Nine things NOT to expect in a nursing home

"Oh, I can't wait to get into a nursing home! I have waited my whole life for this opportunity and it is finally here!" said no one ever.

While we can agree that expecting people to approach nursing homes with glee is not realistic. how about other expectations? Often facilities, family members and residents all have different expectations and that is where things can get challenging.

As someone who has had loved ones in nursing homes and has worked in the industry for years, I have pondered how we can all get on the same page. Wouldn't  it help if we all knew ahead of time what was realistic (or not) to expect from each other. Let's start with nine:

(1) Don't expect a one and one ratio.
Nursing homes exist to provide care to the residents they serve. But that care (and the funding for it) is not the one on one care families might have been able to provide at home to a loved one. Expect that help will be provided as soon as possible. If the call light is turned on, it might take a few minutes for someone to answer it, depending on what the needs of others residents are at the moment.

(2) Don't expect the same routine.
The  staff should ask questions about the resident's history and preferences and together arrange a routine that works for the resident Things will probably be a little different from how they were at home, but resident choices should by honored as much as possible.

(3) Don't expect that all medications will remain the same.
The nursing home is one of the most regulated industries in the United States. These regulations include the dosages and types of medications residents receive. For example while the hospital (or the family) may have been able to provide a sleeping pill to your loved one every night, the nursing home needs to try alternatives before doing this on a regular basis because these medications can increase the risk of falls.

(4) Don't expect perfection.
We all know there is no such thing as perfection in life and unfortunately it will not be found in a nursing home either. When they can improve on something please let them know. (We always try to do better)  Effectively advocate for the resident by calmly expressing your concern to the supervisor. A good supervisor will be thankful that the resident or family member shared a tip with them on how to improve the resident's care.

(5) Don't expect a large, private room.
Sometimes a family member ends up unexpectedly in a nursing facility. He may have fallen and broken a hip, gone to the hospital for surgery and is now in an unfamiliar place and needs rehabilitation or skilled nursing care.  Although a private room is possible, be aware ahead of time that one might not be available at that time.  However, when another rehabilitation or skilled care resident is discharged home the private room they vacated can be used for the family member.

(6) Do not expect that falls will never happen.
Speaking of falling, if your only reason to move your family member into a nursing home is to keep them from falling, you may need to pause. Facilities should evaluate the potential for falls and implement interventions tailored to each resident to reduce the chance of falling, but they are not always able to prevent all falls. Restraints, which include full-length bed rails, pose a significant
hazard to residents;thus many facilities are restraint free for the residents' safety.

(7) Don't expect the family's stress to fully disappear.
Watching residents struggle with Alzheimer's disease or the effects of a stroke may symbolize the potential decline and eventual  loss of their own family member and this can trigger guilt and grief. Additionally, adjusting to not being the main hands-on caregiver can also be a significant loss, even if that caregiver was tired and experiencing burnout. This stress  can be decreased by participating in support groups as well as receiving reassurance and evidence that the loved one's needs are being met.

(8) Don't expect all facilities to be a horror story.
Yes there are bad nursing homes and some staff members that do not care about the residents. However, there are also many very good facilities with employees who deeply care about the residents and go the extra mile. Most  people who work in nursing homes want to do a good job and have chosen to work there because they feel it is their privilege and calling to do so.

(9) Don't expect that residents will never adjust.
Understandably, it takes time for most people to adjust to a nursing home as well as for the staff to become familiar with the resident's personality and needs. While there is no guarantee that the resident will live happily ever after, I have known many people who have experienced a joyful, active and full life in a nursing home. Encouraging positive relationships, providing choices when at all possible and offering meaningful activities can facilitate adjustment and improve quality of life in nursing homes.

Esther Heerema, MSW

Living with Arthritis

Arthritis causes stiffness and pain in the joints. It is a chronic condition and can lead to permanent joint damage, disability, and difficulty working and carrying out everyday activities. There are many different types of arthritis the causes of which are unknown.


Arthritis facts:
Osteoarthritis is the most common type. It is often seen in middle aged and older people although it can happen at any age front joint injury or overuse. It  usually affects the knees, hips and spine and can range from mild to severe,. Osteoarthritis gradually wears away the cartilage covering the ends of the bones as the joint is used.


Rheumatoid arthritis (RA) mainly affects people over 30, although it can strike at any age. It mostly affects the hands and feet, although the hips,  knees and elbows may also be affected. Joints can loose their shape and alignment resulting in pain and loss of movement.


Although there is no cure for arthritis it is treatable. Consult your doctor who may recommend over the counter anti inflammatory drugs or prescribe anti inflammatory drugs to reduce pain and inflammation Treatment of rheumatoid arthritis may require prescription drugs including disease-modifying antirheumatic drugs, which slow joint damage; biological response modifiers which change the body's immune response; and corticosteroids, which decrease inflammation and suppress the immune system.


Joint protection : there are many devices for joint protection, including tools for reaching, opening and dressing; and extenders for household and workplace furniture; canes, splints and braces to support joints; and padded grips for tools. Joint protection may also involve learning new ways to perform activities that do not stress the joints.


Surgical options include arthroscopic surgery  where a small scope and other instruments are inserted into the joint, bone fusion in which the bones are fused together or arthroplasty in which damaged joints are removed or replaced.


Remaining active is very important. The key is to find a balance between activity and rest. Exercising to much may stress sensitive joints-to sedentary can cause stiffness and immobility. Try stretching and gentle movement such as yoga, tai chi and stressing. Aerobic activity such as riding a bike, swimming and water aerobics keep the heart healthy and muscles strong without putting to much pressure on the joints.


Remember to listen to your body. Stop exercising if you feel sharp pain and do not try to work through joint discomfort. Find activities that are gentle on the body and take them at a comfortable pace.

This weeks events honoring out veterans were very moving. We had quite a few veterans (and many spouses) come. Parma's mayor and a councilman also came. We feel that all of our veterans deserve to be honored. Their service and sacrifice are what kept our great nation free.  A good time was had by all.


Saturday November 14 2014 we will host a speaker that will give us information about veterans benefits and programs. This will take place in the Sapphire dining g room in Pleasantview Care Center. It will be a  worthwhile lecture for veterans and their spouses.


Every year Pleasantview has a holiday bazaar that is held to assist our residents with their holiday shopping. We want our residents to continue to experience the thrill of holiday shopping for their family members and community friends. Members of our activity staff set up a "mini mall" complete with gifts for all ages, personal shoppers, and unique gift wrapping services. Coffee and snacks are served in the food court for a true mall experience. This shopping spree will be held on Thursday December 18th 2014 at Pleasantview. You can help add to the enjoyment of the event by donating such items as hats, gloves, kids toys, sweaters and socks. Hand lotions, colognes, jewelry and knick knacks make great gifts . Share your treasures and make a meaningful holiday season for our residents.

Veterans Events

Please join us for special events honoring our Veterans to thank them for their service.


           "A salute to our veterans", Tuesday November 11, 2014 at 2 PM at Pleasantview Care Center in the Sapphire Dining Rood. Refreshments  will be served.
Veterans Pinning Ceremony Friday, November 14, 2014 at 2 PM at  Pleasantview Care Center-Sapphire Dining Room. Sponsored by Crossroads Hospice--"Expect more from us. We do." Refreshments will be served.
Get more informed about Veterans benefits and programs Saturday November 15, 2014 at 2 PM at  Pleasantview Care center in the sapphire dining room.
See you then!

Stop Smoking!

Quitting tobacco is one of the most important steps you can take for your health. Tobacco doesn't just cause lung cancer. It also causes or contributes to other lung diseases such as emphysema and asthma, puts you at higher risk for stroke and heart disease, and is associated with several other cancers.


Quitting tobacco will also increase many of the pleasures of life. You will be able to smell fresh air and perfume, taste subtle flavors, save money  exercise without getting winded.


CHOOSE YOUR QUIT DAY
Find a date  that is no more than 1 month away-within 2 weeks is best. Try to choose a day when you won't be stressed or distracted. Circle the date on the calendar. Tell your family, friends, neighbors and co-workers that you are planning to quit. Ask them to help you find positive nonsmoking experiences or help you resist the urge to smoke.


QUIT DAY TO-DO LIST
After your last cigarette
(1) remove all your cigarettes, lighters and ashtrays from purses, pockets, drawers, vehicle office and any other places you keep your tobacco stuff. (2) keep oral substitutes such as sunflower seeds, carrot sticks or toothpicks handy  (3) if you are using a non-nicotine medicine, take your dose each day of the week leading up to your quit day.


QUITING AIDS
Discuss these tobacco cessation aides with your health care provider.


Nicotine Replacement Treatment
You can purchase nicotine patches, gum and lozenges over the counter: sprays and inhalers require prescriptions. These products are designed to ease the physical symptoms of nicotine withdrawal. Note that combing nicotine replacement with counseling works better than either alone.
Non nicotine medicine: Two non-prescription drugs, bupropion and varenicline, have been approved to help people stop smoking when combined with counseling. They are shown to reduce cravings when used as directed.


HOW TO REDUCE THE TOBACCO CRAVINGS:
(1) begin using nicotine replacement therapy if that is your choice (2) take short walks instead of coffee breaks or take your brakes someplace new. (3) get outdoors and do some deep breathing. Fill your lungs with fresh air. (4) avoid places and situations where the urge to use tobacco is strong. (5) avoid other tobacco users if you can (6) carry sugar-free gum and hard candy for oral substitutes (7) avoid alcohol and caffeine-they often stimulate nicotine cravings (8) call a family member or friend


Withdrawal is not just physical it is also psychological. The trick is to stay calm, cool and collected in the face of cravings that sometimes feel uncontrollable. Sound tough? It is. But it is not impossible. After all, millions of people quit smoking every year.


WITHDRAWAL BUSTERS
(1) for a dry mouth or sore throat, sip ice water or juice or chew sugarless gum.
(2) for headaches and anxiety, take a warm bath and try mediating or simply breathing deeply for a few minutes.
(3) increase the fiber i.e. fruits, vegetables, and whole grains in your diet to reduce bowel irregularity
(4) take a daily nap to beat fatigue. Do not over schedule yourself and make sure you get enough sleep.
(5) exercise daily to reduce your stress and irritability.
(6) use positive self talk, Remind yourself that you are now a nonsmoker.
(7) every time you want a cigarette, inhale deeply, count to ten and exhale. Remember that time is the great healer, and over time your urge to smoke will gradually diminish..











Remember that many people try quitting 3 or more times before they become tobacco free. It is never to late and is worth it!!

Weight loss basics

Two ways to learn if you are overweight are to determine your body mass index (BMI) and your waist circumference.


Your BMI classifies your weight in terms of your height. Too much mass over too little height can mean that you are overweight and possibly even obese. The formula for adults
(1) multiply your weight by 703
(2) divide that number by your height in inches
(3) divide your second answer by your height in inches again


Classify your BMI
18.5-24.9-healthy weight which is associated with the least risk of early death.
25.0-29.9-is overweight. Over 27 is associated with an increased risk of developing health problems
30.0-obese which is associated with the highest risk of health problems and early death


Since BMI may not be accurate for some people waist circumference is also used. Research shows that excess abdominal fat may pose a higher risk of conditions such as type 2 diabetes than excess fat on hips or thighs.


To measure it
(1) run a tape measure around your body just above the highest point on each hip bone
(2) a measurement of more than 35 inches for women or up to 40 inches for men may increase your health risks


We need to eat healthfully and the proper foods. In restaurants  order salad dressings and other sauces on the side. Ask that the food be grilled without butter or oil or be prepared "light". Substitute steamed vegetables for high fat or starchy side dishes. Choose tomato based sauces instead of cream based sauces. drink water, diet soda unsweetened tea instead of regular soda or alcoholic beverages. Stop eating when you are full.


At the grocery store: check food labels for the amount of sodium, saturated and trans fats, cholesterol, sugar and calories. (foods with mostly or only unsaturated fats are healthier than those mostly with saturated and/or trans fats but are also high in calories so consume in moderation) Also be aware that many items sold as single servings actually provide 2 or more servings)


At home cook from scratch as much as possible. Packaged  foods tend  to be high in some or all of these saturated or trans fats, sodium, calories, and or sugar. Broil or bake rather than fry, add lemon or spices instead of butter and eat wholesome varieties of pasta, cereal and rice.


By cutting 250 calories per day is the goal. Simple ways to cut calories include (1) for breakfast substitute herbal tea for high fat cappuccino. (2) at lunch hold the mayo on your sandwich and try spicy mustard instead. Drink water instead of a soda.


And exercise--very important--experts recommend moderate intensity cardio (aerobic)exercise, 150 minutes a week or vigorous intensity cardio 75 minutes a week. You may need to gradually work up to these goals. Do consult your health care provider before significally  changing your activity.

Stress Relief Techniques

Your goal is to deal with stress in a positive and healthy way so you can control it and not let it control you. If many different things cause stress for you, choose one to deal with first. Once you have a handle on that move on to the next. These tips may help:


Avoid quick fixes-drugs, alcohol, tobacco, unhealthy foods and caffeine are all quick ways to reduce stress. They don't work. Once the effects wear off your stress is still there.


Eat healthy foods-choose more fruits, vegetables and whole grains and less fatty and salty foods.


Be positive-when times get tough do not focus on negative things. They are only temporary and will pass. Instead, have a positive approach to the situation.


Exercise-when you exercise your body releases chemicals that are natural antidepressants. It helps you feel refreshed and motivated. Make time to go to the gym several times a week or do some type of exercise at home.


Make time for the things you enjoy-think about what you enjoy doing most and make time for it.


Spend time with friends and family-make time for the important people in your life. Your loved ones can help lift your spirits when you are feeling down.


talk to a professional-"sharing your stress" with a therapist may help. Talking about your problems is a good way to get it out of your system. Once you share your problems they won't feel so heavy.


Get plenty of rest- you need a good night's sleep to recharge your batteries. Allow plenty of time for rest and develop good sleep habits. You will feel refreshed and ready to start the next day.


Learn to relax-Deep breathing exercises, yoga, message and stress  relief exercises may help.


A 60 SECOND EXERCISE
Follow these steps


(1) sit in a straight-backed chair with your eyes closed.
(2) place your hands on your lap with your fingertips lightly touching.
(3) focus your thoughts on your hands. Press your fingertips one by one.
(4) Soon you will find a thought appears that will distract you from focusing on your hands.
(5) gently bring your attention back to your hands.
(6) take a good deep breath and stretch.
(7) finally open your eyes.


DEEP BREATHING EXERCISES
this exercise gets more oxygen into your lungs


(1) sit up straight, stand or lie flat on your back.
(2) let your hands lie comfortably at your side.
(3) take a long deep breath through your nose and hold it for a moment.
(4) purse your lips (like you are going to whistle) to control your speed. Then breath slowly through your mouth.
REPEAT THIS 10 TIMES OR UNTIL YOU FEEL RELAXED. Take 5-10 SECONDS FOR EACH BREATH IN AND OUT.


MUSCLE TIGHTENING AND RELAXING
(1) Clench (tense) your fists as hard as you can and hold them clenched for 5-10 seconds
(2) Relax your fists. Notice the feelings when your fists are clenched and as the tension leaves your hands.
(3) Repeat this 5 times. Concentrate on feeling the tension leaving your hands.


NOW REPEAT THIS TENSE_RELAX ACTION FOR EACH OF THESE MUSCLE GROUPS UNTIL YOU GET THE SAME RELAXED FEELING>


Jaw
Shoulders and back
Arms and hands
Stomach muscles
Buttocks and legs
Feet and toes

What is MRSA?

Staphyloccus aureus or staph is a very common germ that about 1 out of every 3 people have on their skin or in their nose. This germ does not cause any problems for most people who have it on their skin. But sometimes it can cause serious infections such as skin or wound infections, pneumonia, or infections of the blood.


Antibiotics are given to kill Staph germs when they cause infections. Some Staph are resistant, meaning they can't be killed by some antibiotics. "Methicillin-resistant Staphylococcus aureus" or MRSA is a type of Staph that is resistant to some of the antibiotics that are often used to treat Staph infections.


In the hospital, people who are more likely to get MRSA infections are people who: (1) have other health conditions making them sick (2) have been in the hospital (3) have been treated with antibiotics. People who are healthy and who have not been hospitalized can also get MRSA infections. These infections usually involve the skin. People who have MRSA germs on their skin or who are infected with MRSA may be able to spread the germ to others. MRSA can be passed on to bed linens, bed rails, bathroom fixtures, and other medical equipment. It can spread to other people on contaminated equipment and on the hands of doctors, nurses, or other healthcare providers or visitors.


There are antibiotics that can kill MRSA germs. Some patients with MRSA abscesses may need surgery to drain the infection. Your healthcare provider will determine which treatment is best for you.


To prevent MRSA infections doctors, nurses, and other healthcare providers (1) clean their hands with soap and water or an alcohol based hand rub before and after caring for every patient (2) carefully clean hospital rooms and medical equipment (3) use contact precautions when caring for patients with MRSA which means  having patients with MRSA in a private room or share one only with someone else that has MRSA. Also healthcare providers will put on gloves and wear gowns over their clothing while caring for patients with MRSA. Visitors may also be asked to wear a gown and gloves. Also hospital providers and visitors remove their gowns and wash  their hands when leaving the patients room. Patients with MRSA  are asked to remain in their hospital rooms as much as possible. They should not go to common areas such as the gift shop or cafeteria. They may also go to other parts of the hospital for treatments and/or tests.


To help prevent MRSA make sure all healthcare providers clean their hands with soap and water or with alcohol based rub before and after caring for you. If they do not do so please ask them to.


Visitors have a low risk of  getting MRSA while visiting someone that does have it. However to decrease the risk your visitors should (1) clean their hands upon entering and exiting the room and (2) ask a healthcare provider if  the visitor needs to wear gloves and a gown when visiting.


When the resident goes home they need to finish taking the prescribed antibiotic. Avoid sharing personal items, wash and dry your clothes and bed linens in the warmest possible temperatures recommended on the label,, wash hands frequently and tell all healthcare providers that come to the home that you have MRSA.

Memorial Day

Today many of us celebrated Memorial Day with cookouts,  family and friends. But we need to remember the reason we celebrate memorial day is to honor the men and women who have given their lives fighting for our country Thank you for your service and sacrifice.

Glaucoma

Glaucoma is a common eye disease that can cause blindness. It occurs when pressure inside the eye increases and damages the optic nerve. Vision that is lost from glaucoma can never be restored. But when glaucoma is caught early, sight can be saved.


DIAGNOSING GLAUCOMA
Having an eye exam is the only way to determine if you have glaucoma. During the exam, your eye doctor measures the pressure inside your eye with a tonometer which blows a puff of air onto your eye. Your doctor will also check the health of the optic nerve and the drainage angle of your eye. Your field of vision may also be tested. 


RISKS of GLAUCOMA
Glaucoma is more common in people who are:
(1) older
(2) are African Americans, Asians or Native Americans
(3) have a family history of glaucoma
(4) have diabetes, heart disease or high blood pressure
(5) are long term users of steroids or cortisone


TREATMENT
Treatment is aimed at reducing pressure inside the eye. Eye drops or pills may be prescribed alone or in combination. Medications must be continued for life. Surgery may also be suggested.


HOW THE EYE SEES
Light enters the eye through the clear cornea. The colored part of the eye, the iris, controls the amount of light that enters through the pupil. The lens then focuses the light onto the retina, the inside lining at the back of the eye. Signals from the retina travel through the optic nerve to the brain turning into images you see.


NORMAL EYE PRESSURE
Fluid flows into the eye and drains at a spongy outlet where the cornea and iris meet. This area is called the drainage angle. When the outlet is open and the drainage angle normal, fluid drains normally and eye pressure is healthy.


HIGH EYE PRESSURE
Pressure rises when the drainage angle is narrowed. As the pressure increases, nerve fibers in the optic nerve are killed leading to a vision loss. Side vision is often affected first.


IF YOU HAVE LASER TREATMENT OR EYE SURGERY
When medication does not reduce pressure in the eye laser treatment or eye surgery may be suggested.

Cataracts

There are other eye problems. One of the most common are cataracts which is a clouding of the lens of the eye. Normally the lens is clear and allows light to enter the eye. But when a cataract forms, the eye is less able to see clearly. Cataracts are a common vision problem that is highly treatable.


Causes of cataracts--changes within the protein material of the lens are responsible for cataracts. These changes, are a natural part of aging. But some people are born with cataracts. Cataracts can also be due to.
 Long term exposure to sunlight
,Diabetes
.Smoking
.Injury to the eye
.Long term use of steroid medications


Symptoms of cataracts--early stages of cataracts cause little or no visual problems. They often develop in both eyes. The rate  of progression varies with each eye. Left untreated, cataracts can result in loss of vision. As cataracts develop, symptoms may include:


Cloudy or blurry vision
Seeing glare or halos around lights
Trouble seeing at night
Distortion of colors
When the lens is clear light enters the eye through the clear cornea. The colored part of the eye, the iris, controls the amount of light that enters through the pupil. The lens then focuses the light onto the retina at the back of the eye. Signals travel from the retina through the optic nerve to  the brain where they turn into images you see.


When the lens has a cataract the lens is cloudy with a cataract, light can't pass through easily and is scattered. The imagine that is cast on the retina is blurry. That is why having a cataract is like looking through a foggy window. cataracts can form in different parts of the lens, the center, the side, or the back.


An eye exam is needed to find out if you have a cataract. During the evaluation your eye doctor will do the following.
Ask questions about your health and vision. Tell your doctor about any other eye problems. Also mention any medications, vitamins, or herbs
Test your vision to check how well you see and rule out other problems. Bring your glasses or contacts to the exam so your doctor can check the prescription.
Examine your eyes. Eye drops are used to dilate your pupils. This allows the doctor to use instruments such as a slit lamp and ophthalmoscope to look inside each eye. If you will be having cataract surgery, an A-scan or a laser interferometer is used. These are special tools that measure the length of your eyeball to determine the new lens that will replace your old one.

Dry eye: An Irritating Problems

If your eyes often feel dry and scratchy, you may have a condition called dry eye. This occurs when the eyes are not kept moist enough by tears. Dry  eye can be uncomfortable. It raises your chances of eye infection. Left untreated, dry eye can cause serious damage to the eye tissue. Over time, the cornea (the eyes protective covering) could even become scarred , resulting in vision loss. dry eye can also make wearing contact lenses uncomfortable. Dry eye is treatable.


SYMTOMS OF DRY EYE
Dry eye can cause one or more of the following symptoms:


(1) watery eyes
(2) scratchy, dry, irritated or generally uncomfortable eyes
(3) redness of the eyes (4) a burning sensation in the eyes
(4) a feeling of the presence of a foreign body in the eye
(5) blurred vision
(6) an apparent loss of the eye's normal clearness and luster


Two Types Of Tears


Normally, the eye is lubricated by tears, These lubricating tears are made by a gland in the eyelid. (those are different from the more watery reflex tears that are made when you cry) Every time you blink, lubricating tears spread over the surface of the eye. They then flow out of the eye and drain into the nose.


THE ANATOMY OF A TEAR


Lubricating tears form a film on the eye. This keeps the eye moist. These tears have three layers that work together to lubricate the eyes. (the oily outer layer helps prevent the tears from evaporating. This  way their lubricating effects last longer. The watery middle layer cleanses the eye and washes away foreign particles and irritants. The   sticky inner layer coats the surface of the eye, so it stays covered with tears longer.


Dry eye is caused by a problem with the lubricating tears. In some cases, not enough tears are made to moisten the eye. In others, enough tears are made but they don't have the right amounts of each layer to work right. The tears may be too watery or too sticky to properly lubricate the eye.


When the cornea is irritated, the body tries to fix this by making more tears. So, dry eye can actually cause more tears. So, dry eye  can actually cause your eye to  water. But since these tears are not able to properly lubricate the eye, making more of them does not solve the problem.


CAUSES OF DRY EYE
Dry eye can be caused by one or more of the following:


(1) age: as a person gets older, the eyes don't make tears as well as before. More than half of the people who have dry eye are over 50
(2) blinking problems: when you can't blink normally, your eye does not stay as moist.
(3) certain medications, including antihistamines, decongestions, birth control pills, and tranquilizers.
(4) environmental factors such as dry climate or excessive exposure to wind.
(5) allergies or hay fever
(6) chemical or thermal burns to the eyes
(7) certain health problems including arthritis and Sjogren's syndrome which is an autoimmune condition that affects mostly middle aged women.


Early detection of dry eye leads to more effective treatment and helps prevent damage to your eyes. If you have had symptoms of dry eye, make an appointment with your eye doctor. Your eyes will be examined using sophisticated diagnostic tools. You and your eye doctor will also discuss lifestyle habits, environmental factors, medications, and health conditions that could be causing your symptoms. Your examination and this discussion help your eye doctor determine the best form of treatment.


Dry eye can not be permanently  cured, but there are effective treatments. Your eye doctor may recommend one or more of the following.
(1) specially formulated eye drops  called lubricating eye drops or artificial tears which replace your natural lubricating tears
(2) soothing eye ointments that can be applied at bedtime
(3) the use of a humidifier in your home or office during periods of especially dry weather
(4) the insertion of tiny plugs in the tear drainage canal in the inner corner of each eye (for more severe cases of dry eye) These slow down the drainage of tears from the surface of the eye. This way tears remain on the eye longer and provide more natural lubrication. The plugs are inserted during a simple painless procedure.
(5) surgery to permanently close the drainage canals (in rare cases of dry eye) The surgery is simple and painless


See your eye doctor as often as recommended because there are several eye problems --beside dry eye--that can be treated more effectively if detected early.

Know your medications

Your medication is important to your health.  But using medications both prescription and over the counter can be complicated. especially given that many people take multiple prescriptions, which can have potential side effects and adverse interactions.


These tips can help become more informed about your medications and help you work with your health care provider and pharmacist to make sure medications work for your health.


Questions to ask your health care provider if you need a prescription:
(1) What is the name of the medication?
(2) Is this a brand name or generic version
(3)How will it help my health condition?
(4)How and when do I take the medication and for how long?
(5)What foods, drinks, herbals vitamins or other drugs do I need to avoid while taking this medication?
(6)Do I need to avoid any activities while taking this medication?(7)Are there any side potential side effects, and what should I do if they occur?
(7)What is the risk of interactions with other prescription and over the counter drugs I am taking?
(8)How will I know if a medication is working?(9)Does this drug contain anything I am allergic to?(9)How long has the drug been on the market? Does it have a safety record?
(10)How much does this drug cost? Are there equivalent but less costly drugs?


For your safety and those around you.


Store medication out of reach of children and pets
Keep medications in their original containers. Use child-resistant containers if children live with or visit you.
Follow a routine when taking your medication
Separate tubes of ointment from tubes of other products such as toothpaste or children's products.
Use the measuring device that comes with the prescription or over the counter medication (for example the dosage cups or oral syringe)
Never take someone else's medication. Drugs and dosages are usually individual and contain specific in ways that may harm you.
Ask your pharmacist about how to discard expired or unused medications.




Taking Your Medication
(1)Make sure that it is for you. Confirm that your filled prescription contains your personal information.
(2)Read all materials. Printed details, known as patient information, should accompany your prescription. Read it thoroughly for information and to get the best results. If you don't understand something, talk to your pharmacist before using a medication.
(3)Take as directed. Taking medication as prescribed is essential to the medication's success. If you take multiple prescriptions read each label with every dose you take to be sure you are not taking a medication twice. or missing a dose of another.


Keep in mind that if side effects become a concern notify your health care provider right away. Also you may or may not feel that the medication is working. But if the problem persists once you have completed the treatment call your provider.  And of course finish the medication even if you are feeling better. Your health care provider sets the number of days for a reason. The bottom line is to take the medication as instructed unless  your doctor or pharmacist tells you otherwise.

Letters of Gratitude

dental health

Something you are NOT doing could be causing early facial aging. Untreated dental problems can have dire consequences on oral and over all health, and can also contribute to rapid facial aging. A more youthful and defined jaw line gives you a more attractive face! Loosing a tooth--whether from trauma or an extraction-causes bone loss in the surrounding area. And advanced gum disease can gradually reshape your jawbone as well! Anything that accelerates bone loss can make you look older much faster.


This should show you the importance of being proactive. When it comes to your smile, the two major "agers" are decay and gum disease. Both can be prevented through proper daily brushing and flossing coupled with regular dental cleaning and routine dental exams.


No One Wants Tooth Decay:
No filling or crown is permanent; they all will  likely need replacing over time. Failure to replace your older fillings and crowns can result in new decay, jaw infection, root canals and even tooth extractions. Tooth decay and tooth loss start the downward spiral that does not only lead to serious health issues but also to premature face aging.


Preserve That Youthful Glow
Don't skimp on oral hygiene or postpone your dental treatment .Periodontitis  can damage the jawbones that hold your teeth in place leading to tooth loss. The gum infection can cause your gums to recede. Receding gums can make your teeth appear longer, hence, the phrase often used to describe aging "long in the tooth". In time the loss of jawbone support results in caved in facial muscles which contributes sagging facial skin where bone use to be. Excessive bone loss also limits your choices of tooth replacement.


How To Prevent Facial Collapse---Due To Bone Loss
We now know that bone loss can result in facial changes. Too many people attribute facial changes to the normal aging process when in fact some of those changes are a bye-product of dental disease. For example the gradual collapse of bone structure can decrease your facial height. Over time , as jaw volume decrease, your chin may gradually rotate forward and upward. Your natural "cupids bow smile" my loose its shape causing your lip line to straighten. You can appear unhappy when your mouth is at rest. With bone loss tissue can sag long the lower jaw producing jowls.


Studies have shown that bone loss in the jaw and cheeks ages people in ways that even plastic surgery can fix! We all want to look our best . and we all want to save our teeth. To do so we  need to brush, floss and have regular dental exams!

Busting the Myths about fats

Trans fat are the hydrogenated fats in processed foods. Some people think that trans fats are only found in fried foods. . That is not the case. Some trans fats are found naturally in small amounts in meat and dairy products but are not a significant source. Many processed foods use "hydrogenated" vegetable oils that add trans fat, so check the nutrition facts labels.


Another myth is that fats are the same. However, this is not the case. Trans fatty acids raise bad cholesterol levels and lower good cholesterol levels, and increase your risk of developing heart disease or having a stroke.


Another myth is that no trans fat means no taste. Today manufacturers are finding new ways to improve the texture and taste of food without using trans fatty acids.


Saturated fat are generally found in animal based foods.  Some people think that all saturated fats are bad for you. However this is not necessarily true. Steric acid, the most abundant saturated fat in beef and chocolate can be good for you. It does not raise bad cholesterol and gives good cholesterol a boost.




Some people believe that saturated fats are from animal products. However, saturated fatty acids are mainly found in fatty meats and high-fat dairy products, but some plant foods are high in saturated fat such as coconut, palm and palm kernel oils.




There are people that believe that if you eat fat you get fat. However, this is false. Fat is a powerful source of energy, more than twice as concentrated as protein and carbohydrates. Consuming more calories than you need is what makes you gain weight--not the source of the calories.


And finally there is a myth that meat is high in saturated fat. This is not necessarily the case. Foods contain differing amounts of each type of fat. Monounsaturated fatty acids make up half the fat content of lean red meat. Look for the words "round" or "loin" in the name to choose the leanest cuts.


saturated fats should be eaten in moderation-10% of your total intake.

Foods that help you sleep

We live in a non-stop society. In our rush, we too often put sleep on the back burner to get things done. But it is the wrong approach. Sleep has a huge effect on how you feel throughout the day, and nutrition plays a role in how well you sleep. Food relates  directly o serotonin, a key hormone that _along with vitamin B6, B12, and folic acid helps promote healthy sleep. Try to consume foods that calm the body, increase serotonin levels and get you ready for restful sleep.


Here are a few foods to get you started on the path to slumber:


Complex Carbohydrates
Embrace whole-grain breads, cereals, pasta, crackers and brown rice. Steer clear of simple carbohydrates, including breads, pasta and sweets such as cookies, cakes, pastries, and other surgery foods. These tend to reduce serotonin levels and do not promote sleep.


Lean proteins
Lean proteins include low fat cheese, chicken, turkey and fish. These foods are high in the amino acid tryptophan, which tends to increase serotonin levels. On the flipside, avoid high fat cheese, chicken wings or deep fried fish which take longer to digest and can keep you awake.


Heart healthy fats
Unsaturated fats will not only boost your heart health but also improve your serotonin levels. Examples  include peanut butter (read the label to make sure that peanuts are the only ingredient) and nuts such as walnuts, almonds, cashews and pistachios. Avoid foods with saturated and trans fats, such as French fries, potato chips or other high fat snack foods. They have the opposite effect and lower your serotonin levels.


Beverages
Certain drinks can promote or prevent sleep. A good soothing beverage to drink before bedtime would be warm milk (your mother was right) or herbal tea such as chamomile or peppermint.  As for caffeinated drinks, I recommend that if you are having trouble sleeping consume that last cup by 2pm. Caffeine can affect people differently, and even the smallest amount of stimulant can keep you awake. 


Fresh herbs
Fresh herbs can have a calming effect on the body. For example, sage and basil contain chemicals that reduce tension and promote sleep. Try making your own homemade pasta sauce with sage and basil> it is easy to do, and homemade sauces tend to be lower in sugar than store bought versions. However, avoid herbs such as red pepper at night, as they have a stimulatory effect.


Sleep inducing snacks
Try a banana with low fat yogurt
Eat low fat cottage cheese with a few 100 percent whole grain crackers
Enjoy an apple with mozzarella string cheese


Try all these foods to reduce your tossing and turning when you hit the pillow. Sweet dreams!

Brain Fitness

Your brain is constantly changing--creating new neurons and increasing the functional connections among them, known as synapses and dendrites. The level at which it performs these functions determines your brain's fitness, which is dependent on the inflow of nutrients and blood.


Physical exercise promotes brain blood flow and the beneficial brain proteins called neurotrophins. In these ways, exercise protects brain fitness and the capacity of a person to meet the various cognitive demands of life.


As a result, studies have repeatedly shown that older individuals who regularly participate in physical exercise are less likely to succumb to cognitive decline, mild cognitive impairment (MCI) or Alzheimer's disease.


In a study of older adults diagnosed with mild cognitive impairment, scientists found that 40 to 60 minutes of intensive aerobic exercise 4 days a week acted as a "potential (non drug induced) intervention that improves executive control processes for older women at high risk of cognitive decline" Another study of 1300 people by the Mayo Clinic concluded :ANY frequency of moderate exercise performed in midlife or late life was associated with reduced odds of MCI)


Like physical exercise, mental exercise formal education, continuing to learn, mentally engaged in life, and practicing cognitive skills can help prevent cognitive decline, dementia, and Alzheimer's disease. Mental exercise can also improve normally functioning minds.


Studies show that brain fitness can be improved by various cognitive activities, such as chess, bridge, or more structured computer-based workouts. Scientists found that, compared to other computer-based activities, computer brain-boosting exercises improved attention and memory in people over age 60. Other research showed that participants aged 65 and older who performed mental training for two and a half hours weekly improved their memory, reasoning, and information-processing speed-within five weeks.And individuals who did crossword puzzles puzzles four days a week were found to have 47% lower risk of dementia than those who did a crossword puzzle just once a week.

Walking is good exercise

We all can benefit by walking for exercise. It is recommended that one should walk at least 5 times each week. Try to find a partner or group to walk with for motivation and safety. It is advisable to wear reflective clothing, even during daylight hours. It is also a good idea to bring a cell phone  with you and let someone know where you will be walking. Walk standing up straight, tall and relaxed with your head up--do not look down. Hold your arms at  a 90 degree angle and swing them normally. It is a good idea  to stretch before you start. After stretching, start with an easy five minute warm up walk. If walking along the road, always walk on the left side facing traffic. Drink plenty of water or a sports drink while walking. Bring along energy bars, trail mix, or raisins in case you need a snack while walking. If you are wearing headphones, make sure you watch out for cars, bikes, and other pedestrians. If you feel tightness or pain at all while walking, stop and stretch some more. Finally take an easy five to ten minute walk afterward to help cool own. Walking is a good form of exercise no matter what your age!!