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Ariticle Title Submitted By                              Date                          Link
Arthritis-The Whole Picture    Isela Monterrosas   05-22-2019
Arthritis-The Whole Picture
     

 Caregiving Marc Narcus-Kramer    
 Critical Healthcare Contact Care Committee
 







Peer-to-Peer: Senior Travel
June 26, 2019

At the Care Committee’s recent Member-to-Member gathering, many of your fellow villagers chimed in with tips, techniques, and memories of great trips!  We will pass along their collective wisdom here, in hopes that it will help you experience wonderful trips of your own!


Useful Advice
:

  • Travel Light. It makes everything easier, and you can transport luggage yourself.  

     

  • Other countries don’t have the same standards as the U.S. does to ensure easier travel for those with disabilities or mobility issues.

     

  • Have one hand free to hold railings.

     

  • Wear rubber-soled shoes.  Avoid flip-flops and open-toed shoes.  In case of an emergency, it is hard to run in flip-flops or sandals.  You could delay others trying to evacuate an area, and have trouble doing so yourself.

     

  • When boarding planes and trains, or in hotels, note where the exits are.

     

  • Understand the rigors of your trip before you go.

     

  • Try to learn the language before you go, and make yourself familiar with traffic signs.

     

  • Some countries will not allow you to rent a car if you are age 70 or older.

     

  • Research the travel companies you’re considering before you go.

     

  • Get “outside” insurance—not that offered by the tour company.
  • One Villager highly recommends Travel Guard, having had an exceptionally good experience with them.  Some travel rewards credit cards offer insurance.  American Express will cover lost luggage, up to a certain amount.

     

  • American Express has a conversion fee for currency; Capital One does not.

    One Villager advises NOT to use an ATM from Bank Paribas, due to exorbitant exchange rates.

     

  • Avoid Deep Vein Thrombosis (DVT) when traveling, by walking, stretching, or pumping your feet.

     

  • Stay hydrated.

     

  • Carry your own favorite empty water bottle through TSA.

     

  • Bring your own snack foods.  They will have less salt and carbs than the airline meals or snack boxes.

     

  • Beware of non-bottled water in foreign countries-it may be contaminated. Produce washed in tap water may be used in salads, and tap water may have been used for ice cubes in your drinks.

     

  • Small hotels and Bed and Breakfasts rarely have grab bars in showers, or non-slip shower mats. Travel with a portable grab bar. Cut a standard shower mat in half, and take it with you.  Wet towels and non-slip drawer liners also work in place of a shower mat.

Some good trips Villagers have taken

  • River cruises
  • Parker Villa Rentals—accomodations in Italy.
  • Sky Auction—good deals online.
  • Any trip with a direct flight from San Diego, such as British Airways, Japan Airlines, and Lufthansa.  It was noted that Japan is easy to navigate.
  • Princess Cruises has great service.
  • Costa Rica is highly recommended.
  • Tour Companies that were recommended included:
  • Classic Journeys, of La Jolla.  All meals and a local tour guide are included.  The hotels are 5-Star, and groups are no more than 12 people.
  • Smithsonian Tours: You learn from experts.  Their tour guides are top-notch.
  • Road Scholar Tours
  • Tauck Tours

Other Tips:  

  • If you see a unique tour offering, take it!  That itinerary may not be offered again.

     

  • Many posters in Europe advertise free events.  They often turn out to be the most memorable experiences.  You may also google events in your destination city before you go.

     

  • Posters from grocery stores make great (and affordable) souvenirs.

     

  • Go someplace you’ve never been.  Meet the people—it will change your view of the world.

Arthritis is very common but is not well understood. Actually, "arthritis" is not a single disease; it is an informal way of referring to joint pain or joint disease. There are more than 100 different types of arthritis and related conditions. 


Arthritis-The Whole Picture
This presentation provided a general overview of arthritis—what it is, common symptoms, treatment options (clinical and non-clinical), and prevention.  The presenter was Isela Monterrosas from the Arthritis Foundation (
https://www.arthritis.org/).  

The main points of the presentation are as follows:

1. What is arthritis?

 There are many types of arthritis but they generally fall into four categories:  Degenerative, Inflammatory, infectious and metabolic.  If you have arthritis you need to know which type it is because the treatment is associated with the type.   More than 50 million adults and 300,000 children have some type of arthritis. It is most common among women and occurs more frequently as people get older. Descriptions of each type are on the website but here is a summary:

Degenerative arthritis:  Degenerative arthritis is a term synonymous with osteoarthritis, a chronic disorder that damages the cartilage and tissues surrounding a joint. ... Pain typically begins in only one or a few joints, and is most common in the weight-bearing joints of the hips, knees, and feet.

Inflammatory arthritis:  Inflammatory arthritis is a group of diseases characterized by inflammation of the joints and often other tissues. These include rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis and systemic lupus erythematosus (lupus) among others.

Infectious arthritis:  Infectious arthritis is an infection in a joint. It may also be referred to as septic arthritis. It occurs when an infection caused by a bacteria or virus spreads to a joint or the fluid surrounding the joint. This fluid is called the synovial fluid. 

Gout (also called metabolic arthritis):  Gout occurs when uric acid crystals form in and around joints, causing sudden and intense pain, redness and swelling. It mainly affects men over 40 and is usually found in the big toe, but can occur in almost any joint.

2.  Treatments

There are several types of treatments ranging from medicines, exercise, diet, pain management and surgery

2A.  Medicines:

         Supplements:  The arthritis website sited above has a list of 31 supplements that claim to relieve arthritis.  Before you decide to take a supplement that claims to treat arthritis symptoms, please review this list.  https://www.arthritis.org/living-with-arthritis/treatments/natural/supplements-herbs/guide/

            Medicines:In selecting medicines you need to consider side effects, cost, how long they last.  Some are prescription medicines and others such as Tylenol are over the counter.  To read more about medicines go to https://www.arthritis.org/living-with-arthritis/treatments/medication/drug-guide/

2B. Exercise

While you may worry that exercising with osteoarthritis could harm your joints and cause more pain, research shows that people can and should exercise when they have osteoarthritis. In fact, exercise is considered the most effective non-drug treatment for reducing pain and improving movement in patients with osteoarthritis. To read more about this and how to exercise go tohttps://www.arthritis.org/living-with-arthritis/exercise/how-to/

One of the most important resources available on the arthritis website is a resource finder.  Go to https://www.arthritis.org/living-with-arthritis/tools-resources/and click on resource finder.  It gives you information on healthcare providers as well as fitness experts.

2C. Pain Management

Many people who have some form of arthritis or a related disease may be living with chronic pain. Pain is chronic when it lasts three to six months or longer. But arthritis pain can last a lifetime. It may be constant, or it may come and go. Chronic pain can make it hard to perform daily activities like cleaning the house, dressing, or looking after your kids. However, there are ways to effectively manage chronic arthritis pain. Here is what you can do to feel better.  The Village is offering a pain management coursebeginning on September 10thand it provides many ways in which chronic pain can be managed and reduced.

2. D Diet

While different food won’t cure arthritis, there are foods that have anti-inflammatory properties that can alleviate some of the symptoms of arthritis.  These include omega-3, salmon, tuna, black tea, oranges, cherries, onions, pineapple and coffee.  Other foods such as some pizzas, MSG and sweeteners, can cause increased inflammation. Foods that help are listedhttps://www.arthritis.org/living-with-arthritis/arthritis-diet/best-foods-for-arthritis/and foods that should be avoided are also listedhttps://www.arthritis.org/living-with-arthritis/arthritis-diet/foods-to-avoid-limit/

2. E Surgery

One needs to be careful in selecting surgery.  Some surgeries are more complex than others and one’s age and health conditions should be a factor in selecting this option. Generally hips and knees are the easiest surgeries.  Feet and hands are much more complex and have less success. More information on surgeries is in https://www.arthritis.org/living-with-arthritis/treatments/joint-surgery/types/.

3.  Resources

The best resources are the arthritis foundation. The website is listed above and their local office is 

Southern California San Diego Office

Location:

3919 30th Street 
San Diego, CA 92104

Phone: (858) 492-1090

 

It’s All About Food

The Care Committee is pleased to share the collective wisdom gained at a Member-to-Member forum in April. The topic of the conversation centered on ways to reduce our time in the kitchen preparing meals by finding resources within our community and online to make the food preparation process simpler, especially when only cooking for one or two people. They are listed below. 

Delivery options Codes: D= Delivers UE=Uber Eats GH=Grub Hub, Doordash (DD) Amazon Prime (order from select restaurants).

Favorite places in Tierrasanta:Dominos (D), Choice of Mandarin (D), Island Style Café (DD), Lilac Thai (UE), Round Table Pizza (D), Chile Peppers (GH), Tierrasanta Mexican Café (GH), Edamame (GH).

Others in Close Proximity: Bud’s Louisiana Café; Troy’s Greek (D) Khan’s Cave, Fillipis, Restaurant at Kaiser Hospital, Chicken Pie Shop On El Cajon Blvd: buy already frozen pies for later use. 

Kits Delivered: Hello Fresh (delivers meals ready to cook) Blue Apron (sends ingredients, you assemble and cook) Sun Basket (Ditto) Meals on Wheels.

Grocery Deliveries: Von’s (Also may pre-order for pick up). Try thin crust pizza in frozen section. 

Trader Joe’s: Great frozen and fresh entrees with good portion size (try Greek chicken and fish) 

Suggestions from Big Box Stores: Costco: Divide and freeze rotisserie chicken, organic ground beef. Costco butchers will package smaller amounts than those in the refrigerated compartments, upon request.  You don’t have to buy in bulk.

Other Suggestions: Use crock pot recipes , add chicken and veggies to prepared Indian sauces, buy spices in bulk. Note: Sprouts sells spices in bulk.  You may buy small amounts of spices that you use infrequently, and put them in your own jars.


Seniors Driving Safely

This March care committee focus is issues associated with senior driving.  There was a presentation by the Care Committee on March 27th at 12:30 PM and the information presented there is provided in this article.  The information was compiled by me (Marc Narkus-Kramer) and I also led the conversation on the 27th.   

This is actually a very complex subject but very important.  There are many medical issues and those just associated with aging that can significantly impact our driving abilities.  There are 3 major websites that provided me the most important information associated with this subject.  These are:

Also, there are resources on most other insurance companies that insure drivers.  This article will focus on the AAA website, State Farm and the National Institute on Aging.  The AAA has 4 important sections and the National Institute on Aging and State Farm has recommendations associated with some of these.  I have combined the three websites along with a few others and summarized the information.  I recommend that you go through the list and ask yourself if you are doing these things.  If not, go read more about them in the AAA sections and the other two websites.  Also take the driving self -assessment test.

Section 1:  Provides a self assessment test.   This test will help you determine if you can drive safely. The test has 15 questions and can be found at https://seniordriving.aaa.com/wp-content/uploads/2016/08/Driver652.pdf

Section 2: Deals with health changes that often occur with aging:  Vision, Reaction Time, Changes in Medication and Mind and Cognition.  There are subsections with each of these subjects and they provide information on what the impact of these conditions are on driving and what you should do about it.   Here are some key recommendations

  • Vision issues
    • If you are 65 or older, see your eye doctor every year. Ask if there are ways to improve your eyesight.
    • If you need glasses or contact lenses to see far away while driving, make sure your prescription is up-to-date and correct. Always wear them when you are driving.
    • Cut back on or stop driving at night if you have trouble seeing in the dark. Try to avoid driving during sunrise and sunset, when the sun can be directly in your line of vision.
  • Trouble Hearing
    • Have your hearing checked at least every 3 years after age 50.
    • Discuss concerns you have about hearing with your doctor. There may be things that can help.
    • Try to keep the inside of the car as quiet as possible while driving.
  • Slower Reaction Time and Reflexes (mind and cognition)
    • Leave more space between you and the car in front of you.
    • Start braking early when you need to stop.
    • Avoid heavy traffic areas or rush-hour driving when you can.
    • If you must drive on a fast-moving highway, drive in the right-hand lane. Traffic moves more slowly there, giving you more time to make safe driving decisions
  • Medications Can Affect Driving
  • Read medicine labels carefully. Look for any warnings.
  • Make a list of all of your medicines, and talk with your doctor or pharmacist about how they can affect your driving.
  • Don't drive if you feel lightheaded or drowsy.

    Section 3:  Improving your driving skills:  This section of the AAA website contains information on everyday challenges, driving in bad weather, handling unexpected situations and driver improvement courses for seniors.  There are too many issues associated with each subtopic so I am just going to give a few.

  • When in doubt, don't go out. Bad weather like rain, ice, or snow can make it hard for anyone to drive. Try to wait until the weather is better, or use buses, taxis, or other transportation services.
  • Avoid areas where driving can be a problem. For example, choose a route that avoids highways or other high-speed roadways. Or, find a way to go that requires few or no left turns.
  • Keep your windshield, headlights, and mirror clean to improve visibility.
  • Raise your seat high enough so you have a clear view of the road. Sit on a small pillow if necessary.
  • Allow adequate stopping distances.
  • Always wear your seat belt.
  • Keep your headlights on at all times.
  • Keep a safe distance between you and the car ahead so you have ample time to brake safely if necessary.Also allow adequate stopping distances

    Section 4 deals with maintaining mobility and Independence:   There are a few key areas.  The first deals with the type of car you might need to help with mobility issues, cognition issues, arthritis and other health issues.  And finally, there are courses and services that improve your driving and helping you determine if your car fits your needs.  These are:

  • Many insurance companies provide these safe driving courses and you will likely receive a discount on your insurance for taking these courses.Go to your insurance company website or talk to your insurance company directly.
  • There is a DMV publication on senior safe drivinghttps://www.dmv.ca.gov/portal/wcm/connect/8a431ac8-535b-4783-b006-a6c6cf58ef18/dl625senior.pdf?MOD=AJPERES
  • AAA’s Roadwise Driver™ online course is geared toward helping older drivers understand age-related changes they may experience and how to adjust their driving accordingly. This interactive training includes brain training and assessments, helpful tips and explanations, and dashboard camera footage from real driving scenarios.https://www.calif.aaa.com/automotive/driver-education/senior-programs.html
  • AARP has a smart driver course.https://www.aarpdriversafety.org/why-take-our-course.html

Safety features

1950-2000

  • Safety/Convenience Features
  • Cruise Control
  • Seat Belts
  • Antilock Brakes

    2000-2016

  • Rearview Video
  • Systems Automatic Emergency Braking
  • Pedestrian Automatic Emergency Braking
  • Rear Automatic Emergency Braking
  • Rear Cross Traffic Alert
  • Lane Centering Assist

    2017-2020

  • Lane keeping assist
  • Adaptive cruise control
  • Traffic jam assist
  • Self-park

Other Ways to Get Around Besides Driving

When you are not able to drive temporarily or permanently, this does not mean your mobility and independence comes to an end.  There are many alternatives to you driving.  These alternatives were compiled by the Care Committee (Jean and Joan) and were distributed to the village members.  I am repeating them in this write-up below:

The following information is provided to assist TVSD Members with their transportation needs. It does not constitute an official endorsement of any transportation provider.

  1. Uber:Requires the Uber App (free on the App Store) and a smart phone. Uber advertises: “24/7 availability.No phone calls to make, no pickups to schedule.Choose your ride and set your location.You’ll see your driver’s picture and vehicle details, and can track their arrival on the map”.Website: www.uber.com.
  2. Lyft: Similar to Uber.Requires the Lyft App (free on the App Store) and a smart phone. Website: www.lyft.com.
  3. M.T.S. (Metropolitan Transit System):Offers reduced fares for bus and trolley transportation for those aged 60 plus.There are applications on their website for reduced fare passes.For more information contact them at: (619) 233-3004 or on their website at www.sdmts.com.
  4. F.A.C.T. (Full Access to Coordinated Transportation): F.A.C.T.’s mission is to “assist San Diego County residents with barriers to mobility achieve independence through coordination of transportation services”.They maintain a database of transportation providers.Contact them via their website, www.factsd.org, or by calling (888) 924-3228.
  5. Go Go Grandparent: This service lets you use Uber with a phone call.No smart phone required.Sign-up is free.Call 1-(855) 464-6872, or visit their website, www.gogograndparent.com.
  6. Elderhelp: Provides transportation through two of their programs: Seniors A Go Go (SAGG), which has volunteer drivers that transport seniors within a 15-mile radius of their home, and the Concierge Club, in which a care coordinator arranges more specialized transportation.This may include the driver assisting with shopping and other errands.For more information, contact Elderhelp at (858) 380-5245, or at www.elderhelpofsandiego.org.
  7. Jewish Family Services: On The Go offers donation-based transportation services, including those with volunteer drivers-Rides N Smiles; individualized services for personal errands and social activities, called On the Go Silver, and partnership with on-demand ridesharing services through On the Go Navigator.New Riders should call JFS at (858) 637-3210.For more information, their website is www.jfssd.org.
  8. T.V.S.D. Time Bank: Tierrasanta Village Time Bank members offer rides in exchange for services from other TVSD Time Bank members.For more information on becoming a Time Bank member, contact Candy Walsh at (858) 278-7766, or JoAnne Kuelbs at (858) 292-1578.
  9. Local Transportation Service Advertised in Tierra Times:call Geri, at (858) 337-0907.

10. Go Share:  On Demand transportation for your stuff. GoShare contracts with truck and van  owners. www.goshare.com

Transportation Providers

Uber: www.uber.com

Lyft:   www.lyft.com

MTSwww.sdmts.com  or (619) 233-3004.

F.A.C.T.:  www.factsd.org or (888) 924-3228.

GoGoGrandparent: www.gogograndparent.org or 1-(855) 464-6872.

Elderhelp: www.elderhelpofsandiego.org or (858) 380-5245.

Jewish Family Services (OnTheGo): www.jfssd.org or (858) 637-3210.

TVSD Time Bank: www.tvsd.clubexpress.com.

Geri (Advertised in Tierra Times): (858) 337-0907.

GoShare (for your stuff): www.goshare.com.

Adapt Your Care to Meet Your Needs

CarFit is an educational program that offers older adults the opportunity to check how well their personal vehicles "fit" them.  The location and times or the service are on the following site.  https://www.car-fit.org/carfit/RegisterCarFit

Devices that you should look into

There are devices that can help you with driving.  These include

  • Seat Belt extenders that make it easier for you and others to put on a seat belt.Especially those in the back seat
  • Mirror attachments that make it much easier to change lanes and see what is behind you
  • Devices (cane portable handles) that make it much easier to get into and out of a car.

You can read about these:  https://www.mcall.com/entertainment/mc-fea-senior-drivers-gadgets-20180628-story.htm   

 

                              Pay Attention to deadlines for REAL ID
"The Real ID Act of 2005, Pub.L. 109–13, 119 Stat. 302, enacted May 11, 2005, is an Act of Congress that modifies U.S. federal law pertaining to security, authentication, and issuance procedures standards for state driver's licenses and identity documents, as well as various immigration issues pertaining to terrorism.

"Residents of a state that has transitioned to issuing Real IDs have the option to go in and get a new, compliant license or use their passport when they fly. ...
But starting Oct. 1, 2020, every air traveler will need a Real ID-compliant license, or another acceptable form of ID, for domestic air travel.

One warning, if you bring a property tax bill as proof of address, be sure it is not in your trust name.  Better to use a utility bill.  

If you live in CA, check these websites for details.  You want an updated Driver’s license, not a separate ID card. 


REAL ID Act


If you are an AARP member, there are a number of on-line learning experiences next week: Keeping us safe from Scammers:  Whenever it's convenient!     Sign up! It's free! 



What to Do with Our Treasures?

On February 19ththe Care Committee presented a program on “What to Do with Our Treasures?” It was well attended with around 40 village members.    Many of us, probably most of us, have a large number of items in our home that we don’t love or need anymore and they just sit there taking up space.  We would like to sell, donate or trash them but we feel overwhelmed and conflicted about getting rid of anything.  What if my kids will want it?  What if at some time I need it?  So we do nothing and our piles increase.  Often we are forced to face this problem when we are moving or we need space for other more important items that we need.  This presentation provided us with a way to think about our “Treasures” and how to decide what to do with them. There were three speakers:

In addition there were short presentations by people who had moved from the village and downsized as well as personal experiences from people in the audience.

The main points are summarized below:

  • The main point is to keep what you love and what you use
  • When you get to the point of wanting to get rid of stuff or you have to because you move, start with a small area like a few kitchen draws.  Divide the stuff into five categories:
    • Donate
    • Trash
    • Keep
    • Give to Family and Friends
    • Sell

Get some easy to remove stickers with different colors for each category and label each item with one of these stickers.  Remember there maybe items like your kid’s pictures from when they were young that you want to keep.  But, you might have many of them.  Here is one idea;  take pictures of most of them, and just save a few.    In the category of give to family, don’t assume your kids, friends want it.  Take pictures and ask them in advance.  You will be surprised that items you think are wonderful just don’t cut it with your friends and family

  • After you have sorted through your items and have a good idea of what you want to give away, this is the time to get professional help.  The speakers as well as many other services will come into your home and help you evaluate what would be worth selling and what should be donated pr trashed.  They will review your initial choices.  You might be surprised.  Some items that you think are valuable are not worth much and others that you thought were valueless could be worth selling.  They will give you options.  They may offer you a buyout where they give you money for all your stuff and they will get rid of it, one way or another.  They may have an estate sale or give to a  consignment shop where you get a percentage of sales of your items. Some services, for a fee, will help you decide what to take with you, will pack everything up and after the move will actually come to your home and set it up. 
  • If you want to donate but not use  professional services, there are places like Goodwill, Habitat for Humanity and Father Joe’s Village that either pick up your stuff or will receive your stuff as a donation.  You will receive a receipt for tax purposes.  Father Joe’s was especially recommended but may take time to schedule a pickup.  Also, each donation organization will not take specific items, so call in advance. 
  • Most people feel better and good about receiving extra money or donating their stuff as well as feeling lighter.  It is worth the time to do this.  Don’t leave it to your kids or loved ones!


Important Information Resulting from the Meeting on Medicare and Recent Changes
Care Committee Presentation, January 23, 2019

On January 23rd David Weil presented to about 40 village members information on his organization HICAP, Medicare/Medicare Advantage and recent changes to Medicare/Medicare  Advantage. This article summarizes the key points presented in that meeting.  I present the points that I found most relevant and supplemented the points presented with references from websites that I researched.

  1. The Health Insurance Counseling and Advocacy Program

    Villagers should know that if you have any questions about Medicare  (why you were denied coverage, why premiums went up, confusion about supplemental plans, understanding the difference between Medicare and Medicare Advantage programs) you have a vital resource. This is the Health Insurance Counseling and Advocacy Programand it is located 5151 Murphy Canyon Rd #110, San Diego.  The phone number is 800-434-0222 and you can make an appointment and see a counselor at no charge.   The counselors are extremely well trained in healthcare insurance.  You need to call the above number for an appointment

  2. Some changes to Medicare and Medicare Advantagethat you should be aware of:  
  1. The donut hole is closing.  

     

    • Part D beneficiaries who have high prescription drug expenses currently have to pay more once the total cost of their medicines reaches a certain threshold. That’s due to a quirky aspect of Part D called the coverage gap, also known as the "doughnut hole."  It used to be that individuals would have to pay 100% of costs from the time they exceeded a fixed amount of costs until they reached and level of cost that was set as catastrophic coverage.  This is the “doughnut hole.”
    • The doughnut hole has been narrowing each year since the Affordable Care Act (ACA) was passed in 2010. The doughnut hole will now close next year. Beginning in 2019, Part Denrollees will pay 25 percent of the cost of all their prescription drugs from the time they enter the gap until they reach catastrophic coverage. https://www.aarp.org/health/medicare-insurance/info-2018/part-d-donut-hole-closes-fd.html

    b.    There will be small increases in part B premiums and Part A and B deductibles.  However, there are increasing premiums for high income earners.  Part A is for hospital visits and B is for doctors

     c.  Medicare  Advantage Plans.  Medicare Advantage Plans offer extra coverage, like vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D).  A very brief summary of the advantages and disadvantages of Medicare Advantage Plans are on the follow website https://www.kiplinger.com/article/retirement/T039-C000-S002-pros-and-cons-of-private-medicare-advantage-plans.html

    • Starting in 2019, there’s a new Medicare Advantage Open Enrollment Period (OEP). It goes from January 1 through March 31 every year. It replaces the Medicare Advantage Disenrollment Period (January 1 – February 14).
    • The Medicare Advantage OEP is somewhat more limited than the Fall Open Enrollment Period. During the Medicare Advantage OEP, you generally have a one-time opportunity to do any of the following. 
      • Sign up for a Medicare Advantage plan
      • Change from one Medicare Advantage plan to a different Medicare Advantage plan
      • Drop your Medicare Advantage plan and return to Original Medicare, Part A and Part B
      • Sign up for a stand-alone Medicare Part A Prescription Drug Plan, if you returned to Original Medicare.
  2. Switching from Medicare Advantage to Medicare and a Supplemental Insurance Plan has one potential significant drawback.   Once you’ve returned to Original Medicare, you can apply for a Medicare Supplement plan anytime you want – but your acceptance into a plan isn’t always guaranteed. For example, if you have health problems, the insurance company can base its decision on your healthhistory in a process known as medical underwriting.The company can decide not to sell you a plan, or to charge you more because of your health condition.  There are exception and read them on the website with following link https://medicare.com/medicare-supplement/can-i-switch-from-medicare-advantage-to-medicare-supplement-insurance/

 

 

d.  Switching Supplemental Providers.  In California you can switch from one supplemental insurance provider to another within 3 days and you will be guaranteed coverage regardless of health.  This is true in California and a few other states but most states do not allow this. 

 

3.  Avoid Scams

There are a lot of scams that try to get your health card information and social security number and then use them set up loans in your name and other ways they can scam you by using your fake identity.  Social Security or Medicare will never ask for this information over the phone.  Most doctors’ offices have this information and will not ask for it.  If you provide this information to anyone on the phone, know who that person is and don’t give that information out if you don’t trust that person.  Anyone asking for that information that you don’t know, hang up.  

 

Marc Narkus-Kramer – Care Committee Co-Chair

 

Caregiving

One of the ways some of us may stay in our homes is to obtain caregiving services or if a spouse or other family member needs caregiving, we may assume the role of caregiver.  For example, my wife is finding it difficult to walk, so there are some caregiving responsibilities that I have assumed that I did not have before.  This is not a major burden, but I have found that it can create some emotional issues and priority issues.  I do most of the cooking and cleanup, and all the driving. So I wanted to find out about the emotional stress of caregiving and share that information with our TSV community.

I found wonderful articles on caregiving provided by the Family Caregivers Alliance (https://www.caregiver.org/caregiving) and the Mayo Clinic (https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/caregiver-stress/art-20044784)  and will summarize them here with some sentences taken directly from these articles.  But if you want  please click on the links to read the article yourself.  They are short and concise.

The emotional toll of being a caregiver

  • Most caregivers tend to be female, but all caregivers face the same issues and the emotional toll on caregivers can be significant:  high levels of stress, frustration, anxiety, exhaustion, anger, depression, increased use of alcohol or other substances, reduced immune response, poor physical health and more chronic conditions.
  •  Most caregivers are ill-prepared for their role and provide care with little or no support; yet more than one-third of caregivers continue to provide intense care to others while suffering from poor health themselves. An influential factor in a caregiver's decision to place an impaired relative in a long-term care facility is the family caregiver's own physical health.

    The strategies for addressing this problem

  • Accept help. 
  • Focus on what you are able to provide. 
  • Set realistic goals. 
  • Get connected. 
  • Join a support group. 
  • Seek social support. 
  • Set and implement personal health goals.

The Mayo clinic article provides more detail on each of these strategies.

My personal challenge is to find a balance between taking care of my needs and those of my wife.  If I completely ignore my needs, then I become angry and impatient and that does neither of us good.  I need to be clear when I have reached my limits without expressing anger or frustration in a negative way.  The problem of the caregiver is as much a problem for the caregiver as it is for the person receiving care.  If the caregiver doesn’t remain healthy and emotionally solid, the one receiving the care suffers.  I think this is true even if the caregiver is paid and comes to you from an agency.     I have also reached out to friends to discuss my situation and am the process of finding a support group.  If you have more to add to this subject please email me.

Marc Narkus-Kramer, Co-Chair of the Care Committee


Driver Safety


When it comes to driving, there is no set age at which a person becomes less safe when s/he is behind the wheel. Safety depends on a person's physical and mental health which, of course, differs from person to person.
The following issues can be warning signs that suggest it's time to get tested for driving safety:

          Getting lost in familiar areas
          Ignoring traffic signs or signals
          Becoming easily agitated or angered when driving
          Inability to concentrate while driving or appearing  
              inattentive

          Reacting too slowly to dangerous situations
          Ignoring:  
              basic driving basics like yielding right-of-way,  
              using mirrors, and turn signals or failing to check
             for blind spots  
          Having trouble judging distances

If you have any of these behaviors, see your healthcare provider for a checkup for some medication can make a person drowsy and less alert and have a professional evaluate your driving skills. It may be time to start a conversation about driving and safety.


 

Critical Healthcare Contact Information

 

1. Current Chairs of the Care Committee and TVSD central number

 

Bradlyn Mulvey abmulvey@icloud.com

Home Phone: 858-565-1325

Cell: 858-531-8465

 

Marc Narkus-Kramer mnarkus@verizon.net

Home phone: 858-430-6221

Cell: 703-298-6635

 

The Village Central Number is 858-569-9119 

Cassandra Hanrahan (as of 08/01/2019)

2. Healthcare Information Sources:

 

San Diego County District Attorney’s Office:

Elder Abuse Hotline:

1-800-510-2020,

Web Address:

http://www.sdcda.org/helping/elder-abuse.html

 

San Diego County handles approximately 9,000 cases of elder and dependent adult abuse each year. Many other incidents go unreported, leaving vulnerable adults in distressing, potentially life-changing, even dangerous, situations.

 

Abuse often escalates if there is no intervention. Victims will live in silent desperation, unwilling to seek assistance because they believe their cries for help will go unanswered and they fear retaliation from their abusers. Many remain silent to protect abusive family members from the legal consequences of their crimes, or they are too embarrassed to admit that they have fallen victim to predators.

 

San Diego County Health and Human Services Agency

Office of Aging and Independence Services

Adult Protective Services: (800) 510-2020 

Long-Term Care Ombudsman Office:  (800) 640-4661

https://www.sandiegocounty.gov/hhsa/programs/ais/

 

AIS provides services to older adults, people with disabilities and their family members, to help keep clients safely in their homes, promote healthy and vital living, and publicize positive contributions made by older adults and persons with disabilities.

 

Southern Caregiver Resource Center

3675 Ruffin Rd., Suite 230

San Diego CA 92123

(858) 268-4432

www.caregivercenter.org

 

Established in 1987 as a non-profit 501(c)3, Southern Caregiver Resource Center (SCRC) is the leading provider of free caregiver support services for families caring for frail older adults and adults living with Alzheimer’s disease and related disorders in San Diego County. Serving over 80,000 families annually, SCRC offers a wide variety of support services that include education, care planning, case management, counseling, respite care and support groups. 

 

Alzheimer’s Association:

6632 Convoy Court

San Diego CA   92111

(858) 492-4400

24/7 Helpline: 1-800-272-3900

www.alz.org/sandiego

 

The Alzheimer's Association is the leading voluntary health organization in Alzheimer's care, support and research. Our mission is to eliminate Alzheimer's disease through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through the promotion of brain health.

 

 

Jewish Family Service:

 

On The Go: Transportation Solutions for Older Adults

8788 Balboa Ave

San Diego CA 92123-1506

(858) 637-7331

www.jfssd.org

 

On the Go provides group and individual transportation solutions for older adults to medical and personal appointments, community events, Social & Wellness Centers, shopping centers, organized excursions, and more.

 

 

 

 

The Health Insurance Counseling and Advocacy Program

 

5151 Murphy Canyon Rd #110, San Diego, CA 92123

(858) 565-8772

https://cahealthadvocates.org/hicap/san-diego/

 

Villagers should know that if you have any questions about Medicare  (why you were denied coverage, why premiums went up, confusion about supplemental plans, understanding the difference between Medicare and Medicare Advantage programs) you can contact the Health Insurance Counseling and Advocacy Program and the service is free..  You need to call the above number for an appointment.



For Women:
11 Tips for Good Health in Later Life



Older women are more likely than men to have chronic, or ongoing, health conditions such as arthritis, high blood pressure, and osteoporosis. Women are also more likely to develop multiple health problems, according to a recent report from the Kaiser Family Foundation. Older women are also more likely to have memory or other “cognitive” problems, and difficulty carrying out daily activities such as dressing, walking, or bathing without help.

Fortunately, there’s a lot you can do to boost your chances of staying mentally and physically healthy as you age. Here’s what the experts with the American Geriatrics Society’s Health in Aging Foundation recommend.

Even if you feel perfectly healthy, you should see your provider at least once a year for a checkup.

When you visit your provider, bring all of the pills you take, including medicines, vitamins, herbs, and supplements, even those you buy without a prescription. Your provider should check all of your pills to make sure they are safe for you to take.

Always check with your provider before taking any new pills. Take all medicines and other pills as directed, and tell your provider right away if a medication or other pill seems to be causing any problems or side effects.

Certain screening tests can help diagnose health problems early. Ask your healthcare provider which tests are right for you.

Check with your healthcare provider to make sure you’re getting:

A flu shot: every year in late summer or early fall, before flu season starts.
Two pneumonia vaccinations: pneumococcal conjugate vaccine (PCV)13

and pneumococcal polysaccharide vaccine (PPSV)23. Ask your healthcare provider about when to take the two vaccines

A tetanus shot: every 10 years
The shingles (herpes zoster) vaccine: once after age 60 or older

Get 1,200 to 1,500 milligrams of calcium and 800-1000 International Units (IU) of vitamin D daily. Do weight-bearing exercises such as walking, jogging, and aerobic dancing. If you’ve fallen in the past, ask your healthcare provider about local exercise programs that include strength training, balance and stretching exercises.


Aging skin is more susceptible to sun damage, which boosts the risk of skin cancer. Use sunscreen all year round and, for added protection, wear a wide-brimmed hat.


Tell your healthcare provider if you smoke.  He or she can help you stop. For additional help, call 1-800-QUITNOW. It’s never too late to quit.


In later life, you still need healthy foods, but fewer calories. Your healthcare provider and the USDA’s updated myPyramid for Older Adults, at
http://mypyramid.gov/, can help you make good choices. You can also get a personal nutrition plan at the USDA website.

Experts recommend eating at least five servings of fruits and vegetables daily, but less than a third of older adults do this. Don’t miss out. Choose a variety of fruits and vegetables. Go for deep colors: dark green, bright yellow, and orange choices like spinach, collard greens, carrots, oranges, and cantaloupe are extra nutritious. Choose whole grain bread, rice, and pasta instead of the white stuff. Pick less fatty meat, like chicken, and low-fat milk, cheese, and yogurt.

Shoot for heart-healthy fish, like tuna or salmon, twice a week. To help keep your bones strong, include sources of calcium and vitamin D. Two daily servings of milk, yogurt, or cheese are a good bet in your diet. And use healthier fats, such as olive and canola oil instead of butter or lard.

Some women may benefit from one alcoholic drink a day. Check with your healthcare provider to make sure this is right for you. One drink = 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor.


Regular exercise is important for good health at any age. Exercise tones up your heart and circulation, strengthens bones, boosts brain function, lifts your mood, and can help prevent and ease depression. Your healthcare provider can help you come up with an exercise program that’s right for you.

Sign up for a class at the local library, senior center, or community college (some offer free classes for older adults). 

Do word puzzles, number puzzles, jigsaw puzzles - whatever interests you.  Make sure you challenge your brain by trying new things, rather than just repeating the same exercises over and over again.

DISCLAIMER: this information is not intended to diagnose health problems or to take the place of medical advice or care you receive from your physician or other healthcare provider. Always consult your healthcare provider about your medications, symptoms, and health problems. November 2015

©2015 Health in Aging Foundation. All rights reserved. This material may not be reproduced, displayed, modi ed,or distributed without the express prior written permission of the copyright holder. For permission, contact info@ healthinaging. org.



Senior Transportation

 

Let’s start with the bad news…. Eventually we ALL will reach a point where we cannot drive ourselves where we need to go, and when we need to be there.  Being able to just get up and go is almost a basic freedom, and not being able to do so is one of the more dismaying aspects of becoming a “person of age”. 

But the good news is that if there was ever a time in history to be facing personal driving limitations, this is it!  There are now many safe, convenient and economical alternatives to owning and driving your own car.  Particularly in the area we live!   To see a summary of how Villagers can get where they need to be when they can’t drive or when help from friends and family is not available, TVSD Transportation Options

The even better news is we are likely to be the first generation that will be able to take advantage of the self-driving car revolution!  Owning your own car will no longer be a necessity.  It’s likely your garage can soon become a place to permanently store all those treasures you have accumulated over the past decades!


Healthy Recipes

As many of our Villagers have learned from the Empowering Body and Mind classes, good nutrition is a key component in the quest to stay happy, healthy and active.  
Kim Chartrand is offering some of the recipes for those of us seeking meals and snacks that promote a healthier lifestyle.
Her recipes can be found  Here

Healthier Living with Chronic Pain 
Chronic Pain Self-Management Program (CPSMP)

An Evidence-Based self-management program originally developed at Stanford University, now managed by the Self-Management Resource Center for people experiencing chronic pain as well as their family members and caregivers. This program has been proven to achieve positive health outcomes and reduced health care expenditures. The program consists of a workshop that meets once a week for 2 ½ hours per week for six weeks, led by two trained peer educators, who may also have chronic pain or another chronic condition.

Topics include:

• Techniques to deal with problems such as frustration, fatigue, isolation, and poor sleep

• Appropriate exercise for maintaining and improving strength, flexibility, and endurance

• Appropriate use of medications

• Communicating effectively with family, friends, and health professionals

• Nutrition

• Pacing activity and rest

• How to evaluate new treatments

The Healthier Living with Chronic Pain workshops are available at sites throughout the County. Click here for current schedule.

For more information call 858-495-5500.

Positive Experiences with the Burn Institute
This month, Art and Bradlyn Mulvey share their positive experience with the Burn Institute. We were in the market to replace our fire alarms and carbon monoxide sensor and guess what? There was the article in the Vibes and on the website on how the Burn Institute was supplying alarms for seniors free of charge!!! We called the Institute to find out about this program. We were told the wait list was 3 months but we signed up--after all, free is free. Within the next week, however, the Institute called to schedule a time when the interns could come and install them free of charge! On the allotted day and time, an intern called to make sure we were home. A woman and a man--college interns-- came to the house, told us about where and why the alarms should be installed within our home, and then went about installing them. When they finished, they gave us a gift bag with a hot mitt, a Home Fire Escape Plan Graph, a pamphlet entitled, "Fire and Burn Prevention for Seniors" and directions on how to replace our new alarms in 10 years! Yes, these alarms are guaranteed for TEN Years and, if they fail before then, they will replace them free of charge. If they make the ten years, they told us to call the Burn Institute and they will replace them, free again!
What a great deal for alarms/sensors and the interns were very pleasant and filled with great information. Turns out, Art and I didn't really know where to appropriately put the alarms so it was great to have experts out to install fire alarms and to let us know about fire prevention.  Great experience and we'd recommend the service to our Villagers!

 



As many of our Villagers have learned from the Empowering Body and Mind classes, good nutrition is a key component in the quest to stay happy, healthy and active.  Kim Chartrand is offering some of the recipes for those of us seeking meals and snacks that promote a healthier lifestyle.
Her recipes can be found  Here
 

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