Barbara Bush’s Last Legacy: the Importance of End-of-Life Decisions

Barbara Bush was the first, First Lady of my youth.

I was born in 1978, so this isn’t entirely true.

I was around for some of Rosalyn Carter’s tenure and I certainly remember Nancy Reagan.

However, it was only during the Bush presidency (the elder) that I began to appreciate politics and the role of a President and his Wife in American life.

I thought the world of Barbara Bush.

Barbara was an elegant matriarch and a champion of noble causes and platforms.

Her recent passing closes a chapter and leaves a void, without a doubt.

Former first lady Barbara Bush, beloved wife of George H. W. Bush, passed away yesterday at her home in Houston, Texas. She was 92 years old. The first lady will be remembered for her campaign to improve literacy across America, through her the Barbara Bush Foundation for Family Literacy. She was also involved with the battle against childhood leukemia, a cause near to heart since she lost her own child to leukemia at the age of three.

There’s one more thing Mrs. Bush will be remembered for, and that is the spotlight she shone on end-of-life decisions. Two days before her passing on April 17, the Bush family announced that their mother had decided “not to seek medical treatment and will focus on comfort care.” Mrs. Bush suffered from congestive heart failure and COPD, and decided to stop fighting her terminal illness in favor of comfort, or palliative, care.

The announcement sparked national conversation about the definition of comfort care and end-of-life care in general. Nobody likes to contemplate the end of their own life, but it’s important to think about it before it’s too late. Many elderly people don’t make their wishes known to their family or medical providers, and sometimes they’re no longer verbal or even conscious when those crucial decisions need to be made. Barbara Bush, in publicly announcing her medical choices, raised awareness that will hopefully spur more seniors to document their own choices and preferences.

Writing an Advance Healthcare Directive

It’s never too early to start thinking about writing your advance directive, or living will. The advance healthcare directive is a document that allows you to state your wishes for your end-of-life care, in case you become unable to communicate. Even if you are still able to communicate, having your choices documented can help ensure that your wishes are honored.

There is no right or wrong choice when it comes to your end-of-life healthcare. These decisions are highly personal, and each person should create their living will after much thought and consideration. You may also want to consult with your lawyer to make sure your living will is valid and can’t be contested.

Like the late first lady, many people with terminal illnesses opt to receive comfort care, also known as palliative care. With palliative care, all “extreme” measures, such as ventilators or CPR, are discontinued. The focus is on alleviating pain and managing symptoms. This allows the patient to die peacefully, often in their own home.

Other people prefer to pursue all life-prolonging measures available, in the belief that life itself—no matter how limited or painful—is worth prolonging. In all cases, the patient’s wishes should be honored as much as possible.

If your elderly parent doesn’t have some form of living will, start the conversation today. Having an advance directive will make sure your parent gets the care he wants and deserves.


Proton Therapy Gains Popularity in NJ

Doctors first used proton therapy to treat cancer in the 1950s, but it only started gaining popularity in the 1990s, when the first hospital-based proton therapy center opened.  What is this revolutionary cancer treatment, how is it different from traditional radiation, and is it appropriate for your loved one suffering from cancer?

How Radiation Therapy Works

According to cancer.org, the website of the American Cancer Society, radiation treatment “uses high-energy particles or waves to destroy or damage cancer cells.” It works by breaking the DNA in cells, which makes it harder for them to multiply. Rapidly dividing cancer cells are particularly susceptible to this kind of damage, so tumors often shrink or disappear.

Radiation therapy is a localized treatment, unlike chemotherapy, which affects the whole body. The therapy aims radioactive waves at the specific area where the cancer is located. The goal is to limit the damage to the healthy cells in the body, but with traditional radiation therapy, the entire target area is at risk.

How Proton Therapy is Superior

The difference between traditional radiation and proton therapy is in how the radiation is delivered. Traditional therapy sends a  dose of radiation that affects all the tissue in the wave’s path. Proton therapy uses beams of protons—charged subatomic particles that can be controlled with magnets. It uses a small amount of radiation, and most of it goes directly into the tumor. None of it passes through the other side.

An example of how this works is that proton radiation aimed at a spinal tumor wouldn’t reach the heart or lungs, as it would with traditional radiation. Or if the tumor is one part of the brain, the other half would remain unaffected from the treatment.

In addition, because the radiation is more focused, and more of it reaches the tumor, you can use a smaller overall dose. This further limits the radiation damage to healthy cells. Another benefit of proton therapy is that patients must hold still for only seconds at a time, compared with minutes for traditional radiation. An entire treatment takes just a couple of minutes. As with other types of radiation, patients go for treatment once a day, five days a week, for five to eight weeks.

Who Benefits from Proton Therapy

Children with cancer benefit most from proton therapy. This is because more of their normal cells are developing rapidly, making them more prone to damage that could stunt the growth of healthy organs. People with tumors in the head, neck, and spine, and those who have cancers near other very sensitive organs, also benefit greatly. The precision of proton therapy protects their organs from radiation damage caused by traditional radiation.

On the other hand, people with certain cancers will not be candidates for proton therapy. Lymphoma, for example, often requires treatment in a wider area around the lymph nodes because of the way the cancer grows and spreads.  Many common cancers fall into a gray area. Patients and their doctors need to weigh the risks, costs and benefits of different types of treatments.

Because of the lack of extensive research, as well as the price, proton therapy is still considered an uncommon treatment for most cancers. There are only 28 therapy centers in operation in the entire country. However, patients who decide, with their doctor’s guidance, to embark on proton therapy are fortunate to have choices right here in New Jersey. Robert Wood Johnson Medical Center provides proton therapy at the Laurie Proton Therapy Center in their New Brunswick campus. In addition, ProCure Proton Therapy Center, located right near Regency Jewish Heritage in Somerset, opened in 2012 as an affiliate of the CentraState Healthcare System.

If you think you or your loved one can benefit from proton therapy, speak with your doctor today. The cure for your cancer could be just around the corner.



An Amazing Week At Regency Gardens in Wayne!

What an amazing week we had at Regency Gardens in Wayne, NJ!

So many great moments……and the week isn’t even over yet!

Here are two:

David came by to say hello and to thank us again!

Why is this exciting?

Because David was with us for post-acute rehabilitation not too long ago and needed plenty of help. Today he looks like he’s ready to run the marathon  – and that makes us VERY proud!

Here is David with Ruth and with Mark!

Then, you’ll also notice our newly decorated bus just waiting to take our excited residents out for their activities and excursions!

Yeah, we’re pretty pumped about that too!

Enjoy the rest of your week everyone!


Watch Your Back!

At Regency Nursing and Rehabilitation Centers, we don’t simply look after the isolated medical issues and symptoms of our patients; we care for the TOTAL patient.

We regularly in-service and lecture and educate our residents (and our staff too) regarding healthy living.

One of the popular topics we cover is proper posture and “minding your back.”

This is especially relevant to seniors.

Bad back habits can be extremely debilitating, especially to elderly people.

On March 24, 2016 I published an article on this topic, in my capacity as representative of Regency Nursing Centers, on an extremely popular online healthcare resource.

I’d like to re-invite you all to read this important article by clicking on THIS LINK.




Peripheral Neuropathy: What You Need to Know

Peripheral neuropathy is a group of conditions involving damaged or diseased nerves. There are many different forms of peripheral neuropathy, mainly divided into two types: mononeuropathy and polyneuropathy. Mononeuropathy, like its name suggests, is when only one nerve is damaged. Polyneuropathy is when multiple nerves around the body are damaged.

One very prevalent type of chronic polyneuropathy is diabetic neuropathy. This condition occurs in diabetics, particularly those with poor blood sugar control.


The most common symptoms of PN are tingling and numbness in the hands and feet. Depending on which nerves are affected, you may also experience:

  • Sharp, throbbing, or burning pain
  • Diarrhea or constipation
  • Loss of bowel and/or bladder control
  • Sexual dysfunction
  • Low blood pressure
  • Sensitivity to touch
  • Lack of coordination and/or falling
  • Muscle weakness

Causes and Risk Factors

There’s no one cause of PN, since it’s not actually a single disease. It’s a group of disorders, and there are many different causes. Some of the triggers for neuropathy include:

  • Alcoholism
  • Autoimmune disease
  • Bone marrow disorders
  • Certain infections
  • Chemotherapy
  • Diabetes
  • Exposure to toxic substances
  • Trauma
  • Tumors
  • Vitamin deficiencies

There are also some cases of PN where no specific cause can be identified. However, knowing the common causes listed above can help identify people at risk for neuropathy. For example, more than half of all diabetics develop some sort of PN. Those whose blood sugar levels are poorly controlled are at higher risk.

People with kidney, liver, or thyroid disorders are also more likely to develop peripheral neuropathy. In addition, family history puts you at higher risk.

Prevention and Management

People at risk for damaged nerves should take steps to prevent developing neuropathy. The best way to prevent it is to manage the condition that may cause the damage. It will also help to make healthy lifestyle choices, by avoiding alcohol, eating a good diet, and exercising regularly.

If you have already been diagnosed with peripheral neuropathy, you can manage the condition with a healthy lifestyle. Quit smoking, treat injuries and wounds right away, and take care of your extremities.


People suffering from peripheral neuropathy often lose all sensation in their extremities. They can’t feel temperature or pain, so they may burn themselves without realizing. They may also develop sores from injuries or extended pressure they don’t feel.

If your foot becomes injured without you realizing it, it can become infected quickly. As mentioned above, it’s important to check for injuries regularly and treat them before they get infected. Allowing infections to fester untreated may result in limb amputations.

Another complication of peripheral neuropathy is increased risk of falls. Weakness and loss of sensations in the feet make falls more likely.

In order to avoid complications and control the condition, see your doctor right away if you are at risk for PN and you begin experiencing symptoms.


Beating Alzheimer’s

Last week we talked about green leafy vegetables‘ role in improving brain function. Today we’ll explore another delicious vegetable that may prove to be the cure for Alzheimer’s disease.

beets on a wooden table


Beets are root vegetables with striking purplish-red flesh. They’re delicious both raw and cooked, and they’re essential in a healthy diet.

Beets are rich in fiber and contain a variety of vitamins and minerals, including B vitamins, iron, copper, magnesium, and potassium. Among its health benefits are lowered blood pressure, reduced risk of heart disease, increased endurance, and improved liver function.

Now researchers say beets can slow down the progression of Alzheimer’s disease.

Here’s how it works: the signature physiological characteristic of Alzheimer’s is beta-amyloid buildup in the brain. Amino acids called amyloid beta proliferate in the brain. They form large clusters called beta-amyloid plaques that accumulate and disrupt normal neuron function. These beta-amyloid groupings also cause an inflammatory response in the nervous system, which further advances the disease.

New research finds that beets contain a compound that may slow this process. The chemical betanin—the pigment responsible for beets’ deep red color—interacts with amyloid beta. It prevents this accumulation of the harmful proteins in the brain.

The researchers conducted experiments with betanin, and found the pigment reduced the damage caused by amyloid beta by 90 percent. While the scientists were clear that betanin will not completely prevent Alzheimer’s disease, it does appear to slow the growth of beta-amyloid plaque.

This is promising news for drug developers, who can experiment with this widely available pigment in new drug formulas.

For the rest of us, it’s another reason to eat those tasty red orbs.




Spring is Here

crocus flower coming up in the snow

Today, March 20, 2018, is the first day of spring. Yes, really. It certainly doesn’t feel like it, with plunging temperatures and a winter storm warning in effect in New Jersey, but the first day of spring it is. And while right now it looks like it will never happen, the weather will eventually warm up and spring will finally be here.

Spring arrives with flowers, bugs, sun showers…. and health benefits. Here are 3 health benefits to seize this spring:

More Vitamin D

Vitamin D is an essential nutrient that nearly all of us are deficient in. Too little vitamin D means calcium doesn’t get absorbed properly, which in turn results in brittle and weakened bones. Vitamin D deficiency has also been linked to different types of cancers, heart disease, depression, and weight gain. The vitamin assists in regulating the immune system and other body and cell functions.

While we can get vitamin D from nutrition supplements, the best way to get it is for your body to manufacture it itself from sunlight. Sun exposure—particularly UV-B rays—causes the body to develop vitamin D. Experts say fair-skinned people need just 10 minutes in the sun to produce 10,000 international units of vitamin D. More than that would be unsafe without sunscreen.

Make sure to spend time outside when the weather turns sunny. Regency Nursing’s facilities have beautiful gardens and patios to enjoy the bright spring and summer sun.

Increased Exercise

It’s so much more enjoyable to exercise out in the fresh air. And once that fresh air warms up, there’s an extra incentive to exercise. Exercising regularly offers so many health benefits, and when you jog or bicycle outdoors it brings your work out to a whole new level.

When you exercise outdoors, make sure to practice exercise safety—drink regularly and wear a wide-brimmed hat to avoid overheating. Wear well-fitting sneakers and make sure your laces are not in the way. And of course, check with your doctor before starting a new workout.

Better Mental Health

Seasonal affective disorder, or SAD, is a seasons-related depression that causes weight gain, tiredness, and irritability in the winter months. Even if you don’t have SAD, you still might have been experiencing the winter blues. In the winter we tend to “hibernate”—we stay indoors and don’t socialize as much. Now with spring coming, you can get out and enjoy nature’s rebirth.


Regency Nursing Best In Senior Care 2018 Award Winning Photos!!!!!

I’ll cut to the chase.

You all know that Regency Jewish Heritage Nursing, providing rehabilitation in Somersetwoods, was nominated as best in Senior Care for 2018, by the prestigious SeniorAdvisor.com, right?

Now they have prepared a wonderful photo contest and we have entered into it using  the photos below of our smiling residents!!!!!




It’s Multiple Sclerosis Awareness Month

March is Multiple Sclerosis Awareness Month. Multiple sclerosis (MS) is a long-lasting autoimmune disease that causes degeneration throughout the body. It happens when your immune system attacks the myelin sheath, the fatty material protecting your nerve fibers. Your nerves become damaged without this protective layer, and they don’t work as they should.

MS affects everybody differently. Some people have mild symptoms that don’t require treatment, while others will be confined to a wheelchair. It’s also often a degenerative disease, which means it gets worse as time passes. Here we’ll talk about the basics of MS—the early signs, common symptoms, and basic treatments.

Multiple Sclerosis: Early Signs

The first symptoms tend to show up between the ages of 20 and 40. Sometimes symptoms will flare up periodically and then die down, while others linger long-term. MS presents differently in every person; some have a single symptom and then go for years without any other problems, while others will experience a rapid progression of the disease in a matter of weeks.

In many cases, the first sign of MS is called a “clinically isolated syndrome.” As its name suggests, CIS is an isolated neurological episode where your immune system attacks the myelin sheath. It causes nerve damage that results in temporary symptoms of MS. This often presents as optic neuritis—blurry vision, eye pain—or numbness and tingling to the legs. You may also feel something like an electric shock when you move your head or neck.

Having CIS does not mean you will develop MS, but if it happens a few times, your doctor will order an MRI to check for nerve damage and diagnose MS.

Multiple Sclerosis: Symptoms

Ongoing myelin and nerve damage will cause a range of symptoms all over the body. These symptoms include:

  • Frequent urination and trouble emptying your bladder
  • Bowel problems and onstipation.
  • Difficulty walking and keeping your balance
  • Clumsiness
  • Dizziness
  • Fatigue
  • Double vision
  • Muscle spasms, particularly in the legs
  • Slurred or nasal speech
  • Cognitive difficulty or fuzzy memory
  • Tremors
  • Skin sensations such as severe itching, burning, or stabbing pains

These symptoms present with varying degrees of severity, and in many cases some won’t appear at all. For people with progressive MS, the symptoms may be mild at first, and become worse and worse over the subsequent months and years.

Most people with MS can effectively manage their symptoms and continue living fully and happily.

Multiple Sclerosis: Treatment

There is no cure for MS; we aren’t even sure what triggers it in the first place. However, there are many medicines that help prevent nerve damage and slow the disease’s progression. Your lifestyle choices—such as exercise and stress relief—can also play a big part in managing your symptoms.

There are several types of medications and treatments available. Some, such as disease-modifying drugs and steroids, are used to prevent relapses. Others are prescribed to help you manage your symptoms. Different drugs help fight fatigue, relax your muscles, control your bladder, give some pain relief, and ease muscle spasms. Some forms of MS, especially severe and progressive MS, may respond well to a plasma exchange. This is a process that involves removing your diseased plasma and replacing it with a healthier version. 

There are many non-medical ways to manage symptoms as well. If you suffer from constipation, increasing fiber to your diet can help. Swimming is excellent for easing stiff muscles. Low-impact exercises like tai chi and yoga can also help manage symptoms. Certain foods are also beneficial for people with MS. These include turmeric—a bright yellow spice common in Indian cuisine,  fruits and vegetables, ginger, green tea, salmon, legumes, and whole grains. Vitamin D is also an important part of diet.

Living with a chronic illness is tough, and it’s natural to feel anxious or depressed. Exercise is a natural mood-booster, so try a light workout or other stress relief techniques. You may want to meet with a counselor to help you process your feelings, or speak with your doctor about taking an antidepressant.

Remember, if you have MS, you’re not alone. Visit the Multiple Sclerosis Association of America’s website for more information and resources.