Spring 2020 Generation Boomer Magazine by Senior Spectrum Newspapers

Spring 2020

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Life’s a Trip

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Boomers

Moving Forward

Congressional lawmakers passed a $2 trillion stimulus bill to respond to the coronavirus pandemic, with cash and assistance for regular Americans, Main Street businesses and hard-hit airlines and manufacturers, among others. The legislation represents the largest emergency aid package in US history and the most significant legislative action taken to address the rapidly intensifying coronavirus crisis, which is overwhelming hospitals and grinding much of the economy to a halt. Key elements of the proposal are $250 billion set aside for direct payments to individuals and families, $350 billion in small business loans, $250 billion in unemployment insurance benefits and $500 billion in loans for distressed companies. The plan will deliver a massive infusion of financial aid into a struggling economy hard hit by job loss, with provisions to help impacted American workers and families as well as small businesses and major industries including airlines.

Under the plan, individuals who earn $75,000 in adjusted gross income or less would get direct payments of $1,200 each, with married couples earning up to $150,000 receiving $2,400 -- and an additional $500 per each child. The payment would scale down by income, phasing out entirely at $99,000 for singles and $198,000 for couples without children. In addition, the bill would provide a major amount of funding for hard-hit hospitals -- $130 billion -- as well as $150 billion for state and local governments that are cash-strapped due to their response to coronavirus. It also has a provision that would block Trump and his family, as well as other top government officials and members of Congress, from getting loans or investments from Treasury programs in the stimulus, according to Minority Leader Chuck Schumer’s office.

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Boomer Timetable

1940s-1950s

1960s-1970s

1945: Soldiers come home after WWII to make babies at the rate of one every eight seconds over the next two decades.

1975: U.S. evacuates from Vietnam. South Vietnamese government surrenders.

1946: Dr. Benjamin Spock’s “Baby and Child Care,” published. Parents get the okay to become emotionally involved with their children. 1947: Jackie Robinson joins the Brooklyn Dodgers, breaks the color barrier in major league baseball. 1948: The “Kensey Report” on sexual behavior in the human male is published. 1951: Disc jockey Alan Freed coins the term rock ‘n’ roll.

1977: “Star Wars”” opens. Legions of faithful Jedis follow. 1980: John Lennon shot and killed in New York. IBM PC introduced, business boots up. Pac-Man introduced, takes arcade games to a new level. 1981: The CDC publishes report on AIDS epidemic. 1983: Chrysler Minivan introduced. Soccer moms abandon station wagons. Newsweek declares 1983 “the year of the yuppie.”

1952: “Bandstand” begins its long run on TV.

1985: Bob Geldof spearheads Live Aid concerts, raising over $100 million to fight famine in Africa.

1954: Supreme Court deems racial segregation in public schools unconstitutional in Brown v. Board of Education.

1986: The space shuttle Challenger explodes after liftoff.

1955: Elvis Presley ushers in a new age of rock ‘n’ roll with “That’s All Right.” 1959: WHAM-O introduces the first Frisbee. 1960: Birth control pill approved for sale by the FDA.

1989: Berlin Wall falls, leading to the reunification of East and West Germany. 1991: Persian Gulf War liberates Kuwait. 1992: Riots erupt in Los Angeles after jury acquits policemen of beating Rodney King. 1993: Branch Davidian compound burned down near Waco, Texas.

1962: Cuban Missile Crisis – Pres. Kennedy decides not to attack Soviet missiles in Cuba, 1995: Truck bomb explodes outside federal avoids nuclear war. building in Oklahoma City. O.J. Simpson trail captivates a nation. 1968: North Vietnam launches the Tet Offensive. 1998: Viagra hits the shelves. 1969: Neil Armstrong becomes the first man 1999: Shootings at Columbine High School. to walk on the moon. Clinton’s impeachment trail ends without a conviction. 1970: Four students killed at Kent State by National Guardsmen during protest against 2000: Bush wins election after Florida vote the Vietnam War. recount. 1972: Break-in at the Democratic National Committee’s headquarters leads to Nixon’s resignation two years later.

2001: Attack on World Trade Center. 2006: First Boomers turn 60.

The Boomer Century 1946-2046 (www.pbs.org/boomercentury)

20th-21st

Century America 1883-1900 (18 years) The Lost Generation was a term originally used to identify a group of American literary expatriates living in Paris in the 1920s and 1930s; it is now used more generally to describe the generation of young people who came of age in the U.S. during and shortly after WWI. Very few Americans from this generation are currently alive. 1901-1924 (24 years) The G.I. Generation, the generation of veterans that fought and won WWII, later to become the Establishment, and the parents of children who would later become the Baby Boomers (born 1946-1964). Journalist Tom Brokaw dubbed this the Greatest Generation in a 1998 book of that name. 1925-1945 (20 years) The Silent Generation was the generation born between the two World Wars, who were too young too join the service when WWII started. Many had fathers who served in WWI. 1946-1954 (8 years) The Baby Boomers (Boom Generation) were the generation born just after WWII, a time that included a 14-year increase in birthrates worldwide. Baby Boomers in their teen and college years were characteristically part of the 1960s counterculture, but later became more conservative. 1955-1964 (9 years) Generation Jones was the heretofore-lost generation between the Boomers and GenXers, which has emerged now as a bonafide distinct generation. The election of Barack Obama to the U.S. Presidency created significantly increased awareness of this generation as many prominent sources referred to Obama as specifically a member of Generation Jones.

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G.B. Spring 2020 Edition CONTENTS

OUTLOOK 2020s and Aging Boomers

The Medicare Donut Hole

N4 Makes Great Strides

Staying Active

New Parkinson’s Study

Drinking and Aging

OUR GENERATION Telemedicine During Coronavirus

Medicare and Coronavirus

Mental Health During Coronavirus

CORONAVIRUS RESOURCE GUIDE What To Do If You Have COVID-19

COVID-19 Telehealth Services

Coping and Managing During COVID-19

Essentail vs Non-Essential Business

GOOD TASTE Rounds Fresh Packaging

Brewer’s Cabinet Catering

Let’s Do Takeout

Mediterranean Olive Diet

LEISURE Sierra Watercolor Society

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Navigating Aging

What The 2020s Have In Store For By: Judith Graham Kaiser Health News

Aging Boomers

Within 10 years, all of the nation’s 74 million baby boomers will be 65 or older. The most senior among them will be on the cusp of 85. homes] is unaffordable for most families,” said Jean Accius, senior vice president of thought leadership at AARP. He cited data from the Genworth Cost of Care Study: While the median household income for older adults was just $43,696 in 2019, the annual median cost for a private room in a nursing home was $102,204; $48,612 for assisted living; and $35,880 for 30 hours of home care a week. Even sooner, by 2025, the number of seniors (65 million) is expected to surpass that of children age 13 and under (58 million) for the first time, according to Census Bureau projections. “In the history of the human species, there’s never been a time like [this],” said Dr. Richard Hodes, director of the National Institute on Aging, referring to the changing balance between young people and old. What lies ahead in the 2020s, as society copes with this unprecedented demographic shift? I asked a dozen experts to identify important trends. Some responses were aspirational, reflecting what they’d like to see happen. Some were sobering, reflecting a harsh reality: Our nation isn’t prepared for this vast demographic shift and its far-reaching consequences.

Workforce issues are a pressing concern. The need for health aides at home and in medical settings is soaring, even as low wages and poor working conditions discourage workers from applying for or staying in these jobs. By 2026, 7.8 million workers of this kind will be required and hundreds of thousands of jobs may go unfilled. “Boomers have smaller families and are more likely to enter old age single, so families cannot be expected to pick up the slack,” said Karl Pillemer, a professor of human development at Cornell University. “We have only a few years to plan different ways of providing care for frail older people to avoid disastrous consequences.” Living better, longer. Could extending “healthspan,” the time during which older adults are healthy and able to function independently, ease some of these pressures?

Here’s what the experts said: A crisis of care. Never have so many people lived so long, entering the furthest reaches of old age and becoming at risk of illness, frailty, disability, cognitive decline and the need for personal assistance.

The World Health Organization calls this “healthy life expectancy” and publishes this information by country. Japan was the world’s leader, with a healthy life expectancy at birth of 74.8 years in 2016, the most recent year for which data is available. In the U.S., healthy life expectancy was 68.5 years out of a total average life expectancy of 78.7 years.

Even if scientific advances prove extraordinary, “we are going to have to deal with the costs, workforce and service delivery arrangements for large numbers of elders living for at least a year or two with serious disabilities,” said Dr. Joanne Lynn, a legislative aide on health and aging policy for Rep. Thomas Suozzi (D-N.Y.).

Laura Carstensen, director of Stanford University’s Center on Longevity, sees some cause for optimism. “Americans are beginning to exercise more” and eat more healthful diets, she said. And scientific studies published in recent years have shown that behavior and living environments can alter the trajectory of aging.

Experts caution we’re not ready. “The cost of long-term care [help in the home or care in assisted-living facilities or nursing

“With this recognition, conversations about aging societies and longer lives are shifting to the potential to improve quali-

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ty of life throughout,” Carstensen said. Other trends are concerning. Notably, more than one-third of older adults are obese, while 28% are physically inactive, putting them at higher risk of physical impairments and chronic medical conditions. Rather than concentrate on treating disease, “our focus should shift to health promotion and prevention, beginning in early life,” said Dr. Sharon Inouye, a professor at Harvard Medical School and a member of the planning committee for the National Academy of Sciences’ Healthy Longevity Global Grand Challenge. Altering social infrastructure. Recognizing the role that social and physical environments play in healthy aging, experts are calling for significant investments in this area over the next decade. Their wish list: make transportation more readily available, build more affordable housing, modify homes and apartments to help seniors age in place, and create programs to bring young and old people together. Helping older adults remain connected to other people is a common theme. “There is a growing understanding of the need to design our environments and social infrastructure in a

way that designs out loneliness” and social isolation, said Dr. Linda Fried, dean of Columbia University’s Mailman School of Public Health. On a positive note, a worldwide movement to create “age-friendly communities” is taking hold in America, with 430 communities and six states joining an effort to identify and better respond to the needs of older adults. A companion effort to create “age-friendly health systems” is likely to gain momentum. Technology will be increasingly important as well, with agingin-place likely made easier by virtual assistants like Alexa, video chat platforms like Skype or FaceTime, telemedicine, robotic caregivers and wearable devices that monitor indicators such as falls, according to Deborah Carr, chair of the

Steve Reynolds BEYOND MAGAZINE 2016

(Aging Boomers page 8)

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Aging Boomers / page 7 sociology department at Boston University. Changing attitudes. Altering negative attitudes about aging — such as a widespread view that this stage of life is all about decline, loss and irrelevance — needs to be a high priority as these efforts proceed, experts say. “I believe ageism is perhaps the biggest threat to improving quality of life for [older] people in America today,” Harvard’s Inouye said. She called for a national conversation about “how to make the last act of life productive, meaningful and fulfilling.” Although the “OK Boomer” barbs that gained steam last year testify to persistent intergenerational tension, there are signs of progress. The World Health Organization has launched a global campaign to combat ageism. Last year, San Francisco became one of the first U.S. cities to tackle this issue via a public awareness campaign. And a “reframing aging” toolkit developed by the FrameWorks Institute is in use in communities across the country. “On the bright side, as the younger Baby Boom cohort finally enters old age during this decade, the sheer numbers of older adults may help to shift public attitudes,” said Robyn Stone, co-director of LeadingAge’s LTSS (long-term services and supports) Center @UMass Boston. Advancing science. On the scientific front, Dr. Pinchas Cohen, dean of the Leonard Davis School of Gerontology at the University of Southern California, points to a growing recognition that “we can’t just apply one-size-fits-all guidance for healthy aging.” During the next 10 years, “advances in genetic research and big data analytics will enable more personalized — and effective — prescriptions” for both prevention and medical treatments, he said. “My prediction is that the biggest impact of this is going to be felt around predicting dementia and Alzheimer’s disease as biomarker tests [that allow the early identification of people at heightened risk] become more available,” Cohen continued. Although dementia has proved exceptionally difficult to address, “we are now able to identify many more potential targets for treatment than before,” said Hodes, of the National Institute on Aging, and this will result in a “dramatic translation of discovery into a new diversity of promising approaches.” Another potential development: the search for therapies that might slow aging by targeting underlying molecular, cellular and biological processes — a field known as “geroscience.”

OUTLOOK Human trials will occur over the next decade, Hodes said, while noting “this is still far-reaching and very speculative.” Addressing inequality. New therapies spawned by cutting-edge science may be extraordinarily expensive, raising ethical issues. “Will the miracles of bioscience be available to all in the next decade — or only to those with the resources and connections to access special treatment?” asked Paul Irving, chairman of the Milken Institute’s Center for the Future of Aging. Several experts voiced concern about growing inequality in later life. Its most dramatic manifestation: The rich are living longer, while the poor are dying sooner. And the gap in their life expectancies is widening. Carr noted that if the current poverty rate of 9% in the older population holds over the next decade, “more than 7 million older persons will live without sufficient income to pay for their food, medications and utilities.” Most vulnerable will be black and Latina women, she noted. “We now know that health and illness are affected by income, race, education and other social factors” and that inequalities in these areas affect access to care and health outcomes, Pillemer said. “Over the coming decade, we must aggressively address these inequities to ensure a healthier later life for everyone.” Working longer. How will economically vulnerable seniors survive? Many will see no choice but to try to work “past age 65, not necessarily because they prefer to, but because they need to,” Stone said. Dr. John Rowe, a professor of health policy and aging at Columbia University, observed that “low savings rates, increasing out-of-pocket health expenditures and continued increases in life expectancy” put 41% of Americans at risk of running out of money in retirement. Will working longer be a realistic alternative for seniors? Trends point in the opposite direction. On the one hand, the U.S. Bureau of Labor Statistics suggests that by 2026 about 30% of adults ages 65 to 74 and 11% of those 75 and older will be working. On the other hand, age discrimination makes it difficult for large numbers of older adults to keep or find jobs. According to a 2018 AARP survey, 61% of older workers reported witnessing or experiencing age discrimination. “We must address ageism and ageist attitudes within the workplace,” said Accius, of AARP. “A new understanding of lifelong learning and training, as well as targeted public and private sector investments to help certain groups transition [from old jobs to new ones], will be essential.”

Your Money Your Health

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Did The Medicare Part D

“Donut Hole” End in 2020?

By: Toni King prescription for brand-name

Toni: Last fall, I was diagnosed with a serious illness and began taking Humira which is very expensive costing over $5,000 per month. I was told that the Medicare Part D “Donut Hole” was vanishing in 2020, and I would not have to pay more than I did in 2019.

drugs when one would hit the “Donut Hole” and now the cost is a whopping 25% of the brand-name and generic drugs.

initial coverage limit ($4,020 in 2020) and ends when you spend a total of $6,350 outof-pocket in 2020.

• Does the Donut Hole go away…in 2020 it is now called the Donut Hole Discount.

It is amazing how the cost of prescriptions has increased. Maybe this is because the prescription drug manDonut Hole Discount: ufacturers and Part D plans Part D enrollees will receive a have to pay a percentage to 75% Donut Hole discount This did not happen when Medicare for the prescription. on the total cost of their brand-name drugs purchased I went to pick up my prescrip- In 2020, the prescription drug manufacturer must pay while in the Donut Hole. tion at CVS after January 1st. 70%, the Medicare Part D The discount includes, a 70% I had to pay over $1,700 for plan must pay 5%, and the discount paid by the brandthe Humira, and my diabetMedicare beneficiary must pay ic insulin. I was under the impression that my prescrip- 25% until the out-of-pocket cost reaches $6,350. tions were not going to be Below are the Medicare as expensive as 2019. Can Part D costs before and after you please explain what has reaching the “Donut Hole” happened? discount: Shane West U area Part D changes for 2020 are: • Initial Deductible: will be Shane: increased by $20 from $415 in The “Donut Hole” is 2019 to $435 in 2020. a stressful time for most Americans because the cost • Initial Coverage Limit: of your brand name drug is simply more expensive. Now will increase by $200 from the Donut Hole is called the $3,820 in 2019 to $4020 in 2020 where the 2020 “Donut “Donut Hole” discount, Steve Reynolds Hole” begins. and that discount is 25% of BEYOND MAGAZINE 2016 the cost for both brand-name • Out-of-Pocket threshand generic prescriptions. When Healthcare Reform old cost: or (TrOOP) will began, the Donut Hole slowly increase from $5,100 in 2019 began to close but was never to $6,350 in 2020. intended to go completely • Coverage Gap (Donut away. Hole): begins once you reach In the past, one had to pay 100% of the cost of the your Medicare Part D plan’s

name drug manufacturer and a 5% discount paid by your Medicare Part D plan. The 70% paid by the drug manufacturer combined with the 25% you pay, count toward your TrOOP or Donut Hole exit point.

* Be sure that all prescription drugs are covered on the new Part D prescription drug standalone or MAPD plan that you choose and enroll in for a 1st of the month effective date whether turning 65 or retiring past 65.

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OUTLOOK: Faring in Retirement

Neighbor Network of Northern Nevada Making Great Strides to

Further Independence

By: Connie McMullen

The Neighbor Network of Northern Nevada or N4 is a local nonprofit that works to meet the need of Northern Nevada residents for goods, services, transportation and care through innovative and inclusive program concepts. A small start up just a few years ago, N4 is rapidly growing in many local neighborhoods where the demand for services may vary depending on the social and economic demographics of the people who live there. Born from a mission of need, N4 is the brainchild of Amy Dewitt-Smith, the organizations CEO, who had a desire to help people with transportation needs, a huge problem in Northern Nevada. Making application for a grant with the Health Care Access Mobility Design Challenge in 2015, awarded through the Federal Transportation Administration’s “Rides to Wellness” initiative, N4 was one of sixteen applications given funds to design innovative transportation solutions related to health care access. Completing the design challenge the following year, N4 began receiving grant funds to further develop projects with the “village” approach to “connect people with

inclusive, community-based services, volunteer opportunities, and affordable transportation.” Today, N4 has successfully developed into a multifaceted organization to advance access through several different programs uniquely designed for every community they operate. No longer considered a start-up, Dewitt-Smith began the Neighbor Network with the Time Exchange and Volunteer Village concepts, building on partnerships and resources. Not one for lack of imagination, Dewitt-Smith tackled both opportunities as if they existed already for many years. The Time Exchange: is a way for people to give and receive services without exchanging money. When a member provides a service to another member, one hour, or one time credit, is earned for each hour spent providing the service. Members can then exchange their time credits for an hour of service from someone else. One hour of service provided during an exchange is valued the same, no matter the type of work.

Steve Reynolds BEYOND MAGAZINE 2016

The Volunteer Village: builds partnerships with local organizations so N4 members can opt into the volunteer pool without enrolling in the Time Exchange to help people become more comfortable with serving their community. “This past year, more than 300 community volunteers have contributed over 1,000 hours helping various service organizations in Washoe County.”

Boomer Years

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Both the Time Exchange and Volunteer Village are operating in several communities in Northern Nevada, but do exceptionally well in rural communities with little transportation opportunities. Once both programs, adapted specifically for the communities they operate in, are up and running the need for fine-tuning is obvious. N4 Connect for Transportation Services N4 worked with various area transportation partners to expand access for people with disabilities and adults over 60. N4 Connect helps people afford transportation through a shared ride project in collaboration with Lyft. Those eligible who cannot access affordable transportation or use public transportation can qualify for a 50% discount on Lyft. Riders can also sign-up to receive $160 worth of Lyft credits for only $80 per participant each month. For the concierge option an additional dispatching fee is required. There are two ways people can participate in the program: the personal smartphone option and the concierge option. The personal smartphone option is intended for participants who own and can operate their own smartphone and the Lyft application. The concierge option allows members to call the N4 office and schedule rides directly.

Amy Dewitt-Smith, CEO of N4, and Marta Malone, N4 Respite Coordinator on radio show Editorâ&#x20AC;&#x2122;s Desk, at 1180-AM.

More recently, N4 has developed a Community Care program to connect people with respite, caregiving partners, in-home and community-focused services in a person centered approach to care planning. The Community Care Program offers services such as respite for family care partners, companion services, personal care, and social and recreation activities. To find out more about this program and all the other opportunities provided by N4 you can contact an N4 team member at 775-453-4774, or People@NeighborNV.org. The N4 office is located at 999 Pyramid Way, Reno, NV 89431.

OUTLOOK

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Staying Active May Prevent Brain Shrinkage in Boomers Adults who regularly walk, garden, swim or dance may have bigger brains than their inactive peers, according to a preliminary study to be presented at the American Academy of Neurology’s 72nd Annual Meeting in Toronto, Canada, April 25 to May 1, 2020. The effect of exercise was equal to four fewer years of brain aging.

study author Yian Gu, Ph.D., of Columbia University in New York and a member of the American Academy of Neurology. “Recent studies have shown that as people age, physical activity may reduce the risk of cognitive decline and dementia. Our study used brain scans to measure the brain volumes of a diverse group of people and found

The study used magnetic resonance imaging (MRI) scans to measure the brains of people with a range of activity levels, including those who were inactive to those who were very active. The scans showed less active people had smaller brain volume.

that those who engaged in the top third highest level of physical activity had a brain volume the equivalent of four years younger in brain aging than people who were at the bottom third activity level.”

“These results are exciting, as they suggest that people may potentially prevent brain shrinking and the effects of aging on the brain simply by becoming more active,” said

The study involved 1,557 people with an average age of 75. None had dementia, but 296 people had mild cognitive impairment and 28% had the APOE gene that is linked to a greater risk of Alzheimer’s disease.

Boomer Years

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Participants were given physical exams, thinking and memory tests, and were asked about their daily tasks and other physical activities. Researchers then calculated how much time and energy each person spent on those tasks and activities. Researchers divided people into three groups: those who were inactive; those who were somewhat active meaning each week they either had roughly two-and-a-half hours of low-intensity physical activity, one-and-a-half hours of moderate physical activity or one hour of high-intensity physical activity; and those who were most active meaning each week they either had seven hours of low-intensity physical activity, four hours of moderate physical activity or two hours of high-intensity physical activity.

Exercise May Slow Brain Aging by 4 Years

“Our results add to the evidence that more physical activity is linked to larger brain volume in older people,” said Gu. “It also builds on evidence that moving your body more often throughout one’s life may protect against loss of brain volume.”

Researchers then reviewed MRI brain scans of all participants and found that when compared to the people in the inactive group, those who were most active had larger total brain volume.

A limitation of the study was that information on physical activity relied on a person’s ability to remember how often and for how much time they were active. Additionally, Gu noted that due to the particular study design, this study does not prove that exercise prevents brain shrinkage; it shows an association.

After adjusting for age, sex, education, race/ethnicity and APOE gene status, the average brain size for those who were inactive was 871 cubic centimeters compared to 883 cubic centimeters for those who were most active, a difference of 12 cubic centimeters, or 1.4%, or the equivalent of nearly four years of brain aging. The results remained similar even after excluding people who had mild cognitive impairment.

The study was supported by the National Institute on Aging and the National Institutes of Health. Learn more about the brain at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, Twitter and Instagram. SOURCE American Academy of Neurology

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New Study May Aid Treatment and Prevention of Tremors in Parkinson’s Disease By: UNR School of Medicine

International research team, including UNR Med scientist, collaborate on new insights for improved treatments for patients. A new study released from an international research team has made a discovery, identifying major implications for understanding disorders of the nervous system associated with tremor, such as Parkinson’s Disease. The new insights could support the quest for better treatments and improve the lives of people living with debilitating movement disorders. Parkinson’s Disease is a slowly progressive neurodegenerative movement disorder, affecting nearly one million people in the United States, with approximately 60,000 Americans diagnosed each year. The Global Burden of Disease estimates that 6.2 million individuals worldwide have Parkinson’s disease. Currently, there is no cure. The Dundalk Institute of Technology (DkIT) in Ireland is leading an international team of investigators from the Dundalk Institute, University of Edinburgh in Scotland, Queen’s University of Belfast in Northern Ireland and the University of Nevada, Reno School of Medicine (UNR Med) in the U.S., to study the problem of neurodegenerative movement disorders from multiple approaches. The study is receiving funding through the European Union (EU) and has recently been published in the leading scientific journal, Proceedings of the National Academy of Science of the United States of America (PNAS). There are three main symptoms to Parkinson’s Disease, including tremor (shaking), slowness of movement and muscle stiffness. As the disease progresses, people may have difficulty walking and talking. Cognitive and behavioral changes, sleep problems, depression, memory difficulties, and fatigue may also develop. Patients often require around-the-clock nursing care. These symptoms are caused by damage to neurons in a small area of the brain located in the cerebellum. In patients with Parkinson’s, these neurons gradually become damaged and eventually die. Unlike many other cells in the body, nerve cells cannot undergo cell division and make new nerve cells.

“Previous research has determined that a protein called LINGO1, which helps control movement, is abnormally over-expressed in patients with Parkinson’s disease and essential tremor, while other studies showed that a loss of another protein, the BK ion channel, in these cerebellar neurons results in tremor and movement disorders,” said Brian Perrino, Ph.D., associate professor, department of physiology and cell biology at UNR Med and research investigator on the project. Perrino expanded that “these two findings were previously thought to be unrelated. We put these two findings together and showed that LINGO1 inhibits the activity of BK channels, LINGO1 also reduces the expression of BK channels, the brains of Parkinson’s disease patients have higher levels of LINGO1, and LINGO1 is assembled with BK channels in the brains of Parkinson’s disease patients.” “This new knowledge has major implications for our understanding of neurodegenerative disorders associated with tremor, such as Parkinson’s Disease and essential tremor. These findings represent a breakthrough in our understanding of the causes of tremor in Parkinson’s Disease,” said Perrino. Perrino explained that “what is particularly exciting is that by developing innovative therapeutics and pharmacological agents that block the interaction of LINGO1 with the BK channel, the loss of activity in the brain could be prevented, improving the lives of people living with debilitating movement disorders in the future.” Mark Hollywood, Ph.D., professor, molecular physiology at the Dundalk Institute and project lead said, “By bringing together an international team with complementary skills, this multi-disciplinary study promises to advance research and reveal new ways to help reduce the motor disorders associated with major disorders of the human brain.”

Navigating Aging

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Drinking and Healthy Aging: By: Paul Sacco PhD., MSW

Know Your Limits

Alcohol use is common among seniors. Nearly half of older adults aged 65 and older report having consumed alcohol in the past year. They may have a drink at a social event or party, to enhance their mood, or as a means of coping with a difficult symptom such as insomnia. Some older adults even drink alcohol for perceived positive health effects. Although drinking and alcohol problems are less common in older adults than younger people, alcohol use in older adulthood brings specific risks for seniors. As we age, changes to our body composition and ability to metabolize alcohol mean that alcohol affects older adults more profoundly when they drink. Some evidence even suggests that older drinkers are less aware of these effects, even as they are experiencing them. Unhealthy drinking can lead to other problems over time, such as increased risk of falls, dangerous medication interactions, increased risk of cancer, and, in more severe cases, liver disease and early mortality. To avoid risk to your overall health, limit their alcohol use. The National Institute of Alcohol Abuse and Alcoholism (NIAAA) has created specific guidelines for those aged 65 and older. Those who do not take medication and are in good health should limit their total alcohol consumption to no more than seven drinks per week. Additionally, those 65+

(Drinking page 16)

Diabetes Self-Management Education

Take control of your diabetes through: • • • •

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A one-on-one consultation with a dietitian A personalized education plan Six fun group education classes Cooking demos with your favorite foods

accesstohealthcare.org/diabetesclasses 775.284.1898

My Generation

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Congress Acts to Make Telemedicine Available During Coronavirus

Congress is moving forward to make telehealth more available to boomers so they do not have to leave home during the Coronavirus emergency. The Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (P.L. 116-123), which passed with near unanimous support in both the House and Senate, was signed into law by the President on March 6, 2020.

telehealth services to beneficiaries regardless of whether the beneficiary is in a rural community. Telehealth is currently covered by Medicare only under very limited circumstances. The appropriations act gave the Secretary authority to waive telehealth restrictions in Medicare, creating a new pathway for some aging adults to get care during the crisis.

The bill provides $8.3 billion in emergency funding for federal agencies to respond to the coronavirus outbreak. Of the $8.3 billion, $6.7 billion (81%) is designated for the domestic response and $1.6 billion (19%) for the international response. While the majority of the funding goes to research and development of vaccines, therapeutics, medical devices, and countermeasures, $500 million is designated for waiver removing restrictions on Medicare providers allowing them to offer

Drinking / page 15 should consume no more than three drinks on any given day. Those with certain medical conditions such as Major Depression, or those taking certain medications (e.g. pain medications) should consume less alcohol or abstain completely.

and a sense of enjoyment. Nonetheless, unhealthy drinking can harm oneâ&#x20AC;&#x2122;s health and well-being. Stay within NIAAA guidelines and avoid using alcohol as a means of dealing with problems such as insomnia, depression or pain.

For more information about older adults and alcohol As we age, alcohol use can remain a part of a healthy use, check out the following lifestyle. Enjoying a drink resources from NIAAA in with friends or family may the United States and Drink contribute to healthy aging by Wise Age Well in the United fostering social connection Kingdom

Generations

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Will Medicare Pay for the Coronavirus? By: Toni King

Beginning Tuesday March 17, 2020 all local Social Security offices nationwide were closed to in-person visits and have asked those who need assistance to call the local Social Security office or Social Security’s 800 number at 1/800-772-1213 for assistance by phone. There is not a specified reopen date for local Social Security offices currently. Medicare covers the testing, vaccinations or quarantin in a hospital if anyone on Medicare becomes infected with COVID-19. Medicare will cover the testing and medical care for the 2 different Medicare plans…Original Medicare and Medicare Advantage plans: • Original Medicare with Stand-alone Part D and COVID-19 (Coronavirus) testing began on or after Feb. 4, 2020. Beneficiaries will pay nothing for Medicare covered clinical diagnostic laboratory testing provided. Your medical provider will have to wait until April 1, 2020, to be able to submit a claim to Medicare for this test. (**it is very important to verify that your Medicare facility, provider or medical professional is accepting Medicare assignment for Medicare to pay for COVID-19.) When a vaccine is available for the Coronavirus, then all Medicare Part D plans will carry the vaccine and copays may apply. Telehealth is offered with Original Medicare. Medicare Part A (In-patient Hospital) and Part B (Medical Benefit) deductibles and copays may apply. • Medicare Advantage plan with Medicare Part D and COVID-19: Medicare beneficiaries will have access to the same Medicare benefits. Medicare allows Medicare Advantage plans to waive cost-sharing for COVID-19 lab tests. Check with your Medicare Advantage plans to verify your coverage

and costs. Telehealth coverage and additional coverage maybe offered. Once a vaccine for COVID-19 is available, then Medicare Advantage Prescription Drug plan copays apply. It is advised that the medical provider or facility be in network to receive your lowest cost for medical and vaccine costs. After April 1st when the medical community that is accepting Medicare assignment begin to file claims regarding COVID-19 (Coronavirus), then we will really know how claims will be paid. Remember accepting Medicare assignment and not just billing Medicare is the key to how a COVID-19 claim will be paid. Beneficiaries covered by Original Medicare with a Medicare Supplement and stand-alone Medicare Part D, may pay a certain amount for their claim, while beneficiaries covered by a Medicare Advantage plan with Part D may pay a completely different amount or co pays because they are two different types of Medicare plans.

My Generation

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Prioritizing

Mental Health During

the COVID-19 Outbreak

As stated on the Centers for Disease Control (CDC) website regarding managing stress and mental anxiety around the pandemic:

impacting all of us, it’s imperative that people find ways to prioritize their mental health and manage the stress of this pandemic in positive ways. To cope with stress, CDC recommends taking breaks from watching the news or reading about the pandemic, taking care of your body by being physically active, eating healthy, getting plenty of sleep, stretching or practicing meditation, staying engaged in activities you enjoy and staying connected to others even though we are physically distancing from each other. Spending time in parks, on trails, and in open spaces and natural areas is another effective way to cope.

“The outbreak of coronavirus disease 2019 (COVID-19) may be stressful for people. Fear and anxiety about a disease can be overwhelming and cause strong emotions in adults and children. Coping with stress will make you, the people you While it’s recognized that many people care about, and your community stronhave questions and concerns about visitger.” ing their local parks, trails or open spaces at this time, we believe that many parks, CDC reports that stress caused or trails and open spaces can continue to be aggravated by the outbreak can result in used in a safe manner that allows people fear and worry about your health and the to enjoy the mental and physical health health of loved ones, changing in sleep- benefits these spaces provide. In all ing and eating patterns, difficulty coninstances though, it is critical to follow centrating, worsening of chronic health and share published CDC and general problems, and an increase in the use of public health guidelines for response to alcohol, tobacco or other drugs. the current pandemic, and help manage individual stress responses. According to the National Alliance on Mental Illness, one in five U.S. adults ex- As individuals and families navigate their periences mental illness each year. With way through this pandemic, it’s also a twenty percent of the population already time to focus on the overall health of directly impacted by mental illness, and communities. While CDC guidance elevated levels of stress, anxiety and un- and overall mental health policies have certainty due to the COVID-19 outbreak tended to focus on interventions with

individuals, recent research focus has shifted to looking at the immediate and long-term environmental determinants of mental health in our communities as a system that we can plan and manage to help people better cope. This means that we can positively affect not only individuals, but also community-wide mental health through strategic systematic environmental interventions. It is important to provide education and also to have more parks and greenspace freely available and accessible to the public so they can have places (with proper social distancing, of course) to move their bodies, connect to nature, and find re-creation of body, mind and spirit on a daily basis.

Research on the Mental Health Benefits of the Outdoors

There is ample research that supports the positive impact of the environment on diseases and health, including mental health. Some research has increasingly focused on the cognitive (thinking capabilities) or attentional benefits of nature experiences. Patterns have emerged which suggest that living in a place with more nature produces more mental restoration, and is likely to benefit cognitive functioning and attentional capacity. Dr. Nancy Wells is an environmental psychologist and professor at Cornell University who studies people’s relationship to the built and natural environment throughout one’s health. An interesting paper by Wells and colleagues on the natural environment and disease transmission, is just one of many papers focused on identifying how mental health, behavior, and thought processes can be improved through time outdoors. More

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literature on the benefits of children and nature can found through the Children and Nature Network. Access to and views of water, now referred to bluespace, may have an even greater effect on reducing psychological distress for some people. Bluespace includes water bodies such as lakes, oceans, and rivers, and may also include larger pools and even smaller human-made features such as water fountains or spraygrounds. Wallace J. Nichols wrote a book in 2014 called Blue Mind which includes compiled references on the mental, physical, and psychological benefits from access to water. Anecdotally I know that for me as a “water person”, even just standing next to the ocean is a major stress reliever. Research also shows that exposure to parks and natural environments benefits us not only directly, but can also come even through windows. There is currently a broad effort to answer questions about how much time is needed (exposures and the dosage of nature) to promote mental health. Total exposure seems to be most important, but all forms and quantities of exposure to greenspace appear to be helpful. One way nature exposure might be of benefit is through an effect on rumination, which is a pattern of thought that is associated with heightened risk for depression and other mental illnesses. Think of how you can sometimes get a negative thought stuck in your head and just replay it over and over. Studies show that in healthy participants a brief nature experience, such as a 45 to 90-minute walk in a natural setting, decreases rumination and other negative brain activities, whereas a walk in an urban setting may not. Having accessible natural areas in urban contexts may be a critical resource for mental health in our overly stressed world. An exception to beneficial aspects seems to be when someone is raised culturally

to fear or dislike nature, or is simply not used to being outdoors. Carolyn Finney, Ph.D., writes in Black Faces White Spaces that some cultures, especially some black Americans, have been taught that being outdoors is a dangerous place to be. Finney writes that the legacies of slavery, Jim Crow, and racial violence have shaped cultural misunderstandings of the “great outdoors”, along with who can and should have access to natural spaces. These aspects can lead to higher stress for some and need to be sensitively acknowledged. Negative effects can often be addressed through educational and familiarization programs, especially for youth. Poorly planned parks can actually worsen mental health outcomes in some places, effectively doing the opposite of their intended functions. In neighborhoods facing larger social issues like drug usage and crime, parks can serve as a place for non-sanctioned activities to occur. However, that does not appear to be an argument against building or using parks and greenspaces in low-income neighborhoods. They can be strong assets if built and maintained in a way that considers the issues in the community. It is important to include community members in planning and management of the spaces, and include positive activation and safe design aspects, such as Crime Prevention Through Environmental Design (CPTED). Some studies have indicated that effects may not only be related to the distance to greenspace and bluespace, but may also be more related to quality of the spaces and awareness that they are there. Although parks planners and researchers are used to assessing the quantity of available land and water, proximity, and accessibility, a measure of the quality of the space is often left out of the picture. This is in part because it is more difficult to measure objectively, and also because as part of larger urban questions, it is not fully understood. In 2018 GP RED

conducted research for NRPA on these aspects and identified that increasing awareness of where the parks, greenspaces, and natural areas are located is crucial to providing access. These results are outlined in Awareness and the Use of Parks. People can’t get mental health benefits if they don’t know where to go.

Planning for the Future

Additional recommendations for providing overall access to nature and its effects through parks and natural areas systems planning are to: • Add greenspace and bluespace places, activities, and views closer in and equitably around the community • Help people start and continue green or blue activities, especially in times of high stress • Make spaces and programs fit the needs of nearby users • Make green spaces serve multiple activities and uses • Support longer visits • Reconsider barriers to use • Identify and promote awareness of parks and natural areas • Value overall parks and recreation system planning to identify gaps and needs for places and programs As park and recreation professionals, we have the means to help improve mental health in our communities through our well-managed parks and natural areas. This is especially important during times of stress and crisis. We can learn from the needs of today and better plan for addressing stress and mental health in the future. Most of all, don’t forget the biggest recommendation of all – Get your own self outside today!

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What to do if you suspect you have COVID-19 If you are sick with COVID-19 or suspect you are infected with the virus that causes COVID- 19, follow the steps below to help prevent the disease from spreading to people in your home and community. Stay home except to get medical care. You should restrict activities outside your home, except for getting medical care. Do not go to work, school, or public areas. Avoid using public transportation, ride-sharing, or taxis. Separate yourself from other people and animals in your home. People: As much as possible, you should stay in a specific room and away from other people in your home. Also, you should use a separate bathroom, if available. Animals: Do not handle pets or other animals while sick. Call ahead before visiting your doctor. If you have a medical appointment, call the healthcare provider and tell them that you have or may have COVID-19. This will help the healthcare provider’s office take steps to keep other people from getting infected or exposed. Wear a facemask: You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) or pets and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then people who live with you should not stay in the same room with you, or they should wear a facemask if they enter your room. Cover your coughs and sneezes: Cover your mouth and nose with a tissue when you cough or sneeze. Throw used tissues in a lined trash can; immediately wash your hands with soap and water for at least 20 seconds or clean your hands with an alcohol-based hand sanitizer that contains at least 60 to 95% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Soap and water should be used preferentially if hands are visibly dirty. Avoid sharing personal household items: You should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home. After using these items, they should be washed thoroughly with soap and water.

Clean your hands often: Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Soap and water should be used preferentially if hands are visibly dirty. Avoid touching your eyes, nose, and mouth with unwashed hands. Clean all “high-touch” surfaces every day: High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. Also, clean any surfaces that may have blood, stool, or body fluids on them. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product. Monitor your symptoms: Seek prompt medical attention if your illness is worsening (e.g., difficulty breathing). Before seeking care, call your healthcare provider and tell them that you have, or are being evaluated for, COVID-19. Put on a facemask before you enter the facility. These steps will help the healthcare provider’s office to keep other people in the office or waiting room from getting infected or exposed. If you believe you are sick with the 2019 novel coronavirus call your healthcare provider or call the Washoe County Health District’s Communicable Disease Line at (775) 3282447, this number is available 24 hours a day, 7 days a week. Discontinuing home isolation: Patients with confirmed COVID-19 should remain under home isolation precautions until the risk of secondary transmission to others is thought to be low. The decision to discontinue home isolation precautions should be made on a case-by-case basis, in consultation with healthcare providers and state and local health departments.

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COVID-19

Telehealth Services

Nevada Medicaid currently allows for the reimbursement of telehealth services. This guide has been created to aid providers in Nevada with helpful information regarding Nevada Medicaid Policy for telehealth and includes other resources and links that will help providers to maximize the use of telehealth services.

Telehealth is the use of a telecommunications system to substitute for an in-person encounter for professional consultations, office visits, office psychiatry services, and a limited number of other medical services. Telehealth consists of an “originating site” and a “distant site”. The originating site must be located within the State of Nevada and is the location where the recipient is. The originating site can be reimbursed if they are an enrolled Medicaid provider. If the originating site is the recipient’s home or a location that is not enrolled in Nevada Medicaid, there is no re-

During the response for the COVID-19 crisis, Nevada Medicaid may waive certain policy limitations that are currently identified in MSM Chapter 3400.

imbursement. The distant site is the location of the rendering provider. For reimbursement, this provider must be enrolled with Nevada Medicaid. Additionally, the rendering provider at the distant site must bill using the most appropriate CPT code and a 02 place of service code. Please see the billing guide for telehealth services for more specific information. Services provided via telehealth must fall within the scope of practice of the rendering provider and must be clinically appropriate for delivery via telehealth. These services can include office visits, consultations, assessments, etc. Services that are not allowable within telehealth are those in which there is a need to be in-person such as basic skills training (BST), psychosocial rehabilitation (PSR), group therapy, occupational therapy and physical therapy and medical services which require direct contact with the patient. If a service requires a prior authorization in-person, it will also require a prior authorization via telehealth.

Additionally, included below are useful links regarding telehealth services:

Please see the Nevada Medicaid COVID-19 telehealth response memo that provides information Please see the specific COVID-19 telehealth memo for the most current in- on telehealth allowances during the formation. Additionally, please monitor COVID-19 crisis, under Provider secNevada Medicaid’s COVID-19 webpage tion: www.dhcfp.nv.gov/covid19/ as information may change frequently. Telehealth Resource Center: telehealthresourcecenter.org/who-your-trc/ Questions should be directed to the following email address: dhcfp@dhcfp.nv.gov, please title your email telehealth technical assistance.

Medicaid Services Manual (MSM) Chapter 3400 (linked below) outlines the coverage and limitations of telehealth.

Medicaid.gov Telemedicine Resource: medicaid.gov/medicaid/benefits/telemedicine/index.html Webinars provided by the NFARtec: www.nfartec.org/telehealth-tuesdays/

Medicaid Telehealth Billing Guide: www.medicaid.nv.gov/Downloads/provider/NV_Billing_Telehealth.pdf National Frontier and Rural Telehealth (NFARtec) Education Center: www.nfartec.org/technology-based-supervision-guidelines/ MSM Chapter 3400, Telehealth Services: dhcfp.nv.gov/uploadedFiles/ dhcfpnvgov/content/Resources/AdminSupport/Manuals/MSM/C3400/ MSM_3400_17_07_27.pdf

24 Coronavirus Resource Guide

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Coping and Managing during COVID-19 As more people move toward social distancing and staying home, away from public places, it is normal for many to experience increased stress, distress, and isolation. • Tips For Social Distancing, Quarantine, And Isolation During An Infectious Disease Outbreak: samhsa. gov/sites/default/files/tips-social-distancing-quarantine-isolation-031620.pdf • Social distancing and other mitigation strategies for COVID-19: cdc. gov/coronavirus/2019-ncov/downloads/workplace-school-and-home-guidance.pdf • Centers for Disease Control and Prevention Mental Health and Coping During COVID-19: cdc.gov/coronavirus/2019-ncov/about/coping.html • World Health Organization Mental Health Considerations: who.int/ docs/default-source/coronaviruse/ mental-health-considerations.pdf ?sfvrsn=6d3578af_2

• Substance Abuse and Mental Health Services Administration’s Disaster Distress Hotline: Call 1-800985-5990 or text TalkWithUs to 66746. The Disaster Distress Helpline, is a 24/7, 365-day-a-year, national hotline dedicated to providing immediate crisis counseling for people who are experiencing emotional distress related to any natural or human-caused disaster. People with deafness or hearing loss can use their preferred relay service to call 1-800-985-5990. • Nevada 2-1-1: Call 2-1-1 or go to www.nevada211.org/. 211 provides information and referrals to health, human and social service organizations. Dialing 2-1-1 in almost every part of the United States will connect you to human and social services for your area. • Crisis Support Services of Nevada: 1-800-273-8255; text CARE to 839863 for 24/7 crisis services. • Crisis Text Line: Text HOME to 741741 from anywhere in the US, anytime, about any type of crisis.

• Keeping Your Distance to Stay Safe: • Substance Use Disorder Hotline: 1-800-450-9530; text IMREADY to apa.org/practice/programs/dmhi/re839863. search-information/social-distancing • Managing Anxiety and Stress: cdc. gov/coronavirus/2019-ncov/prepare/ managing-stress-anxiety.html • The White House released additional information regarding ways to slow the spread of the virus: whitehouse.gov/wp-content/ uploads/2020/03/03.16.20_coronavirus-guidance_8.5x11_315PM.pdf.

• Behavioral Health Treatment: behavioralhealthnv.org - A database of behavioral health providers specializing in substance use disorder and co-occurring mental health disorder treatment services.

• The NAMI Warmline: Call or text 775-241-4212. The NAMI Warmline is a stigma-free, non-crisis, phone service you can call or text to speak one-on-one with a NAMI WNV CARES operator. The Warmline is staffed by trained peers in recovery, who provide support to peers by telephone. The Warmline provides confidential support when we want to talk to someone. The Warmline gives you a peer’s perspective on how to find support in the community by phone, text, or video. Knowing someone cares can motivate us to carry on in recovery when there is anxiety. • Foundation for Recovery Warmline: 1-800-509-7762. Our peer support specialists will continue to see peers at our recovery community centers. We encourage anyone who has access to a phone or computer to consider seeing peer specialists through tele-recovery supports (over the phone or video session). A full directory of our peer support specialists with emails and phone numbers may be found here: forrecovery.org/meet-ourteam/ • Children’s Mobile Crisis Response Team: If your child is experiencing a mental or behavioral crisis contact the Division of Child and Family Services Children’s Mobile Crisis Response Team. More information also can be found at knowcrisis.com. - Northern Nevada: (775) 688-1670, Monday – Friday 8 am – 8 pm and Saturday/Sunday 8 am – 6 pm - Rural Nevada: (702) 486-7865, Monday – Sunday 9 am – 6 pm - Southern Nevada: (702) 486-7865, Monday – Sunday 24 hours

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Essential versus Non-Essential Business The Nevada Health Response Center (NHRC) released the COVID-19 Risk Mitigation Initiative Wednesday, March 18, 2020, which includes a list of all essential and non-essential businesses. Essential services and sectors include, but are not limited to:

• Fire services, law enforcement agencies, emergency medical services & public safety agencies • Healthcare services • Businesses or organizations that provide food, shelter, or critical social services for disadvantaged populations • Utilities as defined in NRS Chapter 704 • Trash collection • Home maintenance/repair services • Auto repair services & trucking service centers • Grocery stores, supermarkets, hardware stores, convenience & discount stores • Pharmacies, healthcare operations, & biomedical facilities • Post offices & shipping outlets • Gas stations & truck stops • Banks & financial institutions • Veterinary services & pet stores • Laundromats & dry cleaners • Food processing • Agriculture, livestock & feed mills • Logistics & Supply Chain Operations: Warehousing, storage, distribution, and supply-chain related operations • Public transportation • Essential stays in hotels, commercial lodging, dormitories, shelters, and homeless encampments • Child care centers and daycares operating in accordance with requirements set forth by their licensing authorities and COVID-19 guidance • Charitable food distribution sites, including the meals being distributed to

our students in wake of the school closings, along with grocery stores, should remain fully open and operational. • Food services for healthcare facilities and other essential facilities should remain open. Any buffet or food stations used in charitable food distribution settings should transition to boxed meals or served through gloved staff members or volunteers. Other businesses, including but not limited to legal services, business and management consulting, professional services and insurance services are encouraged to have employees work remotely or telecommute.

Non-essential services and sectors include, but are not limited to:

• Entertainment & hospitality, including but not limited to strip clubs and brothels, casinos, concert venues, arenas, auditoriums, stadiums, large conference rooms, meeting halls, and cafeterias • Recreation and athletic facilities, including but not limited to community and recreation centers, gyms, health clubs, fitness centers, yoga, barre and spin facilities • Beauty and personal care services and facilities, including but not limited to barber shops, beauty, tanning, waxing hair salons, and nail salons and spas • Retail facilities, including shopping malls except for pharmacy or other health care facilities within retail operations. Retailers are encouraged to continue online operations with pickup and delivery.

• Restaurants throughout Nevada, in addition to pubs, wineries, bars, and breweries that include meals provided by a full kitchen should be reduced to serving food only in a drive-thru, takeout or delivery capacity. No dine-in at food establishments should be allowed until further notice. This also includes food courts, coffee shops, catered events, clubs, bowling alleys, and other similar venues in which people congregate for the consumption of food. • Pubs, wineries, bars, and breweries that do not include meals provided by a full kitchen should close.

Gaming

The Governor announced that all gaming machines, devices, tables, games, and any equipment related to gaming activity will be shut down. Restaurants and bars located within gaming properties will be subject to the same restrictions as those outside of gaming establishments.

Cannabis

Licensed cannabis stores and medical dispensaries should only remain open if employees and consumers strictly adhere to the social distancing protocol. The Nevada Health Response Center is encouraging consumers to use delivery services and not congregate in stores.

Good Taste

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Rounds offering individually packaged products and support for seniors, children and less vulnerable. In response to the COVID-19 concern Rounds Bakery has taken extreme circumstances to ensure that its guests will receive the superior products they have come to know and love while at the same time providing a healthy and safe environment for all customers as well as staff. “We understand that these are uncertain times affecting families, children, seniors, and even small businesses. We have always been a community first company and will do all we can to ensure children and seniors receive a healthy meal,” Said Anton Novak, owner. “Our main concerns are the children and youth who rely on school lunches, and with possible school closures looming, we need to make sure everyone is taken care of.”

Rounds Bakery menu selections will be prepared fresh daily and packaged placed in our grab n go coolers so that you can enjoy your favorite menu items without the wait and without the added employee handling of a made to order selection. We can easily guarantee the freshness of our products since our end of day products are never wasted but delivered to the NNFB and Eddy House and other local charities on a daily basis.

In addition to providing individually packaged items and items in bulk, Rounds Bakery and staff have taken the following steps to ensure freshness and quality in all its products:

Rounds Bakery COVID 19 Response Fresh Packed Items only

• The restaurant will only serve fresh-packed sandwiches, salads, snacks, and pastries. A list of these items and pricing will be published on the website. • The restaurant will offer take-out, pick-up only. • Only if necessary, customers may dine-in, but the dining room will have fewer tables and chairs farther apart to comply with social separation guidelines. • We will still offer espresso servicelocally brewed blind dog coffee, bottled drinks, and fountain sodas. All service ware will be of the disposable one use type. • Donut production will be limited and available as pre-packed dozens, and donut hole snack cups. • Bagels will be sliced and toasted when ordered and then bagged with a 2oz individual cream cheese in a variety of flavors, and a disposable spreading knife. • All employees will discontinue the use of personal reusable cups. All eating and drinking will be consumed via disposable cups and service ware. • A Parlevel self-service checkout kiosk will be set up with no need to touch the screen. Guests can scan their items and swipe a card or use apple pay. Cash will be accepted with any change going onto an individual account (1 min setup required)

My Generation

Generation Boomer // GenerationBoomerMagazine.com

Rounds Bakery is Reno’s only local provider of the delectably buttery and flaky croissant-doughnut pastry, fondly referred to in our community as the #NotACronut. Customers can also find freshly made doughnuts, sandwiches, salads, and other like pastries. Many items are also available in gluten-free and vegan options. If you’re looking for a great meal, Rounds Bakery offers made-to-order breakfast and deli sandwiches, including our famous New York-style bagels and lox. To view a menu visit roundsbakery.com, call (775) 329-0800.

Where life tastes good, Round Bakery is your community bakery. Known for its authentic New York-style bagels, which are boiled before they’re baked, giving them a harder exterior shell while keeping the inside chewy—true to a New Yorkstyle bagel. Bagels are perfectly spread with a variety of fresh, house-made cream cheeses and pair well with a cup of coffee provided by local suppliers, Magpie Coffee Roasters and Kona Gold Coffee Co.

COVID-19 CORONAVIRUS

PROTECT YOURSELF AND HELP PREVENT THE SPREAD

WASH YOUR HANDS

KEEP YOUR DISTANCE

AVOID TOUCHING YOUR FACE

STAY HOME IF YOU ARE SICK

COVER COUGHS & SNEEZES

CLEAN SURFACES DAILY

FOR MORE INFORMATION:

RENO.GOV/COVID19

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Good Eats

Brewer’s Cabinet &

Round About Catering

Partner to Offer Curbside Beer and Food Pickup The Brewer’s Cabinet was designed with the idea of creating fresh, exciting, and unique beers. This small-batch brewery allows flexibility not limited by popular fads, current trends, or industry pressure in crafting beers. With a small kitchen onsite The Brewer’s Cabinet brewing facility has partnered with Round About Catering to go curbside for the community, of- of the brewpub facility located in downtown Reno, and a fering special beer prices to the public, with $9 for 6-packs and newly developed tasting room, The Brewer’s Cabinet provides $12 for Variety Packs. The production facility will open every a fresh and local menu for customers with an emphasis on day from 12 pm to 6 pm. The Brewer’s Cabinet embraces the quality ingredients that pair superbly with the brews. idea of creating fresh, exciting, and unique beers, of which the Customers can view the meal prep options by Round About most popular and well known are the Tahoe Beer series. Catering and pricing at TheBrewersCabinet.com. Pickup is at The Brewer’s Cabinet Production Facility located at; The Owners and staff have placed an increased focus on hygiene and sanitation to ensure a safe and healthy experience for cus- Brewer’s Cabinet Production Facility, 8565 White Fir Unit B1, Reno, NV 89523. tomers and are following CDC recommendations.

It’s time to embrace beer-to-go and support your local Breweries during the COVID19 lockdown.

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Let’s Do Takeout !

By: Anne Vargas

Once upon a time in Hong Kong, many years ago, my husband and I feasted in a tiny, hole-n the-wall restaurant, on an entire Peking Duck, served I. varying muli-courses. It was divine. We have often lamented the fact that we’ve never again found duck its equal. Until last week. Several people had told us about Kwok’s Asian Bistro, so I checked it out on the Yelp and Trip Advisor websites in quest of more opinions. Rave reviews from readers reinforced what I had already heard so we decided to try it. Those reviews had also forewarned us that the place is small and can be crowded at peak times so we went on a Saturday afternoon about 3:30 (perhaps the Szechuan Eggplant…or Kwok’s Chicken?), the for a late lunch/early dinner. Pork Belly Sliders (these did not sound appealing to me but after seeing them at the next table and listening to the enthuThere were way too many tempting choices on the menu, most of which we had read about in those reviews. We finally siasm of the people devouring them, I may rethink that), one of their many Fried Rice dishes, perhaps the Honey Glazed opted for the Pot Stickers, the Calamari and 1/2 Duck; (you prawns or the Seafood Stir Fry or the Crab Dumpling…or can also order ¼ or a whole duck). anything else, really. We couldn’t possibly eat all of that in one visit so there will need to be two...at least.

Their famous pot stickers were truly delicious; exquisitely plump and full; it was easy to understand why they had been mentioned in every review. The Calamari was very good, I would order it again. And the Duck was perfect; happily reminiscent of that long-ago duck in Hong Kong. The skin was crisp and the meat was moist, not at all greasy as duck sometimes can be. That was as much food as we could manage but those reviews we read (and the plates on nearby tables) persuaded us that subsequent visits should include: a Claypot of some kind

The service was great, wine and beer are reasonably priced. There is a regular menu along with Chef ’s Special menu that changes every six weeks. And speaking of chefs, Kwak Chin, the owner/chef of the Bistro, came out to great us and sat down to briefly chat. He was born in Vietnam but grew up in China, lived in San Francisco and Reno, always in the restaurant arena so he brings a wealth of experience to his kitchen. The restaurant is on West street, #275, about a block north of the West Street Market on the opposite side of the street. They take credit cards but do not take reservations. We had read that parking could be a challenge but we easily found a spot right in front. If the weather turns warm there is patio seating. Open from 11 a.m. to 9:30 p.m. Tuesday through Sunday; they also do a thriving take-out business, clearly evidenced by the number of people coming in to pick up their orders.

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Good Recipes

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Olives of The

an Integral Part

Mediterranean Diet

“Olives have been an integral part of the Mediterranean diet since antiquity; a favorite food in Mediterranean countries to this date, and a centuries-old snack.” — Olive You

Tomato Olive Soup Recipe By: The Olive You Campaign “OLIVE YOU” is a program aimed at informing consumers and professionals about the quality, variety, taste characteristics and benefits of European table olives, increasing demand and developing awareness in the nonproductive countries of the European Zone. Today, “OLIVE YOU” announced a new delicious Tomato Soup European olive recipe.

Tomato Olive Soup Preparation time: 15 minutes Cooking time: 30 minutes Four servings

Ingredients:

• 6 medium-sizedtomatoes • 2 carrots • 2 sprigs of celery • 3 tablespoons virgin olive oil • 3 tablespoons sugar • Zest of half a lemon • 1200 ml vegetable broth • 200 g strained yoghurt • 100 g olive paste • A little cracked pepper

Cut the 6 tomatoes and the carrots into slices, and finely chop the celery. Put these ingredients into a baking pan, drizzle on the olive oil and sprinkle on the sugar. Bake for 30 minutes at 180ºC. Put the cooked ingredients into a strong blender, adding the lemon zest and hot broth. Blend and pour into bowls. Garnish with chilled yoghurt and the spicy olive paste. Sprinkle on the cracked pepper and serve. A hot soup for any time of the day!

OLIVE YOU CAMPAIGN

The “Olive You” campaign is a three-year promotional program co-funded by the European Union, that aims to increase the awareness and demand for European table olives to both professionals and consumers, as well as to help increase exports to the United States and Canada. For more information, visit: www.oliveyou-eu.eu

Your Leisure

Generation Boomer // GenerationBoomerMagazine.com

Sierra Watercolor Svociety By: Carol Foldvary-Anderson

Learning new things is the best way to keep your mind fresh. If you’ve been thinking of trying something new, but don’t want to tackle learning French just yet, watercolors are an easy activity to start without a huge investment. With just one a simple student paint palette, a brush, a sheet of paper and a cup of water, you will be making beautiful marks on paper in no time. Watercolor paints are truly magic. They can be mesmerizing: such a fluid emersion of water and color and paint to paper that can convey a mood, a feeling an unexpected reaction. There exists an added mystery that you have no control over. An enchanting allure and fascination that grows deeper the more you become involved with water media. Surprises happen in this chemistry of mixing ingredients, and mistakes are made, and those mistakes at times become the essence of what would of been, but now, what is! “Many people feel watercolors are the hardest medium to work with. They can be, if you fight them. Oils and acrylics stay where you put them, on the canvas, in that spot. You can paint over that spot, or paint over the entire canvas if you want to. Painting with watercolors can be a meditative process; they have a mind of their own, and that’s part of the fun! Some colors don’t play well with others, and if you don’t use enough water, or use too much, exciting things can happen! The joy of watercolor is allowing it to work its own magic, watching colors gently settle into the paper

as they dry. Often, what you think was a mistake dries into a shining moment of brilliance you use to your advantage. And believe it or not, there are ways to “fix” things that didn’t turn out quite so brilliant.” -Past President, Ronnie Rector If you’re not quite ready to try painting, don’t feel your work is good enough to exhibit, or just want a little inspiration and camaraderie, consider joining the Sierra Watercolor Society (SWS), here in Reno.

(Watercolor page 34)

Generation Boomer // GenerationBoomerMagazine.com

Watercolor / from page 33 Our Mission: “The mission of the Sierra Watercolor Society is to foster, sustain, and increase interest and skills in the art of water-media painting through the sponsorship of meetings, educational programs, displays, and exhibitions. SWS shares the common love of water-media among its members and the public, and promotes the attainment and maintenance of a high standard of art by its members.” SWS meets every other month except in summer, and are a supportive and fun-loving group of painters, art lovers and art teachers. Our meetings are open to the public, and are followed by a free 2-hour demonstration by our visiting workshop artists. Each general meeting includes a painting “Challenge,” allowing members to bring an unframed, unsigned painting they’ve done specifically for the challenge. These little friendly competitions help us try new things, practice techniques we haven’t attempted, and allow us to display our work without exhibiting in a public venue. Meetings also provide members with access to

a large lending library of art instruction DVDs and books to borrow from. The SWS is a non-profit 501(C)(3) organization founded in August of 1989. Meetings are run by an elected volunteer Board, and events are chaired by member volunteers. Membership hovers around 150 watercolor enthusiasts from the Reno, Carson City and Tahoe area, with some members coming from as far away as Winnemucca and northern California. SWS is proud to provide an encouraging environment to all members to grow their work, hang paintings in exhibits and become volunteers to assist at events. They often hang five exhibits each year, including one judged exhibit - with ribbons and prizes for the winners in each category. In serving the community SWS holds free art exhibits at local venues, hosting workshops with nationally recognized watercolor artists, and awarding an annual scholarship to a student who shows particular passion for the arts. A significant outreach effort is our Art Angels children’s program, created and funded by SWS, where members volunteer their time to teach classroom watercolor lessons and provide free children’s workshops each year. SWS’s first exhibit for 2020 will be

“Salute to Spring,” to be held at the North Valleys Library, 1075 N. Hills Blvd., in Reno, from March 3 through April 3. Our annual judged exhibit will hang at the Wilbur May Museum May 20 through June 28. Exact dates for our other exhibits, including the annual ARTown exhibit in July and our Winter show at the May Museum, will be announced on our website at least a month prior to hanging. Workshops we have scheduled for 2020 include Eric Wiegardt (March 17-20), Soon Warren (May 5-8), Paul Jackson (August 12-14) and Barbara Nechis (October 13-16). All are very experienced instructors and gear their instruction to all levels of painters. SWS prices their workshops to just cover their cost, so fees are often quite a bit less than those charged by other clubs hosting these incredible artists. We are also trying out a new 3-day “weekend” workshop featuring member teaching artists, for those who wanting to take a shorter workshop with our talented members. This year we have Tricia Poulos-Leonard on June 26-28, and Ronnie Rector is scheduled for June 25-27, 2021. SWS is a membership-funded organization, with annual dues of $35. They also raise money through grants, donations an annual silent auction of original member art, and raffles for art donated by visiting workshop artists. Being a member allows a 10% discount on purchases over $5 from Nevada Fine Arts, access to their lending library of DVDs and books, and a reduced member rate for scheduled workshops. A monthly newsletter always includes the upcoming meeting dates, workshop opportunities, art and accomplishments by members, and other information.

Generation Boomer // GenerationBoomerMagazine.com

LET’S TURN TODAY INTO A LIFETIME. Your health is worth fighting for. And Renown Health is right there with you, day in and day out — to face any challenge. We’re in this together, and together we will FIGHT THE GOOD FIGHT. renown.org

Generation Boomer // GenerationBoomerMagazine.com