Monday, December 12, 2016

SILVER TEA CANCELLED

THE GHSS ANNUAL 'SILVER TEA' IS SCHEDULED FOR TODAY, MONDAY, 12 DECEMBER.
BUT IT IS SNOWING HERE IN THE GHSS AREA. IT'S VERY PRETTY OUTSIDE. IT ALWAYS IS WITH THE FIRST SNOW. BETTER TO STAY HOME, WARM AND COMFY  

AND ABOVE ALL, SAFE!

HAVE A HAPPY SOLSTICE, KWANZAA, HANUKKAH, ST LUCY'S DAY (13 DECEMBER) AND/OR CHRISTMAS!


Friday, December 2, 2016

who are you?

 ARE YOU A ROBOT?


Over the past couple of months this blog has become very popular, with more than 100 views each day.

I do not believe that more than a small handful  of those views are actually people looking at the GHSS blog, and the traffic sources are, well, iffy at best. There is a process whereby blogs can somehow utilize blogs such as this one, that have infrequent posts and few actual viewers, to boost their own statistics. I don't understand how this happens, but the result for this blog is disconcerting.
'
I really want to know whether this blog is reaching people who are interested in GHSS and Senior issues.

I would greatly appreciate it if you would leave a brief message on the comments tab of this post  to let me know that you are a real person and are at least remotely interested in the subjects that the blog discusses.

Even if you simply write "GHSS" in the comments tab, I will understand.

thanks

Tuesday, November 29, 2016

SENIORS ALIVE! FOR DECEMBER

HERE IS YOUR COPY OF SENIORS ALIVE! FOR DECEMBER


Join your  friends in bus trips to GIFT OF LIGHTS (28 December), A Christmas Carol at the Rochester Opera House (18 December), and Antnrim's James Tuttle Christmas Tree  Festival (7 December). There are also shopping trips to Walmart and Warner.

You might also want to come along , with or without the  kids or grandkids, to  Deering's kid's Holiday Party on the 10th of December in Deering Town Hall. You're kids might win a GINGERBREAD HOUSE, a CHRISTMAS TREE (undecoratede) or a gift card to TOADSTOOL BOOKSTORES. There will be free books too!

Sunday, November 6, 2016

Green Light a Vet


TIME TO HONOR OUR VETERANS

I was down at Shaws in Hillsborough on Saturday and donated for the honor of wearing a Buddy Poppy. Thanking those men who put their lives on the line to preserve our Democracy is important to me (although I am become quite discouraged about the near term future of our Great Democracy. Those who say they want to make America great again seem to have overlooked that we are the greatest nation on the face of this planet.  All I have heard is hatred. That is not representative of the Great America I have  grown up  and love).

Do you know what the Buddy Poppies represent? Red poppies are quite common in the fields of Western Europe. They were there before the insanity of  the wars of the last Century and they still blossom there.  We have come see the brilliant red blooms that carpet those meadows as representing so many dead young men. Men who died for reasons that are just not clear.

These men, and all those men and, now, women, who go into battle for our country, are brave beyond my comprehension. They have my respect.

It is worth reading the poem by World War I Colonel John McCrae, a surgeon with Canada's First Brigade Artillery, In Flanders Fields, when we see those vets asking for your support by donating to the Buddy Poppy program.

In Flanders fields

In Flanders fields the poppies blow
Between the crosses, row on row,
That mark our place; and in the sky
The larks, still bravely singing, fly.
Scarce heard amid the guns below.

We are the dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved, and were loved, and now we lie
In Flanders fields.

Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.



Since the nineteen twenties those Buddy Poppies have been assembled by disabled and needy veterans in VA Hospitals.  The funds raised by sale of the poppies

The VFW Buddy Poppy program provides compensation to the veterans who assemble the poppies, provides financial assistance in maintaining state and national veterans' rehabilitation and service programs and partially supports the VFW National Home for Children.

I hope you will not walk past the vets who are selling Buddy Poppies when you see them.

I read in the paper last week that many veterans are feeling left out and unappreciated when they return home from their war tours. We face a nasty and intractable foe this time around. These ISIS guys seem to have no real aims, their view totally dark and their methods abhorrent. Our guys and gals are making a valiant -- and winning fight. The statistics say that battle field casualties are far less frequently fatal than ever before. I guess we have had a great opportunity to improve war medicine since we have been at war for ever so long. But morality is only part of it. The repeated tours, the horribly maiming wounds, the mental anguish have lead so many vets to very bleak places.

They need more than our recognition of their sacrifice. But at the very least they do need us to let them know how much we appreciate their service.

One new program that serves to recognize our warriors is called 'Greenlight A Vet'. Greenlight A Vet is a campaign to establish visible national support for our veterans by changing one light to green. You can then display your green light on various forms of social media. Check out the link provided here. for more information and get some green light bulbs!

Seniors Alive! for November

Here is the November issue of Senior's Alive!

 By now you should have set your clocks back, although I wonder how many people actually have clocks that are not controlled by their computers or electronic whatevers.

Anyway, if your clock IS set to the correct time, you will certainly not want to miss the Senior Luncheon on Thuirsday, 17 November. It will be served at St Mary's church, which has at long last completed its renovation. The cost, as always, is a mere five bucks but you MUST reserve your place by calling Marie Merrow at 603 464 3067. A senior comic will entertain ( old jokes? dunno...) and Hillsborough's Sgt. Hogden and his trusty K-9 friend Gibbs will be there as well. From what I have heard from Hillsborough PD Chief Roarick, Sgt. Hogden is a phenom that you will not want to miss.

Of course, this being (already) Christmas season, GHSS has scheduled a bunch of trips in our bus to help you find THE PERFECT GIFT. Check them out in this issue.

Sunday, October 23, 2016

AGING IN PLACE

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 (www.hud.gov) 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 (www.dhhs.nh.gov) provides many links for family caregiver support services. Monadnock at Home (www.monadnockathome.org), 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

SENIORS ALIVE! FOR OCTOBER

HERE IS YOUR COPY OF THE OCTOBER ISSUE OF SENIORS ALIVE!


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.

HALLOWEEN FESTIVITIES IN DEERING!

THERE'S A LOT GOING ON AT DEERING TOWN HALL IN OCTOBER

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

WRITING A LAST LETTER

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

SENIOR MOMENTS THEATRE GROUP IN HILLSBOROUGH

GHSS IS VERY HAPPY TO PRESENT 

THE SENIOR MOMENTS THEATRE GROUP


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 http://www.seacoastrep.org/programs/senior-moments/

SENIORS ALIVE! FOR SEPTEMBER

HERE IS YOUR SEPTEMBER ISSUE OF SENIORS ALIVE!

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

A FEEDING TUBE FOR ADVANCED DEMENTIA PATIENT?

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.





















Wednesday, August 17, 2016

OSTEOPOROSIS: THE GOOD NEWS .... AND THE BAD

THERE IS A NEW DRUG THAT STIMULATES GROWTH OF BONE AND PREVENTS FRACTURES


An article in today's New York Times reported on a new drug that stimulates bone growth and prevents fractures at least as well as the other drug on the market. The drug is expected to receive FDA approval soon.


Some 10 million Americans have a disease that weakens bones, 80% of them are women. This leads to an increased frequency of fractures of hip, spine and wrist. These fractures often have a high price, including death, increasing incidence of disease, and high dollar costs. 

We are living longer. We can control chronic conditions such as coronary function, we can treat (with some measure of success) cancers, and we don't smoke -- we take better care of ourselves. But with this increased longevity has come diseases such as osteoporosis (not just one disease but a complex) that in an earlier time we might not have lived long enough to have experienced. In the case of osteoporosis we experience age-related deterioration of our bones.With the dramatic growth of the elderly population and the rise in the incidence of fractures at earlier ages, osteoporosis has become a major public health problem of epidemic proportions.  All ethnic groups are susceptible to osteoporosis, and the disease is under diagnosed in the African American population.

Among the several risk factors for osteoporosis are genetics, insufficient calcium and vitamin D intake, along with some of the usual factors that are out to get us: smoking, too much alcohol and the 'couch potato syndrome.'  


The care for patients with established osteoporosis should include:
  • Early diagnosis of potentially treatable secondary types of osteoporosis
  • Decreasing fracture risk by utilizing medications, such as SERMs, bisphosphonates, denosumab, teriparatide
  • Exercise and activity programs
  • Injury prevention strategies
  • Optimizing nutrition and lifestyle variables to decrease risk.
There is available one hormone-based drug that stimulates bone growth, and the NY Times article reports on a second drug that is likely  to receive federal approval soon. While these drugs offer great promise for some, they -- like many drugs today -- are very expensive and becoming more so. 

Osteoporosis is a serious health problem. It demands federal research funds for research and education to reduce the incidence of  fractures associated with osteoporosis.


Monday, August 15, 2016

SHARE THE WEALTH... WITH GHSS

Here is an interesting concept: local nonprofit organizations (think: GREATER HILLSBOROUGH SENIOR SERVICES) enrich their communities ... and usually are strapped for funds! 


Recognizing this, the TD Bank established the Affinity Membership Program as a way to help nonprofit organizations, including GHSS, with an easy way to raise money. Basically what happens is that when you open an account with TD Bank, or have an existing account, you let the bank know that you are a supporter of GHSS. Once a year the bank contributes its own funds to GHSS. The size of their contribution depends upon the amount  of money that GHSS supporters have on deposit with the bank. As they say, The More The Merrier! 

The bank donates its money, not yours. The more you have on deposit with them, the more of their money they will donate to GHSS.

But, maybe you knew that!

 Here is something you might not know. I didn't.

The Bank will make a financial donation to GHSS based on the wishes of the bank’s subscribers in September.


YOU HAVE TO LET TD BANK KNOW THAT YOU WANT  THEM to contribute to GHSS!

Please stop by the TD Bank in the next two weeks and let them know that you want them to contribute to GHSS!

Wednesday, August 3, 2016

Seniors Alive! for August

Here is your August 2016 issue of Seniors Alive! 
 This and past issues are available at the tab above.

When you go to Shaw's in Hillsborough you might notice a sign at the entrance that gives an update on GHSS fund raising efforts to  buy a new bus. "A new bus? I thought you had a bus!" I can hear you now! So, what's the skinny on the 'new bus' already?

Getting older is not something that you should try on your own. You lose a spouse ... and you are left alone. Your family is far away ... and you are left alone. You no longer drive... and you are left alone. Know what happens to your brain on loneliness? Mush. That's what happens. You need to keep those gray folds churning, solving problems, exercising, looking outwardly ... and socializing. In a word: not being alone. 

This is exactly where GHSS can help: we're the cure for loneliness. GHSS sponsored and supported activities such as our monthly luncheons, pickle ball, and shopping trips bring seniors together for friendly interactions.

This brings us to The  Bus.  We had a choice in this. On one hand we could wait. And wait. And fund raise until we could purchase a new one. AS they say, though, we're not getting any younger ... we decided to first buy an older but still serviceable bus that would buy us a few years and a whole lot of trips. Thanks to some generous corporate and personal donations, and a lot of fund raising, we decided to buy a used bus, which we call Betsy. We don't like to reveal a lady's age,  but our girl has about seventy thousand miles on her and, while she is  fighting trim now, she's got maybe five years of good service left before she heads to Bus Assisted Living, or whatever older buses do. 


Thing is, we're going to have to replace  Betsy, and that means: MORE FUND RAISING! 
Another thing is that Betsy has got to be maintained and fed and this requires MOOLA.

So, yes, we continue to raise money for a bus while we continue to provide Seniors in our area with some pretty nifty trips.

You can check out Betsy's schedule for August in this issue of Senior's Alive! (along with other interesting stuff) but here is the schedule of trips for August:

August 11, Thursday: League of NH Craftsmen Fair at Lake Sunape (https://www.nhcrafts.org/craftsmens-fair-daily-schedule.php). This is a display of truly fantastic craft items and crafting displays. The bus will leave Shaw's at 10 am. Admission is $12.00 (an AARP discount is available) and the bus fare is $5.00. (minimum 6 persons). Reserve by calling Marie Mogavero at 464-4726 or 727-5272.

August 12, Friday: Garden in the Woods in Framingham, MA (http://www.newfs.org/visit/Garden-in-the-Woods). This is the New England Wildflower Society public botanic garden. There is a pond, a bog, woodland.  Trails meander over glacier-sculpted ridges and through narrow valleys. Admission to the garden is $12.00 ($9.00 for seniors 64 yrs and older) and transportation is $11.00. a box lunch is available at the garden or you can bring your own. The bus will leave Shaw's parking lot at 9:00 am.  Reserve by calling Marie Mogavero at 464-4726 or 727-5272.

August 18, Thursday: Monthly trip to Walmart.  The bus fare is $5.00 (minimum: 6 people). Lunch and other possible destinations will be determined at the time. The bus leaves Shaw's parking lot at 9:30 am.  Reserve by calling Marie Mogavero at 464-4726 or 727-5272.

August 18, Thursday: Fisher Cats with fireworks! A generous Hillsborough business person has donated some tickets. To score your ticket hurry up and call Marie Mogavero at 464-4726 or 727-5272. The bus will leave  Shaw's at 5:30 pm.

August 19, Friday: USS Constitution Museum (https://ussconstitutionmuseum.org). The 200+-yr-old USS Constitution houses the largest collection of articles related to the construction, and role of that great sailing ship in the early days of our young republic. Admission on Friday is free, the cost of transportation is $11.00. The bus will leave Shaw's at 8:00 am. Bring a lunch as there  is no restaurant. Reserve by calling Marie Mogavero at 464-4726 or 727-5272.

August 16, 23,  30,  Tuesday nights: Henniker Concerts. 
   August 16: North River -- Pure Americana harmonies from Dylan to the Dixie Chicks
   August 23: Nick’s Other Band -- Party on with this high energy audience engaging band 
Charge for the ride is $1.00. The bus will depart Shaw's. Reserve by calling Marie Mogavero at 464-4726 or 727-5272.

August 23, Tuesday: Mill Brook Gallery & Sculpture Garden, Concord. Original art and contemporary craft by regional and national artists in a home-like setting. If you aren't interested in the art, Betsy will be stopping at Beech Hill Farm for an icy delight on the way back home. Transportation is $3.00. The bus will leave from Shaw's at 1:00 pm. Reserve by calling Marie Mogavero at 464-4726 or 727-5272.

August 26, Friday: Franklin Park Zoo, Boston (http://www.zoonewengland.org). With 128 different critters you're bound to find one to love. An arachnid anybody? A train will carry you from exhibit to exhibit so you can be sure to see each and every one of them. Admission to the zoo for seniors is $16.95. Bus fare is $16.00. The bus will leave Shaw's at 9:00 am. Reserve by calling Marie Mogavero at 464-4726 or 727-5272.


The August Senior Luncheon will take place on  Wednesday, August 17 at the Deering Community Church.This will be a chicken bar-b-cue. Come and meet Hillsborough PD's Sgt. Hogden and his K-9 pooch. Yes, you CAN bring something to share! If your last name begins with A-L, please bring a dessert. those beginning M-Z bring a salad please. The cost for this mid week feast in scenic Deering is only $4.00. Reserve by calling Marie Mogavero at 464-4726 or 727-5272. NO LATER THAN 12 August.


Monday, July 18, 2016

Poison Ivy Season

GETTING RID OF POISON IVY

An article recently published in Yankee Magazine gives some great advice for identifying and removing poison ivy.You might want to have a look at it because, believe me, 'tis the season to be itchy!

Here's a summary.
Of course in order to avoid poison ivy you must know what it looks like. There is enough growing along our stone walls and rock walls hereabouts that you can get lots of practice. Basically it's a scrambling plant. Although it can be variable, it is most readily recognized  by the three shiny leaflets. Sometimes they are not so shiny but there are three. This can be confused with Aralia species that occupy the same roadside habitats, but the aralias have a long stem and do not scramble along the ground.  Poison ivy can make dense growths over the ground. Here are pictures of poison ivy. It can also climb trees and form quite an large vine. In autumn the leaves turn a beautiful red/orange; you can see them climbing up tree trunks.

It's the oil in the leaves that gets you. All you have to do is touch the leaves and you can be affected. The oil will stick to your clothes for some time, so if you have been prancing about in the stuff, get your clothes into the washing machine. That should take care of  it.

How do you get rid of poison ivy? First, think about how much trouble it is giving you in your own site. Can you coexist with poison ivy if you know what it is? If so, maybe you don't have to do anything. Contrary to a popular song a long time ago, poison ivy does not come creeping when you're sleeping. Do your kids tend to play where it grows? If so, or if as happened here when it arrived with some planting material that Patty received from a friend, you probably want to get rid of it.

The most effective way is to physically remove it. You might be able to use a glyphosate spray but glyphosate will kill everything but not necessarily the poison ivy. In Patty's case there were just a few sprigs of poison ivy so she used a plastic bag as a kind of glove and placed the plant in the garbage.

If you have to deal with a larger patch: suit up! Gloves, shirt with sleeves and long pants. Things you can throw into the washing machine. Pull out as much of the root as you can. What root you miss will re-sprout so be diligent. That's pretty much it. Put the plants into some kind of bags and put the bags in the garbage.  Don't compost it.

An important point, and one you might not think of is DO NOT BURN POISON IVY. The oil will be in the smoke. If you inhale poison ivy laced smoke it can affect your lungs. That would require medical intervention.

In the fall poison ivy can be quite lovely but it packs a kick. If you cannot coexist with it, then I suggest you read the article referenced here.

Let us now examine our guts



 

Microbes in our guts? An organ?



One of the greatest challenges to independent living for the elderly is frailty. Frailty occurs when our organs and other bits, such as our eyes or hips, accumulate disorders or just give out. One organ that you would not think would age is the one that consists of the microorganisms in our gut.




Actually, there are about ten times more bacteria than human cells in your body. Together these microbes have over 150 times more genes than you. These microbes, which occur in your gut, are known as the ‘intestinal microbiota’ or ‘microbiome.’ The microbiome is so critical in your life that some scientists call it ‘the forgotten organ,’ or ‘the second brain,’ and the microbiome and the brain are in constant communication with each other.



Our mothers contribute the microbes we are born with, and their activity is crucial in our first days and weeks for development of our immune and neurological systems.  As we age our microbiome becomes more diverse. Each of us has our own microbial community and while it changes somewhat through life, it basically remains constant. We get into trouble when our microbiome is disturbed.



The microbiome can be a friend or a foe, depending upon on how we maintain its composition. This depends upon our diet and our physical environment.  



The composition of our microbiome is all important. There are millions, billions, of microbes down there. Mainly bacteria but also bacterium-like microbes called archaea, fungi, and even viruses. Some are beneficial or at least neutral while others are pathogens that can do you harm. In the environment of your gut there  is constant jockying for dominance. The key is homeostasis, where the good keeps the bad in check. This balance can get out of whack, and when that happens there can be trouble.

The homeostasis of our microbiome is greatly influenced by our individual menvironment and our diet. To illustrate this, scientists compared the diets and gut microbiomes of a modern-day hunter-gatherer people in Tanzania, the Hazda, to contemporary Italians. The research found a marked difference in protein and carbohydrate metabolism between the Hazda and the urban Italians. The diet of the Hazda people consists of 70% plant materials, and this includes many indigestible substrates that favor microbial diversity and gene action in the gut. In contrast the urban Italian diet consisted of highly refined sugars and processed foods that favor lower microbial diversity. Westernized diets comprise cultivated foods that are selected for palatability and caloric content and are subject to extensive processing for maximal digestibility. Interestingly, there was a much lower opportunity for horizontal gene transfer in the Hazda gut microbiome than in the Italian. Horizontal gene transfer is a process by which traits such as antibiotic resistance are transferred between organisms. Horizontal gene transfer is considered to be a main cause of antibiotic resistance and the consequent development of 'super bugs' that cannot be controlled by antibiotics. That western diet of foods that have been cultivated for digestibility and are highly processed seems, indeed, to  contribute to an environment that favors the development of bacterial resistance to antibiotics.



In other studies scientists observed that the incidence of autoimmune diabetes was much higher in Finnish and Estonian children than in kids living across the border in Russia. The scientists found  sharp differences in the types of microbes in the guts of the respective groups of kids. While both microbial gut communities produced endotoxins, the endotoxins in the blood of the Russian children could excite their immune systems much more strongly than could the endotoxins in the blood of  the Finnish and Estonian children. The difference could not be explained by breast feeding but was attributed to an early childhood where the Russian children experienced a greater exposure to microbes that would stimulate, or ‘educate’ the immune system than the kids in the 'more highly developed' (i.e. sterile) environment of Finland and Estonia.



A diverse microbiome is essential for good health. A good diet promotes beneficial microbes while limiting colonization by pathogens. Beneficial microbes produce anti-inflammatory factors, pain relieving compounds, antioxidants and vitamins.  The two-way communication between our brain and our gut microbes modulates brain development. It possibly plays a role in our moods. The association of a disturbed microbiome with behavioral and gastrointestinal manifestations of autism spectrum disorder suggest treatments.



Foods containing probiotics and prebiotics help us maintain our microbial communities. A probiotic is a living organism that may improve the health of the host beyond its inherent nutritional content. Probiotic foods typically contain lactic acid bacteria that are present in traditionally fermented foods such as soy products, pickles, sauerkraut, and yoghurt. Many supplements containing probiotics are available. An important point to consider when purchasing one of the probiotic dietary supplements is that it contain live bacteria.



Prebiotics are indigestible food ingredients that benefit us by stimulating the growth of one or a limited number of certain bacteria in the colon. Foods rich in prebiotics include banana, chocolate, onions, legumes, whole grains and cabbage. 

Probiotics and prebiotics are features of a ‘Mediterranean-style’ diet. Our Standard American Diet, high in trans-fat, sugars and highly processed food, only encourages growth of gut pathogens. In the study cited above, the diet of the Hazda people mainly consists of vegetable material and this is thought to be much closer to the diets of our prehistoric -- or even as recent as early 20th Century -- ancestors.






In the elderly the microbiome may become diminished due to the general state of health, malnutrition, a diet low in microbe-accessible carbohydrates, increased use of antibiotics and pain relievers, and insufficient exercise. One large study revealed that the microbiomes of nursing home residents were far less diverse than those of seniors living in the community.

Among the problems experienced by the elderly is lactose intolerance and an inability to digest dairy products. Probiotic lactic acid bacteria can treat lactose intolerance. Some studies show that older subjects given fermented milk had less severe colds and flu, and were quicker to recover than those who did not get the milk. Other research suggests that probiotics protect against traveler’s diarrhea, help prevent tooth decay, and reduce the severity of eczema.

 
Changes in the composition of the microbiome in the elderly have been linked with inflammatory and metabolic disorders, including inflammatory bowel disease, inflammatory bowel syndrome, obesity, osteoporosis, osteoarthritis, gout and cardiovascular disease.



A common problem in the elderly, and antibiotic induced diarrhea, a significant cause of mortality in the elderly.  Fecal transplants, which is exactly what it sounds like, has been adopted as a measure to treat antibiotic induced diarrhea that is caused by the bacterium Clostridium difficile. The explanation for the effectiveness of this seemingly radical, or at least ‘icky,’ procedure rests in the replacement of a ‘sick’ microbiota, one in which the offending bacterial species has been allowed to dominate, with one in which there is a benign, balanced and diverse microbiota.  Other as yet experimental evidence indicates that fecal transplant may help in the struggle against obesity. Exactly how this all happens, which microbes are involved, is unknown so there is no pill in sight.



Chronic fatigue syndrome (CFS), a condition that causes extreme fatigue and the inability to take part in daily routines, has been considered to be a psychological problem. Newly developing evidence at least suggests a physical cause that might be linked to bacteria in the gut. People with CFS had a much less diverse gut microbiota and much higher levels of inflammatory molecules in their blood than did healthy people. Researchers were able to identify people with CFS through diagnosis of their gut bacteria and inflammatory molecules in their blood in about 80% of the cases. This gives new clues to understanding CFS and to why people experience these symptoms.



Study of our gut microbes is the object of a very large international research effort. Science has revealed astonishing roles for our microbiome in our health. With astonishing frequency links between dysfunction of our microbial organ and medical conditions are being revealed. The connection between our gut microbes and our brains through the vagal nervous system has even lead so speciulation about which is the controlling organ! It is all fascinating in a brave new world sort of way, and at least to me, so unexpected. Tantalizing results suggest that fuller understanding of the human-microbiome connection will soon yield major health benefits to all.



Meanwhile, eat your yoghurt and sauerkraut. They are good for your gut microbes!


Beatrice Trumm Hunter contributed to this article