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.

Wednesday, August 17, 2016



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


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.


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 ( 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 ( 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 ( 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 ( 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.