How to Set an Effective New Years Resolution

As the holiday season draws to a close, and the last of the trimmings have been stored away, most people turn toward the coming year with a resolve to change something for the better. Whatever your age or stage in life, setting goals for self-improvement is a great way to refocus and get a fresh perspective for the new year.

Why is it, then, that so many people—as much as 92 percent of Americans—have all but forgotten their goals come February? Experts say that there is actually a method to finding a New Year’s resolution you can stick to.

Make it positive and enjoyable.

If you’re already dreading it before you start, you’re going to drop that resolution fast. Find something you will look forward to, or at least plan it in an enjoyable way. If you’ve resolved to be more physically active, choose an enjoyable exercise routine or do it with a friend. If you plan to organize your old papers and documents, plan a time of day to work on it, and reward yourself afterward.

Write it down.

Writing down your resolution will help you think it through clearly and plan for strategies for when the going gets tough. While you’ll probably be feeling eager to consume only carrot sticks and green beans for the first week of January, what will happen when that craving for sweets hits?

Get support.

There’s nothing like company when it comes to the journey to reach your goals. Get a friend or family member on board to help you stay focused and motivated.

Pick something small, concrete and doable.

This is probably the biggest factor in the goals that are achieved and the ones that are left to gather dust with the New Year’s party blowers. Don’t paint your resolution in broad terms; break it down into concrete, bite-sized chunks. Want to start eating more healthfully? Plan two ways that you’ll incorporate additional healthy foods into your diet. Dreaming of decluttering your home? Choose one room—or even part of a room!—and designate a specific time for it.

That said, here are six realistic goals that can be your springboard toward an accomplishing 2019:

  • Update legal documents. You never know when you’ll need them, and when you do, it’s usually too late. Draw up your will if you haven’t done so yet, and make sure your living will and power of attorney documents are in order.
  • Choose one area to improve in health. This is a biggie. Good nutrition, healthy sleeping habits, and regular exercise are vital in keeping your body fit for many more years to come. Don’t aim to work on all at once—pick one doable improvement, such as resolving to eat more veggies, and stick to it.
  • Learn something new about technology. One of the best ways to stay young is to keep up with the world around you. What better way than by learning about a useful technology? Skype and social media are great ways to keep in touch with friends and family, and learning new things has been proven to improve cognitive health.
  • Go for a physical. Checkups are ever more important as the body ages. Your doctor will be able to detect small problems before they develop into full-blown crises, and can also assist you in helping to maintain your good health.
  • Have that tough conversation you’ve been pushing off. There’s no time like the present! The start of the new year is the perfect time for a discussion about the future. Talk to your family members about plans for your future needs and care.

10 Warning Signs of Dementia

The risk of developing dementia goes up for every year we live. Humans are living longer than ever before, which naturally means more and more people develop dementia every year.

Alzheimer’s disease is a specific subset of dementia, but there are many different variations of this umbrella disease characterized by progressive memory disorder, personality change, and impaired reason.

But how do you differentiate between normal aging and dementia? Is Mom’s forgetting to turn off the stove a memory lapse or a sign of something more serious? If I forgot to pay a bill on time, should I be worried?

There is no straightforward way to tell the difference between dementia and normal aging. The best way is to monitor your behavior or that of a loved one. Everyone has off-days. But if a behavior has become a disturbing trend, it’s time to visit a neurologist.

Here are 10 warning signs to look out for:

  1. Memory Loss: by far the most common and well-known symptom. Forgetting names, dates, appointments, and other items is a frightening and disorienting experience. If it happens every now and then, you probably just need more sleep. But if happens all the time—or you’re forgetting significant details like your spouse’s first name—it’s probably more serious.
  2. Difficulty with familiar tasks: when cooking, doing laundry, or using the telephone becomes difficult and hard to follow.
  3. Communication difficulties: your loved one forgets everyday words and phrases, and his or her writing is much harder to decipher.
  4. Confusion: this is especially so for time and place. When a senior gets lost on their own street, or forget where they are, it’s a serious sign of dementia.
  5. Poor judgement: dressing inappropriately for the weather, buying things they don’t need, or doing unsafe things like putting foil in the microwave can all mean dementia has taken hold of their judgement.
  6. Difficulty with abstract thinking: finding math problems harder than before can be a sign of dementia.
  7. Difficulty with spatial relationships: difficulty reading, judging distance, and determining color can all mean Alzheimer’s disease or other dementia.
  8. Misplacing things: inability to retrace steps. When you lose something, you’re usually able to retrace your steps and find it. When you notice you can’t do that anymore, or you’re putting things in weird places, it may be a sign of dementia.
  9. Mood changes: mood swings, increased anger, and unprovoked aggression are all common dementia symptoms.
  10. Withdrawal: skipping events, sleeping more, or neglecting oneself can all be signs of dementia. When someone is going through early dementia, they may feel frightened and unsure of themselves, so they’ll withdraw from the world.

If you notice your loved one has stopped participating in his or her own life, find out why. Dementia may be the reason.

Adults and Seniors: Are You Up To Date With This Booster?

August is National Immunization Awareness Month, a project of the CDC and National Public Health Information Coalition.

Immunizations are a public health concern because un-immunized people can spread diseases to their loved ones, neighbors, and co-workers. Vaccines are especially important for seniors, because their bodies are often frailer and more susceptible to complications of various diseases.

Here at Regency Nursing, we take vaccines very seriously for our residents and staff. If you visit loved ones at a Regency facility often, we request you stay up to date on your vaccines. The last thing you want to do is infect your elderly loved one or her roommate.

In honor of National Immunization Awareness Month, today we’re going to talk about a booster shot every single adult should get every 10 years.

national immunization awareness month logo

The Tdap Vaccine and Td Booster

The Tdap vaccine immunizes you against three diseases; tetanus, diphtheria, and pertussis.

  • Tetanus, also called lockjaw, is an infection that causes severe muscle spasms. Symptoms usually start in the jaw and spread to the rest of the body. The illness can last a month, and it can take many more months to fully recover. The disease is fatal in about 10 percent of cases.

    The bacteria that cause tetanus are commonly found in soil, saliva, dust, and manure. People can contract tetanus through a cut or puncture wound by a contaminated object. After getting any kind of puncture wound, you should immediately get a tetanus shot if you are not up-to-date. Being immunized is the best way to prevent tetanus.

  • Diphtheria is a highly contagious infection of the mucus membranes in the throat and nose. Untreated diphtheria can cause severe damage to the kidneys, nervous system, and heart.

    Diphtheria is common in undeveloped countries, and rare in the United States. However, anyone who isn’t up to date on immunization is at risk of contracting the disease from someone else.

  • Pertussis is also known as whooping cough. It’s a respiratory disease that can cause serious illness in people of all ages, although it is most fatal for babies. Seniors are also at higher risk of complications from pertussis.

The Tdap vaccine is usually given to children. The CDC recommends that if you did not receive the immunization as a child, you should get the Tdap as early as possible.

In addition, all adults should get a Td booster—a formula that boosts your immunity to tetanus and diphtheria—every 10 years.

If you have not gotten the booster in the last 10 years, speak with your doctor about getting it today.

 

All About the Shingles Vaccine

August is National Immunization Awareness Month, a project of the CDC and National Public Health Information Coalition.

Immunizations are a public health concern because un-immunized people can spread diseases to their loved ones, neighbors, and co-workers. Vaccines are especially important for seniors, because their bodies are often frailer and more susceptible to complications of various diseases.

Here at Regency Nursing, we take vaccines very seriously for our residents and staff. If you visit loved ones at a Regency facility often, we request you stay up-to-date on your vaccines. The last thing you want to do is infect your elderly loved one or her roommate.

In honor of National Immunization Awareness Month, we’ll highlight a different vaccine every week on our blog. There are specific vaccines that are recommended specifically for seniors, so today we’ll talk about a vaccine you should take if you’re over 50.

national immunization awareness month logo

Shingles

Shingles is acute, painful nerve inflammation. It is caused by the varicella-zoster virus, the same virus as chickenpox. If you have ever had chickenpox, the varicella-zoster virus remains, dormant, in your body. It can reappear at any time in the form of shingles.

Debilitating pain is the main symptom of shingles. A blistering rash usually begins 1–5 days after the pain begins, often on one band of skin. The outbreak can last between 2 and 4 weeks, and can completely devastate daily function, especially in the elderly.

Other symptoms include:

  • fever
  • headache
  • malaise
  • nausea
  • muscle pain and weakness
  • chills
  • upset stomach
  • difficulties with urination
  • fatigue
  • joint pain
  • swollen glands

Shingles can cause complications such as skin infection, inflammation of the brain, eye problems, nerve damage, and weakness.

Your risk of a shingles outbreak goes up exponentially after 50. Therefore, the CDC recommends all individuals age 50 and up receive the singles vaccine.

Shingles Vaccine

A new vaccine called Shingrix received FDA approval last October. It involves two doses, given 2–6 months apart. The vaccine is 90 percent effective against shingles and postherpetic neuralgia—a painful nerve condition that is a known complication of shingles.

The previous shingles vaccine, Zostavax, only reduced your risk of shingles by 51 percent, so this is clearly the better option. The CDC says you should take Shingrix even if you’ve already gotten Zostavax. You should also take the vaccine if you don’t remember having had chickenpox, as you may have had it as a very young child.

Side effects of Shingrix include mild soreness, redness, and swelling at the injection site. Some people also reported headaches or feeling tired and achy after receiving the shot.

The worst side effects lasted 2 or 3 days, and the CDC says that even if you experience those side effects, it’s still better than suffering through weeks of shingles and possible complications.

Did You Get Your Pneumococcal Vaccine?

August is National Immunization Awareness Month, a project of the CDC and National Public Health Information Coalition.

Immunizations are a public health concern because un-immunized people can spread diseases to their loved ones, neighbors, and co-workers. Vaccines are especially important for seniors, because their bodies are often frailer and more susceptible to complications of various diseases.

Here at Regency Nursing, we take vaccines very seriously for our residents and staff. If you visit loved ones at a Regency facility often, we request you stay up-to-date on your vaccines. The last thing you want to do is infect your elderly loved one or her roommate.

In honor of National Immunization Awareness Month, we’ll highlight a different vaccine every week on our blog. There are specific vaccines that are recommended specifically for seniors, so today we’ll talk about a vaccine you should take if you’re 65 or older.

national immunization awareness month logo

Pneumococcal Infections

Pneumococci are a type of bacteria that love infecting people with illnesses that range from mildly annoying to life-threatening. Healthy people can carry the bacteria in their nasal passages, and spread it to other less healthy people by sneezing or coughing.

The most common infections, from mild to severe, are:

  • Ear infection
  • Sinus infection
  • Pneumonia
  • Sepsis
  • Meningitis

Ear and sinus infections, while painful and sometimes debilitating, are generally complication-free. There are cases where these usually harmless infections turned deadly, but the chance of that happening is extremely small.

On the other hand, pneumonia, sepsis, and meningitis are serious infections that can be deadly if not treated promptly. They also carry a high risk of hospitalization and complication.

Old age is a risk factor in all three of these serious pneumococcal infections, and elderly people are also more likely to suffer complications from them. Hospitalization alone can significantly raise your risk of complication.

Pneumococcal Vaccine

Fortunately, there is a fairly effective way to protect yourself or your loved one against pneumococcal infections. You even have options: there are two approved pneumococcal shots available.

The Centers for Disease Control advises all adults 65 years and older to get either the pneumococcal conjugate vaccine, marketed as Prevnar 13, or the pneumococcal polysaccharide vaccine, brand name Pneumovax.

If you are 65 years old or above and have not yet gotten either of these shots, talk with your doctor today.

 

 

What To Do When Social Security Says You’ve Passed On

It’s rare, but it happens to real people. And it happens more often than you might think. Whether it’s due to a clerical error or a misreporting, the Social Security Administration sometimes declares people dead—when they are very much alive.

Every year, the Social Security Administration (SSA) mistakenly declares around 12,000 people dead. Considering about 2.8 million Americans die every year, the error rate is actually quite low.

But if you’re one of those 12,000 people who discovers they’re dead, you probably don’t care about the error rate. Being declared deceased can affect your life in many ways, such as:

  • you no longer receive Social Security benefits
  • your Medicare or other insurance is canceled, making you responsible for all your medical bills
  • your Medicaid benefits are cut off
  • your bank account is locked up

Besides for the many and varied financial ramifications of being officially dead, there will probably also be some emotional fallout. Nobody wants to hear, “Sorry, this person is deceased” when they try to make a doctor’s appointment or fill a prescription.

Fortunately, you can reverse your (erroneous) death, but it can take some time and effort. Dealing with government agencies  can also be an emotionally frustrating experience, so if you’re the senior dealing with this, you might want to enlist the help of a relative or friend. Residents of a long-term care facility like Regency Nursing can also turn to the in-house social worker or administration department for help.

Here’s How to Bring Yourself Back to Life:

The process doesn’t have to be long and drawn out, if you act immediately. Your first clue that something isn’t right may come when a check bounces or your prescription is rejected. Or you might get a notice from Medicare or your insurance company that your health coverage has been canceled.

However you first find out, it’s important to swing into action right away. The sooner you get your life back, the lower the financial impact.

The SSA has a section on their FAQ page telling you what to do if this happens to you.

  1. Go in person to your local Social Security office as soon as possible. Bring at least one original piece of identification, such as a current passport, driver’s license, or insurance card other than Medicare card.
  2. Social Security’s correction will automatically be forwarded to Medicare. They will reinstate your coverage as soon as they receive the notification.
  3. Once your record is corrected, the SSA will give you a letter, called “Erroneous Death Case – Third Party Contact,” to send to your bank, doctors, and other providers.
  4. Confirm with your insurance that any claims denied for no coverage will be reimbursed retroactively. If you had any checks bounce because the bank froze your account, ask the bank to waive those fees. The bank is not required to do so, but many times they will accommodate you.

If you act swiftly, you can reinstate your coverage in a matter of weeks. In my experience—I’ve dealt with four such cases in New Jersey in the last eight years—it can take anywhere from two weeks to two months for Medicare coverage to resume.

Original Medicare vs Medicare Advantage: A Two-Part Series

Which saves you more money, Original Medicare or Medicare Advantage?

The correct answer is, “it depends.” Both forms of medical coverage have unique costs and benefits.  You’ll make your choice based on different factors in your own situation, so there’s no definitive answer to the question.

In this article, we’ll explore Original Medicare, while next week we’ll talk about Medicare Advantage.

First, some definitions.

Original Medicare is, like its name suggests, Medicare in its Original form. Medicare is the federal health insurance program for seniors and certain younger people with disabilities. A small portion of every employee’s paycheck goes toward the Medicare tax, which funds the program. Under Original Medicare, seniors age 65 and older are automatically eligible for coverage in Part A and Part B. Part A covers inpatient services and Part B covers outpatient.

Medicare Advantage (MA) is a  private health plan that administers Medicare benefits. Private insurance companies contract with the federal government to provide these plans. MA plans must cover all the services Medicare covers, however they may have different rules, costs and restrictions on the services. In addition, many MA plans offer benefits beyond Original Medicare, such as dental and vision coverage.

Here’s a more detailed overview of each type of plan, and what you can expect to pay:

Original Medicare

On the face of it, Original Medicare looks cheaper than MA. If you or your spouse contributed to Social Security for at least 10 years, you get Part A free. Plus, the standard monthly premium for Part B is well below average for comparable private coverage.  The monthly premium will change based on your income and whether you’re receiving Social Security benefits at the same time.

While Original Medicare’s premiums certainly are low, they don’t present a full picture of the costs you’ll encounter. Medicare has a high cost-sharing ratio that can leave you with thousands of dollars of medical bills. Here’s what you have to pay with Original Medicare:

  • Deductible

    Medicare starts covering your medical bills after you meet your annual deductible. The Part B deductible is relatively low, just $183 for 2018. The Part A deductible is higher at $1340 per benefit period. (The benefit period ends when you haven’t gotten inpatient care for 60 days in a row, so you can have a few benefit periods in one year.)

  • Part A Coinsurance

    Part A covers inpatient hospital stays at 100% for the first 60 days once you meet your deductible. It covers 100% of skilled nursing care for the first 20 days. After the first 60 and 20 days respectively, there is a coinsurance per day. After 100 days of inpatient care, Part A coverage ends.

  • Part B Coinsurance

    Part B covers 80% of services, leaving the 20% coinsurance for you. Unlike most private insurance plans, there is no yearly limit on your out-of-pocket expenses, so expenses can add up after a while.

  • Non-covered Services

    Some medical expenses aren’t covered by Medicare at all. These include most prescription drugs, dental care, and vision care.

For some relief from the never-ending coinsurance payment, many Medicare beneficiaries opt to also take out a Medigap plan. Medigap plans are standardized supplemental plans that cover a lot of the out-of-pocket costs. The most popular plans in New Jersey average $100-$150, but you can get a plan for as low as $60 a month.

The other alternative to Medicare’s high out-of-pocket cost is enrolling in a Medicare Advantage plan. Look out for our blog post next week where we’ll discuss the pros and cons of Medicare Advantage.

Happy National Skilled Nursing Care Week!

Starting with Mother’s Day, we’ve kicked off our celebration of National Skilled Nursing Care Week here at Regency Nursing. The week-long observance, established by the American Health Care Association, provides an opportunity to recognize the role of skilled nursing care centers in caring for America’s seniors and individuals with disabilities.

American Health Care Association NSNCW logo

This year, the theme for NSNCW is “Celebrating Life’s Stories.” According to AHCA’s announcement, the theme pays tribute to life’s most significant events, relationships and experiences that form the backdrop of each of our unique perspectives. Our residents, families, and staff are encouraged to share their stories with each other. Sharing these narratives will cultivate understanding, love, and acceptance in our community.

How to Celebrate #NSNCW

Do you have a parent, friend, grandparent, or other loved one in a skilled nursing facility? Visit them this week and acknowledge their care providers. Listen to your loved one’s stories, to the staff members, to the other residents. And share your own stories. Your memories and perspective are unique and will contribute to the wonderful sense of community at Regency Nursing.

We shared tips in a previous post about listening and recording your loved one’s stories. If you haven’t yet, try to record—or even just listen to—at least one story this week. Your elderly parent or grandparent won’t be around forever, so take advantage of this special week to hear more about them and their history.

If your loved one has dementia and can’t communicate, you can still have a meaningful visit. Read our post about maximizing your visit with a patient in advanced dementia here. Some of the advice we offered in that post included a suggestion to touch the patient a lot—with hugs, massage, or petting—and to take a stroll in the sunshine.

And don’t forget, make sure to laugh. When you share stories, you build a bond—and that bond is strengthened with laughter. Keep your stories and memories lighthearted and upbeat as you celebrate National Skilled Nursing Care Week.

 

 

Celebrate Life’s Stories

In two weeks, Regency Nursing will celebrate National Skilled Nursing Care Week. Beginning on Mother’s Day, May 13, Skilled Nursing Week will honor the unique stories of our residents, families, and staff.

You can take the opportunity to finally capture your parent or loved one’s life story. As an adult, you might think you know everything about your parents and their stories. Even if you do, it’s still a good idea to record their stories for their descendants. And if your loved one witnessed historical events, other people may also be interested in their account.

Here are some tips to record your elderly loved one’s life story for posterity:

Set the scene to encourage sharing.

Man holding a photoChoose a time when your subject is relaxed and comfortable. Settle them in a quiet location—their room, our beautiful gardens, or a calm corner of the lounge. Consider bringing old family photos or newspaper clippings to stimulate memories.

Another good way to set the mood is to find out what they enjoyed listening to when they were young, and find it online. One resource for old music is freemusicarchive.org. Play the music to get your loved one in a nostalgic mood, perfect for story sharing.

Make sure you have a good recorder, either on your phone or on a separate device. If they agree, try videotaping the session. Having video of your mom or dad will hold incomparable value after they’re gone.

Ask questions to start the flow.

Prepare a list of starter questions to get your parent talking. But don’t stick too closely to your questions. The answers you get might take you to topics you didn’t originally think of, and you’ll discover things you never knew about your parents’ lives. At all times, follow your parent’s cues. If a particular memory seems painful, gently change the subject.

Check out storycorps.org for some question ideas, such as “what is your earliest memory”; “what are you proudest of”; and “is there anything you’ve never told me, but want to tell me now.”

Another way to help your loved one open up is to ask them about historical events that happened when they were younger. Ask them about World War II, Korea, or Vietnam. They may want to share their memories of the Kennedy assassination or the moon landing. These memories also have the advantage of being educational, and you may want to share them with your local library or historical society.

Be a good listener.

Your senior lady smiling and conversingjob is to listen to your loved one’s stories, with some redirecting if necessary. You may hear a story you’ve heard before, but don’t cut them off when they start repeating an old story. First of all, this time you’re getting it on tape. Secondly, they might add new details or share a different perspective this time.

You may hear unpleasant memories, or opinions you don’t agree with. Don’t judge your loved one for her memories; it’s not about you. Keep in mind that the story you’re hearing may not be completely accurate. After many years, certain events get exaggerated and details forgotten. If the story sounds fantastical, it may not have happened that way… or maybe it did! Life can definitely be strange sometimes.

A word of caution.

Unfortunately, some seniors have had dysfunctional, abusive, or otherwise awful childhoods. Similarly, many war veterans still carry the trauma of war, and may not want to talk about it. If you know your loved one has many bad memories in their past, you may want to skip this particular activity. If you feel it’s important to record their story, proceed with caution and sensitivity. Consider consulting with the resident’s doctor or social worker on whether it’s a good idea to bring up these sad or hurtful memories.