tag:blogger.com,1999:blog-67849089382597964942024-03-13T01:52:43.487-07:00The One Minute CaregiverThe information offered here is intended to provide families pragmatic and free advice to enable them to recognize risks of aging and lifestyle changes in their loved ones and what to do to support them.Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.comBlogger52125tag:blogger.com,1999:blog-6784908938259796494.post-15136639844022876852023-06-15T11:19:00.003-07:002023-06-15T11:19:46.427-07:00<h1 style="text-align: left;"><span style="font-family: inherit;"> Tracking Functional Status</span></h1><p class="Body" style="-webkit-text-stroke-width: 0px; caret-color: rgb(0, 0, 0); color: black; font-style: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; margin: 12pt 0in 12pt 42.55pt; text-align: start; text-decoration: none; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;"><span lang="EN-GB"><span style="font-family: inherit; font-size: small;">There is ample research in the field of geriatrics and dementia which has produced accredited studies detailing measurable outcomes from assessment tools designed to quantify characteristics of persons suffering from dementia in the areas of depression, cognition, nutrition, behaviour and even happiness. Using these tools to create baseline assessment and measure changes in condition will enable providers, families and primary care professionals to measure and understand the disease progression and determine the best course of treatment for these residents that will enable them to achieve the highest possible functional status and quality of life.<o:p></o:p></span></span></p><p class="Body" style="-webkit-text-stroke-width: 0px; caret-color: rgb(0, 0, 0); color: black; font-style: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; margin: 12pt 0in; text-align: start; text-decoration: none; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;"><span style="font-family: inherit; font-size: small;"><span lang="EN-GB"><span> </span><b>Assessment Tools</b></span><span>: </span><b><span lang="EN-GB"><o:p></o:p></span></b></span></p><p class="BulletList" style="mso-list: l0 level1 lfo1;"><!--[if !supportLists]--><span style="font-family: inherit; font-size: small;"><span style="mso-list: Ignore;">·<span style="font-feature-settings: normal; font-kerning: auto; font-optical-sizing: auto; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant-alternates: normal; font-variant-caps: normal; font-variant-east-asian: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-position: normal; font-variation-settings: normal; font-weight: normal; line-height: normal;"> </span></span><!--[endif]--><span style="background: white;">The</span><span class="apple-converted-space"><span style="background: white; color: #1b1b1b;"> </span></span><b>Mini–Mental State Examination</b><span class="apple-converted-space"><span style="background: white; color: #1b1b1b;"> </span></span><span style="background: white;">(</span><b>MMSE</b><span style="background: white;">) or</span><span class="apple-converted-space"><span style="background: white; color: #1b1b1b;"> </span></span><b>Folstein test</b><span class="apple-converted-space"><span style="background: white; color: #1b1b1b;"> </span></span><span style="background: white;">is a 30-point questionnaire that is used extensively in clinical and research settings to measure cognitive impairment.</span><span class="converted-anchor"><sup><span style="color: #1b1b1b;"> </span></sup></span><span style="background: white;">It is commonly used in</span><span class="apple-converted-space"><span style="background: white; color: #1b1b1b;">medicine a</span></span><span style="background: white;">nd allied health to screen for </span><span class="apple-converted-space"><span style="background: white; color: #1b1b1b;">dementia</span></span><span class="apple-converted-space"><span style="background: white; color: #1b1b1b;">. </span></span><span style="background: white;"><span> </span>It is also used to estimate the severity and progression of cognitive impairment and to follow the course of cognitive changes in an individual over time; thus making it an effective way to document an individual's response to treatment.</span><span class="apple-converted-space"><span style="background: white; color: #1b1b1b;"> </span></span><o:p></o:p>https://cgatoolkit.ca/Uploads/ContentDocuments/MMSE.pdf</span></p><div style="border-color: currentcolor currentcolor currentcolor blue; border-image: none; border-style: none none none solid; border-width: medium medium medium 2.25pt; padding: 0in;"><p class="BTNI" style="border: medium; line-height: 24px; margin: 0in; padding: 0in;"><span style="font-family: inherit;"><o:p></o:p></span></p></div><p class="BulletList" style="mso-list: l0 level1 lfo1;"><!--[if !supportLists]--><span style="font-family: inherit; font-size: small;"><span style="mso-list: Ignore;">·<span style="font-feature-settings: normal; font-kerning: auto; font-optical-sizing: auto; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant-alternates: normal; font-variant-caps: normal; font-variant-east-asian: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-position: normal; font-variation-settings: normal; font-weight: normal; line-height: normal;"> </span></span><!--[endif]--><span style="background: white; color: #222222;">The<span class="apple-converted-space"> </span></span><b><span style="color: #222222;">Geriatric Depression Scale</span></b><span class="apple-converted-space"><span style="background: white; color: #222222;"> </span></span><span style="background: white; color: #222222;">(</span><b><span style="color: #222222;">GDS</span></b><span style="background: white; color: #222222;">) is a 30-item<span class="apple-converted-space"> </span></span><a href="https://en.wikipedia.org/wiki/Self-report_inventory" style="color: #954f72; text-decoration: underline;" title="Self-report inventory"><span style="color: #0b0080;">self-report</span></a><span class="apple-converted-space"><span style="background: white; color: #222222;"> </span></span><a href="https://en.wikipedia.org/wiki/Psychological_assessment" style="color: #954f72; text-decoration: underline;" title="Psychological assessment"><span style="color: #0b0080;">assessment</span></a><span class="apple-converted-space"><span style="background: white; color: #222222;"> </span></span><span style="background: white; color: #222222;">used to identify<span class="apple-converted-space"> </span></span><a href="https://en.wikipedia.org/wiki/Major_depressive_disorder" style="color: #954f72; text-decoration: underline;" title="Major depressive disorder"><span style="color: #0b0080;">depression</span></a><span class="apple-converted-space"><span style="background: white; color: #222222;"> </span></span><span style="background: white; color: #222222;">in the elderly. </span><span style="background: white; color: #222222;">In the Geriatric Depression Scale, questions are answered "yes" or "no." A five-category response set is not utilized in order to ensure that the scale is simple enough to be used when testing ill or moderately cognitively impaired individuals, for whom a more complex set of answers may be confusing, or lead to inaccurate recording of responses.</span></span></p><p class="BulletList" style="mso-list: l0 level1 lfo1;"><span style="font-family: inherit; font-size: small;"><span style="background: white; color: #222222;"> h</span>ttps://geriatrictoolkit.missouri.edu/cog/GDS_SHORT_FORM.PDF</span></p><div style="border-color: currentcolor currentcolor currentcolor blue; border-image: none; border-style: none none none solid; border-width: medium medium medium 2.25pt; padding: 0in;"><p class="BTNI" style="border: medium; line-height: 24px; margin: 0in; padding: 0in;"><span style="font-family: inherit;"><o:p></o:p></span></p></div><p class="BulletList" style="mso-list: l0 level1 lfo1;"><!--[if !supportLists]--><span style="font-family: inherit; font-size: small;"><span style="mso-list: Ignore;">·<span style="font-feature-settings: normal; font-kerning: auto; font-optical-sizing: auto; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant-alternates: normal; font-variant-caps: normal; font-variant-east-asian: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-position: normal; font-variation-settings: normal; font-weight: normal; line-height: normal;"> </span></span><!--[endif]--><b><span style="background: white; color: #222222;">The Cornell Scale for Depression in Dementia (CSDD)</span></b><span style="background: white; color: #222222;"> </span><span style="background: white; color: #1b1b1b;">is a way to screen </span><span style="background: white;">for </span><a href="https://www.verywellhealth.com/recognizing-the-symptoms-of-depression-in-dementia-98566" style="color: #954f72; text-decoration: underline;"><span style="color: black; text-decoration: none;">symptoms of depression in someone who has dementia</span></a><span style="background: white; color: #1b1b1b;">. Unlike other scales and screens for depression, the CSDD takes into account additional signs of depression that might not be clearly verbalized by a person. For example, if your loved one or patient has </span><a href="https://www.verywellhealth.com/alzheimers-4014762" style="color: #954f72; text-decoration: underline;"><span style="color: black; text-decoration: none;">Alzheimer's disease</span></a><span style="background: white;">, </span><a href="https://www.verywellhealth.com/the-differences-between-alzheimers-vascular-dementia-98750" style="color: #954f72; text-decoration: underline;"><span style="color: black; text-decoration: none;">vascular dementia</span></a><span style="background: white; color: #1b1b1b;"> or other kind of cognitive impairment, he might not consistently be able to accurately express his feelings. The Cornell Scale measures observations and physical signs that could indicate depression. </span><span><o:p></o:p></span><span style="background-color: white; caret-color: rgb(34, 34, 34); color: #222222; text-indent: -23.799999px;"> </span><span style="background-color: white; caret-color: rgb(34, 34, 34); color: #222222; text-indent: -23.799999px;">https://cgatoolkit.ca/Uploads/ContentDocuments/cornell_scale_depression.pdf</span></span></p><p class="BulletList" style="mso-list: l0 level1 lfo1;"><!--[if !supportLists]--><span style="font-family: inherit; font-size: small;"><span style="mso-list: Ignore;">·<span style="font-feature-settings: normal; font-kerning: auto; font-optical-sizing: auto; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant-alternates: normal; font-variant-caps: normal; font-variant-east-asian: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-position: normal; font-variation-settings: normal; font-weight: normal; line-height: normal;"> </span></span><!--[endif]-->The <b>Morse Fall Scale</b> <b>(MFS) </b>is a rapid and simple method of assessing a patient’s likelihood of falling. A large majority of nurses (82.9%) rate the scale as “quick and easy to use,” and 54% estimated that it took less than 3 minutes to rate a patient. It consists of six variables that are quick and easy to score, and it has been shown to have predictive validity and interrater reliability. The MFS is used widely in acute care settings, both in the hospital and long term care inpatient settings. http://networkofcare.org/libraryMorse%20Fall%20Scale.pdf<o:p></o:p></span></p><p class="BulletList" style="mso-list: l0 level1 lfo1;"><!--[if !supportLists]--><span style="font-family: inherit; font-size: small;"><span style="mso-list: Ignore;">·<span style="font-feature-settings: normal; font-kerning: auto; font-optical-sizing: auto; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant-alternates: normal; font-variant-caps: normal; font-variant-east-asian: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-position: normal; font-variation-settings: normal; font-weight: normal; line-height: normal;"> </span></span><!--[endif]--><b>The Comprehensive Geriatric Assessment (CGA)</b> <span style="background: white;">- The geriatric assessment is a multidimensional, multidisciplinary assessment designed to evaluate an older person's functional ability, physical health, cognition and mental health, and socioenvironmental circumstances. It is usually initiated when the physician identifies a potential problem. Specific elements of physical health that are evaluated include nutrition, vision, hearing, fecal and urinary continence, and balance. The geriatric assessment aids in the diagnosis of medical conditions; development of treatment and follow-up plans; coordination of management of care; and evaluation of long-term care needs and optimal placement. The geriatric assessment differs from a standard medical evaluation by including nonmedical domains; by emphasizing functional capacity and quality of life; and, often, by incorporating a multidisciplinary team. It usually yields a more complete and relevant list of medical problems, functional problems, and psychosocial issues. https:/</span>/www.bgs.org.uk/sites/default/files/content/resources/files/2019-02-08/BGS%20Toolkit%20-%20FINAL%20FOR%20WEB_0.pdf</span></p><p class="BulletList" style="mso-list: l0 level1 lfo1;"><!--[if !supportLists]--><span style="font-family: inherit; font-size: small;"><span style="mso-list: Ignore;">·<span style="font-feature-settings: normal; font-kerning: auto; font-optical-sizing: auto; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant-alternates: normal; font-variant-caps: normal; font-variant-east-asian: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-position: normal; font-variation-settings: normal; font-weight: normal; line-height: normal;"> </span></span><!--[endif]--><b>The Mini Nutritional Assessment - </b><span style="background: white;">The Mini Nutritional Assessment is an effective, easily administered tool designed to identify older adults who have or are at risk for developing malnutrition. It consists of 18 questions and can be completed in about 15 minutes. A short form, containing the first six questions, can be used for screening. h</span><o:p></o:p>ttps://www.mna-elderly.com/sites/default/files/2021-10/mna-mini-english.pdf</span></p><div style="border-color: currentcolor currentcolor currentcolor blue; border-image: none; border-style: none none none solid; border-width: medium medium medium 2.25pt; padding: 0in;"><p class="BTNI" style="border: medium; line-height: 24px; margin: 0in; padding: 0in;"><span style="font-family: inherit;"><o:p></o:p></span></p></div><p><style class="WebKit-mso-list-quirks-style">
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</style></p><p class="BulletList"><!--[if !supportLists]--><span style="font-family: inherit; font-size: small;">·<span style="font-feature-settings: normal; font-kerning: auto; font-optical-sizing: auto; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant-alternates: normal; font-variant-caps: normal; font-variant-east-asian: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-position: normal; font-variation-settings: normal; line-height: normal;"> </span><!--[endif]--><b>Saint Louis University Mental Status Examination (SLUMS) - </b>a method of screening for Alzheimer's and other kinds of dementia. It was designed as an alternative screening test to the widely used Mini-Mental State Examination (MMSE). The idea was that the MMSE is not as effective at identifying people with very early Alzheimer's symptoms. Sometimes referred to as Mild Cognitive Impairment (MCI) or mild neurocognitive disorder (MNCD), these symptoms occur as people progress from normal aging to early Alzheimer's. h<b><o:p></o:p></b>ttp://www.memorylosstest.com/dl/slums-english.pdf</span></p><div style="border-color: currentcolor currentcolor currentcolor blue; border-image: none; border-style: none none none solid; border-width: medium medium medium 2.25pt; padding: 0in;"><p class="BTNI" style="border: medium; line-height: 24px; margin: 0in; padding: 0in;"><span style="font-family: inherit;"><o:p></o:p></span></p></div><p class="BulletList"><span style="font-family: inherit;"><br /></span></p><p class="BulletList"><span style="font-family: inherit;"><br /></span></p><p class="BulletList"><br /></p>Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-68907390260535575792020-02-20T07:52:00.002-08:002020-02-20T07:53:25.192-08:00Frequency and Indicators of Malnutrition in the Elderly<div class="MsoBodyText2" style="text-align: justify;">
<span style="color: #e69138; font-family: inherit;">Anorexia is an overall decline
in appetite leading to decreased food intake, and consumption of inadequate
calories. It is the major cause of weight loss and poor nutritional status in
elderly persons<a href="applewebdata://50C7511A-E525-4F23-A987-D09D26ABEFE9#_edn1" name="_ednref1" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference">[i]</span><!--[endif]--></span></span></a>. Malnutrition and dehydration are associated
with susceptibility to infections, cognitive impairment, poor skin and bone
integrity, pressure sores and hip fractures. These serious consequences along
with co-morbidities from chronic illness, often lead to mortality<a href="applewebdata://50C7511A-E525-4F23-A987-D09D26ABEFE9#_edn2" name="_ednref2" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference">[ii]</span><!--[endif]--></span></span></a>.
A protocol to screen and assess elderly
residents for nutritional risk is essential in establishing early interventions
to diminish serious health effects of malnutrition. <o:p></o:p></span></div>
<div class="MsoBodyText2" style="text-align: justify;">
<span style="color: #e69138;"><br /></span></div>
<div class="MsoBodyText">
<span style="color: black;"><span style="color: #e69138; font-family: inherit;">A
research group called the Collaborative Studies of Long Term Care, initiated in
1997 a series of multi-state projects that studied almost 5,000 residents in
more than 350 retirement and assisted living communities published their
findings in a special issue of the <i style="mso-bidi-font-style: normal;">Gerontologist</i>.<a href="applewebdata://50C7511A-E525-4F23-A987-D09D26ABEFE9#_edn3" name="_ednref3" style="mso-endnote-id: edn3;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span style="color: black;">[iii]</span></span><!--[endif]--></span></span></a><span style="mso-spacerun: yes;"> </span>Findings showed that low food intake was
common in 54% of the participants and low fluid intake is prevalent among 51%
of those studied in Long Term Care, particularly those with cognitive
impairment. They found that residents who were closely monitored by staff during
meal times are significantly less likely to have low food and fluid
intake.<span style="mso-spacerun: yes;"> </span>Similarly, residents who eat
their meals in a central dining area are much less likely to have low intake
than those dining in their bedrooms. <span style="mso-spacerun: yes;"> </span>Often, in large facilities meal times are set
and residents have limited time to consume their food.<span style="mso-spacerun: yes;"> </span>Pressured with time limits, staff can
mistakenly assume that the resident is not hungry and removes much of the
uneaten food before the resident is able to finish. <o:p></o:p></span></span></div>
<div class="MsoBodyText">
<span style="color: #e69138;"><br /></span></div>
<div class="MsoBodyText2" style="text-align: justify;">
<span style="color: #e69138; font-family: inherit;">Physical examination can point
to clear, visible signs of weight loss.<span style="mso-spacerun: yes;">
</span>Pronounced indentations at the temporal lobes commonly referred to as
temporal wasting, loss of muscle mass, loose elastic skin, and decreased
functional ability to perform activities of daily living (ADL’s) are all early
indicators. Causes of weight loss are numerous and can include: swallowing
difficulties, poor dentition, mouth pain, psychological disorders, depression,
impaired mobility, and loss of appetite. <span style="color: black;">Residents
who begin to lose 5% of their weight in one month, or 10% over 6 months, or
those who eat less than 75% of their food at meal times should be considered
for a complete nutritional evaluation by a Registered Dietitian.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></span></div>
<div class="MsoBodyText">
<span style="color: #e69138;"><br /></span></div>
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<span style="color: black;"><span style="color: #e69138; font-family: inherit;">Operators
should routinely evaluate body weight at the time of admission, and monthly
thereafter. Use of the Body Mass Index<a href="applewebdata://50C7511A-E525-4F23-A987-D09D26ABEFE9#_edn4" name="_ednref4" style="mso-endnote-id: edn4;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span style="color: black;">[iv]</span></span><!--[endif]--></span></span></a> (BMI) can help establish
a baseline, and subsequent measures can point to clear trends of weight maintenance
or decline. Residents who are determined to be high risk for weight loss can be
identified in their chart and with a silicon bracelet.<span style="mso-spacerun: yes;"> </span>Staff will then notify and involve a
registered dietitian who intervenes with an individualized food plan. <span style="mso-spacerun: yes;"> </span>Angela G. Sullivan MS RD consultant dietitian
for Potomac Homes suggests, “The specific nutritional recommendations we make are
<i style="mso-bidi-font-style: normal;">in addition</i> to a liberalized menu,
offering favorite foods, and routine mealtime practices”.<span style="mso-spacerun: yes;"> </span>“The strategies and protocols for the
resident at risk address prevention of continued weight loss and dehydration.” The
emphasis is to make sure food and fluid are optimized at each meal, snack and
hydration opportunity<a href="applewebdata://50C7511A-E525-4F23-A987-D09D26ABEFE9#_edn5" name="_ednref5" style="mso-endnote-id: edn5;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span style="color: black;">[v]</span></span><!--[endif]--></span></span></a>. <span style="mso-spacerun: yes;"> </span>“Simply adding supplements is not enough to
prevent weight loss”, she warned. Recommendations might include adequate
texture changes for residents who have difficulty swallowing. Cutting up food,
adding sauces and gravy to add extra moisture, and delaying the need to puree
food are all strategies that focus on taste and appearance, and address quality
of life. “Allowing residents additional time to complete their meal, offering
assistance with feeding, using words of encouragement in addition to
nutritional supplements and calorie dense snacks are protocols that can really make
a difference,” She concludes.</span></span></div>
<div class="MsoBodyText">
<span style="color: #e69138;"><br /></span></div>
<div class="MsoBodyText">
<span style="color: black;"><span style="color: #e69138; font-family: inherit;">Researchers
followed weight loss trends of 1000 nursing home residents across the United
States. <span style="mso-spacerun: yes;"> </span>They found many of elderly
residents to be undernourished. During a six month period, 30% of those
residents who continued to lose weight died.<span style="mso-spacerun: yes;">
</span>The study also found that 16-18% of elderly living in communities
consume less than 1000 calories per day.<o:p></o:p></span></span></div>
<div class="MsoBodyText">
<span style="color: #e69138;"><br /></span></div>
<div class="MsoBodyText">
<span style="color: black;"><span style="color: #e69138; font-family: inherit;">Clearly
elderly that are at risk for weight loss who are treated with additional
emphasis during meal times and throughout the day can greatly benefit, even
avoid the early onset of nutritionally triggered catastrophic health
failures. By recognizing at-risk
residents early, operators can have a significant impact on the overall quality
of life of their residents and help manage the acuity of care in their homes.</span><span style="color: black; font-family: "tahoma" , sans-serif;"><o:p></o:p></span></span></div>
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<!--StartFragment-->
<!--EndFragment--><br />
<div style="mso-element: endnote-list;">
<!--[if !supportEndnotes]--><br clear="all" />
<hr align="left" size="1" width="33%" />
<!--[endif]-->
<br />
<div id="edn1" style="mso-element: endnote;">
<div class="MsoEndnoteText">
<a href="applewebdata://50C7511A-E525-4F23-A987-D09D26ABEFE9#_ednref1" name="_edn1" style="mso-endnote-id: edn1;" title=""><span class="MsoEndnoteReference"><span style="font-family: "tahoma" , sans-serif; font-size: 10.0pt;"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span style="font-family: "tahoma" , sans-serif; font-size: 10.0pt;">[i]</span></span><!--[endif]--></span></span></span></a><span style="font-family: "tahoma" , sans-serif; font-size: 10.0pt;"> <i>Thomas, D.R., MD,
Morley, J.E. </i><span style="mso-bidi-font-style: italic;">Regulation of
appetite in older adults.<i> Clinical Strategies in LTC, a Supplement to Annals
of Long-Term Care</i>.<span style="mso-spacerun: yes;"> </span>July, 2002. <span style="mso-spacerun: yes;"> </span>Page 4.<o:p></o:p></span></span></div>
<div class="MsoEndnoteText">
<br /></div>
</div>
<div id="edn2" style="mso-element: endnote;">
<div class="MsoEndnoteText">
<a href="applewebdata://50C7511A-E525-4F23-A987-D09D26ABEFE9#_ednref2" name="_edn2" style="mso-endnote-id: edn2;" title=""><span class="MsoEndnoteReference"><span style="font-family: "tahoma" , sans-serif; font-size: 10.0pt;"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span style="font-family: "tahoma" , sans-serif; font-size: 10.0pt;">[ii]</span></span><!--[endif]--></span></span></span></a><span style="font-family: "tahoma" , sans-serif; font-size: 10.0pt;"> <i>Thomas, D.R. </i><span style="mso-bidi-font-style: italic;">Progress Notes: Nutrition and Chronic Wounds<i>.
Supplement to Annals of Long-Term Care</i>.<span style="mso-spacerun: yes;">
</span>November, 2004. Page 1-12.</span><o:p></o:p></span></div>
<div class="MsoEndnoteText">
<br /></div>
</div>
<div id="edn3" style="mso-element: endnote;">
<div class="MsoEndnoteText">
<a href="applewebdata://50C7511A-E525-4F23-A987-D09D26ABEFE9#_ednref3" name="_edn3" style="mso-endnote-id: edn3;" title=""><span class="MsoEndnoteReference"><span style="font-family: "tahoma" , sans-serif; font-size: 10.0pt;"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span style="font-family: "tahoma" , sans-serif; font-size: 10.0pt;">[iii]</span></span><!--[endif]--></span></span></span></a><span style="font-family: "tahoma" , sans-serif; font-size: 10.0pt;"> Reed, Peter S.,
Zimmerman, Sheryl, Sloane, Philip, Williams, Christianna, and Boustani, Malaz.
Characteristics Associated with Low Food Intake in Long-Term care residents
with Dementia. The Gerontologist. Vol. 45 . October 2005. Page 74-80.<o:p></o:p></span></div>
<div class="MsoEndnoteText">
<br /></div>
</div>
<div id="edn4" style="mso-element: endnote;">
<div class="MsoEndnoteText">
<a href="applewebdata://50C7511A-E525-4F23-A987-D09D26ABEFE9#_ednref4" name="_edn4" style="mso-endnote-id: edn4;" title=""><span class="MsoEndnoteReference"><span style="font-family: "tahoma" , sans-serif; font-size: 10.0pt;"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span style="font-family: "tahoma" , sans-serif; font-size: 10.0pt;">[iv]</span></span><!--[endif]--></span></span></span></a><span style="font-family: "tahoma" , sans-serif; font-size: 10.0pt;"> BMI uses a
mathematical formula that takes into account both a person's height and weight.
BMI equals a person's weight in kilograms divided by height in meters squared.
(BMI=weight<o:p></o:p></span></div>
<div class="MsoEndnoteText">
<span style="font-family: "tahoma" , sans-serif; font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span><i>kg</i>/height <i>m<sup>2</sup></i>). <span style="color: black;">Mahan K. L., Escott-Stump S., <i style="mso-bidi-font-style: normal;">Food Nutrition & Diet Therapy,</i> 9th edition, Saunders., 1996, Appendix
18 pg 950-951<o:p></o:p></span></span></div>
<div class="MsoEndnoteText">
<br /></div>
</div>
<div id="edn5" style="mso-element: endnote;">
<h1 style="margin-bottom: .0001pt; margin: 0in;">
<a href="applewebdata://50C7511A-E525-4F23-A987-D09D26ABEFE9#_ednref5" name="_edn5" style="mso-endnote-id: edn5;" title=""><span class="MsoEndnoteReference"><span style="font-family: "tahoma" , sans-serif; font-size: 10.0pt; font-weight: normal;"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span style="font-family: "tahoma" , sans-serif; font-size: 10.0pt;">[v]</span></span><!--[endif]--></span></span></span></a>
<span style="font-family: "tahoma" , sans-serif; font-size: 10.0pt; font-weight: normal;">Liberalization of the Diet Prescription Improves
Quality of Life for Older Adults in Long-Term Care. <i style="mso-bidi-font-style: normal;">Journal of the American Dietetic Association</i>. Volume 105, Issue 12,
December 2005, Pages 1955-1965.<o:p></o:p></span></h1>
<div class="MsoEndnoteText">
<br /></div>
</div>
</div>
Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-58843960409990464392020-02-20T07:52:00.001-08:002020-02-20T07:52:21.943-08:00Chemosensory changes in the Aging Process: Mom seems to be losing her appetite <div class="MsoNormal">
Most people understand that as we age, the way in which we
experience our world through our senses of sight, hearing, touch, taste, and
smell changes as those senses deteriorate over time. As our visual acuity
diminishes, we wear corrective lenses; with auditory loss, we wear hearing
aids. However, the least accepted and least understood deprivations are those
of taste and smell, the two senses that primarily control the body’s ability to
experience food. Disorders of taste and smell are viewed as affecting the
“lower” senses—those involved with sensual and emotional life—rather than the
“higher” senses that serve the intellect.<span style="mso-bidi-font-family: Cambria;"><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The taste and smell of food have a major effect on levels of
food intake and the maintenance of good nutrition. Losses and distortions in
these chemosensory mechanisms contribute to a significant degree to anorexia in
the elderly. Taste and smell are considered chemical senses because molecules
that contact receptors in the mouth, throat, and nasal cavity stimulate them.
The sense of taste is mediated by taste buds located on the dorsal surface of
the tongue and on the epiglottis, the larynx, and the first third of the
esophagus. Olfactory receptors are bipolar neurons located in the upper portion
of the nasal cavity that project into the limbic system of the brain. The
limbic system also processes information associated with emotions, so there is,
in fact, a medical explanation for the emotional response we have to food. The
olfactory bulb shows considerable degenerative changes during aging, and
cross-sections of the bulb often look “moth-eaten” owing to losses in the
number of cell bodies of neurons. Those losses are especially profound in
patients with Alzheimer’s disease.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Because of reduced function in these key chemosensory
systems, the natural biochemical responses designed to break down food as it
enters the body are consequently also less active. When the body smells,
tastes, or simply sees appetizing food, a number of biochemical responses are
set in motion to aid subsequent digestion. For example, saliva builds up in the
mouth, gastrointestinal juices are released into the stomach, plasma insulin is
released into the bloodstream, and the pancreatic system is engaged. All these
responses have the combined effect of aiding absorption of food and promoting
overall nutrition. As the aging process affects the body’s internal response to
food, seniors do not enjoy food as much or absorb it as well, and as a result
they can become vulnerable to malnutrition, which can contribute further to
health problems.<span style="mso-bidi-font-family: Cambria;"><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
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Taste and smell decrements arise not only from the normal
aging process, but also from certain disease states, pharmacological and
surgical interventions, the effects of radiation, and environmental exposure.
Similar medical conditions and drugs affect the sense of smell. For example,
most people have experienced the metallic taste of orange juice after brushing
their teeth; the chemical in toothpaste responsible for this effect is sodium
lauryl sulfate, which is also used to help fat-soluble drugs dissolve. Most
elderly persons take their medications with their meals to offset the
potentially harmful effects of the drugs on the stomach lining, which in turn
affects their ability to taste and smell their food. Their senses are inhibited
by these drugs, as is their digestive system, and this effect can at times
induce a negative reaction and in severe cases lead to malnutrition.<o:p></o:p></div>
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<br /></div>
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Many medications commonly prescribed are recommended to be
taken with food. Often people will take their medications before they eat,
especially when dinner plans call for a night out to a restaurant. By the time
their meals actually arrive at the table 60 minutes or more could have passed
since they consumed the medication prior to leaving home, giving the medication
taken on an empty stomach ample time to be absorbed into the bloodstream and
the opportunity to adversely affect their ability to taste and smell their
food. Simply advising people to take their medications after they eat rather
than before can have a profound effect on their overall dining satisfaction. In
fact, at one senior living community, after the seniors were educated about
this concept, senior satisfaction in food and beverage service increased by 10
percent over the previous survey, while perceptions of all other conditions
remained constant<a href="applewebdata://F5A06FA0-1C93-47A4-A5F2-D8B3882FF51B#_edn1" name="_ednref1" style="mso-endnote-id: edn1;" title=""><span class="MsoEndnoteReference"><span style="font-family: "calibri" , sans-serif; mso-bidi-font-size: 18.0pt;"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span style="font-family: "calibri" , sans-serif; font-size: 12.0pt;">[i]</span></span><!--[endif]--></span></span></span></a>.<span style="mso-bidi-font-family: Cambria;"><o:p></o:p></span></div>
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<br /></div>
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Measurements of taste and smell dysfunction in adults reveal
a progressive decline with age. Those losses tend to begin around 60 years of
age and become more severe in persons over 70 years of age. In most retirement
communities, the chef and cooking staff have an ability to taste and smell that
is more than twice as acute as that of the people for whom they are cooking. In
one study, persons between the ages of 20 and 70 had approximately 206 taste
buds each. This number was reduced to 88 taste buds for persons between the
ages of 74 and 88 years.<sup><span style="mso-bidi-font-size: 15.0pt;"> </span></sup><span style="mso-spacerun: yes;"> </span>The average age of seniors in retirement
communities today is about 82 years. Therefore even the best-qualified chefs
working with the freshest natural ingredients are working at a considerable
disadvantage, and they will express their frustration in trying to address this
problem using conventional methods. Seniors may inadvertently harm themselves
by trying to amplify the flavors of their food by using too much salt at the
table, or by eating too much dessert because they can still enjoy the sweet
taste of many of these offerings. Compensating in these ways, however, only
leads to nutritional imbalances and could be in direct conflict with
doctor-prescribed dietary guidelines.<span style="mso-bidi-font-family: Cambria;"><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
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Recent studies suggest that the amplification of foods and
beverages with naturally produced flavors can increase preference ratings as
well as subsequent intake and absorption in elderly persons with known
chemosensory losses. These commercially produced flavor enhancers, which are
inexpensive (adding less than a penny to the per-meal cost), are made by
reducing food such as chicken and capturing and concentrating natural flavor
and odor molecules. The concentrate can then be attached to a “carrier” (such
as water, oil, or flour) and added to the food. This added flavor contains no
fat, salt, or other harmful products traditionally associated with flavor
enhancement. <o:p></o:p></div>
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<br /></div>
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Flavor-amplified foods not only are preferred from a sensory
standpoint, but also can influence the body’s natural biochemical response to
food, actually promoting better absorption and, as a result, improving the
immune status of elderly persons. In a study by Schiffman and Warwick, elderly
persons were offered regular food for three weeks, then flavor-enhanced
versions of the same food<a href="applewebdata://F5A06FA0-1C93-47A4-A5F2-D8B3882FF51B#_edn2" name="_ednref2" style="mso-endnote-id: edn2;" title=""><span class="MsoEndnoteReference"><span style="font-family: "calibri" , sans-serif; mso-bidi-font-size: 18.0pt;"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span style="font-family: "calibri" , sans-serif; font-size: 12.0pt;">[ii]</span></span><!--[endif]--></span></span></span></a>.
Blood samples were taken before and after the use of the flavor enhancement.
They showed an increase in levels of T and B cells (white blood cells), the
body’s natural defense agents against disease and injury.<sup><span style="mso-bidi-font-size: 15.0pt;"><span style="mso-spacerun: yes;"> </span></span></sup>Schiffman’s
research confirms that as the body’s biochemical absorption of food improves,
so do nutrition and immune status. This research suggests that the addition to
recipes of natural flavors that increase the perceived flavor intensity would
improve satisfaction with the food and compensate for chemosensory losses due
to normal aging, diseases, and prescription drugs. It can be argued that the
use of flavor enhancements can actually promote better health as well as
improve culinary satisfaction.<span style="mso-bidi-font-family: Cambria;"><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The increased preference for flavor-enhanced food is
extraordinary. In fact, many manufacturers of convenience products, such as Stouffers
and Tyson, now list natural flavors among their ingredients. When a convenience
product and its scratch-made counterpart are served, the convenience product is
often better received than the homemade one. This is simply because the
commercial product is higher in flavor than the homemade product as a result of
added natural flavor. Certainly natural products are important and should
represent the primary ingredient source. The addition of fresh herbs and spices
and pre-treating with marinades should not be abandoned. We walk a fine line,
however: for if too many herbs and spices are added, the seasoning then
overpowers the main ingredients. Often seniors’ delicate digestive systems
become agitated when aromatic herbs and spices are not used in moderation.<span style="mso-bidi-font-family: Cambria;"><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Research has confirmed an improved immune status as measured
by the total level of blood lymphocytes, which help to fight diseases inherent
in the elderly population. In addition, seniors feel better about their dining
experience, and opioid (endorphin) levels increase as seniors’ ability to sense
their food improves. It has actually been proven that seniors become physically
stronger as well. With flavor enhancement, seniors are less interested in fatty
foods and in adding salt to their entrees, and thus they are better able to
adhere to their doctor-prescribed dietary guidelines.<o:p></o:p></div>
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<br />
<div id="edn1" style="mso-element: endnote;">
<div class="MsoEndnoteText">
<a href="applewebdata://F5A06FA0-1C93-47A4-A5F2-D8B3882FF51B#_ednref1" name="_edn1" style="mso-endnote-id: edn1;" title=""><span class="MsoEndnoteReference"><span lang="X-NONE"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span lang="X-NONE" style="font-family: "cambria" , serif; font-size: 12.0pt;">[i]</span></span><!--[endif]--></span></span></span></a><span lang="X-NONE"> Benjamin W. Pearce, <i style="mso-bidi-font-style: normal;">Reactivating
Appetite</i>, Eldercare Advisor Press, Amazon Kindle eBook, Amazon Digital
Services (2014).<o:p></o:p></span></div>
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<a href="applewebdata://F5A06FA0-1C93-47A4-A5F2-D8B3882FF51B#_ednref2" name="_edn2" style="mso-endnote-id: edn2;" title=""><span class="MsoEndnoteReference"><span lang="X-NONE"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span lang="X-NONE" style="font-family: "cambria" , serif; font-size: 12.0pt;">[ii]</span></span><!--[endif]--></span></span></span></a><span lang="X-NONE"> S. S. Schiffman and Z. S. Warwick, "Effects of Flavor
Enhancement of Foods for the Elderly on Nutritional Status: Food Intake,
Biochemical Indices, and Anthropometric Measures," <i style="mso-bidi-font-style: normal;">Physiology and Behavior</i> 53 (1992): 395-402.<o:p></o:p></span></div>
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Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-7680532454997755312020-02-20T07:50:00.001-08:002020-02-20T08:24:25.004-08:00Intervention Series: Mom seems to be losing her cognition - what you can do<h2 style="break-after: avoid; color: #1f4e79; font-family: "Century Gothic", sans-serif; font-size: 16pt; font-weight: normal; margin: 12pt 0in 6pt 42.55pt;">
<a href="https://www.blogger.com/null" name="_Toc30756906">Cognitive Interventions</a><o:p></o:p></h2>
<div class="Body" style="font-family: "Palatino Linotype", serif; font-size: 11pt; margin: 12pt 0in 12pt 42.55pt;">
<span lang="EN-GB">Cognitive interventions must be blended with a perspective allows us to understand a person not only as someone who suffers from illness or unhealthy conditions, but also as someone who inhabits healthy parts and personality that remains even though it seems to be hidden by illness . For staff and families, engaging the person behind the impairment will allow everyone to feel good about participating with the residents in the activity experience. <o:p></o:p></span></div>
<h3 style="break-after: avoid; color: #1f4e79; font-family: "Century Gothic", sans-serif; font-size: 14pt; font-weight: normal; margin: 12pt 0in 12pt 42.55pt;">
<a href="https://www.blogger.com/null" name="_Toc30756907">Alternatives for Cognitive Intervention:</a><o:p></o:p></h3>
<div class="Body" style="font-family: "Palatino Linotype", serif; font-size: 11pt; margin: 12pt 0in 12pt 42.55pt;">
<span lang="EN-GB">A therapeutic, multi-faceted interdisciplinary approach to activities, social and leisure programming provides specialized stimulation to create structure and support in meeting the physical, psychosocial, cognitive and spiritual needs of each participant. This is especially important for people who are confined in a locked unit and unable to freely experience the outside world where most of the rest of us readily access a wide array of activities and stimulation during the course of our everyday lives. The best practices components listed below allows providers to focus on residents' wellness and their holistic needs, rather than the losses the disease causes. The following research-based programming should then be scheduled to align therapeutic activities with common dementia behaviors as they typically occur during the day. This provides stimulation within each resident's capabilities that is failure-free and success oriented, at specific times when they are most likely to respond favourably.<o:p></o:p></span></div>
<div class="Body" style="font-family: "Palatino Linotype", serif; font-size: 11pt; margin: 12pt 0in 12pt 42.55pt;">
<a href="https://www.blogger.com/null" name="_Toc30756908"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Failure-Free</span></span></a><span lang="EN-GB"> - Activities that encourage participation at any functioning level, from low functioning to high functioning while still building self esteem of the participants. Participants are not at risk in these activities of being singled out or embarrassed. (Recommended frequency = Daily).<o:p></o:p></span></div>
<div class="Body" style="font-family: "Palatino Linotype", serif; font-size: 11pt; margin: 12pt 0in 12pt 42.55pt;">
<a href="https://www.blogger.com/null" name="_Toc30756909"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Exercise</span></span></a><span lang="EN-GB"> - Seniors with dementia tend to be less careful ambulating than their non-demented counterparts who are constantly aware of and fear the consequences of a fall. Unfortunately seniors suffering from dementia are at a significantly higher risk for falling than the general elderly population. Morning exercises and physical activities at least every two hours throughout the day keep joints limber and reduce the frequency of devastating falls. </span><span lang="EN-GB">Elderly people need to support their own weight and/or walk at least every two hours. This helps them to maintain body strength and muscle mass while improving their coordination, circulation and avoid pressure sores. Elderly can also experience dizziness when standing up. This is caused by blood pooling in their lower extremities (orthostatic hypotension). It is vital to let them stabilize on their feet for a minute after they have been sitting, or lying for an extended period to prevent dizziness and a potential fall. </span><span lang="EN-GB">(Recommended frequency = Daily).<o:p></o:p></span></div>
<div class="Body" style="font-family: "Palatino Linotype", serif; font-size: 11pt; margin: 12pt 0in 12pt 42.55pt;">
<a href="https://www.blogger.com/null" name="_Toc30756910"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Grooming</span></span></a><span lang="EN-GB"> - Residents who are well groomed feel better about appearing in public than those who do not dress appropriately and groom for their day. People with dementia are at risk of remaining in their rooms in bedclothes without grooming are more at risk for isolation and vulnerable to depression. (Recommended frequency = Daily).<o:p></o:p></span></div>
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<span lang="EN-GB"> </span><a href="https://www.blogger.com/null" name="_Toc30756911"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Current Events</span></span></a><span lang="EN-GB"> - It is important to provide residents a window on the world and keep them informed regarding top stories in the news. This connects them to important events outside their senior living community and stimulates them to maintain cognition. (Recommended frequency = Daily).<o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756912"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Reminiscence</span></span></a><span lang="EN-GB"> - This is the act or process of recollecting past experiences or events. Programs such as trivia, finish the phrase, memories that relate to holidays or the current month, or taking them back to "the Good old days" can help to connect them to their past and ease the fears they experience daily in failing to remember people, places and things. (Recommended frequency = Daily).<o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756913"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Long-Term Memory</span></span></a><span lang="EN-GB"> - These are memories that many people hold onto until late in their disease progression. These are activities that encourage working with familiar life-long tasks of everyday living such as sorting laundry, setting a table, winding yarn, reminding them what they did in their life, by cueing and using memory stations, and encouraging interaction with these familiar items. Programs that cue residents to access their long-term memories can highlight to them what they can still do which builds self-esteem and confidence. (Recommended frequency = Daily).<o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756914"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Short-Term Memory</span></span></a><span lang="EN-GB"> - These are memories in the immediate past present of days or weeks. Normally the first symptom noticed by families. Programs that offer structure, a calendar or written daily agenda, note cards to refer to. Using familiar photos, family albums, pictures of favorite foods or activities recently completed can help build confidence and reduce fear and anxiety. (Recommended frequency = Daily).<o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756915"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Cognitive Stimulation</span></span></a><span lang="EN-GB"> - This is the intervention that offers a range of enjoyable activities providing general stimulation for thinking, concentration and memory, normally in a small social group setting. It is aimed at general enhancement of cognitive and social functioning. These activities include </span><span lang="EN-GB">word games, puzzles, music and practical activities like baking or indoor gardening. All activities were designed to stimulate thinking and memory. Improvements for participants following cognitive stimulation show a much higher functional status. </span><span lang="EN-GB">(Recommended frequency = Daily).<o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756916"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Psychosocial</span></span></a><span lang="EN-GB" style="font-family: Cambria, serif; font-size: 12pt;"> - </span><span lang="EN-GB" style="font-family: Cambria, serif; font-size: 12pt;">Synaptic reserve, neuroplasticity, and perhaps other factors such as neurotransmission, and neurogenesis may be impacted by lifetime intellectual achievement. The relationship of leisure activities or other forms of intellectual stimulation such as social interactions to diminished risk for dementia suggests several mechanisms including stress reduction and overall cognitive stimulation are at play. Offering stimulation that reaches back to life-long love and work for others, helps to reflect on the past and validate the present. Creating activities surrounding lifetime accomplishments, travel destinations and other bucket list accomplishments gives a sense of life purpose to participants. </span><span lang="EN-GB" style="font-family: Cambria, serif; font-size: 12pt;">(Recommended frequency = Weekly</span><span lang="EN-GB">)</span><span lang="EN-GB" style="font-family: Cambria, serif; font-size: 12pt;">.</span><span lang="EN-GB" style="font-family: Cambria, serif; font-size: 12pt;"><o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756917"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Eye-Hand Coordination</span></span></a><span lang="EN-GB"> - Exercising the participant's creativity and fine motor skills can help build a sense of accomplishment. The more you build upon remaining abilities the higher the quality of life they will enjoy. (Recommended frequency = Weekly).<o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756918"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Socialization</span></span></a><span lang="EN-GB"> - Humans are social creatures, but as people begin to lose their memory and become aware of their losses, they tend to seek isolation to avoid embarrassment and confrontation. Programs designed to be delivered in small groups will enable each participant to offer what they can without being singled-out. Programs such as a group exercise activity (parachute) or finish the phrase or wheel of fortune all offer a venue for socialization with other residents while allowing them to express themselves within their individual comfort zone. (Recommended frequency = Daily).<o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756919"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Arts and Crafts</span></span></a><span lang="EN-GB"> - These activities can build self confidence and offer a sense of accomplishment. Creating a door hanger or artwork each month is fun and helps to build self-confidence. Higher functioning residents who help lower functioning residents with their art projects feel a sense of pride and contribution. Assisting others helps to overcome their own insecurities. Art therapy also helps to restore brain synapses through eye-hand coordination. (Recommended frequency = Weekly).<o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756920"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Multimedia Interaction</span></span></a><span lang="EN-GB"> - Researchers surveyed people with dementia and reported that travel and engaging with nature and science were most important to them in terms of their quality of life. Surveying families can help identify life-long interests such as travel, nature, sports, ancient history, oceans, cooking or science. PBS or Nature series programs available to download from the internet and a great commercial-free way for people to access this. Programming exposure to these themes helps participants remain connected with their passions. (Recommended frequency = Daily).<o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756921"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Sing-a-long</span></span></a><span lang="EN-GB"> - Many people with long-term memory remaining will respond well to sing-a-long programs and music therapy where they can participate at will and often surprise themselves with how well they remember popular songs of their younger days. Music bingo, holiday sing-a-longs and other singing games offer a great social and confidence building venue to residents to access past fond memories. (Recommended frequency = Weekly).<o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756922"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Spiritual and Religious</span></span></a><span lang="EN-GB"> - Remaining active spiritually is very important for elderly people who tend to become more religious later in life. A balanced program which offers interdenominational services or even religion specific services can help residents remain connected with their faith. </span><span lang="EN-GB">At the heart of our being exists a core set of virtues – gifts that represent the essence of the human spirit and the content of our character. These gifts are universal, not defined or limited by gender, nation, race or religion. They are inherent in the human experience. Research shows that seniors need to keep in touch with their spiritual self to live life fully. Living virtues provide empowering strategies that inspire the practice of virtues in everyday life through simplicity which support our residents to cultivate their virtues – the gifts of character. </span><span lang="EN-GB">(Recommended frequency = Weekly).<o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756923"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Low-Functioning</span></span></a><span lang="EN-GB"> - Sensory stimulation is needed for even the lowest functioning participants to offer distraction and engagement. Programs that offer simple exposure to stimulate participant's sense of touch, taste, smell, site and hearing can provide engagement and reach into the spirit of someone who may be otherwise catatonic. In many cases it is impossible to tell if a participant is responding mentally to these stimuli, but research has shown that many people with advanced dementia are engaged by sensory stimulation even though they may be unable to physically respond to it. Bubble painting, name that smell, feels like, sounds like, tastes like, or edible art like Hello with Jell-o can all bring stimulation and quality to life. (Recommended frequency = Daily).<o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756924"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Sequencing</span></span></a><span lang="EN-GB"> - Sequencing and muscle memory are among the last cognitive skills to erode for a dementia patient. Sorting silverware, folding napkins, word-find, or playing with musical instruments can restore confidence that participants can still access those skills and be successful in manipulating their form and function. (Recommended frequency = Weekly).<o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756925"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Non-verbal Communication</span></span></a><span lang="EN-GB"> - much of what we perceive about each other is not what is said by how it is communicated. Activities designed to have fun with non-verbal cues can offer both verbal and non-verbal participants a fun and engaging experience. </span><span lang="EN-GB">Introduce the topic by talking about body language. Define it for them if needed. Tell the residents that you are going to communicate non-verbally with your face and body and ask them to guess your mood. Use Happy (smiling and joyful) Sad (mouth turned down and sorrowful) Afraid, amorous, hurt, and yes confused! Have fun with it and ask the residents to show you how they look for each of these emotions. </span><span lang="EN-GB">(Recommended frequency = Daily).<o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756926"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Behavior Modification</span></span></a><span lang="EN-GB"> - Many residents with dementia also experience anxiety disorder. This is typically manifested in the afternoons and often referred to as "sundowning." Physicians normally treat this disorder with medications from the Benzodiazapine family. For many residents, these medications, while effective, can leave patients depressed, dispirited and even catatonic. There has been ample research with essential oils and auditory artifacts that have offered evidence to moderate behaviors without chemical intervention. Aromatherapy is the art of using essential oils to benefit ones physical, spiritual and psychological well-being. Aromatherapy can provide sensory stimulation or relaxation, increase self-esteem, and work against a sense of self-isolation. It can provide opportunities to communicate non-verbally, and enhance reminiscence, memory retrieval, and mood stabilization. Binural beats or delta tones are very low frequency auditory processing artifacts, or apparent sounds, the perception of which arises in the brain for specific physical stimuli. Delta tones have been used extensively with people who suffer from insomnia to induce relaxation, meditation, creativity and dissimulate the brain activity. Binural beats reportedly influence the brain in more subtle ways through the entertainment of brain waves and have been claimed to reduce anxiety and provide other health benefits such as control over pain. </span><span lang="EN-GB">(Recommended frequency = Daily).<o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756927"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt;">Other therapies</span></span></a><span lang="EN-GB"> - Horticultural therapy is an interaction between people and plants. This process has a powerful benefit that gives someone receiving care the opportunity to become a caregiver themselves, as they nurture their plantings. The benefits to a dementia population are many. Not only the physical benefits of utilizing fine and gross motor skills, but also the emotional benefits of working with plants include the sensory and mental stimulation, decreased anxiety, and improved orientation to reality with the stimulation of long-term memories. Pet therapy is another way seniors can stay connected to their past and is for many an opportunity to be the caregiver that is calming to both resident and pet alike. </span><span lang="EN-GB">(Recommended frequency = Monthly).</span></div>
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<span lang="EN-GB"><o:p></o:p></span><a href="https://www.blogger.com/null" name="_Toc30756928"><span class="Heading3Char" style="color: #1f4e79; font-family: "Century Gothic", sans-serif;"><span lang="EN-GB" style="font-size: 14pt; line-height: 19.97333335876465px;">Entertainment</span></span></a><span lang="EN-GB" style="font-family: "Century Gothic", sans-serif; font-size: 11pt; line-height: 15.693333625793457px;"> - Everyone loves to be entertained, whether its live music, multi-media or audio tracks. Having paid entertainer perform for the residents, or even an open mike night can bring that musical stimulation many people crave and enjoy right into their community. Often school bands, or dance groups can be arranged to come and perform for the residents which can offer the group experience performing before a live audience. Regardless of the source or reason, seniors love to be entertained, it stimulates so many emotions and offers a significant boost in their quality of life that is always enjoyed with eager anticipation. Where words fail, music speaks, its the sound of life. </span><span lang="EN-GB" style="font-family: "Century Gothic", sans-serif; font-size: 11pt; line-height: 15.693333625793457px;">(Recommended frequency = Monthly).</span></div>
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<b><span lang="EN-GB" style="font-family: "Century Gothic", sans-serif; font-size: 11pt; line-height: 15.693333625793457px;">Saint Louis University Mental Status Examination (SLUMS) - </span></b><span lang="EN-GB" style="font-family: "Century Gothic", sans-serif; font-size: 11pt; line-height: 15.693333625793457px;">a method of screening for Alzheimer's and other kinds of dementia. It was designed as an alternative screening test to the widely used Mini-Mental State Examination (MMSE). The idea was that the MMSE is not as effective at identifying people with very early Alzheimer's symptoms. Sometimes referred to as Mild Cognitive Impairment (MCI) or mild neurocognitive disorder (MNCD), these symptoms occur as people progress from normal aging to early Alzheimer's.</span></div>
Conduct your own assessment:<br />
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<span lang="EN-GB" style="font-family: "Century Gothic", sans-serif; font-size: 11pt; line-height: 15.693333625793457px;"><a href="http://www.memorylosstest.com/dl/slums-english.pdf" style="color: #954f72;">http://www.memorylosstest.com/dl/slums-english.pdf</a></span>Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-69896658886054192092020-02-20T07:45:00.001-08:002020-02-20T08:24:24.887-08:00Intervention Series: Mom seems to be depressed - what you can do<h2 style="break-after: avoid; color: #1f4e79; font-family: "Century Gothic", sans-serif; font-size: 16pt; font-weight: normal; margin: 12pt 0in 6pt 42.55pt;">
<a href="https://www.blogger.com/null" name="_Toc30756904">Depression Interventions</a><o:p></o:p></h2>
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<span lang="EN-GB">In a recent study researchers found that depressive symptoms were more than twice as common among assisted living residents with mild or moderate dementia than among those without dementia. Depressed residents often do not have positive outcomes and are greater risk of discharge to nursing homes and death. Chronic depression can lead to loss of appetite and weight loss, lethargy, and a host of other premature health complications. Findings of the study document the high prevalence of depressive symptomatology among those with dementia. About 54% of the depressed and 33% of the non-depressed participants were taking antidepressant medication.</span><a href="applewebdata://58D55065-857F-4C47-8234-31D01FDA39F2#_edn1" name="_ednref1" title=""><span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-GB" style="font-family: "tahoma" , sans-serif; font-size: 12pt;"><span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-GB" style="font-size: 12pt; line-height: 17.1200008392334px;">[i]</span></span></span></span></a><span lang="EN-GB"> Sixty-two of the participants of the study were depressed had no formal mental health treatment. Depression was more common among participants with severe dementia, behavioral symptoms and those with pain. The study also found that over half of the depressed participants were undetected by staff.<o:p></o:p></span></div>
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<span lang="EN-GB">These results indicate a strong need to properly assess residents for depression. Seeking interventions for those suffering who are undiagnosed and corrective actions for those currently treated for depression who may not be depressed can derail potential problems. Identifying these at-risk residents and advising attending physicians and family members may help operators to avert unnecessary mental health triggered discharges, while improving the quality of life for each individual.<o:p></o:p></span></div>
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<span lang="EN-GB">The Cornell Scale for Depression in Dementia (CSDD) was developed in response to a need in the industry for a diagnostic tool to quantify incidence of depression in elderly populations with dementia</span><a href="applewebdata://58D55065-857F-4C47-8234-31D01FDA39F2#_edn2" name="_ednref2" title=""><span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-GB" style="font-family: "tahoma" , sans-serif; font-size: 12pt;"><span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-GB" style="font-size: 12pt; line-height: 17.1200008392334px;">[ii]</span></span></span></span></a><span lang="EN-GB">. This simple 19 question tool enables operators to identify at-risk residents who are suffering from depression and are undiagnosed so that they might be treated, and also identify those who may be already prescribed antidepressants who may not in fact be depressed. This way attending physicians may be offered a nationally recognized diagnostic tool to use to evaluate and prescribe for their patients, rather than relying upon sporadic observations from caregivers and family members.<o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756905">Alternatives for Depression Intervention:</a><o:p></o:p></h3>
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<span style="font-family: "palatino linotype" , serif;">Treatment for depression depends upon the cause and severity of the depression and, to some extent, on personal preference. In mild or moderate depression, psychotherapy is often the most appropriate treatment. But incapacitating depression may require medication for a limited time along with psychotherapy. In combined treatments, medication can relieve physical symptoms quickly, while psychotherapy enables the patient to learn more effective ways of handling his/her problems.<o:p></o:p></span></div>
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<span style="font-family: "palatino linotype" , serif;">Personal Measures: mild exercise, music therapy, pet therapy, gardening or other hobbies, social engagement, volunteerism, intergenerational activities, reminiscing with family members or other residents, social interventions to help with isolation and loneliness (group outings, regular visits from volunteers, participation in a support group), humor, maintaining a healthy diet, religious or spiritual groups, continuous engagement in stimulating activities and craft programs.<o:p></o:p></span></div>
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<span style="font-family: "palatino linotype" , serif;">Medical measures: treatment of underlying medical conditions, counseling, psychotherapy, anti-depressants, hormone replacement therapy, changes in prescription dosages. Antidepressant medication can help some people feel better by controlling certain symptoms. The can be helpful in mobilizing people who suvive the repair of a broken hip, but lose the will to get out of bed. It should be noted that antidepressants can potentially lead to falls as they are sedating and can cause a sudden drop in blood pressure when a person stands up. Also selective serotonin reuptake inhibitors (SSRI) drugs can create dependency and may lead to self-destructive thoughts.<o:p></o:p></span></div>
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<span style="font-family: "palatino linotype" , serif;">Psychotherapy and Counseling and Measures: Supportive counseling includes religious and peer counseling. It can help ease the pain of loneliness and address the hopelessness of depression. Both peer counseling and pastoral counseling usually are provided without cost. Cognitive Bahavioral Therapy (CBT) helps people distinguish between problems that can and cannot be resolved, and develop better coping skills. Interpersonal psychotherapy can assist in resolving personal or relationship conflicts. Somatic or trauma psychotherapy with a professional can help bring about resolution of traumatic experiences.</span></div>
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<span style="font-family: "palatino linotype" , serif;"> <o:p></o:p></span><span style="font-family: "palatino linotype" , serif; font-size: 11pt;">Why it is important to treat: The body often follows the mind and depression substantially increases the likelihood of death from physical illnesses. Depression can increase impairment from a mental disorder and impede its improvement, while psychological treatment frequently improves the treatment success rate for a variety of medical conditions. Untreated depression can interfere with a patient’s ability to follow the necessary treatment regimen or participate in a rehabilitation program. According to a study conducted by the Rand institute, depressed elerly patients use 6 time more prescription medications and spend four times more in total healthcare dollars than their nondepressed counterparts. Seniors who are vulnerable for depression experience more comorbidities and run a higher risk of catastrophic health failure.</span></div>
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<b style="font-family: "Palatino Linotype", serif; font-size: 11pt; text-indent: -17.85pt;"><span style="background-color: white;">The Cornell Scale for Depression in Dementia (CSDD)</span></b><span style="background-color: white; font-family: "palatino linotype" , serif; font-size: 11pt; text-indent: -17.85pt;"> </span><span style="background-color: white; font-family: "palatino linotype" , serif; font-size: 11pt; text-indent: -17.85pt;">is a way to screen </span><span style="background-color: white; font-family: "palatino linotype" , serif; font-size: 11pt; text-indent: -17.85pt;">for </span><a href="https://www.verywellhealth.com/recognizing-the-symptoms-of-depression-in-dementia-98566" style="font-family: "Palatino Linotype", serif; font-size: 11pt; text-indent: -17.85pt;"><span style="text-decoration: none;">symptoms of depression in someone who has dementia</span></a><span style="background-color: white; font-family: "palatino linotype" , serif; font-size: 11pt; text-indent: -17.85pt;">. Unlike other scales and screens for depression, the CSDD takes into account additional signs of depression that might not be clearly verbalized by a person. For example, if your loved one or patient has </span><a href="https://www.verywellhealth.com/alzheimers-4014762" style="font-family: "Palatino Linotype", serif; font-size: 11pt; text-indent: -17.85pt;"><span style="text-decoration: none;">Alzheimer's disease</span></a><span style="background-color: white; font-family: "palatino linotype" , serif; font-size: 11pt; text-indent: -17.85pt;">, </span><a href="https://www.verywellhealth.com/the-differences-between-alzheimers-vascular-dementia-98750" style="font-family: "Palatino Linotype", serif; font-size: 11pt; text-indent: -17.85pt;"><span style="text-decoration: none;">vascular dementia</span></a><span style="background-color: white; font-family: "palatino linotype" , serif; font-size: 11pt; text-indent: -17.85pt;"> or other kind of cognitive impairment, he might not consistently be able to accurately express his feelings. The Cornell Scale measures observations and physical signs that could indicate depression. </span></div>
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<span style="background-color: white; color: #1b1b1b; font-family: "palatino linotype" , serif; font-size: 11pt; text-indent: -17.85pt;">Conduct your own assessment: </span><a href="http://primaris.org/sites/default/files/resources/Depression/depression_cornell%20scale%20for%20depression%20final.pdf" style="color: #954f72; font-family: Calibri, sans-serif; font-size: 11pt;">http://primaris.org/sites/default/files/resources/Depression/depression_cornell%20scale%20for%20depression%20final.pdf</a></div>
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<span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-GB" style="font-family: "tahoma" , sans-serif;"><span class="MsoEndnoteReference" style="vertical-align: super;"><br /></span></span></span></div>
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<span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-GB" style="font-family: "tahoma" , sans-serif;"><span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-GB" style="font-size: 10pt; line-height: 14.266666412353516px;"><a href="applewebdata://58D55065-857F-4C47-8234-31D01FDA39F2#_ednref1" name="_edn1" title="">[i]</a></span></span></span></span><span lang="EN-GB" style="font-family: "tahoma" , sans-serif;"> Baldini-Gruber, Ann, Zimmerman, Sheryl, Boustani, Malaz, Watson, Lea, Williams, Christianna, Reed, Peter. Characteristics Associated with Depression in Long-Term Care Residents with Dementia. The Gerontologist. Vol. 45, October 2005, Page 50-55.<o:p></o:p></span></div>
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<a href="applewebdata://58D55065-857F-4C47-8234-31D01FDA39F2#_ednref2" name="_edn2" title=""><span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-GB"><span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-GB" style="font-size: 10pt; line-height: 14.266666412353516px;">[ii]</span></span></span></span></a><span lang="EN-GB"> </span><span lang="EN-GB" style="font-family: "tahoma" , sans-serif;">Alexopoulos, G.S., Abrams, R.C., Young, R.C., & Shamoian, C.A. Cornell Scale for Depression in Dementia. <i>Biological Psychiatry</i>, 23, 1988, Page 271-284.<o:p></o:p></span></div>
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</style>Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-60914725378673022642020-02-20T07:45:00.000-08:002020-02-20T08:24:24.770-08:00Intervention Series: Mom is losing weight - what you can do<h2 style="break-after: avoid; color: #1f4e79; font-family: "Century Gothic", sans-serif; font-size: 16pt; font-weight: normal; margin: 12pt 0in 6pt 42.55pt;">
<a href="https://www.blogger.com/null" name="_Toc30756900"><span lang="EN-GB">Nutritional Interventions</span></a><span lang="EN-GB"><o:p></o:p></span></h2>
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<span lang="EN-GB">Seniors have a special relationship with food. Each phase of the aging process presents different nutritional challenges. Although good nutrition is not a treatment for memory loss, it does improve quality of life dramatically. Good nutrition helps to combat infections, depression, skin breakdown, pneumonia, confusion, as well as risks for falls and urinary tract infections. Here are some of the changing nutritional needs presented with the three general progressive phases of Alzheimer's Disease.<o:p></o:p></span></div>
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<span lang="EN-GB">In phase one, loss and confusion typically fuel depression, which causes changes in appetite. Weight changes may occur. People with AD may anxiously eat nonstop, or they may forget to eat all together. They may forget how to shop for food, or how to prepare a meal. They may forget how to use kitchen equipment, like a microwave or toaster, and become frustrated.<o:p></o:p></span></div>
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<span lang="EN-GB">The increased activity, agitation and wandering that is prominent in phase two increases residents' energy needs. Active residents in this phase may require an extra 1600 calories per day just to maintain their body weight. Getting those extra calories may be challenging if the resident loses interest in food. Swallowing difficulties, inability to recognize or distinguish foods, tasting difficulties, shortened attention span, physical changes like tremors or Apraxia and the inability to cope with the stimulation at the meal site all work against a confused resident. <o:p></o:p></span></div>
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<span lang="EN-GB">In phase three, people with AD are usually confined to a wheelchair. Typically, they forget how much food to put in their mouths or how to swallow. Most people in phase three need to be fed. In order to ensure the maximum nutritional intake, caregivers should take their time, offering cues, coaxing and proper positioning. Appropriate food consistency is essential, as there is a risk for choking. Having the main meal midday helps, too, because that is typically when the resident is at his sharpest.<o:p></o:p></span></div>
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<a href="https://www.blogger.com/null" name="_Toc30756901"><span lang="EN-GB">Alternatives for nutritional intervention:</span></a><span lang="EN-GB"><o:p></o:p></span></h3>
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<span lang="EN-GB">Have foods available at all times.<o:p></o:p></span></div>
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<span lang="EN-GB">Include the resident in choices, preparation and clean up.<o:p></o:p></span></div>
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<span lang="EN-GB">Encourage hydration at least six times per day.<o:p></o:p></span></div>
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<span lang="EN-GB">Have portable/ finger foods available for residents who wander, have limited attention spans, have difficulty using utensils and/or would benefit from six meals per day. (Examples of finger foods: hardboiled eggs, bananas, baby carrots, orange sections, graham crackers with peanut butter, cookies, cheese, chicken nuggets, etc.).<o:p></o:p></span></div>
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<span lang="EN-GB">Offer smaller portions of food frequently throughout the day. <o:p></o:p></span></div>
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<span lang="EN-GB">Offer favorite foods, with a preference on nutrients. (If a resident likes both brown and white rice, serve the nutrient-rich brown rice.)<o:p></o:p></span></div>
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<span lang="EN-GB">“Bulk Up” snacks with peanut butter, cheese and margarine. Use dry milk in sauces and soups. Add ice cream and chocolate syrup to milkshakes and desserts. Sprinkle sugar over everything (unless a no concentrated sweet diet is needed).<o:p></o:p></span></div>
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<span lang="EN-GB">Choose dinnerware for special needs: large handles on mugs and bowls to increase steadiness; plates with a lip to help get food on a spoon or fork; solid colored dishes to highlight food and minimize confusion; contrasting linen colors to make food easy to see.<o:p></o:p></span></div>
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<span lang="EN-GB">Move the plate a ¼-turn to compensate for vision problems. Use dark table linens, so spills won’t show up easily. Use aprons, not bibs, at mealtimes if necessary.<o:p></o:p></span></div>
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<span lang="EN-GB">Consider a swallowing evaluation for residents who are observed doing the following: pocketing of food, coughing or choking after meals or liquids, frequent throat clearing, drooling, gurgly voice quality, effortful chewing, complaining of pain while swallowing, watery eyes or running nose while eating, reflux, prolongation of meals. Implement diet modifications, positioning and swallowing techniques, and modify food consistencies.<o:p></o:p></span></div>
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<span lang="EN-GB">Positioning techniques: keep the resident’s head and upper trunk as upright as possible with head at midline; the head should be slightly forward in relation to the neck and shoulders; the hips and small of the back should be centered at the back of the chair; arms should be resting on the table to facilitate proper shoulder posture; keep residents feet flat; adjust the table height; and have the resident sit close up to the table.<o:p></o:p></span></div>
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<span style="font-family: "palatino linotype" , serif;">Serving and Food preparation techniques: Talk to the resident, tell her who you are and what you will be doing; speak slowly and clearly, feed slowly while alternating foods; don’t startle the resident with the feeding utensil; feed small amounts of food at a time; alternate sides of the mouth; offer sips of liquid often and tell the resident when you are done to put closure on the activity.<o:p></o:p></span></div>
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<span style="font-family: "palatino linotype" , serif;">Nutritional strategies: Remove or substantially modify dietary restrictions; encourage the use of flavor enhancers; encourage more frequent small meals; offer liquid nutritional supplements for use between (not with) meals; improve protein intake by adding meat, peanut butter or protein powder; treat depression with antidepressants that do not aggravate nutritional problems; remove or replace medications that may have anorexia-producing side effects.<o:p></o:p></span></div>
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<span style="font-family: "palatino linotype" , serif;">Staff Interventions: Ensure that residents are equipped with all the necessary sensory aides (dentures, hearing aide, glasses); ensure the resident is seated upright at 90 degrees preferably out of bed in the dining room in a chair (residents eating in the dining room are much less likely to have low intake); remove or minimize unpleasant sights, sounds and smells. </span></div>
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<span style="font-family: "palatino linotype" , serif;"><o:p></o:p></span><span style="font-family: "palatino linotype" , serif; font-size: 11pt;">Pharmacological Nutritional intervention: Megestrol acetate is a synthetic derivative of the female hormone progesterone. It can promote increased appetite and is very tolerated. The medication is designed to increase food intake, BMI, albumin, prealbumin, hemoglobin and lymphocyte count. This will require a physician order.</span></div>
<span style="font-family: "palatino linotype" , serif; font-size: 11pt; line-height: 15.693333625793457px;"> </span><br />
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<b style="font-family: "Palatino Linotype", serif; font-size: 11pt; text-indent: -17.85pt;">The Mini Nutritional Assessment - </b><span style="background-color: white; font-family: "palatino linotype" , serif; font-size: 11pt; text-indent: -17.85pt;">The Mini Nutritional Assessment is an effective, easily administered tool designed to identify older adults who have or are at risk for developing malnutrition. It consists of 18 questions and can be completed in about 15 minutes. A short form, containing the first six questions, can be used for screening. </span><br />
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<span lang="EN-GB" style="font-family: "century gothic" , sans-serif; font-size: 11pt; line-height: 15.693333625793457px; text-indent: 0px;"><a href="https://www.mna-elderly.com/forms/mini/mna_mini_english.pdf" style="color: #954f72;">https://www.mna-elderly.com/forms/mini/mna_mini_english.pdf</a></span><span style="font-size: small; text-indent: 0px;"></span></div>
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</style>Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-56918763791697370572020-02-20T07:31:00.000-08:002020-02-20T08:24:24.593-08:00Intervention Series: Mom is Falling - what you can do<span lang="EN-GB" style="font-family: "Century Gothic", sans-serif; font-size: 11pt; line-height: 15.693333625793457px;"></span><br />
<div class="Body" style="font-family: "Palatino Linotype", serif; font-size: 11pt; margin: 12pt 0in 12pt 42.55pt; text-align: left;">
<span lang="EN-GB">Ninety percent of the more than 352,000 hip fractures in the U.S. each year are the result of a fall. The remaining 10 percent of the hip fractures occur spontaneously due to low bone density or osteoporosis. Spontaneous fractures can then precipitate the fall. Women have two to three times as many hip fractures as men, and white post menopausal women have a 1 in 7 chance of a hip fracture during their lifetime. The hip fracture rate increases at age 50, doubling every five to six years. More than one-third of adults ages 65 years and older fall each year.</span></div>
<h3 style="break-after: avoid; color: #1f4e79; font-family: "Century Gothic", sans-serif; font-size: 14pt; font-weight: normal; margin: 12pt 0in 12pt 42.55pt; text-align: left;">
<a href="https://www.blogger.com/null" name="_Toc30756903">Alternatives for Falls Intervention:</a><o:p></o:p></h3>
<div class="Body" style="font-family: "Palatino Linotype", serif; font-size: 11pt; margin: 12pt 0in 12pt 42.55pt; text-align: left;">
Physical Measures: Using a recliner or rocking chairs, seating adaptations such as wedge cushion, lowering bed or removing of bedframe to put mattress on the floor, commode/urinal at bedside, assistive devices such as quad canes and walkers, review of current medications that may destabilize gait and balance (benzodiazapines), call bell within reach, monitor blood sugar and oxygen levels, check for presence of infections (URI or UTI), consider medications for pain relief, anti-tippers for wheelchairs, self -releasing Velcro lap belt, fall mats at bedside, orthostatic BP & P monitoring, place in high visibility areas. <span lang="EN-GB">Discuss with physician discontinuing or decreasing doses of medications associated with cognition changes, hypnotic or sedative effects (sleeping medications), bradycardia, hypotensive episodes, or sensory changes.<o:p></o:p></span></div>
<div class="Body" style="font-family: "Palatino Linotype", serif; font-size: 11pt; margin: 12pt 0in 12pt 42.55pt; text-align: left;">
<span lang="EN-GB">Environmental Measures: anti-rollback device to wheelchair, remove wheelchair foot supports when not in transport, remove visual barriers, cleat pathways, remove clutter that can fall and pose a hazard (magazines are very slippery on the floor), brakes on beds, bed in low position, repositioning for comfort, personal items within reach, assess seating, brake extenders for wheelchair, walker/cane tips in good condition, room closer to nurses station, assess sidrail use, bed/chair tabs alarms, pressure sensor alarm, reminder signs, non-skid strips on floor, remove wheels from overbed tables, consider motion detection night lights to illuminate pathway to bathroom, non-skid socks while in bed, properly fitting footwear and non-skid shoes, clothing that does not interfere or restrict movement, toileting schedule, room monitor, storage pocket for walker/wheelchair.<o:p></o:p></span></div>
<div class="Body" style="font-family: "Palatino Linotype", serif; font-size: 11pt; margin: 12pt 0in 12pt 42.55pt; text-align: left;">
<span lang="EN-GB">Psychosocial Measures: Active listening, behavioural strategies, sensory stimulation, increased surveillance, mental health evaluation.<o:p></o:p></span></div>
<div class="Body" style="font-family: "Palatino Linotype", serif; font-size: 11pt; margin: 12pt 0in 12pt 42.55pt; text-align: left;">
<span lang="EN-GB">Activity Measures: Structured daily routines, physical exercises, evening exercises, buddy system to monitor, PO/OT screening, music therapy, restorative ambulation, frequent toileting post-opioid pain medication and constipation relief measures.</span><span lang="EN-GB"></span><o:p></o:p></div>
<div class="Body" style="font-family: "Palatino Linotype", serif; font-size: 11pt; margin: 12pt 0in 12pt 42.55pt; text-align: left;">
<span lang="EN-GB"><br /></span></div>
<div class="Body" style="font-family: "Palatino Linotype", serif; font-size: 11pt; margin: 12pt 0in 12pt 42.55pt; text-align: left;">
<span lang="EN-GB"><span lang="EN-GB" style="font-family: "Century Gothic", sans-serif; font-size: 11pt; line-height: 15.693333625793457px;">The <b>Morse Fall Scale</b> <b>(MFS) </b>is a rapid and simple method of assessing a patient’s likelihood of falling. A large majority of nurses (82.9%) rate the scale as “quick and easy to use,” and 54% estimated that it took less than 3 minutes to rate a patient. It consists of six variables that are quick and easy to score, and it has been shown to have predictive validity and interrater reliability. The MFS is used widely in acute care settings, both in the hospital and long term care inpatient settings. Conduct your own falls assessment: </span><a href="http://networkofcare.org/library/Morse%20Fall%20Scale.pdf" style="color: #954f72; font-family: Calibri, sans-serif; font-size: 11pt;">http://networkofcare.org/library/Morse%20Fall%20Scale.pdf</a></span></div>
Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-50480135292131292772020-02-20T07:24:00.000-08:002020-02-20T07:24:14.181-08:00Supplements for Older Adults<div class="MsoNormal">
<span style="mso-bidi-font-family: Times;">The human body is a
complex network of different systems, all intricate in their design and
function. What each system has in common is its need for nourishment, mostly in
the form of nutrients, to operate properly.<span style="mso-spacerun: yes;">
</span>Antioxidants, vitamins and minerals work synergistically to help the
body reach optimal health. Deficiencies in these nutrients can have serious
consequences. The immune system, bones, vision, mental clarity, blood pressure,
metabolic function and energy are just a few of the health areas influenced by
a deficiency in one or more vitamins and minerals. </span><span style="mso-bidi-font-family: f5f50991018990856053c429e2759d6;">There is no
substitute for a healthy, well-balanced diet; however, in today’s fast-paced
lifestyles it is important to ensure the body is getting the fuel it needs.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="mso-bidi-font-family: f5f50991018990856053c429e2759d6;">Ideally,
</span><span style="mso-bidi-font-family: Arial;">consuming foods such as fruits
and vegetables can provide antioxidant protection to cells from the damaging
free radicals as well as offer other essential vitamins and minerals that help
the body perform optimally.<span style="mso-spacerun: yes;"> </span>Unfortunately,
many foods today are grown in mass quantities in soil that has been
nutritionally depleted over many years of use. In a landmark study published in
2004, nutritional data of various vegetables and fruits over a 50-year period
were found to have ‘reliable declines’ in protein, calcium, phosphorus, iron,
Vitamin B2, and Vitamin C. It was felt this was due to the modern agricultural
practices designed to breed new crops that provide larger yields, pest
resistance, and climate adaptability.<a href="applewebdata://34CB9ABA-57D8-46EF-9F3E-EBED9C026527#_edn1" name="_ednref1" style="mso-endnote-id: edn1;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span style="font-family: "cambria" , serif; font-size: 12.0pt;">[i]</span></span><!--[endif]--></span></span></a><o:p></o:p></span></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="mso-bidi-font-family: Arial;">Combine the
nutrient-deficient soil with over-processing and refinement of our foods, then
add chemical preservatives and artificial color and flavor enhancers, and there
is now a great need to supplement the missing vitamins, minerals, and
antioxidants on a daily basis to help combat the inflammation and free radical
production that our modern lifestyle generates. <a href="applewebdata://34CB9ABA-57D8-46EF-9F3E-EBED9C026527#_edn2" name="_ednref2" style="mso-endnote-id: edn2;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span style="font-family: "cambria" , serif; font-size: 12.0pt;">[ii]</span></span><!--[endif]--></span></span></a><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="mso-bidi-font-family: Times;">Because dietary
supplements are not FDA regulated as prescription and non-prescription drugs
are for standards, safety, and effectiveness, there can be a wide variety of
products on the market to choose from.<span style="mso-spacerun: yes;">
</span>These can range from poor quality supplements with high amounts of
fillers and nonessential ingredients to high quality, isotonic forms that have
FDA marketing approval as high quality and easily absorbable.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="mso-bidi-font-family: Arial;">Vitamins are
divided into two types: fat-soluble and water-soluble. Fat-soluble vitamins
(vitamin A, D, E and K) are stored in the fat tissues and liver. They can
remain in the body up to six months. When the body requires these, they are
transported to the area of requirement within the body with help of special
carriers. Water-soluble vitamins (B-vitamins and vitamin C) are not produced
nor stored in the body like the fat soluble ones and need to be replenished
everyday, whether consumed in our foods or supplementation.</span><span style="mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="mso-bidi-font-family: Arial;">Choosing the right multivitamin
supplement is more than just looking at the ingredients. The form in which the
supplement is in can make all the difference in the quality of the supplement
you are receiving. </span><span style="mso-bidi-font-family: Times;"><span style="mso-spacerun: yes;"> </span>A good multivitamin should be easily absorbed
and have all of the required daily levels that are essential to maintain good
health.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="mso-bidi-font-family: Times;">One multivitamin supplement
recommended is ‘isotonic’ which comes as a powdered form to which you add 2
ounces of water to drink.<span style="mso-spacerun: yes;"> </span></span><span style="mso-bidi-font-family: f5f50991018990856053c429e2759d6;">Isotonic, which
means “same pressure,” bears the same chemical resemblance of the body’s blood,
plasma and tears. All fluids in the body have a certain concentration, referred
to as osmotic pressure (which is isotonic) and allow a consistent maintenance
of body tissues. This means that the body has less work to do to in obtaining
maximum absorption. The isotonic state of the suspension allows nutrients to
pass directly into the small intestine and be rapidly absorbed into the
bloodstream. With Isotonix (Nutrametrix) products, little nutritive value is
lost, making the absorption of nutrients highly efficient while delivering
maximum results</span><span style="font-family: "f5f50991018990856053c429e2759d6"; font-size: 14.0pt;">.</span><span style="mso-bidi-font-family: Times;"><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="mso-bidi-font-family: Times;">The Nutrametrix
Daily Multivitamin contains all the basic daily dietary needs, and can be with
or without iron as recommended by your healthcare professional.<span style="mso-spacerun: yes;"> </span>You can then add other Nutrametrix isotonic
dietary supplements according to your own personal needs, for instance, for
arthritis, allergies and joint pains (antioxidants like OPC-3 and vitamin C),
elevated cholesterol (Essential Omega 3 oil with Vitamin E) or nerve
conduction/ nerve pain and stress levels (Activated B-complex).<span style="mso-spacerun: yes;"> </span>These items can be found online at <a href="http://www.nutrametrix.com/karendoll">www.nutrametrix.com/karendoll</a>. <span style="mso-spacerun: yes;"> </span>There is a free “Nutri-physical” you can
complete online that will help individualize your supplement needs according to
your personal needs.<span style="mso-spacerun: yes;"> </span>(<a href="http://www.nutrametrix.com/karendoll/nutri-physical">www.nutrametrix.com/karendoll/nutri-physical</a>).<span style="mso-spacerun: yes;"> </span>Before considering any supplemental regimen,
be sure to consult your healthcare provider.<span style="mso-spacerun: yes;">
</span><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; tab-stops: 11.0pt .5in; text-autospace: none;">
<span style="mso-bidi-font-family: Arial;">Omega 3
fatty acids have been shown to be effective in fighting inflammation<o:p></o:p></span></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; tab-stops: 11.0pt .5in; text-autospace: none;">
<span style="mso-bidi-font-family: Arial;"><span style="mso-spacerun: yes;"> </span>in your body as well as in reducing overall cholesterol
levels and triglycerides, improving blood flow and blood pressure, and may also
help to reduce the occurrence of the more severe outcomes of heart disease.
Fatty fish such as salmon, sardines, anchovies and mackerel provide essential omega
3 fatty acids, especially eicosapentaenoic acid (EPA) and docosahexanenoic acid
(DHA). <span style="mso-spacerun: yes;"> </span>The American Heart Association recommends
</span><span style="mso-bidi-font-family: DroidSans;">1000 mg per day of Omega-3
EPA/DHA for patients with coronary heart disease and 2000 to 4000 mg per day
for patients with high triglycerides. </span><span style="mso-bidi-font-family: Arial;">For vegetarians or those who have fish allergies, flax seeds or flax
seed oil provides an acceptable alternative.<span style="mso-spacerun: yes;">
</span></span><span style="mso-bidi-font-family: DroidSans;"><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="mso-bidi-font-family: Arial;">To achieve this
level of supplementation, a high quality Omega-3 oil is recommended daily as
you want to know it is tested to be free of fillers and non-essential ingredients,
like the Nutrametrix Heart Health Essential Omega-3 with Vitamin E.<span style="mso-spacerun: yes;"> </span></span><span style="mso-bidi-font-family: f5f50991018990856053c429e2759d6;">NutraMetrix Heart Health Essential Omega III
comes from small anchovies and sardines that have a short lifecycle making them
an ideal source of fish oil because they are less prone to accumulating
environmental toxins that can be found in larger, longer-lived fish.</span><span style="mso-bidi-font-family: Arial;"><span style="mso-spacerun: yes;"> </span>A
good quick way to test any fish oil supplement is to place a capsule in the
freezer overnight.<span style="mso-spacerun: yes;"> </span>Pure oil will not
freeze solid, but those with mostly added fillers will.<span style="mso-spacerun: yes;"> </span>If it is firm and inflexible when frozen, it
is likely to be more filler ingredients than omega-3 oil.<o:p></o:p></span></div>
<h4>
<span lang="X-NONE" style="font-size: 12.0pt; font-weight: normal; mso-bidi-font-weight: bold;">Another source of inflammation-fighting healthy fats is nuts—particularly
almonds, which are rich in fiber, calcium, and vitamin E, and walnuts, which
have high amounts of alpha-linolenic acid, a type of omega-3 fat. All nuts,
though, are packed with antioxidants, which can help your body fight off and
repair the damage caused by inflammation.</span></h4>
<div class="MsoNormal">
Antioxidants are another key supplement necessary for
health, especially as we age that will reduce ‘free radical’ formation.<span style="mso-spacerun: yes;"> </span>Free radicals are unstable molecules or
compounds that react negatively with other molecules creating stress on the
body.<span style="mso-spacerun: yes;"> </span>This free radical formation is a
natural process that occurs daily when the body breaks down certain substances
in our environment or food, or comes in contact with pollutants.<span style="mso-spacerun: yes;"> </span>Specifically, antioxidants provide the body
with a defense against the negative effects of the free radicals, then
stabilize and prevent other molecules from turning into unstable free radicals,
thereby promoting good health.<span style="font-family: "f5f50991018990856053c429e2759d6"; font-size: 14.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
Inflammation is part of the body’s immune response;
without it, we can't heal. But when it's out of control it can damage the body.
<span style="mso-bidi-font-family: OpenSans;">Chronic inflammation has been
linked to many cardiovascular diseases. Cholesterol gets deposited in the
lining of blood vessels and acts as an insult.<span style="mso-spacerun: yes;">
</span>Cytokines respond to these insults in the bloodstream, which leads to
systemic inflammation. Inflamed blood vessels and growing fatty plaque can
cause blockages and blood clots, which then can cause heart attacks.<span style="mso-spacerun: yes;"> </span></span><span style="mso-bidi-font-family: f5f50991018990856053c429e2759d6;">Foods high in sugar, saturated and trans fats,
excess weight, smoking, pollution, chemical preservatives, poor oral health and
unhealthy diets in general cause chronic inflammation.<span style="mso-spacerun: yes;"> </span>In addition to cardiovascular disease, inflammation
is also associated with diseases such as arthritis, autoimmune diseases,
allergies, asthma, cancer, and inflammatory bowel diseases.</span><span style="font-family: "times new roman" , serif;"><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Three important antioxidants, OPC-3, Vitamin C, and CoQ10,
have been found to be beneficial for heart health by reducing inflammation as
well as the number of free radicals causing inflammatory damage in our
bodies.<span style="mso-spacerun: yes;"> </span><span style="mso-bidi-font-family: f5f50991018990856053c429e2759d6;">Oligomeric proanthocyanidins (OPCs) are
bioflavonoids (complex organic plant compounds) found in fruits, vegetables and
certain tree barks that provide exceptional nutritional benefits to the human
body. Studies have shown OPCs to be up to 20 times more powerful than vitamin C
and 50 times more powerful than vitamin E in neutralizing free radicals.<span style="mso-spacerun: yes;"> </span>Supplementing with a high quality isotonic
OPC, like the Nutrametrix (Isotonix) formulation OPC-3 taken with your daily
multivitamin will help fight the free radicals and offer an effective
anti-inflammatory.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="mso-bidi-font-family: f5f50991018990856053c429e2759d6;">Vitamin
C is an essential water-soluble nutrient that must be replenished on a daily
basis. It is important to know that cooking destroys vitamin C activity.<span style="mso-spacerun: yes;"> </span>Aside from it’s well known antioxidant
properties, vitamin C supports cardiovascular health in a few different ways,
i.e. normalizing blood pressure and cholesterol levels, in addition to
supporting our immune system and pulmonary health. A lack of vitamin C can
cause general fatigue, as it helps moderate healthy iron absorption, transport
and storage. <span style="mso-spacerun: yes;"> </span>In the typical diet, most
vitamin C comes from fresh fruits and vegetables. Peppers, like sweet green and
red peppers, hot red and green chili peppers, are especially rich in vitamin C.
Other good sources include citrus fruits and juices, brussel sprouts,
cauliflower, cabbage, kale, collards, mustard greens, broccoli, spinach and
strawberries.<o:p></o:p></span></div>
<div class="MsoNormal">
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="footnote text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="header"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="footer"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="index heading"/>
<w:LsdException Locked="false" Priority="35" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="caption"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="table of figures"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="envelope address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="envelope return"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="footnote reference"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation reference"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="line number"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="page number"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="endnote reference"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="endnote text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="table of authorities"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="macro"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="toa heading"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 5"/>
<w:LsdException Locked="false" Priority="10" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Closing"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Signature"/>
<w:LsdException Locked="false" Priority="0" SemiHidden="true"
UnhideWhenUsed="true" Name="Default Paragraph Font"/>
<w:LsdException Locked="false" Priority="0" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="Body Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Message Header"/>
<w:LsdException Locked="false" Priority="11" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Salutation"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Date"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Heading"/>
<w:LsdException Locked="false" Priority="0" SemiHidden="true"
UnhideWhenUsed="true" Name="Body Text 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Block Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Hyperlink"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="FollowedHyperlink"/>
<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Document Map"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Plain Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="E-mail Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Top of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Bottom of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal (Web)"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Acronym"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Cite"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Code"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Definition"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Keyboard"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Sample"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Typewriter"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Variable"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal Table"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation subject"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="No List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Contemporary"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Elegant"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Professional"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Balloon Text"/>
<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Theme"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 9"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="1" QFormat="true"
Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" QFormat="true"
Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" QFormat="true"
Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
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<span style="font-family: "cambria" , serif; font-size: 12.0pt;">Another powerful
antioxidant and vital nutrient to promote energy production within our cells is
CoenzymeQ10 (CoQ10). CoQ10 levels in our
body naturally diminish with age, and even faster with poor eating habits,
stress or infections. It is reported
that the use of statins (cholesterol-lowering medications) will also reduce the
body’s ability to make CoQ10 even further.
It is generally a combination of choosing the right foods containing
CoQ10 with additional supplementation daily that will provide the body with the
best possible amount of CoQ10 for optimal health. CoQ10</span><span style="color: #1a1a1a; font-family: "cambria" , serif; font-size: 12.0pt;"> is naturally found in high levels in organ meats such
as liver, kidney, and heart, as well as in beef, sardines, and mackerel. Vegetable sources of CoQ10 include
spinach, broccoli, and cauliflower with
peanuts and soybeans the best non-animal sources. </span>
<!--EndFragment--><br />
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<!--[if !supportEndnotes]--><br clear="all" />
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<!--[endif]-->
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<a href="applewebdata://34CB9ABA-57D8-46EF-9F3E-EBED9C026527#_ednref1" name="_edn1" style="mso-endnote-id: edn1;" title=""><span class="MsoEndnoteReference"><span lang="X-NONE"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span lang="X-NONE" style="font-family: "cambria" , serif; font-size: 12.0pt;">[i]</span></span><!--[endif]--></span></span></span></a><span lang="X-NONE"> </span><span lang="X-NONE" style="color: #262626; mso-bidi-font-family: Georgia; mso-bidi-font-size: 9.0pt;">University of Texas (UT) at
Austin’s Department of Chemistry and Biochemistry was published in December
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<a href="applewebdata://34CB9ABA-57D8-46EF-9F3E-EBED9C026527#_ednref2" name="_edn2" style="mso-endnote-id: edn2;" title=""><span class="MsoEndnoteReference"><span lang="X-NONE"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span lang="X-NONE" style="font-family: "cambria" , serif; font-size: 12.0pt;">[ii]</span></span><!--[endif]--></span></span></span></a><span lang="X-NONE"> </span><span lang="X-NONE" style="mso-bidi-font-family: Arial;">See
also antioxidants for a definition of free radicals.</span><span lang="X-NONE"><o:p></o:p></span></div>
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Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-14409043950989806942019-01-03T06:02:00.000-08:002019-01-03T06:02:53.214-08:00Medicare and Medicaid in Assisted Living<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "times" , serif; font-size: 11.0pt;">Today's seniors enjoy a life expectancy longer than
any generation in history. An American who turned 65 in 1998 could expect to
live nearly another 18 years beyond their 65th birthday. And while additional
years are generally considered an blessing, it is also true that the older one
grows, the more likely they will need health care services. Today's seniors,
who often consider themselves among the best informed, would do well to learn
about three crucial areas that pertain to their future health care needs: the
potential that they may need long term care, the cost of long term care and the
limited federal and state aid available.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "times" , serif; font-size: 11.0pt;">According to a study by the Agency for Health Care
Policy and Research, some 42 percent of Americans who reach the age of 70 can
expect to utilize some type of long term care during the remainder of their
lives. And with the number of people over age 65 expected to grow to 20 percent
of the U.S. population by 2030, there is little doubt that demand for long term
care services is poised to increase dramatically.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "times" , serif; font-size: 11.0pt;">Long term care services have evolved dramatically
over the past several years. Where the majority of long term care was once
provided only in skilled nursing homes, long term care services today are
provided in a wide range of settings, ranging from in-home care to
community-based facilities such as adult day care and assisted care facilities
to nursing homes. The cost of long term care can be significant, regardless of
the setting in which it is provided. The average cost of a nursing home is
approximately $60,000 a year, and home care costs can range from $50 to more
than $250 a day.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "times" , serif; font-size: 11.0pt;">Medicare and Medicaid provide only limited help for
nursing home care. Medicare only pays for the first 20 days in a skilled
nursing facility - and only after a hospital stay of three days or more. The
patient or their family pays the first $99 per day from the 21st day through
the 100th day, after which Medicare pays nothing. Medicaid rules vary from
state to state, but as former U.S. Senator David Durenburger told the U.S.
Senate Special Committee on Aging, Medicaid "dictates that people must
effectively impoverish themselves in order to receive government
assistance." Medicaid is essentially medical aide for those who have
already spent down their assets.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "times" , serif; font-size: 11.0pt;">Government won't help much with newer forms of long
term care services, either. Though 38 states pay for some assisted living, the
programs are miniscule, covering fewer than 100,000 poor people, so waiting
lists are long. Medicare covers home care, but just 100 visits in the weeks
following a hospital stay. So seniors increasingly are paying their long term
care bills out of their own pockets.<o:p></o:p></span></div>
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Top of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Bottom of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal (Web)"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Acronym"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Cite"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Code"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Definition"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Keyboard"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Sample"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Typewriter"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Variable"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal Table"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation subject"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="No List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Contemporary"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Elegant"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Professional"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Balloon Text"/>
<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Theme"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 9"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="1" QFormat="true"
Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" QFormat="true"
Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" QFormat="true"
Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="46" Name="List Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 6"/>
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<span style="font-family: "times" , serif; font-size: 11.0pt;">Medicaid does not pay for assisted living services
in most assisted living, typically they cover the costs of care in Nursing Homes for those
who have exhausted their assets. The White House recently authorized Medicare
coverage for the treatment of Alzheimer's disease. This means that Medicare
beneficiaries can now receive reimbursement for mental health services that
were formerly denied because the government rationalized that people with the
disease did not respond to mental and physical therapy, this has since been
proven incorrect, hence the reversal of their position. Medicare was never
intended to cover the costs associated with custodial care, which is room and
board, and activities of daily living, and these coverage changes still do not
reimburse for this, further Medicare requires a three-day prequalifying
hospital stay before they pay for care in a nursing home. Medicare covers
certain care procedures, and some limited rehabilitation therapies. The
physicians who visit assisted living are normally all Medicare certified providers, so the
cost of their visits is often covered by Medicare, subject to the co-payment.<o:p></o:p></span></div>
Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com3tag:blogger.com,1999:blog-6784908938259796494.post-74702963896833819712018-02-02T06:19:00.002-08:002018-02-02T06:19:51.642-08:00Learning how to read a food label can help you make good nutritional choices<div class="MsoNormal">
The Food and Drug Administration (FDA) is responsible for
assuring that foods sold in the United States are safe, wholesome, and properly
labeled. This applies to foods produced domestically, as well as foods imported
from foreign countries. The Nutrition Labeling and Education Act (NLEA), which
amended the FD&C Act requires most foods to bear nutrition labeling and
requires food labels that they are nutrient content claims and certain help
messages to comply with specific requirements. It is the responsibility for the
food industry to remain current with the legal requirements for food labeling.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The <b style="mso-bidi-font-weight: normal;">Nutrition Facts</b>
panel on any packaged item is the best way to understand exactly what is in the
product you are buying.<span style="mso-spacerun: yes;"> </span>The front of the
package can be very misleading and tells you only what the manufacturer wants
you to know about the health claims.<span style="mso-spacerun: yes;">
</span>Terms used on packaging, such as “multigrain”, “reduced-fat”, “no
additives” and even “natural” can be misleading, as these terms aren’t tightly
regulated so manufacturers will use words that make you think you are buying
healthy products. Knowing how to read the Nutrition Facts Panel will guide you
to better choices for a healthy lifestyle.<span style="mso-spacerun: yes;">
</span><o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
When deciding what is best to buy, compare nutrients and
calories in one food to those in another. The information may surprise you. For
your heart health, make sure you aren’t eating foods high in carbohydrates,
saturated and <i>trans </i>fats, and sodium.<o:p></o:p></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal">
These steps may help simplify what can be a confusing
Nutrition Fact label.<o:p></o:p></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<br /></div>
<ol start="1" style="margin-top: 0in;" type="1">
<li class="MsoNormalCxSpMiddle" style="mso-layout-grid-align: none; mso-list: l1 level1 lfo2; mso-pagination: none; text-autospace: none;"><b style="mso-bidi-font-weight: normal;">Check Serving Size and Servings Per Container</b></li>
</ol>
<div class="MsoNormal">
This will tell you what is a standardized serving for this
product and the nutritional information listed below relates only to this size
serving.<span style="mso-spacerun: yes;"> </span>It can surprise you to find out
that a small package that seems like one serving can be labeled as two
servings.<span style="mso-spacerun: yes;"> </span>This would mean if you ate the
entire container, you would have to double the calories, carbohydrates, fat,
sodium and everything else on that label to get an accurate measurement of you
are eating.<span style="mso-spacerun: yes;"> </span><o:p></o:p></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<br /></div>
<ol start="2" style="margin-top: 0in;" type="1">
<li class="MsoNormalCxSpMiddle" style="mso-layout-grid-align: none; mso-list: l1 level1 lfo2; mso-pagination: none; text-autospace: none;"><b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: "Helvetica Neue";">Carbohydrates
count more than calories!<a href="https://www.blogger.com/null" name="_GoBack"></a><o:p></o:p></span></b></li>
</ol>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal">
The Total Carbohydrates listed on the label will include
sugar, starch, and fiber – all various forms of carbohydrates.<span style="mso-spacerun: yes;"> </span>This number can be even more important than
the calories, as limiting the carbohydrates you take in will naturally also
limit the amount of calories, especially those ‘empty calories’ in the form of
sugar and high fructose corn syrup that is commonly added when fat is removed. <span style="mso-spacerun: yes;"> </span>For instance, you will be surprised to see
that regular plain Greek yogurt will have approximately 8 carbohydrates per
serving, while ‘low fat’ plain Greek yogurt will have approximately 12
carbohydrates! What?!?<span style="mso-spacerun: yes;"> </span>Manufacturers
know that when you take the fat out of a product, it doesn’t taste as good
therefore ‘fat-free’ high calorie sugar is added to make it taste better! Even
worse, when ‘fruit’ is added, it is generally a sugar-based fruit and the
carbohydrate count jumps to 25+grams per serving!<span style="mso-spacerun: yes;"> </span>Best to get regular plain yogurt, cottage
cheese, etc. and add your own fresh or frozen berries or fruit.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Higher carbohydrate foods that should be limited include
most <u>white</u> bread, pasta, rice, and potatoes.<span style="mso-spacerun: yes;"> </span>Even the higher fiber breads and pastas,
brown rice and sweet potatoes are only slightly better than the white form due
to the additional fiber they contain.<span style="mso-spacerun: yes;">
</span>They still have a higher amount of carbohydrates that should be limited
daily.<span style="mso-spacerun: yes;"> </span>The higher the fiber count, the
better it is to eat.<span style="mso-spacerun: yes;"> </span>Carbohydrates in
food are digested and converted into glucose, or sugar, to provide the cells of
the body with energy. Excess carbohydrates in your body can lead to weight gain
and diabetes.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Mot fruits and vegetables are generally low in
carbohydrates, with the exception of apples and bananas.<span style="mso-spacerun: yes;"> </span>You would be astonished to know that one
medium apple or one medium banana has approximately 25 grams of
carbohydrates!<span style="mso-spacerun: yes;"> </span>Best to eat fresh melons,
berries, peaches, oranges, and pears, etc. and watch the canned fruit as there
can be added syrups and juices that add sugary carbohydrates.<span style="mso-spacerun: yes;"> </span>Limit the starchy vegetables like peas and
corn (read the labels) but don’t hesitate to eat most other vegetables freely.<span style="mso-spacerun: yes;"> </span>Did you know that one orange has only 8 grams
carbohydrates, yet that small 4 oz. glass of orange juice has nearly 25 grams?
Avoid most juices in general as they generally have significant amounts of
added sugar (aka carbohydrates).<span style="mso-spacerun: yes;"> </span>If you
want juice, it would be best to use just a splash for flavor into a glass of
water. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
In general, when looking at the label and the carbohydrate
content, if it has more than 20-30 grams of carbohydrates per serving, then use
it in very limited quantities.<span style="mso-spacerun: yes;">
</span>Moderation is always best.<span style="mso-spacerun: yes;"> </span>As a
guideline, keeping your total daily carbohydrate ‘count’ under 100 grams per
day will result in controlling the amount of ‘empty’ sugar calories you take
in.<span style="mso-spacerun: yes;"> </span>Counting your daily carbohydrate
intake is much easier than counting thousands of calories, and as long as you
choose a variety of colorful fruits and vegetables to eat with your meals and
snacks, you will get a well rounded and balanced intake of nutrients. <o:p></o:p></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal">
For those who wish to count the carbohydrates most
effectively, you are able to reduce the number of carbs counted by whatever
fiber count is shown on the label.<span style="mso-spacerun: yes;"> </span>For
instance, a label showing 10 grams carbohydrates that also has 3 grams fiber,
you need to count only 7 carbs per serving (10-3=7).<span style="mso-spacerun: yes;"> </span>Fiber is the only carbohydrate that is not
changed by the body to sugar and is eliminated without affecting insulin
levels.<span style="mso-spacerun: yes;"> </span>Technically, fiber is considered
a carbohydrate even though it is not digested and it provides no calories.<span style="mso-spacerun: yes;"> </span>Fiber is important for heart health, and
getting at least 25 grams of fiber daily is recommended. Most people, however,
need a fiber supplement to get these recommended levels.<span style="mso-spacerun: yes;"> </span><o:p></o:p></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<br /></div>
<ol start="3" style="margin-top: 0in;" type="1">
<li class="MsoNormalCxSpMiddle" style="mso-layout-grid-align: none; mso-list: l1 level1 lfo2; mso-pagination: none; text-autospace: none;"><b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: "Helvetica Neue";">Look for
Saturated and Trans fats <o:p></o:p></span></b></li>
</ol>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal">
Look for products with the lowest amounts of saturated and
trans fats per serving.<span style="mso-spacerun: yes;"> </span>For the past
years, consumers have been told ‘low fat’ was best and with the added
carbohydrates in place of the fat in most products, people have been eating
more sugar, more refined carbs and processed foods instead, which has made the
world sicker and fatter.<span style="mso-spacerun: yes;"> </span><o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
When reading labels, the amount of Total Fat, Saturated Fat,
and Trans Fat is listed, as the law requires it.<span style="mso-spacerun: yes;"> </span>No amount of trans fat in the diet is
beneficial. Therefore, when a food label indicates "0 grams of trans
fat," that's ideal. However, even then a product may still have some trans
fat. Manufacturers are allowed to list "0 grams" of trans fat if the
product has less than 0.5 grams of trans fat per serving. Some examples are tub
margarines or peanut butter. Usually this isn't a problem if you eat one or two
servings a day. However, if you were to eat many servings, this amount of trans
fat may add up.<span style="mso-spacerun: yes;"> </span><o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
In general, go for the ‘good’ fats, like olive and coconut
oil, and don’t hesitate to use higher fat, yet healthy and nutritious foods on
occasion, such as avocados, cheese, eggs, nuts, chia seeds and yogurt.<span style="mso-spacerun: yes;"> </span>Again, moderation is key to healthy living.<o:p></o:p></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<br /></div>
<ol start="4" style="margin-top: 0in;" type="1">
<li class="MsoNormalCxSpMiddle" style="mso-layout-grid-align: none; mso-list: l1 level1 lfo2; mso-pagination: none; text-autospace: none;"><b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: "Helvetica Neue";">Watch your
Sodium intake <o:p></o:p></span></b></li>
</ol>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
Sodium (salt) regulates your body’s water levels, which is
especially important for those with heart disease and high blood pressure.<span style="mso-spacerun: yes;"> </span>Sodium is listed on the label in milligrams.
When 1500 milligrams is the general limit for people with heart disease, sodium
can add up quickly. That’s equal to little more than ½ teaspoon of salt!<span style="mso-spacerun: yes;"> </span>A low-sodium food is defined by the Food and
Drug Administration as 140 milligrams or less per serving. This can be a
helpful when deciding if and how a certain product can fit into your healthy
eating plan. Most canned foods and highly processed food are high in sodium so
best to buy frozen and or fresh produce and unprocessed or low-sodium meats.<b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: "Helvetica Neue";"><o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormalCxSpMiddle" style="margin-left: .5in; mso-add-space: auto; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; mso-pagination: none; tab-stops: 11.0pt .5in; text-autospace: none; text-indent: -.25in;">
<!--[if !supportLists]--><b><span style="mso-bidi-font-family: Cambria;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></b><!--[endif]--><b><span style="mso-bidi-font-family: "Helvetica Neue";">Review the Ingredient List<o:p></o:p></span></b></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; tab-stops: 11.0pt .5in; text-autospace: none;">
<br /></div>
<div class="MsoNormal">
All food products have the ingredients list by weight in
decreasing order.<span style="mso-spacerun: yes;"> </span>This means the first
items listed are the primary ingredients with the remainder of the list showing
what is less within.<span style="mso-spacerun: yes;"> </span>This can be very
helpful in determining more information about the food product.<span style="mso-spacerun: yes;"> </span><o:p></o:p></div>
<div class="MsoNormal">
<span style="mso-spacerun: yes;"> </span>--If there are more
preservatives and fillers than identifiable ingredients, this food is likely
highly processed and therefore NOT healthy.<span style="mso-spacerun: yes;">
</span><o:p></o:p></div>
<div class="MsoNormal">
<span style="mso-spacerun: yes;"> </span>--If the list
contains ‘partially hydrogenated oil’ then it still has trans fat despite a
label that may say “0 grams” of trans fat. <o:p></o:p></div>
<div class="MsoNormal">
<span style="mso-spacerun: yes;"> </span>--If sugar or
high-fructose corn syrup is listed before the healthy ingredients then likely
the calories and carbohydrates are from sugar and low in other nutrients.<span style="mso-spacerun: yes;"> </span>Other names for sugar include sucrose,
fructose, glucose, maltose, dextrose, high-fructose corn syrup, corn syrup,
concentrated fruit juice, honey and maple syrup. <o:p></o:p></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; mso-pagination: none; tab-stops: 11.0pt .5in; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="margin-left: .5in; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; mso-pagination: none; tab-stops: 11.0pt .5in; text-autospace: none; text-indent: -.5in;">
<b style="mso-bidi-font-weight: normal;"><span style="mso-bidi-font-family: "Helvetica Neue";">What do I do if there is no
Nutrition Facts label?<o:p></o:p></span></b></div>
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 5"/>
<w:LsdException Locked="false" Priority="10" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Closing"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Signature"/>
<w:LsdException Locked="false" Priority="0" SemiHidden="true"
UnhideWhenUsed="true" Name="Default Paragraph Font"/>
<w:LsdException Locked="false" Priority="0" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="Body Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Message Header"/>
<w:LsdException Locked="false" Priority="11" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Salutation"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Date"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Heading"/>
<w:LsdException Locked="false" Priority="0" SemiHidden="true"
UnhideWhenUsed="true" Name="Body Text 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Block Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Hyperlink"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="FollowedHyperlink"/>
<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Document Map"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Plain Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="E-mail Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Top of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Bottom of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal (Web)"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Acronym"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Cite"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Code"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Definition"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Keyboard"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Sample"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Typewriter"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Variable"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal Table"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation subject"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="No List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Contemporary"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Elegant"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Professional"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Balloon Text"/>
<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Theme"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 9"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="1" QFormat="true"
Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" QFormat="true"
Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" QFormat="true"
Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="46" Name="List Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3"/>
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<div class="MsoNormal">
There are many fresh fruits, vegetables, and other grocery
items that do not always come with nutritional labels.<span style="mso-spacerun: yes;"> </span>A highly recommended online site that will
give you nutritional breakdown of all foods is located at <span style="mso-bidi-font-family: "Helvetica Neue";"><a href="http://www.calorieking.com/">www.calorieking.com</a></span>.<span style="mso-spacerun: yes;"> </span>If you do not use a computer, then seeking a
good nutrition book at your local library or bookstore will help you understand
which foods are the healthy choices.<span style="mso-spacerun: yes;"> </span>As
with most lifestyle changes, the more you read and understand the nutritional
value of healthy foods, the easier it will become. <o:p></o:p></div>
Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com1tag:blogger.com,1999:blog-6784908938259796494.post-4761913257202617122017-12-17T08:08:00.001-08:002017-12-17T08:08:13.101-08:00Memory Care during the Holiday Season<div class="MsoNormal" style="text-align: justify;">
Consider very carefully any
inclination to take your loved one out of their familiar surroundings during
the holidays.<span style="mso-spacerun: yes;"> </span>While it is not always a
problem, it can be.<span style="mso-spacerun: yes;"> </span>Families are tempted
to take their loved one home for a holiday party or dinner.<span style="mso-spacerun: yes;"> </span>Others may want to take them to a holiday
show or out to see the holiday lights.<span style="mso-spacerun: yes;">
</span>Many times this change in their usual environment, away from the
familiar surroundings and the people that they are comfortable with can cause
great distress for them.<span style="mso-spacerun: yes;"> </span>Rev. Bob Davis
who is in the early stages of Alzheimer’s disease wrote in his book <i style="mso-bidi-font-style: normal;">My Journey into Alzheimer’s Disease</i> the
following about different surroundings.<span style="mso-spacerun: yes;">
</span>“Leaving the routine of being around my familiar home, having more
people and excitement around than I am accustomed to, varying my ritual for
taking care of my grooming and health care, being unable to lie down and nap at
my usual times, all brought me to a place of not being able to make the most
basic decisions for myself, not even how to relieve my discomfort.”<span style="mso-spacerun: yes;"> </span>Rev. Davis’ insights are not uncommon.<span style="mso-spacerun: yes;"> </span>You and your family may want to join in the
community's holiday party instead of risking bringing your loved one into an
unfamiliar environment.<o:p></o:p></div>
<div class="MsoNormal" style="text-align: justify;">
Rev. Davis’ wife writes of her
journey with her husband, “live every day to the glory of God.<span style="mso-spacerun: yes;"> </span>Do every bit of good we can do for as long as
we can do it.<span style="mso-spacerun: yes;"> </span>We have prepared for the
worst and we are going to live expecting the best.<span style="mso-spacerun: yes;"> </span>If the worst comes we are ready for it.<span style="mso-spacerun: yes;"> </span>If it doesn’t, we will not have wasted today
worrying about it.”<o:p></o:p></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
Here are some great holiday gift
ideas:<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Easy to remove clothing<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Old time musical tapes: Lawrence Welk, Big
Bands, Kate Smith<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Home video of family members<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Videos of “I Love Lucy” or “The Honeymooners”<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Photo Albums<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Socks<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Tote and handbags<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Scarves<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Magazine subscriptions: National Geographic,
Life<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Puzzles with large pieces<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Memory Wallets: include copies of driver’s
license, photos, union cards, library cards<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Family photos in unbreakable frames.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<i style="mso-bidi-font-style: normal;"><span style="font-size: 9.5pt; mso-bidi-font-size: 10.0pt;">You and your family may want
to join in the Potomac Home’s holiday party instead of risking bringing your
loved one into an unfamiliar environment.”<span style="mso-no-proof: yes;"><o:p></o:p></span></span></i></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="color: maroon; font-family: "Georgia",serif; font-size: 22.0pt; mso-bidi-font-size: 10.0pt;">Alzheimer’s and the Holidays<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
The holidays are upon us, it
should be a joyous wonderful time of the year for you, but without careful
planning and consideration this potential blessing may become a
catastrophe.<span style="mso-spacerun: yes;"> </span>There is much that you can
do to avoid the problems.<span style="mso-spacerun: yes;"> </span>We have put
together some suggestions to help you cope with Alzheimer’s and the Holidays.<o:p></o:p></div>
<div class="MsoNormal" style="text-align: justify;">
First and most important, TAKE
CARE OF YOURSELF!<span style="mso-spacerun: yes;"> </span>If you don’t take care
of yourself at this stressful time both you and your loved one with Alzheimer’s
may suffer.<span style="mso-spacerun: yes;"> </span>If you are tired, frustrated,
without patience, become ill, who will be there for your loved one?<span style="mso-spacerun: yes;"> </span>How do you take care of yourself during this
incredibly busy time? <o:p></o:p></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; tab-stops: .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Join a support group.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>These groups vary so you may want to try out
different groups.<span style="mso-spacerun: yes;"> </span>Some people like
groups that are more educational and offer practical suggestions; others may
want a group that encourages more emotion, venting and sharing.<span style="mso-spacerun: yes;"> </span>You can find a group that will support you in
the way that best fits your need or personality.<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .25in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; tab-stops: .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Ask for help.<span style="mso-spacerun: yes;">
</span>Research shows that families of Alzheimer’s loved one’s are reluctant to
ask for or help or use help, often using less help than professionals would
recommend and using the help too late in the course of the illness to offer
much help.<span style="mso-spacerun: yes;"> </span>Even though you have placed
your loved one in Potomac, you are still carrying a heavy burden.<span style="mso-spacerun: yes;"> </span>Let people help.<span style="mso-spacerun: yes;"> </span>Maybe they can pick up something on your
shopping list.<span style="mso-spacerun: yes;"> </span>Maybe they can sit with
your loved one while you shop or get your hair done. Have them bring a
meal.<span style="mso-spacerun: yes;"> </span>Ask them to sit with your loved
one so that you can miss a visit and tend to<span style="mso-spacerun: yes;">
</span>some of the issues of the holidays and not feel guilty.<o:p></o:p></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; tab-stops: .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Adjust your expectations.<span style="mso-spacerun: yes;"> </span>Remember that elaborate attempts to recreate
past holiday traditions and have the same festive meaningful time as last year;
is almost certainly not realistic.<span style="mso-spacerun: yes;">
</span>Alzheimer’s Disease is progressive and it is likely that your loved one
will remember less this year, will be less able to tolerate holiday excitement
and stimulation and will appreciate less.<span style="mso-spacerun: yes;">
</span>As time passes it becomes increasingly likely that the stimulation of
holiday hustle and bustle, decorations, music and other holiday issues will
cause anxiousness, withdrawal or even difficult behaviors.<span style="mso-spacerun: yes;"> </span>People with Alzheimer’s disease need
simplicity and routine.<o:p></o:p></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; tab-stops: .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Give yourself permission to do only what you can
reasonably manage even though this may be significantly less than in other
years.<span style="mso-spacerun: yes;"> </span>Offer to make a dish for the
holiday meal but not to host it.<span style="mso-spacerun: yes;"> </span><o:p></o:p></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; tab-stops: .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Remember that you don’t have to have long visits
with your loved one.<span style="mso-spacerun: yes;"> </span>We know that people
with<span style="mso-spacerun: yes;"> </span>Alzheimer’s disease have limited
attention spans and difficulty focusing.<span style="mso-spacerun: yes;">
</span>Often they cannot sustain a long visit.<span style="mso-spacerun: yes;">
</span>Short and regular visits may be best for both you and your loved one.<o:p></o:p></div>
<div class="MsoNormal" style="margin-left: .25in; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="margin-left: .25in; mso-list: l0 level1 lfo1; tab-stops: .25in; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]-->Prepare visitors.<span style="mso-spacerun: yes;"> </span>Many of your extended family and friends do
not have your experience and insight into this disease and the current
condition of your loved one.<span style="mso-spacerun: yes;"> </span>Tell them
how he or she has changed and what to expect when they visit.<span style="mso-spacerun: yes;"> </span>Some families have even written letters to
friends and<span style="mso-spacerun: yes;"> </span>family to tell them how
things have changed in the last year and give suggestions on how to visit
successfully.<o:p></o:p></div>
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" Priority="39" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="35" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="10" QFormat="true" Name="Title"/>
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="0" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
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<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
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<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
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<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
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<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
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<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
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<w:LsdException Locked="false" Priority="30" QFormat="true"
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<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
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<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
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<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
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<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
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<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
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<w:LsdException Locked="false" Priority="21" QFormat="true"
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<w:LsdException Locked="false" Priority="31" QFormat="true"
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<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
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Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-39019992301043331452017-11-21T07:18:00.003-08:002017-11-21T07:18:55.933-08:00Evolve at Rye is proud to announce its deficiency-free survey from the state of New Hampshire<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_af4cNpz5djeaBaGjI_ER_A8D-9i6OUMMe_-Yp7rdR7Twh40o8zBxH_cU0e1ZQIhfDguP58kNKA6-RT_JdS41359zTWMPeHAEmSsRNP3oRlIi-v_9517BJDbvHuzTdgv48dVX9ro4Mda2/s1600/GraceGM171001_StateSurvey.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="792" data-original-width="612" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_af4cNpz5djeaBaGjI_ER_A8D-9i6OUMMe_-Yp7rdR7Twh40o8zBxH_cU0e1ZQIhfDguP58kNKA6-RT_JdS41359zTWMPeHAEmSsRNP3oRlIi-v_9517BJDbvHuzTdgv48dVX9ro4Mda2/s320/GraceGM171001_StateSurvey.png" width="247" /></a></div>
<h3 id="yui_3_17_2_1_1511277256638_219" style="color: #1f1f1f; font-family: "Helvetica Neue", Arial, sans-serif; font-size: 20px; letter-spacing: 0.49px; line-height: 1.3em; margin: 0px 0px 0.5em; text-rendering: optimizeLegibility;">
We would like to take the opportunity to personally thank all our incredible staff in achieving a deficiency-free perfect clinical survey conducted by the State of New Hampshire Department of Health and Human Services Bureau of Inspection.</h3>
<blockquote style="color: #363636; font-family: "Helvetica Neue", Arial, sans-serif; font-size: 18px; font-style: italic; letter-spacing: 0.5px; margin: 0px; padding: 0.5em 2.5em; word-wrap: break-word;">
This was a concerted effort by all staff, and we want you to know how proud we are of what you have accomplished. You have been great to work with and we are glad to see you receive this recognition from the state as well. We want it to be known that you consistently deliver excellence and rise to the occasion not just for the state survey, but every day. Anyone can look good for a visitor, but it takes commitment to make it happen each and every day. This is the mark of your professionalism.</blockquote>
<blockquote style="color: #363636; font-family: "Helvetica Neue", Arial, sans-serif; font-size: 18px; font-style: italic; letter-spacing: 0.5px; margin: 0px; padding: 0.5em 2.5em; word-wrap: break-word;">
It is an inspiration to see what a finely tuned team can accomplish when you all pull together. We at EvoLve Senior Living are proud to be associated with a dedicated team such as yours. Your focus and commitment to your work has been constant and unwavering. Your insight and sensitivity towards our residents and guests has now literally set the standard upon which excellence in memory care will be measured in your community.</blockquote>
<blockquote style="color: #363636; font-family: "Helvetica Neue", Arial, sans-serif; font-size: 18px; font-style: italic; letter-spacing: 0.5px; margin: 0px; padding: 0.5em 2.5em; word-wrap: break-word;">
Clearly, each of you have turned challenge into achievement. For that we offer our congratulations, our admiration, and our respect.</blockquote>
<blockquote style="color: #363636; font-family: "Helvetica Neue", Arial, sans-serif; font-size: 18px; font-style: italic; letter-spacing: 0.5px; margin: 0px; padding: 0.5em 2.5em; word-wrap: break-word;">
We realize that sometimes it seems as though we are all just tiny drops of water in a sea of regulatory compliance, but you know, sometimes when a ray of sunshine hits those drops just right, they sparkle…they do sparkle!</blockquote>
<blockquote style="color: #363636; font-family: "Helvetica Neue", Arial, sans-serif; font-size: 18px; font-style: italic; letter-spacing: 0.5px; margin: 0px; padding: 0.5em 2.5em; word-wrap: break-word;">
Thank you for bringing the sparkle to the eyes of EvoLve at Rye.</blockquote>
<blockquote style="color: #363636; font-family: "Helvetica Neue", Arial, sans-serif; font-size: 18px; font-style: italic; letter-spacing: 0.5px; margin: 0px; padding: 0.5em 2.5em; word-wrap: break-word;">
Congratulations on behalf of the owners and partners, </blockquote>
<blockquote style="color: #363636; font-family: "Helvetica Neue", Arial, sans-serif; font-size: 18px; font-style: italic; letter-spacing: 0.5px; margin: 0px; padding: 0.5em 2.5em; word-wrap: break-word;">
Benjamin Pearce</blockquote>
<blockquote style="color: #363636; font-family: "Helvetica Neue", Arial, sans-serif; font-size: 18px; font-style: italic; letter-spacing: 0.5px; margin: 0px; padding: 0.5em 2.5em; word-wrap: break-word;">
CEO | EvoLve Senior Living</blockquote>
<br />
<h4>
For more information visit www.evolveatrye.com or call (603) 379-1898</h4>
Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-44287905046670061152017-11-21T07:13:00.000-08:002017-11-21T07:13:20.578-08:00Feeling a little Guilty?<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "times" , serif; font-size: 11.0pt;">There are few people on earth better equipped with
the natural innate ability to make us feel guilty than our mothers. In our
culture guilt has been instinctively crafted to an art form designed to
influence our behaviors. It is a learned behavior passed on from generation to
generation. Feelings of guilt can be self-inflicted or can be imposed upon us
by other people. When guilt is legitimate, it spurs us to do better. When it is
unwarranted, it only causes anxiety and hinders our ability to make sound
decisions and provide quality care.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "times" , serif; font-size: 11.0pt;">As a parent's care needs increase while they
undergo the natural aging process, the amount of time and energy required of
the caregiver increases exponentially. It is very normal to have feelings of
resentment as demands on our time begin to radically change our daily routines.
Often adult children already have their hands full caring for the needs of
their own children. The average woman in America today will spend more time caring
for her parents than for her children. She is typically 45 to 65-year-old
married female with children at home, in college, or with families of their own
and thus can feel herself sandwiched between two generations. As her parents'
needs for assistance increase over time, she often feels as though she simply
cannot do enough for them. Often she will become frustrated when her efforts to
try to "fix" things that go wrong in her parents life begin to create
conflicts in her own life, and the fixes never seem to last. Ultimately she
begins to feel that she is losing control of her life and realizes that things
that were once routine for her and easily manageable are quickly becoming more
than she can handle. Conflicting priorities can often lead to feelings of
helplessness and guilt that she is not doing anything well. This self-imposed
guilt then becomes her constant companion.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "times" , serif; font-size: 11.0pt;">Others can also impose guilt upon us. Failures in
our elder caring duties, and obligations to our own families can lead to criticism
from those whose opinions we value most. One is never really prepared to accept
responsibilities thrust upon them by their aging parents. Few people understand
the complexities of health problems, insurance coverage, assisted living and
nursing homes, drug plans, Medicare, legal obligations and other senior-related
issues. Caregivers continuously bombarded by these issues are bound to make
mistakes, which will frustrate them even further. Uninformed family members,
and siblings seeking to offer help, often only serve to highlight the primary
caregiver's shortcomings. Just remember, there is nothing out there that you
can't learn, seek out the advice of professionals such as Geriatric Care
Managers, Eldercare Attorneys, local support groups, and the local library.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "times" , serif; font-size: 11.0pt;">Feelings of responsibility set us up for the
probability of occasional feelings of guilt. We must be able to distinguish
between legitimate guilt that motivates us to do better and harmful guilt that
might be undeserved and leave us dispirited.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "times" , serif; font-size: 11.0pt;">Sometimes it might be helpful to write down the
things that make you feel guilty. Examine the underlying reasons and determine
if a solution is within your power. Sometimes compartmentalizing a large
problem into several smaller, issues can make things more manageable.
Constantly fretting over what seems to be an insurmountable responsibility can
only lead to more anguish and more guilt. Tackling and completing a few
problems can give you a sense of accomplishment and build your confidence to
handle those never-ending new surprises as they arise. Consider that your
parent may be feeling guilty because of they are imposing on you, while you are
feeling guilty that you don't have the time to do more.</span><sup><span style="font-family: "times" , serif; font-size: 9.0pt;">1</span></sup><span style="font-family: "times" , serif; font-size: 11.0pt;">
Also, it is never helpful anguish about the past, concentrate on what can be
done now and resist the temptation to allow old conflicts to create guilt
today.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "times" , serif; font-size: 11.0pt;">To determine if the guilt you are feeling is
warranted, ask yourself if you have done everything that is practical and
necessary within your own limitations. What is important is ensuring the
quality of life and meeting the realistic needs of the elderly. It is not your
role to insure everyone's happiness, only your own. Perhaps much of the guilt
comes from thinking that you have more influence than you really do.<o:p></o:p></span></div>
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="10" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="0" SemiHidden="true"
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<w:LsdException Locked="false" Priority="1" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="11" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
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<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
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<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
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<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="1" QFormat="true"
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<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
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<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
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<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
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<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
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<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
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<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
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<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
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<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
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<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
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<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
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<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
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<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
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<w:LsdException Locked="false" Priority="21" QFormat="true"
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<w:LsdException Locked="false" Priority="31" QFormat="true"
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<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
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<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
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<span style="font-family: "times" , serif; font-size: 11.0pt;">Often as the caregiver is pulled in conflicting
directions, she may invite her aging parent to come live with them. Caring for
a loved one at home may not be the best solution for either. Many people have
made promises to each other about their elder care when they are young thinking
the day will never come, but it always does. Often the caregiver struggles to
meet the ever-increasing needs of their loved one at great personal sacrifice.
Be realistic about what level of care that you can safely provide. Financial
resources should be applied before the caregiver themselves begin to weaken.
Often the decision to move out of the home is delayed until a nursing home is
the only option. Consider using the financial resources while she can still
gain some benefit from them in a more social environment. Once the funds are
exhausted, the Medicaid alternative is always available in the nursing home
setting. Many senior living environments can provide the additional cushion of
care for your parent when they really need it. This way professionals can deal
with the issues that may be unfamiliar to you and when you visit your parent,
your time with them can be spent more relaxed. This will help to relieve the
stress that may be building in your relationship, and help to quiet the guilt.<o:p></o:p></span></div>
Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-69513714764199584202017-11-01T06:12:00.001-07:002017-11-01T06:13:48.842-07:00Free Family Guidebook to Making the Move to Senior Living Communities<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMj1OcHLU43ulsZ63iiMKP62DCHTjcgZUl-zPyv4zj3qNWINA1jo8lH8k16RA3WlpyFwktzC-7QgG4kkdrGyyaY3nQ5NTzeB0DE1iOk1_vcHljM_3y6yo3MWPJxmxIQPnoN1Rp2PqTK4rW/s1600/Making+the+Move+Cover.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1600" data-original-width="1044" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMj1OcHLU43ulsZ63iiMKP62DCHTjcgZUl-zPyv4zj3qNWINA1jo8lH8k16RA3WlpyFwktzC-7QgG4kkdrGyyaY3nQ5NTzeB0DE1iOk1_vcHljM_3y6yo3MWPJxmxIQPnoN1Rp2PqTK4rW/s320/Making+the+Move+Cover.png" width="208" /></a></div>
<br />
<br />
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<div class="layoutArea">
<div class="column">
<span style="color: rgb(21.560000% , 30.800000% , 43.120000%); font-family: "avenir"; font-size: 11.000000pt;">A complete family guide to making an informed decision regarding
retirement communities and senior living options. Written by a 36-
year veteran operations expert in Senior Housing and author. Learn
about the different types of facilities, how they are priced, and how
to choose which one is right for your situation. How the isolation
of living at home alone can lead to avoidable health problems, tips
on dealing with guilt, downsizing possessions and coordinating the
</span><span style="color: rgb(21.560000% , 30.800000% , 43.120000%); font-family: "avenir"; font-size: 11.000000pt;">move. Explore nancial resources and understand what Medicare
</span><span style="color: rgb(21.560000% , 30.800000% , 43.120000%); font-family: "avenir"; font-size: 11.000000pt;">and Medicaid cover in senior housing. Finally, learn how to deal
with caregiver stress and burnout and the family member who says
“But I’m not ready yet.” Pragmatic and condensed information without advertising.</span><br />
<span style="color: rgb(21.560000% , 30.800000% , 43.120000%); font-family: "avenir"; font-size: 11.000000pt;"><br /></span>
<span style="color: rgb(21.560000% , 30.800000% , 43.120000%); font-family: "avenir"; font-size: 11.000000pt;">Download the PDF here: <a href="http://www.planetbenja.com/Benjamin_Pearce/iLearn_files/EVSL-Book-MakingTheMove-170929-FINAL.pdf" target="_blank">Free Guidebook to Senior Living</a> </span><br />
<span style="color: rgb(21.560000% , 30.800000% , 43.120000%); font-family: "avenir"; font-size: 11.000000pt;"><br /></span>
<span style="color: rgb(21.560000% , 30.800000% , 43.120000%); font-family: "avenir"; font-size: 11.000000pt;"><br /></span>
</div>
</div>
</div>
Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-26853849548427360012017-10-30T11:31:00.000-07:002017-10-30T11:31:23.137-07:00Shopping Smart to purchase Heart-healthy food<h3>
<span lang="X-NONE">Navigating the grocery store<o:p></o:p></span></h3>
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When shopping at a grocery store, it is best to
circumnavigate the store first, using the outside aisles as a guide to the
better selection of quality food products.<span style="mso-spacerun: yes;">
</span>These areas include the fresh fruits, vegetables, meats, and dairy
sections, avoiding the inner aisles as much as possible where the boxed and
canned items are sold.<span style="mso-spacerun: yes;"> </span>Boxed and canned
items will contain higher amounts of preservatives, including artificial
chemicals and salt, which allows a longer shelf life.<span style="mso-spacerun: yes;"> </span>Watch for expiration dates that are listed on
the label as to when the product will no longer have the proper nutrient or
freshness level and know that the newer products are always stocked behind the
ones about to expire.<span style="mso-spacerun: yes;"> </span>Avoid any opened
or dented cans and boxes as it may have allowed bacteria to enter. <o:p></o:p></div>
<h3>
<span lang="X-NONE">Organic food labeling and GMO<o:p></o:p></span></h3>
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For higher quality food products that will promote good
health, look for the ‘certified organic’ label and which means it is also
‘non-GMO’.<span style="mso-spacerun: yes;"> </span>GMO stands for ‘genetically
modified organisms’ and means the food has been genetically engineered or
changed in some way from the original food source. You can also see the term
“GE foods” (genetically engineered) which means the same as GMO.<span style="mso-spacerun: yes;"> </span>This process of genetically modifying foods
is relatively new to the food industry, as there were no GMO or GE food crops
planted in the US prior to 1994, however, there are now more than 165 million
acres of GMO foods planted each year today.<span style="mso-spacerun: yes;">
</span>It is estimated by the Center for Food Safety that 70-75% of all grocery
store products contain at least one genetically modified ingredient.<a href="applewebdata://1EB520BC-B806-4CC7-990B-987062E2A621#_edn1" name="_ednref1" style="mso-endnote-id: edn1;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span style="font-family: "cambria" , serif; font-size: 12.0pt;">[i]</span></span><!--[endif]--></span></span></a><sup>
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="mso-spacerun: yes;"> </span></i></b></sup>The reason for the growth in
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resistance to pests, along with pesticide use, and more profitable to produce.<o:p></o:p></div>
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<br /></div>
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The problem with GMO / GE foods lies with the health risks
associated with them. Genes are the blueprint for making proteins, therefore a
GMO food will contain new proteins that were not present in the food prior to
its modification.<span style="mso-spacerun: yes;"> </span>Since it is proteins
that are often the basis for allergies and our immune system response, many
scientists have speculated that these altered genetic GMO/GE proteins may be a
source of recent increases in body system inflammatory responses, food
allergies, digestive tract dysfunction, as well as autoimmune disorders. <o:p></o:p></div>
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<br /></div>
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<span style="mso-bidi-font-family: Arial;">Unfortunately,
mandatory labeling laws for GMO or GE foods do not yet exist in the United
States and until such labeling is widely adopted, the only practical way to lower
GMO risks is to select ‘certified organic’ foods.<span style="mso-spacerun: yes;"> </span>Since the U.S. National Organics Program
forbids the use of genetic modification in foods to be certified as organic,
purchasing organic is a great way to lower your exposure to GMO or GE foods.<o:p></o:p></span></div>
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Name="Body Text Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Block Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Hyperlink"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="FollowedHyperlink"/>
<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Document Map"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Plain Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="E-mail Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Top of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Bottom of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal (Web)"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Acronym"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Cite"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Code"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Definition"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Keyboard"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Sample"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Typewriter"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Variable"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal Table"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation subject"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="No List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Contemporary"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Elegant"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Professional"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Balloon Text"/>
<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Theme"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 9"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="1" QFormat="true"
Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" QFormat="true"
Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" QFormat="true"
Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="46" Name="List Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/>
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<a href="applewebdata://1EB520BC-B806-4CC7-990B-987062E2A621#_ednref1" name="_edn1" style="mso-endnote-id: edn1;" title=""><span class="MsoEndnoteReference"><span lang="X-NONE"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span lang="X-NONE" style="font-family: "cambria" , serif; font-size: 12.0pt;">[i]</span></span><!--[endif]--></span></span></span></a><span lang="X-NONE"> http://www.whfoods.org <o:p></o:p></span></div>
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Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com1tag:blogger.com,1999:blog-6784908938259796494.post-16697297362986772222017-10-13T07:49:00.001-07:002017-10-13T08:02:22.351-07:00Why Eating Right can Help you Heal<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjY5UDWcn8sndaKtWZxnJlD6WTK5AS5vuCgu9_yqBpEBsn-CPG311l_DM2hMI_AmxN7vEWt8nJ4qZ6MiUD_-6dgesO4feUW0Q_Uid-3CFKttkGBiGgk91Rea7aUv4PTsafLi7Is0MFa7DgF/s1600/52959069134__77FA52AE-7186-4DF9-8224-15B0EFED78B7.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1600" data-original-width="1200" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjY5UDWcn8sndaKtWZxnJlD6WTK5AS5vuCgu9_yqBpEBsn-CPG311l_DM2hMI_AmxN7vEWt8nJ4qZ6MiUD_-6dgesO4feUW0Q_Uid-3CFKttkGBiGgk91Rea7aUv4PTsafLi7Is0MFa7DgF/s320/52959069134__77FA52AE-7186-4DF9-8224-15B0EFED78B7.JPG" width="240" /></a></div>
<h2>
<span lang="X-NONE">How your body processes and converts food into nutrition<o:p></o:p></span></h2>
<div class="MsoNormal">
Annually the U.S Department of Agriculture and the U.S.
Department of Health and Human Services produce Dietary Guidelines for
Americans,<span style="font-family: "cambria" , serif;"> </span>which offers advice to promote health and to reduce the risk of chronic
diseases through diet and physical activity. One of the basic messages of the
Dietary Guidelines is that nutrient needs should be met primarily through consuming
foods. In certain cases, fortified foods and dietary supplements may be
necessary to provide one or more nutrients that otherwise might be consumed in
less than recommended amounts.<span style="mso-spacerun: yes;"> </span>Foods
that provide an array of nutrients and other compounds, within calorie needs,
that have beneficial effects on health. This is of particular importance for
the older adult with set food habits, who with aging, tends to reduce the
amount of calories consumed. Older adults require a high quality diet with
nutrient-dense foods and beverages. This translates into food choices with
sufficient calories and concentrated nutrients. All vegetables, fruits, whole
grains, fat-free or low-fat milk and milk products, seafood, lean meats and
poultry, eggs, beans and peas (legumes), and nuts and seeds that are prepared
without added solid fats, sugars, starches, and sodium are nutrient-dense.<u> <span style="mso-spacerun: yes;"> </span></u>We are often feeding smaller appetites
that require additional nutrients due to the physiological changes of aging
that can impair nutrient absorption and utilization. <o:p></o:p></div>
<h2>
<span lang="X-NONE">Important Nutrient Needs<span style="font-family: "calibri" , sans-serif; font-size: medium;"> </span>for
Older Adults<o:p></o:p></span></h2>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><i>Protein</i></b>—Protein
is the foundation upon which every living organism is built. The body does not
store amino acids (the building blocks of proteins), so an adequate daily
intake of protein is needed to supply your body with all the 20 major amino
acids.<span style="mso-spacerun: yes;"> </span>Adequate intake of dietary
protein is extremely important for tissue repair and healing, especially in the
older adult.<span style="mso-spacerun: yes;"> </span>Illness, surgery, and
inadequate food intake can result in protein energy malnutrition that can
impair immune function, increase susceptibility to infections, slow wound
healing and increase skin breakdown.<span style="mso-spacerun: yes;"> </span><o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
New evidence indicates that eating peanuts and certain tree
nuts (i.e., walnuts, almonds, and pistachios), which are high in protein,
reduces risk factors for cardiovascular disease when consumed as part of a diet
that is nutritionally adequate and within calorie needs. Because nuts and seeds
are also high in calories, they should be eaten in small portions and used to
replace other protein foods.<span style="mso-spacerun: yes;"> </span><span lang="EN" style="mso-ansi-language: EN;">They are so energy dense and tasty that it
can be easy to eat excessive amounts. </span>Choose unsalted nuts and seeds to
help reduce sodium intake.<span style="mso-spacerun: yes;"> </span><o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
In 2003, FDA allowed the first qualified health claim for
nuts, suggesting that scientific evidence supports that eating 1.5 ounces per
day of most nuts as part of a diet low in saturated fats and cholesterol may
reduce the risk for heart disease.<span style="mso-spacerun: yes;">
</span>Clinical trials with tree nuts have reported favorable reduction in
cholesterol levels, particularly the bad LDL cholesterol that elevates heart
disease risk. This effect has been demonstrated consistently in different
population groups using different study designs and methods.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><i>Carbohydrates and
Fiber </i></b>— Sufficient carbohydrates are needed to protect protein from
being used as an energy source, however it is recommended that carbohydrate
intake is limited to whole-grain high fiber unprocessed foods.<span style="mso-spacerun: yes;"> </span>The refining of whole grains involves a
process that results in the loss of vitamins, minerals, and dietary fiber.<span style="mso-spacerun: yes;"> </span>There are three types of carbohydrates -
sugar, starch and fiber. Both sugar and starch are turned into sugar and since
the body lacks the enzymes needed to digest fiber, it is the only carbohydrate
that doesn’t convert to sugar. <span style="mso-spacerun: yes;"> </span><o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
By limiting your daily intake of low fiber highly refined
carbohydrates, you also limit your sugar intake.<span style="mso-spacerun: yes;"> </span>About 78 million Americans—35 percent of the
U.S. adult population over age 18 —have pre-diabetes, which means that blood
glucose (sugar) levels are higher than normal, but not high enough to be called
diabetes.<span style="font-family: "cambria" , serif;"> </span>Carbohydrates in the form of fiber can be found in a variety of fruits,
vegetables, and whole grain foods.<span style="mso-spacerun: yes;"> </span>Avoid
highly refined grains, as these also can be high in solid fats and added sugars
(e.g., cookies and cakes). <span style="mso-spacerun: yes;"> </span><o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><i>Calcium </i></b>—
As people age, a decrease in calcium absorption occurs. When the body does not
get enough calcium per day, it draws calcium from your bones.<span style="mso-spacerun: yes;"> </span>Bone loss also occurs as part of the normal
aging process, particularly in postmenopausal women due to decreased amounts of
estrogen.<span style="mso-spacerun: yes;"> </span>The elderly population is
especially susceptible to osteoporosis (bone loss) and bone fractures. One out
of every two women and one in four men over age 50 will have an
osteoporosis-related fracture in their lifetime.<span style="font-family: cambria, serif;"> </span>Many factors increase the risk of developing osteoporosis, including
being female, thin, inactive, or of advanced age; smoking cigarettes; drinking
excessive amounts of alcohol; and having a family history of osteoporosis. Supplementation
with calcium plus vitamin D has been shown to be effective in reducing
fractures and falls (which can cause fractures) in institutionalized older
adults. Some good sources of calcium include yogurt, milk, cheese, firm tofu, canned
salmon with bones, spinach, and rhubarb.<span style="mso-spacerun: yes;">
</span><span style="font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><i>Vitamin D </i></b><i>—
</i>Vitamin D is generally referred to as ‘the sunshine vitamin’ as it is
created by our bodies with sun exposure.<span style="mso-spacerun: yes;">
</span>However, recent findings of low Vitamin D levels in many patients lead
some to believe that despite getting at least 20 minutes of sunshine daily and
adequate intake of foods high in Vitamin D, a daily supplementation is
necessary to reach optimum levels.<span style="mso-spacerun: yes;">
</span>Additionally, if your body doesn’t have sufficient precursors in your
skin to convert to Vitamin D, no amount of sunshine will help and
supplementation will be required.<span style="mso-spacerun: yes;"> </span>Recent
research has shown a possible link between Vitamin D supplementation and
lowered risk of dementia, heart failure, diabetic neuropathy, and even
cancer.<span style="mso-spacerun: yes;"> </span>Adequate vitamin D also can help
reduce the risk of bone fractures, especially when taken with calcium
supplementation.<span style="mso-spacerun: yes;"> </span>Some sources of Vitamin
D are vitamin D milk, egg yolk, salmon, tuna fish, and sardines. You can ask
for a simple blood test from your healthcare provider to determine your risk
for Vitamin D deficiency. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Water </i></b>— <span style="mso-bidi-font-style: italic;">Aging adults
are more susceptible to dehydration due to inadequate daily intake of fluids.
The ability to sense ‘thirst’ is reduced and can significantly decrease optimum
fluid intake to cause dehydration.<span style="mso-spacerun: yes;"> </span>By
the time one senses they are thirsty, the body is already dehydrated to a
slight degree so that sensing a feeling of thirstiness is actually a symptom of
dehydration.<span style="mso-spacerun: yes;"> </span>Because our bodies need
water to function normally, when you’re dehydrated you may feel tired, have
trouble concentrating or wind up eating more than usual since our bodies often
misinterpret thirst as hunger.<span style="mso-spacerun: yes;"> </span>Beverages
that contain caffeine or alcohol can be dehydrating, so be sure you drink plenty
of water to offset your coffee or alcohol consumption.<span style="mso-spacerun: yes;"> </span>A minimum of 1500 cc’s / day is recommended
for most adults, but there can be lesser requirements for some patients with
certain medical conditions (like kidney disease). Be sure to consult your
healthcare professional for the amount of fluid you are allowed to consume
daily. <o:p></o:p></span></div>
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Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-3662468316994601052017-10-13T07:47:00.001-07:002017-10-13T07:48:10.885-07:00A new Portrait of Dementia - Brush to Canvas<span style="font-family: "times new roman"; font-size: 12pt;">Evolve at Rye Alzheimer’s residents are creating new portraits of dementia. For many who suffer from Alzheimer’s disease and related dementias, while their short-term memories may be fleeting, their <i>long-term</i> memories are still often intact. Evolve’s activity director Lori Wiswell believes that reaching those long term memories is often a matter of channeling their attention to target familiar images that we all hold onto during our lives. There is a palpable sense of enthusiasm bubbling from Lori “Here at Evolve at Rye we offer a therapeutic, multi-faceted interdisciplinary approach to activities and social and leisure programming,” “Our goal is to provide specialized stimulation to create structure and support in meeting the physical, psychosocial, cognitive and spiritual needs of each resident, in this case it’s through the imagery of art therapy.” Every week art therapy imagery comes to life. The artwork of the Evolve at Rye residents are on display at the community rooms for everyone to enjoy. “We focus on the resident’s wellness and the holistic needs, rather than the losses that the disease causes,” explains Lori. By focusing and building upon remaining abilities, projects such as these can build the confidence of the residents, rather than reminding them of what they may be losing. All program components are designed to provide <i>“failure-free”</i> stimulation according to the cognitive ability of each resident. The intimate homey environment offers unique structure for early and later stage residents separately which enables staff to individualize programming for each resident. “Our programming is designed to provide stimulation within each resident’s capabilities that is confidence building and success oriented,” concluded Lori.</span><span style="font-family: "calibri"; font-size: 18px;"> </span><br />
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<span style="font-family: "calibri"; font-size: 18px;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjui1pJyPnUcZTJMQR_NnfAHctcgA8YiN3TE4fnbLZjFUYabVc9vAkmViusjkpXHg_Swg7nxv9al9e3HKWv1Dxf9Uaog6qOgcmfxxfIm8FDNsZqSzeE7Pybfj7xIM1ZsVL19Pi81Jfuo1us/s1600/IMG_3022.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1600" data-original-width="1200" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjui1pJyPnUcZTJMQR_NnfAHctcgA8YiN3TE4fnbLZjFUYabVc9vAkmViusjkpXHg_Swg7nxv9al9e3HKWv1Dxf9Uaog6qOgcmfxxfIm8FDNsZqSzeE7Pybfj7xIM1ZsVL19Pi81Jfuo1us/s320/IMG_3022.JPG" width="240" /></a></span></div>
<span style="font-family: "calibri"; font-size: 18px;"><span id="goog_2120116498"></span><span id="goog_2120116499"></span></span>Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-27132861719676800542017-09-15T12:48:00.001-07:002017-09-15T12:48:33.306-07:00Dementia is not always Alzheimer's disease<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Dementia is a neurological disorder that affects
your ability to think, speak, reason, remember and move. While Alzheimer's
disease is the most common cause of dementia, many other conditions also cause
these symptoms. Some of these disorders get worse with time and cannot be
cured. Other types can be treated and reversed.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">The three most common forms of dementia are
Alzheimer's disease, vascular dementia and Lewy body dementia. Sometimes, a
person can have more than one of these problems at the same time. You can have dementia without having Alzheimer's disease but everyone with Alzheimer's disease will have dementia.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Alzheimer's disease involves a loss of nerve cells
in the areas of the brain vital to memory and other mental functions. This loss
is associated with the development of abnormal clumps and tangles of protein in
brain cells. The first sign of Alzheimer's disease is usually forgetfulness. As
the disease progresses, it affects language, reasoning and understanding.
Eventually, people with Alzheimer's lose the ability to care for themselves.
The precise cause of Alzheimer's disease is unknown, but risk increases with
age. Ten percent of the population over the age of 65 has Alzheimer's, while
nearly half of the population over 85 has the disease.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Another common form of dementia, vascular dementia
occurs when arteries feeding the brain become narrowed or blocked. The onset of
symptoms usually is abrupt, frequently occurring after a stroke. However, some
forms of vascular dementia progress slowly, making them difficult to
distinguish from Alzheimer's disease. Some people have Alzheimer's and vascular
dementia at the same time. Vascular dementia often causes problems with
thinking, language, walking, bladder control and vision. Preventing additional
strokes by treating underlying diseases, such as high blood pressure, may halt
the progression of vascular dementia.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Lewy body dementia: Has Alzheimer's-like and
Parkinson's-like features. In this form of dementia, abnormal round structures
- Lewy bodies - develop within cells of the midbrain, beneath the cerebral
hemispheres. Lewy body dementia shares characteristics with both Alzheimer's
disease and Parkinson's disease. Like Alzheimer's disease, it causes confusion
and impaired memory and judgment. And it often produces two distinctive
physical signs typical of Parkinson's disease - a shuffling gait and flexed
posture. Lewy body dementia can also cause hallucinations.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Lewy bodies contain a protein associated with
Parkinson's disease, and Lewy bodies often are found in the brains of people
who have Parkinson's disease or Alzheimer's disease. This suggests that the
three ailments are related, or that Lewy body dementia and Alzheimer's or
Parkinson's disease sometimes co-exist in the same person. Some people with
Lewy body dementia have experienced dramatic improvements in symptoms when
treated with Alzheimer's or Parkinson's medications.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Several less common brain disorders also can result
in dementia.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; mso-pagination: none; tab-stops: 11.0pt .5in; text-autospace: none; text-indent: -.5in;">
<!--[if !supportLists]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times; mso-fareast-font-family: Times;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Frontotemporal dementia. Because it affects the
lobes of the brain that are responsible for judgment and social behavior, frontotemporal
dementia can result in impolite and socially inappropriate behavior. Symptoms
of this form of dementia usually appear between the ages of 40 and 65. The
disease seems to run in families.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; mso-pagination: none; tab-stops: 11.0pt .5in; text-autospace: none; text-indent: -.5in;">
<!--[if !supportLists]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times; mso-fareast-font-family: Times;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Huntington's disease. Symptoms of this hereditary
disorder typically begin between the ages of 30 and 50, starting with mild
personality changes. As the disorder progresses, a person with Huntington's
develops involuntary jerky movements, muscle weakness and clumsiness. Dementia
commonly develops in the later stages of the disease.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; mso-pagination: none; tab-stops: 11.0pt .5in; text-autospace: none; text-indent: -.5in;">
<!--[if !supportLists]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times; mso-fareast-font-family: Times;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Parkinson's disease. People with Parkinson's
disease may experience stiffness of limbs, shaking at rest (tremor), speech
impairment and a shuffling gait. Some people with Parkinson's develop dementia
late in the disease.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-layout-grid-align: none; mso-list: l0 level1 lfo1; mso-pagination: none; tab-stops: 11.0pt .5in; text-autospace: none; text-indent: -.5in;">
<!--[if !supportLists]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times; mso-fareast-font-family: Times;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Creutzfeldt-Jakob disease. This extremely rare and
fatal brain disorder belongs to a family of human and animal diseases known as
the transmissible spongiform encephalopathies. A new variety of
Creutzfeldt-Jakob disease has emerged - particularly in Great Britain. It's believed
to be linked to the human consumption of beef from cattle with mad cow disease
(bovine spongiform encephalopathy).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Many other conditions, some reversible, can cause
dementia or dementia-like symptoms.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; mso-pagination: none; tab-stops: 11.0pt .5in; text-autospace: none; text-indent: -.5in;">
<!--[if !supportLists]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times; mso-fareast-font-family: Times;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Reactions to medications. Some medications have side
effects that mimic the symptoms of dementia. A single medicine may trigger such
a reaction in an older person or in someone whose liver fails to eliminate the
drug properly. Interactions among two or more drugs may lead to reversible
symptoms of dementia as well.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; mso-pagination: none; tab-stops: 11.0pt .5in; text-autospace: none; text-indent: -.5in;">
<!--[if !supportLists]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times; mso-fareast-font-family: Times;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Metabolic abnormalities. Decreased thyroid function
(hypothyroidism) can result in apathy, depression or dementia. Hypoglycemia, a
condition in which there isn't enough sugar in the bloodstream, can cause
confusion or personality changes. Pernicious anemia - an impaired ability to
absorb vitamin B-12 - also can cause personality changes.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; mso-pagination: none; tab-stops: 11.0pt .5in; text-autospace: none; text-indent: -.5in;">
<!--[if !supportLists]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times; mso-fareast-font-family: Times;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Nutritional deficiencies. Chronic alcoholism can
result in deficiencies of thiamin (vitamin B-1), which can seriously impair
mental abilities. Severe deficiency of vitamin B-6 may lead to pellagra, a
neurological illness with features of dementia. Dehydration also can cause
confusion that may resemble dementia.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; mso-pagination: none; tab-stops: 11.0pt .5in; text-autospace: none; text-indent: -.5in;">
<!--[if !supportLists]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times; mso-fareast-font-family: Times;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Emotional problems. The confusion, apathy and
forgetfulness associated with depression are sometimes mistaken for dementia,
particularly in older individuals.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-layout-grid-align: none; mso-list: l1 level1 lfo2; mso-pagination: none; tab-stops: 11.0pt .5in; text-autospace: none; text-indent: -.5in;">
<!--[if !supportLists]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times; mso-fareast-font-family: Times;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Infections. Meningitis and encephalitis, which are
infections of the brain or the membrane that covers it, can cause confusion,
memory loss or sudden dementia. Untreated syphilis can damage the brain and
cause dementia. People in the advanced stages of AIDS also may develop a form
of dementia.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 11.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<b><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Seek evaluation and treatment</span></b><span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;"><o:p></o:p></span></div>
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UnhideWhenUsed="true" QFormat="true" Name="Body Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Message Header"/>
<w:LsdException Locked="false" Priority="11" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Salutation"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Date"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Heading"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Block Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Hyperlink"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="FollowedHyperlink"/>
<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Document Map"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Plain Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="E-mail Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Top of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Bottom of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal (Web)"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Acronym"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Cite"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Code"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Definition"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Keyboard"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Sample"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Typewriter"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Variable"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal Table"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation subject"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="No List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Contemporary"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Elegant"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Professional"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Balloon Text"/>
<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Theme"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Level 9"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="1" QFormat="true"
Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" QFormat="true"
Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" QFormat="true"
Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="46" Name="List Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
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<span style="font-family: "Times",serif; font-size: 11.0pt; mso-bidi-font-family: Times;">Dementia isn't always due to Alzheimer's. Before
you conclude that a loved one's memory loss and confusion stem from an
irreversible disease process, get a thorough medical evaluation. Even if the
evaluation uncovers no underlying condition that, with treatment, can reverse
dementia, options may be available for easing its symptoms. Knowing the likely
cause of dementia, however, is the essential first step toward managing it.<o:p></o:p></span></div>
Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-56034472756567607762017-07-25T14:59:00.000-07:002017-07-25T14:59:54.602-07:00Finish that Phrase Americana<iframe allowfullscreen="" frameborder="0" height="344" src="https://www.youtube.com/embed/DaiZK5Imq_s" width="459"></iframe>Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com3tag:blogger.com,1999:blog-6784908938259796494.post-82093000572325884212017-07-15T07:52:00.000-07:002017-07-15T07:52:31.631-07:00"Secret Dollars" Veterans Aide and Attendance<div class="s2" style="margin-bottom: 0px; margin-top: 0px;">
<span class="s7"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Elder Law attorneys, have only recently learned how to help clients who may need an important VA benefit available to wartime veterans who may be facing substantial medical and care expenses. A veteran who is confined to their home or needs an assisted living facility care may qualify for benefits. The Department of Veterans Affairs recently reported that the VA is reaching out to veterans and spouses to alert them to an underused benefit called “Aid and Attendance” (A and A). It has been reported by the VA that tens of thousands of veterans across the country may not be receiving the VA disability benefits they are entitled to. One of the VA’s best-kept secrets, which is an excellent potential source of funds for long-term care (either at home or in an assisted living facility) are veteran’s benefits for a non-service connected disability. Most VA benefits and pensions are based on a disability, which was incurred during a veteran’s wartime service. This particular benefit, A and A, is available for individuals who are disabled due to the issues of old age, such as Alzheimer’s, Parkinson’s, multiple sclerosis, and other physical disabilities. For those veterans and widows (ers) who are eligible, these benefits can be a blessing for the disabled individual who is not yet ready for a nursing home. This benefit can be as high as $1,954.00 per month for a married veteran. This money can potentially be used for home healthcare or assisted living facilities. We were shocked to learn that so many veterans may be missing out on this valuable benefit, which they have a legal right to receive. The benefit is not generally used for the cost of nursing home benefits. </span></span></div>
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<span class="s7"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">The pension benefits provided by the Veterans Administration generally fall into two categories: service connected and non-service connected. This article focuses on non-service connected benefits which are available to certain wartime veterans (or their dependents) who are disabled because of a non-service connected condition and who are in financial need due to their unreimbursed medical expenses. Once the veteran’s eligibility requirements are met, a family member may be able to obtain benefits based on his or her status as the veteran’s dependent. </span></span></div>
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<span class="s7"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">There is a specific portion of the pension program, which is of particular importance. This program is “Aid and Attendance” (A and A) and is available to a veteran who is not only disabled, but has the additional requirement of needing the aid and attendance of another person in order to avoid the hazards of his or her daily environment. What that means in English is someone needs to help you to prepare meals, to bathe, to dress and otherwise take care of yourself. </span></span></div>
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<span class="s7"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Under this program, a veteran can receive a maximum of $1,954.00 per month in benefits and a widow or widower can receive up to $1,056.00 as a maximum benefit for A and A for the year 2008. The applicant must be determined to be “permanently and totally disabled”. The applicant does not need to be helpless – he/she need only show that he/she is in need of aid and attendance on a regular basis. Someone who is housebound or in an assisted living facility and over the age of 65 is presumed by the Veterans Administration to be in need of aid and attendance. </span></span></div>
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<span class="s7"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">This particular program does have substantial limitations related to the income and assets that are held by the applicant. It is very important to meet with a knowledgeable veteran’s service officer or an experienced elder law attorney for a pre-filing consultation to determine whether or not you may qualify for this benefit and to review the estate planning work that may be done to assist you in qualifying for this particular benefit. It is very confusing to many individuals in determining what is the countable income that is measured by the Veterans Administration. It may appear on first blush that anyone who has a countable income in excess of $18,000.00 per year is not eligible for this benefit. However, the countable income for veterans’ benefits is determined by taking an individual’s gross income and subtracting from that all of their unreimbursed medical expenses to determine a lower income, which is their income for Veteran Administration purposes. Income for Veteran Administration purposes is the countable income, which is used to determine whether or not a person qualifies. </span></span></div>
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<span class="s7"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">In computing the income of the applicant, certain items can be deducted. Specifically, unreimbursed medical expenses (UMEs) paid by an individual may be used to reduce the applicant’s income. </span></span></div>
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<span class="s7"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Home attendants or aides are an allowable medical expense deduction, as long as that attendant is providing some medical or nursing services for the disabled person. </span></span></div>
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<span class="s7"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">The cost of an assisted living facility, and even part or all of the cost of an independent living facility, can also be an allowable medical deduction to reduce your gross income to a much lower net countable income that may qualify you for veterans’ benefits. To file a claim for this benefit, it is wise to seek the involvement of a trained veteran’s service officer. A Veteran’s Service Officer is critical to the filing of an application with the local VA regional office. It is also important to seek the guidance of an experienced elder law attorney who is familiar with estate planning, disability, Medicaid and veterans’ benefits. An attorney skilled in elder law can provide a veteran and the veteran’s family with appropriate pre-filing consultations to determine the appropriate steps that must be taken to be able to determine if it would be right to apply for this VA benefit. </span></span></div>
Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-69327872744175169272017-01-17T14:59:00.000-08:002017-01-17T14:59:36.679-08:00Is Alzheimer's Care a Tax Deductible Expense?<div class="s6" style="margin-bottom: 11px; margin-top: 0px;">
<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Over the years I have been asked countless times by residents and families "Are the costs associated with the care they receive tax deductible?" While much of the tax code is subject to varied interpretations, and <i>each individual should seek competent advice from their own professionals</i>, it appears that the answer to this question is "likely."</span></span></div>
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<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Section #213 of the publication Selected Federal Taxation Statutes and Regulations states "There shall be allowed as a deduction the expenses paid during the taxable year not compensated for by insurance or otherwise for medical care of the taxpayer, his spouse or a dependent to the extent where that expense exceed 7.5 percent of adjusted gross income." The exact definition of medical care has been further explained in Section 1016 "If an individual in a nursing home or a home for the aged because of his physical condition and the availability of medical care is a principal reason for his presence there, the entire cost of maintenance, including meals and lodging is deductible." The key distinction is the purpose of living there. If it is for personal or family reasons, then only the portion of the cost attributable to medical or nursing cost is deductible. The reason that the deductibility becomes cloudy is that service fees in assisted living facilities bundle the medical care component with room and board, making it difficult to determine or justify what portion of the rent covers the care of the resident. Further, most assisted living facilities go out of their way to advertise that they are not a medical care facility. Officially it is defined as: "Assisted living facilities are a type of living arrangement which combines shelter with various personal support services, such as meals, housekeeping, laundry, and maintenance. Assisted living is designed for seniors who need regular help with activities of daily living (ADLs), but do not need nursing home care." Under this definition the deductibility of costs associated with these facilities may be hard to justify.</span></span></div>
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<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Publication 502 by the Department of the Treasury, Internal Revenue Service entitled Medical and Dental Expenses helps to clarify the question. "You can include in medical expenses the cost of medical care in a nursing home or home for the aged for yourself, your spouse, or your dependents. This includes the cost of meals and lodging in the home if the main reason for being there is to get medical care. Do not include the cost of meals and lodging if the reason for being in the home is personal. You can however, include in medical expenses the part of the cost that is for medical or nursing care." This means that in an assisted living facility, unless the purpose of the stay is to receive medical care, the cost of lodging and meals may not be deductible.</span></span></div>
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<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">However, if the individual is chronically ill, as defined under the section entitled Qualified long-term care services all costs associated with the care and supervision of the individual may be tax deductible subject to the 7.5 percent adjustment. Chronically ill is defined in Publication 502: "A chronically ill individual is one who has been certified by a licensed health care practitioner within the previous 12 months as: 1) Being unable for at least 90 days, to perform at least two activities of daily living without substantial assistance from another individual, due to the loss of functional capacity. Activities of daily living are eating, toileting, transferring, bathing, dressing, and continence or 2) Requiring substantial supervision to be protected from threats to health and safety due to severe cognitive impairment." With the enactment of the Kennedy-Kassebaum bill, the law is now clear. Congress stated clearly that the tax code should provide equal consideration for persons with Alzheimer's disease or other irreversible dementia. The only cloudy area remaining is the fee structure of the facility in which they reside.</span></span></div>
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<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Another important consideration is the entrance fee, lifecare fee or "founder's fee". "You can include in medical expenses a part of the lifecare fee or founder's fee you pay either monthly or as a lump sum under an agreement with a retirement home. The part of the payment you include is the amount properly allocable to medical care." Many of today's assisted living communities charge an entrance or maintenance fee. This fee is intended to cover administrative processing and maintenance of the property, rendering it a non-tax deductible expense according to the Internal Revenue Service.</span></span></div>
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<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Memory Care Units, which are dedicated to caring for people with Alzheimer's disease and related dementia rendering substantial supervision to protect residents from threats to health and safety due to severe cognitive impairment, meet the test. Residents fall under the care of licensed health care practitioners who certify their status. In units specifically designed for the care of those with Alzheimer's disease and related dementia, the care, meals and lodging are in integral part of the complete service plan to constitute "medical care." An entrance fee, if it is intended to cover the cost of the initial assessment, and development of the plan of care for the resident and relates completely to medical care, should qualify it as tax deductible under the definition.</span></span></div>
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<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">What does all this mean? Well, depending upon your personal income, the deductibility of your monthly fees in a special care unit properly qualified can result in an annual after tax savings of between 15 and 20 percent. If you are looking at several different providers offering similar environments and care, this after tax savings could be a deciding factor on who to choose. So it might be more than worth your while to check this out with your accountant or financial advisor prior to making your decision on where to place your loved one.</span></span></div>
Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com2tag:blogger.com,1999:blog-6784908938259796494.post-17678868550565699892016-10-01T13:39:00.000-07:002016-10-01T13:39:23.129-07:00Hidden Liabilities of Home Companions<div class="s6" style="margin-bottom: 11px; margin-top: 0px;">
<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">At-home care using home companions or home health aides is the single largest, yet informal system for the delivery of healthcare services in this country today accounting for an estimated 95% of care delivered. Families that hire caregivers or outside contractors such as home health aides or home companions to perform a variety of services may unknowingly be exposing themselves to a variety of risks that may not be covered through their homeowner's or general liability insurance policies. In addition, as an employer, there are certain tax consequences associated with the employment of a home companion for which they may be unaware.</span></span></div>
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<span class="s7"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Tax Consequences</span></span></div>
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<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Domestic employment practices first received media attention when Attorney General-designate Zoe Baird, was unable to secure what was expected to be a unanimous approval during her January 1993 Senate confirmation hearings due to the failure to pay employment taxes and violation of immigration laws relating to the employment of her domestic help. She was also found to be subject to penalties and fines relating to her employment practices. The Internal Revenue Service requires payroll tax filings by a domestic employer who pays a caregiver more than $1,200 cash wages in a calendar year. These payroll tax obligations may include: Social Security and Medicare Taxes (7.65% of Gross Wages), Federal Unemployment Tax (FUTA), State unemployment and disability insurance taxes levied on the employer, and advance payment of earned income credit for eligible employees. The employer (often the family of the elderly person in need) is required to collect the employee's social security and Medicare taxes. Should the employer fail to collect, they still remain responsible to remit these taxes for the employee. Congress revised the "Nanny Tax" legislation in October 1994, offering employers alternative means to remit the federal payroll taxes for wages paid. This legislation requires employers to disclose the wages paid to household staff on the employer's personal income tax return. Failure to disclose this information will compromise the integrity of your personal tax return. Additionally, there is no statute of limitations on the failure to report and remit federal payroll taxes. You are most likely to be "caught" when a former employee files for unemployment, disability or social security benefits. The state then realizes that the person was receiving unreported compensation. Employers are generally required to pay back taxes, penalties and interest charges, and usually professional fees for an accountant and/or attorney. Employers are required to give their employee a wage and tax statement (Form W-2) no later than January 31.</span></span></div>
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<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Additionally, domestic employees must be paid at least the Federal minimum wage, currently $5.15 (9/1/97). Live-in employees must be paid for every hour worked; all employees must be paid overtime for any hours exceeding 40 hours per week. If the person lives on site then the Department of Labor assumes 8 hours sleeping or 16 hours working per day, or 112 hours per week. Since anything in excess of 40 hours per week is required to be paid at time and one half, this situation would result in 72 weekly hours of overtime. This translates to $2,600 per month for 24-hour coverage, not including loading for payroll taxes, which is comparable to the cost of assisted living. For a live-in, fair value of room and board can be deducted from straight pay. Failure to observe employment regulations relating to the payment overtime can subject the employer to multiple damages for the unpaid amounts. Also you are legally required to verify your candidate's employment eligibility under immigration laws using Form I-9.</span></span></div>
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<span class="s7"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Insurance</span></span></div>
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<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">While most home health agencies normally carry comprehensive general liability insurance and professional liability insurance each with separate limits of $1 million per occurrence, and workers compensation insurance, most independent home companions do not. This means that if the home companion that you hired is injured on the job while providing care for your family member you may be liable personally for their injury. New Jersey is one of several states that take the decision for workers' compensation insurance out of your hands by mandating the coverage. Prices vary, but a typical policy costs around $400 for employees making at least $15,000 annually. A typical back injury, which is very common among caregivers, can easily reach $50,000 in medical expenses and lost wages. If the injury results in a disabling condition the employer may be liable for long-term loss of income. Additionally, should there be no workers' compensation insurance in place, the injured caregiver's remedy could entail a law suit against the employer claiming negligence, and typical homeowners policies will not cover any injury to an employee. Be aware that experience among employers has proven that, caregivers tend to have a high incidence of injuries when they realize that their employment may be coming to an end.</span></span></div>
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<span class="s7"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Personnel Screening</span></span></div>
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<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">It is estimated that over 2 million older adults are mistreated each year in the United States. Elder mistreatment first gained attention as a medical and social problem about 20 years ago, when the term "granny battering" first appeared in a British medical journal. The American Medical Association defines elder mistreatment as "an act or omission, which results in harm or threatened harm to the health or welfare of an elderly person." Recognizing mistreatment is often very difficult. The older adult may be unable or unwilling to provide information due to a cognitive impairment or out of fear of retaliation by the abuser. Older adults are often fearful of being placed in a nursing home, and some may prefer to be abused in their own home rather than moved to such a facility. The elderly have been found to be taken advantage of, stolen from, verbally and even physically abused. Most states now require employers to perform a criminal offender record information check prior to providing employment to caregivers. This is a simple procedure that is often overlooked by families hiring home companions. Often these individuals are available for employment because they failed the screening process and were unable to secure full time employment due to past employment difficulties. It is also important to verify the status of your companion's certification, and if they are qualified or trained to provide the services that the elderly person requires. Many home companions may be forced to provide treatments or medication administration that is not permitted by state law under their license simply because there is no one else available to provide it.</span></span></div>
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<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Understanding your liability exposure when employing independent home care companions can be a complex task. While the access to this apparently inexpensive pool of help for an aging parent may at first glance be an attractive option for many families seeking to help their aging parents remain at home, the ultimate risks to the family could be devastating. Further, as the level of care increases over time, it is often much less expensive and more advantageous to seek healthcare professionals to deliver this care in a safe, homelike environment where the quality of life can be very high.</span></span></div>
Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-53455818124477993802016-07-31T05:09:00.001-07:002016-07-31T05:09:31.128-07:00Quiet the Guilt<h2><span style="font-size: 17px; -webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Feeling a Little Guilty?</span></h2><p class="s6" style="margin-top: 0px; margin-bottom: 11px;"><span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">There are few people on earth better equipped with the natural innate ability to make us feel guilty than our mothers. In our culture guilt has been instinctively crafted to an art form designed to influence our behaviors. It is a learned behavior passed on from generation to generation. Feelings of guilt can be self-inflicted or can be imposed upon us by other people. When guilt is legitimate, it spurs us to do better. When it is unwarranted, it only causes anxiety and hinders our ability to make sound decisions and provide quality care.</span></span></p><p class="s6" style="margin-top: 0px; margin-bottom: 11px;"><span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">As a parent's care needs increase while they undergo the natural aging process, the amount of time and energy required of the caregiver increases exponentially. It is very normal to have feelings of resentment as demands on our time begin to radically change our daily routines. Often adult children already have their hands full caring for the needs of their own children. The average woman in America today will spend more time caring for her parents than for her children. She is typically 45 to 65-year-old married female with children at home, in college, or with families of their own and thus can feel herself sandwiched between two generations. As her parents' needs for assistance increase over time, she often feels as though she simply cannot do enough for them. Often she will become frustrated when her efforts to try to "fix" things that go wrong in her parents life begin to create conflicts in her own life, and the fixes never seem to last. Ultimately she begins to feel that she is losing control of her life and realizes that things that were once routine for her and easily manageable are quickly becoming more than she can handle. Conflicting priorities can often lead to feelings of helplessness and guilt that she is not doing anything well. This self-imposed guilt then becomes her constant companion.</span></span></p><p class="s6" style="margin-top: 0px; margin-bottom: 11px;"><span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Others can also impose guilt upon us. Failures in our elder caring duties, and obligations to our own families can lead to criticism from those whose opinions we value most. One is never really prepared to accept responsibilities thrust upon them by their aging parents. Few people understand the complexities of health problems, insurance coverage, assisted living and nursing homes, drug plans, Medicare, legal obligations and other senior-related issues. Caregivers continuously bombarded by these issues are bound to make mistakes, which will frustrate them even further. Uninformed family members, and siblings seeking to offer help, often only serve to highlight the primary caregiver's shortcomings. Just remember, there is nothing out there that you can't learn, seek out the advice of professionals such as Geriatric Care Managers, Eldercare Attorneys, local support groups, and the local library.</span></span></p><p class="s6" style="margin-top: 0px; margin-bottom: 11px;"><span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Feelings of responsibility set us up for the probability of occasional feelings of guilt. We must be able to distinguish between legitimate guilt that motivates us to do better and harmful guilt that might be undeserved and leave us dispirited.</span></span></p><p class="s6" style="margin-top: 0px; margin-bottom: 11px;"><span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s5"><span class="bumpedFont15">Sometimes it might be helpful to write down the things that make you feel guilty. Examine the underlying reasons and determine if a solution is within your power. Sometimes compartmentalizing a large problem into several smaller, issues can make things more manageable. Constantly fretting over what seems to be an insurmountable responsibility can only lead to more anguish and more guilt. Tackling and completing a few problems can give you a sense of accomplishment and build your confidence to handle those never-ending new surprises as they arise. Consider that your parent may be feeling guilty because of they are imposing on you, while you are feeling guilty that you don't have the time to do more.</span></span><span class="s7" style="vertical-align: super;"><span class="bumpedFont20">1</span></span><span class="s5"><span class="bumpedFont15"> Also, it is never helpful anguish about the past, concentrate on what can be done now and resist the temptation to allow old conflicts to create guilt today.</span></span></span></p><p class="s6" style="margin-top: 0px; margin-bottom: 11px;"><span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">To determine if the guilt you are feeling is warranted, ask yourself if you have done everything that is practical and necessary within your own limitations. What is important is ensuring the quality of life and meeting the realistic needs of the elderly. It is not your role to insure everyone's happiness, only your own. Perhaps much of the guilt comes from thinking that you have more influence than you really do.</span></span></p><p class="s6" style="margin-top: 0px; margin-bottom: 11px;"><span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Often as the caregiver is pulled in conflicting directions, she may invite her aging parent to come live with them. Caring for a loved one at home may not be the best solution for either. Many people have made promises to each other about their elder care when they are young thinking the day will never come, but it always does. Often the caregiver struggles to meet the ever-increasing needs of their loved one at great personal sacrifice. Be realistic about what level of care that you can safely provide. Financial resources should be applied before the caregiver themselves begin to weaken. Often the decision to move out of the home is delayed until a nursing home is the only option. Consider using the financial resources while she can still gain some benefit from them in a more social environment. Once the funds are exhausted, the Medicaid alternative is always available in the nursing home setting. Many senior living environments can provide the additional cushion of care for your parent when they really need it. This way professionals can deal with the issues that may be unfamiliar to you and when you visit your parent, your time with them can be spent more relaxed. This will help to relieve the stress that may be building in your relationship, and help to quiet the guilt.</span></span></p>Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0tag:blogger.com,1999:blog-6784908938259796494.post-37248374303183341452016-06-18T06:39:00.000-07:002016-06-18T06:39:13.399-07:00Financial Resources for Assisted Living<div class="s7" style="margin-bottom: 11px; margin-top: 0px;">
<span class="s6"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Today's seniors enjoy a life expectancy longer than any generation in history. An American who turned 65 in 1998 could expect to live nearly another 18 years beyond their 65th birthday. And while additional years are generally considered a blessing, it is also true that the older one grows, the more likely it is that they will need health care services. Today's seniors, who often consider themselves among the best informed, would do well to learn about three crucial areas that pertain to their future health care needs: the potential that they may need long term care, the cost of long term care and the limited federal and state aid available.</span></span></div>
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<span class="s6"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">According to a study by the Agency for Health Care Policy and Research, more Americans than ever will expect to utilize some type of long term care during the remainder of their lives. And with the number of people over age 65 expected to grow to 20 percent of the U.S. population by 2030, there is little doubt that demand for long term care services is poised to increase dramatically.</span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s6"><span class="bumpedFont15">Long term</span></span><span class="s6"><span class="bumpedFont15"> care services have evolved dramatically over the past several years. The majority of </span></span><span class="s6"><span class="bumpedFont15">long term</span></span><span class="s6"><span class="bumpedFont15"> care was once provided only in skilled nursing homes, long term care services today are provided in a wide range of settings, ranging from in-home care to community-based facilities such as adult day care and assisted care facilities to nursing homes. The cost of long term care can be significant, regardless of the setting in which it is provided. The average cost of a nursing home nationally is approximately $70,000 a year, and home care costs can reach up to $300 a day.</span></span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s8" style="font-weight: bold;"><span class="bumpedFont15">Medicare</span></span><span class="s6"><span class="bumpedFont15"> and </span></span><span class="s8" style="font-weight: bold;"><span class="bumpedFont15">Medicaid</span></span><span class="s6"><span class="bumpedFont15"> provide only limited help for nursing home care. </span></span><span class="s8" style="font-weight: bold;"><span class="bumpedFont15">Medicare</span></span><span class="s6"><span class="bumpedFont15"> is our Nation's basic health insurance program for people 65 and older, regardless of their income, who qualify for Social Security benefits. Medicare has two Parts: Hospital insurance (Part A) which helps pay for inpatient hospital care and certain follow-up services; and Medical Insurance (Part B) which helps pay for doctors' services, outpatient hospital care, home health care, hospice and other medical services. </span></span><span class="s8" style="font-weight: bold;"><span class="bumpedFont15">Medicare</span></span><span class="s6"><span class="bumpedFont15"> only pays for the first 20 days in a skilled nursing facility - and only after a hospital stay of three days or more. The patient or their family pays the first $99 per day from the 21st day through the 100th day, after which Medicare pays nothing. </span></span><span class="s8" style="font-weight: bold;"><span class="bumpedFont15">Medicaid</span></span><span class="s6"><span class="bumpedFont15"> rules vary from state to state, but as former U.S. Senator David Durenburger told the U.S. Senate Special Committee on Aging, Medicaid "dictates that people must effectively impoverish themselves in order to receive government assistance." </span></span><span class="s8" style="font-weight: bold;"><span class="bumpedFont15">Medicaid</span></span><span class="s6"><span class="bumpedFont15"> is essentially medical aide for those who have already spent down their assets.</span></span></span></div>
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<span class="s9" style="font-weight: bold;"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Medicaid Waiver Programs</span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s6"><span class="bumpedFont15">Under Section 1915(c) of the Social Security Act, </span></span><span class="s8" style="font-weight: bold;"><span class="bumpedFont15">Medicaid </span></span><span class="s6"><span class="bumpedFont15">law authorizes the Secretary of the U.S. Department of Health and Human Services to waive certain Medicaid statutory requirements. These Medicaid Waiver programs enable States to cover a broad array of home and community-based services (HCBS) for targeted populations as an alternative to institutionalization. Waiver services may be optional State Plan services which either </span></span><span class="s6"><span class="bumpedFont15">are</span></span><span class="s6"><span class="bumpedFont15"> not covered by a particular State or which enhance the State's coverage. Waivers may also include services not covered through the State Plan such as respite care, environmental modifications, or family training. To be a waiver participant, an individual must be medically qualified, certified for the waiver's institutional level of care, choose to enroll in the waiver as an alternative to institutionalization, cost Medicaid no more in the community under the waiver than he or she would have cost Medicaid in an institution, and be financially eligible based on their income and assets. In addition, most Assisted Living Communities that do participate in the waiver program allocate only assisted living apartments for this not dementia units in their special care unit. Also Medicaid will only pay for a semi-private room, so they may need to double up with a </span></span><span class="s6"><span class="bumpedFont15">room mate</span></span><span class="s6"><span class="bumpedFont15">. They may however receive supplementation from their family or from an irrevocable trust to cover the cost of an upgrade to a private room. Those assisted living communities who do participate in the program offer it first to their existing residents and normally require two years of private pay to even be considered for it. Also remember that since </span></span><span class="s6"><span class="bumpedFont15">February,</span></span><span class="s6"><span class="bumpedFont15"> 2006 the look back period for Medicaid was lengthened to five years. Though 38 states pay for some assisted living, the programs are miniscule, covering fewer than 100,000 poor people, so waiting lists are long. Medicare covers home care, but just 100 visits in the weeks following a hospital stay. Contact your state Department of Health and Senior services to learn more about waiver programs.</span></span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s6"><span class="bumpedFont15">The White House recently authorized Medicare coverage for the treatment of Alzheimer's disease. This means that Medicare beneficiaries can now receive reimbursement for mental health services that were formerly denied because the government rationalized that people with the disease did not respond to mental and physical therapy; this has since been proven incorrect, hence the reversal of their position. </span></span><span class="s8" style="font-weight: bold;"><span class="bumpedFont15">Medicare</span></span><span class="s6"><span class="bumpedFont15"> was never intended to cover the costs associated with custodial care, which is room and board, and activities of daily living, and these coverage changes still do not reimburse for this, further </span></span><span class="s8" style="font-weight: bold;"><span class="bumpedFont15">Medicare</span></span><span class="s6"><span class="bumpedFont15"> requires a three-day prequalifying hospital stay before they pay for care in a nursing home. Medicare covers certain care procedures, and some limited rehabilitation therapies. The physicians who visit our homes are all Medicare certified providers, so </span></span><span class="s6"><span class="bumpedFont15">the cost of their visits is often covered by Medicare</span></span><span class="s6"><span class="bumpedFont15">, subject to the co-payment.</span></span></span></div>
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<span class="s9" style="font-weight: bold;"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Veteran's Benefits</span></span></div>
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<span class="s6"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Veterans and surviving spouses may be entitled to V.A. Aid and Attendance.</span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s11" style="text-decoration: underline;"><span class="bumpedFont15">To Qualify</span></span><span class="s6"><span class="bumpedFont15">: The Veteran must have been "honorably" discharged. The Veteran must have served at least 90 days, 1 day during wartime. Individual must be over age 65, or permanently and totally disabled.</span></span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s11" style="text-decoration: underline;"><span class="bumpedFont15">Income qualifications to Determine Eligibility</span></span><span class="s6"><span class="bumpedFont15">: The gross household income less out-of-pocket </span></span><span class="s6"><span class="bumpedFont15">medical expenses (including AL, skilled care or home care) is</span></span><span class="s6"><span class="bumpedFont15"> the income counted by the V.A. -- V.A. will not pay benefits if income is GREATER than the Maximum Available Pension Resource (MAPR).</span></span></span></div>
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<span class="s11" style="text-decoration: underline;"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Limits on Net Worth</span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s12">• </span><span class="s6"><span class="bumpedFont15">Couple: About $80,000</span></span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s12">• </span><span class="s6"><span class="bumpedFont15">Single (Veteran or Surviving Spouse): About $40,000</span></span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s11" style="text-decoration: underline;"><span class="bumpedFont15">Maximum Monthly Payout</span></span><span class="s6"><span class="bumpedFont15"> (Subject to change)</span></span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s12">• </span><span class="s6"><span class="bumpedFont15">Single Veteran: $1644</span></span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s12">• </span><span class="s6"><span class="bumpedFont15">Married Veteran: $1949</span></span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s12">• </span><span class="s6"><span class="bumpedFont15">Surviving Spouse of a Veteran: $1056</span></span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s11" style="text-decoration: underline;"><span class="bumpedFont15">Exempt Assets</span></span><span class="s6"><span class="bumpedFont15">: Primary Residence, Car, Term Life Insurance and Certain Investments (in payout status)</span></span></span></div>
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<span class="s14" style="font-style: italic;"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">The cash value of life insurance is countable.</span></span></div>
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<span class="s6"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">If assets exceed the allowable amount, this is where a good Elder Attorney comes in to play, i.e., sets up a trust and moves assets to a trust, thereby meeting the asset qualification thresholds.</span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s11" style="text-decoration: underline;"><span class="bumpedFont15">Have the right documents in hand before calling the V.A.</span></span><span class="s6"><span class="bumpedFont15">: Veteran's Honorable Discharge: DD-214 or 53-55 • Marriage Certificate and Death Certificate (if applicable)</span></span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s6"><span class="bumpedFont15">For more information on Veterans programs or to see if you qualify for the VA Aide and Attendance benefit contact Yale Hauptman, elder law attorney at </span></span><a href=""><span class="s15" style="text-decoration: underline;"><span class="bumpedFont15">www.hauptmanlaw.com</span></span></a></span></div>
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<span class="s14" style="font-style: italic;"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Prepared 2-18-11 (Consult the Veteran's Administration on benefit and qualifications).</span></span></div>
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<span class="s9" style="font-weight: bold;"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Long-term Care Insurance</span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s6"><span class="bumpedFont15">Long-term care insurance is one other way you may pay for long-term care. This type of insurance will pay for some or all of your care depending upon the benefit amount and the setting. Many newer policies feature endorsements to cover costs of home health care and assisted living. The Health Insurance Portability and Accountability Act of 1996, or HIPAA, gives some federal income tax advantages to people who buy certain long-term care insurance policies. These Tax-qualified policies offer deduction of premiums, and other benefits. One national study</span></span><span class="s16" style="vertical-align: super;"><span class="bumpedFont20">1</span></span><span class="s6"><span class="bumpedFont15"> projecting nursing home use noted: "Of the approximately 2.2 million persons who turned 65 in 1990, more than 900,000 (43%) are expected to enter a nursing home at least once before they die." The same study reported that 1 in 3 will spend three months or more in a nursing home and 1 in 4 will spend a year or more. Many seniors opt to purchase a policy with a benefit amount that covers a portion of the expected monthly costs so as to hedge their expected use. Insurer rating services such as </span></span><a href=""><span class="s15" style="text-decoration: underline;"><span class="bumpedFont15">www.ambest.com</span></span></a><span class="s6"><span class="bumpedFont15"> can help to compare insurer's financial strength and offerings, or you can check for free at your local public library. Seniors who purchase these policies early will pay dramatically lower premiums then those who wait until they are 60 or older.</span></span></span></div>
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<span class="s9" style="font-weight: bold;"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">FHA/HUD HECM Reverse Mortgage Program</span></span></div>
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<span class="s6"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">A reverse mortgage is a home loan taken against the equity one has amassed in their home. Unlike conventional mortgages or home equity loans, the FHA/HUD HECM reverse mortgage currently allows homeowners over the age of 62 to borrow some of their home equity (a percentage of the appraised value of the home with a maximum home value of up to $625,500) with no income or credit score requirement and never have to repay it as long as one of the borrowers resides in the home. Eligible properties are 1-4 family homes, FHA approved Condominiums and PUD's.</span></span></div>
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<span class="s6"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Borrowers can receive funds in a lump sum, as a line of credit or get monthly payments every month. There are no restrictions on what the funds are to be used for and the payments are not considered income so they generally do not affect social security, Medicare and in some States can even be used in conjunction with Medicaid.</span></span></div>
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<span class="s6"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">These loans are very safe, as there is no personal liability. The most one can ever owe is the appraised value of the home when the last borrower permanently leaves the home. In order to assure that homeowners are doing the right thing, FHA requires that borrowers attend a "Counseling" session with a FHA approved counselor before they can apply for a HECM reverse mortgage.</span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s6"><span class="bumpedFont15">Wells Fargo is the leading national reverse mortgage lender and a local specialist can be found at </span></span><a href=""><span class="s15" style="text-decoration: underline;"><span class="bumpedFont15">www.reversemortgageguru.net</span></span></a></span></div>
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<span class="s9" style="font-weight: bold;"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Medications</span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s6"><span class="bumpedFont15">The Pharmaceutical Assistance to the Aged & Disabled (PAAD) program helps eligible New Jersey residents pay for prescription drugs, insulin, insulin needles, certain diabetic testing materials and syringes and needles for injectable medicines used for the treatment of multiple sclerosis. Only drugs approved by the Food and Drug Administration are covered. Drugs purchased outside the State of New Jersey are not covered, nor is any pharmaceutical product whose manufacturer has not agreed to provide rebates to the State of New Jersey. You are eligible for </span></span><span class="s8" style="font-weight: bold;"><span class="bumpedFont15">PAAD</span></span><span class="s6"><span class="bumpedFont15">, </span></span><span class="s8" style="font-weight: bold;"><span class="bumpedFont15">Lifeline</span></span><span class="s6"><span class="bumpedFont15">, or </span></span><span class="s8" style="font-weight: bold;"><span class="bumpedFont15">HAAAD</span></span><span class="s6"><span class="bumpedFont15">if you meet the following requirements: You are a New Jersey resident; your total income for 2009 is less than $24,432 if you are single and less than $29,956 if you are married; and you are at least 65 years of age, OR at least 18 years of age and receiving Social Security Disability benefits. PAAD will also pay up to $225 per year for a participant's heating bill. Call <a href="tel:(800)%20792%209745" x-apple-data-detectors-result="6" x-apple-data-detectors-type="telephone" x-apple-data-detectors="true">(800) 792 9745</a> for more information.</span></span></span></div>
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<span class="s6"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">The Senior Gold program is also available to assist with the cost of prescription drugs. The senior pays $15 plus half of the remaining cost of the prescription. The income limit to access this program for an individual is $34,432 or for a married couple its $39,956. Call <a href="tel:(800)%20792%209745" x-apple-data-detectors-result="7" x-apple-data-detectors-type="telephone" x-apple-data-detectors="true">(800) 792 9745</a> for more information.</span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s6"><span class="bumpedFont15">The Pharmaceutical Research and Manufacturers of America (</span></span><span class="s8" style="font-weight: bold;"><span class="bumpedFont15">PhRMA</span></span><span class="s6"><span class="bumpedFont15">) maintains a directory of programs that provide drugs to physicians whose patients cannot otherwise afford them. For more information on this program call <a href="tel:(800)%20762-4636" x-apple-data-detectors-result="8" x-apple-data-detectors-type="telephone" x-apple-data-detectors="true">(800) 762-4636</a>.</span></span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s6"><span class="bumpedFont15">Walmart Pharmacy has recently instituted a prescription plan for just $4.00. The list of eligible drugs in the $4 Prescriptions Program — available at Walmart, Neighborhood Market and Sam's Club pharmacies nationwide — represents up to 95 percent of the prescriptions written in the majority of therapeutic categories. The affordable prices for these prescriptions are available for commonly prescribed dosages for up to 30-day or 90-day supplies. Ask your pharmacist or physician about switching to 90-day prescriptions for appropriate medications. Their extensive list of approved medications can be found at </span></span><a href=""><span class="s15" style="text-decoration: underline;"><span class="bumpedFont15">www.walmart.com/4prescriptions</span></span></a><span class="s6"><span class="bumpedFont15">.</span></span></span></div>
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<span class="s9" style="font-weight: bold;"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Home Repairs</span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s6"><span class="bumpedFont15">The Chore Service helps senior citizens (age 60 and over) and disabled homeowners of all ages remain safe and secure in their homes by performing minor household repairs that they can neither do themselves nor get anyone else to do. </span></span><span class="s6"><span class="bumpedFont15">Services are provided by Chore's crew of 21 volunteer handypersons working as teams with paid drivers</span></span><span class="s6"><span class="bumpedFont15">. There is no charge for Chore's services, but clients are expected to pay for the parts necessary to complete the repair. Call <a href="tel:(201)%20489-7790" x-apple-data-detectors-result="10" x-apple-data-detectors-type="telephone" x-apple-data-detectors="true">(201) 489-7790</a> for more information.</span></span></span></div>
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<span class="s9" style="font-weight: bold;"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Care Management</span></span></div>
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<span class="s6"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">The State Health Insurance Assistance Program, or SHIP, is a national program that offers one-on-one counseling and assistance to people with Medicare and their families. Through federal grants directed to states, SHIPs provide free counseling and assistance via telephone and face-to-face interactive sessions, public education presentations and programs, and media activities. These programs have been very popular to help families decide which Medicare Supplement program is right for them. Call <a href="tel:(201)%20336-7400" x-apple-data-detectors-result="11" x-apple-data-detectors-type="telephone" x-apple-data-detectors="true">(201) 336-7400</a> for more information.</span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s6"><span class="bumpedFont15">Heightened Independence & Progress (</span></span><span class="s8" style="font-weight: bold;"><span class="bumpedFont15">hip</span></span><span class="s6"><span class="bumpedFont15">) has administered two premier Centers for Independent Living in New Jersey for many years - since 1980 in Bergen County and in Hudson County since 1987. Through the years, programs and initiatives have continued to expand. In some situations identical services are provided, while in other instances programs are specific to each </span></span><span class="s6"><span class="bumpedFont15">CIL which</span></span><span class="s6"><span class="bumpedFont15"> may have County boundaries or span the entire state. This program provides up to six months of free care management services. Contact <a href="tel:(201)%20996-9100" x-apple-data-detectors-result="12" x-apple-data-detectors-type="telephone" x-apple-data-detectors="true">(201) 996-9100</a> or </span></span><a href=""><span class="s15" style="text-decoration: underline;"><span class="bumpedFont15">www.hipcil.org</span></span></a><span class="s6"><span class="bumpedFont15"> for additional information.</span></span></span></div>
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<span class="s9" style="font-weight: bold;"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Home Health Care Services</span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s6"><span class="bumpedFont15">Effective January 1, 2009, the Department of Health and Senior Services (DHSS) received approval from the U.S. Centers for Medicare and Medicaid Services to consolidate three Medicaid-supported home and community-based service programs operated by DHSS into a single program known as Global Options (GO) for Long Term Care. The consolidation improves access to a wider range of in-home long-term supportive services for a greater number of seniors and adults with physical disabilities who meet the income, asset and nursing facility level of care requirements established by Medicaid. GO participants have the options to hire and direct their own service providers. GO is designed to supplement – not replace – the assistance already being provided by family, friends and neighbors. By providing a flexible package of services and supports, GO strengthens the ability of caregivers to continue in their vital role as primary support providers. GO participants work with a care manager to create an individualized plan of care based on a comprehensive assessment of the participant's healthcare needs. Once the plan of care is approved, community-based services are put in place and monitored to ensure quality and effectiveness. The GO program essentially replaces the Community Care Program for Elderly and Disabled (CCPED</span></span><span class="s6"><span class="bumpedFont15">) which</span></span><span class="s6"><span class="bumpedFont15"> typically provides a maximum of 5 hours per day; 5 days a week in home care assistance. Participants must demonstrate need for assistance in at least three activities of dailiy livings (ADLs) or have a cognitive impairment. In order to be eligible, financial and clinical criteria must be met. </span></span><span class="s6"><span class="bumpedFont15">Monthly income maximum $2,022, individual assets $2,000.</span></span><span class="s6"><span class="bumpedFont15"> Contact <a href="tel:(877)%20222-3737" x-apple-data-detectors-result="14" x-apple-data-detectors-type="telephone" x-apple-data-detectors="true">(877) 222-3737</a> for additional information.</span></span></span></div>
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<span style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);"><span class="s6"><span class="bumpedFont15">Jersey Assistance for Community Caregiving (JACC).</span></span><span class="s6"><span class="bumpedFont15"> JACC is a State-funded program that provides a broad array of in-home services to enable an individual, at risk of placement in a nursing facility and who meets income and resource requirements, to remain in his or her community home. By providing a uniquely designed package of supports for the individual, JACC delays or prevents placement in a nursing facility. Cost caps are applied to specific services under JACC as well as to the cost per person per month. JACC services are limited to a maximum of $600 per month or $7,200 annually. The service package provided is based on an assessment of the individual's needs, unique care plan, and availability of services and funding. Participants share the cost of care on a sliding scale basis, and must be home bound. There is an asset test for qualification of below $40,000 for an individual, or $60,000 for a couple. Contact <a href="tel:(877)%20222-3737" x-apple-data-detectors-result="15" x-apple-data-detectors-type="telephone" x-apple-data-detectors="true">(877) 222-3737</a> for additional information.</span></span></span></div>
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<span class="s6"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">The NJ Statewide Respite Care Program has been operational since April of 1988. This program provides up to 21 days per year respite care services for elderly and functionally impaired persons age 18 and older to relieve their unpaid caregivers of stress arising from the responsibility of providing daily care. A secondary goal of the program is to provide the support necessary to help families avoid making nursing home placement of their relatives. There is an asset test for qualification of below $40,000 for an individual, or $60,000 for a couple. To reach the Statewide Respite Care Program in your county, call NJEASE toll-free at <a href="tel:1-877-222-3737" x-apple-data-detectors-result="16" x-apple-data-detectors-type="telephone" x-apple-data-detectors="true">1-877-222-3737</a>.</span></span></div>
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<span class="s9" style="font-weight: bold;"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Other Programs</span></span></div>
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<span class="s6"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">The Americans with Disabilities Act (ADA) of 1990 is a civil rights law that protects the rights of people with disabilities. The ADA requires public transportation systems to offer ADA paratransit service to individuals who are unable to use local bus service as a result of their disability. As New Jersey's public transportation provider, NJ TRANSIT has specific guidelines that must be followed in providing ADA paratransit. Access Link is a public transportation service developed to comply with the paratransit regulations of the ADA. Access Link service is comparable to the NJ TRANSIT local fixed route bus system. Access Link is for people with disabilities who are unable to use the local fixed route bus. In order to use Access Link, you must first apply for eligibility. All persons interested in applying for Access Link service are required to attend an in-person transportation assessment interview. To arrange for a transportation assessment appointment, please contact NJ TRANSIT by dialing <a href="tel:1-800-955-2321" x-apple-data-detectors-result="17" x-apple-data-detectors-type="telephone" x-apple-data-detectors="true">1-800-955-2321</a> between the hours of 8:30 a.m. to 5:00 p.m. Monday through Friday.</span></span></div>
Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com3tag:blogger.com,1999:blog-6784908938259796494.post-88732629892170769962016-05-19T09:15:00.000-07:002016-05-19T09:15:15.414-07:00Caregiver Burnout<div class="s6" style="margin-bottom: 11px; margin-top: 0px;">
<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Many family members who find themselves caring for a loved one may be unable to recognize their own limitation before the strains and stress of their care giving activities turn them into a patient as well. This is especially true for someone who started out providing intermittent assistance to someone with simple tasks as shopping, errands, or bill paying who, as their loved one declines ends up providing heavy personal care such as bathing and dressing. Studies have shown recently that nearly 25% of American families are caring for an aging family member, friend or adult child with disabilities. Part of the art of being a successful caregiver in the ability to set expectations, see one’s own limitations and learn to care for ourselves as well as others.</span></span></div>
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<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">In many cases, care giving responsibilities saturate one's life to the extent that we may not even recognize what was once our "normal" routine. The responsibilities for providing care for someone else can become gradually overwhelming as the personal needs of the loved one inevitably increase over time. But burnout isn't like the flu with defined and recognizable symptoms. It creeps up on you gradually over time. You may wake up one morning look into the mirror and not even recognize the person or professional that you once were.</span></span></div>
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<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Symptoms of burnout can have a profound influence on your quality of life. Most caregivers experience a heightened sense of helplessness and depression along with a sense of ongoing and constant fatigue. Care giving activities for others may force a withdrawal from social contacts and friends who are your primary support structure, or even cause you to lose interest in work where you may receive professional validation. Still others may experience a change in eating habits, or an increasing use of stimulants and alcohol. While most people can endure and recover from some of these symptoms, they tend to accumulate over time and increase in severity. Eventually they can have a dramatic impact on the overall health of the caregiver and their ability to effectively provide care for someone else. Ultimately this can lead to a collapse of the "cushion of care" that was originally intended and render the caregiver a patient himself or herself. This can create a cycle of failure, which becomes self-perpetuating.</span></span></div>
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<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Strategies to cope with burnout are critical to maintaining the health of both parties. Acknowledge your emotions and find an outlet for them. Feelings of anxiety, worry, anger, guilt, sadness and resentment are normal, and should be shared with others. Most communities have well-organized networks of support groups. These are groups of people who have experienced similar family crises and have banded together to help one another. Support group meetings such as those sponsored by the Alzheimer's Association provide a monthly forum for caregivers to receive feedback and coping strategies from others in the same predicament.</span></span></div>
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<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Recognize the importance of your own identity, and allocate some personal time for things you enjoy such as exercise, hobbies, other family members, and even some "quiet time." Establish some understandings regarding what an emergency is, and more importantly what is not an emergency requiring your immediate response or interruption. Do not hesitate to say "no" if the problem can wait, someone else's crisis only becomes yours if you accept it. Knowing what things can wait can provide you more control over your life. Also recognize that the more you do for someone, the more dependent they can become. Studies have shown that starting or completing tasks for people can offer more independence for both than doing it all for them "quickly." Try to focus of what abilities remain rather than those that have become lost or difficult. This helps to build confidence, rather than leaving you with the feeling that you can never do enough.</span></span></div>
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<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Don’t allow yourself to get into a rut. Often caregivers can become so wrapped-up in handling one problem after another that they can lose perspective. Varying the responsibilities of the caregiver is a way to stay fresh. If possible rotate tasks between other family members, or look into day care to give yourself some personal time during the day. Most senior living providers also offer respite programs to allow short-term residency while caregivers take a well-deserved rest or vacation. These programs can provide the caregiver some peace of mind in knowing that professionals are looking after Mother or Dad so that the caregiver can relax, recharge and regain their perspective. Respite can also serve to introduce your parents to the concept of assisted living so that they can overcome any fears they might have of living there one day. Once they see that others have made the choice to live there and how their lives and family relationships have improved as a result, they might consider the option for themselves.</span></span></div>
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<span class="s5"><span class="bumpedFont15" style="-webkit-text-size-adjust: auto; background-color: rgba(255, 255, 255, 0);">Recognize that you do not have to do it all. Being a good caregiver doesn't mean that you have to be a martyr. If other family members are giving you direction and advice, then they should share in the burden. Learn to ask for and accept help from others, maintaining a balance in your life will help you avoid future burnout. Take time for yourself to recharge and to nurture your own family and friendships. Make time to protect your own health; you will need it now more than ever.</span></span></div>
Benjamin Pearcehttp://www.blogger.com/profile/01456978989520605849noreply@blogger.com0