In the timeless tale, The Wizard of Oz, our heroine Dorothy and her endearing companions are warned to remain on the yellow brick road. Had they heeded the Good Witch’s advice, they would have avoided powerful trouble. Joan's Journey Beware of Fake MerchandiseThe unforgettable Oz tale haunts me, because recently I had a potentially disastrous adventure. I was lured off the safe road, not by fragrant poppies, but by intoxicating alleged bargain-price designer merchandise.

In recent posts, I’ve discussed seniors having fun. Living in a senior residence is carefree and offers time to enjoy a variety of in-house activities and explore one’s community. In my modus operandi of having fun, I opted for a shopping trip on a budget. To protect the privacy of those involved in my shopping “shame on me,” I’ve invented fictitious names of people, stores and streets. I call my friend, Dorothy.

Learn what happened to Joan when she ventured off the yellow brick road in Joan’s Journey, Part 28.

Swallowing seems an innate function for younger people, but our swallowing ability is actually a function that often declines with age. It’s often frustrating for older adults when a meal that’s always been enjoyable suddenly proves challenging because of swallowing difficulties.

Deterioration in swallowing function is sometimes attributed to weakened or absent teeth, loss of moisture in the mucosal surfaces of the mouth and throat, or decreased muscle strength in the throat that slows swallowing and increases the difficulty of swallowing hard or dry solid foods, according to Today’s Geriatric Medicine. Swallowing Difficulties in Older Adults

Dysphagia is a term used to describe “problems with neural control or structures in any part of the swallowing process.” Swallowing difficulties are often a consequence of a medical condition, such as stroke, diseases that impact the nervous system (such as Alzheimer’s or dementia, Parkinson’s disease, or multiple sclerosis), and even surgeries affecting the head and neck.

When swallowing difficulties are a more serious concern

If you notice your loved one is no longer enjoying mealtime or has difficulty eating, it’s a good idea to discuss these changes with their physician because sometimes swallowing difficulties can be a sign of a more serious problem or even lead to a more serious condition such as aspiration pneumonia. Aspiration occurs when food or liquid enters the windpipe, causing coughing and choking during eating. This frequently occurs in older adults with later stages of Alzheimer’s disease or dementia, who, over time, lose their ability to perform activities of daily living (ADLs), including eating. If aspiration happens frequently, the person is at risk of developing aspiration pneumonia. When decreased swallowing function is the result of a neurological disease, cancer, or stroke, it is often difficult to prevent the eventual loss in function.

How to preserve swallowing function

Maintaining an adequate nutritional intake is a concern for older adults, even without swallowing difficulties, so difficulties with swallowing or dysphagia only exacerbates this challenge. Often, normal changes in swallowing ability occur gradually, and older adults simply adapt to these changes over time. The Swallowing Disorder Foundation outlines several strategies which you can have your loved one use to maintain swallowing ability and prevent minor swallowing difficulties from becoming more severe, including:

  • taking good care of their teeth
  • practicing good oral hygiene
  • chewing carefully
  • taking smaller bites

If your loved one often experience coughing during swallowing, having them tuck their chin to their chest prior to swallowing can help to protect their airway. There are also swallowing tests that can help diagnose the problem so that appropriate treatments can be prescribed from physicians or speech-language pathologists.

Liquid thickeners and other solutions for swallowing difficulties

Older adults who have swallowing difficulties may be referred to a speech therapist who can help older adults retain as much swallowing function as possible through the use of targeted exercises. For older adults who have difficulty swallowing liquids, thickeners are helpful for reducing aspiration. Thicker liquids travel more slowly down the throat, giving the person’s muscles and nerves more time to complete the swallowing process before the liquid enters the lungs and places the person at risk of pneumonia.

Ensuring their loved ones continuing to receive proper nutrition should be a top priority for caregivers. Often older adults who have trouble swallowing may avoid eating because it’s no longer enjoyable. Foods with a thicker consistency, but are not solids, such as Jell-o, yogurt or pudding, are often good choices. Other foods that are naturally easier to chew and swallow, such as oatmeal, beans and pasta, are also good to incorporate into meals.

Parentgiving offers several valuable tips for coping with swallowing difficulties, including:

  • avoid foods that crumble, like crackers, which can lead to gagging
  • make sure your loved one drinks enough water (6 to 8, 8-ounce glasses each day) to help maintain moisture in the mouth and throat
  • offer gum or candies between meals, as this helps to keep the mouth moist by inducing glands to produce saliva
  • puree or blend foods to break them down into a smooth consistency that is easier to swallow.
  • choose moist foods, mashed potatoes is a good starch option, whenever possible over dry, rough foods such as grains.
  • steam foods such as vegetables for a softer, easier-to-chew consistency

If your loved one is experiencing difficulty swallowing, talk with their physician to determine if further tests are needed to pinpoint a cause and rule out more serious conditions. Whether swallowing difficulty is a normal progression of aging, caused by a chronic disease, or the result of a stroke or similar event, there are strategies you can use to ensure your loved one receives adequate nutrition. A speech therapist or speech-language pathologist can help you formulate a specific treatment plan to help your loved one retain as much swallowing function as possible and develop modifications to ensure your loved one continues to receive adequate nutrition and avoids the negative consequences of poor nourishment and dehydration.

Margery's friend with his dogHalloween is a popular time for pets at my senior residence. Many of the dog parents and one cat parent parade their costumed children in our large community room and residents vote for the best costumes. Sometimes the pets get a little impatient with the event, but their proud owners are determined to march them through the admiring crowd. Pets are welcome residents here. No, I don’t have a pet but I love knowing the pets of my friends.

Learn more about my observations of the role that pets play in my friends’ lives in my latest post Senior Living with Pets.

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.”

When you enter your 40s, 50s and 60s, you may begin to notice that it becomes more difficult to read small print. You may find yourself squinting to read books you easily read when younger. It may become difficult to decipher the dosage instructions on a box of medication. Difficulty seeing clearly when reading and other close work is one of the most common problems adults develop between the ages of 41 and 60, according to the American Optometric Association.

Some vision loss is a normal part of aging

Some vision loss is actually a normal change in the eye’s ability to focus which occurs with age. Known as presbyopia, this condition gradually worsens over time. There are other common vision challenges that occur with age as well, including:

  • needing more light to see clearly
  • problems with glare from vehicle headlights or sun reflecting from windshields or pavement
  • changes in color perception, making it more difficult to tell the difference between certain shades
  • reduced tear production

Cataracts, considered an aging-related disease of the eye, is such a common condition among seniors that many experts consider cataracts a normal part of aging. According to a report by the CDC, more than half of all people age 65 and older have cataracts. Normal changes in vision can often be corrected with eye glasses, contact lenses, or laser eye surgery, or in the case of cataracts, with cataract surgery.

When vision loss becomes a problem

However, substantial vision loss is one of the most common causes of elderly losing their independence. The CDC reports that 1.8 million non-institutionalized elderly people in the U.S. report some difficulties with activities of daily living at least in part due to visual impairment. The most common danger caused by visual impairment is an increased risk of falls and fractures, leading to hospitalization, nursing home placement, disability or even premature death.

To put it in perspective, 92 percent of adults age 70 and older wear prescription lenses. Eighteen percent also use a magnifying glass for reading and other close work. The number of seniors who have difficulty seeing clearly even with corrective measures increases with age, ranging from 14 percent among seniors aged 70 to 74, up to 32 percent among adults age 85 and older.

Visual symptoms can be warning signs of serious underlying conditions

Vision changes in middle age and beyond can also be a warning sign of a more serious underlying condition. The American Optometric Association points out several visual symptoms that can indicate a more serious condition:

  • Vision that fluctuates - If the clarity of your vision fluctuates from day to day, this can be a sign of hypertension (high blood pressure).
  • Floaters and flashes - Seeing floaters from time to time is actually normal; these are typically shadowy images of particles that float in the fluid that fills the inside of the eye. However, if you suddenly see more floaters than normal, and they are accompanied by bright, flashing lights, it could be an indication of retinal detachment (a tear of the retina).
  • Loss of peripheral vision - A loss of peripheral vision, or side vision, can be a warning sign of glaucoma. Glaucoma is a disease in which the optic nerve becomes damaged and no longer transmits visual images to the brain. Unfortunately, symptoms often don’t appear until damage to your vision has already occurred.
  • Distorted vision - Do straight lines now seem warped or wavy? Is there a blind spot in the middle of your visual field? This can be a sign of age-related macular degeneration (AMD), a disease of the macula, a part of the eye’s retina that’s responsible for the central visual field, where visual acuity is typically sharpest.

How to cope with loss of vision

Some diseases of the eye are treatable, like some normal vision loss can be corrected with corrective lenses or surgery. However, other diseases of the eye cause permanent damage that is not correctable by corrective or surgical procedures. Whether your vision loss is correctable or not, there are some general tips and strategies you can use to decrease your risk of falls, fractures and other accidents as a result of poor vision in your day-to-day life.

  • Have regular eye exams - A regular visit to your optometrist can pinpoint problems like glaucoma and other diseases of the eye before you begin having symptoms that can lead to permanent vision loss.
  • Keep your environment well-lit - If you have trouble seeing in dim lighting, make sure your home has ample lighting to illuminate the areas where you spend the most time, as well as in difficult-to-navigate areas, such as stairs and hallways.
  • Remove clutter -For seniors with visual impairment, it can be difficult to discern objects such as cords that extend across a room or hallway or a throw rug with a turned-up edge. These hazards can easily lead to dangerous falls. Keep your home as clutter-free as possible, removing hazards and spacing out furniture to allow for ample walking room.
  • Wear sunglasses in bright sunlight - Ultraviolet light can lead to the development of cataracts, so protect your eyes when you’re out enjoying the sunshine.
  • Mark the edge of stairs with brightly-colored tape - If navigating stairs proves especially challenging, marking the edges with brightly-colored tape makes it easier to discern individual steps to avoid trips and falls. In fact, contrasting colors are helpful visual aids when it comes to things like doors and door frames, plates and place mats, and other everyday objects that may not be easy to differentiate from the objects next to or behind them.
  • Decide when to give up the keys - If your vision loss is severe and not correctable with corrective lenses or other measures, it may be time to give up driving for your own safety and the safety of others. Talk with your optometrist, your primary physician, and your family to determine when it’s time to hang up the keys.

While some vision loss is considered a normal part of aging, you should be mindful of warning signs that could indicate a more serious problem. Having a regular eye exam is the best way to pinpoint these problems before they become major issues. Even with substantial vision impairment, it’s possible for many seniors to live happy, independent lives with the right support and safety precautions.

So what’s the difference between retirement communities and independent living? First let’s establish what an independent living community is not. An independent living community is not synonymous with a 55+ community or active adult retirement communities. These communities typically do not offer services and their residents are generally in their 60s-70s. In contrast, an independent living community provides services that are included in the monthly rent, with standard amenities being a meal plan,Senior Adults Playing Bocce Ballhousekeeping, linen service and transportation.

As its name implies, independent living means that residents are fully independent and do not require assistance with life’s daily activities, whether it’s dressing, walking or medication management. Communities may offer only independent living services or may be part of a larger campus, such as in the case of continuing care communities, which also offer assisted living or skilled nursing services. Apartment-style living with buildings that are single to multiple storied are the norm; however, many now offer free-standing cottages that mimic homes without the burden of yard work or the annual property taxes.

The perks of joining an independent living community often mean that you have access to amenities, such as a movie theater, beauty salon or fitness center, which you wouldn’t have in your own home. Not only do these conveniences save you a trip into town, but they also foster a sense of community amongst residents because they can meet up for movie nights or exercise classes. Other amenities also found in newer communities include hobby rooms or woodshops, gardening areas and walking paths.

Because seniors in independent living communities don’t require healthcare services, their demographics aren’t tracked as closely as those living in assisted living communities or nursing homes. What is known is that seniors who call independent living communities home typically are in their late 70s-80s. With more seniors deciding to live at home before transitioning to an assisted living community, the senior living industry is trending toward building more assisted living and memory care communities rather than solely independent living communities.

To learn more about independent living, read our new, comprehensive article here; it’s a one-stop article with all the information you’ll need to answer your questions about which community setting is the right choice.  And if you have further questions about independent living or want to find the right independent living community for yourself, simply call the number at the top of this page.

Ticket stubs from concerts or calluses built up from decades of pushing a lawnmower are not the only mementos your parents have of these experiences. Unless they wore hearing protection, these experiences had an invisible impact that is likely affecting them—and you—right now. If your priorities are watching Woman whispering into husband's earyour parents’ blood pressure or cholesterol, you’re not alone. Hearing loss isn’t a health issue that receives publicity, but it can have a significant effect upon an older adult’s relationships and well-being than their families realize.

“Hearing loss is inevitable because of the biological structure of the ear,” says Christine Seymour, owner of CS-Deaf and Hard of Hearing Resource Specialists. “Those nerve cells will wear down and the high frequency wears out first.”

While age-related hearing loss is common, hearing loss may occur at any age for a variety of reasons. The National Institute on Deafness and Other Communication Disorders reports that 2 percent of adults 45-54 have disabling hearing loss, and this number jumps to 25 percent of adults who are between the ages of 65-74. And of the adult population who is 75 and older, 50 percent have hearing loss. But this condition doesn’t just affect baby boomers and their parents. Twenty-six million Americans between the ages of 20-69 are estimated to have high-frequency hearing loss resulting from exposure from leisure activities or work-related noise.

Symptoms of hearing loss

Hearing loss impacts people’s lives the greatest, as it “sneaks up on you because it’s gradual,” Seymour says. High-frequency loss is most common in older adults and is associated with being unable to hear most consonant sounds. What this means is someone is able to hear the voice of the speaker but not understand the words. Shouting doesn’t help because increasing volume usually cannot compensate for the loss of specific frequencies. .

Consequentially, a senior is likely to withdraw from social situations, which can lead to isolation and depression. And when these seniors are involved in conversations, they are likely to appear confused when spoken to, or nod and smile along because they are unable to hear all the words being spoken.

This behavior is why older adults may be diagnosed with dementia instead of a hearing loss. “Hearing loss behavior and dementia behavior can look alike,” Seymour explains. “Unfortunately, [hearing tests] are not part of the annual wellness assessments recommended,” which can leave older adults undiagnosed for years.

Seymour says she has witnessed seniors becoming reengaged with life upon receiving a hearing aid, and it makes a tangible difference in the quality of living. Most people wait five-seven years after recognizing a hearing loss before taking steps to remedy it. Unfortunately when they finally purchase hearing aids, they have lived without environmental sounds for a long time. While a normal-hearing person can filter background noise from conversation, a hearing aid receives all sound through a microphone. And when the hearing aids are turned on, all noises (from rain on the window to a person talking in front of you) comes through at the same volume. Seymour says this is often why hearing aids end up in a drawer—seniors are overwhelmed by the flood of noises because the brain has to readjust to filtering out background noise.

Hearing loss requires new methods of communication

For adult children who want their parents’ hearing tested, most insurance companies and Medicare will cover a diagnostic test. Seymour recommends going to a licensed audiologist to do the test because they are “more attuned to the hearing health of the person” and can teach families learn new communication methods to compensate for hearing loss and its effects upon an individual.

One simple way Seymour advises to improve communication is saying your parent’s name before talking. We are conditioned to respond to our name even if we are unable to hear it spoken, but all too often we begin speaking without getting the Friends chatting over coffeelistener’s attention first. By saying your parent’s name first, they have the opportunity to prepare to listen. Another method requires being more conscious of how you speak:  slowing down and speaking clearer.

Another method, which will take some getting used to, is using fewer words. It may seem as though you are dumbing down the conversation, but that’s not the case. Rather, you are distilling the conversation to its root. Seymour also suggests introducing the topic of conversation first before starting the discussion. Instead of saying, “The sun is shining and the weather is warm, let’s go for a picnic,” say instead, “Let’s go for a picnic because the weather is pleasant.”

Seymour says that hearing loss is a two-way street, but those with hearing loss have the larger part of responsibility in letting people know what they need. And unfortunately if people with hearing loss have not learned self-advocacy skills, they will likely not let the speaker know that they can’t understand what is being said.

Giving hearing loss its due

It is only within the last 30 years that hearing loss has started receiving the attention it deserves. But Seymour sees more work ahead to make seniors and their families aware of its effects, as this may reduce the number of hearing aids being abandoned in drawers.

Though hearing aid technology has advanced significantly, with some models being made smaller so it’s not obvious that someone has a hearing loss, “hearing loss is invisible,” and there is a benefit to visible hearing aids because it “announces to the world that I can’t hear,” Seymour says. This allows speakers to adjust their communication methods accordingly to minimize confusion and frustration. So during your parent’s annual physical, don’t forget the hearing test—and don’t forget ordering a test for yourself, too.

In “Tinsel Town,” aka Hollywood, almost anything is possible, including At-Home Spa PAWdicures for pets. What fun Holiday Villa East (HVE) residents had as our furry friends enjoyed deluxe treatment at a senior discount from Hollywood Grooming. Nail trims, teeth brushing, fur grooming, and lots of love and attention were part of the act “where every pet is a star!”

Joan's Journey - Pet Spa DayOur senior community, located near Hollywood but close to the Pacific Ocean, has a beach atmosphere. Therefore, feline owners declined the bling of paw polish and the glitz of rhinestone bows. We kept to our budgets and loved the experience—and the convenience of not leaving home. My beautiful Ragdoll Breed kitten, Heather who is 11 months, looks absolutely “Red Carpet” ready.

In addition, we have the satisfaction that our best friends and roommates will not scratch us or other residents, or catch long nails on clothes, chairs or carpets. Cat Scratch Disease may cause a serious infection, and cutting cats’ nails, not declawing, is recommended by veterinarians and animal rights groups.

Last Joan’s Journey, I reinvented Cindi Lauper’s ever-popular song from the 1980s, Girls Just Wanna Have Fun. For me, the lyrics represent seniors who have worked hard throughout their lives and have reached a milestone where they too want to have fun.

HVE’s Spa PAWdicure Day showcases seniors working with the activity director and a local pet mobile-grooming company toward the common goal of having fun. Senior communities, which allow pet ownership and provide daily meals, housekeeping, planned activities, exercise classes, scheduled transportation and no maintenance concerns, encourage and enhance one’s free time to enjoy life—whatever that means to each individual.

In the next Joan’s Journey follow me on a fun adventure until a spontaneous change of plans and an unwise decision potentially lead to disaster. and I invite you to share your fun experiences in the Comment Section. Until the next Joan’s Journeyers, enjoy the trip 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

Seniors often don’t want to bother others. Trust me, I understand. No one wants to be a burden. But, as we age, everyone needs more help.

As CEO of Alert1, we want to give seniors the support they need. You already know that Alert1 sends help in the event of emergencies. What you may not know is that we also provide seniors with emotional support when they need it.

In the last post, I shared a story about being prepared for falls. This story, inspired by the true testimonial of an Alert1 member, shows the importance of having a community of support.

Ruth hugged herself as a shiver ran down her spine. The winter wind swirled through the empty cottage. It was time to start a fire in the fireplace, but this brought back memories of her husband. Ruth remembered how Colin would always start the fires for her.The value of having an emergency response pendant

“Men should always start the fires!” he would declare with a smile. Instead of rolling her eyes, she would smile right back at him.

But now her husband was gone, and this fire was a task for her alone. Ruth had purchased a new home to leave the memories behind, but she was still trying to get used to the quiet. She missed Colin’s loud, expressive personality. Her life with him had been full of conversation, laughter, and noise.

Before she knew it, the fire caught, and the room was filled with the light of dancing flames.

Ruth stared into the fire and half expected Colin to come up behind her. She imagined him congratulating her, to which she would respond, “Women don’t need men to start fires.”

A tear trickled down her cheek.

Ruth met Colin at the young age of 18. He was loud, vibrant and daring. He took care of her, and she took care of him. It was as if his spirit matched hers. Through the years they danced together side-by-side, like the shadow and the flame.

Ruth struggled to move on after Colin’s passing. With the support of her bereavement group, she had taken the first step into reentering the world—buying a new home.

Ruth found herself reaching for the Alert1 pendant around her neck for comfort. Ruth became a member at the recommendation of a close friend. Her pendant hung on a pretty beaded lanyard that Colin would have loved.

She found solace in the idea that, with a press of a button, there would be someone there to care for her. Alert1 helped stave off the fear of being alone for the first time.

As she toyed with the pendant, Ruth pressed the alarm button.

“Oh no! Now they’ll think I’m in an emergency!” Ruth panicked and wished she could un-push the button.

“Hi there Ruth, this is Elaine from Alert1, do you need help?”

“Hi Elaine. I’m sorry, I pressed the button on accident! Everything is fine.”

“No problem at all Ruth. Please feel free to press the button whenever you would like.”

“Really?! I thought this was only for emergencies.”

“We are here for you Ruth, no matter what you need. You can always press your button to test your device or just to talk with us if you want to say good morning or good night.”

“Tha- that is wonderful. My husband passed away recently, and he used to say both those things every day.”

“I’m so sorry to hear that.”

“Thank you, Elaine.”

“Have a good night, Ruth. And, just so you have heard it once today, have a good morning as well.”

Ruth felt a tear trickle down her cheek for a second time that night, but this time around, she was smiling.

“Good night and good morning, Elaine.”

Lessons for seniors:Seniors playing cards

  • Remember: medical alerts are for more than emergencies. You can talk to a friendly voice at any time, for any reason.
  • Seniors should stay physically active. Your body will feel better, and the endorphins will boost your mood if you do a little each day. Take a walk around the neighborhood, join a local tai chi class or start doing yoga. These activities are low-impact, which is better for your joints.
  • Seniors who have recently lost a loved one may want to visit a local bereavement group. They will support you in recovering and moving on from your loss. In Ruth’s case, they helped her with buying a new house!
  • It’s important for seniors to keep active at their hobbies. Fun activities give you an excuse to get out of the house and spend time with friends. They give you something to look forward to. They release stress and help bring your emotions into balance.
  • Caregivers, it is important to give your senior emotional support. Give a hug and be a listening ear when he/she needs it. Your loved one needs to know that you are available during trying times. Be the one who says good night and good morning so that your loved one does not feel alone.

Shayne Fitz-Coy is the Co-CEO and President of Alert-1, an aging-in-place technology company headquartered in Williamsport, Penn. Shayne is an NAHB Certified Aging-in-Place Specialist with a Bachelor’s in Psychology from Harvard and a Masters in Business Administration from Stanford. He hails from Maryland.

It’s no secret that the cost of long-term care is high, and costs have been rising for several years. The rising costs are an obstacle, but many seniors find no way to avoid the eventual need for long-term care services. In fact, 75 percent of all people over the age of 65 will eventually need long-term care, according to a study by Mutual of Omaha.

Even more disheartening are other long-term care statistics: The average cost of a one-year stay in a skilled nursing community, according to sources like AARP and CNN Money, are estimated between $50,000 and $80,000. It’s no surprise, then, that many seniors spend their retirement savings within a year or two of a long-term care need arising.

For these reasons, planning for long-term care at a younger age is essential. Long-term care insurance is one option to ensure that your care needs will be met as you grow older. A typical long-term care insurance policy covers not only nursing home services, but home healthcare, assisted living communities, respite care, and even services such as adult day care and hospice care.

But knowing whether long-term care insurance is right for you, what tax implications exist, and what your policy should include aren’t easy questions to answer. Our guide to long-term care insurance, “Long-Term Insurance: Planning for Your Future,” outlines the basics of long-term care insurance and how these policies work to offer financial protection and ensure that you or your loved ones will have access to the care you need as you grow older.

For more information about the costs of long-term care, how long-term care insurance works, consumer protections, and how to determine if long-term care insurance is right for you, read our comprehensive article here.

Our baby boomer kids are concerned about us and our cars. When is it no longer safe for us older adults to drive? Are we capable of making realistic decisions? Do we need their help in deciding when to give up the car? At my retirement community, I frequently see this stressful dilemma. Of the many decisions adult children need to make for, or with, their aging parents, the keys to the car may be one of the hardest.

Read what is happening at my place in my latest post Who Should Drive The Car?

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.”