driving-ms-joan-resultsWelcome Joan’s Journeyers. In my opinion, giving up one’s car and agreeing to no longer drive, belongs on the stress scale with death of a loved one, divorce and moving. Each of these events is life changing. For me, handing over my car keys to the friendly dealership representative was like cutting off a body part. My keys, and the life they represented, have been a part of me since age 16. Saturday, June 13, 2015, will remain in my instant recall for the rest of my life.

I returned my car about noon, filled out the paperwork and looked around the dealership for the last time. The attendant took my keys and whisked away my lovely vehicle to be serviced and sold.

How did I cope those first days, how did I manage without a car and how am I doing now? Learn more about the results of the driving Ms. Joan experiment in Joan’s Journey, Part 36.

Joan London is a freelance medical and social service writer who specializes in topics on aging. London moved from Maryland to California to enjoy life in a senior living community and enhance her quality of life by living closer to her children and grandchildren.

SWhen it comes to discussions with your parents, there are few more awkward or uncomfortable than the sex talk or the coming out talk. Yet for adult children, there is another discussion that can be added to the list—the aging talk. Just as you likely didn’t want to have the sex talk with your parents, they likely dread the discussion on aging. And while the inclination may be to procrastinate, putting off the matter for another year, there are some signs that you cannot ignore, meaning that you may have to discuss the issue now.

Is a parent withdrawing from social situations?

Not everyone is an extrovert; some prefer solitude or only socializing with familiar friends. Yet some medical conditions can increase the desire to remain solitary. These conditions include depression, dementia and even hearing loss, and we will discuss this in greater detail in Friday’s post, as many symptoms can overlap and one condition might mask another. Should you notice your that parent is not socializing as they once did, it might be time to ask how they are feeling, suggesting a checkup with their physician.

Has their behavior changed?

The first signs of short-term memory loss appear in your 40s according to ACL’s Brain Health, and unfortunately that trend doesn’t reverse. In some cases cognitive decline can impact a person’s well-being and independence. Perhaps the easiest way to determine whether your parents are experiencing cognitive decline is identifying whether their behavior has changed significantly. These changes can manifest in many ways, such as a news junkie who is no longer aware of current events or an unkempt house with unwatered plants and dirty floors. If you see changes that seem out of character, discuss scheduling a visit with their physician.

Do they have difficulty walking or have they fallen recently?

This could be either an issue of mobility or an eyesight problem. For eyesight it is worthwhile to examine their glasses, making sure their prescription is adequate. If your loved one has difficulties with mobility, this could signal a diminishing physical ability. Fortunately, there are a number of remedies including rearranging furniture or replacing steps with ramps that can help loved ones adapt. Your physician might also suggest physical therapy exercises to retain and increase muscle strength and flexibility.

What you should know is that these signs don’t necessarily mean your parents will need to leave their home. Rather, there are numerous care types available that can keep them safe and independent. Next week we’ll discuss these options so you can determine how to best accommodate your loved one’s lifestyle and while meeting their needs.

margery-refreshThere’s a new buzzword at my place—refresh. If we had read our Resident Documents when we moved in, we would probably know what to expect when refresh is mentioned. Yet I would hate to quiz anyone about what is in that Resident Documents binder. It’s like the yearly mailing from Medicare: we have it and store it, but who reads it unless there is a problem. And even if we did read it, we probably wouldn’t understand the explanation anyway.

During the past year at our monthly Town Hall meetings, our money people, residents and administrator have warned us to watch our operating pennies because we will need money for refresh. Refresh is what our company does after a resident has lived for seven years in an apartment or cottage, and the cost comes out of our operating budget. Refresh means new carpet and a repaint of the unit, as well as some mechanical cleaning. Closets have to be emptied and ornaments removed.

Read about refresh agitation that my friends are experiencing in the Last Stop: Part 25.

This post was written by Margery Fridstein, an author and retired psychotherapist who lives in a CCRC outside of Denver, CO. She is chronicling her experience in the monthly series, “The Last Stop With Margery Fridstein.”

Senior couple at home on sofa with adult children

With the year-end holidays of Thanksgiving, Christmas and Hanukkah rapidly approaching, long-distance adult children, cousins and grandchildren will make the journey to visit parents, siblings and grandparents. For adult children, the holidays can bring about sobering realizations if mom and dad aren’t moving about as easily as they used to or seemingly minor fender benders betray symptoms of something worse. Have these incidents been occurring for the past year, perhaps even longer, or are these isolated events?

Aging is an inevitable part of life and with that comes diminished physical and mental capability. This realization is difficult for people to accept because it can mean giving up cherished activities of driving, cooking or gardening.  And broaching the conversation that your parents might need help can be difficult if siblings don’t recognize the problem or if parents insist they are physically fine. Unfortunately, this is the reality that all to often families experience. Cathy Knight, state director for the Washington State Association of Area Agencies on Aging, remarked in an earlier interview with SeniorHomes.com that frequently people don’t research information on where to find care until there is a crisis, and by then, they are at their wit’s end.

Consider this:  who will care for your parents if an unexpected accident happens, leaving them injured? Or if an ailment or other infirmity results in their being too frail to handle cooking, cleaning or dressing themselves?

The Administration on Aging reports that “by 2040, there will be about 82.3 million older persons,” representing 21.7% of the population, which means that millions of families will face the aforementioned scenarios. To help people learn how to navigate the senior living landscape and often-dizzying array of care options, we will devote the next month to discussing this situation in greater depth. From deciding which option is right for you to learning their respective costs and understanding the available state-provided services, we will help you prepare to broach the subject so you and your family can proactively make decisions to avert a future crisis.


Three senior men laughing, close-up (focus on man wearing glasses)

Do you’re think you’re too young or active to attend a senior center? There’s no such thing as being too old! The senior center of today is a lively, social, vibrant community hub and is over 10,000 centers strong across the United States.

You will likely be amazed by the participants and pursuits you find at your local senior center. The National Institute of Senior Centers (NISC) highlights a few of the unique offerings that are available at senior centers, such as a television studio at the Iowa City/Johnson County Senior Senior or competitive Wii bowling at the Verona Senior Center.

A study by the National Institute on Aging found that seniors who maintain an active lifestyle-physically, mentally and socially-remain independent longer, feel more contented and fulfilled, and experience an improved quality of life. Isn’t that a lifestyle we’d all like to experience? Dropping by your neighborhood senior center is a great way to take the first step on your journey to health and happiness.

Senior centers are locally run and operated. Because of this local connection, the governing board can be responsive to the needs of their members by tailoring the offered programs and activities. Many senior centers are members of the NISC, which provides resources and program materials to its members. Senior centers can even receive NISC accreditation.

What can you expect to find at a senior center? Trips and tours, volunteer opportunities and more are highlighted on our Senior Centers: A Primer.

joan-and-her-car-twoWelcome Joan’s Journeyers. Since June, my fabulous-fake designer purse is slightly less crowded. The absence of car keys has lightened my purse and elevated my bank account. Moreover, the heavy responsibilities of driving throughout greater Los Angeles Metropolitan Area are the responsibility of professional drivers.

Since moving to my senior living community in Santa Monica nearly two years ago, my daughter Allison has been concerned about the complex, often dangerous driving on the roads and freeways. I am a excellent driver and am quite proud of my 54-year driving record. Allison’s concerns are the other drivers.

The leasing agreement on my comfortable sedan terminated last June. For months prior to the lease’s completion, Allison lobbied with her two brothers to convince me not to lease or buy another car. Their solution to LA driving was hiring drivers from Uber and Lyft, professional driving services that provide almost immediate door-to-door travel at a cost allegedly lower than traditional taxi rates.

For months I argued the virtues of driving my own car but received relentless insistence from my adult children that I consider a three-month trial of professional driving services. June 2015 arrived and my car lease expired. To stop their conjoling, I most unhappily agreed to the Driving Ms. Joan Experiment.

The Driving Ms. Joan Experiment

To determine whether these professional driving services actually saved me money, I decided to do a comparison of using these services instead of my own personal automobile. The factors I compared included:

  • Monthly driver costs versus leasing and/or owning vehicle, including monthly lease or purchase fees, gasoline, auto insurance, and auto maintenance
  • Safety of driver service vehicle and driver
  • Courtesy of professional driver and driving habits
  • Availability of driver when ordered
  • Length of time to pick up
  • Comfort of service automobile

In the next Joan’s Journey, I’ll share the surprising results of my Driving Ms. Joan Experiment, including an unexpected transportation perk of senior living. Until the next post, enjoy your journey day by day.

Joan London is a freelance medical and social service writer who specializes in topics on aging. London moved from Maryland to California to enjoy life in a senior living community and enhance her quality of life by living closer to her children and grandchildren.

You may have noticed an increase in men sporting moustaches in recent years during the month of November, which, since 2003, has become known as “Movember.” All the fuss (and extra facial hair) is about more than merely an excuse for men to get creative with their moustaches; it’s an important movement designed to raise awareness of men’s health issues. Since its inception in 2003, The Movember Foundation has raised more than $650 million and funded more than 1,000 programs that focus on men’s health concerns such as prostate cancer, testicular cancer, poor mental health and physical activity.

Movember vs. No Shave November Movember vs No Shave November

If you thought Movember was about growing extraordinarily bushy beards, you’re not alone. In fact, No Shave November is actually a thing, and it’s often confused with Movember. Both movements aim to increase awareness of men’s health issues, primarily prostate cancer and testicular cancer. The difference lies in the approach: Movember participants grow a moustache, while No Shave November participants can grow both beards and moustaches.

The No Shave November website explains, “The goal of No Shave November is to grow awareness by embracing our hair, which many cancer patients lose, and letting it grow wild and free.” Participants grow a full beard, shaving a unique moustache at the end of the month. Men are asked to donate the money they would typically spend on shaving and grooming to “educate about cancer prevention, save lives, and aid those fighting the battle.

According to some sources, Movember does not allow beards; in fact, there are strict rules regarding manscaping. Your moustache may not join with your sideburns, which is considered a beard. Your moustache may also not join the handlebars to your chin, which would be considered a goatee. Moustaches only for “Mo Bros,” as participants have become known.

Movember and No Shave November fundraising

While both movements support the same initiatives, one key difference between the two is that Movember raises funds which go directly to support organizations that research and men’s health issues. No Shave November, on the other hand, encourages participants to donate the funds they’ve saved from shaving and grooming to these charities and organizations on their own.

According to the Prostate Cancer Foundation, “Funds raised in the US are directed to programs run directly by Movember, Prostate Cancer Foundation and the LIVESTRONG Foundation. Together, the three channels work together to ensure that Movember funds are supporting a broad range of innovative, world-class programs in the areas of awareness and education, survivorship and research.”

Men are able to register at Movember.com to participate, and women (“Mo Sistas”) and men alike are able to support his efforts in growing a “Mo,” Australian slang for moustache, as the movement originated in Australia. For 30 days, Movember participants get friends and family members to support his efforts through donations. No Shave November also allows men to create teams and fundraising pages to get friends and family involved in their efforts to support men’s health initiatives.

How are the funds used?

At the time of this writing, 943 teams with more than 3,500 participants in No Shave November have raised nearly $190,000 to support organizations like the American Cancer Society, the Prevent Cancer Foundation, Fight Colorectal Cancer, and St. Jude Children’s Research Hospital. In 2014, participants in Movember raised $20.2 million in the U.S. for the Movember Foundation, with 80 percent of the funds raised allocated to men’s health programs. In the U.S., Movember’s partner programs include “the Prostate Cancer Foundation, the LIVESTRONG Foundation and the Prevention Institute.

“These partners, along with Movember Foundation managed programs, ensure that donations support a broad range of innovative, world-class initiatives.” According to the Movember website, all funds distributed to these partners are restricted for use only in Movember approved programs. For participants, that means assurance that 100 percent of the funds are used to directly support the delivery of health initiatives; none are used to cover Movember partners’ fundraising and promotional costs.

No matter your preference for facial hair, there’s a way for every man and every woman to get involved in raising awareness for men’s health issues this month. Whether you sport a moustache, grow out your beard, or simply support someone else who is, everyone can participate in improving the health and well-being for men everywhere during the month of November.

There are many recommendations for health screenings for people in various age groups, but one particular demographic that’s not often discussed is older men. We’ve talked about the importance of regular screening for breast cancer for older women (through monthly breast self-exams and periodic mammograms), but what preventative health screenings should older men receive? We’ve identified five of the most recommended and important screenings to help older men be more proactive about their health.

Blood pressure, cholesterol, and heart disease prevention

While blood pressure and cholesterol screenings are actually different tests, we’ve grouped them together as a single recommended screening simply because it’s easy to have these screenings all performed at the same time. According to the National Institutes of Health, U.S. National Library of Medicine, men over the age of 65 should have their blood pressure checked annually and their cholesterol checked every five years – if your levels are normal. An EKG (Electrocardiogram) may be included with this group of screenings and is recommended for adults over age 50 every three years. Important health screenings for older men

If your levels are abnormal, or you have high cholesterol, diabetes, heart disease, kidney problems, or other related conditions, it may be necessary to have your blood pressure, cholesterol levels or both checked more frequently. Your healthcare provider will direct you if your current health status necessitates more frequent screenings.

Prostate screening

According to the Mayo Clinic, “The majority of prostate cancers are found in men age 65 or older.” The American Cancer Society recommends that discussions about prostate screening should begin between healthcare providers and men at the age of 50. Together, they can decide whether prostate screening is right for him. Should he move forward with testing, he will receive a PSA (prostate specific antigen) test, which is a blood test, with or without a DRE (digital rectal exam).

The frequency of prostate screenings moving forward is based on the man’s PSA level. However, PSA testing is only recommended for men with a life expectancy of 10 to 15 years, and as the Mayo Clinic points out, some experts and health providers have concerns with the risks involved with PSA testing. Therefore, most health organizations leave this decision up to the individual and his healthcare provider.

Colorectal cancer screening

Colorectal cancer (CRC) is the third leading cause of cancer-related deaths among men in the United States, behind lung and prostate cancer. However, with proper screening and the removal of adenomatous polyps (precancerous polyps, or growths which can be removed before symptoms develop), most CRC is preventable. Yet, one-third of adults between the ages of 50 and 75 are not getting the recommended screenings.

There are a variety of imaging tests and laboratory tests which can be used to screen for colorectal cancer. A colonoscopy or sigmoidoscopy are the tests most frequently recommended by organizations such as the American Cancer Society, U.S. Preventive Services Task Force (USPSTF) and the American College of Gastroenterology (ACG), and most recommendations suggest that screenings should begin at the age of 50 and continue through the age of 75 for men (and women) with average risk. The general recommendations for those with average risk include a stool test annually, a flexible sigmoidoscopy every 5 – 10 years with a stool guaiac test or a colonoscopy every 10 years. Men with a family history of colorectal cancer or other risk factors may benefit from more frequent screenings. These men should discuss their risk factors with their healthcare providers to determine whether more frequent, aggressive screenings are advisable.

Diabetes screening

The National Diabetes Education Initiative (NDEI) highlights the diabetes screening guidelines recommended by the American Diabetes Association (ADA). These guidelines recommend screening for any adult who is overweight or obese (defined as a BMI – Body Mass Index – of 25 or higher or 23 or higher in Asian Americans) and has one or more diabetes risk factors.

Risk factors may include a first-degree relative with diabetes, physical inactivity, a history of cardiovascular disease, hypertension (high blood pressure), a high A1C (average blood glucose over a 2-3 month period) from a previous screening, risk factors related to race or ethnicity, or other conditions associated with insulin resistance, such as severe obesity or a condition called acanthosis nigricans. Testing should begin at age 45, particularly if the patient is overweight or obese, and if results are normal may be repeated every three years. A fasting plasma glucose (FPG) is typically the first screening method of choice. Results are typically confirmed with a second screening method on a different day, such as 2-hour postload plasma or hemoglobin A1C.

Dental, vision, and hearing exams

Dental, vision, and hearing exams are, of course, all distinct screening tests. While annual dental exams and cleanings and annual or bi-annual eye exams are considered pretty standard practice, it’s easy for older men to become less diligent about following through with these screenings as they get older.

Older men should have dental exams (and cleanings) annually, and vision exams are generally recommended either annually or bi-annually, especially for those who have vision problems or glaucoma risk. An eye exam can detect serious health problems like glaucoma before symptoms appear, and regular dental exams and cleanings will help to prevent problems such as gingivitis. Hearing tests are typically recommended only if you’re experiencing trouble hearing. However, as WebMD points out, “At least 25% of people age 65 to 74 have disabling hearing loss, most of which is treatable. That number increases to 50% after the age of 74.” If you feel like you’re not hearing as well as you used to, a hearing exam is in order.

While some of these screenings may not sound like a swell time, preventative health is extremely important for men who plan to live a long, healthy, and vibrant life long into their golden years. Spending time in a doctor’s office isn’t a whole lot of fun for anyone. But as the risks for many diseases and disorders affecting men climb with age, your body – and the people who love you – will thank you 10 to 15 years from now for being so proactive about your health today.

179218923The reasons to consider aging at home are tangible, relevant and emotional. The most important for most people is that your home is your comfort zone, your memories and because accepting a lifestyle change can be difficult. Depending upon how you view your retirement years, you may feel that a known and comfortable place is the best place for you to be. While that may be the case, it is important to make plans in the event caring for yourself becomes too difficult.

Approaching that plan is not as daunting as you might imagine. According to the National Aging in Place Council, “Americans of all ages value their ability to live independently. But without a plan for aging in place, it can be hard to stay in control of your life. Knowing your health risks and financial options can make a big difference in your ability to stay in a familiar place.”

Aging at home should be considered a major decision, rather than happening because you’re already there or you don’t believe it will ever be a problem. Read more about how to prepare for aging at home

cfpb-documentWhen it comes to the tasks of caregiving, responsibilities such as medication management, running errands or cooking meals frequently come to mind. Yet caregivers often have to assume responsibility for oversight of finances, or even power of attorney, for a loved one. Bills still have to be paid and healthcare decisions must be made. And if families haven’t discussed who will assume power of attorney or how the finances will be managed, the result can be a situation where everyone is stressed and unsure of how to begin the process.

That’s why it’s important to have these discussions well in advance of a crisis and to educate yourself and your parents as to what is involved so everyone is prepared when a situation arises. To help make transitioning into these responsibilities easier, the Consumer Financial Protection Bureau (CFPB) created four guides to assist those who will assume the roles of:

  • Power of attorney
  • Court-appointed guardians
  • Trustees
  • Government fiduciaries

If you’re unsure about where to start, you may appreciate the Where to go for help section within each guide. And while there is the disclaimer that the “guides are not intended to provide legal advice or serve as a substitute for your own legal counsel,” the guides nonetheless are an important reference tool for navigating these new responsibilities.

When you have the finances discussion, it is also important to bring up the matter of advance healthcare directives and wills. Not having these documents prepared in advance of a crisis can also result in unfortunate snap decisions and unnecessary hardship. Although the holidays aren’t a time when people want to discuss end-of-life issues because families are together in one place, it is often the best time.