compensates by employing visual cues and deductive reasoning skills. Though it’s amazing that the brain can do this, it is quite literally working harder than it needs to which has a negative impact on cognition, working memory and of course communication,” Walters says. What’s the best way of dealing with hearing loss? Don’t shy
away from hearing technology. “Today devices are rechargeable, can connect to your smartphone, sound more natural than ever, and are cuter than ever before,” Walters says, adding that in today’s society, audio gadgets in ears are so ubiquitous, there’s no standing out even if a device is visible, which today’s rarely are. “Health care professionals appreciate that people may be reluctant to adopt technology because it carries the meaning of ‘being old’,” says Walters, explaining that by reducing communication challenges and sustaining self-reliance, the reverse is actually true. “We see it firsthand every day. Prioritizing sensory health keeps people young.” Boulder Valley Hearing Associates 4745 Arapahoe Ave., #130 Boulder; 90 Health Park Drive, #220, Louisville; 300 Exempla Circle, #210, Lafayette, 303.443.2772, boulderhearingclinic.com. Eye Care Center of Northern Colorado 3000 Center Green Drive, Suite 250, Boulder; 1400 Dry Creek Drive, Longmont; 300 Exempla Circle, Suite 120, Lafayette, 303.772.3300, eyecaresite.com Family Hearing 3059 Walnut St., Boulder, 303.872.9757; 300 Nickel St., Suite 15, Broomfield, 303.857.5838; 2770 Arapahoe Road, Suite 126, Lafayette, 303.872.6467, familyhearingco.com
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Two Roads Converge for Help when Vision is Impaired
By Linda Thorsen Bond for Aging at Altitude
T
he mission of Ensight Skills Center is “To provide people with low vision the services and resources that empower independent and productive living,” but development director Melody Bettenhaussen has an even better way of saying it: “We want people to know there is always hope. When people have low-vision or visually-impairment, they may think nothing can be done and they become depressed and isolated. We help people discover that the whole world can still be available to them if they learn to adapt.” Ensight offers low-vision rehabilitation and optometry 36
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with a low vision specialist, occupational therapy, mobility, counseling and coaching and low-vision tools and equipment. People can call or visit the website or may be referred by a physician or other health care professional. People first see Ensight’s doctor and the occupational therapist for a 90-minute assessment. “This is not an appointment to see the health of the eye, but to see functionality of the person with low-vision, working in conjunction with the primary care provider,” Bettenhausen explained. “It’s not ‘either/or’ situation.” The occupational therapists can make home calls or can help with adaptation of the volunteer site or workplace. During the pandemic, Ensight has done a lot of training
by phone and Zoom, assisted by the Area Agency on Aging to help people get computers, iPads and Alexa. The nonprofit organization accepts Medicare and Medicaid and has information about assistance for private insurance. The mission of the Audio Information Network of Colorado (AINC) is to provide news and information in audio
format for the blind, low vision and print disabled community of Colorado. The services are 100 percent free and include podcasts and broadcasts 24/7; listening equipment, setup, and training; English, Spanish, and other language programming. Executive Director Kim Wardlow said that for 30 years, the general focus has been to DAILY CAMERA, TIMES CALL
provide audio access to printed material from newspapers to grocery ads. AINC’s world is expanding. “We still do those things,” she said, “but there are other types information that people may need access to.” She counts among those a complete audio version of how to complete the census, accessible voting, and COVID-19 information. There are about 150 volunteers who read everything from a “Medicare and You” booklet in Spanish to a CDC course on care and prevention of diabetes. Ensight and AINC work together to make information easier to find for the consumers they share. “We help people access information about cooking, transportation, classes – all the things we take for granted. When people lose their vision they have to learn to do things in a different way and we can help connect them to so many resources,” Wardlow said.
Feldenkrais
The net impact is to reduce isolation for people who have lost part or all of their vision. Yes, there is technology such as Echo Dot and Alexa and training to be able to use that technology. Two organizations converge for those who have visual impairment and they are helping empower individuals to be self-sufficient, connected to community, and continuously learning. Audio Information Network of Colorado 1700 55th Street, Suite A, Boulder, 303.786.7777, aincolorado.org Ensight Skills Center Located at the Eye Care Center of Northern Colorado – 300 Exempla Circle, #120, Lafayette; 1400 Dry Creek Drive, Longmont, 303.757.4500, ensightskills.org
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HEALTHY AGING
Getting Rest, for the Rest of Your Life How your mouth tells a story about your sleep
By Kathleen Duff for Aging at Altitude
Y
our mouth speaks volumes when it comes to understanding how you’re sleeping at night. “The teeth, the mouth, the tongue, the skeleton all give us clues as to what’s going on,” said Dr. Andrew Kelson of Dental Horizons in Longmont.
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Kelson said a strong connection exists between the mouth and sleep health, particularly when it comes to obstructive sleep apnea. The condition occurs when a person repeatedly stops and starts breathing through the night, sometimes several times an hour. Those with sleep apnea often snore and snort, awakening themselves. It can lead to daytime
sleepiness, headaches, high blood pressure, acid reflux and a greater risk of cardiac death, among other health concerns. Kelson said plenty of signs point to sleep disorders. For example, a person’s airway can be restricted for anatomical reasons. Perhaps a person has a large mouth or a large tongue or an elongated uvula. Or, patients may have small windpipes or a very
Dr. Andrew Kelson DAILY CAMERA, TIMES CALL
HEALTHY AGING
vaulted palate. Even those with tongue-tie may have difficulty breathing. “These are all things we see when a person comes in for a dental exam,” he said. “For much of my career, I just looked at crowded teeth just as crowded teeth. But for a sleep standpoint, it may mean their airway is narrower and their tongue may fall back, creating an atmosphere in which it is difficult to breathe.” Mouth breathing is another manifestation of sleep apnea. Patients who breathe through their mouths can create an environment for bacteria to thrive, and a higher risk of periodontal disease and tooth decay. There also is a higher risk for tonsils and adenoids to be larger. Those who don’t breathe through their nose lose the body’s best air filter and the ability to generate nitric oxide, which relaxes the body’s vascular
system. them. If he gathers We pay He explained, enough evidence, “We pay attention attention to how he may refer them to how we eat, to a physician for we eat, how we a sleep study to how we exercise, but we don’t determine their exercise, but pay attention to condition. we don’t pay how we breathe. But dentists But how we also are doing attention to how more than breathe affects our circulatory we breathe. asking questions. system and our Kelson said digestive system. (day and night) Patients are not breathing at night dental appliances can be used and they don’t even know it. The to remodel the jaw, with more teeth just scream that I’m not emphasis now being placed breathing.” on expanding the upper jaw to He said some research is increase the airway. The devices, showing that children are which can be worn 12-24 months, occasionally being misdiagnosed may reduce the need for CPAP with Attention Deficit machines, often recommended Hyperactive Disorder when they for those with sleep apnea. may really have a sleep disorder. “We can certainly help While Kelson cannot diagnose adults, but with kids, it’s even sleep disorders, he can and does more exciting. There are dental ask his patients questions about appliances they can wear at night their sleep habits as he examines that can stimulate and encourage
“
”
growth and development of the skeleton, so there aren’t problems in the future. It can address the need or extent of the need to straighten teeth.” Kelson said of the broader approach to dentistry, “It’s extremely rewarding to help someone breathe better, and the cascade of benefits that come from breathing better certainly affect the teeth. When they use that dental appliance ... they are excited because it’s changing their life. They are waking up and feeling rested for the first time in their lives. Anxiety and stress are reduced. ... It changes their motivation and their ability to heal in general.”
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Supplements Supporting Healthy Aging By Elise Oberliesen for Aging at Altitude
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s an aging adult, it is time to learn new ways to manage a body that’s constantly changing. Sometimes it feels like the body needs extra tune-ups because of new pain – or you can’t find the car keys – again. Maybe it’s time to consider supplements designed to support healthy aging. That way you can keep living the life you love – with fewer pains and worry. Science tells us that free radicals contribute to oxidative stress – which makes those pesky crow’s feet and fine lines on the face. But it’s also responsible for serious age-related ailments, including inflammatory and autoimmune diseases like arthritis, to cataracts and cancer. “Customers say it has brought their inflammation and swelling down. People who use it as a topical formulation apply it over joints to help with chronic pain,” he said. Some customers have reported that Greska’s Carbon-60 helps increase energy and mental clarity, Greska said. Other customers have experienced pain relief after applying the product to their joints and muscles. Greska’s Carbon-60 supports better health, wellness and improved quality of life, says Greska.
CBD AND CANNABIS – ROADMAP FOR RELIEF
Soar muscles work a lot like stalkers. They wait quietly until you spring from the couch – and leave you with a tweaked back. Or, when you wake up all sideways,
you’re left with a half-bowed stiff neck. No need to suffer anymore thanks to a wide variety of CBD and THC products. Staff at Terrapin Care Station, in Boulder and Longmont, help customers and patients learn about the therapeutic effects of CBD, THC and the combination, says Penny Komes, the company’s communications manager. Terrapin carries a vast array of products to help with sleep, pain and pleasure. Choose from CBD oils and tinctures, to flower and vaporized products, Komes says. Using cannabis products is not a one size fits all approach. That’s why she suggests talking to your physician and budtender when deciding on products. “Everybody is very different physiologically and may react differently to cannabis products. For acute pain relief, smoking or vaporizing is the quickest consumption method to feel medicinal benefits.” When purchasing CBD and you care what’s inside the product, Komes said dispensaries are your best bet. That’s because rigorous guidelines require dispensaries to prove product purity and concentration levels, unlike products sold at gas stations and grocery stores.
Greska’s Carbon-60 720.600.6040, c-60.com Terrapin Care Station 1795 Folsom Street, Boulder, 5370 Manhattan Circle, #104, Boulder; 1 Broadway, #A150, Denver; 650 20th Ave., Longmont; 303, 954.8402, terrapincarestation.com DAILY CAMERA, TIMES CALL
Getting Back in the Saddle – Say Goodbye to Erectile Dysfunction By Elise Oberliesen for Aging at Altitude
I
f you or the man in your life has experienced erectile dysfunction (ED), you’re not alone. Approximately 30 million American men experience blood flow issues later in life. ED not only affects a man’s performance in the bedroom, but can also affect his partner –and the shared intimacy couples experience during lovemaking. If this sounds familiar, maybe it’s time to explore treatment options so you can get back to spicing it up under the sheets. Superior Medical Solutions is here to help you put an end to ED so you and your partner can rekindle the romance behind closed doors. For the past 20 years, they have helped thousands of men regain their confidence in the bedroom – so couples can get back to letting the sparks fly. “With ED, a lot of couples give up on sexual intercourse,” says Kolleen Hulyk, office manager with Superior Medical Solutions, in Arvada. But it doesn’t have to be that way if you find a treatment that works for you, she added. Sex is just one way for couples to experience intimacy, she said, and it’s just as important to look for ways outside the bedroom to build on it.
“Intimacy means different things to different people,” Hulyk said. If you choose to work with Superior Medical Solutions, you will meet with Medical Director Aubrey Copeland, MD. He will discuss how the treatment works and answer any questions. Patients range from mid 40s to well into their 70s. “The initial office visit is $95. The doctor goes over medical history and sends the patient home with samples of autoject Trimix,” Hulyk said. The treatment is fast acting and has been around for decades, Hulyk says. Since it carries virtually no side effects, compared to other ED medications, many patients prefer it. However, if you want oral medication, that too is an option. “A lot of people tell us ‘You saved my marriage,’” Hulyk said. “Another gentleman had tried oral medication and it worked, but when he tried Trimix, he told us ‘It blew his mind,’” she said. Don’t let reluctance stop you from enjoying the sex life you’ve been dreaming about. Superior Medical Solutions 5730 Ward Road, #201, Arvada, 303.424.8988 smscolorado.com
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HEALTHY AGING
Dementia, Alzheimer’s & Neuroplasticity
What might help today
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By Emily Kemme for Aging at Altitude
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s people age, cognitive decline may be a natural part of the process. Occurrences like forgetting where we placed our keys, losing track of a topic in midconversation, or walking into a room and wondering why we are there generate worries that we, or a loved one, are developing dementia or Alzheimer’s. While forgetfulness occurs, according to the Alzheimer’s Association (AA) website, dementia is not normal in human aging. The Association explains it “is a general term for symptoms like decline in memory, reasoning or other thinking skills... Dementia is
caused by damage to brain cells that affects [a person’s] ability to communicate, which can affect thinking, behavior and feelings.” There are many causes of the serious mental decline that constitutes dementia. Alzheimer’s, a degenerative brain disease affecting transmission of information between brain neurons and synapses, causes 60-80% of dementia cases. The disease develops over time, destroying synapses and neurons, the essential elements of our brain’s communication network. Dr. Ilene Naomi Rusk, Ph.D., a Neurotherapist and Director of the Healthy Brain Program at The Brain and Behavior Clinic in Boulder, said neurons may be able to create connections through a new concept called DAILY CAMERA, TIMES CALL
Ilene Naomi Rusk, Ph. D The Brain and Behavior Clinic
neuroplasticity. “Neurons can change depending on the environment they’re in, growing brain strength and fitness,” Rusk said. She said the idea of mitigating cognitive decline for people with dementia stems from treatment of patients recovering from brain stroke. Rusk cites two pathways for brain neuroplasticity in response to disease. “There is negative neuroplasticity when the brain changes in response to injury or illness, and positive neuroplasticity, changes people can make by altering their environment or behavior.” It’s a lifelong physiological process of remodeling neurons, synapses, and the organization of brain networks. “Alzheimer’s and possibly other neurodegenerative diseases begin up to twenty years before first symptoms occur,” Rusk said. Rusk recommends a “Brain Health Check-Up” to assess patients for contributors to cognitive decline or dementia. A personalized plan considers diagnosis, stress reduction, and trauma healing. The goal is to establish new brain healthy lifestyle habits. Using Functional Medicine to account for possible root causes — inflammation, insulin resistance, gastrointestinal complications, and metabolic imbalances, among others — APRIL 2021
Rusk’s Healthy Brain Program seeks underlying medical factors potentially causing cognitive problems. “There are medical issues you can control — hypertension, diabetes, head trauma, smoking, obesity, and depression — all increase the likelihood of dementia,” she said. Rusk’s team consists of a nutritionist, neuropsychologist, psychotherapist, cognitive trainer, and physician. They concentrate on eight pillars for brain health, working to prevent cognitive decline, optimize cognition, and address brain disease. Concepts center on engaging people and finding what’s meaningful to them. The first pillar, nutrition, is optimized, and a combination Mediterranean and hypertension diet is recommended to improve gut health. Eliminating gluten, dairy, white sugar, and other potential toxins that can leak into the bloodstream and cause cytokine reactions that trigger immune reactions is part of the next three pillars: decreasing inflammation, improving digestion, and enhancing detoxification. The fifth pillar focuses on reducing stress. Rusk said that chronic or ongoing stress increases levels of cortisol, weakens immune systems, and can contribute to heart disease, high blood pressure, depression, and anxiety. Positive neuroplasticity may be achieved by following exercise programs incorporating movement activities designed to increase heart rate. Yoga, walking, light weight lifting, and dancing are encouraged, as is challenging patients to increase duration and speed. The final pillars encompass cognitive stimulation by new learning — a language, reading music, or simply staying curious. “You lose your curiosity when
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you have moderate dementia,” Rusk noted. “Challenge yourself daily not to a point of stress, but to a point of stretch.” Lastly, improved sleep is critical to memory retention and for eliminating potentially toxic soluble waste proteins like Amyloid by the glymphatic system, a newly discovered function in the central nervous system. AA recommends U.S. Food and Drug Administration approved medications, cholinesterase inhibitors (Aricept®, Razadyne®, and Exelon®) and memantine (Namenda®) as disease treatments to delay or slow worsening of symptoms, including memory loss, confusion, and problems thinking or reasoning. The Association advises that medications may lessen or stabilize symptoms for a limited time.
G E T A B R A I N H E A LT H C H E C K - U P at The Brain & Behavior Clinic
With regard to multidimensional lifestyle interventions, Niles Frantz, Director, news media engagement at AA’s Chicago home office, said that as “an evidence based organization [AA is] open to therapy that has convincing, not anecdotal evidence that can be proven, replicated, and is consensus built.” Maria C. Carrillo, Ph.D., AA’s chief science officer, said, “This area of research — multicomponent lifestyle interventions to treat or prevent dementia — is intriguing and hopeful . . . [having] therapeutic possibilities on its own or in combination with future drug therapies. . ..” AA is exploring research to develop credible evidence on the topic through the U.S. POINTER Study, utilizing a two-year clinical trial testing 2,000 seniors aged 60-79 who
are at increased risk of cognitive decline, she stated on the AA website. Rusk and AA acknowledge that currently Alzheimer’s is not reversible. But research to protect cognitive function and identify risk factors which may prevent Alzheimer’s and other dementias offers hope for disease treatments. Alzheimer’s Association of Colorado 455 Sherman St., #500, Denver, 303.813.1669, alz.org/co Ilene Naomi Rusk, Ph.D., Co-Director, Healthy Brain Program, The Brain and Behavior Clinic 2523 Broadway, #200, Boulder; 303.938.9244; ilenenaomirusk.com healthybrain.clinic
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ACTIVE LIVING
Movement and Fall Prevention for Healthy Living By Barbra Cohn for Aging at Altitude
M
ovement and physical activity can go a long way toward fall prevention. We reached out to two local experts to get their take on exercise and activities that help reduce the risk of falls. Scott Salus, occupational therapist and co-owner with physical therapist Daniel Basta, of Kind Rehabilitation says, “One of
“It’s really important to address falls
before they happen. Caregivers need to come from an honest and firm place, because the moment someone has their first fall that can be the moment they lose their independence.
”
the main things that helps prevent falls is understanding that a fear of falling is one of the best predictors that someone will eventually fall.
“It’s really important to address falls before they happen. Caregivers need to come from an honest and firm place, because the moment someone has their first fall that can be the moment they lose their independence,” he says. When Salus’ then-65-yearold, physically-fit mother and her boyfriend were moving, he insisted they look into the future to think about mobility issues. Would it be more prudent to live in a ranch than a multilevel home? “You can start the conversation early and plan for an eventuality that may never take
(Photo courtesy: Kind Rehabilitation (Left) and Al Wadleigh/ Feldenkrais Store (Right). 46
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place,” he says. Salus, who specializes in working with patients with dementia and Parkinson’s, says, “The process of fall reduction is a delicate one that includes practicing every-day activities. We reassure patients that it’s safe to practice pulling up their pants, or going into a shower fully clothed.” He evaluates if the patient has vertigo when bending to tie their shoes or getting up from a seated position. Have they had a recent surgery or new diagnosis? How do they manage pain? Do they need a commode, or learn to reposition their arms, feet, and legs when toileting or getting out of a chair? A physical therapy program might include exercises for strength, flexibility, good posture, and gait training. Learning to maintain balance while you’re walking and distracted or multitasking is also important, Salus adds. The Feldenkrais Method® (Awareness Through Movement® and Functional Integration® developed by Moshe Feldenkrais) is another modality that helps prevent falls by teaching individuals to pay closer attention to the way they move. Al Wadleigh, a Feldenkrais practitioner who teaches privately and at the Longmont Senior Center, starts a chair class by asking the participants to begin with a scan by turning the awareness inward. “Get a sense of how you’re making contact with the chair and with your feet on the floor. How is your weight distributed on the pelvis? Now roll back and forward to sense how DAILY CAMERA, TIMES CALL
ACTIVE LIVING
your lower back is in relationship to the chair,” he says. “We go through the lessons – and there are 2,000 of them – to fill out the idea of exploring and sensing what feels good. It’s to figure out, when given a better opportunity and choice, what the nervous system prefers. It’s development learning in order to change habits from old injuries, surgeries, emotions, work, and thoughts that don’t serve us.” The aim of Feldenkrais is to invigorate your brain and nervous system with new ways of organizing and sensing your movement in the world. “Around age 50 the brain says ‘we’re not using all our neuropathways.’ We have fewer to rely on, so we have to neutralize the old habits in order to live life with more vitality,” Wadleigh adds. He ends the class by asking participants to do a self-inquiry. One person says, “I’ve done the pelvis rock many times but sitting
on a chair made it clearer.” Wadleigh responds that the smaller the movement the more precise it can be. Once you’re aware of what you’re not aware of, you can fill in those parts.” Another person with Multiple Sclerosis says that one of his feet was dragging that morning. “Now I can lift it up.” He adds, “I feel a centered-ness since doing Feldenkrais, and have better structure. Now when I stand and I’m reaching for something I’m able to move easier. That’s big for me.”
Al Wadleigh / Feldenkrais Store 420 21st Ave., #110, Longmont, 303.709.0639, achievingexcellence.com Kind Rehabilitation 566 McCaslin Blvd., #270316, Superior, 303.919.2324, kindrehab.com
20 TIPS FOR PREVENTING FALLS Have adequate lighting throughout the house; place night lights in the bedroom and bathroom. Limit liquids after dinner to reduce nighttime toileting. Get adequate sleep. Remove loose area rugs. Wear gripping socks, sturdy slippers, or shoes in the house. Avoid unsafe shoes, i.e. flip flops and high-heels. Place guardrails where needed. Stand up slowly. Use a walker or cane for steadiness. Declutter and remove excess furniture. Implement an exercise program to support muscle strength, stability, and balance. Use a “reach stick” to grab out-of-reach items. Do not use a step ladder. Eliminate or reduce alcohol and smoking. Be wary of medications that cause dizziness, sleepiness, and unsteadiness. Be attentive to pain management. Be aware of where your pet is to avoid tripping. Get adequate calcium and vitamin D to maintain bone health. Maintain a healthy weight. Get regular vision and hearing check-ups.
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ACTIVE LIVING
In-Home Services for Aging By Pam Moore for Aging at Altitude
W
hen daily life gets challenging, a helping hand can make all the difference. TRU PACE (Program of All-inclusive Care for the Elderly) is an all-encompassing local resource that is vital to the success of any senior hoping to age in place. Aging in place is exactly what it sounds like:
growing older in your own home with access to home care as needed, rather than relocating to a residential facility as your needs increase. TRU PACE is just one of the many resources housed under TRU Community Care. Founded in 1976, TRU Community Care is a Colorado-licensed, Medicare and Medicaid-certified nonprofit healthcare organization. Providing services to residents
(Photo courtesy: TRU PACE).
of Boulder, Boulder, Broomfield, Adams, Jefferson, Denver, and Weld Counties and more, it’s a resource that Front Range seniors have relied on for more than four decades. TRU PACE provides the services and support that make it possible for older adults to live healthy, meaningful lives in their communities. To qualify for TRU PACE, individuals must be 55 or older, live in Boulder or Southwestern Weld counties, be certified by the state to require nursing-home-level care, and be able to live safely in the community with PACE support at the time of enrollment. With support from an interdisciplinary team, TRU PACE allows people to maintain their independence to the fullest extent possible. The team organizes and administers every aspect of seniors’ care, including preventive, primary, acute, and long-term services that support the ability to maintain their ability to live safely in the community. For many PACE participants, this looks like living in your own home, whether that’s a house, an apartment, or a condominium, and being picked up each day by the PACE van each morning to
head over to the PACE center. There, depending on your personalized care plan, you might engage in social activities among friends, go to a physical therapy session to work on strength and balance, with the ultimate goal of fall prevention, and enjoy meals that adhere to any dietary restrictions you might have, before being driven back to your home by the PACE van in the evening. The interdisciplinary healthcare team works out of the physical PACE site, which is also home to rehabilitation services, home health coordination, social work, recreational therapies, social activities, and much more. Not only that, the interdisciplinary care team supports families as they navigate the complexities of watching their loved ones go through the aging process. Aging inevitably comes with ups and downs but PACE is there to make sure you’re not managing the tough parts alone. TRU PACE (Program of All-Inclusive Care for the Elderly) 2593 Park Lane, Lafayette, 303.665.0115, pace.trucare.org
Affirming life at every step of your journey with illness and loss.
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AGING AT ALTITUDE
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ACTIVE LIVING
Staying Active For Your Health By Adam Goldstein for Aging at Altitude
F
or many seniors, the threats posed by the COVID-19 pandemic weren’t simply physical. One year ago, when the world as we all knew it shut down, seniors faced risks that were just as dangerous as the frightening physiological symptoms of the virus. A world without the everyday contact, socialization and engagement of physical spaces was a threat to their emotional and mental well-being; a quarantined world without the in-person fitness classes, coffee groups, wellness gettogethers and other cherished routines that many seniors had come to depend on was a very bleak world, indeed. Andra Coberly has come to recognize just how important these everyday routines for those aged 55 and older. As spokeswoman for YMCA of Boulder Valley, Coberly can speak directly to how much an active lifestyle can mean for older adults. Like its fellow YMCA organizations across the state and the country, the Y of Boulder Valley has long offered a wide variety of classes, workshops and clubs for older patrons. These have activities ranged from physical fitness to arts and crafts, and they’d come to mean the world for many before COVID upended everyone’s familiar routines. “Our fitness classes help with balance and falls prevention. Our prevention and healing programs help prevent chronic disease, combat the symptoms of Parkinson’s and support the recovery efforts of cancer survivors,” Coberly noted. “The Y is a community. Our members, especially our older members, have a place to visit, to sit and have coffee, to chat and to make connections. Our programs and classes give seniors an opportunity to get out of the house, combat isolation and develop new friendships. “This is the mental and emotional health side of the Y, and it makes our facilities into more than simply gyms or fitness centers,” she added. The disruption of the past year has meant that the Y and other organizations across Boulder County that cater to older patrons have had to reimagine how they serve their community. The pandemic has spurred health
APRIL 2021
organizations, fitness programs and arts institutions to reimagine how they reach those who value their services so much. Concurrently, older workout buffs, theater lovers and wellness enthusiasts have added new tools to access the resources they cherish. For example, the Boulder-based Viva Theatre Company, a troupe that specializing in offering opportunities for older adults to participate in the arts, has been forced to discontinue live performances in the wake of COVID. As a solution, they’ve introduced the “Viva Live Salon,” a monthly virtual format that’s been touted as a “grown-up show and tell, but on Zoom.” “Do you have a monologue or a poem you’d like to perform? Or perhaps you’d like to share some artwork, or crafts, or show off your garden,” organizers explain on the troupe’s website. “Maybe it’s a prized recipe you’d like to show us. Here’s your chance to be a Zoom star for a day.” Those interested in participating can find more information about taking part in the salons at vivatheater.org. Meanwhile, important medical resources have also shifted online. Boulder County’s Area Agency on Aging offers seniors a wide array of wellness programs and classes, information kits and other vital tips on its website, bouldercounty.org/families/seniors/services/ wellness-programs. Whether it’s reading up on best preventive practices, or scheduling an online class on the intricacies of Medicare or finding a diabetes support group online, this agency has shifted its most valuable tools to a safely accessible format. According to Coberly, it didn’t take long for those whose everyday work is dedicating to supporting seniors to recognize the importance of shifting resources online. As soon as the pandemic began seriously shutting down in-person classes, meetings and facilities, the Boulder Valley YMCA started looking for other options. “As soon as we decided to close our doors
last spring, our staff knew that we couldn’t just forget about our members, especially our older members who were facing so much isolation and loneliness at the time,” she said. “We have done Zoom fitness classes and coffee hours and other social opportunities. We also filmed about 15 classes for our YouTube channel to allow members to have on-demand options. We developed a free-for-members hiking/ snowshoeing program, because some of our members were looking for options that allowed them to be with a group, but in an outdoor setting.” The Y’s rapid response drew an enthusiastic response from community members. According to Coberly, in 202, members logged on to live-streaming classes more than 17,600 times. Of those participants, about 70 percent were seniors. It’s a response that’s proven that seniors are savvy to the demands of the times, and that they’re willing to show flexibility as their favorite organizations face a continually changing reality in the spring and summer months. Indeed, the impact of the pandemic months is sure to persist long after the virus itself has faded. Moving forward, seniors will have even more options to enjoy their favorite fitness classes, arts organizations and community gettogethers. And these organizations will have learned how to conduct in-person activities even more efficiently, effectively and safely. Boulder County Area Agency on Aging, 3482 Broadway, Boulder 303.441.3570, bouldercounty.org/ departments/community-services/ area-agency-aging Viva Theater, P.O. Box 19882, Boulder, 720.301.7658, vivatheater.org YMCA of Northern Colorado Multiple Locations; 2800 Dagny Way, Lafayette, 303.664.5455, ymcanoco.org AGING AT ALTITUDE
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