Sunday, October 23, 2016


When staying at home is an option.

Most seniors prefer to live in their own homes and communities for as long as they are able. It makes sense. Where it’s possible, the outcomes for their health are far better than for those who are forced into long-term care facilities, and living at home is a lot less expensive than going to one of those places.   But, as they say, aging is not for beginners. Successful aging in place has several requirements. These involve housing, transportation, health, social engagement, opportunities for volunteering, support for care givers, and advocates for the concerns of the elderly. 

Successful aging in place requires planning. What do you want your future to look like? Not only financially but also personally. Do you want to live with or near your children? Do you want to continue to live in your broad community or would you rather live in a smaller ‘senior’ or mixed community? Maybe you want to remain in your community but live in a smaller house.  And so on. Talk this out with your family now so that you can plan for the future that you want.

Some of the most important adjustments you will make to enable you to age in place will involve where you live, your physical environment. Your house. Is it close to shopping? A medical center? Public transportation? Your children and/or friends?  You really should plan for level entries and make modifications to enable you to live on a single floor within the house.  We did all that when we built our house in 2011, but we should have put hand railings in our shower because my balance has deteriorated in the past couple of years. Many web sites (AARP is an example) discuss all this. The National Aging in Place Council offers many suggestions for making your house senior friendly.

Around here some of our fellow residents are living in houses that they grew up in in the forties or fifties or earlier. Your venerable old New England homestead might have gotten much too big after the kids left. In 2016 a New Hampshire law, soon to be codified as RSA 674:71 to 73, will permit you to build an Accessory Dwelling Unit attached to your house. It doesn’t have to be an ‘in-law’ or ‘granny’ flat; you don’t have to be related to whoever lives in it, but it must be self-contained with a kitchen and sanitation.  You might want to adopt this smaller space for yourself and rent out the old place to a young family. There is a shortage of rental accommodation in our state and this could provide you with some needed income. Some towns already permit these additions, but the new law supersedes zoning ordinances in the towns that prohibit such development.   

Another possibility is house sharing. If you don’t use the computer, get somebody to search on ‘elder house sharing’ and you will come up with lots of sites that describe ways of sharing your house with a roommate, sometimes in return for some level of care or maintenance. Of course you must exercise care in going this route, in accepting a roommate, and you must be sure to consider your own need for privacy, but getting a roommate can be a good way to stay in the old house.

Modifying your house to enable you to live independently can be expensive. Some low-cost loans are available, mainly from government sources. The US Department of Housing and Human Development ( outlines many options to aid you.  Medicaid and Medicare can help with some things, and there are programs to help veterans. It might helpful for you to engage a professional occupational therapist to help modify your house. Sometimes they are paid for by Medicare. Do think in the long-term as you plan your modifications because the trend is for us to live a lot longer (the obesity epidemic not withstanding). 

The Granite State ties with Vermont as the 2nd oldest state in the Union, behind Maine. Currently folks aged 65 and up are in a minority, but this segment is growing rapidly. Nationally, the US Census Bureau projects that the life expectancy of a child born in 2060 will be about 85 years, up about 5 years from 2015. The average life remaining to men who reach 65 is projected to rise from 17.5 years in 2010 to 22.2 years in 2050; for females, these numbers will rise from 19.9 years in 2010 to 24.1 years in 2050. In The Granite State, Baby Boomers are choosing to stay. What this adds up to is that the population of us old folks will nearly double between 2010 and 2025 and, because younger people are leaving, the elderly population will amount to about a quarter of the state’s population.

How is New Hampshire to prepare for this shift?

Aging place requires more than your own personal planning. It requires significant political and financial contribution from your community and from the state. Policies for affordable housing, transportation, and land use (which can help older adults live closer to or within walking distance of the services they need) are the three major components AARP lists as ways states can enable aging in place.  The New Hampshire Dept. of Health and Human Services ( provides many links for family caregiver support services. Monadnock at Home (, a 501 (C) (3) membership organization that serves towns in the  Eastern Monadnock region, is an example of an organization that has the vision of building community and systems to meet the needs of seniors as they age in place

Communities first need to recognize a need. Your Select Board members, for example, should be made to understand that a large part of their electorate comprises senior citizens.  Seniors need to be involved in planning. Land-use policies and local regulations can segregate senior citizens into age-restricted housing, contrary to the wishes of those who wish to age in place. It takes a community to decide to provide and recruit amenities (a senior center, a library, a grocery store) that are easily accessible to seniors and where seniors can come together along with other community members and engage in physical and mental activities that are so important to a successful old age. Communities should foster local health facilities. Shuttered stores in malls can be transformed into medical centers (for physical therapy, easy access to doctors and pharmacies). The county or state should invest in public transportation so that the independent senior can be truly independent.  So much of our state has no public transport and seniors must rely on the good will of volunteers. There is a limit to what volunteer groups such as Greater Hillsborough Senior Services can provide.

How does New Hampshire pay for needed senior amenities? I did not hear any of the current batch of candidates for governor or congress discuss our aging population.  We hear emphasis on the need to bring young families to the Granite State so that they can buy houses and pay real estate taxes. How attractive is New Hampshire to young families? Why is in-state tuition to UNH the highest in the nation? This only drives kids seeking higher education to leave the state. Immigrants, despite dire warnings from some politicians, contribute to the state and community in many ways, not least of which is financial. True, the first crop of immigrants costs money, but they and their children develop businesses that generate tax revenues … and cultural diversity. Their children remain in New Hampshire. Data show that the second generation of immigrants actually contributes more to the state and local economy than residents who have been here for a long time.

Seniors themselves are great entrepreneurs and potential tax payers.  How can we facilitate them in following new career paths? New Hampshire may have to reconsider its antipathy to income taxes. The burden for funding communities lies squarely with real estate taxes and as our population ages, our ability to pay those taxes diminishes. This is not sustainable.

Election Day is very close at hand, and our local elections take place in March. As you weigh the merits of the candidates, ask them where they stand on planning for our state’s ‘Silver Lining.’

Wednesday, October 12, 2016



There is lots of good stuff in here. GHSS sponsors several shopping trips (Christmas IS coming!). Armchair Yoga is starting up, Tuesdays at 10. If you're interested give Janet Gilman a call at 503 478 3544. I had comments on our earlier announcement of armchair yoga from as far away as China! The next senior lunch will be held on 20 October; you've got to reserve for this no later than 14 October by calling Marie Merrow at 464  3067.

Hillsboro Senior Advisory Committee has included a schedule of doings for Seniors in our area. You should check it out. Pickelball anybody? And please don't forget the RUOK telephone assurance system that is run by the Hillsborough and Deering police departments.

One important announcement in this issue relates to the coming election on 8 NOVEMBER.

 First off, let me say, that you have a moral responsibility to vote. I don't care who you vote for, but I do care passionately that you vote for somebody.

Many people, maybe your friends and relatives, have died in wars fought to protect our right to vote, beginning with our great Revolution and continuing to this day against the very dark forces of ISIS.

African Americans and  Women in the United States were denied the right to vote for far too long. Even today in some districts laws have been passed that have the effect of limiting the ability to vote.

This right we have to vote for our representatives was hard fought for and fragile. Do no sit out any election.

GHSS is doing its bit to help you vote by providing transport to the polls at least. If you need a ride give Marie Mogavero a call at 464 4726.



Everybody is welcome to attend these events and THEY ARE FREE!

On Saturday, 22 October, 1-4 pm,  the Deering Association will bring its new CIDER PRESS to Deering Town Hall for some cider making. . Bring a bag of apples (no drops please) to share and a jug. Try your hand at operating the new cider press and take home fresh cider. 

Saturday, 22 October, 1-4 pm, Deering Town Hall. Set up your scarecrow.  This is the second year that the trustees of the Deering Public Library will host a gathering of scarecrows at our town hall. Bring your scarecrow to town hall, introduce it to the others, sit back and smile. As you make your scarecrow please remember to refrain from politics and keep your scarecrows G-rated.  Gift cards to Toadstool Bookstores will be awarded for the three best scarecrows (one scarecrow per family) at the Halloween Party (29 October).

Saturday, 29 October, Deering Town Hall, 5-7 pm. The Third Annual Deering Town Halloween Party. Come in a costume, roast marshmallows, play some games. There will be hay rides and a haunted house. Bring a carved pumpkin. There will be prizes for best costumes, pumpkins and scarecrows. There will be cider and donuts. Bring something to share if you like.

Sunday, September 11, 2016


In the perfect life we would be square with the world when our number is up. Our loved ones should know that we love them. There's nothing wrong with confirming that fact on a daily basis. Sometimes it doesn't work that way though. We should forgive whomever it is we should forgive. Mend broken friendships. Sometimes that's hard to do and we put it off, and put it off. 

In that perfect world we would have planned for the 'administrative necessities' of our deaths: Will? Check! Advanced Directive? Check! Living Will? Check!

I hope you have an advanced directive and a living will. People who do not clearly document their wishes and preferences for care at the end of life are often subjected to futile medical treatments that they neither seek nor benefit from. Their families are burdened by the medical bills accrued from the numerous ineffective treatments many patients get at the end of life. 

Regret is common at the end. How we wished we had said, or forgiven, or .... It can be difficult to express to loved ones the fact that they actually ARE  loved. That one is proud of one's children. That offenses, real or otherwise, may be forgiven. We shouldn't have to bear the burden of regret in our last hours.

But, who wants to think of dying?  It can be difficult to actually lay out  a concrete plan  for the last days. To what extent do you want care? What about your  body? We shouldn't require our family members, loved ones, agents and/or medical professionals to guess how we want our end, and after the end, to play out.

We should really deal with these things when we're healthy and not wait until we're at death's door. It can be hard to say these things though. Maybe you simply cannot bring yourself to put your emotions into words,  face-to-face. Maybe the person you want to forgive is not nearby  or you don't know where he is.

Contemplating one’s own death and doing some basic preparatory work is certainly not an easy task. You can download advanced directive and living will forms, but those emotional issues? Maybe you need some help with that one. For many reasons, it might be easier to write down than to express verbally whatever you really need to say. Now there are tools to help in this difficult job.

With this in mind the Stanford Letter Project was developed. This project provides tools for writing letters that, in addition to advanced care directives, inform medical staff of what you think is important in your care, and that help you to express emotional concerns to friends and family. The tools include templates for letters in several languages, and can be filled out as paper copies or on-line. There is also a tool that can hep to  share your  letter  with others.

Letter Project Tools:

  • What Matters Most Letter: This is a letter template that allows anyone to document what matters most to them and what treatments they want in the future. This tool is free and is available in print, as an online fillable form and as an iPhone and Android App in eight different languages.
  • Letter Project Advance Directive: This tool allows anyone to answer a few simple questions in English. When they finish and click print, the tool will send them an auto-filled valid advance directive document and a supplemental letter to their doctor describing their preferences for medical care at the end of life. This tool is free and is available in print, as an online fillable form and as an iPhone and Android App.
  • Friends and Family Letter: This letter can help all adults complete their seven life review tasks: acknowledging important people in our lives ; remembering  treasured  moments in our lives; apologizing to those we may have hurt; forgiving those who have hurt us; and saying “thank you,” “I love you” and “goodbye”. Using this template, you can write a letter to your friends and family in one of eight languages using an online form, an iPhone or Android App or a printable form.

Here are some of the comments on a NY Times article about the Stanford Letter Project

"This is such an important project as it brings closure not only to the reader of the letter, but also the writer. There are many topics that are difficult to talk about for many reasons but a letter gives the chance to express feelings that may have otherwise been left unsaid, and also an opportunity for the reader to understand what was really going on in the writer’s head; Or the writer can choose to have a loved-one read the letter with them so they can both appreciate what was touched upon. Either way what was written will last for a long time and can be reread many times. For example, I would have loved to receive a letter from my grandmother, containing stories or important lessons, but unfortunately she now has dementia, and I will never get to hear what she had to say. That is why it is so crucial to write a letter while healthy.
Another reason is because we never know what the future has in store for us. People suffer from the mentality that we can “get to it tomorrow.” But in reality we do not know what is coming tomorrow, or if there will be a tomorrow. Writing a letter now gives the elderly, really anyone a chance to say “I love you,” “ I am sorry” or simply goodbye. These words are actually more difficult to say face-to-face than in a letter. With apologies it can be especially helpful, because pride may get in the way of saying sorry. But through a letter, a person can apologize and get the closure they need. Writing is a great outlet for situations like these."

"I am a senior citizen and have often, especially after being rescued from one heart attack, wondered how I will be remembered. I have come to believe that our day-to-day relationships with all of those around us is imperative for human survival. While I do endorse a written commitment to those we love (that can be a reminder of our caring when they come across it during their busy lives in the future), I think we need to start each day with a commitment to share our apologies and expressions of gratitude and love.:"

"My mother died of breast cancer in 1961 when I was 13. All my life I have wished that she had left me something in writing—something that I could have read when I was older that helped me understand what she felt about me, her disease, her life, her loves, her dying. Something that would have let me know her when I was old enough to understand what in her healthy and then unhealthy life had been important to her. But I've made do with old family snapshots. In one especially when I am a baby in her arms, I can see the look of love on her face. In others, I intuit what was important to her by the snaps she chose to take. Not the same as words but, at least, something.

"-I wish I had a letter from my mom. I'm not sure I could read it on a regular basis- even old birthday cards tear my heart out. But knowing I could read it if I wanted to would be a comfort to me and would fill the void her passing left in my heart."

Monday, September 5, 2016




On Thursday, 12 September, this troupe of volunteer senior actors will will present a FREE  performance dealing with senior issues in an “irreverent” and “bawdy” format.  Our minds and bodies may be changing and maybe we're neither as pretty or physically fit as we once were, but the old noggin is still working (most days) and we've got a healthy sense of humor (most days). This special performance promises to be a lot of fun as it strikes familiar chords. 

You don't have to attend the luncheon to attend this memorable and entertaining production.  BUT WHY NOT? 

The performance will take place at 1:00 at the Valley Bible Chapel, in Hillsborough, opposite Butler Park.

The luncheon, chicken pot pie this month, starts at noon and will only costs $5.00. You've got to reserve to attend the lunch. To do so, contact Marie Merrow at 464-3067.

Senior Moments was founded in 1999 by the late Joanne Dodge as an all-volunteer performance group for seniors by seniors. The group writes its own plays and short skits, which focus on issues affecting elders, and performs them throughout the state at senior centers and other senior gathering places. The program encourages creativity, celebration of the aging process and the active participation of seniors in the arts.

Past performances have included *Yes, There is a Tomorrow* (depression and suicide prevention), *Help Me, I’m Falling, and I Can’t Get Up* (safety issues), and *I Haven’t Got Time for the Pain* (myths and realistic approaches to dealing with chronic pain). Senior Moments also provides classes in theatre and members routinely meet with seniors to read plays at assisted living homes and day out programs.

Senior Moments has appeared at the New Hampshire Conference on Aging, Maine Senior Expo, Association of American Retired Persons, National Association of the Mentally Ill, WSCA Audio Theatre Players, New Hampshire Public Radio, New Hampshire Public Television, as well as a score of community groups and organizations throughout New England.

You can learn more about this group at



Highlights of this issue include nifty September and October trips in our trusty bus BETSY
Apart from our regular shopping runs,  here are trips that you won't want to miss!

21 September, Wednesday The Eastern States Exposition. Celebrate the 100th anniversary of this mighty exhibition. Lots of agricultural exhibits ranging from 1916  to today. Budweiser Clydesdales, pig races, butter sculpture, Storrowton Village, wine and cheese barn and  fiber Festival of New England and much more.  Leaving Shaw's at 8:00 am. Transportation $12.00, admission to The Big E $12.00. To reserve call Marie Mogavero at 464 4726 or 724-5272. Minimum 10.

6 October, Thursday. a Mystery Trip. Bring your lunch, we'll provide a dessert and a beverage. BE ADVENTURESOME!  The last Mystery Trip was very popular. Leaving Shaw's at 10:30 am. $6.00. To reserve call Marie Mogavero at 464 4726 or 724-5272.

 8 October, Saturday. FALL FOLIAGE TURKEY DINNER TRAIN.  Enjoy a complete turkey dinner aboard the train, catered by Hart's Turkey Farm. Your round trip Fall Foliage Dinner Train will depart Meredith Station and travel south along the western shore of Lake Winneepesaukee through the village of Weirs Beach and along Paugus Bay towards Lakeport and back alongthe very same route. Along the way youll enjoy breathtaking views of New Hampshire's largest lake while sneaking a peek at some of the many beautiful lakeside homes you'll pass along the way. This 2-hour dinner train departs at 5:00 pm, returning to Hillsborough at about 9:00 pm. Thanks to generous support from the town of Hillsborough, the cost to you of the train ride and the dinner is only $30.00 per person. Please make checks payable to "GHSS." To reserve  call Marie Mogavero at 464-4726 or 724-5272

The September Senior Lunch will be held on Thursday, 15 September at noon at the Valley Bible Chapel, on Main St Hillsborough, opposite Butler Park. The cost for the lunch is only $5.00. As a special treat, The Senior Moments Theatre Group, a group of volunteer senior actors from Portsmouth, will present a hilarious send up of the whole idea of getting old. The play will start at about 1:00 pm. You do not need to attend the luncheon to see the play. You must reserve to attend the lunch by calling Marie Merrow at 464-3068 no later than 12 September.

Wednesday, August 31, 2016


Food is such an important part of all of our rituals. There are few greater altruistic acts than to give food and ask nothing in return.  Chicken soup from Mom's hand makes colds, flues and maybe even jilted love bearable. Comfort food might not rate very high on a nutritional scale, but boy does it FEEL good! 

So it is when people like our parents who are in late states of dementia often have problems eating and drinking. They cannot communicate, they cannot eat, they lose weight.  Chewing is hard. They aspirate food particles into the lungs, which can result in difficulty in breathing and pneumonia. This is hard to take. Surely if they would eat, they would get better, and often a feeding tube is offered as an option. Feeding tubes are more commonly used in the south and among African Americans than here in New England. 

Think twice before taking this route.

An article in the New York Times describes the decline in the use of feeding tubes in these cases of late stage of  Alzheimer's, following recommendations by the American Geriatrics Society and the American Board of Internal Medicine.  In summary, feeding tubes do not give any better outcome than careful handfeeding but they do increase risk:
  • It can cause bleeding, infection, skin irritation, or leaking around the tube.
  • It can cause nausea, vomiting, and diarrhea.
  • The tube can get blocked or fall out, and must be replaced in a hospital.
  • Many people with Alzheimer’s disease are bothered by the tube and try to pull it out. To prevent that, they are often tied down or given drugs.
  • Tube-fed patients are more likely to get pressure sores.
  • Tube-fed patients are more likely to spit up food, which may lead to pneumonia.
  • At the end of life, fluids can fill the patient’s lungs, and cause breathing problems.
Feeding tubes are associated with increased agitation in the patient which can lead to physical or chemical restraint.

 And they cost a lot to put in place. 

There are times when feeding tubes are a good idea. These include conditions that have a good prognosis, unlike advanced  Alzheimer's.

The ABIM report cited above includes several recommendations from Consumer Reports for caring for a person who has severe Alzheimer's Disease. These include treating conditions that lead to loss of  apatite such as constipation, stopping unneeded medications that can make eating problems worse, and scheduling dental care in case a problem with the teeth results in painful eating. 

All this should be discussed with the patient and the patient's medical team.

Most important is that there is an advanced medical directive and that you have that talk with your parents about what they want done to and for them at the end of their lives.